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1.
Background: A major mechanism underlying warm ischemia/reperfusion (I/R) injury during liver transplantation is the activation of the caspase chain, which leads to apoptosis. Recently, it was demonstrated that the release of cathepsin B, a cysteine protease, from the cytosol in liver injury induces mitochondrial release of cytochrome c and the activation of caspase-3 and -9, thereby leading to apoptosis. The aim of this study was to ascertain if cathepsin B inactivation attenuates the apoptotic injury due to I/R in mouse liver. Methods: A model of segmental (70%) hepatic ischemia was used. Eighteen mice were anesthetized and randomly divided into three groups: (1) Control group: sham operation (laparotomy); (2) Ischemic group: midline laparotomy followed by occlusion of all structures in the portal triad to the left and median lobes for 60 min (ischemic period); (3) Study group: like group 2, but with intraperitoneal administration of a pharmacological inhibitor of cathepsin B (4 mg/100 g) 30 min before induction of ischemia. Serum liver enzyme levels were measured by biochemical analysis, and intrahepatic caspase-3 activity was measured by fluorometric assay; apoptotic cells were identified by morphological criteria, the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) fluorometric assay, and immunohistochemistry for caspase-3. Results: Showed that at 6 h of reperfusion, there was a statistically significant reduction in liver enzyme levels in the animals pretreated with cathepsin B inhibitor (p < 0.05). On fluorometric assay, caspase-3 activity was significantly decreased in group 3 compared to group 2 (p < 0.0001). The reduction in postischemic apoptotic hepatic injury in the cathepsin B inhibitor -treated group was confirmed morphologically, by the significantly fewer apoptotic hepatocyte cells detected (p < 0.05); immunohistochemically, by the significantly weaker activation of caspase-3 compared to the ischemic group (p < 0.05); and by the TUNEL assay (p < 0.05). Conclusion: The administration of cathepsin B inhibitor before induction of ischemia can attenuate postischemic hepatocyte apoptosis and thereby minimize liver damage. Apoptotic hepatic injury seems to be mediated through caspase-3 activity. These findings have important implications for the potential use of cathepsin B inhibitors in I/R injury during liver transplantation.  相似文献   

2.
After parenchymal loss, the liver regenerates restoring normal mass and metabolic function. Prevailing theories on triggering events leading to regeneration include humoral, metabolic, and flow-mediated mechanisms, the latter emphasizing the importance of shear stress mediated nitric oxide regulation. We aimed to investigate whether the grade of resection and hence the portal venous pressure and sinusoidal shear stress increase would be reflected in the gene expression profiles in the liver remnant by using a global porcine cDNA microarray chip with approximately 23,000 genes represented. Six pig livers were resected with 62% (low portal pressure resection) and 75% (high portal pressure resection), resulting in a portal venous pressure increase from a baseline of 6.1-8.2 and 12 mmHg, respectively. By sampling consecutive biopsies from the liver remnants, we found differentially expressed genes in the high portal pressure resection group to have functions related primarily to apoptosis, nitric oxide metabolism and oxidative stress, whereas differentially expressed genes in the low portal pressure resection group potentially regulate the cell cycle. Common to both groups was the upregulation of genes regulating inflammation, transport, cell proliferation, development, and protein metabolism. Also common to both groups was both up- and downregulation of genes regulating cell-cell signaling, signal transduction, cell adhesion, and translation. Genes regulating the metabolism of lipids, hormones, amines, and alcohol were downregulated in both groups. In conclusion, the genetic regenerative response in the liver remnant to varies according to the level of resection.  相似文献   

3.
摘要 目的:探讨不同比例输血策略对创伤-失血性休克大鼠的凝血指标、血浆代谢指标影响及作用机制。方法:选择Sprague- Dawley大鼠24只,制备创伤-失血性休克动物模型,采用血气分析仪检测凝血指标(PT及ATPP)血气分析指标(包括pH、PO2、PCO2、乳酸),采用比色法检测常见代谢酶活性,采用PCR法检测mRNA含量,记录并对比目标血压为80 mmHg时B、C、D三组大鼠的输血量。结果:与A组大鼠相比,B、D组大鼠的ATPP、PT水平明显较高(P<0.05),A组与C组间对比无统计学意义(P>0.05);与B组大鼠相比,D组大鼠的ATPP、PT水平明显较低(P<0.05)。与A组相比,B、C、D组大鼠的pH、PO2水平明显降低、PCO2及乳酸水平明显升高对比(P>0.05);与B组大鼠相比,C、D组大鼠的pH、PO2明较高,PCO2、乳酸明显较低(P<0.05);C、D组间对比无统计学意义(P>0.05)。四组大鼠的血浆肌酸激酶、天门冬氨酸基转移酶、碱性磷酸酶、丙氨酸氨基转移酶活动水平对比无统计学意义(P>0.05)。与A组相比,B、D组大鼠的血浆miR-24水平明显较高,肝脏FX mRNA水平明显较低(P<0.05),C组大鼠的血浆miR-24与肝脏FX mRNA与A组对比无统计学意义(P>0.05);与B组相比,D组大鼠的血浆miR-24水平明显较低,肝脏FX mRNA水平明显较高(P<0.05)。达到目标血压为80 mmHg时,输血量B组>C组>D组(F=133.139,P<0.001)。结论:新鲜冰冻血浆:红细胞比为1:1的输血策略较1:2.5的输血策略对创伤-失血性休克大鼠的复苏效果更好,可能与其降低大鼠的循环miR-24水平,提高肝脏FX mRNA水平表达有关。  相似文献   

4.

Background

It is observed that combined liver and colon surgery especially when this includes major liver resection with Pringle maneuver (PM) performance does not have a favorable outcome. Aim of our experimental study is to investigate the impact of portal triad occlusion on the large bowel and intra-abdominal inflammation and potent protective effects of the variants of (PM) in the combined surgical cases.

Materials and Methods

Forty-four rats were divided into four groups. In group A (control group), 1cm of the left partial colon was resected and then an end-to-end anastomosis was performed. In group B, a continuous PM for 30 minutes was performed followed by resection of 1cm of the left colon and an end-to-end anastomosis. In group C, the left colonic resection and anastomosis was performed after intermittent PM (IPM), which was 10 minutes PM followed by 5 minutes reperfusion repeated for three circles. In group D, an ischemic preconditioning for 10 minutes was initially performed followed by 5 minutes reperfusion and then continuous PM for 30 minutes. Finally the rats in group D underwent a 1cm left colonic resection and an end-to-end anastomosis.

Results

The percentage of colitis was higher in the B group (P = 0,19). The percentage of inflammation was not significantly higher even when we compared all “occlusion” groups (B+C+D) with the sham group. No evidence of pancreatitis was found in the sham group whereas amylase and lipase levels were higher in Groups B, C and D together (P = 0,0267). The comparison of group A to group B showed a significant difference (P = 0,0014) caused by continuous PM for 30 minutes, but there was no such result after IPM.

Conclusions

Major liver resections are performed with PM in order to minimize intra-operative blood loss. In the combined cases of colon surgery and major liver resections where PM is needed our results showed that IPM presents with better outcome and could be preferred compared with the other PM variants.  相似文献   

5.
Abstact Cadmium is one of the most toxic pollutants in environment. Cadmium accumulation in blood affects the renal cortex and causes renal failure. In this study, we aimed to evaluate the effects of cadmium on rat liver tissue. Eighteen male albino rats aged ten weeks old were used in the study. 15 ppm of cadmium was administered to rats via consumption water daily. At the end of the 30th study day, the animals were killed under ether anesthesia. After the liver tissue samples were taken, histopathological and biochemical examinations were performed. Histopathologic changes have included vacuolar and granular degenerations in hepatocytes, heterochromatic nucleuses and sinusoidal and portal widenings. Central vein diameters were normal in cadmium exposed group. Whereas, there was statistically significant difference between two groups by means of sinusoidal (p< 0.001) and portal triad diameters (p< 0.01). Malondialdehyde (MDA) is an indicator of lipid peroxidation. In this study, MDA was used as a marker of oxidative stress-induced liver impairment in cadmium exposed rats. Superoxide dismutase (SOD) and catalase (CAT) activities were also measured to evaluate the changes in antioxidative system in liver tissues. Current findings showed that MDA levels were increased and SOD and CAT activities were decreased in cadmium exposed group compared to control group. The difference between two groups was statistically significant (pvalues: MDA,p< 0.01; CAT,p< 0.01 and SOD,p< 0.05). In conclusion, these findings suggest the role of oxidative mechanisms in cadmium-induced liver tissue damage  相似文献   

6.
目的:探讨大鼠部分肝切除后肝功能的变化及川芎嗪对肝修复性再生能力的影响。方法:在相同月龄的动物中按体重均衡的原则随机分组。实验动物共分为5组:设正常对照组(对照组)、青年假手术对照组(假术组)、青年肝切除组(青切组)、中年肝切除组(中切组)和中年肝切除治疗组(切治组),每组动物10只,常规饲养,自由饮水。参照Higgins and Aderson给大鼠施行肝脏70%切除手术,中切组大鼠术前以川芎嗪(200 mg/kg/d)腹腔注射7d,其余组注射生理盐水。假术组大鼠以同样的手术程序打开腹腔但不施行肝部分切除术。各组施行手术动物在切除术后24 h沿腹中线切开动物腹腔,于腹主动脉两髂分支处取血分离血清,切取所有肝脏,待测。采用试剂盒法分别测定各组血清中丙氨转氨酶(ALT)、谷草转氨酶(AST)含量;肝脏匀浆后,采用八木国夫法检测肝组织中丙二醛(MDA)含量,采用western blot法测定肝组织中核增殖抗原(PCNA)和铜锌超氧化物歧化酶(SOD1)、锰超氧化物歧化酶(SOD2)的蛋白表达。结果:与中切组相比手术动物相比,切治组组大鼠血清中ALT、AST水平显著降低(P<0.05),肝细胞中PCNA表达显著升高(P<0.05),肝组织中MDA含量显著降低(P<0.05);肝组织中SOD1、SOD2表达显著增加。结论:肝脏切除70%后,肝功受损,氧化应激增加,但核增殖能力增强。川芎嗪可以抑制肝切手术导致的氧化应激损伤,促进SOD的表达,抑制MDA的升高,降低ALT、AST水平,提高PCNA的表达。提示中年大鼠肝切除后肝功能受损与氧化应激相关,给予抗氧化药物能够促进肝再生修复能力,青年肝切除手术大鼠肝的修复能力强于中年动物。  相似文献   

7.
目的:对肝硬化门静脉高压症大鼠行脾切除手术,观察术后大鼠免疫系统功能的变化情况,探讨脾切除术对免疫系统的影响,为临床治疗提供理论基础。方法:选取SD大鼠45只建立PHT模型,随机分为PHT组、脾全切组及部分脾切除组,每组各15只。另选取10只健康大鼠为对照组。分别对四组大鼠行不同的脾切除方案,术后检测四组大鼠的血常规、免疫球蛋白含量、T淋巴细胞亚群的变化及组织病理学染色结果等,分析各指标的意义。结果:四组大鼠血常规检测结果显示,PHT组大鼠WBC高于对照组,PHTTS组高于PHT组,PHTSS组高于PHTTS组,差异显著且具有统计学意义(P0.05)。四组大鼠血浆中IgG含量差异显著(P0.05);IgA、IgM含量无显著性差异(P0.05)。四组大鼠CD4+、CD8+含量差异显著(P0.05);CD29+含量无显著性差异(P0.05)。结论:脾脏直接参于细胞介导免疫调节,脾切除可降低门脉压力,消除脾亢,有利于肝硬化门脉高压症的缓解。  相似文献   

8.
目的:探讨不同血流阻断方式对荷瘤小鼠肝细胞功能的影响。方法:选择昆明小鼠24只随机分为三组,正常对照组(Suspe-nded operation,SO)、肝门阻断组(Occlusion of the portal triad,OPT)、保留肝动脉持续阻断门静脉(Occlusion of portal vein,OPV)各8只。采用门静脉注射肿瘤的方法建立肝癌模型,建模后3天采用阻断范围为左外叶和中叶、阻断时间为60分钟的入肝血流阻断方式,复流后5天后,通过测量3组对肝脏的缺血再灌注损伤程度以及病理学变化来评价不同血流阻断方式对肝细胞功能影响的程度。结果:门静脉注射小鼠肝癌细胞8天后,对照组测量小鼠正常丙氨酸氨基转移酶(ALT)值为66.5±22.3 IU/L,OPT组值为276.3±80.5 IU/L,OPV组值为89.6±28.4 IU/L,两组比较有统计学差异(P0.01);对照组测量小鼠正常天冬氨酸氨基转移酶(AST)值为301.3±126.7 IU/L,OPT组值为1126.4±285.5 IU/L,OPV组值为438.6±150.7 IU/L,两组比较有统计学差异(P0.01),病理组织学OPV组肝细胞损伤程度明显较OPT组轻。结论:保留肝动脉持续阻断门静脉可以减轻荷瘤小鼠肝脏的缺血再灌注损伤。  相似文献   

9.
Abstract

This experimental study aimed to evaluate colon healing after portal ischemia followed by reperfusion. Seventy male Wistar rats randomly distributed in four groups were used: Group 1, colonic anastomosis (n = 20); Group 2, portal ischemia-reperfusion (n = 20); Group 3, colonic anastomosis and portal ischemia-reperfusion (n = 20); and Group 4, control (n = 10). In the postoperative period, these rats were re-allocated into subgroups and lipid peroxidation and protein oxidation plasma levels were evaluated on days 1 and 5 by thiobarbituric acid reactive substances (TBARS) and slot-blotting assays, respectively. A segment of the right colon was also removed for collagen analysis. Both malondialdehyde (MDA) and protein carbonyl levels (oxidative markers of lipids and proteins) presented a significant increase after reperfusion in Group 3 on days 1 (P < 0.002) and 5 (P < 0.0001). In this same group, an extensive inflammatory process showing decreased fibroplasia was observed, with deficiency in collagen deposition on both sides of the anastomosis edges. Taken together, these results indicate that portal congestion followed by reperfusion induces an oxidative stress, which impaired the mechanism of colon anastomotic healing.  相似文献   

10.
The expression of the chemorepellent Sema3a is inversely related to sympathetic innervation. We investigated whether overexpression of Sema3a in the myocardial infarction (MI) border zone could attenuate sympathetic hyper‐innervation and decrease the vulnerability to malignant ventricular tachyarrhythmia (VT) in rats. Survived MI rats were randomized to phosphate buffered saline (PBS, n = 12); mock lentivirus (MLV, n = 13) and lentivirus‐mediated overexpression of Sema3a (SLV, n = 13) groups. Sham‐operated rats served as control group (CON, n = 20). Cardiac function and electrophysiological study (PES) were performed at 1 week later. Blood and tissue samples were collected for histological analysis, epinephrine (EPI), growth‐associated factor 43 (GAP43) and tyrosine hydroxylase (TH) measurements. QTc intervals were significantly shorter in SLV group than in PBS and MLV groups (168.6 ± 7.8 vs. 178.1 ± 9.5 and 180.9 ± 8.2 ms, all P < 0.01). Inducibility of VT by PES was significantly lower in the SLV group [30.8% (4/13)] than in PBS [66.7% (8/12)] and MLV [61.5% (8/13)] groups (P < 0.05). mRNA and protein expressions of Sema3a were significantly higher and the protein expression of GAP43 and TH was significantly lower at 7 days after transduction in SLV group compared with PBS, MLV and CON groups. Myocardial EPI in the border zone was also significantly lower in SLV group than in PBS and MLV group (8.73 ± 1.30 vs. 11.94 ± 1.71 and 12.24 ± 1.54 μg/g protein, P < 0.001). Overexpression of Sema3a in MI border zone could reduce the inducibility of ventricular arrhythmias by reducing sympathetic hyper‐reinnervation after infarction.  相似文献   

11.
Effects of carvacrol upon the liver of rats undergoing partial hepatectomy   总被引:1,自引:0,他引:1  
The present study aims to investigate the possible effects of carvacrol obtained from origanum oil upon the regenerative feature of the liver subsequent to partial hepatectomy in rats.Male Wistar Albino rats, weighing 230±30 g, were divided into three experiment groups. Group I (n=8) were used as sham operation group. Group II (n=8) were applied saline solution and hepatectomy. Carvacrol and hepatectomy (73 mg/kg) were applied to Group III (n=8). One dose of test material was injected 1 h before 68% partial hepatectomy. At the end of the experiments, blood and organs were removed. The liver regeneration rate of the rats was calculated measuring the weights of their liver before and after the hepatectomy. Hematoxylin and eosin, interleukin-6 (IL-6) and proliferating cell nuclear antigen (PCNA) treatments were applied to liver sections. Aspartate transaminase (AST), alanine transaminase (ALT), tumor necrosis factor-alpha (TNF-α) and IL-6 levels were determined in serum samples.The liver regeneration, mitotic index and PCNA index increased significantly in rats of Group III over the Group II at the 72nd hour after partial hepatectomy. Histological evaluations were also similar with these results of PCNA and mitotic indexes. In AST, ALT, TNF-α and IL-6 levels, there was no statistically significant difference.According to these results, it is concluded that carvacrol increases the liver regeneration rate.  相似文献   

12.
The innervation of the liver and gallbladder of the lizard Podarcis hispanica has been studied by the following methods: a) demonstration of cholinesterase activity; b) FIF method for catecholamines; and c) immunohistochemistry for VIP. The hepatic parenchyma of the reptile's liver show hepatocytes arranged in regular rows of hepatic cords, the portal triad being typical of higher vertebrates (birds and mammals). Nerve fibers are found in the scarce connective tissue distributed among the hepatocytes. The innervation is restricted to the big branches of blood vessels and biliary ducts. It is represented by cholinergic, noradrenergic and VIPergic fibers. The gallbladder shows a well developed cholinergic plexus with pyramidal cells in the interconnection points of the fiber network. The noradrenergic and VIPergic plexuses are also more widely distributed in the gallbladder than in the liver.  相似文献   

13.
Exposure to microgravity in humans causes cardiovascular deconditioning affecting blood pressure, heart rate and vascular responsiveness. This study investigated cardiac output, arterial blood pressure and regional blood flows [radioactive microspheres: 57Co, 15.5 (SEM 0.1) μm in diameter] in conscious and freely moving rats subjected to 14 days of simulated microgravity (head-down suspension, HDS) in male Wistar rats: control (horizontally attached, n = 7), suspended for 14 days (n = 8) and suspended/allowed to recover for 10 min (R10min, n = 5) or 24 h (n = 9). Compared to the control group, 14 days of HDS resulted in reduced total peripheral resistance (37%); an increased cardiac index (65%) was associated with no significant change in the mean arterial pressure . There were elevated brain (63%), visceral (>20%), hindlimb (>80%) and forelimb (>215%) muscle blood flows. In the R10min group, the decreased (18%) and the regional blood flows returned to control values. Within 24 h the as well as cardiac index and total peripheral resistance were restored. In conclusion, 14 days of HDS engendered local circulatory changes resulting in transient blood pressure instability during recovery. Accepted: 26 March 1998  相似文献   

14.
This study evaluated the effects of curcumin and/or insulin on antioxidant enzyme activity in blood, liver, and kidney, as well as on lipid peroxidation and delta aminolevulinic dehydratase (δ-ALA-D) activity, and a histopathological analysis of streptozotocin-induced diabetic rats. The animals were divided into six groups (n = 6): control/saline (C); control/curcumin (CCur); diabetic/saline (D); diabetic/insulin (DIns); diabetic/curcumin (DCur); and diabetic/insulin/curcumin (DInsCur). After 30 days of treatment with curcumin and/or insulin, the animals were sacrificed and the liver, kidney, and serum were used for experimental determinations. Results of histopathological analysis showed that the treatment with insulin ameliorate renal and hepatic lesions from both DIns and DInsCur groups. TBARS levels were significantly increased in serum, liver, and kidney in D group and the administration of curcumin and insulin prevented this increase in DIns and DCur groups. The activities of catalase (CAT), superoxide dismutase, and δ-ALA-D presented a significant decrease in the liver and kidney D group when compared to C group (P < 0.05). The animals treated with curcumin and insulin presented an increase of CAT activity, revealing a positive interaction between both substances. The treatments with curcumin or insulin prevented oxidative stress in blood, through modulation of enzymatic antioxidant defenses. These findings contributed to the comprehension that antioxidants from medicinal plants could be used as adjuvant in the treatment of this endocrinopathy and not as single therapy.  相似文献   

15.
刘广欣  党立力  黄启科  周亮  张福琴  陶开山 《生物磁学》2014,(8):1428-1430,1445
目的:大鼠肝部分切除模型被广泛的应用于肝脏疾病的研究,随着干细胞治疗肝损伤及护肝药物研究的发展,对大鼠肝损伤模型也提出了很多新的要求。本实验拟在大鼠肝部分切除术的基础上改进以建立大鼠肝断面门静脉分支残端的静脉置管模型,并进行细胞移植实验,对比分析新模型的优劣。方法:60只F344大鼠分为三组。A、B组行行85%肝切除术;C组行85%肝切除术+肝断面门静脉分支残端置管术。术中B组经门静脉注入4×105个表达GFP(greenfluorescenceprotein,GFP)的胎肝干细胞(fetalliverstern/progenitorcells,FLSPCs)。c组经留置导管注射入同等量的FLSPCs,A组注射同等剂量的培养液。72小时取血清,测定肝功能ALT、AST,统计死亡率;取肝脏组织切片观察其修复情况。统计学采用方差分析和LSD—t检验。结果:B、C组F344大鼠72小时肝功指标(ALT、AST)均明显优于A组;B组、C组肝脏组织学的病理损伤的恢复分别较A组快。B、C组间肝功指标无统计学意义。结论:经门静脉分支残端置管途径移植FLSPCs效果等同于经门静脉穿刺途径,且该模型具有可反复、可选时、减少创伤等优点。  相似文献   

16.

Background & Aims

Portal hyperperfusion after extended hepatectomy or small-for-size liver transplantation may induce organ dysfunction and failure. The underlying mechanisms, however, are still not completely understood. Herein, we analysed whether hepatectomy-associated portal hyperperfusion induces a hepatic arterial buffer response, i.e., an adaptive hepatic arterial constriction, which may cause hepatocellular hypoxia and organ dysfunction.

Methods

Sprague-Dawley rats underwent 30%, 70% and 90% hepatectomy. Baseline measurements before hepatectomy served as controls. Hepatic arterial and portal venous flows were analysed by ultrasonic flow measurement. Microvascular blood flow and mitochondrial redox state were determined by intravital fluorescence microscopy. Hepatic tissue pO2 was analysed by polarographic techniques. Hepatic function and integrity were studied by bromosulfophthalein bile excretion and liver histology.

Results

Portal blood flow was 2- to 4-fold increased after 70% and 90% hepatectomy. This, however, did not provoke a hepatic arterial buffer response. Nonetheless, portal hyperperfusion and constant hepatic arterial blood flow were associated with a reduced mitochondrial redox state and a decreased hepatic tissue pO2 after 70% and 90% hepatectomy. Microvascular blood flow increased significantly after hepatectomy and functional sinusoidal density was found only slightly reduced. Major hepatectomy further induced a 2- to 3-fold increase of bile flow. This was associated with a 2-fold increase of bromosulfophthalein excretion.

Conclusions

Portal hyperperfusion after extended hepatectomy does not induce a hepatic arterial buffer response but reduces mitochondrial redox state and hepatocellular oxygenation. This is not due to a deterioration of microvascular perfusion, but rather due to a relative hypermetabolism of the remnant liver after major resection.  相似文献   

17.
In this study, we administered various diets of stearidonic acid (SDA, 18:4n?3) soybean oil to rats and examined the subsequent blood and organ biochemical parameters. Male Wistar rats (seven rats/group, six groups total) were fed diets supplemented with a test oil for 4 weeks. Diets containing test oils were: FFC diet (fish-oil-free control diet), C diet (control group, assuming a Japanese diet), SDA25 diet (25% 18:4n?3 soybean oil in the C diet), SDA50 (50% 18:4n?3 soybean oil in the C diet), ALA diet (34% flaxseed oil in the C diet), and EPA+DHA diet (34% fish oil in the C diet). The intake of 18:4n?3 showed increased relative efficiency of 20:5n?3 accretions in serum and liver triacylglycerol and significantly decreased the serum triacylglycerol level in rats. The results suggested that the consumption of 18:4n?3 soybean oil may modify the lipid and fatty acid profiles of body fats, even when EPA and DHA derived from fish is consumed.  相似文献   

18.
In the period between the December 2000 and September 2004, altogether 13 patients underwent preoperative portal vein embolization (PPVE); 9 patients with colorectal metastases and 4 patients with hepatocellular carcinoma. The indirect splenic portography was performed after catheter was introduced into superior mesenteric artery via femoral artery approach. The portal vein was punctured percutaneously transhepatic under fluoroscopy. Following portography, selected portal vein segments were embolized by injecting polyvinil alcohol (PVA) particles until stasis of blood flow was achieved. Proximal parts of branches and the channel in the liver parenchyma were occluded with Gelfoam particles. The increase of the remnant liver parenchyma was measured by magnetic resonance imaging. iTwo patients experienced post-embolization syndrome and another one had subcapsular hematoma. The volume of the liver parenchyma increased minimally for 8% and maximally for 109%. Altogether, 10 patients underwent surgical resection. In two patients, the disease progressed and carcinoma spread to the previously healthy liver lobe and in one there was no hypertrophy and we decided for artery chemoembolization (AC). The results show that PPVE triggers a strong regenerative response resulting in hypertrophy of normal liver parenchyma and expand possibilities of curative surgery for patients who would not otherwise have been candidates for extended resection.  相似文献   

19.
目的:探究选择性入肝血流阻断(SPVE 法)在肝癌合并门脉高压手术中的临床应用效果。方法:选择我院2009 年10 月 ~2014 年10 月期间确诊为肝癌合并门脉高压的患者80 例,按照随机数字数表法分为观察组和对照组各40 例,观察组行SPVE 法进行血流阻断,对照组行全入肝血流阻断法(Pringle 法)进行血流阻断。对比两组手术时间、阻断血流时间、手术中出血量、输血 量、手术前后患者肝功能相关指标及术后并发症发生率。结果:两组手术时间和血流阻断时间对比差异无统计学意义(P>0.05),而 观察组术中出血量及输血量均小于对照组,差异具有统计学意义(P<0.05);术后观察组血液中谷丙转氨酶(ALT)、谷草转氨酶 (AST)和总胆红素(TB)水平均低于对照组,而血清蛋白(ALB)和血红蛋白(Hb)水平高于对照组,差异均有统计学意义(均P<0. 05);观察组并发症发生率为22.5%,明显低于对照组的37.5%,差异有统计学意义(P<0.05)。结论:SPVE法应用在肝癌合并门脉 高压手术中,可以显著减少术中的出血量和输血量,有利于术后肝功能的恢复,有效地降低术后并发症的发生。  相似文献   

20.
Hepatocyte Growth Factor (HGF), which is a most potent growth factor for primary cultured hepatocytes, may act as a trigger for liver regeneration. After 70% of the rat liver was removed, HGF activity in the remnant liver began to increase within 24 h. In parallel with the activity, the HGF mRNA level in the remnant liver increased at 12 h after the operation and reached a maximum at 24 h. Increases in HGF activity and in the mRNA level were much lower and later than those in the liver of rats with hepatitis induced with CCl4. However, the first increase in HGF activity in the plasma of hepatectomized rats was noted 3 h after the resection, that is much earlier than the initial DNA synthesis in the remnant liver. Thus, while HGF production was induced in the remnant liver during regeneration after partial hepatectomy, the initial trigger may not be the liver-derived HGF, rather, it may be HGF derived from extrahepatic organs, via blood circulation.  相似文献   

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