Large intersubject variability in the neurobiologie effects of aging has been noted by several investigators.44,45 These reports, individually limited by small sample sizes, suggest, that aging effects on brain function are likely highly variable, affected by structural brain changes and systemic factors, and may differ between “successful aging” and individuals with substantial medical burden. Alterations in SB939 cell line neurotransmitter systems The functional integrity of several neurotransmitter systems is

altered by the aging process. Characterizing the profile of normal aging changes in neurotransmittcrmediated synaptic processes is the foundation upon Inhibitors,research,lifescience,medical which we will come to decipher the biological basis of behavioral and mood alterations accompanying aging. Further, the potential interaction between age effects and neurochemical

disturbances associated with neuropsychiatrie disease states may influence the susceptibility of the elderly to certain neurobehavioral disorders. Our knowledge of the effect of age on neuroreceptor function is primarily Inhibitors,research,lifescience,medical inferred by postmortem studies, with limited and variable regional sampling of the brain, and by animal models, which may not Inhibitors,research,lifescience,medical appropriately represent, human brain aging. In contrast to studies of pathological changes in aging, there are many problems associated with the biochemical study of neurotransmission in humans. These include the effects of postmortem delay, hypoxia, and drug treatment, as well as the fundamental point that the material is removed most often removed following a terminal illness, which may itself influence neurotransmission regardless of the age at which the patient died. Inhibitors,research,lifescience,medical ‘ITtic reader is referred to a comprehensive review

of the subject, Inhibitors,research,lifescience,medical by DeKosky and Palmer.46 With the development of highly selective radioligands for neuroreceptors, transporters, and other markers of neuronal function, it is possible to study the effects of aging and disease on brain neurotransmitter systems in vivo with PET. This approach permits whole-brain quantitative imaging in well-characterized subjects, with the potential for obtaining longitudinal measures. Such work has demonstrated specific aging reductions in dopamine and serotonin (5-hydroxytryptamine [5-HT]) receptor subtypes (Figure 1).47-50 Interestingly, there is evidence that some neuroreceptors SB-3CT actually increase in density with age, a finding of note in the opiate system.51 PET techniques are desirable relative to neuroendocrine challenge studies, which lack spatial localizing information and physiologic specificity. However, the combination of PET with neuropharmacologic probes is a powerful technique for localizing and quantifying neurotransmitter-mediated function in aging and disease. Figure 1. [18F]Altanserin positron emission tomography (PET) imaging of the 5-hydroxytryptamine (serotonin) type-2A receptor (5-HT2A). Left.

Angiotensin converting enzyme

inhibitors should be avoided in the second and third trimester but are safe to use postpartum. Beta-blockers can be used when not contraindicated during pregnancy, and they can be used postpartum. During pregnancy, β-1 selective agents are preferred because β-2 receptor blockade may have an antitocolytic effect. Inotropic agents should be used in patients with signs of low cardiac output or with persistent congestion despite diuretics/afterload-reducing agents. Anticoagulation is recommended in patients with PPCM as these patients have a high incidence of LV thrombus, Inhibitors,research,lifescience,medical especially patients with an LVEF <35%. Heparin (unfractionated and low-molecular-weight) is favored in pregnancy since, unlike warfarin, it doesn’t cross the placenta. Warfarin should Inhibitors,research,lifescience,medical be avoided as it is teratogenic in early pregnancy and has a risk of causing fetal cerebral hemorrhage in the second and third trimester. After delivery, PPCM should be treated according to current guidelines for heart failure.22 Specific Experimental Treatment Strategies Awaiting Further Validation Immunosuppressive agents: The prevalence of myocarditis in PPCM varies from 9–78%.32, 33 A single nonrandomized study

suggested that immunosuppression Inhibitors,research,lifescience,medical may benefit women with biopsy-proven myocarditis.34 However, the Myocarditis Treatment Trial did not show any benefit of immunosuppressive medications Inhibitors,research,lifescience,medical and, given the risks of immunosuppressive therapy, they are currently not widely utilized.33, 35 Intravenous immune globulin (IVIG): The

role of IVIG in PPCM was evaluated in a retrospective study of six women treated with IVIG and 11 controls treated conventionally.36 After a 6-month follow-up, the absolute increase in LVEF was greater in those treated with IVIG compared to controls Inhibitors,research,lifescience,medical (26% vs. 13%). However, the IMAC trial (Controlled Trial of Intravenous Immune Globulin in Recent-Onset Dilated Cardiomyopathy) showed that despite the potential therapeutic efficacy suggested by previous uncontrolled studies, immune globulin treatment of adult patients with recent-onset http://www.selleckchem.com/products/Adrucil(Fluorouracil).html Cardiomyopathy in this placebo-controlled trial did not affect improvements in LVEF or functional capacity during follow-up.36 Bromocriptine: This treatment strategy is based on an experimental observation of preventing Sodium butyrate PPCM in mice via prolactin blockade with bromocriptine.11 In a randomized open-label study performed in South Africa, 20 women with newly diagnosed PPCM were randomly assigned to receive either standard care plus bromocriptine or standard care alone.37 The 10 women receiving bromocriptine demonstrated significantly greater improvement in LVEF compared to the 10 women receiving standard care only (27% to 58% vs. 27% to 36%). One patient in the bromocriptine group died compared to four in the standard care group.

44 The gene for catecholamine O-methyltransferase (COMT) codes for one of the major enzymes catalyzing the metabolism of dopamine. It has been mapped to chromosomal region 22q11, and contains a functional polymorphism (Val158Met) that results in two common variants of the enzyme

(Val and Met) corresponding to high and low dopamine catabolism, respectively The COMT gene has been examined several times for an Cyclosporin A datasheet association with schizophrenia. Although not conclusive, family-based association studies and case-control studies do support the claim that variability Inhibitors,research,lifescience,medical of this gene could constitute a risk factor for schizophrenia, specifically the Val allele.45 Studies of healthy individuals, and schizophrenia patients have further demonstrated that the Inhibitors,research,lifescience,medical COMT genotype is related in an allele dosage fashion to performance on tests of working memory and executive functions, with more Met alleles associated with better performance.46-48 Egan et al46 also examined the effect of COMT genotype on prefrontal physiology during a working memory task using functional magnetic resonance imaging (MRI) . Met allele load consistently predicted a more efficient physiological response in prefrontal cortex. Thus, according to these results, the high levels of dopamine

Inhibitors,research,lifescience,medical in individuals with the Met/Met genotype enhance prefrontal function and Inhibitors,research,lifescience,medical therefore cognitive performance, and are also associated with lower risk for psychosis (Figure 2). Figure 2. Schematic representation of the putative

effect of a schizophrenia susceptibility gene (COMT) on neurotransmission and the relationship with cognition and psychosis. COMT polymorphisms effect dopamine regulation in the frontal lobes, through which Inhibitors,research,lifescience,medical cognitive … Conclusion The evidence reviewed in this paper strongly supports the view that cognitive deficits are a risk factor for schizophrenia and other psychotic disorders. Cognitive deficit is a stable, “trait-like” condition, independent of psychotic symptoms and mostly unaffected by antipsychotic treatments. In some patients, it is evident many years before psychotic symptoms are expressed and, after the onset of psychotic symptoms, cognitive deficits are present in the large majority of patients. Future studies of the genetic basis of specific cognitive functions and the association between Adenylyl cyclase genes, cognition, and brain processes will undoubtedly help better understand the role of cognition in the development of psychotic illness.
Historically, pioneers of the concept of schizophrenia were more convinced of the evidence for hereditary than environmental causes for the disorder. In considering disease causation, Bleuler wrote “Schizophrenia appears to be independent of external conditions and circumstances.”1 Kraepelin also emphasized the importance of inheritance, but did consider that “…

Hence, only the coding region is actually translated into protein. Of the alternate exon 1 sequences identified, four correspond to exon 1 sequences previously identified in mouse, exons 11,15, 19, and 110 84,85 Most alternative exons are located in a 3-kb CpG island upstream of exon 2 that exhibits substantial promoter activity in transfected cells (Figure 2). Ribonuclease protection assays demonstrate significant levels of six alternative exon 1 sequences in vivo in the

rat, with differential expression in the liver, hippocampus, and thymus presumably reflecting tissue-specific differences in promoter activity. The different promoters respond to different signals, Inhibitors,research,lifescience,medical which Inhibitors,research,lifescience,medical forms the basis for tissue-specific laterations in gene expression. Simply put, it is the process by which environmental or hormonal signals can alter GR expression in one region of the body, without affecting expression in another. Hippocampal RNA contains significant levels of the exon 17-containing GR mRNA variants expressed at undetectable levels in liver and thymus. These studies thus identify a brain-specific GR Inhibitors,research,lifescience,medical promoter, the exon 17 sequence. Figure 2.

Map of the noncoding exon 1 region of the glucocorticoid receptor (GR) gene cloned from rat hippocampus.83 The sequence of the critical exon 17 region is provided below, highlighting the NGFIA (nerve growth factor-induced clone A) consensus sequence. … In transient transfection experiments, a construct

encoding the entire regulatory region of the GR gene, including eight of the alternate exon 1 sequences and the splice acceptor site within the intron 5′ of exon 2, Inhibitors,research,lifescience,medical was fused to a lucif erase reporter gene. The lucif Inhibitors,research,lifescience,medical erase gene is activated by the coupled promoters and its activity thus reflects the ability of the regulatory sites to activate gene transcription – hence the term reporter gene. Fusion to the socalled reporter gene permits a check details measure of the degree to which individual sequences can potentially influence gene expression. This alteration in activity results from various sequences originating at any point within the regulatory region and, we Sitaxentan presume, represents the sum of the activity of individual promoters on the genomic DNA fragment. In subsequent studies examining the potency of the individual promoters, we found that the relative activity of the individual exon 1 sequences is similar, with one notable exception, the exon 17 promoter sequence. The fused exon 17 has the highest transcriptional activity of any single promoter construct. More recent studies confirm the transactivational effect of NGFIA at the exon 17sequence. We used a cotransfection model with human embryonic kidney (HEK) cells (intentionally aiming as far from the neural target as possible) with an NGFIA expression vector and an exon 17-luciferase construct.

The client is also given another

copy of the CGT handout to provide to a supportive person who will attend the third session. Session 3 Usually session 3 includes a supportive person such as a family member or close friend, either in person or, if necessary, by telephone. The rationales for including a supportive person are that individuals experiencing complicated grief often lose a sense of connection with others, which the treatment aims to help restore; an outside perspective on the client and the way that grief is affecting his or her life can be helpful for the therapist; and a friend or family member can facilitate the treatment by understanding what the client is doing and why, and Inhibitors,research,lifescience,medical providing support throughout the process, which

is often difficult and painful. During the session, Inhibitors,research,lifescience,medical this individual is asked to describe the client since the death, his or her reactions to grief, and any avoided situations or activities. The therapist then provides an overview of the CG model and treatment to the support person. The client and support person discuss ways in which the latter can Inhibitors,research,lifescience,medical be helpful as the client progresses through the treatment. During the last 15 minutes or so, the client is seen alone to review the grief monitoring diary and provide an update on goal work. Session 4 The heart of CGT begins in this session, with the introduction of imaginal revisiting. Imaginal revisiting is a core element of CGT that in some ways resembles prolonged exposure, an empirically supported Inhibitors,research,lifescience,medical therapy for trauma and post-traumatic stress disorder (PTSD).57,58 In this technique, the client briefly (for approximately 5 minutes) visualizes and tells the story of when he or she became aware of the loved one’s death into a tape recorder and then debriefs with the therapist. The goal of the exercise is to help the client come to Inhibitors,research,lifescience,medical terms with the loss by processing it at an emotional level and integrating that emotional processing with the rational knowledge that the loved one has died. In the Nutlin 3 debriefing portion of the exercise, the client describes what he or she observed

while telling the story; the function of this discussion is to encourage the client to reflect on the story from the vantage point of the present. The client then participates in another visualization exercise in which the story Megestrol Acetate is put away. Finally, clients identify a reward they can give themselves for doing the hard, painful work of revisiting, both in session and during the assignment of listening to the tape every day between sessions. Other elements that continue throughout the treatment include the grief monitoring diary and restoration-oriented work to help the client move toward a personal goal that is unrelated to grief, in order to begin to visualize life with the capacity for joy and satisfaction without the loved one who died.

Epithelial markers such as CAM 5.2 are used to confirm the presence of an epithelioid variant of AS (70-72). There are no clear guidelines on the management of anorectal AS. We know from other sites that surgery and radiation therapy have an important role. For example, in a retrospective review of 67 patients with non-anorectal AS, Mark et al. showed a 5-year disease-free survival of 43% in patients who underwent surgery and radiation as opposed to 17% in patients who underwent surgery without radiation

Inhibitors,research,lifescience,medical (73). The role for chemotherapy on the other hand is still under investigation, with some response reported with Paclitaxel, Docetaxel, Doxorubicin and Inhibitors,research,lifescience,medical Daunorubicin (74). There are 12 cases of AS of the rectum reported in the literature and none of the anus (63-68,75-79). Among these, one had metastasis to bone and two had lymph node involvement at the time of diagnosis (66,67,76). Average age at presentation was 57 years (range, 30-79) and 75% of patients were women. Tumor size ranged between 2 and 16.5 cm (average: 5 cm). Eight patients underwent surgical excision: 6 radical resections (APR or anterior resection) and 2 local excisions. Of these, 6 also received adjuvant radiation therapy. Of the four non-surgical Inhibitors,research,lifescience,medical cases published, 2 were treated with radiotherapy and no treatment details

were provided for the remaining 2. Seven of these publications reported follow up data. The longest disease-free survival was 27 Azacitidine supplier months in a young patient treated by posterior exenteration followed by chemotherapy and radiation. Three patients were reported to have died of their disease, Inhibitors,research,lifescience,medical all within 8 months. Raising questions about the appropriateness of their preoperative staging (66,67,79). There are too few anorectal AS cases to support prognostic associations, however, a recent review of colon AS has shown that tumor size (>5 cm), node positivity and distant metastasis all correlated with poor prognosis (80). At the moment, two phase II trials are studying the use of bevacizumab with radiation Inhibitors,research,lifescience,medical in the treatment of AS (74). Although these trials do not

specifically target anorectal AS, it is hoped that positive findings would translate into easier treatment planning for over AS of the anus and rectum. Dermatofibrosarcoma protruberans Dermatofibrosarcoma protruberans (DFSP) is thought to arise as a result of the chromosomal translocation t[17;22] in 90% of cases. As a result, the COL1A1 gene fuses with a platelet derived growth factor (PDGF) gene in fibroblasts, leading to over production of PDGF, which is a growth stimulant, thinking it is a structural protein. Fibroblasts contain the receptor for PDGF and thus further stimulating release, growth and mitosis (81,82). DFSP has a 0.4% incidence of distant metastasis, but close to 25% local recurrence rate (83,84).

The latter probes are also capable to provide single-beat full-volume acquisition, as well as real-time 3D color Doppler imaging (Fig. 1). Fig. 1 Different acquisition modalities available with three-dimensional echocardiography: A: Zoom mode; it can acquired either single-beat (to encompass a specific region or structures like en-face valve display without the need of cropping) or PI3K inhibitor multi-beat to … 3DE is the only imaging technique based

on volumetric scanning able to show moving structures in the beating Inhibitors,research,lifescience,medical heart, in contrast to cardiac magnetic resonance (CMR) and computed tomography, which are based on post-acquisition 3D reconstruction from multiple tomographic images and displaying only 3D rendered snapshots. At present two different methods for 3D

data acquisition are available: “real-time” (or “live” 3D mode) and Inhibitors,research,lifescience,medical multi-beat 3D mode (Fig. 2). In the real-time mode, a thin sector of a pyramidal 3D volume data set is obtained and visualized live, beat after beat as during 2D scanning. Imaging is usually available in several fashions, as narrow volume, zoom, wide-angle (full-volume) and color-Doppler modalities. Heart dynamics is shown in a realistic Inhibitors,research,lifescience,medical way, with instantaneous Inhibitors,research,lifescience,medical on-line volume rendered reconstruction. It allows fast acquisition from a single acoustic view of dynamic pyramidal data

structures that can encompass the entire heart without the need of reference system, electrocardiogram (ECG) and respiratory gating. Real-time imaging is time-saving both for data acquisition and analysis. Although this acquisition mode overcomes rhythm disturbances or respiratory motion limitations, Inhibitors,research,lifescience,medical it still suffers of relatively poor temporal and spatial resolution. Fig. 2 Schematic representation of two-dimensional (i.e. tomographic; A) and single-beat three-dimensional (i.e. volumetric; B) of the left ventricular short-axis at mitral valve level. Volumetric rendering displays many more details Dipeptidyl peptidase and allow better appreciation … Conversely, multi-beat acquisition is realized through sequential acquisitions of narrow smaller volumes obtained from several ECG-gated consecutive heart cycles (from 2 to 6) that are subsequently stitched together to create a single volumetric data set. It provides large data sets with high temporal and spatial resolution, but more prone to artifacts due to patient or respiratory motion or irregular cardiac rhythms. The most appropriate acquisition mode for the specific clinical setting will be chosen in each individual case (Fig. 2).

The VEGF/VEGFR signaling is a well studied pro-angiogenic pathway and the ligands click here include VEGF-A, VEGF-B, VEGF-C, VEGF-D and placental growth factor (PIGF) that interact with membrane bound tyrosine kinase receptors VEGFR-1 (FLT-1), VEGFR-2 (FLK-1/KDR) and VEGFR-3 (FLT4); and other co-receptors include neurophilin (NRP)-1 and NRP-2 (16-18). The binding of VEGF-A (or VEGF) to VEGFR-2 had been found to be key mediator of angiogenesis (17). VEGF-A (commonly known as VEGF) is expressed in many human cancers and binding with VEGFR-2 in tumor microenvironment triggers a number of intracellular signaling cascades in endothelial cells leading to formation and enhancement

of tumor Inhibitors,research,lifescience,medical microvasculature (18,19). Bevacizumab

Bevacizumab is a recombinant humanized monoclonal IgG1 antibody that binds to and inhibits the biologic activity of VEGF by preventing its binding to VEGFR-1 and VEGFR-2 (Figure 1). The therapeutic role of bevacizumab in treating metastatic CRC patients is well established Inhibitors,research,lifescience,medical and supported by well-conducted randomized trials (7,8,20-22). Inhibitors,research,lifescience,medical These topics had been well reviewed in the literature and we refer readers to those articles (23,24). Recently, the benefit of continuing angiogenetic suppression beyond first disease progression in mCRC patients was confirmed recently by the ML18147 study. In this randomized phase III trial, bevacizumab beyond disease progression while switching the cytotoxic chemotherapy improved the Inhibitors,research,lifescience,medical PFS (5.7 vs. 4.1 months) and OS (11.2

vs. 9.8 months) in the group that continued bevacizumab compared to those who didn’t (25). Figure 1 Pro-angiogenic targets of bevacizumab, aflibercept and regorafenib. Bevacizumab binds to VEGF-A and interrupts the interaction with VEGFR-1 and -2. In addition to VEGF-1, aflibercept binds to and interrupts the function of VEGF-B Inhibitors,research,lifescience,medical and PlGF. Regorafenib … Despite benefit in metastatic setting, the addition of bevacizumab had not improved clinical outcome in adjuvant setting in CRC (26,27). The AVANT trial randomized curatively resected stage III or high risk stage II Thymidine kinase colon cancer to 3 arms: FOLFOX4 for 12 cycles, bevacizumab 5 mg/kg plus FOLFOX4 for 12 cycles or bevacizumab 7.5 mg/kg plus oxaliplatin and capecitabine (XELOX); both bevacizumab arm will receive additional bevacizumab 7.5 mg/kg monotherapy every 3 weeks for eight cycles after completing combination therapy. The hazard ratio (HR) for disease-free survival (DFS) and OS for bevacizumab-FOLFOX4 versus FOLFOX4 were 1.17 (95% CI: 0.98-1.39; P=0.07) and 1.27 (95% CI: 1.03-1.57; P=0.02) respectively; and for bevacizumab-XELOX versus FOLFOX4 was 1.07 (95% CI: 0.9-1.28; P=0.44) and 1.15 (95% CI: 0.93-1.42; P=0.21) respectively (27).

In cases where valve implantation is definitively “too high” and incompatible with an acceptable result, the valve can be repositioned into the ascending aorta. The primary goal is to ensure a safe area for the implantation of a second valve. As a result, the operator must reposition the first implanted valve high in the ascending aorta to

avoid jeopardizing the functioning of the second valve by (1) severely restricting second-valve expansion, and (2) potentially compromising coronary arterial flow by creating Inhibitors,research,lifescience,medical a long skirt — a potential consequence of two valves placed in continuation. Because the CoreValve prosthesis measures approximately 50-53 mm in height depending on valve size, a safe distance of >50 mm above the annulus level is optimal. Note that the “Lasso” technique for frame loop engagement to achieve higher repositioning of the valve has been previously described. In small Inhibitors,research,lifescience,medical anatomies, this technique may not be feasible due to lack of space in the ascending aorta that can nullify any axial force exerted through the frame loop. In such a case, the “goose-neck” Inhibitors,research,lifescience,medical catheter can be advanced through the struts of the frame towards the inflow aspect and “hooking” at that point. This allows for effective retrieval of the valve when pulling on the

“goose-neck” catheter. Finally, and again for additional selleck screening library safety, the first valve should be secured in the correct position high in the ascending aorta with the use of the “goose-neck”

catheter when a second valve is advanced through the first valve. Paravalvular Regurgitation Albeit not a true complication, AR grade ≥2 on a control angiogram or TEE is not rare (>20% of overall cases). Inhibitors,research,lifescience,medical This can occur for the following reasons: (1) Low implantation of the valve; (2) under-expansion of the frame in a severely calcified aortic valve; or (3) under-evaluation of annulus measurement. Severity of the AR should be evaluated carefully, Inhibitors,research,lifescience,medical but specific guidelines on how to quantify and classify the severity of paravalvular regurgitation in the context of TAVI are lacking. Minimum basic rules should be followed. Transesophageal echocardiography requires longer duration of the regurgitant signal, eccentricity of the jet, and extension of the jet signal deep into the left ventricular cavity. Aortography requires a minimum of 20 ml of contrast media injection, right anterior oblique projection, and position of the pigtail catheter slightly above the functioning portion SPTLC1 of the implanted valve for the angiogram to reflect an accurate AR evaluation. Despite adherence to these rules, different parameters can influence the degree of AR, such as blood pressure, heart rate, and LV dysfunction. Therefore, there is still the risk of underestimating the severity of the regurgitation at the time of implantation and having to face — during follow-up and under different hemodynamic conditions — a more severe AR.

Kim et al. (23) reported on their initial experience with 10 patients with colorectal cancer and synchronous liver metastases in order to assess the feasibility of a minimally invasive approach to synchronous disease. The primary tumors were resected via anterior or low anterior resection in eight patients, right hemicolectomy in one patient, and subtotal Inhibitors,research,lifescience,medical colectomy in one patient. Major hepatectomies were performed in six patients.

There were no perioperative deaths. One patient developed postoperative bleeding requiring open re-exploration. The authors concluded that a synchronous minimally invasive approach was feasible in selected patients with colorectal cancer and hepatic metastases. Akiyoshi (24) also published their results following synchronous laparoscopic resection in 10 patients. All primary tumors were located Inhibitors,research,lifescience,medical in the sigmoid or rectum. Seven of their patients had an open hepatic resection following their laparoscopic colorectal resection and three patients underwent

a minimally invasive resection for an isolated hepatic metastasis. There was no postoperative mortality and one patient developed a complication unrelated to the colorectal or hepatic resection. The open technique required for the hepatic resections limits the significance of this Inhibitors,research,lifescience,medical study but provides some insight into the safety of hybrid laparoscopic resections for synchronous colorectal cancer. Lee et al. (25) recently published their 10 patient series of laparoscopic simultaneous Inhibitors,research,lifescience,medical colorectal and hepatic resection. Primary tumors were right-sided in four patients, left-sided in three cases, and rectal in three cases. Six patients had single hepatic metastases while the other four patients had ≥2 hepatic metastases. One patient underwent a right hemihepatectomy while others underwent minor hepatic resections. One case required conversion to

an open approach due to bleeding from a hepatic Inhibitors,research,lifescience,medical vein and this patient also developed an anastomotic leak. There were no postoperative mortalities. This study provides additional limited support for a simultaneous minimally invasive approach for colorectal cancer with limited hepatic metastases. The largest study to date on simultaneous minimally invasive resection of colorectal cancer with hepatic metastases was published by Huh et al. (26). In their study, they VX-689 clinical trial compared 20 patients who underwent before laparoscopic colorectal resection with 20 patients who had an open approach. In all cases, after the colorectal was completed (either laparoscopically or open), hepatic resection was performed, either laparoscopically or via laparotomy. There were no differences between the laparoscopic and open colectomy groups with regard to the extent of hepatic disease. Minor hepatectomies were performed in 95% of the laparoscopic group and 75% of the open colectomy group.