Despite the operative risk involved, we believe that pancreatic resection should be considered in selected patients with good performance status, stable disease and isolated pancreatic metastases.

No abstract

Pinot blanc is a leading grapevine variety in South Tyrol (Italy) for wine production. The high quality of its wines derives from a typical aroma of elegant apple notes and lively acidity. The typicity of the final wine depends on the origin of the vine, the soil, the oenological practices and time of harvest. The South Tyrolean mountainous areas meet the cold climatic requirements of Pinot blanc, which guarantee its sweet-acidic harmony obtained when organic acids are in balance with the other components of the wine. However, increasing temperatures in valley sites during the berry development period boost the activity of malic acid (MA) enzymes, which negatively affect the final sugar/acid ratio. Researchers are currently focused on understanding acid dynamics in wines, and there are no references for the best sugar/acid ratio for Pinot blanc. Moreover, the contribution of individual acids to the sensory profile of this wine has not yet been studied. In this study we address the effect of different climate conditions and site elevations on the sugar/acid ratio in developmental grapevine berries, and  we evaluate the effect on wine bouquet. Even if different models and indices have been proposed for predicting sugar content, no predictive models exist for MA in white grapes. In a three-year study (2017, 2018 and 2019) that involved eight vineyards in four different location in South Tyrol at various elevations ranging from 223 to 730 m a.s.l., the relationships between bioclimatic indices, such as growing-degree day (GDD) and grapevine sugar ripeness (GSR) and grapevine berry content were investigated. The analysis reveals that GDD may potentially predict MA dynamics in Pinot blanc; hence, a GDD-based model was used to determine the GDD to reach target MA concentrations (3.5, 3.0, 2.5, 2.0 g/L). This simple model was improved with additional temperature-based parameters by feature selection, and the best three advanced models were selected and evaluated by 5-fold cross-validation. These models could be used to support location and harvest date choice to produce high-quality Pinot blanc wines.

In an era of growing international competition in modern viticulture, the study and implementation of innovative technologies to increase the production of high-quality grapes and wines are of critical importance. In this study, the non-destructive portable sensor Multiplex, based on fluorescence sensing technique, was applied to evaluate grape maturity parameters and flavonol content of the understudied Pinot blanc variety. The effects of environmental and agronomical factors on flavonol content of Pinot blanc grapes were investigated in eight vineyards characterised by different microclimatic and agronomic conditions. Furthermore, the direct impact of canopy management treatment on the flavonol dynamics of the grapes oriented in the four cardinal directions was assessed. Results highlight the positive role of moderate temperatures and direct sunlight exposure on Pinot blanc flavonol content; however, no direct vineyard-elevation effect was observed. The ability to modulate and evaluate the flavonol content in field represent crucial factors because of their potential effect on flavonoids-dependent wine characteristics, such as stability and ageing. In the present study, for the first time, two calibration curves were reported for pre- and post-veraison periods between flavonol indices and the berry skin flavonol content and a good correlation was observed between Multiplex measurement and the total polyphenolic content of grape juice. Moreover, the strong correlation between the chlorophyll index with grape juice sugar content and titratable acidity revealed the practical application of non-destructive sensors to predict the optimal harvest time for Pinot blanc grapes. In conclusion, the non-destructive fluorescence sensor Multiplex is a high-potential tool for innovative viticulture, for evaluating grape skin composition variables in white grape varieties.

The opportunities offered by the Internet are employed increasingly in medicine. To obtain data on the extent to which the Internet is used by hand surgeons, survey forms were sent to 1043 participants of the Congress of the IFSSH in Vancouver in 1998. Ninety-four per cent of the respondents use the Internet. Most of the participants use the World Wide Web for literature searches, information on events and to read scientific articles. E-mail is used for general and scientific communication with colleagues and also for transmission of patient-related data. Perceived apprehensions include secure transmission of sensitive data, slow data transmission, and the lack of structure and of an authority to control the contents of the Internet. Virtual congresses and a newsgroup on hand surgery seem to be worthwhile future goals. Some problems pointed out in this survey have already been solved, at least partially, and possible solutions for the rest are discussed.