ABSTRACT
BACKGROUND: Inadequate volume of future liver remnant (FLR) is a major challenge for hepatobiliary surgeons treating large or multiple liver tumors. As an alternative to associating liver partition and portal vein ligation (ALPPS) for staged hepatectomy and liver venous deprivation (LVD) using stage 1 interventional radiology for vascular embolization combined with stage 2 open liver resection have been used. CASE SUMMARY: A novel modified LVD technique was performed in a patient with pancreatic neuroendocrine tumor with liver metastases by using stage 1 laparoscopic ligation of the right hepatic vein, right posterior portal vein, and short hepatic veins combined with local excision of three liver metastases in the left hemiliver. The operation was followed three days later by interventional radiology to embolize an anomalous right anterior portal vein to complete LVD. A stage 2 laparoscopic right hemihepatectomy and pancreaticosplenectomy were then carried out. CONCLUSION: The minimally invasive technique promoted a rapid increase, comparable to ALPPS, in volume of the FLR after the stage 1 operation to allow the laparoscopic stage 2 resection to be performed.
ABSTRACT
The Raman spectra of PolyA, PolyU and their double-stranded complex were measured, and the spectral changes upon the formation of double-stranded complex were studied. The experimental results show: (1) Under the experimental conditions used in the present work (0.14 mol x L(-1) NaCl, 1 mmol x L(-1) Tris solution, neutral pH and 15 degrees C), PolyU, PolyA and PolyA x PolyU occur as random-coiled, A-single-stranded helical and A-double-stranded helical conformations, respectively. One of the main spectral differences between the latter two conformations and the former one is the Raman band near 814 cm(-1) of ordered structures. Another difference is in the full width at half the maximum (i.e. FWHM) of the band near 1100 cm(-1). The FWHM of the band 1100 cm(-1) of PolyA is the same as that of PolyA x PolyU, while the band of PolyU shows remarkable broadening. In addition, we found that the conformation of PolyA is somewhat not so ordered as that of its duplex, which can be concluded from the value of I814/I1100 of the two polynucleotides. (2) The formation of duplex makes base-base stacking interactions much stronger, and the conformation of the backbone more ordered, which leads to obvious Raman hypochromic effect with some corresponding band shift. In this process, PolyU underwent more significant spectral changes than PolyA. As spectral markers, these results can be of great importance in Raman spectral signal detection of gene-chips.
