Most cases of pancreatic ductal adenocarcinoma (PDAC) are lethal. Margin-negative surgical resection is a mainstay of treatment and the only chance of a cure. Differences in pathological reporting, surgical technique, definitions of resection margin, and group stratification all affect outcome analyses. Furthermore, there are controversial issues influencing the clinical interpretation of resection margin after pancreatectomy. There is no standardized definition of margin involvement in resected specimens of PDAC. The non-standardized pathologic approach explains the wide range of positive resection margin rates (13-71%) that have previously been reported. A standardized pathologic evaluation needs to be developed for proper assessment of resection margin after oncologic pancreatectomy. This manuscript reviews the current controversial issues in assessing resection margin in order to enhance understanding of the current status and potential role of pathological evaluation in patients with PDAC.

This was the earliest in a long series of examples that were to prove the versatility and generality of the phenomenon. Later, the concept of tautomerism was extended to comprise all types of rapidly and reversibly equilibrated transformations (see, for examples, refs. 2 and 3).Since these early days the tautomeric equilibria in solutions of /I-dicarbonyl compounds have been the subject of continuous interest. Various aspects of this subject have received extensive treatment in several review articles.'-The group of /3-dicarbonyls comprises compounds such as (a), (b), and (c).

Official statistics routinely underestimate mortality from specific microorganisms and deaths are assigned to non-specific syndromes. Here we estimate mortality attributed to specific pathogens by modelling non-specific infant deaths from laboratory reports and codes on death certificates for these pathogens, 1993-2000 in England and Wales using a generalized linear model. In total, 22.4-59.8% of non-specific deaths in infants (25-66 deaths a year) are attributable to specific pathogens. Yearly deaths from Bordetella pertussis in neonates are 6.8 [95% confidence interval (CI) 1.5-11.9]. In post-neonates 9.4 (95% CI 2.3-16.6) deaths a year are attributable to Neisseria meningitidis, 7.3 (95% CI 2.4-12.3) to Streptococcus pneumoniae, from 2.8 (95% CI 0.8-4.9) to 15.1 (95% CI 9.4-20.9) to respiratory syncytial virus (RSV) and 3 (95% CI 0.3-5.9) to parainfluenza type 2. Our results suggest there is substantial hidden mortality for a number of pathogens in infants. A considerable proportion of deaths classified to infectious syndromes are non-infectious, suggesting low specificity of death certification. Laboratory reports were the more reliable source, reinforcing the asset of strong surveillance systems.

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