The MRI scan of his head revealed a small mass (5 mm) in the pituitary gland. The CT scan revealed

http://www.selleckchem.com/products/Adrucil(Fluorouracil).html two pancreatic tumors; a 3.8 cm mass in the head of the pancreas (Figure 1 left) and a 1.2 cm mass in the body of the pancreas (Figure 1 right, arrowheads). His surgical treatment included resection of the head of the pancreas (Whipple’s procedure) and enucleation of the tumor from the body of the pancreas. Within 1 week of surgery, his diarrhea had resolved and his serum potassium had returned to normal. Histology revealed neuroendocrine tumors of uncertain malignant potential (Figure 2, above) with positive immunohistochemical staining for chromogranin A and vasoactive intestinal peptide (VIP, Figure 2, below). INK 128 research buy The neoplasms were also focally positive for glucagon but negative for proinsulin, gastrin, serotonin and somatostatin. His family history was helpful as his father had complicated peptic ulcer disease caused by a pancreatic gastrinoma and was treated with a subtotal gastrectomy. MENI is an uncommon disease with a prevalence of approximately 1:30,000 people. It is caused by mutations in the MENI gene that encodes a protein called menin. The most common clinical manifestation is hyperparathyroidism that occurs in approximately 90% of patients. Most patients also develop neoplasms in

the pancreas that may be non-functional or may result in the secretion of hormones such as gastrin, insulin, glucagon, somatostatin and VIP. VIPomas are extremely rare with an estimated annual incidence of 1:10 million people. With immunocytochemistry, some VIPomas can have positive staining with other hormones such as pancreatic polypeptide, glucagon and somatostatin. For patients without metastases, 上海皓元 the treatment of choice is surgical excision of the neoplasms. This usually results in improvement or resolution of diarrhea. Contributed by “
“Sayin SI, Wahlstrom A, Felin J, Jantti S, Marschall HU, Bamberg

K, et al. Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid, a naturally occurring FXR antagonist. Cell Metab 2013;17:225-235. (Reprinted with permission). Bile acids are synthesized from cholesterol in the liver and further metabolized by the gut microbiota into secondary bile acids. Bile acid synthesis is under negative feedback control through activation of the nuclear receptor farnesoid X receptor (FXR) in the ileum and liver. Here we profiled the bile acid composition throughout the enterohepatic system in germfree (GF) and conventionally raised (CONV-R) mice. We confirmed a dramatic reduction in muricholic acid, but not cholic acid, levels in CONV-R mice.