In modern surgical and transplantation procedures the recognition of anatomic vascular abnormalities of the hepatic arteries is of greater importance than ever. The purpose of this study was to evaluate and classify these variations with respect to their impact on visceral surgery. A total of 604 selective celiac and superior mesenteric angiographies performed on patients with known or suspected liver cirrhosis or hepatic or pancreatic malignancies and on donors of partial liver grafts were analyzed retrospectively. The vascular anatomy of the liver was classified according to different established systems and with particular attention to rare variations. Hepatic arterial anatomy as considered normal in textbook descriptions was found in 79.1%, an aberrant or accessory left hepatic artery (LHA) arising from the left gastric artery in 3.0% and an aberrant or accessory right hepatic artery (RHA) branching off the superior mesenteric artery in 11.9% of the cases. In 1.4% of the cases there was a combination of anomalies of both the LHA and RHA. Variants of the celiac trunk, double hepatic arteries branching at the celiac trunk or hepatic arteries arising directly from the aorta, occurred in 4.1% of the cases. Further atypical branches of the LHA and RHA were found in 0.5% of the cases. Since the incidence and pattern of different types of hepatic arterial anatomy can require specialized preoperative diagnostic as well as intraoperative strategies, knowledge of these abnormalities and their frequency is of major importance for the surgeon as well as the radiologist.

Aims. We describe the design, construction, and characterization of the Band 9 heterodyne receivers (600-720 GHz) for the Atacama Large Millimeter/submillimeter Array (ALMA). First-light Band 9 data, obtained during ALMA commissioning and science verification phases, are presented as well. Methods. The ALMA Band 9 receiver units (so-called "cartridges"), which are installed in the telescope's front end, have been designed to detect and down-convert two orthogonal linear polarization components of the light collected by the ALMA antennas. The light entering the front end is refocused with a compact arrangement of mirrors, which is fully contained within the cartridge. The arrangement contains a grid to separate the polarizations and two beam splitters to combine each resulting beam with a local oscillator signal. The combined beams are fed into independent double-sideband mixers, each with a corrugated feedhorn coupling the radiation by way of a waveguide with backshort cavity into an impedance-tuned superconductor-insulator-superconductor (SIS) junction that performs the heterodyne down-conversion. Finally, the generated intermediate frequency (IF) signals are amplified by cryogenic and room-temperature HEMT amplifiers and exported to the telescope's IF back end for further processing and, finally, correlation. Results. The receivers have been constructed and tested in the laboratory and they show an excellent performance, complying with ALMA requirements. Performance statistics on all 73 Band 9 receivers are reported. Importantly, two different tunnel-barrier technologies (necessitating different tuning circuits) for the SIS junctions have been used, namely conventional AlO x barriers and the more recent high-current-density AlN barriers. On-sky characterization and tests of the performance of the Band 9 cartridges are presented using commissioning data. Continuum and line images of the low-mass protobinary IRAS 16293-2422 are presented which were obtained as part of the ALMA science verification program. An 8 GHz wide Band 9 spectrum extracted over a 0.3 × 0.3 region near source B, containing more than 100 emission lines, illustrates the quality of the data.

Radiologic placement of a totally implanted central VAP is a safe procedure with a low rate of both early and late device-related complications. The method is effective for delivery of chemotherapy, parenteral nutrition, and frequent IV medication.