OBJECTIVE. The aim of our study was to prospectively evaluate the accuracy of dual-phase helical CT in the preoperative assessment of resectabiliy in patients with suspected pancreatic cancer using surgical and histopathologic correlation.SUBJECTS AND METHODS. Between January 1999 and December 2000, 76 patients with suspected pancreatic cancer underwent preoperative evaluation and staging with dual-phase helical CT (3-mm collimation for pancreatic phase, 5-mm collimation for portal phase). Iodinated contrast material was injected IV (170 mL at a rate of 4 mL/sec); acquisition began at 40 sec during the pancreatic phase and at 70 sec during the portal phase. Three radiologists prospectively evaluated the imaging findings to determine the presence of pancreatic tumor and signs of unresectability (liver metastasis, vascular encasement, or regional lymph nodes metastasis). The degree of tumor—vessel contiguity was recorded for each patient (no contiguity with tumor, contiguity of <50%, or contiguity of ≥50%)....

Context The proinflammatory cytokine TNFα is a key player in insulin resistance (IR). While several miRNAs are believed to be involved in the development of adipose tissue (AT) IR, the role of miRNAs in the association between inflammation and IR is poorly understood. Objective To investigate the expression profile of miR-181a-5p and miR-23a-3p in obesity and to study their role in TNFα-induced IR in adipocytes. Design Two separate cohorts were employed. Cohort 1 was used for AT expression studies and included 28 subjects with BMI<30 and 30 subjects with BMI≥30. Cohort 2 was used for circulating serum miRNA studies and included 101 subjects with 4-years follow-up (48 cases and 53 controls). miR-181a-5p and miR-23a-3p expression was assessed in subcutaneous (SAT) and visceral (VAT) AT. Functional analysis was performed in adipocytes utilizing miRNA mimics and inhibitors. Key molecules of the insulin pathway, AKT, PTEN, AS160 and S6K, were analyzed. Results Expression of miR-181a-5p and miR-23a-3p was reduced in AT from obese and diabetic subjects and was inversely correlated to adiposity and HOMA-IR. Overexpression of miR-181a-5p and miR-23a-3p in adipocytes upregulated insulin-stimulated AKT activation and reduced TNFα-induced IR, regulating PTEN and S6K expression. Serum levels of miR-181a-5p were reduced in cases vs controls at baseline, pointing towards its prognostic value. Variable importance in projection scores revealed miR-181a-5p had more impact in the model than insulin or glucose at 120 minutes. Conclusions miR-181a-5p and miR-23a-3p may prevent TNFα-induced IR in adipocytes through modulation of PTEN and S6K expression.