Liver resections: complications and survival outcome

none1noToday, liver resection represents one of the most effective therapies in the treatment of defined liver diseases, particularly for hepatocellular carcinomas, liver metastases and tumors originating from the bile ducts. There have been a number of improvements in the technique but the use of kellyclasia associated with meticulous control of hemostasis and biliostasis appears to be more effective and efficient. The procedure is still burdened with some postoperative complications, the more characteristic of which are liver insufficiency, biliary leakage and ascites. Several neoplastic diseases, both primitive and secondary, can benefit from this therapy with substantial improvement of long-term survival, and a notable change in the natural history of the disease. For these situations, a consultation should always be performed by a surgeon experienced in hepatic surgery.mixedGrazi GLGrazi G

Modeling Spatial Sustainability: Spatial Welfare Economics versus Ecological Footprint

A spatial welfare framework for the analysis of the spatial dimensions of sustainability is developed. It incorporates agglomeration effects, interregional trade, negative environmental externalities and various land use categories. The model is used to compare rankings of spatial configurations according to evaluations based on social welfare and ecological footprint indicators. Five spatial configurations are considered for this purpose. The exercise is operationalized with the help of a two-region model of the economy that is in line with the ‘new economic geography’. Various (counter) examples show that the footprint method is not consistent with an approach aimed at maximum social welfare.Agglomeration effects, Trade advantages, Negative externalities, Population density, Spatial configuration, Transport

TRANSAMIDINASE OF HOG KIDNEY. I. PURIFICATION AND PROPERTIES.

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Peliosis hepatis. Personal experience and literature review

Peliosis hepatis (PH) is a disease characterized by multiple and small, blood-filled cysts within the parenchymatous organs. PH is a very rare disease, more common in adults, and when it affects the liver, it comes to the surgeon’s attention only in an extremely urgent situation after the lesion’s rupture with the resulting hemoperitoneum. This report describes the case of a 29-year-old woman affected by recurring abdominal pain. CT scans showed a hepatic lesion formed by multiple hypodense areas, which showed an early acquisition of the contrast during the arterial phase. Furthermore, it remained isodense with the remaining parenchyma during the late venous phase. We decided on performing a liver resection of segment Ⅶ while avoiding a biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal PH. PH should always be considered in the differential diagnosis of hepatic lesions. Clinicians should discuss the possible causes and issues related to the differential diagnosis in addition to the appropriate therapeutic approach. The fortuitous finding of a lesion, potentially compatible with PH, requires elective surgery with diagnostic and therapeutic intents. The main aim is to prevent the risk of a sudden bleeding that, in absence of properly equipped structures, may have a fatal outcome

Fructose 1,6-Diphosphatase from Rabbit Liver XII. EFFECT OF SUBSTRATE AND ADENOSINE MONOPHOSPHATE ON THE IONIZATION OF THE TYROSYL RESIDUES

Abstract The effects of substrate and AMP on the state of ionization of tyrosyl residues of fructose 1,6-diphosphatase have been investigated. In the native enzyme, 5 to 6 tyrosyl residues were titrated with a pK of about 8.4, and 7 to 8 residues were titrated with a pK of 9 to 9.2. The remaining tyrosyl residues were not titrated below pH 10. In the presence of 10-5 m fructose 1,6-diphosphate, when 4 moles of substrate are bound per mole of enzyme, approximately 4 of the low pK tyrosyl residues are shifted from pK 8.4 to pK 9.7. However, all of the pK values are modified, and under these conditions 2 tyrosyl residues show a pK of 8.7, and 10 or 11 residues show a pK of 9.7. At a high concentration of fructose 1,6-diphosphate, 10-3 m, all 12 to 13 of the tyrosyl residues are titrated with a pK of 9.8. The results can be correlated with previous studies on the acetylation of fructose 1,6-diphosphatase. The tyrosyl residues with low pK are more reactive and are associated with loss of sensitivity to AMP. However, after acetylation, only 10 tyrosyl residues are titrated with a pK of 9.3 to 9.4, and the pK is shifted to 9.7 when the substrate is bound. A method of analyzing the titration data is presented which permits simultaneous evaluation of number of residues and pK value of each titrated group. This has revealed changes in tyrosyl residues that would otherwise have been overlooked

Attentional Factors Involved in Learning in the First Grade

In the school population, attentional problems are one of the most frequent causes of failure in learning; sometimes these take the form of a specific deficit and in other cases an attention disorder occurs in comorbidity with a learning disorder. It seems crucial to focus on what peculiar characteristics of attention are involved in basic learning in order to contribute to the diagnostic order and to arrange paths of development. This research aims to verify the weight of the different components of attention involved in the outcomes of the first stages of learning. A total of 69 children (34 males and 35 females, aged 6.4 ±1.1 years and 7.3 ±1.2 years respectively) in first grade, participated in the study. The results of the correlational analysis carried out show that there are specific significant relationships between the various components of attention and performance in reading, writing and calculation. In particular, visual attention appears to be the aspect most involved in the initial development of the learning of these three abilities. Factorial analysis shows a single factor involved in the learning of reading, writing and calculation: "Rapid Visual Attention". The processes identified in the factor are: Selective Attention, Visual Selective Attention, Shifting Focus, Focused Attention, Planning and Inhibition. This factor is characterised by speed in Selective/Sustained Visual Attention and this explains the role of attention in success in reading, writing and calculation in the early stages of school learning. The Rapid Visual Attention Factor contributes to rapidity in reading, speed in writing and numerical knowledge in first grade children, confirming the causal relationship between visual attention and initial learning in this age group. This "Rapid Visual Attention" Factor may be crucial in accounting for the comorbidity between Attention Deficit Hyperactivity Disorder and Learning Disabilities

Studies on the mechanism of action of the gluconate 6-phosphate dehydrogenase. The presence of a cysteine residue in the active center.

Abstract The role of the sulfhydryl groups in the gluconate 6-phosphate dehydrogenase has been studied. Nine cysteine residues have been detected by spectrophotometric titration with p-hydroxymercuribenzoate, but the reaction of only 3 of them is sufficient to inactivate the enzyme completely. Chlorodinitrobenzene acts even more specifically. Incorporation of 1.6 dinitrobenzene residues leads to enzyme inactivation. The amino acid residues involved in dinitrophenylation have been identified as cysteine. Gluconate 6-phosphate completely protects the enzyme against inactivation by chlorodinitrobenzene

Effect of orthophosphate on the transaldolase reaction.

In previous studies' with a dialyzed supernatant fraction from rat liver it was observed that the formation of heptulose phosphate from fructose g-phosphate was significantly inhibited by inorganic phosphate. It has since been shown (1, 2) that the activity of the dialyzed liver fraction can be related to its content of transketolase and transaldolase and it became of interest to determine whether the inhibition of the over-all process by phosphate was due to its effect on one or both of the enzymes involved in this process. Preliminary experiments indicated that both transketolase and transaldolase were inhibited by inorganic phosphate when the enzymes were tested in the usual assay procedures. The effect of phosphate on transaldolase is reported in the present paper