There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

Background and Aims:The lack of consensus on how to define and grade adverse postoperative events has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992, was updated 5 years ago. It is based on the type of therapy needed to correct the co

The Clavien-Dindo classification of surgical complications: five-year experience.

Prospective Cohort Study

ObjectiveThere is a need for clearly defined and widely applicable clinical criteria for the selection of patients who may benefit from hepatic resection for metastatic colorectal cancer. Such criteria would also be useful for stratification of patients in clinical trials for this disease.MethodsCli

/pdf/clinical-score-for-predicting-recurrence-after-hepatic-2a004axarc.pdf

Clinical Score for Predicting Recurrence After Hepatic Resection for Metastatic Colorectal Cancer: Analysis of 1001 Consecutive Cases

Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer

/pdf/image-of-the-month-hepatic-calcifying-fibrous-pseudotumor-77tjug4gdq.pdf

Image of the month. Hepatic calcifying fibrous pseudotumor.

Histologic characteristics of non-microsatellite-instable colon adenomas correlate with distinct molecular patterns.

Objective To assess the specificity of increased 18 F-dihydroxyphenylalanine (18 F-FDOPA) uptake in patients who underwent PET/CT for suspicion of isolated pancreatic neuroendocrine tumour (pNET). False-positive results mimicking a pNET have been investigated. Material and methods Carbidopa-assisted 18 F-FDOPA PET/CT scans performed in patients with suspicion of localized pNET were retrieved. Only patients with a definitive diagnosis were retrospectively included. When available, the histopathological result after pancreatic surgery was the gold standard. In other cases, the diagnosis was based on endoscopic ultrasonography (EUS)/cytology and/or on concordant imaging results of at least two of the following: contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS). Results Forty-four among 731 patients were selected. Among these, 36 patients (82%) were surgically treated, revealing pNET (n = 28), solid pseudopapillary tumour (SPT) (n = 4), adenocarcinoma (n = 2), serous cystadenomas (n = 1) and solitary fibrous tumour (n = 1) cases. An additional three cases of pNET were diagnosed by EUS/cytology. In the remaining five patients, a consensus was reached on follow-up imaging results: pNET (n = 1), serous cystadenoma (n = 2) and undetermined/no pNET (n = 2). Both specificity and negative predictive value of 18 F-FDOPA PET/CT for localized pNET were 67%. Surprisingly, all four false-positive results were SPTs showing intense 18 F-FDOPA uptake and negative SRS. There was no significant difference in 18 F-FDOPA uptake intensity between PET-positive pNETs and SPTs. Conclusion 18 F-FDOPA PET/CT is not specific for pNET in patients with localized pancreatic lesions. SPT could mimic pNET and should be part of differential diagnosis in such a clinical situation. If these results are confirmed in a broader population, the imaging pattern 18 F-FDOPA PET-positive/SRS-negative lesions might be considered as the imaging phenotype of SPT.

Solid pseudopapillary tumour should be part of differential diagnosis of focal pancreatic lesions with increased 18 F-FDOPA uptake.

RESUME La resection hepatique est le seul traitement a visee curative offrant un espoir de survie a long terme (25 a 40 % a 5 ans) aux patients presentant des metastases hepatiques de cancers colorectaux La resection hepatique est effectuee avec une mortalite et une morbidite faibles Toutefois seulement 10 a 20 % des patients peuvent beneficier de cette option therapeutique et 80 a 90 %recoivent un traitement palliatif Le developpement de nouvelles technologies a permis, dans le cadre de strategies therapeutiques multidisciplinaires innovantes, d’augmenter le nombre de patients pouvant beneficier d’une resection curative de leurs metastases hepatiques Ces strategies permettent d’obtenir des resultats similaires a ceux observes apres resection hepatique pour des metastases resecables d’emblee Notre experience globale porte sur 438 patients operes pourmetastases hepatiques de 1987 a 2002 La mortalite globale est de 1,1 % et la morbidite de 26 % La survie actuarielle a 5 ans est de 29,6 %, et de 20,1 % a 10 ans

Process in surgical exeresis of colorectal cancer liver metastases

Liver transplantation, utilized routinely for end-stage liver disease, has been constrained by the paucity of organ donors, and is being complemented by alternative strategies such as liver cell transplantation. One of the most promising forms of liver cell transplantation is hepatic stem cell therapies, as the number of human hepatic stem cells (hHpSCs) and other early hepatic progenitor cells (HPCs) are sufficient to provide treatment for multiple patients from a single liver source. In the present study, human adult livers were exposed to cold ischemia and then processed after <24 or 48 h. Cells positive for epithelial cell adhesion molecule (EpCAM), a marker on early lineage stage HPCs, were immunoselected and counted. Approximately 100,000 EpCAM+ cells/gram of tissue was obtained from surgical resection of livers subjected to cold ischemia up to 24 h and comparable numbers, albeit somewhat lower, were obtained from those exposed to 48 h of cold ischemia. The yields are similar to those reported from ...

Philippe Bachellier

Papers

Image of the month. Hepatic calcifying fibrous pseudotumor.

Histologic characteristics of non-microsatellite-instable colon adenomas correlate with distinct molecular patterns.

Solid pseudopapillary tumour should be part of differential diagnosis of focal pancreatic lesions with increased 18 F-FDOPA uptake.

Process in surgical exeresis of colorectal cancer liver metastases

Isolation of viable human hepatic progenitors from adult livers is possible even after 48 hours of cold ischemia.