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Positron emission tomography (PET) using F-18 fluoro-2-deoxy-d-glucose ( 18 F-FDG) is now well established as a noninvasive diagnostic tool for the detection of a variety of malignant tumors. However, in the case of hepatocellular carcinoma (HCC), several investigators have reported controversial conclusions and an inadequate sensitivity for PET (50-55%). Nevertheless, a high positive rate of 18 F-FDG accumulation has been reported in patients with high-grade HCC and in those with markedly elevated alpha-fetoprotein (AFP) levels. Here, we retrospectively reviewed 38 HCC cases that received liver transplantation (LT) at our center between November 2000 and July 2004 and underwent whole-body PET imaging.18 F-FDG uptake was assessed in the liver, and its prognostic significance was investigated. Of 38 patients enrolled, 13 patients had positive PET scans for a liver tumor. When we analyzed the association between tumor factors and PETϩ (greater PET lesion uptake) in the liver, preoperative AFP level and vascular invasion were found to be significantly associated with PETϩ (P ϭ 0.003 and P Ͻ 0.001, respectively). However, the association between histological grade and PETϩ findings did not reach statistical significant difference (P ϭ 0.074). Moreover, the 2-year recurrence-free survival rate of PETϪ patients was significantly higher than that of PETϩ patients (85.1% vs. 46.1%) (P ϭ 0.0005). Of 6 PETϩ patients who met the Milan criteria, 4 patients (66.7%) had recurrence, but all 20 PETϪ patients who met the Milan criteria were recurrence free. Thus, PET imaging could be a good preoperative tool for estimating the post-LT risk of tumor recurrence, because histological grade and vascular invasion cannot be determined preoperatively. Importantly, our results indicate that tumor recurrence can be highly anticipated for PETimaging-positive HCC patients who satisfy the Milan criteria. We advise that PETϩ HCC patients be selected cautiously for LT.

A donor right hepatectomy (RH) is associated with a higher rate of morbidity than a left hepatectomy. Therefore, the precise morbidity should be known to improve the success of donor RH implementation. However, the rate of complication varies according to the individual definition of morbidity. This study prospectively analyzed the outcomes of 83 consecutive living donor RHs between January 2002 and July 2004 using a standardized classification of the severity of complications. The morbidity was classified using the modified Clavien system: grade I for minor complications; grade II for potentially lifethreatening complications requiring pharmacological treatment; grade III for complications requiring invasive intervention; grade IV for complications causing organ dysfunction requiring intensive care unit management; and grade V complications resulting in the death of the patient. The donors were followed-up regularly for at least 12 months. No donor death or relaparotomy was noted. Overall, 65 out of 83 donors (78.3%) experienced postoperative complications: grades I, II, III, IV, and V complications in 64 (77.1%), 11 (13.3%), 1 (1.2%), 0, and 0 patients, respectively. The most common grade I complications were hyperbilirubinemia (n ϭ 31) and pleural effusion (n ϭ 31), and bile leakage in grade II (n ϭ 7). The bilirubin and alanine aminotransferase levels were normal in 92.7% of donors at the 1-year follow-up. In conclusion, although most of these adverse events were minor and self-limited, 78% of right liver donors still experienced morbidity. Therefore, continuous standardized reporting of the donor morbidity as well as meticulous surgery and intensive care are essential for the success of donor RH implementation. Liver Transpl 13: [797][798][799][800][801][802][803][804][805][806] 2007 See Editorial on Page 781Since the first case of living donor liver transplantation (LDLT) was reported in 1989, 1,2 many transplantation centers have performed LDLT due to the shortage of cadaveric donors. 3 LDLT is now common practice in many transplantation centers worldwide and achieves results comparable to those of deceased donor liver transplantation. However, the donor morbidity and size mismatch are a major obstacle to the expansion of LDLT to adult recipients. 4 The transplantation of the right liver from a living donor was demonstrated to be technically feasible in the mid-1990s. A right liver graft has been used in many centers to meet the metabolic demands of large recipients. Despite the rapid implementation of this procedure, analysis of the outcome of the right liver donor is still incomplete.There were extensive ethical discussions when right liver LDLT was first performed, because a right liver LDLT involves the most complicated and technically demanding surgical procedure. In the worldwide reports of LDLT, the rate of complication from a right liver donor was approximately 31%, ranging widely from 0% and 67%, depending on the individual definition and recognition of morbidity. [5][6][7][8] The latest results...

Many branch duct IPMNs are malignant. Surgical treatment is recommended, except in cases that are strongly suspected to be benign or cases that present a high operative risk. Observation is only recommended in patients with a tumor size of

We report the first unambiguous ferroelectric properties of ultra-thin-walled Pb(Zr,Ti)O 3 (PZT) nanotube arrays, each with 5 nm thick walls and outer diameters of 50 nm. Ferroelectric switching behavior with well-saturated hysteresis loops is observed in these ferroelectric PZT nanotubes with P r and E c values of about 1.5 microC cm (-2) and 86 kV cm (-1), respectively, for a maximum applied electric field of 400 kV cm (-1). These PZT nanotube arrays (10 (12) nanotubes cm (-2)) might provide a competitive approach toward the development of three-dimensional capacitors for the terabyte ferroelectric random access memory.