Laparoscopic Liver Resection: A South American Experience with 2887 Cases.

BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.

Alimentos orgánicos / Organic foods

La agricultura orgánica es una forma activa de trabajo ecológico, que se produce bajo un conjunto de procedimientos denominados “orgánicos”, teniendo el productor bajo su responsabilidad un territorio al que debe liberar de toda contaminación y preocuparse por estimular la diversidad de especies, protegiendo la fauna. Dichos procedimientos tienen como objetivo principal la obtención de alimentos más saludables y la protección del medio ambiente por medio del uso de técnicas no contaminantes, además de disminuir el uso de energía y de sustancias inorgánicas, sobre todo si son de origen sintético.

Pancreatitis autoinmune asociada a colangitis esclerosante primaria. Hallazgos por tomografía computada multicorte de 64 canales y colangiorresonancia / Autoimmune pancreatitis associated to primary slcerosing cholangitis. Findings by 64 channel multi-slice magnetic computed tomography and magnetic resonance cholangiopancreatography

Reportamos el caso de un paciente de 43 años de edad con antecedente de ictericia obstructiva crónica de más de un año de evolución, sin causa objetivable, y disminución de peso con sospecha clínica de neoplasia pancreática. Luego de la colocación de un stent endobiliar para resolver la ictericia y de varias ecografías abdominales, dos colangiopancreatografías retrógradas endoscópicas (CPRE), una colangiorresonancia y dos tomografías computadas multicorte (TCMC) dinámicas se arribó al diagnóstico presuntivo de pancreatitis autoinmune asociada a colangitis esclerosante. El propósito de este artículo es describir los hallazgos imagenológicos que hicieron posible sospechar este diagnóstico. Es muy importante reconocer el compromiso multiorgánico de esta entidad y estar familiarizados con los signos clínicos e imagenológicos, puesto que la respuesta es favorable con el tratamiento adecuado. En nuestro caso, el paciente fue finalmente derivado a un centro de mayor complejidad para hacer el diagnóstico de certeza. La biopsia confirmó el diagnóstico de pancreatitis autoinmune relacionada con la inmunoglobulina G4, en asociación con una colangitis esclerosante primaria...

Aplicación de la termoablación por radiofrecuencia en el tratamiento de los tumores de hígado: resultados preliminares / Radiofrequency thermoablation in the treatment for liver tumors: initial results

Antecedentes: La termoablación por radiofrecuencia ocupa un lugar importante actualmente en el tratamiento de los tumores malignos de hígado. Objetivo: Comunicar nuestra experiencia con el uso de la radiofrecuencia en el tratamiento de los tumores de hígado. Lugar de aplicación: Hospital privado de comunidad. Diseño: Serie de casos, retrospectivo. Material y método: 44 pacientes tratados con radiofrecuencia entre enero de 1999 y diciembre de 2002. Población: Fue dividida según el origen tumoral en: 1. primario, 2. metástasis colorrectal, 3. metástasis neuroendocrina y 4. metástasis no colorrectal no neuroendocrina. La radiofrecuencia fue utilizada: 1. como única modalidad, 2. asociada a cirugía y 3. combinada con otro procedimiento. Se evaluaron la vía de abordaje, la morbilidad, mortalidad, control local, recurrencia local y supervivencia. Resultados: Media de edad 64 años. Masculinos 65 por ciento. Origen del tumor: colorrectal 50 por ciento, hepatocarcinoma 32 por ciento y no colorrectal no neuroendocrino 18 por ciento. Vía de abordaje: Laparotómica 82 por ciento, percutánea 13,5 por ciento y laparoscópica en 4,5 por ciento. Estadía hospitalaria promedio: 4 días. Complicaciones: 8 pacientes (18 por ciento). No hubo mortalidad, ni necesidad de reoperación. Se observó una recidiva parietal luego del abordaje percutáneo. En 8 pacientes (18 por ciento) se indicó radiofrecuencia por segunda vez. Supervivencia actuarial global: 28 por ciento a los 4 años. Conclusiones: La radiofrecuencia es un procedimiento válido y seguro en pacientes seleccionados. Puede ser considerada un tratamiento alternativo en pacientes con imposibilidad o rechazo al tratamiento quirúrgico. En pacientes seleccionados la radiofrecuencia se puede indicar asociada a tratamiento quirúrgico resectivo

Aplicación de la termoablación por radiofrecuencia en el tratamiento de los tumores de hígado: resultados preliminares / Radiofrequency thermoablation in the treatment for liver tumors: initial results

Antecedentes: La termoablación por radiofrecuencia ocupa un lugar importante actualmente en el tratamiento de los tumores malignos de hígado. Objetivo: Comunicar nuestra experiencia con el uso de la radiofrecuencia en el tratamiento de los tumores de hígado. Lugar de aplicación: Hospital privado de comunidad. Diseño: Serie de casos, retrospectivo. Material y método: 44 pacientes tratados con radiofrecuencia entre enero de 1999 y diciembre de 2002. Población: Fue dividida según el origen tumoral en: 1. primario, 2. metástasis colorrectal, 3. metástasis neuroendocrina y 4. metástasis no colorrectal no neuroendocrina. La radiofrecuencia fue utilizada: 1. como única modalidad, 2. asociada a cirugía y 3. combinada con otro procedimiento. Se evaluaron la vía de abordaje, la morbilidad, mortalidad, control local, recurrencia local y supervivencia. Resultados: Media de edad 64 años. Masculinos 65 por ciento. Origen del tumor: colorrectal 50 por ciento, hepatocarcinoma 32 por ciento y no colorrectal no neuroendocrino 18 por ciento. Vía de abordaje: Laparotómica 82 por ciento, percutánea 13,5 por ciento y laparoscópica en 4,5 por ciento. Estadía hospitalaria promedio: 4 días. Complicaciones: 8 pacientes (18 por ciento). No hubo mortalidad, ni necesidad de reoperación. Se observó una recidiva parietal luego del abordaje percutáneo. En 8 pacientes (18 por ciento) se indicó radiofrecuencia por segunda vez. Supervivencia actuarial global: 28 por ciento a los 4 años. Conclusiones: La radiofrecuencia es un procedimiento válido y seguro en pacientes seleccionados. Puede ser considerada un tratamiento alternativo en pacientes con imposibilidad o rechazo al tratamiento quirúrgico. En pacientes seleccionados la radiofrecuencia se puede indicar asociada a tratamiento quirúrgico resectivo (AU)

[Hemorrhagic acute abdomen due to rupture of splenic artery aneurysm. Tomography contribution in the diagnosis]. / Abdomen agudo hemorrágico por rotura de aneurisma de la arteria esplénica. La tomografía de abdomen en el diagnóstico.

Three new splenic artery aneurysm rupture cases are presented insisting on the usefulness of abdominal helicoidal computed tomography (AHCT) with intravenous contrast pump. The three patients presented were hospitalized showing acute abdomen associated with non-traumatic hypovolemic shock. In two of the three cases, abdominal computed tomography was used to arrive at the pre-surgical diagnosis. In one of them the abdominal computed tomography with intravenous contrast pump was used, which showed high specificity for the diagnosis, thus becoming a useful methodology whenever arteriography is not available.

The first stereoselective total synthesis of quinine.

The first entirely stereoselective total synthesis of (-)-quinine is reported.

Abdomen agudo hemorrágico por rotura de aneurisma de la arteria esplénica. La tomografía de abdomen en el diagnóstico. / [Hemorrhagic acute abdomen due to rupture of splenic artery aneurysm. Tomography contribution in the diagnosis]

Three new splenic artery aneurysm rupture cases are presented insisting on the usefulness of abdominal helicoidal computed tomography (AHCT) with intravenous contrast pump. The three patients presented were hospitalized showing acute abdomen associated with non-traumatic hypovolemic shock. In two of the three cases, abdominal computed tomography was used to arrive at the pre-surgical diagnosis. In one of them the abdominal computed tomography with intravenous contrast pump was used, which showed high specificity for the diagnosis, thus becoming a useful methodology whenever arteriography is not available.

[Organic synthesis]. / La synthèse organique.

Some comments on the problems that are encountered by organic chemists who attempt the total synthesis of a molecule having several asymmetric centers. These difficulties explain the relatively slow progress of that branch of chemistry, although some of its successes merit being considered works of art.

Some contributions to regio and stereo control: from Cincholoipon and Cantharidin to the present.

A condensed review of some of the major original contributions of the author's research group to organic synthesis during more than half a century. The emphasis is on methodology, especially as it involves the control of regio- and stereochemistry. The application of these methods in the total synthesis of specific natural products in the author's laboratory is not discussed in extenso, but only by focusing on certain key steps which illustrate the application of the methods mentioned here. Methods discussed in this fashion are: cationic polyene cyclizations; the enamine alkylation and acylation of ketones and aldehydes; the metalloenamine alkylation; the regiospecific formation and trapping of enolates, via electron addition or via conjugate addition of organometallic reagents to enones; regiospecific enolate formation-trapping from saturated ketones and from beta-alkoxy enones; the epoxynitrile and the allylic epoxynitrile cyclizations; the cyclization of olefinic diazoketones; the cyclization of alkynyl ketones; protected cyanohydrins as acylcarbanion equivalents; the vinyl radical cyclization; the control of regio- and stereochemistry via radical cyclization to temporary rings.

Highly polar metabolites of nitroaromatic compounds in ammunition wastewater.

Transformation processes of nitroaromatic compounds (NAC) are described that lead to polar and highly hydrophilic metabolites in ammunition waste water. For the identification of proposed metabolites, several analytical methods for the separation and determination of these compounds were developed and applied to the investigation of a former ammunition plant and its surroundings. The compound classes which were investigated include nitro and amino substituted toluenesulfonic acids, nitrobenzoic acids, aminobenzoic acids and nitromethylphenols. Method development was usually done with high performance liquid chromatography and ion pairing or ion suppression techniques. In the leachate water of a disposal site of a former ammunition plant in Stadtallendorf, Germany, 15 compounds from the above-mentioned categories have been found to be present in concentrations up to a few hundred microgram/L. The presence of so many polar compounds suggest that current and future surveying programs should include representative analytes of the investigated categories.

Gas chromatographic determination of aromatic amines in water samples after solid-phase extraction and derivatization with iodine. I. Derivatization.

A new method for the selective determination of aromatic amines is presented, which is based on the solid-phase extraction at pH 9 and subsequent derivatization of the analytes to the corresponding iodobenzenes. These can selectively and sensitively be determined with gas chromatography and electron-capture detection. Separation of at least 30 compounds in a single chromatographic run in 30 min is possible. With this method, 56 aromatic amines were investigated, and only in six cases no derivatives were obtained. Limits of quantitation were between 0.5 and 8 micrograms 1(-1), but may still be lowered with higher sample volumes or different injection techniques. The application to water samples revealed the suitability for the investigation of ground, leachate and wastewater.

Gas chromatographic determination of aromatic amines in water samples after solid-phase extraction and derivatization with iodine. II. Enrichment.

A procedure for the enrichment of aromatic amines via solid-phase extraction was developed. A HR-P phase based on styrene-divinylbenzene was used for the investigations, generally followed by derivatization with iodine and determination via GC-ECD. The recoveries of 53 aromatic amines in a drinking water matrix at pH 9 were determined. Most anilines showed relative recoveries between 80-120% with relative standard deviations of< or = 5% at concentration levels between 10 and 20 micrograms 1(-1). The comparison with a wastewater matrix led to similar results. The enrichment procedure was applied to real samples, e.g., samples of ammunition wastewater.

[Continuous intraoperative measurement of Na+, K+ and Ca++ with carrier membrane disc electrodes (author's transl)]. / Kontinuierliche intraoperative Messwertregistrierung von Na+, K+ und Ca++ mit Carrier-Membran-Disk-Elektroden.

The application of a two-channel flow-through analyzer with carrier membrane disc electrodes for the electrochemical analysis of heparinized blood, plasma or serum is described, its capabilities discussed and results of direct patient measurements presented.