The Falciform Ligament for Mesenteric and Portal Vein Reconstruction in Local Advanced Pancreatic Tumor: A Surgical Guide and Single-Center Experience

Background. Since local tumor infiltration to the mesenteric-portal axis might represent a challenging assignment for curative intended resectability during pancreatic surgery, appropriate techniques for venous reconstruction are essential. In this study, we acknowledge the falciform ligament as a feasible and convenient substitute for mesenteric and portal vein reconstruction with high reliability and patency for local advanced pancreatic tumor. Methods. A retrospective single-center analysis. Between June 2017 and January 2018, a total of eleven consecutive patients underwent pancreatic resections with venous reconstruction using falciform ligament. Among them, venous resection was performed in nine cases by wedge and in two cases by full segment. Patency rates and perioperative details were reviewed. Results. Mean clamping time of the mesenteric-portal blood flow was 34 min, while perioperative mortality rate was 0%. By means of Duplex ultrasonography, nine patients were shown to be patent on the day of discharge, while two cases revealed an entire occlusion of the mesenteric-portal axis. Orthograde flow demonstrated a mean value of 34 cm/s. All patent grafts on discharge revealed persistent patencywithin various follow-up assessments. Conclusion. The falciform ligament appears to be a feasible and reliable autologous tissue for venous blood flow reconstruction with high postoperative patency. Especially the possibility of customizing graft dimensions to the individual needs based on local findings allows an optimal size matching of the conduit. The risk of stenosis and/or segmental occlusionmay thus be further reduced

Spectroscopic investigations of Np(V/VI) redox speciation in hyperalkaline TMA-(OH, Cl) solutions

The redox chemistry of Np(V/VI) was investigated in ∼0.6M tetramethylammonium hydroxide/chloride (TMA-(OH, Cl)) solutions with 9 ≤ −log [H+] ≤ 13.5. Redox conditions were defined by the absence or presence of ClO− as oxidizing agent (Na-salt, 5×10−3M and 5×10−2M). The high total Np concentration ([Np]tot ∼ 2×10−3M) led to the precipitation of solid phases in some of the samples. The carbonate concentration (as impurity of TMA-OH) was 2-3×10−3M. UV-vis/NIR spectra obtained from the supernatant in TMA-(OH, Cl) solutions and absence of ClO− showed clear Np(V) features, identified as NpO2+, NpO2CO3− and (NpO2)x(CO3)y(OH)zx−2y−z. No NIR features were observed within 800nm ≤ λ ≤ 1300nm for samples with ClO−. XANES edge energies and features of these samples confirmed the predominance of Np(V) in the absence of ClO− and Np(VI) in the presence of ClO−, by comparison to XANES reference spectra of Np(III/IV/V/VI) prepared within the present work by in-situ electrolysis. Asimilar Np redox distribution was observed for the solid phases based on XANES and EXAFS measurements. EXAFS spectra indicative of NpVO2OH(s) and NpVIO3· xH2O(s) were obtained for samples in absence and presence of ClO−, respectively. The formation of aNa-Np(VI) phase in 5×10−2M ClO− and −log [H+] ∼ 12 was also indicated from the EXAFS, chemical analysis and SEM-EDS. These results indicate that Np(VI) aqueous species and solid compounds prevail far below the oxidation border of water in alkaline solutions and also far below the EH border calculated with the current NEA data selection [1]. These observations are further supported by correlations of literature thermodynamic data for actinides (U, Np, Pu and Am), which predict the formation of NpO2(OH)3− and NpO2(OH)42− aqueous species with stability constants (log *βº1,3 and log *βº1,4) similar to those available for U(VI

Postoperative single-sequence (PoSSe) MRI: imaging work-up for CT-guided or endoscopic drainage indication of collections after hepatopancreaticobiliary surgery

Purpose: Fluid collections due to anastomotic leakage are a common complication after hepatopancreaticobiliary (HPB) surgery and are usually treated with drainage. We conducted a study to evaluate imaging work-up with a postoperative single-sequence (PoSSe) MRI for the detection of collections and indication of drainage. Material and methods: Forty-six patients who developed signs of leakage (fever, pain, laboratory findings) after HPB surgery were prospectively enrolled. Each patient was examined by abdominal sonography and our PoSSe MRI protocol (axial T2-weighted HASTE only). PoSSe MRI examination time (from entering to leaving the MR scanner room) was measured. Sonography and MRI were evaluated regarding the detection and localization of fluid collections. Each examination was classified for diagnostic sufficiency and an imaging-based recommendation if CT-guided or endoscopic drainage is reasonable or not was proposed. Imaging work-up was evaluated in terms of feasibility and the possibility of drainage indication. Results: Sonography, as first-line modality, detected 21 focal fluid collections and allowed to decide about the need for drainage in 41% of patients. The average time in the scanning room for PoSSe MRI was 9:23 min [7:50-13:32 min]. PoSSe MRI detected 46 focal collections and allowed therapeutic decisions in all patients. Drainage was suggested based on PoSSe MRI in 25 patients (54%) and subsequently indicated and performed in 21 patients (100% sensitivity and 84% specificity). No patient needed further imaging to optimize the treatment. Conclusions: The PoSSe MRI approach is feasible in the early and intermediate postoperative setting after HPB surgery and shows a higher detection rate than sonography. Imaging work-up regarding drainage of collections was successful in all patients and our proposed PoSSe MRI algorithm provides an alternative to the standard work-up

Imaging standardization in metastatic colorectal cancer : a joint EORTC-ESOI-ESGAR expert consensus recommendation

Background: Treatment monitoring in metastatic colorectal cancer (mCRC) relies on imaging to evaluate the tumor burden. Response Evaluation Criteria in Solid Tumors (RECIST) provide a framework on reporting and interpretation of imaging findings yet offer no guidance on a standardized imaging protocol tailored to mCRC patients. Imaging protocol heterogeneity remains a challenge for the reproducibility of conventional imaging endpoints and is an obstacle for research on novel imaging endpoints. Patients and methods: Acknowledging the recently highlighted potential of radiomics and artificial intelligence (AI) tools as decision support for patient care in mCRC, a multidisciplinary, international, and expert panel of imaging specialists was formed to find consensus on mCRC imaging protocols using the Delphi method. Results: Under the guidance of the European Organisation for Research and Treatment of Cancer (EORTC) Imaging and Gastrointestinal Tract Cancer Groups, the European Society of Oncologic Imaging (ESOI) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the EORTC-ESOI-ESGAR core imaging protocol was identified. Conclusion: This consensus protocol attempts to promote standardization and to diminish variations in patient preparation, scan acquisition and scan reconstruction. We anticipate that this standardization will increase reproducibility of radiomics and AI studies and serve as a catalyst for future research on imaging endpoints. For ongoing and future mCRC trials, we encourage principal investigators to support the dissemination of these imaging standards across recruiting centers.peer-reviewe

Combining data and text mining techniques for yeast gene regulation prediction: A case study

In order to solve task 2 of the KDD Cup 2002, we exploited various available information sources. In particular, use of relational information describing the interactions among genes and information automatically extracted from scientific abstracts improves the accuracy of our predictions

Cell tracking in vitro reveals that the extracellular matrix glycoprotein Tenascin-C modulates cell cycle length and differentiation in neural stem/progenitor cells of the developing mouse spinal cord

Generation of astrocytes during the development of the mammalian spinal cord is poorly understood. Previously, we have shown that the glycoprotein of the extracellular matrix (ECM) tenascin-C (Tnc) modulates the expression territories of the patterning genes Nkx6.1 and Nkx2.2 in the developing ventral spinal cord, tunes the responsiveness of neural stem/progenitor cells towards the cytokines FGF2 and EGF and thereby promotes astrocyte maturation. In order to obtain further mechanistic insight into these processes, we have compared embryonic day-15 spinal cord neural progenitor cells (NPCs) from wild-type and Tnc knockout mice using continuous single-cell live imaging and cell lineage analysis in vitro. Tnc knockout cells displayed a significantly reduced rate of cell division both in response to FGF2 and EGF. When individual clones of dividing cells were investigated with regard to their cell lineage trees using the tTt tracking software, it appeared that the cell cycle length in response to growth factors was reduced in the knockout. Furthermore, when Tnc knockout NPCs were induced to differentiate by the removal of FGF2 and EGF glial differentiation was enhanced. We conclude that the constituent of the stem cell niche Tnc contributes to preserve stemness of NPCs