Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma.

INTRODUCTION: Total pancreatectomy with en-bloc celiac axis resection (TP-CAR) and interposition graft placement between the aorta and the proper hepatic artery is a technically demanding, very uncommonly performed operation, even in high-volume pancreatic centers. PRESENTATION OF CASE: We present, in clinical and technical detail, a patient with locally advanced adenocarcinoma of the pancreatic body and neck involving the celiac and common hepatic arteries and portal vein, who underwent neoadjuvant chemotherapy and radiation with very good response, followed by TP-CAR and aorto-proper hepatic artery bypass using saphenous vein graft. The patient had an uneventful intraoperative and postoperative course, short hospital stay, and histology consistent with a curative resection. DISCUSSION: TP-CAR with common hepatic artery resection and proper hepatic artery reconstruction in patients with locally advanced pancreatic body cancer after appropriate neoadjuvant therapy can be performed safely and be potentially curative in centers with an established track record in advanced pancreatic surgery involving major peripancreatic vessels. CONCLUSION: TP-CAR with proper hepatic artery reconstruction is a rare but potentially curative operation for selected patients with otherwise unresectable pancreatic adenocarcinoma.

Cesium-137 monitoring using lichens from W. Macedonia, N. Greece.

(137)Cs content in lichens and substrate (soil, bark) collected from W. Macedonia, Greece was measured 20 years after the Chernobyl reactor accident. Archive material from previous collections was also used for comparison and a diachronic estimation of the radio-contamination status. A gradual decrease was detected which depended on various factors such as the collected species, location, growth rate and substrate. Maximum accumulation capacity of (137)Cs was observed in epilithic lichens in comparison to epigeic or epiphytic ones. Furthermore, foliose or crustose lichens such as Parmelia sulcata, Xanthoria parietina, Xanthoria calcicola, Xanthoparmelia somloensis were more contaminated than filamentose at the same biotope. Among filamentose or fruticose species those with large surface area to biomass ratio e.g. Usnea sp. showed also greater accumulation capacity. Autoradiography revealed an amount of (137)Cs distributed more or less uniformly in lichen thalli. The high (137)Cs activities found in lichens 20 years after Chernobyl suggest that these primitive plants are effective, suitable and inexpensive biological detectors of the distribution and burden of fallout radionuclide fallout pattern.

Cesium-137 monitoring using mosses from W. Macedonia, N. Greece.

(137)Cs activities in mosses and substrate (soil, bark) collected from W. Macedonia, Greece were measured 20 years after the Chernobyl reactor accident. Archive material from previous studies was also used for comparison and diachronic estimation of the radio-contamination status. A gradual decrease was detected which depended on various factors such as the collected species, location, growth rate and substrate. Maximum accumulation capacity of (137)Cs was observed in the epilithic mosses in comparison to the epiphytic ones. The (137)Cs content in the bark of the two broad-leaved species (oak and fagus) was higher than that of the conifer (pinus). Bark specimens of about 50 cm height were in general more contaminated than those of 200 cm. Autoradiography revealed an amount of (137)Cs distributed more or less uniformly in moss thalli. The high (137)Cs activities found in mosses 20 years after Chernobyl suggest that these primitive plants are effective, suitable and inexpensive biological detectors of the distribution and burden of radionuclide fallout pattern.