Intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma in patients undergoing liver transplantation: a Spanish matched cohort multicenter study.

OBJECTIVE: To evaluate the outcome of patients with hepatocellular-cholangiocarcinoma (HCC-CC) or intrahepatic cholangiocarcinoma (I-CC) on pathological examination after liver transplantation for HCC. BACKGROUND: Information on the outcome of cirrhotic patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study is limited. METHODS: Multicenter, retrospective, matched cohort 1:2 study. STUDY GROUP: 42 patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study; and control group: 84 patients with a diagnosis of HCC. I-CC subgroup: 27 patients compared with 54 controls; HCC-CC subgroup: 15 patients compared with 30 controls. Patients were also divided according to the preoperative tumor size and number: uninodular tumors 2 cm or smaller and multinodular or uninodular tumors 2 cm or larger. Median follow-up: 51 (range, 3-142) months. RESULTS: The 1-, 3-, and 5-year actuarial survival rate differed between the study and control groups (83%, 70%, and 60% vs 99%, 94%, and 89%, respectively; P < 0.001). Differences were found in 1-, 3-, and 5-year actuarial survival rates between the I-CC subgroup and their controls (78%, 66%, and 51% vs 100%, 98%, and 93%; P < 0.001), but no differences were observed between the HCC-CC subgroup and their controls (93%, 78%, and 78% vs 97%, 86%, and 86%; P = 0.9). Patients with uninodular tumors 2 cm or smaller in the study and control groups had similar 1-, 3-, and 5-year survival rate (92%, 83%, 62% vs 100%, 80%, 80%; P = 0.4). In contrast, patients in the study group with multinodular or uninodular tumors larger than 2 cm had worse 1-, 3-, and 5-year survival rates than their controls (80%, 66%, and 61% vs 99%, 96%, and 90%; P < 0.001). CONCLUSIONS: Patients with HCC-CC have similar survival to patients undergoing a transplant for HCC. Preoperative diagnosis of HCC-CC should not prompt the exclusion of these patients from transplant option.

"Very early" intrahepatic cholangiocarcinoma in cirrhotic patients: should liver transplantation be reconsidered in these patients?

A retrospective cohort multicenter study was conducted to analyze the risk factors for tumor recurrence after liver transplantation (LT) in cirrhotic patients found to have an intrahepatic cholangiocarcinoma (iCCA) on pathology examination. We also aimed to ascertain whether there existed a subgroup of patients with single tumors ≤2 cm ("very early") in which results after LT can be acceptable. Twenty-nine patients comprised the study group, eight of whom had a "very early" iCCA (four of them incidentals). The risk of tumor recurrence was significantly associated with larger tumor size as well as larger tumor volume, microscopic vascular invasion and poor degree of differentiation. None of the patients in the "very early" iCCA subgroup presented tumor recurrence compared to 36.4% of those with single tumors >2 cm or multinodular tumors, p = 0.02. The 1-, 3- and 5-year actuarial survival of those in the "very early" iCCA subgroup was 100%, 73% and 73%, respectively. The present is the first multicenter attempt to ascertain the risk factors for tumor recurrence in cirrhotic patients found to have an iCCA on pathology examination. Cirrhotic patients with iCCA ≤2 cm achieved excellent 5-year survival, and validation of these findings by other groups may change the current exclusion of such patients from transplant programs.

Estudio pretasplante y seguimiento a largo plazo del paciente trasplantado: aspectos clínicos y ecográficos / No disponible

No disponible

Spectrophotometric and adsorptive stripping square wave voltammetric determination of iron in olive oils, as complex with 5,5-dimethylcyclohexane-1,2,3-trione 1,2-dioxime 3-thiosemicarbazone (DCDT).

Two methods for the determination of iron in olive oil by spectrophotometry and by adsorptive stripping square wave voltammetry (Ad-SSWV) have been developed. These two methods are based on the formation of a 5,5-dimethylcyclohexane-1,2,3-trione 1,2-dioxime 3-thiosemicarbazone (DCDT)-iron(II) complex in strongly acid media. In both, iron is extracted from the olive oil by using HCl. Spectrophotometric determination of iron with DCDT is based on the feature that the DCDT-Fe complex shows an absorbance maximum at 550 nm. A calibration graph has been constructed from 0 to 4000 ng mL(-)(1), and the detection limit was 115 ng mL(-)(1) (57 ng g(-)(1) in olive oil). On the other hand, the voltammetric determination of the metal is based on the appearance of a peak due to an adsorptive reductive process of the complex that it is observed when the Ad-SSWV technique is used. A calibration graph has been constructed from 0 to 30 ng mL(-)(1), and the detection limit was 0.55 ng mL(-)(1) (13.75 ng g(-)(1) in olive oil according to the proposed procedure).

Resolution by polarographic techniques of the ternary mixture of captan, captafol and folpet by using PLS calibration and artificial neuronal networks.

The simultaneous polarographic determination of the ternary mixture of captan-captafol and folpet is studied. The polarographic signals of these compounds in their mixture show a high overlapping. For this reason different chemometric methods such as PLS, PCR and artificial neuronal network (ANN) have been utilized for the simultaneous determination of these compounds in mixtures. The calibration model is built from solutions containing river water of known pesticide concentrations and the signals obtained by Sampled DC and DPP (differential pulse polarography) have been used. The analysis of both synthetic and real samples (river water) has been carried out by PLS with satisfactory results in most cases. It is possible to determine 0.25 ppm of each pesticide in river water samples after a preconcentration step by extraction into diethyl ether. ANN has also been applied to improve the results obtained by the PLS tool when the sampled DC current is recorded or when liquid-solid extraction with C18 cartridges is performed.

Study and determination of the pesticide Imidacloprid by square wave adsorptive stripping voltammetry.

An electroanalytical method has been developed for the detection and determination of the pesticide 1-(6-chloro-3-pyridylmethyl)-N-nitroimidazolidin-2ylidineamine (Imidacloprid) by square wave adsorptive stripping voltammetry on a hanging mercury drop electrode (HMDE) in aqueous solution with Britton-Robinson buffer as supporting electrolyte. The best adsorption conditions were found to be pH 7.2, an accumulation potential of -1050 mV (HMDE vs. Ag/AgCl-KCl 3M) and an accumulation time of 50 s. Effects of square wave frequency, step potential and pulse amplitude were examined for the optimization of instrumental conditions. Calibration curve is linear in the range 2 x 10(-8)-5 x 10(-7) M with a detection limit of 1.6 x 10(-8) M (Clayton et al. method). The method is applied to the direct determination of the pesticide in river water samples. For a concentration of 4.1 x 10(-8) M a recovery value of 104+/-3% is obtained. In order to determine lower concentrations, previous preconcentration and cleaning steps (liquid-liquid extraction into CH(2)Cl(2) and solid-phase extraction with Sep-Pak C(18) cartridges) are carried out. The recovery values obtained in spiked river water are 89+/-4% for 2 x 10(-8) M and 90+/-6% for 8 x 10(-9) M.