Laparoscopic distal pancreatectomy - new standard in the pancreatic surgery.

UNLABELLED: The improvement of laparoscopic techniques that we witnessed over the last decade, also applied to pancreatic surgery. Both worldwide and in Poland, increasingly more patients with lesions located within the body and tail of the pancreas are treated using laparoscopic distal pancreatectomy. The aim of the study was to compare the outcomes of laparoscopic and open distal pancreatectomy. MATERIAL AND METHOD: Between January 2009 and March 2013, 107 patients underwent distal pancreatectomy at a single institution: 39 using laparoscopic technique and 68 using open technique. This was a retrospective study. RESULTS: There were no significance differences with regard to duration of the surgical procedure, duration of hospitalization and complication rate between both groups. Statistically significant difference was found for the incidence of spleen preservation in patients undergoing laparoscopy, due to better visualization of the structures. In the group of patients with pancreatic cancer there was no significance difference in the incidence of malignancy found in the surgical margin. Our results are similar to that presented in the literature. CONCLUSIONS: Laparoscopic distal pancreatectomy is a safe method, with a higher rate of spleen preservation among the patients with the lesion located in the body and tail of the pancreas.

CD40L and IL-4 stimulation of acute lymphoblastic leukemia cells results in upregulation of mRNA level of FLICE--an important component of apoptosis.

The use of cancer vaccines based on dendritic cells (DC) presenting tumor antigens can be a promising tool in the treatment of leukemia. The functional characteristics of leukemia derived DC is still to be elucidated. CD40 promotes survival, proliferation and differentiation of normal B cells. CD40 triggering was used to enhance the poor antigen-presenting capacity of leukemic B-cells. Since it is still unclear whether CD40 ligation drives neoplastic B-cells to apoptosis or not, we assessed the mRNA expression of FLICE, FAS, FADD and TRADD - important components of apoptosis machinery, using real-time PCR in acute lymphoblastic leukemia cells before and after CD40 and IL-4 stimulation. ALL cells stimulated with CD40L/IL-4 expressed dendritic cell phenotype at mRNA and protein levels (upregulation of main costimulatory and adhesion molecules noted in real-time RT PCR and flow cytometry); they also expressed higher amounts of mRNA for FLICE, TRADD and FADD after CD40L/IL-4 stimulation. However differences statistically significant comparing cells cultured with CD40L/IL-4 and medium alone regarded only FLICE. Concluding, we showed upregulation of important elements of apoptosis at mRNA level in ALL cells after CD40 ligation.