Homogeneity in immune features between colorectal liver metastases better identifies patients with good prognosis compared to pathological response to preoperative chemotherapy.

In colorectal cancer liver metastases (CRLM), the density of tumor-infiltrating lymphocytes, the expression of class I major histocompatibility complex (MHC-I), and the pathological response to preoperative chemotherapy have been associated with oncological outcomes after complete resection. However, the prognostic significance of the heterogeneity of these features in patients with multiple CRLMs remains under investigation. We used a tissue microarray of 220 mismatch repair-gene proficient CRLMs resected in 97 patients followed prospectively to quantify CD3 T cells and MHC-I by immunohistochemistry.

Anomaly detection in microservice environments using distributed tracing data analysis and NLP.

In recent years DevOps and agile approaches like microservice architectures and Continuous Integration have become extremely popular given the increasing need for flexible and scalable solutions. However, several factors such as their distribution in the network, the use of different technologies, their short life, etc. make microservices prone to the occurrence of anomalous system behaviours.

Prognostic implications of adaptive immune features in MMR-proficient colorectal liver metastases classified by histopathological growth patterns.

Background: After resection, colorectal cancer liver metastases (CRLM) surrounded by a desmoplastic rim carry a better prognosis than the metastases replacing the adjacent liver. However, these histopathological growth patterns (HGPs) are insufficient to guide clinical decision-making. We explored whether the adaptive immune features of HGPs could refine prognostication.

Distributed Architecture for an Integrated Development Environment, Large Trace Analysis, and Visualization.

Integrated development environments (IDEs) provide many useful tools such as a code editor, a compiler, and a debugger for creating software. These tools are highly sophisticated, and their development requires a significant effort. Traditionally, an IDE supports different programming languages via plugins that are not usually reusable in other IDEs.

A Framework for Detecting System Performance Anomalies Using Tracing Data Analysis.

Advances in technology and computing power have led to the emergence of complex and large-scale software architectures in recent years. However, they are prone to performance anomalies due to various reasons, including software bugs, hardware failures, and resource contentions. Performance metrics represent the average load on the system and do not help discover the cause of the problem if abnormal behavior occurs during software execution.

Outcomes of Older Patients with Resectable Colorectal Liver Metastases Cancer (CRLM): Single Center Experience.

Surgery is the only potential curative option of CRLM if resectable. The curative approach in patients over 70 years old is challenging mainly because of comorbidities and other geriatric syndromes. Herein, we report outcomes of older patients with resectable CRLM in our center.

Prognostic value of CD73 expression in resected colorectal cancer liver metastasis.

Immune checkpoint blockade has not yet been effective in patients with mismatch repair proficient metastatic colorectal cancer. Targeting immunosuppressive metabolic pathways is being explored as a new immunotherapeutic approach. We assessed whether CD73, the rate limiting enzyme that catalyzes the degradation of extracellular AMP into immunosuppressive adenosine, could be an immunological determinant of colorectal liver metastases (CRLMs).

Portal vein embolization does not affect the long-term survival and risk of cancer recurrence among colorectal liver metastases patients: A prospective cohort study.

Background: Previous studies comparing the survival outcomes of liver resections with and without preoperative portal vein embolization (PVE) for colorectal liver metastases (CLM) have linked PVE to higher rate of tumor progression, lower overall survival (OS) and lower disease-free survival (DFS). The lack of adjusted models to compare these outcomes is a limitation of these studies since patients requiring PVE may differ significantly from the ones receiving upfront surgery.

Materials And Methods: Prospective cohort study of 128 patients undergoing CLM resection.

Development of a Predictive Model for Blood Transfusions and Bleeding During Liver Transplantation: An Observational Cohort Study.

Objective: Orthotopic liver transplantation (OLT) frequently is associated with major blood loss and considerable transfusion requirements. The goal of this study was to define the risk factors for multiple transfusions and major bleeding during OLT and to help identify higher risk patients that could benefit from targeted interventions.

Design: OLTs were studied for this observational cohort study.

Comparison of techniques for volumetric analysis of the future liver remnant: implications for major hepatic resections.

Objective: The purpose of this work was to compare measured and estimated volumetry prior to liver resection.

Methods: Data for consecutive patients submitted to major liver resection for colorectal liver metastases at two centres during 2004-2012 were reviewed. All patients underwent volumetric analysis to define the measured total liver volume (mTLV) and measured future liver remnant ratio (mR(FLR)).

Hepatic rupture in hemolysis, elevated liver enzymes, low platelets syndrome.

Objective: Rupture of hepatic hematoma associated with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is a catastrophic complication of pregnancy. Maternal and fetal mortality rates are still high despite advances in diagnosis and treatment. We aimed to present our experience at two referral centers for hepatic disease and to compare it with cases from the literature.

Is intra-operative ultrasound still useful for the detection of a hepatic tumour in the era of modern pre-operative imaging?

Background: The current role of intra-operative ultrasound (IOUS) is questioned because of recent progress in medical imaging. The aim of the present study was to determine the accuracy of IOUS in the detection of a hepatic tumour (HT) compared with a pre-operative multi-detector computed tomography (MDCT) scan and magnetic resonance imaging (MRI).

Methods: This retrospective study included 418 patients evaluated using an 8-slice MDCT scan (SCAN8), 64-slice MDCT scan (SCAN64) and MRI alone or combined with a computed tomography (CT) scan.

Evaluation of the addition of bupivacaine to intrathecal morphine and fentanyl for postoperative pain management in laparascopic liver resection.

Background: Optimal modality of pain management after liver resection has been controversial. Epidural analgesia is often avoided because of transient coagulopathy and the associated risk of epidural hematoma. Single-dose intrathecal morphine has been shown to be an effective alternative in open liver resection.

Long-lasting analgesic effects of intraoperative thoracic epidural with bupivacaine for liver resection.

Objectives: Continuous epidural analgesia may be considered in liver resection but is often avoided because of possible coagulopathies and the risk of epidural hematoma in the postoperative period. On the other hand, there is no coagulation defect during the surgery. Effective prevention of postoperative pain may require continuous sensory ablation throughout the surgery event.

Hypertrophy of the non-embolized liver after chemotherapy.

Background: Neoadjuvant chemotherapy (NC(+)) and portal vein embolization (PVE) enables curative resection in more patients with colorectal-liver metastases (CRLM). However, after NC(+), structural alterations have been reported with the risk of post-operative hepatic failure. We undertook to determine if NC(+) toxicity limits future remnant liver (FRL) hypertrophy after PVE.

MELD score and blood product requirements during liver transplantation: no link.

Background: Orthotopic liver transplantation has been traditionally associated with major blood loss and the need for allogenic blood product transfusions. In recent years, improvements in surgical and anesthetic techniques have greatly decreased the amount of blood products transfused. We have published a median of 0 for all intraoperative blood products transfused.

Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: a clue for pathogenesis.

Gastric antral vascular ectasia (GAVE) is a rare cause of chronic bleeding in cirrhotic patients. It has been suggested that these gastric lesions might be related to portal hypertension, hepatic insufficiency, or both parameters. We report two cases of cirrhotic patients in whom GAVE was the source of recurrent bleeding.

Helical CT with CT angiography in assessing periampullary neoplasms: identification of vascular invasion.

Purpose: To determine the accuracy of helical computed tomography (CT) with CT angiography in identifying vascular invasion by periampullary neoplasms and to assess the added value of CT angiography.

Materials And Methods: Sixty-nine patients suspected of having periampullary neoplasms were examined. Images from dual phase helical CT with CT angiography were compared with surgical findings in 36 patients.