A Case of Breast Cancer Metastasizing to the Ampulla of Vater.

Secondary tumors of the ampulla of Vater are exceedingly rare and associated with relatively poor prognosis. Tumors of the ampulla are classified into four distinct subtypes based on the location and involvement of surrounding structures. Most reported cases are of renal cell or malignant skin melanoma primary with only five previously reported cases of breast primary found in a literature review.

Hepatitis A and B screening and vaccination rates among patients with chronic liver disease.

Vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV) are recommended for patients with chronic liver disease (CLD), yet implementation of these recommendations is lacking. This study reviewed HAV and HBV antibody testing and vaccination status of patients with CLD. In 2008, we began using pre-printed liver order sets, which included vaccination options.

Endoscopic ultrasound in the evaluation of chronic upper abdominal pain of unknown etiology: a retrospective chart review examining the efficacy of EUS in determining a new diagnosis.

Goals: To explore the utility of endoscopic ultrasound (EUS) in the evaluation of chronic upper abdominal pain (UAP) of undetermined etiology.

Background: Chronic UAP is a common problem with a challenging diagnosis and management. The role of EUS in the diagnosis of UAP may minimize additional testing; however, few studies describe the percentage of new diagnoses yielded in these patients.

Anandamide exerts its antiproliferative actions on cholangiocarcinoma by activation of the GPR55 receptor.

Cholangiocarcinomas are devastating cancers of biliary origin with limited treatment options. It has previously been shown that the endocannabinoid anandamide exerts antiproliferative effects on cholangiocarcinoma independent of any known cannabinoid receptors, and by the stabilization of lipid rafts, thereby allowing the recruitment and activation of the Fas death receptor complex. Recently, GPR55 was identified as a putative cannabinoid receptor; therefore, the role of GPR55 in the antiproliferative effects of anandamide was evaluated.

Increased local dopamine secretion has growth-promoting effects in cholangiocarcinoma.

Cholangiocarcinoma is a devastating cancer of biliary origin with limited treatment options. Symptoms are usually evident after blockage of the bile duct by the tumor, and at this late stage, they are relatively resistant to chemotherapy and radiation therapy. Therefore, it is imperative that alternative treatment options are explored.