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Background: Hydatid cyst is a zoonotic disease caused by Echinococcus genera. Surgery is needed in most cases. We aimed to describe our center's experience in the surgical management of hepatic hydated cysts (HHC)., Methods: Data was retrospectively collected for patients who underwent operative management for HHC between the years 1994-2014., Results: Sixty-nine underwent surgical treatment for HHC. Group A included 34 treated with an unroofing procedure, group B included 24 patients who underwent hepatectomy and group C included 11 patients who underwent peri-cystectomy. The median ± (range) age for groups A, B and C were 39.5 (6.5-69), 40 (17-74) and 32 (20-62), respectively (P > 0.1). Post-operative complications occurred in 16, 11 and 5 patients in group A, B and C, respectively, as assessed by clavien-dindo classification (CDC). The average CDC was significantly higher in the hepatectomy group as compared to the unroofing group (2.3 vs.1.5, P = 0.04). Recurrence was significantly higher after the unroofing procedure as compared to the hepatectomy group (P = 0.05)., Conclusion: Surgery remains the mainstay of treatment for HHC, once surgery is pursued, the results are satisfactory., (Copyright © 2018. Published by Elsevier Taiwan LLC.)

Background: Temozolomide (TMZ) is an alkylating agent used for treatment of brain neoplasms and levetiracetam (LEV) is a commonly used antiepileptic. When administered separately each medication has few negative side effects impacting the liver., Aims: We sought to determine the risk of liver injury associated with the co-administration of TMZ and LEV., Methods: A case-control study was performed comparing patients who received combination therapy of TMZ and LEV (group A) with matched controls (group B) who received monotherapy with one of either TMZ or LEV. We assessed patient demographics, laboratory results including presence of liver injury, and mortality., Results: Twenty-six patients were included in group A and 68 patients were included in group B. Both groups were similar with respect to demographics and baseline liver function tests (P>0.05). There was a significant elevation in liver enzymes in 73%, 46%, 19%, 31% and 27% of ALT, AST, ALK-P, GGT and bilirubin, respectively, in group A, as compared to elevations of 10.3%, 19%, 1.5%, 7% and 1.5%, respectively in group B (P<0.05). One patient in group A died as a result of acute liver failure while no deaths from acute liver failure occurred in group B (P=0.05). Univariate analysis identified combination therapy as a risk factor for liver injury. Multivariate regression showed that only co-treatment with TMZ and LEV was an independent risk factor for liver injury with an odds ratio of 19.1 (95 CI, 2.16-160)., Conclusions: Combination therapy with TMZ and LEV may precipitate acute liver injury and even death., (Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Background: The incidence of coronary artery bypass graft surgery (CABG) performed in elderly patients has been increasing over recent years. We sought to evaluate clinical outcomes of octogenarians undergoing CABG using an audited state-wide mandatory database., Methods: New York State Department of Health's Cardiac Reporting System was analyzed from 1998 to 2002. In all, 88,154 patients undergoing isolated CABG were identified. Patients were divided into four age groups: less than 50 years (group 1, n = 6,527), 50 to 64 years (group 2, n = 30,088), 65 to 79 years (group 3, n = 43,369), and 80 years and above (group 4, n = 8,170)., Results: Of all patients, 9.3% were octogenarians. In addition to marginally worse coronary artery disease, octogenarians generally manifested a higher incidence of preoperative risk factors such as cerebrovascular disease, peripheral vascular disease, and congestive heart failure compared with younger patients at baseline. Both length of hospital stay and in-hospital mortality rate were significantly higher among octogenarians. The incidence of postoperative complications was higher among octogenarians. Multivariate analysis demonstrated renal failure requiring dialysis (odds ratio [OR] = 4.4), myocardial infarction within 6 hours before surgery (OR = 3.6), chronic obstructive pulmonary disease (OR = 1.7), congestive heart failure at admission (OR = 1.7), emergent operation (OR = 1.6), Canadian Cardiovascular Society functional class IV (OR = 1.5), hypertension (OR = 1.4), and low ejection fraction (OR = 0.98) to be significant independent predictors of in-hospital mortality of octogenarians. Discharge to home rates were significantly lower for octogenarians., Conclusions: Although early outcomes in octogenarians are acceptable, these factors alone are not sufficient to reflect overall success of CABG in these patients, given the strikingly lower discharge to home rates. Attention to full functional recovery in octogenarians is essential.

An improved method for the partial chemical synthesis of unsaturated and radioactively labeled phosphatidylcholines is described. This procedure offers advantages over conventional acylation methods in that it can be carried out on a millimole or micromole scale under mild conditions and it does not require a large excess of the fatty acid acylating reagent. In this procedure sn-glycero-3-phosphorylcholine is reacted with twice the theoretical amount of fatty acid imidazolide and sodium methylsulfinylmethide in dimethylsulfoxide for several minutes at 17 degrees C. Phosphatidylcholine, which was purified by gradient-elution chromatography on silicic acid, was isolated in 60% yield and was estimated to be about 99% pure. The preparations of 1,2-dioleoyl-, 1,2-dilinoleoyl-, and 1,2-dilinolenoyl-sn-glycero-3-phosphorylcholine are described. The reaction was also carried out on a small scale for the preparation of high specific activity 1,2-di[ 1'(-14)C]oleoyl-sn-glycero-3-phosphorylcholine in 38% yield with a specific activity of about 9.7 muCi/mumol.

Preparation of methyl phytanate from phytol by catalytic hydrogenation and chromic oxide oxidation is described. The method was applied to the preparation of methyl phytanate-(14)C.

The polyunsaturated wax esters which occur in an oil droplet in Calanus helgolandicus apparently serve as a short term reserve metabolic fuel. The lipids of the copepods were labeled by feeding them (14)C-labeled diatoms, Skeletonema costatum, after which starvation and turnover experiments were carried out. During starvation both wax esters and triglycerides are largely depleted within 72 hr, whereas cholesterol and phospholipid decreased at much slower rates.