Abdominal Cavity Research Articles

Therapeutic effect of hUC-MSCs from different transplantation routes on acute liver failure in rats

ObjectiveAcute liver failure (ALF) is a rare yet serious clinical syndrome. Recent studies have indicated that stem cells can effectively treat this condition. However, the optimal route for stem cell transplantation in the treatment of ALF remains unclear. This study aims to investigate the most effective transplantation route for stem cell therapy in ALF.MethodsHuman umbilical cord mesenchymal stem cells (hUC-MSCs) expressing both luciferase and green fluorescent protein were generated using a lentiviral vector. The hUC-MSCs were transplanted via the tail vein, portal vein, and abdominal cavity. The survival and distribution of the transplanted hUC-MSCs in rats were assessed through in vivo imaging and immunofluorescence. Furthermore, the therapeutic effects of hUC-MSCs transplanted via different routes on ALF were compared.ResultsThe survival time of hUC-MSCs transplanted via the tail vein and portal vein was shorter compared to those transplanted intraperitoneally. The distribution of hUC-MSCs varied by transplantation route: those injected via the tail vein and portal vein were primarily found in the lungs and liver, respectively, while intraperitoneally transplanted hUC-MSCs predominantly localized in the abdominal cavity. In ALF rats, hUC-MSCs transplanted via the tail vein and portal vein improved survival rates, enhanced liver pathology, and reduced levels of inflammatory cytokines in liver tissue. In contrast, abdominal transplantation of hUC-MSCs showed no significant therapeutic effect.ConclusionhUC-MSCs transplanted via the tail vein and portal vein exhibited similar therapeutic effects on ALF; however, abdominal transplantation of hUC-MSCs showed no significant effect.

Mesenteric lymphangioma in childhood: a case report and narrative literature review

Lymphangioma is an uncommon benign neoplasm of the lymphatic system, predominantly observed in children and infants and infrequently in adults. Mesenteric lymphangioma is very rare. This article reports on the case of a 4-year-old female who was admitted to the hospital due to abdominal pain. Ultrasonography identified a cystic mass in the abdominal cavity, diagnosed as mesenteric lymphangioma, for which surgical intervention was advised. The patient underwent laparoscopic lesion resection with small bowel resection and anastomosis under general anesthesia. Pathological examination confirmed the diagnosis of mesenteric lymphangioma. In children, it frequently presents as an acute abdomen. Our comprehensive literature analysis strongly suggests that treatment decisions for pediatric mesenteric lymphangioma need to be guided by a careful assessment of individual patient presentations. Although exploratory laparotomy with tumor resection and involved bowel segment removal remains the gold-standard treatment, the advent of laparoscopic techniques and sclerotherapy has facilitated the evolution of personalized therapeutic strategies, potentially reducing dependence on conventional surgical approaches in the future.

KEVS: enhancing segmentation of visceral adipose tissue in pre-cystectomy CT with Gaussian kernel density estimation.

The distribution of visceral adipose tissue (VAT) in cystectomy patients is indicative of the incidence of postoperative complications. Existing VAT segmentation methods for computed tomography (CT) employing intensity thresholding have limitations relating to inter-observer variability. Moreover, the difficulty in creating ground-truth masks limits the development of deep learning (DL) models for this task. This paper introduces a novel method for VAT prediction in pre-cystectomy CT, which is fully automated and does not require ground-truth VAT masks for training, overcoming aforementioned limitations. We introduce the kernel density-enhanced VAT segmentator (KEVS), combining a DL semantic segmentation model, for multi-body feature prediction, with Gaussian kernel density estimation analysis of predicted subcutaneous adipose tissue to achieve accurate scan-specific predictions of VAT in the abdominal cavity. Uniquely for a DL pipeline, KEVS does not require ground-truth VAT masks. We verify the ability of KEVS to accurately segment abdominal organs in unseen CT data and compare KEVS VAT segmentation predictions to existing state-of-the-art (SOTA) approaches in a dataset of 20 pre-cystectomy CT scans, collected from University College London Hospital (UCLH-Cyst), with expert ground-truth annotations. KEVS presents a and improvement in Dice coefficient over the second best DL and thresholding-based VAT segmentation techniques respectively when evaluated on UCLH-Cyst. This research introduces KEVS, an automated, SOTA method for the prediction of VAT in pre-cystectomy CT which eliminates inter-observer variability and is trained entirely on open-source CT datasets which do not contain ground-truth VAT masks.

Professor Vasily Parmenovich Obraztsov — a surgeon who became an outstanding therapist and founder of the school of internal medicine at Kiev university (on the 175th anniversary of his birth)

Vasily Parmenovich Obraztsov (1851–1920) was an outstanding Russian physician (pathologist, surgeon, and therapist). He graduated from the Imperial Medical and Surgical Academy in St. Petersburg in 1875. For 25 years (from 1893 to 1918), he was a professor at Vladimir University in Kyiv and head of the Department of Special Pathology and Therapy, and from 1903 to 1918, he also served as the director of the university clinic of internal diseases. Professor Obraztsov introduced several methods for examining patients: deep sliding (methodical) palpation of the abdominal organs, direct auscultation of the heart (which allows for the recognition of gallop rhythm and the third heart sound), and direct percussion with one finger on the organs of the chest and abdominal cavity. In 1910, he diagnosed myocardial infarction. He was the chairman of the Kyiv Physical-Medical Society, the Kyiv Society of Physicians, and founded a school of internal diseases.

Extended Hematological Parameters and Short-Term Mortality in Sepsis Patients: A Retrospective Study

Background/Objectives: Sepsis has a high mortality rate, with septic shock exceeding 50%. The most common score for diagnosis and prognosis in sepsis is the Sepsis-related Organ Failure Assessment (SOFA). This study aimed to identify hematological parameters for the prediction of intensive care unit (ICU) mortality. Methods: This study collected demographic and clinical data from sepsis patients, including age, sex, infection site, length of stay, the SOFA, and ICU mortality. The standard laboratory panel included, among others, complete blood count with differential and reticulocyte panel. Intergroup differences were analyzed using Student’s t-test, Mann–Whitney U test, Pearson’s χ2, and Fisher’s test where applicable. The AUROC was used for evaluating the predictive value of hematological parameters. Multiple logistic regression was performed to exclude the impact of potential confounding factors. Results: This study analyzed data from 190 sepsis patients hospitalized in the ICU, excluding patients with other conditions significantly affecting mortality. The median age was 65.0 (IQR 51.0–71.0) years. The sexes were almost perfectly balanced. The sites of infection were mostly the abdominal cavity, lungs, and urinary tract. The short-term mortality rate was 30%, with higher SOFA scores and significant differences in leukocyte, platelet, and erythrocyte parameters between survivors and non-survivors. The percentage of nucleated red blood cells (NRBCs) showed the highest AUROC. Conclusions: The only reliable hematological parameter for predicting ICU mortality in sepsis patients may be the percentage of NRBCs. The presence of NRBCs in a blood smear is linked to a worse prognosis.

Investigation of the morphofunctional status of macrophages in abdominal adhesions in rats and on exposure to oxidized dextran

Abdominal adhesions result from the organization of fibrinous exudate and subsequent fibrosis, attributed to the low phagocytic activity of macrophages associated with their M1 phenotype. Oxidized dextran (OD) can limit the development of fibrosis by exerting a stimulating effect on phagocytosis.The aim of the study is to investigate the morphofunctional status of macrophages during the formation of abdominal adhesions in an experimental model and under exposure to OD.Material and methods. In male Wistar rats (n = 30), the adhesive process in the abdominal cavity was simulated. The animals were divided into 3 groups: group 1 – control, with adhesions in the abdominal cavity; group 2 rats were injected once with 2 ml of OD 5 % aqueous solution; the 3rd group consisted of intact animals. The rats were removed from the experiment on the 7th and 21st days. Histological immunohistochemical (Il-10, IFNγ, Il-1, TNFα, TGF-β) and electron microscopic study of abdominal adhesions, morphometry of structures were performed.Results and discussion. Macrophages in adhesions of group 1 and 2 rats were larger, compared to those in intact animals. On days 7 and 21 macrophages in group 2 rats were 19 % and 2.5 times larger, respectively, compared to group 1 animals, contained in the cytoplasm a greater number of phagosomes, phagolysosomes and rough endoplasmic reticulum, by the 21st day nuclear-to-cytoplasmic ratio was shifted towards the cytoplasm. The expression of IFNγ in the infiltrates of adhesions in group 2 rats increased 3,2-fold, indicating greater phagocytotic activity of macrophages. The expression of IL-10 and TGFβ on the 7th and 21st days was represented in a larger number of macrophages of group 2 than group 1 rats (2.7 and 4.1 times, respectively), but IL-1 and TNFα ‒ in a smaller number (4.6 and 3.2 times, respectively), which corresponded to the phenotypic characteristics of M2 macrophages.Conclusions. The population of macrophages in inflammatory infiltrates of abdominal adhesions is heterogeneous, there are signs of M1 and M2 type. Under the influence of OD, the phagocytic activity of M2 type macrophages increases, preventing the formation of adhesions.

The Many Faces of the Angry Peritoneum

The peritoneum is a thin membrane that lines the abdominal cavity and covers the abdominal organs. It serves as a conduit for the spread of various pathological processes, including gas and fluid collections, inflammation, infections, and neoplastic conditions. Peritoneal carcinomatosis is the most common and well-known pathology involving the peritoneum, typically resulting from the dissemination of gastrointestinal and pelvic malignancies. However, numerous benign and malignant peritoneal diseases can mimic the imaging appearance of peritoneal carcinomatosis. The aim of this review is to revisit the anatomy of peritoneal compartments and elucidate the patterns of peritoneal disease spread. Emphasis is placed on identifying the distinctive imaging features of both neoplastic and non-neoplastic peritoneal diseases that differ from peritoneal carcinomatosis.

The mystery of the “air-dried chaplain” solved: the life and “afterlife” of an unusual human mummy from eighteenth century Austria

The multidisciplinary study of the well preserved cadaver of the so-called “air-dried chaplain” from the church crypt of St. Thomas am Blasenstein (Upper Austria) not only solved the “mystery” of the excellent preservation of the trunk of this unusual mummified human body, but also provided circumstantial information about this historic individual, his life and disease history, and conclusion of his cause of death. The mummy of a 35–45 year old male, radiocarbon dated to the period 1730–1780 CE is most likely that of the local aristocratic parish vicar Franz Xaver Sidler von Rosenegg who had been temporarily delegated to St. Thomas parish from his mother monastery of Waldhausen im Strudengau (Upper Austria). He had a high-quality diet based on terrestrial animal products, showed no signs of major physical work load, was most likely a pipe smoker and suffered from chronic active pulmonary tuberculosis with peripheral and central (hilar) calcifications (primary tuberculous complex) and a right lower lobe cavity with focal heterotopic ossification and potential active inflammation. This latter may have caused acute pulmonary hemorrhage which may have been the cause of death. Most surprisingly, we detected, in the otherwise completely intact abdominal (and pelvic) cavity, extensive packing with foreign material which was identified as a mixture of wood chips, fragmented twigs, large amounts of fabric of various types including elaborate embroidered linen, and even pieces of silk. Furthermore, this embalming method seems to have included high level zinc-ion solution impregnation (most likely zinc-chloride with small amounts of arsenic) and the addition of copper. The packing was inserted into the abdominal body cavity through the rectum. It led to an excellent state of conservation of the trunk, while the face (and skull) and peripheral extremities were less well preserved.

Intestinal and Liver Involvement by Endometrial Stromal Sarcoma: Expanding the Differential Diagnosis of Mesenchymal Tumors Involving the GI Tract.

Intestinal and Liver Involvement by Endometrial Stromal Sarcoma: Expanding the Differential Diagnosis of Mesenchymal Tumors Involving the GI Tract.

Average Dose Rate is the Major Temporal Beam Structure Parameter for Preserving Murine Intestines with Pulsed Electron FLASH-RT.

Average Dose Rate is the Major Temporal Beam Structure Parameter for Preserving Murine Intestines with Pulsed Electron FLASH-RT.

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Procedure, Complications and Nursing Care

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a minimally invasive surgical cancer treatment procedure. It is a treatment method in which aerosolized chemotherapy drugs administered into the abdominal cavity with the help of trocars are aimed at acting directly on cancer cells. This method aims to maximize the effect on cancer cells and reduce systemic toxicity. The PIPAC treatment has advantages and disadvantages. Therefore, the operating room nurse has many tasks. The PIPAC procedure can cause various symptoms. The most common symptoms related to the surgical procedure are abdominal pain, bleeding, deep vein thrombosis, intestinal obstruction, and ascites. Allergies, loss of taste, nausea, and vomiting can occur due to the effect of chemotherapy drugs on the stomach and intestines, while irritation of the intestines can lead to diarrhea. The impact of symptoms can affect the patient's quality of life and compliance with treatment. Therefore, appropriate precautions should be taken before and after the PIPAC procedure. Nurses should monitor symptoms and guide patients to contact their surgeon if necessary. The patient should be informed about what to do if they experience symptoms, and medications should be administered by nurses if necessary. It is important to provide psychosocial support to patients. In conclusion, procedure-related symptoms should be managed effectively in patients undergoing PIPAC procedures, and operating room nurses play an important role in this regard.

AFAST in Veterinary Emergency Medicine: Technique, Applications and Diagnostic Relevance

The Abdominal Focused Assessment with Sonography for Trauma (AFAST) is a rapid, point-of-care ultrasound technique increasingly utilized in veterinary emergency medicine. Adapted from human medical practices, AFAST is designed to detect free fluid within the abdominal cavity, particularly in trauma patients or those presenting with acute clinical deterioration. Its application enhances the clinician’s ability to assess internal injury swiftly, supporting critical decision-making during initial triage and ongoing patient monitoring. The AFAST protocol involves four standardized sonographic views—diaphragmatic-hepatic, splenorenal, cystocolic and hepatorenal—each offering targeted evaluation of dependent regions where effusion tends to accumulate. The Abdominal Fluid Scoring (AFS) system, based on the presence and quantity of anechoic fluid at these sites, provides a semi-quantitative assessment of intra-abdominal hemorrhage or effusion. The technique has demonstrated high diagnostic sensitivity and specificity, comparable to more advanced imaging modalities, while offering speed, repeatability and non-invasiveness advantages. Beyond trauma, AFAST is valuable in identifying non-traumatic conditions such as hemoperitoneum, pericardial and pleural effusion, ruptured organs and acute anaphylactic reactions. Although its diagnostic utility in cases of penetrating trauma remains under investigation, AFAST remains a reliable adjunctive tool in emergency settings. Due to its simplicity, portability and diagnostic accuracy, AFAST has become an essential component of emergency care protocols in veterinary practice. With continued validation and clinical application, it holds considerable promise for improving outcomes in critically ill animals and optimizing the use of diagnostic resources in emergency and critical care settings.

Full-term Abdominal Pregnancy with Live Child: About a Case in the Service of Gynecology-Obstetrics at the Ignace Deen National Hospital, Conakry / Guinea

Abdominal pregnancy is a rare form of ectopic pregnancy, in which the fertilized egg implants and develops in the abdominal cavity. Diagnosis and management are difficult. We report the case of a 31 year-old female accountant referred from a local clinic for abdominal pregnancy in the context of 10 years of primary infertility. Despite the presence of suggestive signs and the number of ultrasounds performed, it was not until the 29th and 31st weeks that the diagnosis of abdominal pregnancy was made. We performed a laparotomy at 37 weeks and extracted a healthy live infant. Fetal extraction led to placental intrusion, the after-effects of which were enamelled with haemorrhagic complications originating from the placenta. These led to a right adnexectomy removing the placenta after an unsuccessful attempt to stop the abundant haemorrhage originating from the placenta. The immediate post-operative course was straightforward, with the patient discharged on the third post-operative day and the newborn well. The importance of this case is to underline the delay in making the diagnosis of abdominal pregnancy in our environment, despite the more frequent use of ultrasound and the possibility of full-term delivery of a healthy child. <i>Conclusion</i>: Abdominal pregnancy is a rare event. It is difficult to diagnose, and a conservative attitude to pregnancy is possible.

Experimental determination of the safety of bioresorbable polylactate-coglycolide-based implants

Introduction. Treatment of bone fractures with growth zone disorders in children is an urgent task. Near- and intra-articular fractures are common injuries to the musculoskeletal system in children. However, the issue of choosing a safe retainer remains unresolved. Objective. To determine the safety of a bioresorbable polylactate-coglycolide (PLGA) implant for the surgical treatment of distal tibial metaepiphyseolysis in children. Materials and methods. The work was performed on one hundred twenty white 3 months rats, weighing 110–120 g. The animals were divided into 2 groups: the main group consisted of 100 rats, 50 females and males each. Fragments of PLGA biopolymer were implanted intraperitoneally in animals of this group. The healing took place naturally. The control group consisted of 20 rats, 10 females and 10 males each, and no biopolymer was implanted in these animals. The observation was carried out for 3 months from the date of implantation. Results. The PLGA-based implant had no adverse effect on the condition of the animals, and there were no signs of inflammation. After 3 months, the implant was destroyed in the abdominal cavity of the animals. There were no significant deviations in the condition of the animals, a decrease in their body weight, or changes in blood tests. Conclusion. A biopolymer based on PLGA can be used as a bioresorbable fixative for near- and intra-articular bone fractures.

The Diagnostic Yield of Whole-body Computed Tomography in Dogs and Cats in the Oncology Setting.

Clinical staging has become essential in veterinary oncology. It is crucial for creating effective treatment plans and predicting outcomes. Whole-body computed tomography (WBCT) can serve as a comprehensive staging examination, offering a detailed view of a patient's internal anatomy. This retrospective study aimed to assess the diagnostic yield of WBCT in diagnosing cancer in dogs and cats. We reviewed medical records of cats and dogs that underwent a WBCT scan between January 2016 and May 2023. Only cases with a confirmed cytological or histological diagnosis of the primary tumor and complete medical records were considered. We collected data on histological diagnoses and diagnostic methods used. Our study included 57 animals that underwent WBCT for cancer-related reasons. Metastases were detected in 14 dogs, with four showing metastases in multiple locations, five in the lungs, three in the lymph nodes, one in the skeleton, and one in the liver, yielding a diagnostic rate of 31.8%. In cats, metastases were detected in six cases (five in the lungs and one in the lymph nodes), with a diagnostic yield of 46.2%. WBCT identified metastasis in over 35% of cases, including those outside the thoracic and abdominal cavities, indicating potentially greater accuracy than radiography and ultrasound. WBCT is an effective and safe method for tumor staging and oncological diagnosis in dogs and cats.

Kansui-liquorice enhances the “water-expelling” effect of Gansui Banxia decoction in rats with malignant ascites by targeting the NPs/NPRs/cGMP/PKGⅡ pathway and T cell immunity

Ethnopharmacological relevanceThe combination of Euphorbia kansui Liou ex S.B.Ho (kansui) and Glycyrrhiza uralensis Fisch (liquorice) is contraindicated in Chinese medicine, but whether it can be used in clinical practice remains controversial. The classic formula, Gansui Banxia decoction (GBD), contains kansui and liquorice, which is effective in treating an abnormal accumulation of body fluids, such as malignant ascites (MA); however, the contraindications of kansui and liquorice have limited its clinical application.Aim of the studyThis study aims to provide a theoretical basis for the rational application of kansui-liquorice by investigating its role and mechanism in GBD.Materials and methodsLC-MS/MS was used to detect the metabolic differences of - glycyrrhetinic acid, glycyrrhizic acid, glycyrrhizin, glycyrrhizin, glycyrrhizin terpinolipid A, and paeoniflorin - in the liquid of MA rats before and after taking GBD. Network pharmacology was employed to predict the potential targets and mechanisms of GBD in the treatment of MA. The experimental validation was still using MA rats as a model. Flow cytometry was used to assess the expression of immune cells in blood and ascites, and the proliferation and development of T cells in bone marrow and thymus. Elisa was used to detect the content of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in blood. Western blot and qRT-PCR were used to detect the expression of NPs/NPR-A/cGMP/PKG II pathway-related gene and proteins in kidney. The MA model was established by intraperitoneal injection of walker-256 cells at a concentration of 2 × 106/mL and an injection volume of 1 mL. The model was successfully established when the abdominal cavity was obviously distend and touched with a water-shaking sound, and ascites could be seen after opening the abdominal cavity.ResultsWe confirmed that GBD containing kansui-liquorice could promote the metabolism of liquorice and reduce the precipitation of toxic substances (kansuinine A). It may also target cellular immunity to exert a drug effect. Further experimental verification found that GBD containing kansui-liquorice could promote the activation of the NPs/NPRs/cGMP/PKGⅡ pathway and exert a diuretic effect in MA rats. Besides that, it could increase the proportion of CD8CD28 T cells, reduce the proportion of immune-suppressing cells, and maintain the stability of the developmental environment of the T cells.ConclusionWe believe that kansui and liquorice are important components of GBD, and their combination could promote GBD to promote the clinical remission of MA through direct (activation of the NPs/NPRs/cGMP/PKGⅡ pathway) and indirect (regulating T-cell immunity) water-expelling effects.

Features of the se lection and implementation of surgical tactics in gunshot peritonitis

The OBJECTIVE was to substantiate the algorithm for selecting and implementing surgical tactics for gunshot peritonitis (GP) taking into account the characteristics of its clinical course.METHODS AND MATERIALS. The results of treatment of 472 victims with gunshot wounds to the abdomen were analyzed. As part of the tactics of multi-stage surgical treatment, modern techniques were used: vacuum-assisted and vacuum-instillation laparostomy (VAL and VIL), while the choice of indications was carried out using the peritonitis progression risk scale developed in the clinic.RESULTS. The frequency of postoperative complications was 43.8 %, and hospital mortality was 4.9 %. At the same time, in 45 % of cases, the trigger factors for thanatogenesis were complications associated with defects in surgical treatment at previous stages. The progression of peritonitis with the development of abdominal sepsis against the background of the treatment carried out in the clinic was noted only in 8 % of cases. The incidence of unformed intestinal fistulas was 9.8 %, and with VIL this figure was significantly lower than with VAL: 2.4 % versus 12.1 % (p=0.06). In addition, the use of VIL was accompanied by a more rapid elimination of pathogenic microflora and a less pronounced adhesive process.CONCLUSION. The relief of GP requires multi-stage surgical treatment. The key to its successful implementation is compliance with uniform tactical approaches, as well as the use of an effective technique for temporary closure of the abdominal cavity. The original scale of the risk of peritonitis progression provides a reasonable approach to laparostomy, with VIL being the most preferable option.

Adenocarcinoma originating from a colonic duplication cyst: A case report

BACKGROUND Gastrointestinal duplication is a rare congenital anomaly of the digestive tract, with colonic manifestations being particularly uncommon. Malignant transformation of colonic duplication cysts is rare, with adenocarcinoma being the most frequently reported type. Herein, we report a rare case of adenocarcinoma originating from a colonic duplication cyst. CASE SUMMARY A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup. Imaging revealed a well-defined abdominal cavity cystic mass, which was initially suspected to be an ovarian teratoma. Laparoscopic surgery revealed a duplication cyst, and pathological examination confirmed adenocarcinoma arising from the cyst. The mass within the transverse mesocolon was successfully excised by a colorectal surgeon. Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria. Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy, except for an elevated cancer antigen 19-9 level. A multidisciplinary team recommended no further chemotherapy, advising routine follow-up for monitoring. CONCLUSION Colonic duplications, though rare, remain a differential diagnosis of unexplained abdominal masses, with complete resection being their primary treatment approach.

The role of ultrasonography in the diagnosis and management of chronic pancreatitis: Opportunities, limitations and prospects for development – a literature review

Introduction and purpose Chronic pancreatitis is a progressive disorder of the pancreas that may be caused by numerous factors. It leads to impaired nutrient absorption, diabetes development, chronic pain and an increased risk of pancreatic cancer development over the long term. Ultrasonography, both transabdominal and endoscopic, is a valuable diagnostic modality for CP, that provides good visualization of pathologic changes. A brief description of the state of knowledge The most common etiologies of chronic pancreatitis are alcohol consumption, smoking and genetic mutations. Ultrasound diagnostics, due to recent improvements in technology, enables early detection of the disease, making it possible to initiate treatment early enough, enhance the likelihood of its success and decrease the risk of complications, which include pseudocysts, duodenal stricture, splanchnic vein thrombosis and pancreatic cancer. The most common ultrasonographic findings in CP include dilatation of the main pancreatic duct, parenchymal calcifications, increased pancreatic volume, uneven contours, enlarged lymph nodes and the presence of free fluid in the abdominal cavity. Conclusions The findings above can be visualized using ultrasound techniques, including the least invasive and most accessible transabdominal ultrasound, endoscopic ultrasound, which enables the detection of pathologies at early disease stages, and emerging techniques such as elastography, which allows for the assessment of pancreatic fibrosis. Although there has been considerable improvement in ultrasound technology over the past few years, further development in the imaging modalities and the introduction of new, more precise guidelines and scoring systems is still required.

Targeting metabolic vulnerability by combining NAMPT inhibitors and disulfiram for treatment of recurrent ovarian cancer

Ovarian cancer (OV) has the highest mortality rate among gynecological cancers. As OV progresses, tumor cells spread outside the ovaries to the peritoneal and abdominal cavities, forming cell clusters that float in the ascitic fluid caused by peritonitis carcinomatosa, leading to further dissemination and metastasis. These cell clusters are enriched with cancer stem cells (CSCs) which are responsible for treatment resistance, recurrence, and metastasis. Therefore, targeting CSCs is a potentially effective approach for treating OV. However, understanding how CSCs acquire treatment resistance and identifying targets against CSCs remains challenging. In this study, we demonstrate that 3D-spheroids of OV cell lines exhibit higher stemness than conventional adherent cells. Metabolomics profiling studies have revealed that 3D-spheroids maintain a high-energy state through increased glucose utilization in the citric acid cycle (TCA), efficient nucleotide phosphorylation, and elevated phosphocreatine as an energy buffer. We also found that nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme for NAD+ production, is highly expressed in OV. Furthermore, the approach based on NAMPT dependence rather than histology found NAMPT to be a potential therapeutic target against CSCs, while also serving as a prognostic indicator in OV. Moreover, we identified a previously unrecognized anti-tumor mechanism whereby disulfiram, an aldehyde dehydrogenase (ALDH) inhibitor, synergistically inhibited mitochondrial function when combined with NAMPT inhibitors - leading to cell cycle arrest in G2/M. Finally, the combination of a NAMPT inhibitor and disulfiram showed significant anti-tumor effects and extended survival in an animal model. Our findings demonstrate the potential of spheroids as a preclinical model for targeting OV CSCs and also indicate that the combination of NAMPT inhibitors and disulfiram is a promising therapeutic strategy to overcome recurrent OV.