Surgical management and longterm follow-up of non-parasitic hepatic cysts

BACKGROUND: Despite the increasing use of laparoscopic techniques, the optimal surgical approach for cystic liver disease has not been well defined. This study aims to determine the optimum operative approach for these patients. METHODS: Data were identified from the Lothian Surgical Audit, case note review and general practitioner contact. Patients were contacted and asked to complete the SF-36 questionnaire on quality of life. RESULTS: A total of 102 patients (67 with simple cysts, 31 with polycystic liver disease [PCLD], four with cystic tumours) underwent 62 laparoscopic deroofings, 15 open deroofings, 36 resections and one liver transplant between June 1985 and April 2006. The median follow-up was 77 months (range 3–250 months). Morbidity and recurrent symptom rates after laparoscopic surgery were greater in PCLD patients compared with simple cyst patients, at 31% (four patients) vs. 15% (seven patients) and 85% (11 patients) vs. 29% (24 patients), respectively. Four patients with simple cysts and eight with PCLD required further surgery. All patients with simple cysts had comparable quality of life after surgery. Patients with recurrent symptoms after surgery for PCLD had a significantly better quality of life following laparoscopic deroofing than after resection. CONCLUSIONS: Most simple cysts can be managed laparoscopically, but there is a definite role for open resection in some patients. Open deroofing is the preferred approach for a dominant cyst pattern in PCLD, whereas resection is necessary for diffuse cystic disease

Single Port Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Preliminary Report

Single port laparoscopic surgery is an emerging technique, now commonly used in cholecystectomy. The experience of using this technique in liver resection for hepatocellular carcinoma is described in a series of 3 cases with single port laparoscopic liver resection performed during 2010. All patients were male aged 61 to 70 years, with several comorbidities. There were no complications in this early series. The length of hospital stay was 3–5 days. The blood loss was 200–450 mL, with operating time between 142 and 171 minutes. We conclude that this technique is feasible and safe to perform in experienced centers

Multi-Phase Cross-modal Learning for Noninvasive Gene Mutation Prediction in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the fourth most common cause of cancer-related death worldwide. Understanding the underlying gene mutations in HCC provides great prognostic value for treatment planning and targeted therapy. Radiogenomics has revealed an association between non-invasive imaging features and molecular genomics. However, imaging feature identification is laborious and error-prone. In this paper, we propose an end-to-end deep learning framework for mutation prediction in APOB, COL11A1 and ATRX genes using multiphasic CT scans. Considering intra-tumour heterogeneity (ITH) in HCC, multi-region sampling technology is implemented to generate the dataset for experiments. Experimental results demonstrate the effectiveness of the proposed model.Comment: Accepted version to be published in the 42nd IEEE Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2020, Montreal, Canad

Micropropagation and conservation of selected endangered anticancer medicinal plants from the Western Ghats of India

Globally, cancer is a constant battle which severely affects the human population. The major limitations of the anticancer drugs are the deleterious side effects on the quality of life. Plants play a vital role in curing many diseases with minimal or no side effects. Phytocompounds derived from various medicinal plants serve as the best source of drugs to treat cancer. The global demand for phytomedicines is mostly reached by the medicinal herbs from the tropical nations of the world even though many plant species are threatened with extinction. India is one of the mega diverse countries of the world due to its ecological habitats, latitudinal variation, and diverse climatic range. Western Ghats of India is one of the most important depositories of endemic herbs. It is found along the stretch of south western part of India and constitutes rain forest with more than 4000 diverse medicinal plant species. In recent times, many of these therapeutically valued herbs have become endangered and are being included under the red-listed plant category in this region. Due to a sharp rise in the demand for plant-based products, this rich collection is diminishing at an alarming rate that eventually triggered dangerous to biodiversity. Thus, conservation of the endangered medicinal plants has become a matter of importance. The conservation by using only in situ approaches may not be sufficient enough to safeguard such a huge bio-resource of endangered medicinal plants. Hence, the use of biotechnological methods would be vital to complement the ex vitro protection programs and help to reestablish endangered plant species. In this backdrop, the key tools of biotechnology that could assist plant conservation were developed in terms of in vitro regeneration, seed banking, DNA storage, pollen storage, germplasm storage, gene bank (field gene banking), tissue bank, and cryopreservation. In this chapter, an attempt has been made to critically review major endangered medicinal plants that possess anticancer compounds and their conservation aspects by integrating various biotechnological tool

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Not AvailableThere is a need to empower the coconut farmers to overcome structural constraints of the sector in terms of fragmented holdings, non-uniform levels ofknowledge, skill and resources, and prevalence ofnon-transparent and multi-node marketing channels, to become globally competitive. Utility of a value chain framework in this regard was tested under World Bank assisted National Agricultural Innovation Project on 'Value Chain in Coconut' which was implemented in Kasaragod district of Kerala. Baseline survey was conducted to benchmark and to identifY the constraints preventing better value realization in the value chain segments (production, post-harvest handling, processing, and marketing). Upgrading of coconut value chain was achieved through (i) horizontal coordination of important nodes as well as management of human capital, (ii) process upgrading to improve operational productivity; and (iii) product upgrading to improve strategic productivity. In the first instance, 10 Community Based Organizations offarmers were formed that covered 250 ha area and 534 farmers. For increasing the operational productivity, appropriate production technology-interventions such as (a) cultivation of intercrops, (b) growing of leguminous green manure crops in the coconut basin and its incorporation, (c) integrated nutrient management including organic recycling, and (d) need based plant protection measures, were implemented. Average net returns due to enhanced operation al productivity of value chain was Rs.200,201 per ha against the baseline value of Rs.44,981. Product upgrading was achieved through development of 14 protocols for value added products and conducting marketing studies: Four Women Self Help Groups were formed to produce coconut value added products. Value addition through product diversification had the potential to provide a net profit of Rs.200,000 per ha. This study establishes the scope for enhancing coconut value chain productivity through adoption of improved production technologies, better coordination in procurement, and community level processing and thus, will be a benchmark for extension strategies having a value chain perspective.Not Availabl

A predictive nomogram to identify factors influencing the success of a concomitant laparoscopic cholecystectomy with common bile duct exploration for choledocholithiasis

10.1016/j.hpb.2017.09.005HPB204313-320HPBI