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Sample records for adult primary liver

  1. Body mass index in childhood and adult risk of primary liver cancer

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus

    2014-01-01

    BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort...... hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS: Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight...

  2. Primary culture of adult rat liver cells. I. Preparation of isolated cells from trypsin-perfused liver of adult rat

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    Miyazaki,Masahiro

    1977-12-01

    Full Text Available Isolated hepatic cells from adult rats were prepared by perfusing the livers with trypsin. The highest yield of viable cells was obtained by perfusing the liver with 0.1% trypsin, pH 7.0, at 37 degrees C for 30 min. Following this treatment about 70% of cells excluded trypan blue. The isolated cells contained many binucleate cells. Between 60 and 70% of DNA present originally in the liver was recovered from the isolated hepatic cells, which had higher glucose 6-phosphatase activity than the liver. Thus the resulting cell population seems to be rich in hepatocytes. The isolated hepatic cells, however, lost some of their cellular proteins such as alanine and tyrosine amino-transferases. It was suggested that the membranes of isolated hepatic cells might be damaged by both enzymatic digestion and mechanical destruction.

  3. Preparation and Primary Culture of Liver Cells Isolated from Adult Rats by Dispase Perfusion

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    Wahid,Syarifuddin

    1984-06-01

    Full Text Available The dispase perfusion technique was used to isolate liver cells from adult rats. The optimum conditions for obtaining many isolated liver cells with high viability were an enzyme concentration of 2000 U/ml, a pH of 7.5 and a perfusion time of 20 min. The population of isolated liver cells prepared with dispase consisted of 43.6% cells with diameters less than 20 micron and 56.4% cells with diameters above 20 micron. The isolated liver cells were cultured in basal culture medium either supplemented with or without dexamethasone (1 X 10(-5M and insulin (10 micrograms/ml. The addition of hormones to the culture medium improved the attachment efficiency of the isolated liver cells and delayed the disappearance of mature hepatocytes. Epithelial-like clear cells proliferated early in primary culture even in the presence of hormones. Therefore, functioning mature hepatocytes and proliferating epithelial-like clear cells coexisted well in the hormone-containing medium. Furthermore, the number of cultured cells reached a maximal level earlier in the presence of hormones than in the absence of hormones. The level of TAT activity in primary cultured cells was higher up to 3 days after inoculation in the presence of hormones than in their absence. No difference between G6Pase activity in primary cultured cells in the presence of hormones and that in the absence of hormones was found.

  4. PET-CT in Determining the Radioembolization Dose Delivered to Patients With Liver Metastasis, Primary Liver Cancer, or Biliary Cancer

    Science.gov (United States)

    2017-01-24

    Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Metastatic Extrahepatic Bile Duct Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Stage D Adult Primary Liver Cancer (BCLC); Unspecified Adult Solid Tumor, Protocol Specific

  5. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Berentzen, Tina L.; Gamborg, Michael

    2016-01-01

    regression models stratified by birth cohort. During 5.1 million person-years of follow-up, 185 men and 65 women developed PLC. Sex modified the association between birth weight and adult PLC (p-value for interaction=0.0005). Compared with a sex-specific reference group of birth weights between 3.25-3.75 kg......Whether the prenatal period is critical for the development of adult primary liver cancer (PLC) is sparsely investigated. Recently, attention has been drawn to potential sex-differences in the early origins of adult disease. We investigated the association between birth weight and adult PLC......, and after accounting for diagnoses of alcohol-related disorders, viral hepatitis, and biliary cirrhosis. Prenatal exposures influence the risk of adult PLC, and the effects at the high birth weight levels appear to be sex-specific. Our findings underscore the importance of considering sex...

  6. Primary tubercular liver abscess in an immunocompetent adult: a case report

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    Baveja CP

    2009-10-01

    Full Text Available Abstract Introduction Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality. Case presentation A 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably. Conclusion This report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.

  7. Brain tumor - primary - adults

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    ... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...

  8. 3-Tesla MRI Response to TACE in HCC (Liver Cancer)

    Science.gov (United States)

    2016-08-22

    Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Localized Resectable Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Stage A Adult Primary Liver Cancer (BCLC); Stage B Adult Primary Liver Cancer (BCLC)

  9. Prevalence and factors associated with the presence of non alcoholic fatty liver disease in an apparently healthy adult population in primary care units

    Directory of Open Access Journals (Sweden)

    Pizarro Gregorio

    2007-11-01

    Full Text Available Abstract Background Fatty liver disease is characterized by the accumulation of fat vacuoles inside of the hepatocytes. Non alcoholic fatty liver is associated with obesity, type 2 diabetes, dyslipemia, the intake of certain drugs and with the so-called metabolic syndrome. However, there is little information on the clinical relevance of this disorder as a healthcare problem in the general population, since the studies published generally include a limited number of patients and the diagnosis is established on the basis of clear biochemical alterations and liver biopsy. Methods/Design The aim of the study is the prevalence of non-alcoholic fatty liver disease in a general adult population by hepatic ultrasonography. A population-based, descriptive, transversal, multicentre study. Eighteen primary care centres of the north of Barcelona and the Maresme Areas of Healthcare Management attending an urban and semi-urban population of 360.000 inhabitants. A randomized sample of 786 subjects of 15 years or older were selected from the population and assigned to the participating centres according to the Primary Care Information System (SIAP: This population is practically the same as the general population of the area. The following determinations will be carried out in all the participants: hepatic ultrasonography to detect fatty liver, a questionnaire concerning liver diseases, alcohol intake, smoking and drug use, physical examination including abdominal perimeter and body mass index and biochemical analysis including liver function tests and parameters related to the metabolic syndrome and the HAIR score. Ultrasonographic diagnosis of fatty liver will be made according to established criteria (American Gastroenterology Association and diagnosis of metabolic syndrome according to the criteria of the European Group for the Study of Insulin Resistance. Discussion This study will attempt to determine the prevalence of non alcoholic fatty liver disease

  10. Liver Disease and Adult Vaccination

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    ... Resources for Healthcare Professionals Liver Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  11. Primary sclerosing cholangitis and liver transplantation

    NARCIS (Netherlands)

    Klompmaker, IJ; Haagsma, EB; Jansen, PLM; Slooff, MJH

    1996-01-01

    Primary sclerosing cholangitis is a chronic disease, strongly associated with ulcerative colitis and cholangiocarcinoma. Ulcerative colitis itself does not influence the liver transplant results. However; intensified screening after liver transplantation for carcinoma of the colon may be necessary.

  12. Primary pleomorphic sarcoma of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Mani, S.; Naik, L.; Shet, S.; Vora, I.M.; Rananavare, R. [BYL Nail Hospital, Bombay (India). Departments of Radiology and Pathology

    1998-02-01

    A 35-year-old woman presented with abdominal distension and a palpable liver mass. Ultrasonography and computed tomography revealed a large well-delineated liver mass with bilobar involvement. Based on autopsy and immunohistochemical findings, a final diagnosis of primary pleomorphic liver sarcoma with myogenic differentiation W established. Copyright (1998) Blackwell Science Pty Ltd 8 refs., 5 figs.

  13. Traditional Chinese medicine for primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    @@ Further progress has been made in the traditional Chinese medicine for primary liver cancer over the past few years, especially in the research of traditional Chinese medicine (TCM) treatment principle, improvement of therapeutic results and prolonging the survival.

  14. Primary liver transplantation for autoimmune hepatitis: A comparative analysis of the European liver transplant registry

    NARCIS (Netherlands)

    C. Schramm (Christoph); M. Bubenheim (Michael); R. Adam (René); V. Karam (Vincent); J. Buckels (John); J.G. O'Grady (John); N. Jamieson (Neville); S. Pollard (Stephen); P. Neuhaus (Peter); M.M. Manns (Michael); R.J. Porte (Robert); D. Castaing (Denis); A. Paul (Anna); O. Traynor (Oscar); J. Garden (James); S. Friman (Styrbjörn); B.G. Ericzon; L. Fischer (Lutz); S. Vitko (Stefan); M. Krawczyk (Marek); H.J. Metselaar (Herold); A. Foss (Aksel); M. Kilic (Murat); K. Rolles (Keith); P. Burra (Patrizia); X. Rogiers (Xavier); A.W. Lohse (Ansgar)

    2010-01-01

    textabstractThe principal aim of this study was to compare the probability of and potential risk factors for death and graft loss after primary adult and pediatric liver transplantation in patients undergoing transplantation for autoimmune hepatitis (AIH) to those in patients undergoing transplantat

  15. Primary Liver Transplantation for Autoimmune Hepatitis : A Comparative Analysis of the European Liver Transplant Registry

    NARCIS (Netherlands)

    Schramm, Christoph; Bubenheim, Michael; Adam, Rene; Karam, Vincent; Buckels, John; O'Grady, John G.; Jamieson, Neville; Pollard, Stephen; Neuhaus, Peter; Manns, Michael M.; Porte, Robert; Castaing, Denis; Paul, Andreas; Traynor, Oscar; Garden, James; Friman, Styrbjorn; Ericzon, Bo-Goran; Fischer, Lutz; Vitko, Stefan; Krawczyk, Marek; Metselaar, Herold J.; Foss, Aksel; Kilic, Murat; Rolles, Keith; Burra, Patrizia; Rogiers, Xavier; Lohse, Ansgar W.

    2010-01-01

    The principal aim of this study was to compare the probability of and potential risk factors for death and graft loss after primary adult and pediatric liver transplantation in patients undergoing transplantation for autoimmune hepatitis (AIH) to those in patients undergoing transplantation for prim

  16. Induction of digitoxigenin monodigitoxoside UDP-glucuronosyltransferase activity by glucocorticoids and other inducers of cytochrome P-450p in primary monolayer cultures of adult rat hepatocytes and in human liver.

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    Schuetz, E G; Hazelton, G A; Hall, J; Watkins, P B; Klaassen, C D; Guzelian, P S

    1986-06-25

    We have recently proposed that glucocorticoids induce cytochrome P-450p, a liver microsomal hemoprotein originally isolated from rats treated with the antiglucocorticoid pregnenolone 16 alpha-carbonitrile (PCN), through a mechanism that involves a stereospecific recognition system clearly distinguishable from the classic glucocorticoid receptor (Schuetz, E. G., Wrighton, S. A., Barwick, J. L., and Guzelian, P. S. (1984) J. Biol. Chem. 259, 1999-2012). We now report that digitoxigenin monodigitoxoside UDP-glucuronosyltransferase (DIG UDP-glucuronosyltransferase), a liver microsomal enzyme activity induced by PCN in rats, is also inducible, as is P-450p, in primary monolayer cultures of adult rat hepatocytes. DIG UDP-glucuronosyltransferase activity closely resembled reported characteristics of induction of P-450p in its time course of induction, concentration-response relationships, exclusivity of induction by steroids with glucocorticoid properties, unusual rank order of potency of glucocorticoid agonists, unusually high ED50 for induction by glucocorticoids, enhanced induction rather than inhibition by anti-glucocorticoids in the presence of glucocorticoids, and finally, induction by nonsteroidal inducers of P-450p. DIG UDP-glucuronosyltransferase activity was also readily detected in human liver microsomes and was elevated in two patients who had received inducers of P-450p. We conclude that the liver enzymes controlled by the postulated PCN recognition system include not only P-450p but also one or more UDP-glucuronosyltransferases.

  17. Primary liver cancer; Tumeurs primitives hepatiques

    Energy Technology Data Exchange (ETDEWEB)

    Quivrina, M.; Martin, E.; Ligey-Bartolomeu, A.; Nouhaud, E.; Chamois, J.; Maingon, P.; Crehange, G. [Departement de radiotherapie, Centre Georges-Francois-Leclerc, 21 - Dijon (France); Mornex, F.; Enachescu, C. [Departement de radiotherapie, Centre hospitalier Lyon-Sud, 69 - Lyon-Pierre-Benite (France)

    2010-07-01

    Due to its increasing incidence and a grim prognosis, primary liver cancer remains a diagnostic and therapeutic challenge. For small localized tumors, surgical resection and liver transplantation are standard treatments with a curative-intent. Therapeutic options for locally advanced or metastatic diseases are limited. Globally, surgery fits less than 20% of patients. Early detection in high-risk patients and prevention of risk factors remain the key points in the standard care. External radiotherapy is a non invasive treatment with encouraging results for non operable patients. Emerging stereotactic radiotherapy yields high rates of local control without compromising toxicity. Tumors with bad prognostic factors could be cured with this approach. (authors)

  18. Right trisectionectomy for primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Jing-An Rui; Shao-Bin Wang; Shu-Guang Chen; Li Zhou

    2003-01-01

    AIM: To evaluate the value of right trisectionectomy,previously named right trisegmentectomy, in the treatment of primary liver cancer by summarizing our 13-year experience for this procedure.METHODS: Thirty three primary liver cancer patients undergoing right trisectionectomy from Apr. 1987 to Dec.1999 were investigated retrospectively. The impacts in survival of patients by cancerous biological behavior, such as tumor thrombi and satellite nodules, were discussed respectively. All right trisectionectomies were performed under normothermic interruption of porta hepatis at single time. Ultrasonic dissector (CUSA system 200) was used in dissection of hepatic parenchyma from Nov. 1992, instead of finger fracture.RESULTS: 1-, 3- and 5-year survival rates were 71.9 %,40.6 % and 34.4 %, respectively. The longest survival term with free cancer was 150 months (alive). There were no significant differences in survival curves between cases with and without tumor thrombi (right branch of portal vein) and satellite nodules. Operative mortality was 3.0 % (1/33). Main surgical complications occurred in 5 cases.CONCLUSION: Right trisectionectomy should be regarded as an effective and safe procedure for huge primary liver cancers and is worth using more widely.

  19. Poor initial graft function after orthotopic liver transplantation : can it be predicted and does it affect outcome? An analysis of 125 adult primary transplantations

    NARCIS (Netherlands)

    Maring, JK; Klompmaker, IJ; Zwaveling, JH; Kranenburg, K; TenVergert, EM; Slooff, MJH

    1997-01-01

    Donor liver shortage is a persistent problem in liver transplantation. A more liberal donor acceptance policy may be a possible solution. However, this might put recipients at risk for initial poor function or even non-function of the graft. Therefore risk factors for initial graft dysfunction shoul

  20. Primary brain tumours in adults.

    Science.gov (United States)

    Ricard, Damien; Idbaih, Ahmed; Ducray, François; Lahutte, Marion; Hoang-Xuan, Khê; Delattre, Jean-Yves

    2012-05-26

    Important advances have been made in the understanding and management of adult gliomas and primary CNS lymphomas--the two most common primary brain tumours. Progress in imaging has led to a better analysis of the nature and grade of these tumours. Findings from large phase 3 studies have yielded some standard treatments for gliomas, and have confirmed the prognostic value of specific molecular alterations. High-throughput methods that enable genome-wide analysis of tumours have improved the knowledge of tumour biology, which should lead to a better classification of gliomas and pave the way for so-called targeted therapy trials. Primary CNS lymphomas are a group of rare non-Hodgkin lymphomas. High-dose methotrexate-based regimens increase survival, but the standards of care and the place of whole-brain radiotherapy remain unclear, and are likely to depend on the age of the patient. The focus now is on the development of new polychemotherapy regimens to reduce or defer whole-brain radiotherapy and its delayed complications.

  1. Primary malignant liver mesenchymal tumor: A case report

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Primary malignant liver mesenchymal tumor is a rare condition defined as a tumor with vascular, fibrous, adi-pose, and other mesenchymal tissue differentiation. We report a case of primary malignant liver mesenchymal tumor in a 51-year-old male with anemia, weight loss and hepatomegaly. Finally unconventional liver biopsy and histological manifestation led to the definitive diag-nosis.

  2. Prevalence and factors associated with the presence of non alcoholic fatty liver disease in an apparently healthy adult population in primary care units

    OpenAIRE

    Pizarro Gregorio; Aubà Josep; Bernad Jesús; Canut Santiago; Planas Jaume; Muñoz Laura; Gil Dolors; Pera Guillem; Aznar Jesús; Miranda Dolores; Torán Pere; Auladell Ma Antonia; Caballería Llorenç; Aizpurua Miren; Altaba Anna

    2007-01-01

    Abstract Background Fatty liver disease is characterized by the accumulation of fat vacuoles inside of the hepatocytes. Non alcoholic fatty liver is associated with obesity, type 2 diabetes, dyslipemia, the intake of certain drugs and with the so-called metabolic syndrome. However, there is little information on the clinical relevance of this disorder as a healthcare problem in the general population, since the studies published generally include a limited number of patients and the diagnosis...

  3. Management of adults with paediatric-onset chronic liver disease: strategic issues for transition care.

    Science.gov (United States)

    Vajro, Pietro; Ferrante, Lorenza; Lenta, Selvaggia; Mandato, Claudia; Persico, Marcello

    2014-04-01

    Advances in the management of children with chronic liver disease have enabled many to survive into adulthood with or without their native livers, so that the most common of these conditions are becoming increasingly common in adult hepatology practice. Because the aetiologies of chronic liver disease in children may vary significantly from those in adulthood, adults with paediatric-onset chronic liver disease may often present with clinical manifestations unfamiliar to their adulthood physician. Transition of medical care to adult practice requires that the adulthood medical staff (primary physicians and subspecialists) have a comprehensive knowledge of childhood liver disease and their implications, and of the differences in caring for these patients. Pending still unavailable Scientific Society guidelines, this article examines causes, presentation modes, evaluation, management, and complications of the main paediatric-onset chronic liver diseases, and discusses key issues to aid in planning a program of transition from paediatric to adult patients.

  4. [Histopathological differential diagnosis of primary liver tumors].

    Science.gov (United States)

    Honsová, E

    2014-03-01

    The most common primary hepatic malignancy is hepatocellular carcinoma, which constitutes 80-85% of all malignant epithelial neoplasms originating in the liver. The second most common primary hepatic malignancy is cholangiocellular carcinoma. In recent years, remarkable progress has been made in elucidating the molecular pathology of hepatic tumors. Advances in our understanding of molecular subtypes have led to a creation of a new classification system of hepatocellular adenomas, with important genotype-phenotype correlations and easy application to routine diagnostic practice. In the field of early hepatic neoplasia, a consensus on the definition of dysplastic nodules and early hepatocellular carcinoma has been reached. Immunohistochemical detection of glypican-3 and stromal invasion are used for the differential diagnosis. A lot of problems still exist in the category of mixed hepatocellular and cholangiocellular carcinoma. Although this category is recognized in the WHO classification, confusing terminology has been generated to describe tumors with morphological features of both HCC and CC. We further specify problems and pitfalls of the differential histopathological diagnosis of liver malignant tumors.

  5. Effect of liver cirrhosis on percutaneous selective portal vein embolization for primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    孙军辉

    2014-01-01

    Objective To evaluate the clinical value of PVE(portal vein embolism)prior to surgery in primary liver cancer(PLC)patients and the effect of liver cirrhosis on1iver lobe hyperplasia after PVE.Methods 13 patientswith primary liver cancer non-suitable for curative hepatectomy underwent k sequential transcatheter arterial chemoembolization(TACE)(1-3 times)

  6. Clinical and molecular insights into primary pediatric liver cancer

    NARCIS (Netherlands)

    V.B. Weeda

    2016-01-01

    This thesis aims to give insight into the clinical status quo of primary pediatric liver tumors and investigate signaling pathways that may be of importance for liver tumorigenesis. The most recent series of the International Childhood Liver Tumors Strategy Group (SIOPEL) of hepatocellular carcinoma

  7. Intracardiac Thrombosis during Adult Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Marina Moguilevitch

    2013-01-01

    Full Text Available Intracardiac thrombosis (ICT and pulmonary embolism (PE during adult liver transplantation are rare but potentially lethal complications. They are often overlooked because of significant diagnostic challenges. The combination of hemodynamic compromise and transesophageal echocardiography (TEE findings allows for correct diagnosis. A large variety of putative risk factors for ICT and PE have been suggested, but these events are considered to be multifactorial. There are different proposed treatment modalities for these devastating complications. Unfortunately, in spite of growing knowledge in this area, intraoperative and postoperative mortalities remain very high. The retrospective nature of the study of these events makes the case reports extremely valuable.

  8. Liver regeneration after living donor transplantation: adult-to-adult living donor liver transplantation cohort study.

    Science.gov (United States)

    Olthoff, Kim M; Emond, Jean C; Shearon, Tempie H; Everson, Greg; Baker, Talia B; Fisher, Robert A; Freise, Chris E; Gillespie, Brenda W; Everhart, James E

    2015-01-01

    Adult-to-adult living donors and recipients were studied to characterize patterns of liver growth and identify associated factors in a multicenter study. Three hundred and fifty donors and 353 recipients in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) receiving transplants between March 2003 and February 2010 were included. Potential predictors of 3-month liver volume included total and standard liver volumes (TLV and SLV), Model for End-Stage Liver Disease (MELD) score (in recipients), the remnant and graft size, remnant-to-donor and graft-to-recipient weight ratios (RDWR and GRWR), remnant/TLV, and graft/SLV. Among donors, 3-month absolute growth was 676 ± 251 g (mean ± SD), and percentage reconstitution was 80% ± 13%. Among recipients, GRWR was 1.3% ± 0.4% (8 Graft weight was 60% ± 13% of SLV. Three-month absolute growth was 549 ± 267 g, and percentage reconstitution was 93% ± 18%. Predictors of greater 3-month liver volume included larger patient size (donors and recipients), larger graft volume (recipients), and larger TLV (donors). Donors with the smallest remnant/TLV ratios had larger than expected growth but also had higher postoperative bilirubin and international normalized ratio at 7 and 30 days. In a combined donor-recipient analysis, donors had smaller 3-month liver volumes than recipients adjusted for patient size, remnant or graft volume, and TLV or SLV (P = 0.004). Recipient graft failure in the first 90 days was predicted by poor graft function at day 7 (HR = 4.50, P = 0.001) but not by GRWR or graft fraction (P > 0.90 for each). Both donors and recipients had rapid yet incomplete restoration of tissue mass in the first 3 months, and this confirmed previous reports. Recipients achieved a greater percentage of expected total volume. Patient size and recipient graft volume significantly influenced 3-month volumes. Importantly, donor liver volume is a critical predictor

  9. Surgical treatment of double primary liver cancer

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    Li, Aijun; Ma, Senlin; Pawlik, Timothy; Wu, Bin; Yang, Xiaoyu; Cui, Longjiu; Wu, Mengchao

    2016-01-01

    Abstract Double primary liver cancer (DPLC) is a special type of clinical situation. As such, a detailed analysis of the surgical management and prognosis of patients with DPLC is lacking. The objective of the current study was to define the management and outcome of patients undergoing surgery for DPLC at a major hepatobiliary center. A total of 87 patients treated by surgical resection at the Eastern Hepatobiliary Surgery Hospital from January 1st, 2007 to October 31st, 2013 who had DPLC demonstrated by final pathological diagnosis were identified. Among these, 50 patients had complete clinical and prognostic data. Demographic and tumor characteristics as well as the prognosis were analyzed. The proportion of hepatitis B surface antigen (HBsAg) (+) and hepatitis B virus e antigen (HBeAg) (+), HBsAg (+), and HBeAg (−) hepatocirrhosis in all patients was 21.84%, 67.82%, and 63.22%, respectively. Incidental findings accounted for 58.62% of patients; among those who had symptoms, the main symptom was abdominal pain (31.03%). Nonanatomic wedge resection was the main operative approach (62.07%). Postoperatively, the main complications included seroperitoneum (11.49%), hypoproteinemia (10.34%), and pleural effusion (8.05%). Factors associated with disease-free survival (DFS) included intrahepatic cholangiocarcinoma (ICC) tumor size (P = 0.002) and use of postoperative prophylactic transcatheter arterial chemoembolization (TACE) treatment (P = 0.015). Meanwhile, hepatocellular carcinoma (HCC) size (P = 0.045), ICC size (P < 0.001), and liver function (including aspartate aminotransferase [P = 0.001] and r-glutamyl transferase [P < 0.001]) were associated with overall survival (OS). Hepatitis B virus (HBV)-related hepatitis or cirrhosis is also an important factor in the pathogenesis of DPLC and surgical treatment is safe for it with low complication rates. In addition, it is effective to prolong DFS that DPLC patients undergo postoperative

  10. General Information about Adult Primary Liver Cancer

    Science.gov (United States)

    ... tumor markers . An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of ... conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even ...

  11. Stages of Adult Primary Liver Cancer

    Science.gov (United States)

    ... tumor markers . An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of ... conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even ...

  12. Treatment Options for Adult Primary Liver Cancer

    Science.gov (United States)

    ... tumor markers . An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of ... conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even ...

  13. Treatment Option Overview (Adult Primary Liver Cancer)

    Science.gov (United States)

    ... tumor markers . An increased level of alpha-fetoprotein (AFP) in the blood may be a sign of ... conditions, including cirrhosis and hepatitis, may also increase AFP levels. Sometimes the AFP level is normal even ...

  14. A case of huge primary liposarcoma in the liver

    Institute of Scientific and Technical Information of China (English)

    Liang-Mou Kuo; Hong-Shiue Chou; Kun-Ming Chan; Ming-Chin Yu; Wei-Chen Lee

    2006-01-01

    Primary liver liposarcoma is a rare disease. Because of its rarity, the knowledge of the clinical course, management, and prognosis of primary liver liposarcoma are all limited for clinicians. A 61-year-old female patient who suffered from a huge primary liposarcoma in the central portion of the liver had the clinical presentations of fever, nausea, vomiting, jaundice, and body weight loss.The huge tumor was resected successfully. However,the tumor recurred repeatedly and she had repeated hepatectomies to remove the tumor. Thetumor became aggravating after repeated surgeries. Eventually, the patient had cervical spinal metastasis of liposarcoma and she survived for 26 months after liver liposarcoma was diagnosed. Although the tumor may become aggravating after repeated surgeries, repeated hepatectomies are still the best policy to achieve a long-term survival for the patients.

  15. Judgement on Extended Hepatectomy for Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    YANGJiamei; TONGYing; CHENHan; XUFeng; KANTong; WUMengchao

    2003-01-01

    Objective: To expore the indications and safety of extended hepatectomy for primary liver cancer (PLC). Methods: From Nov. 2000 to Oct. 2002, 33 patients with PLC received extended hepatectomy, 26 of whom were complicated with liver cirrhosis. Preoperative findings, intraoperative management and the outcome of postoperative recovery were analyzed and evaluated. Results: Operative mortality was zero in this group and postoperative morbidity of complications was 33.3%, and all complications were cured after proper treatment. Conclusion: Extended hepatectomy for PLC was safe and viable for the patients who had enough reserve of liver function if the incised liver volume was less than 50% of the liver and the supporting treatment of the remnant liver was given as well as the postoperative complications were managed appropriately.

  16. Outcomes of liver transplantation with liver grafts from pediatric donors used in adult recipients.

    Science.gov (United States)

    Croome, Kristopher P; Lee, David D; Burns, Justin M; Saucedo-Crespo, Hector; Perry, Dana K; Nguyen, Justin H; Taner, C Burcin

    2016-08-01

    Although there is an agreement that liver grafts from pediatric donors (PDs) should ideally be used for pediatric patients, there remain situations when these grafts are turned down for pediatric recipients and are then offered to adult recipients. The present study aimed to investigate the outcomes of using these grafts for liver transplantation (LT) in adult patients. Data from all patients undergoing LT between 2002 and 2014 were obtained from the United Network for Organ Sharing Standard Analysis and Research file. Adult recipients undergoing LT were divided into 2 groups: those receiving a pediatric liver graft (pediatric-to-adult group) and those receiving a liver graft from adult donors (adult-to-adult group). A separate subgroup analysis comparing the PDs used for adult recipients and those used for pediatric recipients was also performed. Patient and graft survival were not significantly different between pediatric-to-adult and adult-to-adult groups (P = 0.08 and P = 0.21, respectively). Hepatic artery thrombosis as the cause for graft loss was higher in the pediatric-to-adult group (3.6%) than the adult-to-adult group (1.9%; P graft-to-recipient weight ratio (GRWR) graft loss rate than those with a GRWR ≥ 0.8 (39% versus 9%; P graft survival can be achieved with the use of pediatric liver grafts in adult recipients, when these grafts have been determined to be inappropriate for usage in the pediatric population. Liver Transplantation 22 1099-1106 2016 AASLD.

  17. Management of liver cirrhosis between primary care and specialists

    Institute of Scientific and Technical Information of China (English)

    Ignazio Grattagliano; Enzo Ubaldi; Leonilde Bonfrate; Piero Portincasa

    2011-01-01

    This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis","cirrhosis", "chronic hepatitis", "chronic liver disease","decompensated cirrhosis", "hepatic encephalopathy","hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology,Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications.Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.

  18. In Vitro Generation of Functional Liver Organoid-Like Structures Using Adult Human Cells

    NARCIS (Netherlands)

    Ramachandran, S.D.; Schirmer, K.; Munst, B.; Heinz, S.; Ghafoory, S.; Wolfl, S.; Simon-Keller, K.; Marx, A.; Oie, C.I.; Ebert, M.P.; Walles, H.; Braspenning, J.C.; Breitkopf-Heinlein, K.

    2015-01-01

    In this study we used differentiated adult human upcyte(R) cells for the in vitro generation of liver organoids. Upcyte(R) cells are genetically engineered cell strains derived from primary human cells by lenti-viral transduction of genes or gene combinations inducing transient proliferation capacit

  19. Sequential and simultaneous revascularization in adult orthotopic piggyback liver transplantation

    NARCIS (Netherlands)

    Polak, WG; Miyamoto, S; Nemes, BA; Peeters, PMJG; de Jong, KP; Porte, RJ; Slooff, MJH

    2005-01-01

    The aim of the study was to assess whether there is a difference in outcome after sequential or simultaneous revascularization during orthotopic liver transplantation (OLT) in terms of patient and graft survival, mortality, morbidity, and liver function. The study population consisted of 102 adult p

  20. [A clinicopathological study of primary liver cancer associated with alcoholic liver injury].

    Science.gov (United States)

    Kohgo, Y; Ohhira, M; Ono, M

    1996-04-01

    We described a clinicopathological study of primary hepatoma associated with alcoholic liver diseases without viral liver diseases. In 150 patients with primary hepatoma, 6 patients (4%) have hepatoma associated with pure alcoholic liver disease, although 143 hepatoma were associated with chronic viral liver diseases and one was with primary biliary cirrhosis. All patients were male. The diagnosis of hepatoma was obtained at the age of 54 to 67 years old, and the duration of ethanol intake was 33 to 40 years. Three cases had a history of temperance. As an underlying liver disease, liver fibrosis was found in 3 cases and liver cirrhosis was in 3 cases. Chronic infections of hepatitis B and C viruses were ruled out by assaying serum virus markers. Autoimmune hepatitis and primary biliary cirrhosis were neglected by serum autoantibody. Hemochromatosis and Wilson's disease were also excluded. Hepatocellular carcinoma was diagnosed histologically in all the cases. Serum alpha-fetoprotein and PIVKA-II were positive in patients with advanced hepatocellular carcinoma. In cases with small hepatoma, the tumor was resected surgically in two cases and percutaneous ethanol injection against hepatoma was performed in one case. In these cases with small hepatoma, the patients were alive without tumor recurrence during observation period. In advanced hepatoma, transcatheter arterial infusion of anticancer agent was performed in two cases and no therapy was performed due to poor general condition in one case. One case was alive with recurrent hepatoma for 27 months, during which a therapy was repeated five times. Other 2 cases were died. The clinicopathological features of hepatoma associated with alcoholic liver disease were essentially same as those associated with chronic viral infection, although the incidence of hepatoma in alcoholic liver disease was lower than in viral liver disease. The mechanism of hepatocarcinogenesis in alcoholic liver disease was unclear and, therefore

  1. PREDICTION AND PREVENTION OF LIVER FAILURE AFTER MAJOR LIVER PRIMARY AND METASTATIC TUMORS RESECTION

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Abstract Purpose of the study. Improvement of results of treatment in patients with primary and metastatic liver cancer by decreasing the risk of post-resection liver failure on the basis of the evaluation of the functional reserves of the liver.Materials and Methods. The study included two independent samples of patients operated about primary or metastatic lesions of the liver at the Department of abdominal Oncology, P. A. Hertsen MORI. The first group included 53 patients who carried out 13C-breath test metallimovie and dynamic scintigraphy of the liver in the preoperative stage in addition to the standard algorithm of examination. Patients of the 2nd group (n=35 had a standard clinical and laboratory examination, the patients were not performed the preoperative evaluation of the functional reserve of the liver, the incidences of total bilirubin, albumin and prothrombin time did not reveal a reduction of liver function. Post-resection liver failure have been established on the basis of the 50/50 criterion in the evaluation on day 5 after surgery.Results. Analysis of operating characteristics of the functional tests showed the absolute methacin breath test sensitivity (SE≥100%, high specificity (SP≥67% of scintigraphy of the liver and the negative predictive value of outcome (VP≥100% at complex use of two diagnostic methods. The incidence of PROPS in the study group was significantly 2 times higher in the control group –15,1% and 26.8%, respectively (p<0.001.Conclusion. The combination of preoperative dynamic scintigraphy of the liver with carrying out 13C-breath methacin test allows you to conduct a comprehensive evaluation of the liver functional reserve and can significantly improve preoperative evaluation and postoperative results of anatomic resection in patients with primary and metastatic liver lesions.

  2. Undifferentiated liver embryonal sarcoma in adults: A report of four cases and literature review

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To evaluate the undifferentiated embryonal sarcoma of liver (UESL) in adults in order to improve its diagnosis and treatment. METHODS: Four primary and one recurrent cases of UESL were clinicopathologically evaluated and immunohistochemically investigated with a panel of antibodies using the EnVision+ system. Relevant literature about UESL in adults was reviewed. RESULTS: Three males and one female were enrolled in this study. Their chief complaints were abdominal pain, weight loss, or fever. Laborator...

  3. Establishing Primary Adult Fibroblast Cultures From Rodents

    Science.gov (United States)

    Seluanov, Andrei; Vaidya, Amita; Gorbunova, Vera

    2010-01-01

    The importance of using primary cells, rather than cancer cell lines, for biological studies is becoming widely recognized. Primary cells are preferred in studies of cell cycle control, apoptosis, and DNA repair, as cancer cells carry mutations in genes involved in these processes. Primary cells cannot be cultured indefinitely due to the onset of replicative senescence or aneuploidization. Hence, new cultures need to be established regularly. The procedure for isolation of rodent embryonic fibroblasts is well established, but isolating adult fibroblast cultures often presents a challenge. Adult rodent fibroblasts isolated from mouse models of human disease may be a preferred control when comparing them to fibroblasts from human patients. Furthermore, adult fibroblasts are the only available material when working with wild rodents where pregnant females cannot be easily obtained. Here we provide a protocol for isolation and culture of adult fibroblasts from rodent skin and lungs. We used this procedure successfully to isolate fibroblasts from over twenty rodent species from laboratory mice and rats to wild rodents such as beaver, porcupine, and squirrel. PMID:20972406

  4. Adult human liver mesenchymal progenitor cells express phenylalanine hydroxylase.

    Science.gov (United States)

    Baruteau, Julien; Nyabi, Omar; Najimi, Mustapha; Fauvart, Maarten; Sokal, Etienne

    2014-09-01

    Phenylketonuria (PKU) is one of the most prevalent inherited metabolic diseases and is accountable for a severe encephalopathy by progressive intoxication of the brain by phenylalanine. This results from an ineffective L-phenylalanine hydroxylase enzyme (PAH) due to a mutated phenylalanine hydroxylase (PAH) gene. Neonatal screening programs allow an early dietetic treatment with restrictive phenylalanine intake. This diet prevents most of the neuropsychological disabilities but remains challenging for lifelong compliance. Adult-derived human liver progenitor cells (ADHLPC) are a pool of precursors that can differentiate into hepatocytes. We aim to study PAH expression and PAH activity in a differenciated ADHLPC. ADHLPC were isolated from human hepatocyte primary culture of two different donors and differenciated under specific culture conditions. We demonstrated the high expression of PAH and a large increase of PAH activity in differenciated LPC. The age of the donor, the cellular viability after liver digestion and cryopreservation affects PAH activity. ADHLPC might therefore be considered as a suitable source for cell therapy in PKU.

  5. Primary malignant melanoma of the liver: A case report

    Institute of Scientific and Technical Information of China (English)

    Li Gong; Yan-Hong Li; Jian-Ye Zhao; Xu-Xia Wang; Shao-Jun Zhu; Wei Zhang

    2008-01-01

    Primary malignant melanoma of the liver is an exceedingly rare tumor.Only 12 cases have been reported in the worldwide lirerature.We present a case of isolated malignant melanoma of the liver occurring in a 36-year-old Chinese male patient.Comprehensive dermatologic and ophthalmologic examinations revealed no evidence of a cutaneous or ocular primary lesion.Other lesions in brain,respiratory tract,lung,gastrointestinal tract and anus,were not demonstrated by serial position emission tomography(PET).Microscopic examination of the resected specimen revealed a malignant melanoma,which was confirmed by immunohistochemical staining for HMB-45,S-100 protein,melanoma-pan and vimentin.Moreover,electron microscopy demonstrated melanosomes in tumor cell cytoplasm.Our case shows that primary malignant melanoma may occur in the liver and should be considered when the histopathological appearance is not typical for other hepatic neoplasm.

  6. Adult-to-adult living donor liver transplantation for acute liver failure in China

    Institute of Scientific and Technical Information of China (English)

    Ding Yuan; Fei Liu; Yong-Gang Wei; Bo Li; Lv-Nan Yan; Tian-Fu Wen; Ji-Chun Zhao

    2012-01-01

    AIM:To investigate the long-term outcome of recipients and donors of adult-to-adult living-donor liver transplantation (AALDLT) for acute liver failure (ALF).METHODS:Between January 2005 and March 2010,170 living donor liver transplantations were performed at West China Hospital of Sichuan University.All living liver donor was voluntary and provided informed consent.Twenty ALF patients underwent AALDLT for rapid deterioration of liver function.ALF was defined based on the criteria of the American Association for the Study of Liver Diseases,including evidence of coagulation abnormality [international normalized ratio (INR) ≥ 1.5] and degree of mental alteration without pre-existing cirrhosis and with an illness of < 26 wk duration.We reviewed the clinical indications,operative procedure and prognosis of AALDTL performed on patients with ALF and corresponding living donors.The potential factors of recipient with ALF and corresponding donor outcome were respectively investigated using multivariate analysis.Survival rates after operation were analyzed using the Kaplan-Meier method.Receiver operator characteristic (ROC) curve analysis was undertaken to identify the threshold of potential risk factors.RESULTS:The causes of ALF were hepatitis B (n =18),drug-induced (n =1) and indeterminate (n =1).The score of the model for end-stage liver disease was 37.1 ± 8.6,and the waiting duration of recipients was 5 ± 4 d.The graft types included right lobe (n=17) and dual graft (n =3).The mean graft weight was 623.3 ± 111.3 g,which corresponded to graft-to-recipient weight ratio of 0.95% ± 0.14%.The segment Ⅴor Ⅷ hepatic vein was reconstructed in 11 right-lobe grafts.The 1-year and 3-year recipient's survival and graft survival rates were 65% (13 of 20).Postoperative results of total bilirubin,INR and creatinine showed obvious improvements in the survived patients.However,the creatinine level of the deaths was increased postoperatively and became more aggravated

  7. Primary Meningococcal Polyarthritis in an Adult Woman

    Directory of Open Access Journals (Sweden)

    José Celso Giordan Cavalcanti Sarinho

    2015-01-01

    Full Text Available Primary joint infection caused by the Gram-negative bacteria Neisseria meningitidis is rare. Normally, joint involvement comes secondary to meningitis or severe sepsis caused by this agent. When primary arthritis is seen, monoarthritis is the most common presentation. A meningococcal polyarthritis is described in less than 10 case reports according to current literature. This case report aims to briefly review this rare clinical event in an adult woman with no previous history of rheumatological disease. Early diagnosis of polyarthritis caused by meningococcal bacteria usually present a good prognosis when properly treated.

  8. Adult primary hypoparathyroidism: A rare presentation

    Directory of Open Access Journals (Sweden)

    Ashima Datey Chakrabarty

    2013-01-01

    Full Text Available The common causes of stridor in adults are abscesses or swelling of upper airway, tumors, paralysis or malfunction of vocal cords. Laryngospasm due to hypocalcemia is a rare cause of stridor in adults, although occasionally reported in the neonates. We report an elderly lady having stridor and laryngospasm, secondary to acquired hypoparathyroidism and secondary hypocalcemia, without risk factors for hypoparathyroidism such as recent neck surgery or irradiation. We did an extensive review of literature to find only a few cases of acquired primary hypoparathyroidism in adults with the only complaint being stridor. This case underlines the fact that a common symptom like stridor rarely occurs due to uncommon causes. This case is being reported for its rarity and amenability to complete cure in event of correct diagnosis.

  9. Imaging of Primary Liver Carcinosarcoma Scintigraphically; A Case Report

    Directory of Open Access Journals (Sweden)

    Ümmühan Abdulrezzak

    2014-02-01

    Full Text Available Primary liver carcinosarcoma is a very rare disease. There have been only a few cases described to date, none of which has been imaged by bone scintigraphy. A 69-year-old man who developed right back pain and weight loss was admitted to our hospital. Tenderness of the right upper abdomen, hepatomegaly, and a giant mass were the main physical examination signs. Abdominal ultrasonography showed a large lobulated heterogeneous echogenic solid mass with multiple cystic areas of varying size and a highly echogenic region that had posterior acoustic shadowing within the mass in the right lobe of the liver. Labeled erythrocyte imaging and 99mTc-nanocolloid liver-spleen scan were performed to exclude hemangioma, showing a large intrahepatic photon deficient area. 99mTcmethylene diphosphonate (MDP bone scintigraphy revealed heterogeneous, irregular and dense activity accumulation thought to be osteoblastic activity in the liver mass. Postsurgical pathological diagnosis revealed “carcinosarcoma”.

  10. Oncogenic role of the Notch pathway in primary liver cancer

    Science.gov (United States)

    LU, JIE; XIA, YUJING; CHEN, KAN; ZHENG, YUANYUAN; WANG, JIANRONG; LU, WENXIA; YIN, QIN; WANG, FAN; ZHOU, YINGQUN; GUO, CHUANYONG

    2016-01-01

    Primary liver cancer, which includes hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and fibrolamellar HCC, is one of the most common malignancies and the third leading cause of cancer-associated mortality, worldwide. Despite the development of novel therapies, the prognosis of liver cancer patients remains extremely poor. Thus, investigation of the genetic background and molecular mechanisms underlying the development and progression of this disease has gained significant attention. The Notch signaling pathway is a crucial determinant of cell fate during development and disease in several organs. In the liver, Notch signaling is involved in biliary tree development and tubulogenesis, and is also significant in the development of HCC and ICC. These findings suggest that the modulation of Notch pathway activity may have therapeutic relevance. The present review summarizes Notch signaling during HCC and ICC development and discusses the findings of recent studies regarding Notch expression, which reveal novel insights into its function in liver cancer progression. PMID:27347091

  11. Ablation techniques for primary and metastatic liver tumors

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Ablative treatment methods have emerged as safe and effective therapies for patients with primary andsecondary liver tumors who are not surgical candidatesat the time of diagnosis. This article reviews the currentliterature and describes the techniques, complicationsand results for radiofrequency ablation, microwaveablation, cryoablation, and irreversible electroporation.

  12. Increased Porphyrins in Primary Liver Cancer Mainly Reflect a Parallel Liver Disease

    Directory of Open Access Journals (Sweden)

    Jerzy Kaczynski

    2009-01-01

    Full Text Available Hepatic porphyries have been associated with an increased risk of primary liver cancer (PLC, which on the other hand may cause an increased porphyrin production. To evaluate the role of an underlying liver disorder we analyzed porphyrins in patients with hepatocellular carcinoma (HCC (n=65, cholangiocellular carcinoma (n=3, or suspected PLC, which turned out to be metastases (n=18 or a benign disorder (n=11. None of the patients had a family history of porphyry or clinical signs of porphyry. Increased aminolevulinic acid or porphyrin values were common not only in patients with PLC (43% but also in metastatic (50% and benign (64% liver disorders. The corresponding proportion for HCC patients with liver cirrhosis (55% was higher (P<.05 than in those without cirrhosis (17%. We conclude that symptomatic porphyries are unusual in PLC, whereas elevated urinary and/or faecal porphyrins are common, primarily reflecting a parallel liver disease and not the PLC.

  13. Stereotactic radiotherapy of primary liver cancer and hepatic metastases

    Energy Technology Data Exchange (ETDEWEB)

    Wulf, Joern; Guckenberger, Matthias; Haedinger, Ulrich; Oppitz, Ulrich; Mueller, Gerd; Baier, Kurt; Flentje, Michael [Univ. of Wuerzburg (Germany). Dept. of Radiotherapy

    2006-09-15

    The purpose was to evaluate the clinical results of stereotactic radiotherapy in primary liver tumors and hepatic metastases. Five patients with primary liver cancer and 39 patients with 51 hepatic metastases were treated by stereotactic radiotherapy since 1997. Twenty-eight targets were treated in a 'low-dose'-group with 3x10 Gy (n=27) or 4x7 Gy (n=1) prescribed to the PTV-encl. 65%-isodose. In a 'high-dose'-group patients were treated with 3x12 - 12.5 Gy (n=19; same dose prescription) or 1x26 Gy/PTV-enclosing 80%-isodose (n=9). Median follow-up was 15 months (2-48 months) for primary liver cancer and 15 months (2-85 months) for hepatic metastases. While all primary liver cancers were controlled, nine local failures (3-19 months) of 51 metastases were observed resulting in an actuarial local control rate of 92% after 12 months and 66% after 24 months and later. A borderline significant correlation between dose and local control was observed (p=0.077): the actuarial local control rate after 12 and 24?months was 86% and 58% in the low-dose-group versus 100% and 82% in the high-dose-group. In multivariate analysis high versus low-dose was the only significant factor predicting local control (p=0.0089). Overall survival after 1 and 2 years was 72% and 32% for all patients and was impaired due to systemic progression of disease. No severe acute or late toxicity exceeding RTOG/EORTC-score 2 were observed. Stereotactic irradiation of primary liver cancer and hepatic metastases offers a locally effective treatment without significant complications in patients, who are not amenable for surgery. Patient selection is important, because those with low risk for systemic progression are more likely to benefit from this approach.

  14. Estimating liver weight of adults by body weight and gender

    Institute of Scientific and Technical Information of China (English)

    See Ching Chan; Chi Leung Liu; Chung Mau Lo; Banny K Lam; Evelyn W Lee; Yik Wong; Sheung Tat Fan

    2006-01-01

    AIM: To estimate the standard liver weight for assessing adequacies of graft size in live donor liver transplantation and remnant liver in major hepatectomy for cancer.METHODS: In this study, anthropometric data of body weight and body height were tested for a correlation with liver weight in 159 live liver donors who underwent donor right hepatectomy including the middle hepatic vein. Liver weights were calculated from the right lobe graft weight obtained at the back table, divided by the proportion of the right lobe on the computed tomography.RESULTS: The subjects, all Chinese, had a mean age of 35.8 ± 10.5 years, and a female to male ratio of 118:41. The mean volume of the right lobe was 710.14 ±131.46 mL and occupied 64.55%±4.47% of the whole liver on computed tomography. Right lobe weighed 598.90±117.39 g and the estimated liver weight was 927.54 ± 168.78 g. When body weight and body height were subjected to multiple stepwise linear regression analysis, body height was found to be insignificant. Females of the same body weight had a slightly lower liver weight. A formula based on body weight and gender was derived: Estimated standard liver weight (g) = 218 + BW (kg) x 12.3 + genderx 51 (R2 = 0.48)(female = 0, male = 1). Based on the anthropometric data of these 159 subjects, liver weights were calculated using previously published formulae derived from studies on Caucasian, Japanese, Korean, and Chinese.All formulae overestimated liver weights compared to this formula. The Japanese formula overestimated the estimated standard liver weight (ESLW) for adults less than 60 kg.CONCLUSION: A formula applicable to Chinese males and females is available. A formula for individual races appears necessary.

  15. Adult-to-Adult Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Shimul A Shah

    2006-01-01

    Full Text Available The present review outlines the principles of living donor liver transplantation, donor workup, procedure and outcomes. Living donation offers a solution to the growing gap between the need for liver transplants and the limited availability of deceased donor organs. With a multidisciplinary team focused on donor safety and experienced surgeons capable of performing complex resection/reconstruction procedures, donor morbidity is low and recipient outcomes are comparable with results of deceased donor transplantation.

  16. [Living donor liver transplantation in adults].

    Science.gov (United States)

    Neumann, U P; Neuhaus, P; Schmeding, M

    2010-09-01

    The worldwide shortage of adequate donor organs implies that living donor liver transplantation represents a valuable alternative to cadaveric transplantation. In addition to the complex surgical procedure the correct identification of eligible donors and recipients plays a decisive role in living donor liver transplantation. Donor safety must be of ultimate priority and overrules all other aspects involved. In contrast to the slightly receding numbers in Europe and North America, in recent years Asian programs have enjoyed constantly increasing living donor activity. The experience of the past 15 years has clearly demonstrated that technical challenges of both bile duct anastomosis and venous outflow of the graft significantly influence postoperative outcome. While short-term in-hospital morbidity remains increased compared to cadaveric transplantation, long-term survival of both graft and patient are comparable or even better than in deceased donor transplantation. Especially for patients expecting long waiting times under the MELD allocation system, living donor liver transplantation offers an excellent therapeutic alternative. Expanding the so-called "Milan criteria" for HCC patients with the option for living donor liver transplantation is currently being controversially debated.

  17. In Vitro Generation of Functional Liver Organoid-Like Structures Using Adult Human Cells.

    Directory of Open Access Journals (Sweden)

    Sarada Devi Ramachandran

    Full Text Available In this study we used differentiated adult human upcyte® cells for the in vitro generation of liver organoids. Upcyte® cells are genetically engineered cell strains derived from primary human cells by lenti-viral transduction of genes or gene combinations inducing transient proliferation capacity (upcyte® process. Proliferating upcyte® cells undergo a finite number of cell divisions, i.e., 20 to 40 population doublings, but upon withdrawal of proliferation stimulating factors, they regain most of the cell specific characteristics of primary cells. When a defined mixture of differentiated human upcyte® cells (hepatocytes, liver sinusoidal endothelial cells (LSECs and mesenchymal stem cells (MSCs was cultured in vitro on a thick layer of Matrigel™, they self-organized to form liver organoid-like structures within 24 hours. When further cultured for 10 days in a bioreactor, these liver organoids show typical functional characteristics of liver parenchyma including activity of cytochromes P450, CYP3A4, CYP2B6 and CYP2C9 as well as mRNA expression of several marker genes and other enzymes. In summary, we hereby describe that 3D functional hepatic structures composed of primary human cell strains can be generated in vitro. They can be cultured for a prolonged period of time and are potentially useful ex vivo models to study liver functions.

  18. Fetal and adult liver stem cells for liver regeneration and tissue engineering.

    Science.gov (United States)

    Fiegel, H C; Lange, Claudia; Kneser, U; Lambrecht, W; Zander, A R; Rogiers, X; Kluth, D

    2006-01-01

    For the development of innovative cell-based liver directed therapies, e.g. liver tissue engineering, the use of stem cells might be very attractive to overcome the limitation of donor liver tissue. Liver specific differentiation of embryonic, fetal or adult stem cells is currently under investigation. Different types of fetal liver (stem) cells during development were identified, and their advantageous growth potential and bipotential differentiation capacity were shown. However, ethical and legal issues have to be addressed before using fetal cells. Use of adult stem cells is clinically established, e.g. transplantation of hematopoietic stem cells. Other bone marrow derived liver stem cells might be mesenchymal stem cells (MSC). However, the transdifferentiation potential is still in question due to the observation of cellular fusion in several in vivo experiments. In vitro experiments revealed a crucial role of the environment (e.g. growth factors and extracellular matrix) for specific differentiation of stem cells. Co-cultured liver cells also seemed to be important for hepatic gene expression of MSC. For successful liver cell transplantation, a novel approach of tissue engineering by orthotopic transplantation of gel-immobilized cells could be promising, providing optimal environment for the injected cells. Moreover, an orthotopic tissue engineering approach using bipotential stem cells could lead to a repopulation of the recipients liver with healthy liver and biliary cells, thus providing both hepatic functions and biliary excretion. Future studies have to investigate, which stem cell and environmental conditions would be most suitable for the use of stem cells for liver regeneration or tissue engineering approaches.

  19. Expression of Twist Gene in Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    XU Jing; CHEN Xiaoping

    2007-01-01

    In order to investigate the possibility of overexpression of Twist in primary liver cancer (PLC), the Twist expression was detected by using immunohistochemical analysis and RT-PCR assay in 45 patients with PLC. Control tissues were obtained from 9 patients with liver hemangioma. It was found that in 36 (80.0%) out of 45 PLC patients, cancerous regions showed positive cytoplasm and nucleus staining for Twist with a diffuse pattern. In noncancerous adjacent areas and control liver tissues, the expression of Twist was 57.8% and 22.2% respectively. The results of RT-PCR assay re- vealed that the expression of Twist was stronger in the cancerous tissues than that in the noncancer- ous adjacent tissues. It was suggested that the expression of Twist was up-regulated in PLC, which play an important role in the progression of PLC.

  20. Small-for-size syndrome in adult-to-adult living-related liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Salvatore; Gruttadauria; Duilio; Pagano; Angelo; Luca; Bruno; Gridelli

    2010-01-01

    Small-for-size syndrome (SFSS) in adult-to-adult living-related donor liver transplantation (LRLT) remains the greatest limiting factor for the expansion of segmental liver transplantation from either cadaveric or living donors. Portal hyperperfusion, venous pathology, and the arterial buffer response signif icantly contribute to clinical and histopathological manifestations of SFSS. Here, we review the technical aspects of surgical and radiological procedures developed to treat SFSS in LRLT, along with the...

  1. Primary hepatic leiomyosarcoma with liver metastasis of rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Kiyoto Takehara; Hideki Aoki; Yuko Takehara; Rie Yamasaki; Kohji Tanakaya; Hitoshi Takeuchi

    2012-01-01

    Primary hepatic leiomyosarcoma is a particularly rare tumor with a poor prognosis.Curative resection is currently the only effective treatment,and the efficacy of chemotherapy is unclear.This represents the first case report of a patient with primary hepatic leiomyosarcoma co-existing with metastatic liver carcinoma.We present a 59-year-old man who was diagnosed preoperatively with rectal cancer with multiple liver metastases.He underwent a curative hepatectomy after a series of chemotherapy regimens with modified FOLFOX6 consisting of 5-fluorouracil,leucovorin and oxaliplatin plus bevacizumab,FOLFIRI consisting of 5-fluorouracil,leucovorin and irinotecan plus bevacizumab,and irinotecan plus cetuximab.One of the liver tumors showed a different response to chemotherapy and was diagnosed as a leiomyosarcoma following histopathological examination.This case suggests that irinotecan has the potential to inhibit the growth of hepatic leiomyosarcomas.The possibility of comorbid different histological types of tumors should be suspected when considering the treatment of multiple liver tumors.

  2. Transarterial chemoembolization for primary and metastatic liver tumors

    Directory of Open Access Journals (Sweden)

    Popov M.V.

    2016-12-01

    Full Text Available The literature review presents the methodology of transarterial chemoembolization (TACE — widely used method of treatment of primary and secondary liver tumors. The TACE role as a neoadjuvant therapy and the role in the management of unresectable primary and secondary liver tumors are shown. The morphofunctional basis of TACE, benefits of superselective intra-arterial administration of cytostatic agents especially in combination with ischemic impact on a tumor are described. The subject of the choice of the chemotherapeutic agent is also touched; modern drug-loaded microspheres which allow the use of higher doses of the chemotherapeutic drug without increasing systemic effect and prolong its effect on tumor are described. Lack of correlation of presence and severity of a post-embolization syndrome with success of the procedure is noted.

  3. Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng; LU Sheng; PU Liyong; LU Ling; WANG Xuehao; LI Xiangcheng; KONG Lianbao; SUN Beicheng; LI Guoqiang; QIAN Xiaofen; CHEN Feng; WANG Ke

    2007-01-01

    Fulminant hepatitis is fatal in most cases and timely liver transplantation is the only effective treatment.This study evaluates the survival outcomes of patients who underwent living-donor liver transplantation (LDLT)using right lobe liver grafts for fulminant liver failure due to hepatitis B infection.Nine cases of adult right lobe LDLT were performed in our department from September 2002 to August 2005 and the clinical and following-up data were reviewed.According to the pre-transplant Child-Pugh-Turcotte classification,the nine patients were classified as grade C.The model for end-stage liver disease (MELD) score of these patients ranged from 16 to 42.The principal complications before transplantation included abnormal renal function,hepatic coma of different degrees and alimentary tract hemorrhage.The main complications after transplantation included pulmonary infection in two cases,acute renal failure in three cases and transplantation-related encephalopathy in one case.No primary failure of vascular or biliary complications occurred.The one-year survival rate was 55.6%.There were no serious complications or deaths in donors.In general,it is extremely difficult to treat fulminant hepatitis by conservative regimen,particularly,in cases with rapid progresslon.Emergency adult living-donor liver transplantation is an effective treatment for fulminant hepatitis patients and is relatively safe for donors.

  4. Imaging of Primary Liver Carcinosarcoma Scintigraphically; A Case Report

    Science.gov (United States)

    Abdulrezzak, Ümmühan; Kula, Mustafa; Erdoğan, Zeynep; Tutuş, Ahmet

    2014-01-01

    Primary liver carcinosarcoma is a very rare disease. There have been only a few cases described to date, none of which has been imaged by bone scintigraphy. A 69-year-old man who developed right back pain and weight loss was admitted to our hospital. Tenderness of the right upper abdomen, hepatomegaly, and a giant mass were the main physical examination signs. Abdominal ultrasonography showed a large lobulated heterogeneous echogenic solid mass with multiple cystic areas of varying size and a highly echogenic region that had posterior acoustic shadowing within the mass in the right lobe of the liver. Labeled erythrocyte imaging and 99mTc-nanocolloid liver-spleen scan were performed to exclude hemangioma, showing a large intrahepatic photon deficient area. 99mTc-methylene diphosphonate (MDP) bone scintigraphy revealed heterogeneous, irregular and dense activity accumulation thought to be osteoblastic activity in the liver mass. Postsurgical pathological diagnosis revealed “carcinosarcoma”. Conflict of interest:None declared. PMID:24653934

  5. Adult-to-adult living donor liver transplantation using extended right lobe grafts

    OpenAIRE

    Lo, CM; Fan, ST; Wei, WI; Lai, CL; Ng, IOL; Wong, J.; Uu, CL; Lo, RJW; Chan, JKF; Fung, A

    1997-01-01

    Objective: The authors report their experience with living donor liver transplantation (LDLT) using extended right lobe grafts for adult patients under high-urgency situations. Summary Background Data: The efficacy of LDLT in the treatment of children has been established. The major limitation of adult-to-adult LDLT is the adequacy of the graft size. A left lobe graft from a relatively small volunteer donor will not meet the metabolic demand of a larger recipient. Methods: From May 1996 to No...

  6. Salvage Liver Transplantation Leads to Poorer Outcome in Hepatocellular Carcinoma Compared with Primary Liver Transplantation

    Science.gov (United States)

    Shan, Yuhua; Huang, Lifeng; Xia, Qiang

    2017-01-01

    Hepatocellular carcinoma is the most common liver malignancy. Salvage liver transplantation (SLT) is viewed as a feasible cure for recurrence of HCC after resectomy, but the effect is under dispute. A retrospective study examined data at Renji Hospital for 239 transplants from January 2006 to December 2015, including 211 who received primary liver transplantation (PLT) and 28 who underwent SLT. A multivariable cox regression model was employed to pick out relative factors to overall survival (OS) and recurrence free survival (RFS). Propensity score matching (PSM) was used to balance the bias. Both OS and RFS were worse in SLT group than in PLT group, especially for those patients within Milan criteria. Our study demonstrates that SLT bears higher risk of recurrence and death than PLT, indicating that SLT should be given a more careful thought at performance. PMID:28294176

  7. CIRRHOSIS AND PRIMARY (LIVER CANCER CARCINOMA INCIDENCE IN IRAN

    Directory of Open Access Journals (Sweden)

    K. Armin

    1970-07-01

    Full Text Available The incidence of cirrhosis and primary hepatic carcinoma in the autopsy material is studied. in 4389 autopsies performed, during the last 9 years we found 134 (3% cases of cirrhosis and 24 (0.5% cases of primary hepatic carcinoma. The majority of the patients were from NorthWest and west part of the city. of the 134 cases of cirrhosis 90 correspond to the portal type, 24 to the post-necrotic type, 12 to the biliary cirrhosis, 6 to the post-hepatitis cirrhosis and two cardiac cisrhosis. 19 of our 134 cases of cirrhosis, occured in children between the age of 4months to 13 years. The liver of the 90 cases diagnosed, Portal cirrhosis were characterized grossely by weights from 510-2800 Gr and fine uniformly nodular surface. Micscopically there was marked, fatty change of hepatic cells, focal and spotty necrosis and delicated fibrillary tongue, interconnecting portal spaces. of the 24 cases post-necrotic cirrhosis 4 had had (26% an antecedent jaundice. The liver ranged, from 700-2500 gr., presenting broad scarring and coars nodules. In bur six cases, Post-hepatitic cirrhosis, the liver were redish brown, and presented uniform nodules, 0,5 to 1.5 Cm. in diameter. Liver weights varried form 850 to 1200 Gr. Microscopically 17 cases of carcinoma were hepato-carcinoma, two presented mixed structures of hepatoma and 5 cases were cholangio Carcinoma. Six of hepatomas showed previous portal cirrhosis and one mixed carcinoma showed previous portal cirrhosis.

  8. Primary Lymphoma of the Liver: A Case Report and Review

    Directory of Open Access Journals (Sweden)

    Franzjosef Schweiger

    2000-01-01

    Full Text Available The case of a previously healthy man who developed primary non-Hodgkin’s lymphoma of the liver is presented. Biopsy confirmed that the tumour was of the diffuse large cell type and was of apparent T-cell origin. The diagnosis of these rare tumours is suggested by the presence of a hepatic mass without lymphadenopathy, splenomegaly or bone marrow involvement, as well as normal carcinoembryonic antigen and alpha-fetoprotein levels. However, histological examination of tissue is essential to confirm the diagnosis. The response to treatment varies, but surgical resection and/or chemotherapy can result in prolonged remissions. The literature on this topic is briefly reviewed.

  9. Non-coding RNAs in primary liver cancer

    Directory of Open Access Journals (Sweden)

    Michele eGhidini

    2015-06-01

    Full Text Available Hepatocellular carcinoma (HCC is a primary malignancy of the liver with poor prognosis and limited therapeutic options. Over the past few years, many studies have evaluated the role of non-coding RNAs (ncRNAs in hepatocarcinogenesis and tumour progression. ncRNAs were shown to have diagnostic, prognostic and therapeutic potential in HCC. In this manuscript, we review the latest major discoveries concerning microRNAs and long ncRNAs in HCC pathogenesis, and discuss the potentials and the limitations for their use in clinical practice.

  10. Interventional radiology procedures in adult patients who underwent liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Roberto Miraglia; Luigi Maruzzelli; Settimo Caruso; Mariapina Milazzo; Gianluca Marrone; Giuseppe Mamone; Vincenzo Carollo; Salvatore Gruttadauria; Angelo Luca; Bruno Gridelli

    2009-01-01

    Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

  11. Congenital hepatic fibrosis, liver cell carcinoma and adult polycystic kidneys.

    Science.gov (United States)

    Manes, J L; Kissane, J M; Valdes, A J

    1977-06-01

    In reviewing the literature, we found no liver cell carcinoma (LCC) or well-documented adult polycystic kidneys (APK) associated with congenital hepatic fibrosis (CHF). We report a 69-year-old man with CHF, LCC, APK, duplication cyst of distal portion of stomach, two calcified splenic artery aneurysms, myocardial fibrosis and muscular hypertrophy of esophagus. The LCC was grossly predunculated and microscopically showed prominent fibrosis and hyaline intracytoplasmic inclusions in the tumor cells.

  12. Open-Porous Hydroxyapatite Scaffolds for Three-Dimensional Culture of Human Adult Liver Cells

    Directory of Open Access Journals (Sweden)

    Anthony Finoli

    2016-01-01

    Full Text Available Liver cell culture within three-dimensional structures provides an improved culture system for various applications in basic research, pharmacological screening, and implantable or extracorporeal liver support. Biodegradable calcium-based scaffolds in such systems could enhance liver cell functionality by providing endothelial and hepatic cell support through locally elevated calcium levels, increased surface area for cell attachment, and allowing three-dimensional tissue restructuring. Open-porous hydroxyapatite scaffolds were fabricated and seeded with primary adult human liver cells, which were embedded within or without gels of extracellular matrix protein collagen-1 or hyaluronan. Metabolic functions were assessed after 5, 15, and 28 days. Longer-term cultures exhibited highest cell numbers and liver specific gene expression when cultured on hydroxyapatite scaffolds in collagen-1. Endothelial gene expression was induced in cells cultured on scaffolds without extracellular matrix proteins. Hydroxyapatite induced gene expression for cytokeratin-19 when cells were cultured in collagen-1 gel while culture in hyaluronan increased cytokeratin-19 gene expression independent of the use of scaffold in long-term culture. The implementation of hydroxyapatite composites with extracellular matrices affected liver cell cultures and cell differentiation depending on the type of matrix protein and the presence of a scaffold. The hydroxyapatite scaffolds enable scale-up of hepatic three-dimensional culture models for regenerative medicine applications.

  13. Open-Porous Hydroxyapatite Scaffolds for Three-Dimensional Culture of Human Adult Liver Cells.

    Science.gov (United States)

    Finoli, Anthony; Schmelzer, Eva; Over, Patrick; Nettleship, Ian; Gerlach, Joerg C

    2016-01-01

    Liver cell culture within three-dimensional structures provides an improved culture system for various applications in basic research, pharmacological screening, and implantable or extracorporeal liver support. Biodegradable calcium-based scaffolds in such systems could enhance liver cell functionality by providing endothelial and hepatic cell support through locally elevated calcium levels, increased surface area for cell attachment, and allowing three-dimensional tissue restructuring. Open-porous hydroxyapatite scaffolds were fabricated and seeded with primary adult human liver cells, which were embedded within or without gels of extracellular matrix protein collagen-1 or hyaluronan. Metabolic functions were assessed after 5, 15, and 28 days. Longer-term cultures exhibited highest cell numbers and liver specific gene expression when cultured on hydroxyapatite scaffolds in collagen-1. Endothelial gene expression was induced in cells cultured on scaffolds without extracellular matrix proteins. Hydroxyapatite induced gene expression for cytokeratin-19 when cells were cultured in collagen-1 gel while culture in hyaluronan increased cytokeratin-19 gene expression independent of the use of scaffold in long-term culture. The implementation of hydroxyapatite composites with extracellular matrices affected liver cell cultures and cell differentiation depending on the type of matrix protein and the presence of a scaffold. The hydroxyapatite scaffolds enable scale-up of hepatic three-dimensional culture models for regenerative medicine applications.

  14. Rational Operation for Primary Gastric Carcinoma with Liver Metastasis

    Institute of Scientific and Technical Information of China (English)

    Caigang Liu; Ping Lu; Jinsong Gu; Junqing Chen

    2007-01-01

    OBJECTIVE To investigate the prognosis of advanced gastric carcinoma patients with liver metastasis, and provide a foundation for rational operations.METHODS The operations and prognosis of 102 primary gastric carcinoma patients with liver metastasis were studied retrospectively. RESULTS In gastric carcinoma patients with H1 metastasis who under went a resection operation, the 6-month, 1- and 2-year post-operative survival rates were 61%, 42% and 7%. There was a statistically significant difference in survival between resected and non-resected patients (P=0.000) In gastric carcinoma cases with H2 metastasis, resection operations resulted in 54%,16% and 8% respective survival rates, with no significant difference compared to patients not receiving a resection (P=0.132). Gastric carcinoma patients with H3 metastasis who received a resection operation showed 25%, 13% and 0% respective survivals with no significantly better prognosis compared to the non-resected cases (P=0.135). There was no statistically significant difference in survival between the cases with or without peritoneal metastasis (P=0.152).CONCLUSION A resection operation provides a better prognosis for gastric carcinoma patients with H1 metastasis independent of peritoneal metastasis, but resection has no benefit for gastric carcinoma cases with H2 or H3 metastasis. Peritoneal metastases are not the significant influencing factor for the prognosis of gastric cancer with liver metastasis.

  15. Sonic Hedgehog signaling pathway in primary liver cancer cells

    Institute of Scientific and Technical Information of China (English)

    Lian-Yi Guo; Pei Liu; Ying Wen; Wei Cui; Ying Zhou

    2014-01-01

    Objective:To investigate clinical significance ofSonicHedgehog(SHH) signaling pathway molecularShh,Smo andGli2 in primary hepatocellular carcinoma(HCC) tissue.Methods:A total of30HCC tissue samples were collected.Protein expression ofSHH signaling pathway moleculesShh,Smo andGli2 inHCC tissues and para - carcinoma tissue were detected by using immunohistochemical method.Cirrhosis and normal liver tissue specimens were observed as control to analyze the expression ofSHH signaling pathway molecularShh,Smo andGli2 mRNA inHCC tissues and corresponding para-carcinoma tissues and its relationship with the onset of HCC.Results:There was no expression ofShh,Smo andGli2 protein in normal liver tissue, while their positive rates were63.3%,76.7% and66.7% inHCC tissues, respectively, with asignificantly higher expression level than that in the para - carcinoma tissue(P0.05);Shh andSmo protein was detected in part of cirrhosis with positive expression, butGli2 protein was not observable in cirrhosis tissues.Conclusions:InHCC tissues, the high expression level ofSHH signaling pathway molecules signal peptide(Shh), membrane protein receiptor(Smo) and nuclear transcription molecular(Gli2) can be indicators of the onset of liver cancer.

  16. Risk factors for primary liver carcinoma in Chinese population

    Institute of Scientific and Technical Information of China (English)

    Rui-Hong Luo; Zhi-Xin Zhao; Xu-Yu Zhou; Zhi-Liang Gao; Ji-Lu Yao

    2005-01-01

    AIM: To evaluate the risk factors for primary liver carcinoma (PLC) in Chinese population.METHODS: Chinese Biomedical Literature Database,China Hospital Knowledge Database and MEDLINE were searched. All the related literatures were screened, and the risk factors for PLC in Chinese population were studied.Heterogeneity was evaluated by odds ratio (OR) q test.Combined OR and its 95% confidence interval (95%CI)were calculated, the association between the investigated risk factors and PLC was determined. Validity and bias of the findings were evaluated by sensitivity analysis and funnel plot analysis respectively.RESULTS: Fifty-five of one hundred and ninety identified studies were accepted according to the inclusive criteria.Ten factors related to PLC were demonstrated by sensitive analysis and funnel plot analysis. They were cirrhosis (OR = 11.97, P= 0.000), HBV infection (OR = 11.34, P= 0.000),HCV infection (OR = 4.28, P = 0.000), family history of liver cancer (OR = 3.49, P = 0.000), unstable emotion (OR = 2.20, P = 0.000), depressed characters (OR = 3.07,P = 0.000), aflatoxin (OR = 1.80, P = 0.000), alcoholic (OR = 1.88, P = 0.000), intake of musty food (OR = 1.87,P = 0.000) and drinking contaminated water from pond (OR = 1.77, P= 0.003).CONCLUSION: The main risk factors for PLC in China are liver diseases, family history of liver carcinoma, poor psychic status, afiatoxin, and some unhealthy behaviors.

  17. Recurrence of primary sclerosing cholangitis in pediatric liver transplant recipients.

    Science.gov (United States)

    Venkat, Veena L; Ranganathan, Sarangarajan; Mazariegos, George V; Sun, Qing; Sindhi, Rakesh

    2014-06-01

    There is little detailed clinical information on recurrent primary sclerosing cholangitis (rPSC) after liver transplantation in children. Our purpose was to describe the characteristics of children who had experienced rPSC after liver transplantation so that we could identify potential risk factors for recurrence. Clinical information for pediatric patients undergoing transplantation for primary sclerosing cholangitis (PSC) was retrospectively reviewed, and variables related to the pretransplant diagnosis of PSC and posttransplant variables were abstracted. The studied variables included the following: cytomegalovirus/Epstein-Barr virus status, early/late rejection, induction regimen, immunosuppression in the first year, steroid-resistant rejection, diagnosis of inflammatory bowel disease, and human leukocyte antigen markers commonly associated with PSC. A diagnosis of rPSC was made on the basis of radiographic features, histology, or both. Twelve patients underwent liver transplantation for PSC between 1993 and 2012. Patients received tacrolimus for maintenance immunosuppression after induction with steroids (n = 6) or thymoglobulin (n = 6). Three patients were diagnosed with rPSC 44, 60, and 62 months after transplantation. A fourth patient underwent retransplantation for graft failure with features of both hepatic artery stenosis and rPSC. This patient had distinct histological features of rPSC in the second graft. Three of the 4 patients were 7 years old or younger at the diagnosis of PSC. The patient and graft survival rates were similar for the steroid and thymoglobulin groups. All 4 children with rPSC received steroid-free thymoglobulin induction. In conclusion, our observation of an association between thymoglobulin, and age less than 10 years at the diagnosis of PSC, and rPSC adds to the existing suggestion of a link between the immune environment and the pathogenesis of rPSC. Defining the natural history of rPSC and searching for the etiology and

  18. Liver graft regeneration in right lobe adult living donor liver transplantation.

    Science.gov (United States)

    Cheng, Y-F; Huang, T-L; Chen, T-Y; Tsang, L L-C; Ou, H-Y; Yu, C-Y; Concejero, A; Wang, C-C; Wang, S-H; Lin, T-S; Liu, Y-W; Yang, C-H; Yong, C-C; Chiu, K-W; Jawan, B; Eng, H-L; Chen, C-L

    2009-06-01

    Optimal portal flow is one of the essentials in adequate liver function, graft regeneration and outcome of the graft after right lobe adult living donor liver transplantation (ALDLT). The relations among factors that cause sufficient liver graft regeneration are still unclear. The aim of this study is to evaluate the potential predisposing factors that encourage liver graft regeneration after ALDLT. The study population consisted of right lobe ALDLT recipients from Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan. The records, preoperative images, postoperative Doppler ultrasound evaluation and computed tomography studies performed 6 months after transplant were reviewed. The volume of the graft 6 months after transplant divided by the standard liver volume was calculated as the regeneration ratio. The predisposing risk factors were compiled from statistical analyses and included age, recipient body weight, native liver disease, spleen size before transplant, patency of the hepatic venous graft, graft weight-to-recipient weight ratio (GRWR), posttransplant portal flow, vascular and biliary complications and rejection. One hundred forty-five recipients were enrolled in this study. The liver graft regeneration ratio was 91.2 +/- 12.6% (range, 58-151). The size of the spleen (p = 0.00015), total portal flow and GRWR (p = 0.005) were linearly correlated with the regeneration rate. Patency of the hepatic venous tributary reconstructed was positively correlated to graft regeneration and was statistically significant (p = 0.017). Splenic artery ligation was advantageous to promote liver regeneration in specific cases but splenectomy did not show any positive advantage. Spleen size is a major factor contributing to portal flow and may directly trigger regeneration after transplant. Control of sufficient portal flow and adequate hepatic outflow are important factors in graft regeneration.

  19. Gut perforation after orthotopic liver transplantation in adults

    Institute of Scientific and Technical Information of China (English)

    Jun Xiong; Shen You; Xiao-Shun He

    2007-01-01

    AIM: To describe cases of gut perforation after orthotopic liver transplantation.METHODS: Data were colleted from our center database and medical records. Six of 187 patients (3.2%)who underwent orthotopic liver transplantation from January to December 2005 developed gut perforation.All patients were male with an average age of 46 years.Modified piggyback liver transplantation was performed at the Organ Transplantation Center, First Affiliated Hospital, Sun Yat-Sen University.RESULTS: Previous operation, steroid therapy, and prolonged portal venous cross clamp time, poor nutritional status and iatrogenic injury were found to be its ecological factors. The patients with gut perforation were found to have fever, increased leukocytes, mild abdominal pain and tenderness. The median portal venous clamp time was 63 min (range 45-72 min),median cold ischaemia time was 11.3 h (range 7-15 h).Median intraoperative blood loss was 500 mL (range 100-1200 mL) and median operation time was 8.8 h (range 6-12 h). None of the six patients developed acute cellular rejection. White cell count was above 18 × 109/L in five patients (neutrophilic leukocytes were above 90%) and 1.5 × 109/L in one patient. Bacterial culture in drainage liquid revealed enterococci in five patients. Of the 6 patients undergoing orthotopic liver transplantation, 3 survived and 3 died after modified piggyback liver transplantation.CONCLUSION: Gut perforation occurs after orthotopic liver transplantation in adults. A careful and minimal dissection during OLT, longer retention of the stomach tube, and reducing the portal clamp time and steroid dose should be taken into consideration. If gut perforation is not prevented, then early diagnosis,preferably through detection of enterococci may ensure better survival.

  20. Pharmacologic therapy for nonalcoholic fatty liver disease in adults.

    Science.gov (United States)

    Malinowski, Scott S; Byrd, Jennifer S; Bell, Allison M; Wofford, Marion R; Riche, Daniel M

    2013-02-01

    Nonalcoholic fatty liver disease (NAFLD) is characterized by the accumulation of triglycerides in hepatocytes in the absence of excessive alcohol intake, ranging in severity from simple steatosis to nonalcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis can ultimately progress to cirrhosis and hepatocellular carcinoma. NAFLD is associated with cardiometabolic risk factors and is the most common chronic liver disease among adults in the Western Hemisphere. Although simple steatosis is generally considered a self-limiting disease, evidence suggests an increased risk of cardiovascular disease, and, less conclusively, mortality, among individuals with NAFLD and/or NASH. The current standard of care for the treatment of patients with NAFLD focuses on lifestyle interventions, particularly diet and exercise. There is a lack of consensus regarding the most effective and appropriate pharmacologic therapy. A PubMed search was conducted using the medical subject heading terms "fatty liver" and "steatohepatitis." This review focuses on the current pharmacologic options available for treating adults with NAFLD and/or NASH. Continued investigation of drugs or combinations that improve NAFLD progression is crucial. Clinicians, particularly pharmacists, must take an active role in identification and appropriate selection of pharmacotherapy for NAFLD.

  1. Primary Tubercular Liver Abscess Complicated by Tubercular Meningitis in Portal Cavernoma Cholangiopathy

    Science.gov (United States)

    Choksi, Dhaval; Poddar, Prateik; Shah, Kaivan; Ingle, Meghraj; Sawant, Prabha

    2016-01-01

    While hepatic tuberculosis is rare, primary tubercular liver abscess (TLA) is a rarer condition even in endemic countries such as India. Liver abscess in portal cavernoma cholangiopathy (PCC) is predominantly pyogenic. A 14-year-old girl was found to have PCC with multiple liver abscesses. Persistent fever and development of neurological symptoms prompted further evaluation, and she was found to have primary TLA complicated by tubercular meningitis. We report a rare case of primary TLA complicated by tubercular meningitis in asymptomatic PCC.

  2. Histochemical and immunohistochemical analyses of primary carcinoma of the liver.

    Directory of Open Access Journals (Sweden)

    Sacho,Masanori

    1991-12-01

    Full Text Available Hematoxylin and eosin (H-E stained liver sections of 47 autopsy cases of hepatic malignancies were examined. There were 43 cases of hepatocellular carcinoma (subtypes of 30 trabecular, 7 solid, 5 pseudoglandular, and one scirrhous carcinoma, 3 of cholangiocellular carcinoma and one of mixed carcinoma. After immunohistochemical staining, benign hepatocytes reacted positively with anti-epithelial membrane antigen (EMA. Hepatocellular carcinoma cells reacted more weakly than benign hepatocytes. It was noted that the microtubular structure, which could not be demonstrated even by alcian blue or cationic ferric hydroxide colloid stabilized with cacodylate (Fe-CaC, was clearly detected with anti-EMA. The EMA-positive microtubular structures may indicate terminal cholangiolar differentiation. Based on EMA, seven more cases formerly classified as hepatocellular carcinoma by H-E were reclassified as mixed carcinoma, totaling eight (17.0%. The histologic classification of "mixed carcinoma" has been 1.5 to 2.0% of primary liver cancers in Japan, but we suggest there may be more cases of "mixed carcinoma" identified in the future. In conclusion, we emphasize that EMA staining is useful for more accurate classification of hepatic tumors.

  3. Recurrence and rejection in liver transplantation for primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Bjarte Fosby; Tom H Karlsen; Espen Melum

    2012-01-01

    Primary sclerosing cholangitis (PSC) is a chronic progressive inflammatory disease affecting the bile ducts, leading to fibrosis and eventually cirrhosis in most patients. Its etiology is unknown and so far no effective medical therapy is available. Liver transplantation (LTX) is the only curative treatment and at present PSC is the main indication for LTX in the Scandinavian countries. Close to half of the PSC patients experience one or more episodes of acute cellular rejection (ACR) following transplantation and approximately 1/5 of the transplanted patients develop recurrent disease in the graft. In addition, some reports indicate that ACR early after LTX for PSC can influence the risk for recurrent disease. For these important post-transplantation entities affecting PSC patients, we have reviewed the current literature on epidemiology, pathogenesis, treatment and the possible influence of rejection on the risk of recurrent disease in the allograft.

  4. Purification of fetal liver stem/progenitor cells containing all the repopulation potential for normal adult rat liver

    DEFF Research Database (Denmark)

    Oertel, Michael; Menthena, Anuradha; Chen, Yuan-Qing

    2008-01-01

    BACKGROUND & AIMS: Previously, we showed high-level, long-term liver replacement after transplantation of unfractionated embryonic day (ED) 14 fetal liver stem/progenitor cells (FLSPC). However, for clinical applications, it will be essential to transplant highly enriched cells, while maintaining....... Rat ED14 FLSPC are alpha-fetoprotein(+)/cytokeratin-19(+) or alpha-fetoprotein(+)/cytokeratin-19(-) and contain all of the normal liver repopulation capacity found in fetal liver. Hematopoietic stem cells, a major component in crude fetal liver cell preparations that engraft in other organs......, such as bone marrow, spleen, and lung, are totally removed by Dlk-1 selection, and Dlk-1 purified FLSPC repopulate only the liver. CONCLUSIONS: This is the first study reporting purification of hepatic stem/progenitor cells from fetal liver that are fully capable of repopulating the normal adult liver...

  5. Outcomes of adult-to-adult living donor liver transplantation:a single center experience

    Institute of Scientific and Technical Information of China (English)

    FENG Xi; YUAN Ding; WEI Yong-gang; LI Fu-qiang; WEN Tian-fu; ZENG Yong; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing; YANG Jia-yin; MA Yu-kui; CHEN Zhe-yu; YE Hui; YAN Lü-nan; LI Bo

    2009-01-01

    Background Since January 2002,adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers.This study presents a detailed analysis of the outcomes of AALDLT in a single center.Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007.Among these,67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts.Three-dimensional volumetric computed tomography,magnetic resonance imaging with angiography and cholangiography were performed preoperatively.Recipient operation time,intraoperative transfusion requirement,length of intensive care unit stay,length of hospital stay,liver function tests,coagulation tests and surgical outcomes were routinely investigated throughout this study.Results All donors survived the procedure with an overall complication rate of 15.3%.Overall recipient 1-year survival and complication rates were 87.1% and 34.2%,respectively.Among the 70 cases,average graft recipient weight ratio was 0.94% (0.72%-1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74%-71.68%).All residual liver volumes exceeded 35%.Liver function and coagulation recovered rapidly within the first 7 days after transplantation.Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease.Patient selection and timely decision-making for transplantation are essential in achieving good outcomes.With accumulation of experience in surgery and clinical management,timely feedback and proper modification,we foresee better outcomes in the future.

  6. NEUTROPHIL CYTOPLASMIC AUTOANTIBODIES AFTER LIVER-TRANSPLANTATION IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS

    NARCIS (Netherlands)

    Haagsma, E.B.; MULDER, A.H.L.; Gouw, A.S.H.; MEERMAN, L.; Slooff, M.JH; Kallenberg, Cees; Horst, G.

    1993-01-01

    The immunopathogenic importance of neutrophil cytoplasmic autoantibodies in ulcerative colitis and primary sclerosing cholangitis is unknown. These autoantibodies were investigated before and after liver transplantation in 9 patients with primary sclerosing cholangitis. Sera from 10 patients transpl

  7. Expression and Clinical Significance of p27kip1 Protein in Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    史光军; 杨鹏; 陈孝平

    2004-01-01

    To investigate the expression and clinical significance of p27kip1 protein in primary liver cancer, the expression of p27kip1 protein and the relationship with clinicopathological factors were studied in primary liver cancer by using SABC immunohistochemical staining in specimens of 40 cases of primary liver cancer and 20 cases of liver cirrihosis. Our results showed that positive expression rate of p27kip1 protein in primary liver cancer was 37.5 % (15/40), which was lower than that in benign lesion of liver 80.0 % (16/20, P<0.01). The expression level of p27kip1 protein in primary liver cancer showed significant differences in tumor size, Edmonson histological grade, portal invasion, lymph node metastasis, TNM stage (P<0.05, for all), but not significantly correlated with patient's age and histological types. Log rank test showed that the p27kip1 expression was significantly related with prognosis of the patients (P<0.05), and the prognosis of the patients with p27kip1 positive expression was markedly better than that of those with p27kip1 negative expression. It is concluded that the expression of p27kip1 was significantly related clinicopathological factors of primary liver cancer. p27kip1 protein may be used as a novel tumor marker for primary liver cancer.

  8. Primary squamous cell carcinoma of the liver: A successful surgically treated case

    Institute of Scientific and Technical Information of China (English)

    Hsiang-Lin Lee; Yu-Yin Liu; Chun-Nan Yeh; Kun-Chun Chiang; Tse-Ching Chen; Yi-Yin Jan

    2006-01-01

    Primary squamous cell carcinoma (SCC) of the liver is rare. Totally nine such cases have been reported in the literature. Primary SCC of the liver has been reported to be associated with hepatic teratoma,hepatic cyst, or hepatolithiasis. Complete remission of poorly differentiated SCC of the liver could be achieved by systemic chemotherapy followed by surgery or remarkably respond to hepatic arterial injection of low dose chemotherapeutic drugs. Here we report the first case of primary SCC of the liver presenting as a solid tumor and receiving successful hepatic resection with 9-mo disease free survival.

  9. Adult to adult living related liver transplantation: Where do we currently stand?

    Institute of Scientific and Technical Information of China (English)

    Erica M Carlisle; Giuliano Testa

    2012-01-01

    Adult to adult living donor liver transplantation (AALDLT) was first preformed in the United States in 1997.The procedure was rapidly integrated into clinical practice,but in 2002,possibly due to the first widely publicized donor death,the number of living liver donors plummeted.The number of donors has since reached a steady plateau far below its initial peak.In this review we evaluate the current climate of AALDLT.Specifically,we focus on several issues key to the success of AALDLT:determining the optimal indications for AALDLT,balancing graft size and donor safety,assuring adequate outflow,minimizing biliary complications,and maintaining ethical practices.We conclude by offering suggestions for the future of AALDLT in United States transplantation centers.

  10. Changes in liver and spleen volumes after living liver donation: a report from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL).

    Science.gov (United States)

    Emond, Jean C; Fisher, Robert A; Everson, Gregory; Samstein, Benjamin; Pomposelli, James J; Zhao, Binsheng; Forney, Sarah; Olthoff, Kim M; Baker, Talia B; Gillespie, Brenda W; Merion, Robert M

    2015-02-01

    Previous reports have drawn attention to persistently decreased platelet counts among liver donors. We hypothesized an etiologic association between altered platelet counts and postdonation splenomegaly and sought to explore this relationship. This study analyzed de-identified computed tomography/magnetic resonance scans of 388 donors from 9 Adult-to-Adult Living Donor Liver Transplantation Cohort Study centers read at a central computational image analysis laboratory. Resulting liver and spleen volumes were correlated with time-matched clinical laboratory values. Predonation liver volumes varied 2-fold in healthy subjects, even when they were normalized by the body surface area (BSA; range = 522-1887 cc/m(2) , n = 346). At month 3 (M3), postdonation liver volumes were, on average, 79% of predonation volumes [interquartile range (IQR) = 73%-86%, n = 165] and approached 88% at year 1 (Y1; IQR = 80%-93%, n = 75). The mean spleen volume before donation was 245 cc (n = 346). Spleen volumes greater than 100% of the predonation volume occurred in 92% of donors at M3 (n = 165) and in 88% at Y1 after donation (n = 75). We sought to develop a standard spleen volume (SSV) model to predict normal spleen volumes in donors before donation and found that decreased platelet counts, a younger age, a higher predonation liver volume, higher hemoglobin levels, and a higher BSA predicted a larger spleen volume (n = 344, R(2)  = 0.52). When this was applied to postdonation values, some large volumes were underpredicted by the SSV model. Models developed on the basis of the reduced sample of postdonation volumes yielded smaller underpredictions. These findings confirm previous observations of thrombocytopenia being associated with splenomegaly after donation. The results of the SSV model suggest that the biology of this phenomenon is complex. This merits further long-term mechanistic studies of liver donors with an investigation of the role of

  11. Adult liver stem cells in hepatic regeneration and cancer

    NARCIS (Netherlands)

    Nantasanti, Sathidpak

    2015-01-01

    An alternative source of livers for transplantation in patients with (genetic) liver diseases and liver failure is needed because liver donors are scarce. HPC-derived hepatocyte-like cells could be one of the options. Because dogs and humans share liver-pathologies and disease-pathways, the dog is c

  12. Diagnostic value of the lfuoroscopic triggering 3D LAVA technique for primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yong Shen; Chun-Hua Chai; Wen-Bo Xiao; Qi-Dong Wang

    2010-01-01

    BACKGROUND: Primary liver cancer (PLC) is one of the common malignant tumors. Liver acquisition with acceleration volume acquisition (LAVA), which allows simultaneous dynamic enhancement of the hepatic parenchyma and vascu-lature imaging, is of great help in the diagnosis of PLC. This study aimed to evaluate application of the lfuoroscopic triggering 3D LAVA technique in the imaging of PLC and liver vasculature. METHODS: The clinical data and imaging ifndings of 38 adults with PLC (22 men and 16 women;average age 52 years), pathologically conifrmed by surgical resection or biopsy, were collected and analyzed. All magnetic resonance images were obtained with a 1.5-T system (General Electrics Medical Systems) with an eight-element body array coil and application of the lfuoroscopic triggering 3D LAVA technique. Overall image quality was assessed on a 5-point scale by two experienced radiologists. All the nodules and blood vessel were recorded and compared. The diagnostic accuracy and feasibility of LAVA were evaluated. RESULTS: Thirty-eight patients gave high quality images of 72 nodules in the liver for diagnosis. The accuracy of LAVA was 97.2% (70/72), and the coincidence rate between the extent of tumor judged by dynamic enhancement and pathological examination was 87.5%(63/72). Displayed by the maximum intensity projection reconstruction, nearly all cases gave satisfactory images of branchesⅢandⅣof the hepatic artery. Furthermore, small early-stage enhancing hepatic lesions and the parallel portal vein were also well displayed. CONCLUSIONS: Sequence of LAVA provides good multi-phase dynamic enhancement scanning of hepatic lesions. Combined with conventional scanning technology, LAVA effectively and safely displays focal hepatic lesions and the relationship between tumor and normal tissues, especially blood vessels.

  13. Primary Leiomyoma of the Liver: A Review of a Rare Tumour

    Directory of Open Access Journals (Sweden)

    Ayodeji Oluwarotimi Omiyale

    2014-01-01

    Full Text Available Context. Primary leiomyoma of the liver is a rare tumour with uncertain pathogenesis with similar presentation with other tumours of the liver. Little is known about its clinical course. Objectives. To review the literature for case reports of primary leiomyoma of the liver. Methods. Extensive literature search was carried out for case reports of primary leiomyoma of the liver. Results. A total of 36 cases of primary leiomyoma of the liver were reviewed. The mean age of presentation is 43 years with slight female sex affectation; females accounted for 55.6% of the cases reported in the literature. The average size of the tumour is 8.7 cm. 34.4% of the cases reviewed were incidental finding with the mean follow-up time of 33 months with most cases reporting no evidence of disease. Conclusions. Primary leiomyoma of the liver is very rare tumour with complex pathogenesis which remains largely unknown. Imaging of the tumour does not allow for a tissue specific diagnosis; hence histological review of the tissue specimen and immunohistochemical stains are imperative for diagnosis. Surgical resection is both diagnostic and curative. The diagnosis of primary leiomyoma of the liver should be considered as a differential in the management of liver tumours.

  14. IS THERE RECURRENCE OF PRIMARY BILIARY-CIRRHOSIS AFTER LIVER-TRANSPLANTATION - A CLINICOPATHOLOGICAL STUDY IN LONG-TERM SURVIVORS

    NARCIS (Netherlands)

    GOUW, ASH; HAAGSMA, EB; MANNS, M; KLOMPMAKER, IJ; SLOOFF, MJH; GERBER, MA

    1994-01-01

    Liver transplantation has been accepted as a successful therapeutic tool for irreversible liver diseases such as primary biliary cirrhosis. However, removal of the diseased liver may not eliminate this autoimmune disease, and recurrence of primary biliary cirrhosis in the liver graft has been report

  15. Metabolic aspects of adult patients with nonalcoholic fatty liver disease

    Science.gov (United States)

    Abenavoli, Ludovico; Milic, Natasa; Di Renzo, Laura; Preveden, Tomislav; Medić-Stojanoska, Milica; De Lorenzo, Antonino

    2016-01-01

    Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease and it encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, or cirrhosis. The mechanisms involved in the occurrence of NAFLD and its progression are probably due to a metabolic profile expressed within the context of a genetic predisposition and is associated with a higher energy intake. The metabolic syndrome (MS) is a cluster of metabolic alterations associated with an increased risk for the development of cardiovascular diseases and diabetes. NAFLD patients have more than one feature of the MS, and now they are considered the hepatic components of the MS. Several scientific advances in understanding the association between NAFLD and MS have identified insulin resistance (IR) as the key aspect in the pathophysiology of both diseases. In the multi parallel hits theory of NAFLD pathogenesis, IR was described to be central in the predisposition of hepatocytes to be susceptible to other multiple pathogenetic factors. The recent knowledge gained from these advances can be applied clinically in the prevention and management of NAFLD and its associated metabolic changes. The present review analyses the current literature and highlights the new evidence on the metabolic aspects in the adult patients with NAFLD. PMID:27610012

  16. Aggressive Recurrence of Primary Hepatic Epithelioid Haemangioendothelioma after Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Qusay A. Abdoh

    2016-01-01

    Full Text Available HEHE is a rare neoplasm of vascular origin that occurs in the liver; UNOS reported a favorable outcome after liver transplantation in 110 patients with 1-year and 5-year survival of 80% and 64%. Case Report. A 40-year-old lady presented with a three-month history of right upper abdominal pain with nausea, vomiting, and significant loss of weight associated with scleral icterus and progressive abdominal distension. Examination revealed jaundice, hepatomegaly, and ascites. Serum bilirubin was 26.5 mg/dL and ALP was 552 CT. Abdomen and pelvis showed diffuse infiltrative neoplastic process of the liver with a mass effect and stretching of the hepatic and portal veins, in addition to bile duct dilatation. Viral hepatitis markers were negative and serum alpha fetoprotein was within reference range. Liver biopsy was consistent with HEHE, with positive endothelial markers (CD31, CD34, and factor VIII-related antigen. She underwent living related liver transplantation on June 2013 and was discharged after 20 days with normal liver enzymes. Four months later, she presented with diffuse disease recurrence. Liver biopsy confirmed disease recurrence; she received supportive treatment and unfortunately she died 2 weeks later. Conclusion. HEHE can have rapid and aggressive recurrence after liver transplantation.

  17. Primary lymphoma of the liver. Report of a case with diagnosis by fine needle aspiration.

    Science.gov (United States)

    Netto, D; Spielberger, R; Awasthi, S; Balaban, E P; Nowak, J A; Demian, S D

    1993-01-01

    In a 69-year-old man with hepatomegaly, a diagnosis of primary non-Hodgkin's lymphoma (NHL) of the liver was made by fine needle aspiration (FNA). At the time of presentation there was no evidence of involvement of the lymph nodes, bone marrow or any other organ. Although hepatic involvement is common in advanced stages of Hodgkin's disease and NHL, primary lymphoma of the liver is rare. The purpose of this paper is to report a rare occurrence of primary lymphoma of the liver and to demonstrate the possibility of making this diagnosis by FNA.

  18. Surgical resection of adrenal metastasis from primary liver tumors:a report of two cases

    Institute of Scientific and Technical Information of China (English)

    Durgatosh Pandey; Kai-Chah Tan

    2008-01-01

    BACKGROUND: Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative, solitary metastasis from such tumors offers a possibility of cure by surgical resection. The adrenal gland is an uncommon site for metastasis from primary liver tumors. METHOD: We report two cases of adrenalectomy for solitary adrenal metastasis: one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma. RESULTS: The patient with intrahepatic cholangiocar-cinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However, he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy. The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma. He is presently alive and disease-free 27 months after adrenalectomy. CONCLUSION: Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.

  19. Management of liver cirrhosis between primary care and specialists

    OpenAIRE

    Grattagliano, Ignazio; Ubaldi, Enzo; Bonfrate, Leonilde; Portincasa, Piero

    2011-01-01

    This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: “ascites”, “liver fibrosis”, “cirrhosis”, “chronic hepatitis”, “chronic liver disease”, “deco...

  20. Refractory Adult Primary Autoimmune Neutropenia that Responded to Alemtuzumab.

    Science.gov (United States)

    Neerukonda, Anu R; Lan, Fengshuo; Gabig, Theodore; Saraya, Takeshi

    2016-01-01

    Primary autoimmune neutropenia (P-AIN) is an extremely rare disease. The most effective treatment for primary P-AIN is a granulocyte colony-stimulating factor; however, no curative treatment has been reported. We herein report a case of an adult P-AIN patient with a relatively mild medical history (irrespective of the severe neutropenia) who showed a sustained hematological response over seventeen months after the initiation of treatment with subcutaneous Alemtuzumab.

  1. Cyclosporin versus tacrolimus as primary immunosuppressant after liver transplantation

    DEFF Research Database (Denmark)

    McAlister, V C; Haddad, E; Renouf, E;

    2006-01-01

    A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were...

  2. Immunosuppression after liver transplantation for primary sclerosing cholangitis influences activity of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Jørgensen, Kristin Kaasen; Lindström, Lina; Cvancarova, Milada

    2013-01-01

    Previous studies have shown conflicting results regarding the course of inflammatory bowel disease (IBD) after liver transplantation in patients with primary sclerosing cholangitis (PSC). We studied the progression of IBD in patients with PSC who have undergone liver transplantation. We also...

  3. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopic approach

    OpenAIRE

    2013-01-01

    Liver metastasis of colorectal cancer is common. Resection of solitary tumors of primary and metastatic colorectal cancer can have a favorable outcome. Open resection of primary colorectal tumor and liver metastasis in one operation or in separate operations is currently common practice. Reports have shown that synchronous resections do not jeopardize short or long-term surgical outcomes and that this is a safe and effective approach in open surgery. The development of laparoscopic colorectal...

  4. Primary care for young adult cancer survivors: an international perspective.

    NARCIS (Netherlands)

    Holge-Hazelton, B.; Blake-Gumbs, L.; Miedema, B.; Rijswijk, E. van

    2010-01-01

    PURPOSE: Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement. METHODS: Comparative descriptions and literature review. RESULTS: Cancer among YAs is rare and

  5. Outpatient Treatment of Primary Anorexia Nervosa in Adult Males.

    Science.gov (United States)

    Ziesat, Harold A., Jr.; Ferguson, James M.

    1984-01-01

    Describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. (JAC)

  6. Use of liposome encapsulated hemoglobin as an oxygen carrier for fetal and adult rat liver cell culture.

    Science.gov (United States)

    Montagne, Kevin; Huang, Hongyun; Ohara, Keikou; Matsumoto, Kunio; Mizuno, Atsushi; Ohta, Katsuji; Sakai, Yasuyuki

    2011-11-01

    Engineering liver tissue constructs with sufficient cell mass for transplantation implies culturing large numbers of hepatocytes in a reduced volume; however, providing sufficient oxygen to dense cell cultures is still not feasible using only conventional culture medium. Liposome-encapsulated hemoglobin (LEH), an oxygen-carrying blood substitute originally designed for short-term perfusion, may be a good candidate as an oxygen carrier to cultured liver cells. In this study, we investigated the feasibility of maintaining long term hepatocyte cultures using LEH. Primary fetal and adult rat liver cells were directly exposed to LEH for 6 to 14 days in static culture or in a perfused flat plate bioreactor. The functions and viability of adult rat hepatocytes exposed to LEH were not adversely affected in static monolayer culture and were even improved in the bioreactor. However, some cytotoxicity of LEH was observed with fetal rat liver cells after 4 days of culture. LEH, though a suitable oxygen carrier for long-term culture of mature hepatocytes, is not suitable in its present form for perfusing fetal hepatocyte cultures in direct contact with the liposomes; either the LEH will have to be made less toxic or a more sophisticated bioreactor that prevents the direct contact between hepatocytes and perfusates will have to be designed if fetal cells are to be used for liver tissue engineering.

  7. Parenteral nutrition-associated liver disease in adult and pediatric patients.

    Science.gov (United States)

    Kumpf, Vanessa J

    2006-06-01

    There are essentially 3 types of hepatobiliary disorders associated with parenteral nutrition (PN) therapy: steatosis, cholestasis, and gallbladder sludge/stones. Reported prevalence rates of PN-associated liver disease (PNALD) vary greatly, and there are distinct differences between adult and pediatric patients. Various etiologic factors have been evaluated for significance in contributing to PNALD, including enteral feeding history, septic events, bacterial overgrowth, length of intestinal resection, and prematurity/low birth weight. Etiologic factors specifically related to the PN formulation or nutrient intake have also been evaluated, including excessive calorie intake, dextrose-to-lipid ratio, amino acid dose, taurine deficiency, IV fat emulsion (IVFE) dose, carnitine deficiency, choline deficiency, and continuous vs cyclic infusion. Minor increases in serum aminotransferase concentrations are relatively common in patients receiving PN therapy and generally require no intervention. The primary indicator of cholestasis is a serum conjugated bilirubin >2 mg/dL. When a patient receiving PN develops liver complications, it is necessary to rule out all treatable causes and minimize other risk factors. All potential hepatotoxic medications and herbal supplements should be eliminated. Modifications to the PN regimen that may be helpful include reduction of calories, reduction of IVFE dose to <1 g/kg/d, supplementation of taurine in the infant, and use of cyclic infusion. Initiation of even small amounts of enteral nutrition and use of ursodiol may be beneficial in stimulating bile flow. In the long-term PN patient with severe and progressive liver disease, intestinal or liver transplantation may be the only remaining treatment option.

  8. The correlation analysis of primary liver cancer with Type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Q Su

    2015-01-01

    Full Text Available OBJECTIVE: To explore the relationship between Type 2 diabetes and primary liver cancer. MATERIALS AND METHODS: In the period from December 2008 to December 2014, all blood sugar data of patients in our hospital was collected, and the total number is 18213. Except for repeatedly hospitalized diabetic person, newborn stress status, or venous transfusion blood glucose, gestational diabetes, etc., By retrieving the medical record information of patients in the hospital, and using telephone or letter follow-up the patients, we collected 127 people with type 1 diabetes and found no liver cancer patients; Type 2 diabetes, 10,794 cases of patient information, 59 with primary liver cancer. For data analysis, Stata11.0 ratio was used as the main analysis indicators, using Chi-square test and statistical analysis. RESULTS: About 10,794 Type 2 diabetes cases with 59 primary liver cancer, the incidence is 54.66/10,000, men liver cancer incidence (92.78/10,000 than women (27.13/10,000, with significant difference (χ2 = 26.621, P < 0.001. As the growth of the age, the possibility of liver cancer in patients with diabetes increased significantly (χ2 = 19.961, P = 0.001. The rate was highest for 50-60-year-old men, and the women at age 70, and older incidence is highest. Irrespective of men or women with diabetes as the growth of the age, the possibility of liver cancer had significantly increased (P = 0.001, P = 0.002. Hepatitis B or hepatitis C incidence was 2.94%, but diabetes incidence of hepatitis men (3.98% and women (2.01% did not find significant differences (χ2 = 0.3361, P = 0.562. Three hundred and seventeen cases of Type 2 diabetes with hepatitis, the incidence of primary liver cancer was 11.67%, the liver cancer incidence of diabetes patients with hepatitis men (17.78% than women (3.97%, with significant difference (χ2 = 37.429, P < 0.001. With the growth of age, the overall risk of getting liver cancer (χ2 =15.023, P = 0.01 of diabetes and

  9. Role of FNA and Core Biopsy of Primary and Metastatic Liver Disease

    Directory of Open Access Journals (Sweden)

    John P. McGahan

    2013-01-01

    liver and to define methods for improvement of diagnosis of primary liver tumors. Methods. This include retrospective study of 189 biopsies of 185 liver masses for cytological or histological analysis. Patients were subdivided into two groups. Group 1 consisted of 124 suspected metastasis. Group 2 consisted of 61 suspected primary neoplasms. Biopsies were considered positive or equivocal. In equivocal cases, special stains were performed. In Group 2, cases were classified by contrast CT or MRI as to (I classic HCC, (II infiltrated HCC, or (Ill equivocal. Results. Definitive diagnosis was obtained in 117/124 masses (94% in Group 1, 48/61 masses (79% in Group 2, and (Ill equivocal 13 cases in Group II. In two equivocal cases in which special stains were performed, they were reclassified as HCC. In 8/13 cases, CT findings were consistent with HCC. Conclusion. Liver biopsies are useful in obtaining a definitive diagnosis of suspected metastatic liver disease. Biopsy results are less reliable in patients with suspected primary liver tumors. In these situations, strategies can include basing treatment on imaging criteria or use of newer special pathological stains. Advances in Knowledge. Use of newer special immunological stains improves accuracy in definitive diagnosis of primary liver tumors.

  10. Parvovirus B19 induced hepatic failure in an adult requiring liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Darin S Krygier; Urs P Steinbrecher; Martin Petric; Siegfried R Erb; Stephen W Chung; Charles H Scudamore; Andrzej K Buczkowski; Eric M Yoshida

    2009-01-01

    Parvovirus B19 induced acute hepatitis and hepatic failure have been previously reported,mainly in children.Very few cases of parvovirus induced hepatic failure have been reported in adults and fewer still have required liver transplantation.We report the case of a 55-year-old immunocompetent woman who developed fulminant hepatic failure after acute infection with Parvovirus B19 who subsequently underwent orthotopic liver transplantation.This is believed to be the first reported case in the literature in which an adult patient with fulminant hepatic failure associated with acute parvovirus B19 infection and without hematologic abnormalities has been identified prior to undergoing liver transplantation.This case suggests that Parvovirus B19 induced liver disease can affect adults,can occur in the absence of hematologic abnormalities and can be severe enough to require liver transplantation.

  11. Cancer Stem Cells in Primary Liver Cancers: Pathological Concepts and Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ijin [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Kim, Haeryoung [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lee, Jeong Min [Department of Radiology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

    2015-11-01

    There is accumulating evidence that cancer stem cells (CSCs) play an integral role in the initiation of hepatocarcinogenesis and the maintaining of tumor growth. Liver CSCs derived from hepatic stem/progenitor cells have the potential to differentiate into either hepatocytes or cholangiocytes. Primary liver cancers originating from CSCs constitute a heterogeneous histopathologic spectrum, including hepatocellular carcinoma, combined hepatocellular-cholangiocarcinoma, and intrahepatic cholangiocarcinoma with various radiologic manifestations. In this article, we reviewed the recent concepts of CSCs in the development of primary liver cancers, focusing on their pathological and radiological findings. Awareness of the pathological concepts and imaging findings of primary liver cancers with features of CSCs is critical for accurate diagnosis, prediction of outcome, and appropriate treatment options for patients.

  12. Intra-Arterial Treatment of Primary and Metastatic Liver Tumors

    NARCIS (Netherlands)

    Buijs, M.A.M.; Vossen, J.A.

    2009-01-01

    The aims of this thesis were, first, to investigate the toxicities associated with trans-arterial chemoembolization (TACE) of liver tumors and to evaluate the use of MR imaging in characterizing tumor response after this locoregional therapy, second, to further develop intra-arterial therapy of live

  13. Adult congenital diaphragmatic hernia of the liver: a rare case report

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Congenital diaphragmatic hernia (CDH), which mainly occurs in the newborn or in childhood with severe respiratory distress and high mortality, is rarely found in adult, especially for those uncommon right CDH [1–4]. Whereas, liver as the main hernial

  14. Isolation and characterization of liver epithelial progenitor cells from normal adult rhesus monkeys (Macaca mulatta)

    Institute of Scientific and Technical Information of China (English)

    Lifang Jin; Shaohui Ji; Xianghui Tang; Xiangyu Guo; Yongqing Lu; Hongwei Chen; Hongkui Deng; Qi Zhou; Weizhi Ji

    2009-01-01

    @@ Dear Editor, Based on their ability to proliferate and the capacity to differentiate into specific cell types, hepatic progenitor/stem cells (HPCs) from adult human liver may have potential therapeutic effects on end-stage liver failure. In addition, adult HPCs have a reduced risk of teratoma formation and are not subject to the same ethical issues as fetal HPCs or embryonic stem cells [1]. The HPCs from rhesus monkeys are relevant because they may serve as a valuable preclinical model for assessment of cell therapy in humans. To date, there are no reports of HPCs or liver epithelial progenitor cells (LEPCs) isolated from normal adult rhesus monkey although a few studies in other species were reported [2, 3]. We report here for the first time the successful isolation of rhesus monkey LEPCs (mLEPCs) from normal adult livers (n=12).

  15. Ascertainment of acute liver injury in two European primary care databases

    NARCIS (Netherlands)

    Ruigómez, A.; Brauer, R.; Rodríguez, L. A García; Huerta, C.; Requena, G.; Gil, M.; de Abajo, Francisco; Downey, G.; Bate, A.; Tepie, M. Feudjo; de Groot, M.C.H.; Schlienger, R.; Reynolds, R.; Klungel, O.

    2014-01-01

    Purpose The purpose of this study was to ascertain acute liver injury (ALI) in primary care databases using different computer algorithms. The aim of this investigation was to study and compare the incidence of ALI in different primary care databases and using different definitions of ALI. Methods T

  16. Liver retransplantation in adults: the largest multicenter Italian study.

    Directory of Open Access Journals (Sweden)

    Umberto Maggi

    Full Text Available This study is the largest Italian survey on liver retransplantations (RET. Data report on 167 adult patients who received 2 grafts, 16 who received 3 grafts, and one who received 4 grafts over a 11 yr period.There was no statistically significant difference in graft survival after the first or the second RET (52, 40, and 29% vs 44, 36, and 18% at 1,5,and 10 yr, respectively: Log-Rank test, p = 0.30.Survivals at 1, 5, and 10 years of patients who underwent 2 (n = 151 or 3 (n = 15 RETs, were 65, 48,and 39% vs 59, 44, and 30%, respectively (p = 0.59.Multivariate analysis of survival showed that only the type of graft (whole vs reduced was associated with a statistically significant difference (HR = 3.77, Wald test p = 0. 05; the donor age appeared to be a relevant factor as well, although the difference was not statistically significant (HR = 1.91, Wald test p = 0.08.Though late RETs have better results on long term survival relative to early RETs, no statistically significant difference can be found in early results, till three years after RET.Considering late first RETs (interval>30 days from previous transplantation with whole grafts the difference in graft survival in RETs due to HCV recurrence (n = 17 was not significantly different from RETs due to other causes (n = 53 (65-58 and 31% vs 66-57 and 28% respectively at 1-5 and 10 years, p = 0.66.

  17. An Unusual Presentation of Liver Failure in a Patient with Primary Gastrointestinal Hodgkin's Lymphoma

    Directory of Open Access Journals (Sweden)

    Gabrielle B. Rocque

    2011-01-01

    Full Text Available Introduction. Hodgkin's lymphoma (HL presenting either with primary bowel involvement or with cholestasis is unusual. The combination of primary gastrointestinal HL presenting with cholestasis and ductopenia has not been previously described. Case Report. We present a case of primary gastrointestinal HL with evidence of liver involvement, but also with prominent ductopenia on liver biopsy and associated intrahepatic cholestasis. A 50-year-old man with a history of Crohn's disease presented with a bowel obstruction, for which he underwent a small bowel resection. Histology revealed HL. His course was complicated by cholestatic liver failure. A subsequent liver biopsy revealed both focal involvement by lymphoma and ductopenia, resembling vanishing bile duct syndrome (VBDS. He was treated with chemotherapy with improvement in his cholestasis, but he eventually succumbed due to further complications of his disease and treatment toxicities. Conclusion. This case of primary gastrointestinal HL associated with ductopenia does not meet classic criteria for VBDS, but the clinical presentation and pathology are suggestive of a VBDS-like paraneoplastic process. Therapies for HL in the setting of cholestatic liver failure require special consideration, but some reports of durable remissions and recovery of liver function have been reported.

  18. Cross-modal synaptic plasticity in adult primary sensory cortices.

    Science.gov (United States)

    Lee, Hey-Kyoung; Whitt, Jessica L

    2015-12-01

    Sensory loss leads to widespread adaptation of brain circuits to allow an organism to navigate its environment with its remaining senses, which is broadly referred to as cross-modal plasticity. Such adaptation can be observed even in the primary sensory cortices, and falls into two distinct categories: recruitment of the deprived sensory cortex for processing the remaining senses, which we term 'cross-modal recruitment', and experience-dependent refinement of the spared sensory cortices referred to as 'compensatory plasticity.' Here we will review recent studies demonstrating that cortical adaptation to sensory loss involves LTP/LTD and homeostatic synaptic plasticity. Cross-modal synaptic plasticity is observed in adults, hence cross-modal sensory deprivation may be an effective way to promote plasticity in adult primary sensory cortices.

  19. Hepatitis Viral Markers in Patients Undergoing Primary Liver Transplants

    OpenAIRE

    1993-01-01

    The purpose of the study was to determine the prevalence in liver transplant (OLTx) patients of the hepatitis markers (anti-A, anti-B, anti-C, anti-D and HBsAg) and the interrelationships between markers and patients’ sexes, ages, dates of transplant, clinicopathological diagnoses, and short-term survivals. Slightly more than half of the patients were male. Anti-A and anti-B were about evenly distributed between male and female. Anti-C, anti-D, and HBsAg were far more common in males. Age and...

  20. Successful Treatment of Recurrent Primary Sclerosing Cholangitis after Orthotopic Liver Transplantation with Oral Vancomycin

    Directory of Open Access Journals (Sweden)

    Yinka K. Davies

    2013-01-01

    Full Text Available Primary sclerosing cholangitis (PSC is a progressive, cholestatic disease of the liver that is marked by inflammation of the bile ducts and damage to the hepatic biliary tree. Approximately 60–70% of patients also have inflammatory bowel disease and progression of PSC can lead to ulcerative colitis and cirrhosis of the liver. Due to limited understanding of the etiology and mechanism of PSC, the only existing treatment option is orthotopic liver transplantation (OLT; however, recurrence of PSC, after OLT is estimated to be between 5% and 35%. We discuss the successful treatment of a pediatric patient, with recurrent PSC, after OLT with oral Vancomycin.

  1. [Isolation and purification of primary Kupffer cells from mouse liver].

    Science.gov (United States)

    Sun, Chao; Luo, Qingbo; Lu, Xiuxian; Zheng, Daofeng; He, Diao; Wu, Zhongjun

    2016-08-01

    Objective To isolate and purify Kupffer cells (KCs) from BALB/c mice by an efficient method of low-speed centrifugation and rapid adherence. Methods The mouse liver tissue was perfused in situ and digested with 0.5 g/L collagenase type IV in vitro by water bath. Then, through the low-speed centrifugation, KCs were separated from the mixed hepatocytes, and purified by rapid adherent characteristics. Finally, the production and activity of KCs obtained by this modified method were compared with those isolated by Percoll density gradient centrifugation. We used F4/80 antibody immunofluorescence technique to observe morphological features of KCs, flow cytometry (FCM) to detect the expression of F4/80 antibody and the ink uptake test to observe the phagocytic activity. Moreover, using FCM, we evaluated the expressions of molecules associated with antigen presentation, including major histocompatibility complex class II (MHC II), CD40, CD86 and CD68 on the surface of KCs subjected to hypoxia/reoxygenation (H/R) modeling. And, ELISA was conducted to measure tumor necrosis factor-α (TNF-α) production of the cultured KCs following H/R. Results The yield of KCs was (5.83±0.54)×10(6) per mouse liver and the survival rate of KCs was up to 92% by low-speed centrifugation and rapid adherent method. Compared with Percoll density gradient centrifugation [the yield of KCs was (2.19±0.43)×10(6) per liver], this new method significantly improved the yield of KCs. F4/80 immunofluorescence showed typical morphologic features of KCs such as spindle or polygon shapes and FCM identified nearly 90% F4/80 positive cells. The phagocytic assay showed that lots of ink particles were phagocytosed into the isolated cells. KC H/R models expressed more MHC II, CD40 and CD86 and produced more TNF-α participating in inflammation. Conclusion The efficient method to isolate and purify KCs from BALB /c mice has been successfully established.

  2. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopic approach.

    Science.gov (United States)

    Cheung, Tan To; Poon, Ronnie Tung Ping

    2013-06-27

    Liver metastasis of colorectal cancer is common. Resection of solitary tumors of primary and metastatic colorectal cancer can have a favorable outcome. Open resection of primary colorectal tumor and liver metastasis in one operation or in separate operations is currently common practice. Reports have shown that synchronous resections do not jeopardize short or long-term surgical outcomes and that this is a safe and effective approach in open surgery. The development of laparoscopic colorectal surgery and laparoscopic hepatectomy has made a minimally invasive surgical approach to treating colorectal cancer with liver metastasis feasible. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopy have recently been reported. The efficacy and safety of laparoscopic colorectal resection and laparoscopic hepatectomy have been proven separately but synchronous resections by laparoscopy are in hot debate. As it has been shown that open resection of primary colorectal tumor and liver metastasis in one operation results in an equally good short-term outcome when compared with that done in separate operations, laparoscopic resection of the same in one single operation seems to be a good option. Recent evidence has shown that this new approach is a safe alternative with a shorter hospital stay. Large scale randomized controlled trials are needed to demonstrate the effectiveness of this minimally invasive approach.

  3. Clinical study on safety of adult-to-adult living donor liver transplantation in both donors and recipients

    Institute of Scientific and Technical Information of China (English)

    Bin Liu; Ji-Chun Zhao; Yu-Kui Ma; Jiang-Wen Liu; Hong Wu; Lu-Nan Yan; Wen-Tao Wang; Bo Li; Yong Zeng; Tian-Fu Wen; Ming-Qing Xu; Jia-Yin Yang; Zhe-Yu Chen

    2007-01-01

    AIM: To investigate the safety of adult-to-adult living donor liver transplantation (A-A LDLT) in both donors and recipients.METHODS: From January 2002 to July 2006, 50 cases of A-A LDLT were performed at West China Hospital, Sichuan University, consisting of 47 cases using right lobe graft without middle hepatic vein (MHV), and 3 cases using dual grafts (one case using two left lobe, 2 using one right lobe and one left lobe). The most common diagnoses were hepatitis B liver cirrosis, 30 (60%) cases; and hepatocellular carcinoma, 15 (30%) cases in adult recipients. Among them, 10 cases had the model of end-stage liver disease (MELD) with a score of more than 25. Donor screening consisted of reconstruction of the hepatic blood vessels and biliary system with 3-dimension computed tomography and volumetry of whole liver and right liver volume. Various improved surgical techniques were adopted in the procedures for both donors and recipients .RESULTS: Forty-nine right lobes and 3 left lobes (2 left lobe grafts for 1 recipient, 1 left lobe graft for 1 recipient who had received right lobe graft donated by relative living donor) were obtained from 52 living donors. The 49 right lobe grafts, without MHV, weighed 400 g-850 g (media 550 g), and the ratio of graft volume to recipient standard liver volume (GV/SLV) ranged from 31.74% to 71.68% (mean 45.35%). All donors' remnant liver volume was over 35% of the whole liver volume. There was no donor mortality. With a follow-up of 2-52 mo (media 9 mo), among 50 adult recipients, complications occurred in 13 (26%) cases and 4 (8%) died postoperatively within 3 mo. Their 1-year actual survival rate was 92%.CONCLUSION: When preoperative CT volumetry shows volume of remnant liver is more than 35%, the ratio of right lobe graft to recipients standard liver volume exceeding 40%, A-A LDLT using right lobe graft without MHV should be a very safe procedure for both donors and recipients, otherwise dual grafts liver transplantation

  4. Expression pattern of thymosin beta 4 in the adult human liver

    Science.gov (United States)

    Nemolato, S.; Van Eyken, P.; Cabras, T.; Cau, F.; Fanari, M.U.; Locci, A.; Fanni, D.; Gerosa, C.; Messana, I.; Castagnola, M.; Faa, G.

    2011-01-01

    Thymosin beta-4 (Tβ4) is a member of beta-thymosins, a family of small peptides involved in polymerization of G-actin, and in many critical biological processes including apoptosis, cell migration, angiogenesis, and fibrosis. Previous studies in the newborn liver did not reveal any significant reactivity for Tβ4 during the intrauterine life. The aim of the present study was to investigate by immunohistochemistry Tβ4 expression in the adult normal liver. Thirty-five human liver samples, including 11 needle liver biopsies and 24 liver specimens obtained at autopsy, in which no pathological change was detected at the histological examination, were immunostained utilizing an anti-Tβ4 commercial antibody. Tβ4 was detected in the hepatocytes of all adult normal livers examined. A zonation of Tβ4 expression was evident in the vast majority of cases. Immunostaining was preferentially detected in zone 3, while a minor degree of reactivity was detected in periportal hepatocytes (zone 1). At higher power, Tβ4-reactive granules appeared mainly localized at the biliary pole of hepatocytes. In cases with a strong immunostaining, even perinuclear areas and the sinusoidal pole of hepatocytes appeared interested by immunoreactivity for Tβ4. The current work first evidences a strong diffuse expression of Tβ4 in the adult human liver, and adds hepatocytes to the list of human cells able to synthesize large amounts of Tβ4 in adulthood. Moreover, Tβ4 should be added to the liver proteins characterized by a zonate expression pattern, in a descending gradient from the terminal vein to the periportal areas of the liver acinus. Identifying the intimate role played by this peptide intracellularly and extracellularly, in physiology and in different liver diseases, is a major challenge for future research focusing on Tβ4. PMID:22073372

  5. Expression pattern of thymosin beta 4 in the adult human liver

    Directory of Open Access Journals (Sweden)

    S. Nemolato

    2011-09-01

    Full Text Available Thymosin beta-4 (Tβ4 is a member of beta-thymosins, a family of small peptides involved in polymerization of G-actin, and in many critical biological processes including apoptosis, cell migration, angiogenesis, and fibrosis. Previous studies in the newborn liver did not reveal any significant reactivity for Tβ4 during the intrauterine life. The aim of the present study was to investigate by immunohistochemistry Tβ4 expression in the adult normal liver. Thirty-five human liver samples, including 11 needle liver biopsies and 24 liver specimens obtained at autopsy, in which no pathological change was detected at the histological examination, were immunostained utilizing an anti-Tβ4 commercial antibody. Tβ4 was detected in the hepatocytes of all adult normal livers examined. A zonation of Tβ4 expression was evident in the vast majority of cases. Immunostaining was preferentially detected in zone 3, while a minor degree of reactivity was detected in periportal hepatocytes (zone 1. At higher power, Tβ4-reactive granules appeared mainly localized at the biliary pole of hepatocytes. In cases with a strong immunostaining, even perinuclear areas and the sinusoidal pole of hepatocytes appeared interested by immunoreactivity for Tβ4. The current work first evidences a strong diffuse expression of Tβ4 in the adult human liver, and adds hepatocytes to the list of human cells able to synthesize large amounts of Tβ4 in adulthood. Moreover, Tβ4 should be added to the liver proteins characterized by a zonate expression pattern, in a descending gradient from the terminal vein to the periportal areas of the liver acinus. Identifying the intimate role played by this peptide intracellularly and extracellularly, in physiology and in different liver diseases, is a major challenge for future research focusing on Tβ4.

  6. Sonographic fatty liver and hepatitis B virus carrier status: Synergistic effect on liver damage in Taiwanese adults

    Institute of Scientific and Technical Information of China (English)

    Yu-Cheng Lin; Shu-Tin Hsiao; Jong-Dar Chen

    2007-01-01

    AIM:To examine the epidemiology of hepatitis B virus carrier status (HBVC) and Sonographic fatty liver (SFL) in Taiwanese adults,and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint,we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.METHODS:A cross-sectional retrospective analysis of health records including medical history,physical examination,abdominal sonogram,blood biochemistry and hepatic virological tests. We utilized the Student's f-test,chi-square,multivariate logistic regression and synergy index to assess risks for LD.RESULTS:Among a total of 5406 Taiwanese adults (mean age 46.2 years,51.5% males),the prevalence of LD,HBVC and SFL were 12.3%,15.1% and 33.4%,respectively; 5.1% of participants had SFL plus HBVC. Muifivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8,95% confidence interval (CI):2.3-3.5),overweight state (OR = 1.6,95% CI:1.3-2.0),HBVC (OR = 2.5,95% CI:2.0-3.1) and SFL (OR = 4.2,95% CI:2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI:2.4-4.6),SFL-alone,4.7 (95% CI:3.7-6.1) and combined HBVC and SFL,9.5 (95% CI:6.8-13.3); the synergy index was 1.4 (95% CI:1.001-2.0).CONCLUSION:In Taiwanese adults,SFL plus HBVC have a significant Synergistic association with LD.

  7. Primary Colonic Eosinophilia and Eosinophilic Colitis in Adults.

    Science.gov (United States)

    Turner, Kevin O; Sinkre, Richa A; Neumann, William L; Genta, Robert M

    2017-02-01

    The normal content of eosinophils in the adult colon and the criteria for the histopathologic diagnosis of eosinophilic colitis remain undefined. This study aimed at: (1) establishing the numbers of eosinophils in the normal adult colon; and (2) proposing a clinicopathologic framework for the diagnosis of primary colonic eosinophilia and eosinophilic colitis. To accomplish these goals, we counted the eosinophils in the right, transverse, and left colon of 159 adults with normal colonic histology. Using a database of 1.2 million patients with colonic biopsies, we extracted all adults with a diagnosis of colonic eosinophilia. We reviewed the slides from all cases and captured demographic, clinical, and pathologic data, including information about eosinophilia in other organs. We then compared the clinical manifestations of the study patients (those with no identifiable cause of eosinophilia) to those of patients with other types of colitis. The normal eosinophil counts (per mm) were 55.7±23.4 in the right, 41.0±18.6 in the transverse, and 28.6±17.2 in the left colon. Of the 194 study patients (eosinophil counts 166-5050/mm), 63 were asymptomatic and had a normal colonoscopy. Diarrhea and abdominal pain were the commonest indications for colonoscopy (38% and 27%, respectively) among the 131 patients who had symptoms, endoscopic abnormalities, or both. Neither clinical manifestations nor endoscopic appearance were sufficiently characteristic to elicit the suspicion of colonic eosinophilia. In conclusion, primary colonic eosinophilia was extremely rare in this series (reporting high colonic eosinophilia may result in increased opportunities for clinicopathologic studies that might lead to a better definition of this still elusive entity.

  8. Liver transplantation in adults:Choosing the appropriate timing

    Institute of Scientific and Technical Information of China (English)

    Maria; Siciliano; Lucia; Parlati; Federica; Maldarelli; Massimo; Rossi; Stefano; Ginanni; Corradini

    2012-01-01

    Liver transplantation is indicated in patients with acute liver failure,decompensated cirrhosis,hepatocellular carcinoma and rare liver-based genetic defects that trigger damage of other organs.Early referral to a transplant center is crucial in acute liver failure due to the high mortality with medical therapy and its unpredictable evolution.Referral to a transplant center should be considered when at least one complication of cirrhosis occurs during its natural history.However,because of the shortage of organ donors and the short-term mortality after liver transplantation on one hand and the possibility of managing the complications of cirrhosis with other treatments on the other,patients are carefully selected by the transplant center to ensure that transplantation is indicated and that there are no medical,surgical and psychological contraindications.Patients approved for transplantation are placed on the transplant waiting list and prioritized according to disease severity.Thus,the appropriate timing of transplantation depends on recipient disease severity and,although this is still a matter of debate,also on donor quality.These two variables are known to determine the "transplant benefit"(i.e.,when the expected patient survival is better with,than without,transplantation) and should guide donor allocation.

  9. Expression of Yes-associated protein modulates Survivin expression in primary liver malignancies.

    Science.gov (United States)

    Bai, Haibo; Gayyed, Mariana F; Lam-Himlin, Dora M; Klein, Alison P; Nayar, Suresh K; Xu, Yang; Khan, Mehtab; Argani, Pedram; Pan, Duojia; Anders, Robert A

    2012-09-01

    Hepatocellular carcinoma and intrahepatic cholangiocarcinoma account for 95% of primary liver cancer. For each of these malignancies, the outcome is dismal; incidence is rapidly increasing, and mechanistic understanding is limited. We observed abnormal proliferation of both biliary epithelium and hepatocytes in mice after genetic manipulation of Yes-associated protein, a transcription coactivator. Here, we comprehensively documented Yes-associated protein expression in the human liver and primary liver cancers. We showed that nuclear Yes-associated protein expression is significantly increased in human intrahepatic cholangiocarcinoma and hepatocellular carcinoma. We found that increased Yes-associated protein levels in hepatocellular carcinoma are due to multiple mechanisms including gene amplification and transcriptional and posttranscriptional regulation. Survivin, a member of the inhibitors-of-apoptosis protein family, has been reported as an independent prognostic factor for poor survival in both hepatocellular carcinoma and intrahepatic cholangiocarcinoma. We found that nuclear Yes-associated protein expression correlates significantly with nuclear Survivin expression for both intrahepatic cholangiocarcinoma and hepatocellular carcinoma. Furthermore, using mice engineered to conditionally overexpress Yes-associated protein in the liver, we found that Survivin messenger RNA expression depends upon Yes-associated protein levels. Our findings suggested that Yes-associated protein contributes to primary liver tumorigenesis and likely mediates its oncogenic effects through modulating Survivin expression.

  10. Primary localized malignant biphasic mesothelioma of the liver in a patient with asbestosis

    Institute of Scientific and Technical Information of China (English)

    Motoko Sasaki; Ichiro Araki; Toshiaki Yasui; Masaru Kinoshita; Keita Itatsu; Takayuki Nojima; Yasuni Nakanuma

    2009-01-01

    We report a case of primary localized malignant biphasic mesothelioma of the liver in a 66-yearold man associated with asbestosis. The tumor was detected as a hepatic nodule, 4 cm in diameter, in the right lobe (S8 segment) on CT scan. Histopathological examination demonstrated an intrahepatic tumor with central necrosis consisting of a papillary epithelioid pattern on the surface of the liver, microcystic (microglandular or adenomatoid) pattern mainly in the subcapsular area and sarcomatoid pattern intermingled with microcystic pattern in the major part of the hepatic nodular tumor. Tumor cells, especially of epithelioid type, showed distinct immunoreactivity for mesothelial markers (WT-1, calretinin, D2-40, CK5/6,mesothelin, thrombomodulin) and no immunoreactivity for epithelial (adenocarcinoma) markers (CEA, CD15,BerEP4, BG8, MOC31). P53 immunoreactivity was detected focally in papillary epithelioid tumor cells and extensively in microcystic and sarcomatoid components, suggesting that the papillary epithelioid mesothelioma arose on the surface of the liver, and tumor cells showing microcystic and sarcomatoid patterns invaded and grew into the liver. To date, this is the first case of primary localized malignant biphasic mesothelioma of the liver, since all three primary hepatic mesotheliomas reported so far were epithelioid type.

  11. Adult congenital diaphragmatic hernia of the liver: a rare case report

    Institute of Scientific and Technical Information of China (English)

    LIU LiGuo; XU YiYao; MAO YiLei; SANG XinTing; YANG ZhiYing; LU Xin; ZHONG ShouXian; HUANG JieFu

    2010-01-01

    @@ Congenital diaphragmatic hernia (CDH), which mainly occurs in the newborn or in childhood with severe respiratory distress and high mortality, is rarely found in adult, especially for those uncommon right CDH [1-4].Whereas, liver as the main hernial content has been reported only in two cases throughout the world [5-6].This is a report of a right-sided congenital diaphragmatic hernia of the liver in a 46-year-old woman.

  12. Colorectal neoplasia in patients with primary sclerosing cholangitis undergoing liver transplantation

    DEFF Research Database (Denmark)

    Jørgensen, Kristin Kaasen; Lindström, Lina; Cvancarova, Milada

    2012-01-01

    OBJECTIVE: Several studies have implicated primary sclerosing cholangitis (PSC) as an additional risk factor for colorectal neoplasia in inflammatory bowel disease (IBD). Some reports have indicated that the risk is even higher in PSC-IBD patients after liver transplantation (Ltx), but this issue...

  13. Clinical relevance of recurrence of primary biliary cirrhosis after liver transplantation

    NARCIS (Netherlands)

    Haagsma, EB

    1999-01-01

    Review of the literature shows that recurrence of primary biliary cirrhosis occurs in about 10% of patients in the first few years after liver transplantation. The cumulative risk is expected to increase in time, The rate of recurrent disease may be affected by the immunosuppression used. Weaning fr

  14. Primary biliary cirrhosis : Dutch application of the Mayo model before and after orthotopic liver transplantation

    NARCIS (Netherlands)

    vanDam, GM; Verbaan, BW; Therneau, TM; Dickson, ER; Malinchoc, M; Murtaugh, PA; Huizenga, [No Value; Gips, CH

    1997-01-01

    Background/Aims: A retrospective study of primary biliary cirrhosis (PBC) was performed to study the Original Mayo Model for predicting survival by a Dutch data-set of patients, presentation of disease progression; assessment of liver transplantation, prediction of post-transplantation survival; and

  15. Union examination of AFP,AFU,AFPL3 and γ-GT in early diagnosis of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To explore the significance of union examination of blood serum liver cancer tracers in the early diagnosis of liver cancer. Methods We observed and compared the level of blood serum liver cancer tracers armor embryo protein (AFP),crag algae glycosidase (AFU),armor embryo protein heteroplasmon (AFPL3) and γ-Gu Anxian transferase (γ-GT) in early time for primary liver cancer patients and hepatitis liver cirrhosis patients and those chronic hepatitis B patients who had liver cancer family history. R...

  16. LONG-TERM RESULTS AFTER LIVER-TRANSPLANTATION IN ADULTS

    NARCIS (Netherlands)

    HAAGSMA, EB; KLOMPMAKER, IJ; SLOOFF, MJH

    1991-01-01

    The prospects for patients who survive the first year after liver transplantation are discussed. The 10-year survival for these patients is more than 80%. The quality of life is good, as measured on self-assessment scales. Pregnancy is possible. The main side-effects of drugs concern osteoporosis (c

  17. Reducing biliary complications in adult-to-adult living donor liver transplantation using right lobe graft: experience of 124 cases

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The aim of this paper is to summarize our experience of using right lobe liver grafts to reduce biliary complications in adult-to-adult(A-A)living donor liver transplantation(LDLT).From January 2002 to October 2007,124 adult patients underwent living donor liver transplantation using right lobe grafts at the West China Hospital,Sichuan University Medical School,China.There was no death in all donors.Biliary reconstruction for 178 hepatic duct orifices from 124 donor grafts was performed which included 106 reconstructions of duct-toduct anastomoses and 72 cholangiojejunostomy.Nine recipients had biliary complications including six bile leakages(four from the anastomotic site and two from the cut surface of the liver graft)and three biliary strictures.With the improved techniques for biliary reconstruction,we have achieved good results in 124 recipients of A-A LDLT.We ascribe our success to the introduction of microsurgical techniques and the use of fixed operators which help in decreasing the biliary complications of LDLT.

  18. Characterizing the lymphopoietic kinetics and features of hematopoietic progenitors contained in the adult murine liver in vivo.

    Directory of Open Access Journals (Sweden)

    Xiaojun Jiang

    Full Text Available The appearance of donor-derived lymphocytes in liver transplant patients suggests that adult livers may contain cells capable of lymphopoiesis. However, only a few published studies have addressed the lymphopoietic capacity of adult liver cells, and its kinetics and features remain unclear. Herein, we investigated the lymphopoietic capacity of adult liver mononuclear cells (MNCs and purified liver hematopoietic progenitor cells (HPCs in vivo. Similar to bone-marrow transplantation (BMT, transplantation of liver MNCs alone was able to rescue survival of lethally irradiated mice. In terms of kinetics, liver MNC-derived myeloid lineage cells reconstituted more slowly than those from BMT. Liver MNC-derived lymphocyte lineage cells in the blood, spleen and BM also reconstituted more slowly than BMT, but lymphocytes in the liver recovered at a similar rate. Interestingly, liver MNCs predominantly gave rise to CD3(+CD19(- T cells in both irradiated WT and non-irradiated lymphocyte-deficient Rag-1(-/-Il2rg(-/- recipients. To define the lymphopoietic potential of various cell populations within liver MNCs, we transplanted purified lineage-negative (Lin(- liver HPCs into recipient mice. Unlike total liver MNCs, liver HPCs reconstituted T and B cells in similar frequencies to BMT. We further determined that the predominance of T cells observed after transplanting total liver MNCs likely originated from mature T cells, as purified donor liver T cells proliferated in the recipients and gave rise to CD8(+ T cells. Thus, the capacity of donor adult liver cells to reconstitute lymphocytes in recipients derives from both HPCs and mature T cells contained in the liver MNC population.

  19. Comparison of anamnestic history, alcohol intake and smoking, nutritional status, and liver dysfunction between thorotrast patients who developed primary liver cancer and those who did not

    Energy Technology Data Exchange (ETDEWEB)

    Kiyosawa, K.; Imai, H.; Sodeyama, T.; Franca, S.T.; Yousuf, M.; Furuta, S.; Fujisawa, K.; Kido, C. (Shinshu Univ. School of Medicine, Matsumoto (Japan))

    1989-08-01

    In order to clarify the differences in past history, nutritional condition and, consumption of alcohol and tobacco, and liver dysfunction between the thorotrast patients who developed primary liver cancer and those who did not, 103 persons who had no primary liver cancer in January 1980 were studied. All subjects were military men who had undergone angiography with thorotrast between 1943 and 1946. Twenty persons developed hepatocellular carcinoma and 16 developed intrahepatic bile duct carcinoma by April 1987, whereas 67 are still alive without any cancer. There was no difference in age or period after thorotrast infusion between those two groups of patients in January 1980. A difference in history of hepatitis and/or jaundice and presence of hepatic dysfunction was found between the subjects who developed primary liver cancers and those who did not. These findings suggest that an anamnestic history of hepatitis and liver dysfunction are risks for development of thorotrast-induced liver cancer. On the basis of the above findings, early detection of liver dysfunction offers a possibility of early diagnosis of primary liver cancer.

  20. An attempt to eliminate fibroblast-like cells from primary cultures of fetal human livers.

    Directory of Open Access Journals (Sweden)

    Tokiwa,Takayoshi

    1986-04-01

    Full Text Available The elimination of fibroblast-like cells from primary cultures of fetal human livers was studied. A fibroblast-like cell line (HuF, which was obtained by subculturing fetal human liver cells 4 or more times, was briefly treated with hydrocortisone (HC or putrescine (PUT. The growth of HuF cells was inhibited by HC at a concentration of 10(-2 M and by PUT at a concentration higher than 10(-3 M. Long-term treatment of HuF cells with 10(-3 M HC inhibited the growth of the cells. Primary cultures of fetal human livers were made in medium containing HC or PUT, and morphological and functional examinations were made. The cultures were predominantly composed of epithelial-like cells, with few fibroblast-like cells, when the HC concentration was 10(-5M to 10(-3 M. A high amount of albumin was secreted at these concentrations of HC. On the other hand, at 10(-3 M PUT, many epithelial-like cells were seen, but albumin was undetectable. The present results indicate that albumin-producing epithelial-like cells can be selectively maintained in medium containing HC, in primary cultures of fetal human livers.

  1. Predominant expression of Th1-type cytokines in primary hepatic cancer and adjacent liver tissues

    Institute of Scientific and Technical Information of China (English)

    Fa-Bo Qiu; Li-Qun Wu; Yun Lu; Shun Zhang; Bing-Yuan Zhang

    2007-01-01

    BACKGROUND: Research has revealed a shift towards Th2 in many types of malignant tumor, but the state of Th1/Th2 is not clear in patients with primary hepatic cancer (PHC). This study was designed to determine the expression of Th1-versus Th2-type cytokines in primary hepatic cancer and the adjacent liver tissue in order to provide evidence for treatment of the Th1/Th2 shift. METHODS:Samples were collected from 11 patients with PHC. The gene expression of Th1/Th2 cytokines was detected by reverse transcriptase polymerase chain reaction (RT-PCR) using IFN-γ and IL-2 as Th1-type cytokine genes, and IL-4 and IL-10 as Th2-type cytokine genes. RESULTS: Th1-type cytokines were expressed in 7/11 PHCs and 9/11 adjacent liver tissues, while Th0 type cytokines occurred in 4/11 PHCs and 2/11 adjacent liver tissues. CONCLUSION: Th1-type cytokines are expressed predominantly in primary hepatic cancer and the adjacent liver tissue.

  2. Adverse effects of the antimalaria drug, mefloquine: due to primary liver damage with secondary thyroid involvement?

    Directory of Open Access Journals (Sweden)

    Herxheimer Andrew

    2002-03-01

    Full Text Available Abstract Background Mefloquine is a clinically important antimalaria drug, which is often not well tolerated. We critically reviewed 516 published case reports of mefloquine adverse effects, to clarify the phenomenology of the harms associated with mefloquine, and to make recommendations for safer prescribing. Presentation We postulate that many of the adverse effects of mefloquine are a post-hepatic syndrome caused by primary liver damage. In some users we believe that symptomatic thyroid disturbance occurs, either independently or as a secondary consequence of the hepatocellular injury. The mefloquine syndrome presents in a variety of ways including headache, gastrointestinal disturbances, nervousness, fatigue, disorders of sleep, mood, memory and concentration, and occasionally frank psychosis. Previous liver or thyroid disease, and concurrent insults to the liver (such as from alcohol, dehydration, an oral contraceptive pill, recreational drugs, and other liver-damaging drugs may be related to the development of severe or prolonged adverse reactions to mefloquine. Implications We believe that people with active liver or thyroid disease should not take mefloquine, whereas those with fully resolved neuropsychiatric illness may do so safely. Mefloquine users should avoid alcohol, recreational drugs, hormonal contraception and co-medications known to cause liver damage or thyroid damage. With these caveats, we believe that mefloquine may be safely prescribed in pregnancy, and also to occupational groups who carry out safety-critical tasks. Testing Mefloquine's adverse effects need to be investigated through a multicentre cohort study, with small controlled studies testing specific elements of the hypothesis.

  3. Simultaneous laparoscopic resection of primary colorectal cancer and associated liver metastases: a systematic review.

    Science.gov (United States)

    Lupinacci, R M; Andraus, W; De Paiva Haddad, L B; Carneiro D' Albuquerque, L A; Herman, P

    2014-02-01

    As many as 25 % of colorectal cancer (CRC) patients have liver metastases at presentation. However, the optimal strategy for resectable synchronous colorectal liver metastasis remains controversial. Despite the increasing use of laparoscopy in colorectal and liver resections, combined laparoscopic resection of the primary CRC and synchronous liver metastasis is rarely performed. The potential benefits of this approach are the possibility to perform a radical operation with small incisions, earlier recovery, and reduction in costs. The aim of this study was to review the literature on feasibility and short-term results of simultaneous laparoscopic resection. We conducted a systematic search of all articles published until February 2013. Search terms included: hepatectomy [Mesh], "liver resection," laparoscopy [Mesh], hand-assisted laparoscopy [Mesh], surgical procedures, minimally invasive [Mesh], colectomy [Mesh], colorectal neoplasms [Mesh], and "colorectal resections." No randomized trials are available. All data have been reported as case reports, case series, or case-control studies. Thirty-nine minimally invasive simultaneous resections were identified in 14 different articles. There were 9 (23 %) major hepatic resections. The most performed liver resection was left lateral sectionectomy in 26 (67 %) patients. Colorectal resections included low rectal resections with total mesorectal excision, right and left hemicolectomies, and anterior resections. Despite the lack of high-quality evidence, the laparoscopic combined procedure appeared to be feasible and safe, even with major hepatectomies. Good patient selection and refined surgical technique are the keys to successful simultaneous resection. Simultaneous left lateral sectionectomy associated with colorectal resection should be routinely proposed.

  4. Liver transplantation in polycystic liver disease: a relevant treatment modality for adults?

    DEFF Research Database (Denmark)

    Krohn, P.S.; Hillingso, J.G.; Kirkegaard, P.

    2008-01-01

    OBJECTIVE: Polycystic liver disease (PLD) is a rare, hereditary, benign disorder. Hepatic failure is uncommon and symptoms are caused by mass effects leading to abdominal distension and pain. Liver transplantation (LTX) offers fully curative treatment, but there is still some controversy about...... whether it is a relevant modality considering the absence of liver failure, relative organ shortage, perioperative risks and lifelong immunosuppression. The purpose of this study was to review our experience of LTX for PLD and to compare the survival with the overall survival of patients who underwent LTX....../kidney transplantation. One patient had undergone kidney transplantation 10 years earlier. RESULTS: Median follow-up was 55 months. One patient who underwent combined transplantation died after 5.4 months because of multiorgan failure after re-LTX, and one patient, with well-functioning grafts, died of lymphoma after 7...

  5. In Vitro and In Vivo Hepatic Differentiation of Adult Somatic Stem Cells and Extraembryonic Stem Cells for Treating End Stage Liver Diseases

    Directory of Open Access Journals (Sweden)

    Chenxia Hu

    2015-01-01

    Full Text Available The shortage of liver donors is a major handicap that prevents most patients from receiving liver transplantation and places them on a waiting list for donated liver tissue. Then, primary hepatocyte transplantation and bioartificial livers have emerged as two alternative treatments for these often fatal diseases. However, another problem has emerged. Functional hepatocytes for liver regeneration are in short supply, and they will dedifferentiate immediately in vitro after they are isolated from liver tissue. Alternative stem-cell-based therapeutic strategies, including hepatic stem cells (HSCs, embryonic stem cells (ESCs, induced pluripotent stem cells (iPSCs, and mesenchymal stem cells (MSCs, are more promising, and more attention has been devoted to these approaches because of the high potency and proliferation ability of the cells. This review will focus on the general characteristics and the progress in hepatic differentiation of adult somatic stem cells and extraembryonic stem cells in vitro and in vivo for the treatment of end stage liver diseases. The hepatic differentiation of stem cells would offer an ideal and promising source for cell therapy and tissue engineering for treating liver diseases.

  6. [A case of undifferentiated (embryonal) liver sarcoma mimicking klatskin tumor in an adult].

    Science.gov (United States)

    Lee, Ji Ae; Kim, Tae Wan; Min, Jae Hoon; Byon, Sun Jung; Jang, Seung Hoon; Choi, Seung Yeon; Kim, Hong Joo

    2010-02-01

    Undifferentiated sarcoma is an uncommon primary malignant tumor of the liver typically occurring in older children. It is also referred to as malignant mesenchymoma, fibromyxosarcoma, or mesenchymal sarcoma. We experienced a case of undifferentiated sarcoma in 72-year-old male. Contrast enhanced liver CT scan revealed a 3.4 cm heterogeneously enhancing, ill-defined, and low attenuated mass in the left liver and subtle intrahepatic duct dilatation. And, in tubogram, there were segmental stenosis and occlusion from the hilum to the proximal common bile duct. We did ultrasonography guided liver biopsy. The pathologic finding revealed infiltrative growth of atypical cells with rhabdoid features. Some atypical cells showed clear cytoplasm, but no organoid pattern was identified. The stroma around atypical cells was filled with eosinophilic hyaline material. These tumor cells were positive for vimentin only, and the tumor was consistent with undifferentiated sarcoma of the liver.

  7. The usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Hee Kyung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, Sung Gyu; Lee, Young Joo; Park, Kwang Min; Hwang, Shin [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

    2002-04-01

    Living donor liver transplantation has become an accepted procedure to overcome the shortage of adult donor organs. The aim of this study was to evaluate the usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation. We analysed 82 hepatobiliary scintigraphy studies performed using technetium-99m DISIDA in 60 adult patients (44 males, 16 females) who had been transplanted with a living donor's hepatic lobe (right lobe, 32; left lobe, 28). Indications for hepatobiliary scintigraphy were abnormal symptoms and/or liver function tests (n=54) or suspected bile leak or biloma (n=28). Median interval between transplantation and scintigraphy was 69 days (9 days to 23 months). Scintigraphic findings were classified into hepatic parenchymal dysfunction, total biliary obstruction, segmental biliary obstruction, bile leak and normal graft. Scintigraphic findings were confirmed by liver biopsy in 17 cases, and by radiological and clinical follow-up in 65 cases. There were 29 events relating to biliary complications (six total biliary obstructions, eight segmental biliary obstructions and 15 bile leaks) and 19 relating to non-biliary complications (15 cases of rejection, two of infection and two of vascular compromise) in 38 patients. Hepatobiliary scintigraphy provided the correct diagnosis in all eight segmental and five of six total biliary obstructions, and in all 15 cases of bile leak. Of the 19 non-biliary complications, 16 showed parenchymal dysfunction regardless of the aetiology and three showed total biliary obstruction on scintigraphy. All but three of 34 normally functioning grafts were normal on scintigraphy. The diagnostic sensitivity and specificity of scintigraphy for biliary obstruction in the 54 patients with abnormal symptoms or liver function tests were 93% (100% for segmental, 83% for total) and 88% (35/40), respectively. The sensitivity and specificity were each 100% (15/15, 13

  8. Does bilioenteric anastomosis impair results of liver resection in primary intrahepatic lithiasis?

    Institute of Scientific and Technical Information of China (English)

    Paulo; Herman; Marcos; V; Perini; Vincenzo; Pugliese; Julio; Cesar; Pereira; Marcel; Autran; C; Machado; William; A; Saad; Luiz; AC; D; Albuquerque; Ivan; Cecconello

    2010-01-01

    AIM:To evaluate the long-term results of liver resection for the treatment of primary intrahepatic lithiasis.Prognostic factors,especially the impact of bilioenteric anastomosis on recurrence of symptoms were assessed.METHODS:Forty one patients with intrahepatic stones and parenchyma fibrosis/atrophy and/or biliary stenosis were submitted to liver resection.Resection was associated with a Roux-en-Y hepaticojejunostomy in all patients with bilateral stones and in those with unilateral disease and dilation of...

  9. Volumetry-based selection of right posterior sector grafts for adult living donor liver transplantation.

    Science.gov (United States)

    Kim, Bong-Wan; Xu, Weiguang; Wang, Hee-Jung; Park, Yong-Keun; Lee, Kwangil; Kim, Myung-Wook

    2011-09-01

    To determine the feasibility of volumetric criteria without anatomic exclusion for the selection of right posterior sector (RPS) grafts for adult-to-adult living donor liver transplantation (LDLT), we reviewed and compared our transplant data for RPS grafts and right lobe (RL) grafts. Between January 2008 and September 2010, adult-to-adult LDLT was performed 65 times at our institute; 13 of the procedures (20%) were performed with RPS grafts [the posterior sector (PS) group], and 39 (60%) were performed with RL grafts (the RL group). The volumetry of the 13 RPS donor livers showed that the RPS volume was 39.8% ± 7.6% of the total liver volume. Ten of the 13 donors had to donate RPS grafts because the left liver volume was inadequate. All donor procedures were performed successfully, and all donors recovered from hepatectomy. However, longer operative times were required for the procurement of RPS grafts versus RL grafts (418 ± 40 versus 345 ± 48 minutes, P liver function was smoother for the donors of the PS group versus the donors of the RL group. The RPS grafts had significantly smaller hepatic artery and bile duct openings than the RL grafts. All recipients with RPS grafts survived LDLT. No recipients experienced vascular graft complications or small-for-size graft dysfunction. There were no significant differences in the incidence of posttransplant complications between the donors and recipients of the PS and RL groups. The 3-year graft survival rates were favorable in both groups (100% in the PS group versus 91% in the RL group). In conclusion, the selection of RPS grafts by volume criteria is a feasible strategy for an adult-to-adult LDLT program.

  10. Risk factors associated with non-alcoholic fatty liver disease in subjects from primary care units. A case-control study

    Directory of Open Access Journals (Sweden)

    Bernad Jesús

    2008-10-01

    Full Text Available Abstract Background Non alcoholic fatty liver disease (NAFL consists in the accumulation of fat vacuoles in the cytoplasm of hepatocytes. Many etiologic factors are associated with NAFL, such as, the metabolic syndrome factors, medications, bariatric surgery, nutritional disorders. However, very little information is available on the clinical relevance of this disorder as a health problem in the general population. Methods and design The aim of the study is establish the risk factors most frequently associated with NAFL in a general adult population assigned to the primary care units and to investigate the relationship between each component of the metabolic syndrome and the risk of having a NAFL. A population based case-control, observational and multicenter study will be carried out in 18 primary care units from the "Area de Gestión del Barcelonés Nord y Maresme" (Barcelona attending a population of 360,000 inhabitants and will include 326 cases and 370 controls. Cases are defined as all subjects fulfilling the inclusion criteria and with evidence of fatty liver in an abdominal ultrasonography performed for any reason. One control will be randomly selected for each case from the population, matched for age, gender and primary care center. Controls with fatty liver or other liver diseases will be excluded. All cases and controls will be asked about previous hepatic diseases, consumption of alcohol, smoking and drugs, and a physical examination, biochemical analyses including liver function tests, the different components of the metabolic syndrome and the HAIR score will also be performed. Paired controls will also undergo an abdominal ultrasonography. Discussion This study will attempt to determine the factors most frequently associated with the presence of NAFL investigate the relationship between the metabolic syndrome and the risk of fatty liver and study the influence of the different primary care professionals in avoiding the evolution

  11. Imaging findings in Langerhans` cell histiocytosis of the liver and the spleen in an adult

    Energy Technology Data Exchange (ETDEWEB)

    Mampaey, S. [Dept. of Radiology, Aalsters Stedelijk Ziekenhuis, Aalst (Belgium)]|[Dept. of Radiology, University of Antwerp (Belgium); Warson, F. [Dept. of Anatomopathology, Aalsters Stedelijk Ziekenhuis, Aalst (Belgium); Hedent, E. van [Dept. of Radiology, Aalsters Stedelijk Ziekenhuis, Aalst (Belgium); Schepper, A.M. de [Dept. of Radiology, University of Antwerp (Belgium)

    1999-02-01

    We present a case of Langerhans` cell histiocytosis (LCH) of the liver and spleen in an adult. The imaging features are different from those in the few previously reported cases of individual organ involvement by LCH. (orig.) (orig.) With 2 figs., 5 refs.

  12. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    Science.gov (United States)

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  13. Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project

    DEFF Research Database (Denmark)

    Pedersen, Marie; Andersen, Zorana J.; Stafoggia, Massimo

    2017-01-01

    Background: Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution. Objectives: We evaluated the association between residential exposure to air pollution and primary liver cancer incidence...... in PM2.5. Conclusions: The results provide suggestive evidence that ambient air pollution may increase the risk of liver cancer. Confidence intervals for associations with NO2 and NOX were narrower than for the other exposures.......) at baseline home addresses were estimated using land-use regression models from the ESCAPE project. We also investigated traffic density on the nearest road. We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and random-effects meta...

  14. Short-Term Outcomes of Simultaneous Laparoscopic Colectomy and Hepatectomy for Primary Colorectal Cancer With Synchronous Liver Metastases

    OpenAIRE

    2014-01-01

    Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer an...

  15. Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein

    Institute of Scientific and Technical Information of China (English)

    WU Hong; LU Qiang; CHEN Zhe-yu; MA Yu-kui; LI Jin; YANG Jia-yin; YAN Lü-nan; LI Bo; ZENG Yong; WEN Tian-fu; ZHAO Ji-chun; WANG Wen-tao; XU Ming-qing

    2007-01-01

    Background It is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.Methods A retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.Results No deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepaticvein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1),left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.Conclusions The multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.

  16. Current status of adult-to-adult living donor liver transplantation: surgical techniques and innovations

    Institute of Scientific and Technical Information of China (English)

    YAN Lü-nan; WU Hong; CHEN Zhe-yu; LIN Yi-xin

    2009-01-01

    @@ In response to critical organ shortage, transplant surgeons have utilized living donors in an attempt to decrease the mortality rate associated with waiting on the liver transplant list. Although the surgical techniques were first utilized clinically 15 years ago, the application of living donor liver transplantation (LDLT) has been somewhat limited by the steep learning curve associated with developing a program.

  17. Dose-dependent DNA ruptures induced by the procarcinogen dimethylnitrosamine on primary rat liver cultures.

    Science.gov (United States)

    Mendoza-Figueroa, T; López-Revilla, R; Villa-Treviño, S

    1979-08-01

    The effect of certain procarcinogens, among which demethylnitrosamine (DMN) is included, has been difficult to detect in several short-term assays. An alternative system, in which DMN effects could be easily quantitated, might be useful in studies of chemical carcinogenesis and environmental contamination. To develop such a system, we tested the possibility of measuring the amount of breakage produced by DMN on radiolabeled DNA of primary liver cultures. Rat liver cells were isolated 20 to 24 hr after partial hepatectomy, cultured, and pulse labeled in vitro with [3H]thymidine. Radioactively labeled cultures were treated with DMN or with the direct carcinogen N-methyl-N'-nitro-N-nitrosoguanidine and then lysed directly onto alkaline sucrose gradients. DMN and N-methyl-N'-nitro-N-nitrosoguanidine caused a dose-dependent reduction in the molecular weight of DNA, N-methyl-N'-nitro-N-nitrosoguanidine being approximately 1000 times more potent than DMN. DNA breaks appeared to be carcinogen specific and not due to cell death since treatment with high doses of cycloheximide, a noncarcinogenic hepatotoxic, was without significant effect. Our data indicate that detection of DNA breaks constitutes a more sensitive assay of DMN effects than does unscheduled DNA synthesis in primary liver cultures. Therefore, it could be useful to extend our work to determine the general applicability of quantitation of DNA breaks in liver cells as a short-term assay for the identification of possible carcinogens and procarcinogens.

  18. Primary Diffuse Large B-Cell Lymphoma of the Liver in a Patient with Sjogren Syndrome

    Directory of Open Access Journals (Sweden)

    Vadim Gorodetskiy

    2016-01-01

    Full Text Available Sjögren’s syndrome (SS has the highest incidence of malignant lymphoproliferative disorders transformation among autoimmune diseases. We present a case of extranodal high grade lymphoma of the liver in a 52-year-old patient with long history of SS. Lymphoma manifested with sharp significant pain in the right hypochondrium, weakness, and profuse night sweats. Contrast-enhanced computed tomography scan (CT-scan of the abdomen revealed multiple low density foci with homogeneous structure and clear contours in both lobes of the liver. Histologically, proliferation of medium sized lymphoma cells with round-oval and slightly irregular nuclei with fine chromatin was shown. Immunohistochemical and molecular features of the tumors allowed diagnosis of diffuse large B-cell lymphoma (DLBCL. To exclude secondary liver lesion by non-Hodgkin lymphoma, chest and small pelvis CT-scan, endoscopy of upper and lower gastrointestinal tract and study of bone marrow were performed. After 8 cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, the complete remission was achieved, which persists after 45 months of follow-up. Primary hepatic lymphomas are extremely rare, and previously only low-grade hepatic lymphomas have been described in SS. To our knowledge, the patient described here represents the first reported case of DLBCL with primary liver involvement in SS.

  19. The Effects of Combined Hepatectomy and Immunochemotherapy on Postoperative Recurrence of Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOUWeiping; WUMengchao; 等

    2002-01-01

    Ojbective To Study the effects of combined hepatectomy and immunochemotherapy on postoperative recurrence of primary liver cancer.Methods 121 caes were divided into four groups:operation only(OP group);combined operation and chemotherapy(OC group);combined operation and immunotherapy(OI group);combined operation and immunochemotherapy(OIC group).Chemotherapy was performed through hepatic arter or port vein,and the immunotherapy was used with LAK cell IL-2 and IFN-γ。Results Three-yeau recurrence rate in the four groups was 76.7%,55.6%,45.2% and 36.4%,respectively.The recurrence rate of OI group and OIC group was significantly lower than that of OP group.Conclusion Combined operation and immunochemotherapy in useful in preventing postoperative recurrence of primary liver cancer.

  20. Specific genomic aberrations in primary colorectal cancer are associated with liver metastases

    Directory of Open Access Journals (Sweden)

    Wessels Lodewyk F

    2010-12-01

    Full Text Available Abstract Background Accurate staging of colorectal cancer (CRC with clinicopathological parameters is important for predicting prognosis and guiding treatment but provides no information about organ site of metastases. Patterns of genomic aberrations in primary colorectal tumors may reveal a chromosomal signature for organ specific metastases. Methods Array Comparative Genomic Hybridization (aCGH was employed to asses DNA copy number changes in primary colorectal tumors of three distinctive patient groups. This included formalin-fixed, paraffin-embedded tissue of patients who developed liver metastases (LM; n = 36, metastases (PM; n = 37 and a group that remained metastases-free (M0; n = 25. A novel statistical method for identifying recurrent copy number changes, KC-SMART, was used to find specific locations of genomic aberrations specific for various groups. We created a classifier for organ specific metastases based on the aCGH data using Prediction Analysis for Microarrays (PAM. Results Specifically in the tumors of primary CRC patients who subsequently developed liver metastasis, KC-SMART analysis identified genomic aberrations on chromosome 20q. LM-PAM, a shrunken centroids classifier for liver metastases occurrence, was able to distinguish the LM group from the other groups (M0&PM with 80% accuracy (78% sensitivity and 86% specificity. The classification is predominantly based on chromosome 20q aberrations. Conclusion Liver specific CRC metastases may be predicted with a high accuracy based on specific genomic aberrations in the primary CRC tumor. The ability to predict the site of metastases is important for improvement of personalized patient management.

  1. Phase I-II study of isotopic immunoglobulin therapy for primary liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ettinger, D.S.; Order, S.E.; Wharam, M.D.; Parker, M.K.; Klein, J.L.; Leichner, P.K.

    1982-02-01

    A phase I-II study of isotopic immunoglobulin therapy was performed in 18 patients with primary liver cancer; 14 were evaluable for toxicity. The patients received a dose of 37-157 millicuries of 131I-labeled antibody. The dose-limiting factor appears to be hematologic toxicity, especially thrombocytopenia. An objective antitumor effect was seen in six of nine patients who were evaluable for response. Present results suggest that further clinical studies with isotopic immunoglobulin are indicated.

  2. Positron emission tomography / computerized tomography evaluation of primary Hodgkin's disease of liver.

    Science.gov (United States)

    Gota, V S; Purandare, N C; Gujral, S; Shah, S; Nair, R; Rangarajan, V

    2009-01-01

    Occurrence of primary Hodgkin's lymphoma (PHL) of the liver is extremely rare. We report on a case of a 60-year-old male who presented with liver mass and B-symptomatology. Hepatoma or hepatic metastasis from a gastrointestinal primary was initially suspected. Tumor markers like AFP, CEA, Total PSA, and CA-19.9 were within normal limits. Positron Emission Tomography / Computerized Tomography (PET/CT) revealed a large hepatic lesion and a nodal mass in the porta hepatis. A liver biopsy was consistent with Hodgkin's lymphoma. There was complete regression of the hepatic lesion and evidence of shrinkage of the nodal mass following four cycles of chemotherapy. 18F Fluro -de-oxy Glucose (FDG) PET / CT in this case helped in establishing a primary hepatic lymphoma by demonstrating the absence of pathologically hypermetabolic foci in any other nodes or organs. PET / CT scan is a useful adjunct to conventional imaging and histopathology, not only to establish the initial diagnosis, but also to monitor treatment response in PHL.

  3. Gene expression profiles of primary colorectal carcinomas, liver metastases, and carcinomatoses

    Directory of Open Access Journals (Sweden)

    Myklebost Ola

    2007-01-01

    Full Text Available Abstract Background Despite the fact that metastases are the leading cause of colorectal cancer deaths, little is known about the underlying molecular changes in these advanced disease stages. Few have studied the overall gene expression levels in metastases from colorectal carcinomas, and so far, none has investigated the peritoneal carcinomatoses by use of DNA microarrays. Therefore, the aim of the present study is to investigate and compare the gene expression patterns of primary carcinomas (n = 18, liver metastases (n = 4, and carcinomatoses (n = 4, relative to normal samples from the large bowel. Results Transcriptome profiles of colorectal cancer metastases independent of tumor site, as well as separate profiles associated with primary carcinomas, liver metastases, or peritoneal carcinomatoses, were assessed by use of Bayesian statistics. Gains of chromosome arm 5p are common in peritoneal carcinomatoses and several candidate genes (including PTGER4, SKP2, and ZNF622 mapping to this region were overexpressed in the tumors. Expression signatures stratified on TP53 mutation status were identified across all tumors regardless of stage. Furthermore, the gene expression levels for the in vivo tumors were compared with an in vitro model consisting of cell lines representing all three tumor stages established from one patient. Conclusion By statistical analysis of gene expression data from primary colorectal carcinomas, liver metastases, and carcinomatoses, we are able to identify genetic patterns associated with the different stages of tumorigenesis.

  4. Primary malignant melanoma of the liver:One case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Dongfang Huang; Jinsheng Wu; Guofeng Chen; Jianhuai Zhang

    2016-01-01

    Objective Primary malignant melanomas of the liver are exceedingly rare. Only 19 cases have been reported in the literature worldwide. In this report, we describe our pathological findings and review the literature in order to improve our understanding of the disease and prevent misdiagnosis, as wel as provide evidence for its treatment and prognosis. Methods We present a case of an isolated malignant melanoma of the liver in a 61-year-old male Chi-nese patient. Results Comprehensive dermatological and ophthalmological examinations did not reveal any evidence of a primary cutaneous or ocular lesion. Similarly, serial physical examinations, auxiliary examinations, and bone scans did not demonstrate any other lesions in the brain, respiratory tract, and gastrointestinal tract. Microscopic examination of the resected specimen revealed malignant melanoma, which was confirmed by immunohistochemical staining for S-100 protein (+), ki67 (30%+), EMA (+), CD10 (+), and HMB-45 (++). Conclusion Primary malignant melanoma may occur in the liver, and should be considered when the histopathological appearance is atypical of other hepatic neoplasms. The diagnostic criteria for hepatic malignant melanoma depend mainly on the clinical, radiographic, and histopathological findings. Pathomor-phology and immumohistochemical staining can be utilized to confirm the diagnosis.

  5. Culture and establishment of self-renewing human and mouse adult liver and pancreas 3D organoids and their genetic manipulation.

    Science.gov (United States)

    Broutier, Laura; Andersson-Rolf, Amanda; Hindley, Christopher J; Boj, Sylvia F; Clevers, Hans; Koo, Bon-Kyoung; Huch, Meritxell

    2016-09-01

    Adult somatic tissues have proven difficult to expand in vitro, largely because of the complexity of recreating appropriate environmental signals in culture. We have overcome this problem recently and developed culture conditions for adult stem cells that allow the long-term expansion of adult primary tissues from small intestine, stomach, liver and pancreas into self-assembling 3D structures that we have termed 'organoids'. We provide a detailed protocol that describes how to grow adult mouse and human liver and pancreas organoids, from cell isolation and long-term expansion to genetic manipulation in vitro. Liver and pancreas cells grow in a gel-based extracellular matrix (ECM) and a defined medium. The cells can self-organize into organoids that self-renew in vitro while retaining their tissue-of-origin commitment, genetic stability and potential to differentiate into functional cells in vitro (hepatocytes) and in vivo (hepatocytes and endocrine cells). Genetic modification of these organoids opens up avenues for the manipulation of adult stem cells in vitro, which could facilitate the study of human biology and allow gene correction for regenerative medicine purposes. The complete protocol takes 1-4 weeks to generate self-renewing 3D organoids and to perform genetic manipulation experiments. Personnel with basic scientific training can conduct this protocol.

  6. Repeated-dose liver micronucleus test of 4,4'-methylenedianiline using young adult rats.

    Science.gov (United States)

    Sanada, Hisakazu; Koyama, Naomi; Wako, Yumi; Kawasako, Kazufumi; Hamada, Shuichi

    2015-03-01

    Liver micronucleus (MN) tests using partial hepatectomized rats or juvenile rats have been shown to be useful for the detection of hepatic carcinogens. Moreover, Narumi et al. established the repeated-dose liver MN test using young adult rats for integration into general toxicity. In the present study, in order to examine the usefulness of the repeated-dose liver MN test, we investigated MN induction with a 14 or 28 day treatment protocol using young adult rats treated with 4,4′-methylenedianiline (MDA), a known hepatic carcinogen. MDA dose-dependently induced micronuclei in hepatocytes in 14- and 28-day repeated-dose tests. However, although statistically significant increases in micronuclei were observed in bone marrow cells at two dose levels in the 14-day study, there was no dose response and no increases in micronuclei in the 28-day study. These results indicate that the evaluation of genotoxic effects using hepatocytes is effective in cases where chromosomal aberrations are not clearly detectable in bone marrow cells. Moreover, the repeated-dose liver MN test allows evaluation at a dose below the maximum tolerable dose, which is required for the conventional MN test because micronucleated hepatocytes accumulate. The repeated-dose liver MN test employed in the present study can be integrated into the spectrum of general toxicity tests without further procedural modifications.

  7. Adult Mesenchymal Hamartoma of the Liver: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Zachary Klaassen

    2010-03-01

    Full Text Available Mesenchymal hamartoma of the liver (MHL is a rare benign lesion occurring primarily in the pediatric population. While the precise pathogenesis of the tumor is not certain, the most common theory relates to aberrant mesenchyme development in the portal tract likely related to the bile ducts. A 53-year-old female was evaluated for an incidental liver mass. Initial CT scan showed a cystic lesion in the right lobe of the liver and follow-up imaging revealed an increase in size and the percent solid component within the mass. In view of these changes, a nondiagnostic biopsy was obtained followed by extirpation of the lesion. Gross pathological review of the lesion identified a 9 × 9 × 7.5 cm, pink-yellow-tan, gelatinous mass, with a >1 cm clear surgical margin. Histologically, the mass consisted of benign dilated bile ducts, as well as myxoid stroma with spindle cells showing smooth muscle differentiation. The patient was discharged home on postoperative day five. A review of the literature for MHL in adults reports 30 previous cases, predominantly published as individual case reports describing the size, lobe(s of the liver affected, and the cystic/solid nature of the tumor. MHL in adults may represent a potentially premalignant lesion, as the emerging literature supports a potential relationship between MHL and malignant undifferentiated embryonal sarcoma in regards to cytogenetic analysis. Aggressive surgical management of MHL in adults is mandated when feasible.

  8. Application of cryopreserved vein grafts as a conduit between the coronary vein and liver graft to reconstruct portal flow in adult living liver transplantation.

    Science.gov (United States)

    Wu, Tsung-Han; Chou, Hong-Shiue; Pan, Kuang-Tse; Lee, Ching-Song; Wu, Ting-Jun; Chu, Sung-Yu; Chen, Miin-Fu; Lee, Wei-Chen

    2009-01-01

    Adult-to-adult living donor liver transplantation is an alternative to donation from a deceased individual, and can help relieve the shortage of liver donations available for adult patients in Asian countries. When transplant candidates have thrombosis and deterioration of the portal vein, living donor liver transplantation is relatively contraindicated because portal veins in the grafts are short and vein grafts may not be available to reconstruct the portal vein. From June 2003 to May 2007, 82 adult living donor liver transplantations were performed at Chang-Gung Memorial Hospital. Three patients had portal vein thrombosis and marked fibrosis of the portal vein and cryopreserved vein grafts were used to reconstruct portal flow from the engorged coronary vein to the graft portal vein. All vein grafts are patent and all patients have normal liver function at 21-36 months after transplantation. When cryopreserved vein grafts are available, adult living donor liver transplantation can be successfully performed in patients with marked deterioration of the portal vein. The short distance from the engorged coronary vein to the graft portal vein may decrease the incidence of re-thrombosis of the venous conduit.

  9. Development and validation of a microRNA based diagnostic assay for primary tumor site classification of liver core biopsies

    DEFF Research Database (Denmark)

    Perell, Katharina; Vincent, Martin; Vainer, Ben;

    2015-01-01

    negatively affect the accuracy and usability of molecular classifiers. We have developed and validated a microRNA-based classifier, which predicts the primary tumor site of liver biopsies, containing a limited number of tumor cells. Concurrently we explored the influence of surrounding normal tissue...... for normal liver tissue contamination. Performance was estimated by cross-validation, followed by independent validation on 55 liver core biopsies with a tumor content as low as 10%. A microRNA classifier developed, using the statistical contamination model, showed an overall classification accuracy of 74...... on classification. MicroRNA profiling was performed using quantitative Real-Time PCR on formalin-fixed paraffin-embedded samples. 278 primary tumors and liver metastases, representing nine primary tumor classes, as well as normal liver samples were used as a training set. A statistical model was applied to adjust...

  10. Can epithermal boron neutron capture therapy treat primary and metastatic liver cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, S.A. [Austin Repatriation Medical Centre, Heidelberg (Australia); Carolan, M.C. [Illawarra Cancer Care Centre, Wollongong (Australia); Allen, B.J. [St George Cancer Care Centre, Kogarah (Australia)

    1996-12-31

    Full text: The poor prognosis of metastatic cancer to the liver calls for the investigation of alternative treatment modalities. This paper analyses the possible use of epithermal boron neutron capture therapy for the palliative treatment of these cancers. We examine possible treatment planning scenarios for selected tumour to liver boron ratios, and specifically for the epithermal beam at the HFR, Petten. It is required that a therapeutic ratio> 1 be achieved over the entire organ. Monte Carlo calculations were performed using the radiation transport code MCNP. The geometrical model used a `variable voxel` technique to reconstruct an anthropomorphic phantom from CT scans. Regions of interest such as the liver were modelled to a resolution of a few millimetres, whereas surrounding regions were modelled with lesser detail thereby facilitating faster computation time. Three dimensional dose distributions were calculated for a frontal beam directed at the liver, and found to be in satisfactory agreement with measurements using bare and cadmium covered gold foils, PIN and MOSFET dosimeters for fast neutron and gamma measurements respectively. Dose distributions were calculated for orthogonal epithermal neutron beams to the front and side, using the parameters of the epithermal beam at Petten, and assumed tumour and normal tissue boron-10 concentrations of 30 ppm and 7.5 ppm boron-10 respectively. The therapeutic ratio (i e the dose to the tumour relative to the maximum dose to normal tissue) was found to be about 1.8, reducing to unity for the limiting condition of a tumour in the posterior liver. This result opens up the possibility of palliative therapy for the management of primary and metastatic liver cancer.

  11. p53 Mutations and Protein Overexpression in Primary Colorectal Cancer and its Liver Metastasis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To compare p53 status in primary and hepatic metastatic colorectal cancer in 34 patients. Methods: p53 gene status (exons 5- 9) was examined by PCR, denaturing gradient gel electrophoresis (DGGE) and automated sequencing. P53 protein was detected by immunohistochemistry using monoclonal antibody DO-7. Results: p53 mutations were found in exons 5 through 9 in 21 of 34 patients (61.8%). Among them, 5 patients had mutation in liver metastasis but not in their primary tumors while in the other patients the same mutations were found in both primary and metastatic colorectal cancers. In no patients was p53 mutation exclusively found in the primary colorectal tumors. Moreover, additional mutation was detected in the metastatic lesions in two cases. Of the 37 mutations within the exons examined, 73% was missense mutation and 16% was nonsense mutation. There were 4 microinsertions. P53 protein was overexpressed in both primary and metastatic colorectal cancers with p53 gene mutations. The presence of p53 mutation significantly correlated with p53 protein accumulation (r=0.96, p< 0.001). However, in 4 patients with p53 nonsense mutation, immunohistochemical staining was negative. In three patients who showed no p53 mutation of the primary tumor, p53 protein was consistently overexpressed. Conclusion: In colorectal cancers, p53 gene mutation usually appears first in the primary tumor and maintains as such but is more prominent when metastasized to the liver. However, p53 gene mutation may occur only after being metastasized.Although p53 gene mutation and p53 protein overexpression correlate with each other, either parameter examined alone may lead to false positive or negative results.

  12. Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China

    Institute of Scientific and Technical Information of China (English)

    YAN Lunan; CHEN Zheyu; LIU Jiangwen; WU Hong; LI Bo; ZENG Yong; WEN Tianfu; ZHAO Jichun; WANG Wentao; YANG Jiayin; XU Mingqing; MA Yukui

    2007-01-01

    The aim of this paper is to report the authors'experience in performing adult-to-adult living donor liver transplantation (LDLT)by using a modified technique in using grafts of the right lobe of the liver.From January 2002 to September 2006,56 adult patients underwent LDLT using right lobe grafts at the Wlest China Hospital.Sichuan University Medical School,China.All patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein (RHV)and the tributariers of the middle hepatic vein(MHV)by interposing a vessel graft,and by anastomosing the hepatic arteries and bile ducts.There were no severe complications or deaths in all donors.Fifty-two (92.8%) recipients survived the operations.Among the 56 recipients,complications were seen in 15 recipients(26.8%),including hepatic vein stricture(one case),small-for-size syndrome(one case),hepatic artery thrombosis(two cases),intestinal bleeding (one case),bile leakage(two cases),left subphrenic abscess (one case),renal failure(two cases)and pulmonary infection (five cases).Within three months after transplantation,four recipients(7.1 4%)died due to smallfor-size syndrome(one case),renal failure(one case)and multiple organ failure(two cases).All patients underwent direct anastomoses of the RHV and the inferior vena cava (IVC),and in 23 cases,reconstruction of the right inferior hepatic vein was also done.In 24 patients,the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow.Trifurcation of the portal vein was seen in nine cases.Thus,veno-plasty or separate anastomoses were performed.The graft and recipient body weight ratios(GRWR)were between 0.72%and 1.43%,and in three cases it was<0.8%.The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86%and 71.68%.among which four cases had<40%.No "small-for-size syndrome"occurred.With modification of the surgical technique,especially in the

  13. Surgical management of 143 patients with adult primary retroperitoneal tumor

    Institute of Scientific and Technical Information of China (English)

    Yuan-Hong Xu; Ke-Jian Guo; Ren-Xuan Guo; Chun-Lin Ge; Yu-Lin Tian; San-Guang He

    2007-01-01

    AIM: To analyze the surgical management of adult primary retroperitoneal tumors (APRT) and the factors influencing the outcome after operation.METHODS: Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Medical University were evaluated retrospectively.RESULTS: A total of 143 cases of APRT were treated surgically. Among them, 122 (85.3%) underwent complete resection, 16 (11.2%) incomplete resection,and 3 (3%) surgical biopsies. Twenty-nine (20.2%)underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%,and 0%, respectively (P < 0.001). The Cox multi-various regression analysis showed the completeness of tumor,sex and histological type were associated closely with local recurrence.CONCLUSION: Sufficient preoperative preparation and complete tumor resection play important roles in reducing recurrence and improving survival.

  14. Comparing endophenotypes in adult-onset primary torsion dystonia.

    LENUS (Irish Health Repository)

    Bradley, David

    2012-02-01

    Adult-onset primary torsion dystonia (AOPTD) has an autosomal dominant pattern of inheritance with markedly reduced penetrance; the genetic causes of most forms of AOPTD remain unknown. Endophenotypes, markers of sub-clinical gene carriage, may be of use detecting non-manifesting gene carriers in relatives of AOPTD patients. The aim of this study was to compare the utility of the spatial discrimination threshold (SDT) and temporal discrimination threshold (TDT) as potential endophenotypes in AOPTD. Data on other published candidate endophenotypes are also considered. Both SDT and TDT testing were performed in 24 AOPTD patients and 34 of their unaffected first degree relatives; results were compared with normal values from a control population. Of the 24 AOPTD patients 5 (21%) had abnormal SDTs and 20 (83%) had abnormal TDTs. Of the 34 first degree relatives 17 (50%) had abnormal SDTs and 14 (41%) had abnormal TDTs. Discordant results on SDT and TDT testing were found in 16 (67%) AOPTD patients and 21 (62%) first degree relatives. TDT testing has superior sensitivity compared to SDT testing in AOPTD patients; although false positive TDTs are recognised, the specificity of TDT testing in unaffected relatives is not determinable. The high level of discordance between the two tests probably relates methodological difficulties with SDT testing. The SDT is an unreliable AOPTD endophenotype; TDT testing fulfils criteria for a reliable endophenotype with a high sensitivity.

  15. The Natural History of Inflammatory Bowel Disease and Primary Sclerosing Cholangitis after Liver Transplantation – a Single-Centre Experience

    Directory of Open Access Journals (Sweden)

    Karli J Moncrief

    2010-01-01

    Full Text Available OBJECTIVE: To describe the natural history of primary sclerosing cholangitis (PSC and inflammatory bowel disease (IBD after liver transplant, the predictors of PSC and IBD recurrence, and the interaction of these disease processes.

  16. Short-term outcomes of simultaneous laparoscopic colectomy and hepatectomy for primary colorectal cancer with synchronous liver metastases.

    Science.gov (United States)

    Inoue, Akira; Uemura, Mamoru; Yamamoto, Hirofumi; Hiraki, Masayuki; Naito, Atsushi; Ogino, Takayuki; Nonaka, Ryoji; Nishimura, Junichi; Wada, Hiroshi; Hata, Taishi; Takemasa, Ichiro; Eguchi, Hidetoshi; Mizushima, Tsunekazu; Nagano, Hiroaki; Doki, Yuichiro; Mori, Masaki

    2014-01-01

    Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer and synchronous liver metastases with curative intent at our institute. The median operative time was 452 minutes, and the median estimated blood loss was 245 mL. Median times to discharge from the hospital and adjuvant chemotherapy were 13.5 and 44 postoperative days, respectively. Negative resection margins were achieved in all cases, with no postoperative mortality or major morbidity. Simultaneous laparoscopic colectomy and hepatectomy for primary colorectal cancer with synchronous liver metastases appears feasible with low morbidity and favorable outcomes.

  17. Union examination of AFP, AFU, AFPL3 andγ-GT in early diagnosis of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Yuan Shao; Zuo-ren Wang; Lei Shi

    2009-01-01

    Objective To explore the significance of union examination of blood serum liver cancer tracers in the early diagnosis of liver cancer. Methods We observed and compared the level of blood serum liver cancer tracers armor embryo protein (AFP), crag algae glycosidase (AFU), armor embryo protein heteroplasmon (AFPL3) andγ-Gu Anxian transferase (γ-GT) in early time for primary liver cancer patients and hepatitis liver cirrhosis patients and those chronic hepatitis B patients who had liver cancer family history. Results Finally among the 30 patients in the early liver cancer group, 23 were positive with AFP, 20 with AFU, 15 with AFPL3 and 21 with γ-GT. Five were found positive with blood serum AFP, AFPL3, AFU and γ-GT at the same time; 5 with AFP, AFPL3 and γ-GT; 5 with AFP, AFU and AFPL3; 7 with AFP, AFU andγ-GT. By contrast, in the control group, among the 30 hepatitis liver cirrhosis patients and those chronic hepatitis B patients with liver cancer family history, 11 were found positive with AFP, 3 with AFPL3, 12 with AFU and 14 with γ-GT. None of the patients were found positive with union examination of AFP, AFPL3, AFU and γ-GT in the blood serum at the same time. Conclusion The union examination of AFP, AFU, AFPL3 and γ-GT is significant to the early diagnosis of primary liver cancer.

  18. Motion – Patients with Primary Sclerosing Cholangitis Should Undergo Early Liver Transplantation: Arguments against the Motion

    Directory of Open Access Journals (Sweden)

    Jeffrey S Crippin

    2002-01-01

    Full Text Available Liver transplantation is an accepted form of treatment for patients with primary sclerosing cholangitis (PSC and can provide long term survival. Cholangiocarcinoma occurs in 10% to 20% of patients with PSC, is difficult to diagnose and has a poor prognosis. It has been proposed that liver transplantation be undertaken early in the course of the PSC, before cancer develops. Such a proposal would have significant implications for the method of assigning priority to patients awaiting liver transplantation. Other patients on the waiting list would experience further delays, while there is no proven benefit for PSC patients. Few patients with this disease are removed from the waiting list because they developed cancer. If one were to state that PSC patients warrant special consideration because of the hypothetical risk of cholangiocarcinoma, the same argument could be applied to patients with hepatitis C and other causes of cirrhosis, who are at increased risk of hepatocellular carcinoma. The transplant allocation system is applied in an equitable fashion to patients with a large variety of liver diseases. Alteration of this system to benefit a small number of patients with PSC would violate the principles on which it was created, and cannot be justified.

  19. Distribution of Ca, Fe, Cu and Zn in primary colorectal cancer and secondary colorectal liver metastases

    Science.gov (United States)

    Al-Ebraheem, A.; Mersov, A.; Gurusamy, K.; Farquharson, M. J.

    2010-07-01

    A microbeam synchrotron X-ray fluorescence (μSRXRF) technique has been used to determine the localization and the relative concentrations of Zn, Cu, Fe and Ca in primary colorectal cancer and secondary colorectal liver metastases. 24 colon and 23 liver samples were examined, all of which were formalin fixed tissues arranged as microarrays of 1.0 mm diameter and 10 μm thickness. The distribution of these metals was compared with light transmission images of adjacent sections that were H and E stained to reveal the location of the cancer cells. Histological details were provided for each sample which enable concentrations of all elements in different tissue types to be compared. In the case of liver, significant differences have been found for all elements when comparing tumour, normal, necrotic, fibrotic, and blood vessel tissues (Kruskal Wallis Test, Pcolon samples (Kruskal Wallis Test, Pcolon tissues. Comparing liver tumour and colon tumour samples, significant differences have been found for all elements (Mann Whitney, Pcolon areas (independent T test, P=0.007 for Zn and Mann Whitney test P<0.0001 for Cu, Fe and Ca). For the blood vessel tissue, the analysis revealed that the difference was only significant for Fe ( P=0.009) from independent T test.

  20. Percutaneous Ethanol Intratumoral Injection for Treatment of Small Primary Liver Cancer:Summary of 240 Cases

    Institute of Scientific and Technical Information of China (English)

    GUOJia; CHENHan; 等

    2002-01-01

    Objective To evaluate the therapeutic effects of percutaneous ethanol intratumoral injection(PETT) for treatment of small primary liver cancer(SPLC). Methods 240 patients with surgically or pathologically proved SPLC(<3 cm in diameter)were treated by PETT(under the guidance of B-ultrasound).Of the 240 patients ,163 had recurrent liver cancer,55 had inoperable liver cancer because of cardiac ,pulmonary ,hepat-ic and renal dydfunctions or due to the close proximity of trmor to the major vessels,and 22 refused to receive surgical resection.In 40 pa-tients who received surgical resection after PETT treatment, the resected tumors were pathologically evaluated for necrotic status and the pa-tients were followed up postoperatively.Results Postoperative1-,2- and 3-year survival rate of the 240 patients was 94.9%,84.2% and 66.3% respectively.Conclusion PETTcan be used as a non-invasive treatment for SPLC,and preoperative PETT appears to be helpful in reducing recurrence of postoperative liver cancer.

  1. Recurrent primary biliary cirrhosis: peritransplant factors and ursodeoxycholic acid treatment post-liver transplant.

    Science.gov (United States)

    Guy, Jennifer E; Qian, Peiqing; Lowell, Jeffrey A; Peters, Marion G

    2005-10-01

    Primary biliary cirrhosis (PBC) recurs after orthotopic liver transplantation (OLT) in up to one-third of patients. These patients are typically asymptomatic, can be identified by abnormal liver biochemistries, and have evidence of histologic recurrence on liver biopsy. The effect of treatment on recurrence has not been determined. This pilot study evaluates the factors associated with recurrent PBC and describes our experience using ursodeoxycholic acid treatment in this patient population. Forty-eight patients with PBC were followed for at least 1 yr post-OLT, and 27 patients (56%) developed abnormal serum alkaline phosphatase. Seventeen patients (35%) had evidence of recurrent PBC by liver biopsy. Patients with recurrent PBC had a trend toward longer warm ischemia times and more episodes of acute cellular rejection in the first year posttransplant, but this was not significant in multivariate analysis. Donor or recipient age, donor and recipient cytomegalovirus status, and dose of immunosuppression did not correlate with recurrence of PBC. Those patients diagnosed with recurrent PBC were placed on ursodeoxycholic acid, 15 mg/kg daily, with improvement in serum alkaline phosphatase in the majority. In conclusion, recurrent PBC is not infrequent post-OLT, and ursodeoxycholic acid can be used with some benefit post-OLT. Treatment effects on long-term survival are not known.

  2. Circumstances associated with the contamination of food by aflatoxin in a high primary liver cancer area.

    Science.gov (United States)

    Van Rensburg, S J; Kirsipuu, A; Coutinho, L P; Van Der Watt, J J

    1975-05-24

    The variable incidence of primary liver cancer has been shown to be related to the average daily intake of aflatoxin in various parts of the world. This study was made to detect and report strategic points of contamination of foodstuffs in the region with the highest known incidence of liver cancer. Methods of food production, harvesting, storage and preparation were examined, and defects which promote fungus growth on food were found at each stage. Most meals consisted of a single dish with three basic ingredients -- a protein, bulk carbohydrate and green vegetables. Groundnuts were the main source of protein, but were also the main cause of aflatoxin contamination, since casual traditional methods of agriculture are not suited to the production of this exotic crop. Aflatoxin production appears to occur in the main sources of carbohydrate, such as cassava and maize, during storage. Leaves of various kinds provide substitutes for green vegetables and common methods of handling the crop promote fungal growth. Western-type foods had a particularly low aflatoxin content, or were free of it. Education and economic opportunities external to the subsistence economy structure are contributing to the westerisation of some living habits, a process believed to be responsible for the observed decrease in the incidence of primary liver cancer. Current knowledge indicates that a pertinent but simple educational programme could further markedly reduce the incidence of the disease.

  3. The 14-day repeated dose liver micronucleus test with methapyrilene hydrochloride using young adult rats.

    Science.gov (United States)

    Inoue, Kenji; Ochi, Akimu; Koda, Akira; Wako, Yumi; Kawasako, Kazufumi; Doi, Takaaki

    2015-03-01

    The repeated dose liver micronucleus (RDLMN) assay using young adult rats has the potential to detect genotoxic hepatocarcinogens that can be integrated into a general toxicity study. The assay methods were thoroughly validated by 19 Japanese facilities. Methapyrilene hydrochloride (MP), known to be a non-genotoxic hepatocarcinogen, was examined in the present study. MP was dosed orally at 10, 30 and 100mg/kg/day to 6-week-old male Crl:CD (SD) rats daily for 14 days. Treatment with MP resulted in an increase in micronucleated hepatocytes (MNHEPs) with a dosage of only 100mg/kg/day. At this dose level, cytotoxicity followed by regenerative cell growth was noted in the liver. These findings suggest that MP may induce clastogenic effects indirectly on the liver or hepatotoxicity of MP followed by regeneration may cause increase in spontaneous incidence of MNHEPs.

  4. The effect of a positive T-lymphocytotoxic crossmatch on clinical outcomes in adult-to-adult living donor liver transplantation

    OpenAIRE

    Kim, Young-Kyu; Kim, Seong Hoon; Moon, In Sung; Han, Sung-Sik; Cho, Seong Yeon; You, Tae; Park, Sang-Jae

    2013-01-01

    Purpose There is controversy concerning the effect of a positive T-lymphocytotoxic crossmatch (TLC) on clinical outcomes in adult living donor liver transplantation (LDLT). The aim of this study was to investigate the effect of TLC on clinical outcomes in LDLT and to determine how long a pretransplant positive TLC continues after liver transplantation (LT). Methods Between January 2005 and June 2010, 219 patients underwent adult LDLT at National Cancer Center. The TLC test was routinely perfo...

  5. Liver transplantation in a patient with primary antiphospholipid syndrome and Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    Tatiana; M; Reshetnyak; Natalia; V; Seredavkina; Maria; A; Satybaldyeva; Evgeniy; L; Nasonov; Vasiliy; I; Reshetnyak

    2015-01-01

    The antiphospholipid syndrome(APS) is an acquired thrombophilic disorder in which autoantibodies are produced to a variety of phospholipids determinants of cell membranes or phospholipid binding proteins. There are few reports about association between antiphospholipid antibodies and development of BuddChiari syndrome(BCS). We report the case of BCS development in young Russian male with primary APS. The patient underwent orthotopic liver transplantation on August 26, 2012. At present time his state is good, the blood flow in the liver restored and its function is not impaired. We report about the first time the successful use of dabigatran etexilate for prolonged anticoagulation therapy in APS patient with BCS. In addition patient is managed with immunosuppressive drugs.

  6. A case of primary malignant fibrous histiocytoma of the pancreas with liver metastasis

    Institute of Scientific and Technical Information of China (English)

    Wenlong Zhai; Jianwen Ye; Zhiwei Liang; Chuang Zhou; Longshuan Zhao

    2015-01-01

    Malignant fibrous histiocytoma (MFH) is one of most common types of soft-tissue sarcoma. However, it accounts for less than 1% of al human cancer types. In addition, primary MFH of the pancreas is very rare. Herein, we report of a 37-year-old man who presented with a pancreatic mass and did not show any specific symptoms. Pre-contrast computed tomography (CT) showed a heterogeneous, liquid-filed necrotic mass in the uncinate lobe of the pancreas. Contrast-enhanced CT showed a mild enhancement of solid components and the pancreaticoduodenal artery across the mass. The patient underwent a pancreatico-duodenectomy, ethanol ablation of the liver lesions, and chemotherapy with 4 cycles of ifosfamide and doxorubicin. The tumor recurred in the liver, but not in the pancreas, after 8 months.

  7. The challenges of liver transplantation in children with primary sclerosing cholangitis.

    Science.gov (United States)

    Venkat, Veena L; Ranganathan, Sarangarajan; Sindhi, Rakesh

    2015-03-01

    Primary sclerosing cholangitis (PSC) in children can progress to end-stage liver disease requiring liver transplantation. PSC poses many challenges beginning with evaluation and classification of ductal involvement and overlap syndromes, few options for medical management and unique risks in the post-transplant period. The construct that PSC may be an autoimmune disease is based on positive autoantibodies, association with inflammatory bowel disease, linkage to HLA type and overlap/autoimmune sclerosing cholangitis; however, PSC is not responsive to standard immunosuppression. Study of PSC and post-transplant outcomes in children may provide a unique background in which to study this challenging disease. This is particularly intriguing in the subset of patients diagnosed in the first decade of life, suggesting a strong link to predisposing genetic susceptibility and immune dysregulation. Long-term, multicenter effort is likely to be the only mechanism to study this rare disease in children and to improve outcomes in the future.

  8. Does Lysosomial Acid Lipase Reduction Play a Role in Adult Non-Alcoholic Fatty Liver Disease?

    Directory of Open Access Journals (Sweden)

    Francesco Baratta

    2015-11-01

    Full Text Available Lysosomal Acid Lipase (LAL is a key enzyme involved in lipid metabolism, responsible for hydrolysing the cholesteryl esters and triglycerides. Wolman Disease represents the early onset phenotype of LAL deficiency rapidly leading to death. Cholesterol Ester Storage Disease is a late onset phenotype that occurs with fatty liver, elevated aminotransferase levels, hepatomegaly and dyslipidaemia, the latter characterized by elevated LDL-C and low HDL-C. The natural history and the clinical manifestations of the LAL deficiency in adults are not well defined, and the diagnosis is often incidental. LAL deficiency has been suggested as an under-recognized cause of dyslipidaemia and fatty liver. Therefore, LAL activity may be reduced also in non-obese patients presenting non-alcoholic fatty liver disease (NAFLD, unexplained persistently elevated liver transaminases or with elevation in LDL cholesterol. In these patients, it could be indicated to test LAL activity. So far, very few studies have been performed to assess LAL activity in representative samples of normal subjects or patients with NAFLD. Moreover, no large study has been carried out in adult subjects with NAFLD or cryptogenic cirrhosis.

  9. The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

    OpenAIRE

    Hara, Takanobu; Soyama, Akihiko; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Carpenter, Izumi; Kinoshita, Ayaka; Adachi, Tomohiko; Kitasato, Amane; Kuroki, Tamotsu; Eguchi, Susumu

    2014-01-01

    Background: The impact of treated preoperative bacterial infections on the outcome of living-donor liver transplantation (LDLT) is not well defined. The aim of this study was to determine the frequency of pre-transplant bacterial infections within one month before LDLT and their impact on the post-transplant morbidity and mortality. Material/Methods: We retrospectively reviewed the records of 50 adult LDLT recipients between January 2009 and October 2011. Patients were divided into two gro...

  10. 3D hepatic cultures simultaneously maintain primary hepatocyte and liver sinusoidal endothelial cell phenotypes.

    Directory of Open Access Journals (Sweden)

    Yeonhee Kim

    Full Text Available Developing in vitro engineered hepatic tissues that exhibit stable phenotype is a major challenge in the field of hepatic tissue engineering. However, the rapid dedifferentiation of hepatic parenchymal (hepatocytes and non-parenchymal (liver sinusoidal endothelial, LSEC cell types when removed from their natural environment in vivo remains a major obstacle. The primary goal of this study was to demonstrate that hepatic cells cultured in layered architectures could preserve or potentially enhance liver-specific behavior of both cell types. Primary rat hepatocytes and rat LSECs (rLSECs were cultured in a layered three-dimensional (3D configuration. The cell layers were separated by a chitosan-hyaluronic acid polyelectrolyte multilayer (PEM, which served to mimic the Space of Disse. Hepatocytes and rLSECs exhibited several key phenotypic characteristics over a twelve day culture period. Immunostaining for the sinusoidal endothelial 1 antibody (SE-1 demonstrated that rLSECs cultured in the 3D hepatic model maintained this unique feature over twelve days. In contrast, rLSECs cultured in monolayers lost their phenotype within three days. The unique stratified structure of the 3D culture resulted in enhanced heterotypic cell-cell interactions, which led to improvements in hepatocyte functions. Albumin production increased three to six fold in the rLSEC-PEM-Hepatocyte cultures. Only rLSEC-PEM-Hepatocyte cultures exhibited increasing CYP1A1/2 and CYP3A activity. Well-defined bile canaliculi were observed only in the rLSEC-PEM-Hepatocyte cultures. Together, these data suggest that rLSEC-PEM-Hepatocyte cultures are highly suitable models to monitor the transformation of toxins in the liver and their transport out of this organ. In summary, these results indicate that the layered rLSEC-PEM-hepatocyte model, which recapitulates key features of hepatic sinusoids, is a potentially powerful medium for obtaining comprehensive knowledge on liver metabolism

  11. Multi-cellular 3D human primary liver cell culture elevates metabolic activity under fluidic flow.

    Science.gov (United States)

    Esch, Mandy B; Prot, Jean-Matthieu; Wang, Ying I; Miller, Paula; Llamas-Vidales, Jose Ricardo; Naughton, Brian A; Applegate, Dawn R; Shuler, Michael L

    2015-05-21

    We have developed a low-cost liver cell culture device that creates fluidic flow over a 3D primary liver cell culture that consists of multiple liver cell types, including hepatocytes and non-parenchymal cells (fibroblasts, stellate cells, and Kupffer cells). We tested the performance of the cell culture under fluidic flow for 14 days, finding that hepatocytes produced albumin and urea at elevated levels compared to static cultures. Hepatocytes also responded with induction of P450 (CYP1A1 and CYP3A4) enzyme activity when challenged with P450 inducers, although we did not find significant differences between static and fluidic cultures. Non-parenchymal cells were similarly responsive, producing interleukin 8 (IL-8) when challenged with 10 μM bacterial lipoprotein (LPS). To create the fluidic flow in an inexpensive manner, we used a rocking platform that tilts the cell culture devices at angles between ±12°, resulting in a periodically changing hydrostatic pressure drop between reservoirs and the accompanying periodically changing fluidic flow (average flow rate of 650 μL min(-1), and a maximum shear stress of 0.64 dyne cm(-2)). The increase in metabolic activity is consistent with the hypothesis that, similar to unidirectional fluidic flow, primary liver cell cultures increase their metabolic activity in response to fluidic flow periodically changes direction. Since fluidic flow that changes direction periodically drastically changes the behavior of other cells types that are shear sensitive, our findings support the theory that the increase in hepatic metabolic activity associated with fluidic flow is either activated by mechanisms other than shear sensing (for example increased opportunities for gas and metabolite exchange), or that it follows a shear sensing mechanism that does not depend on the direction of shear. Our mode of device operation allows us to evaluate drugs under fluidic cell culture conditions and at low device manufacturing and operation

  12. Therapeutic factors related to irradiation in primary and metastatic liver cancer using multivariate analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hatano, Kazuo (Chiba Univ. (Japan). School of Medicine)

    1990-06-01

    Between December 1973 and August 1987, 21 patients with primary liver cancer and 41 patients with metastatic liver cancer were treated with external irradiation, intra-arterial infusion chemotherapy and/or trans-arterial embolization (TAE) at the National Medical Center Hospital, the National South Kyushu Central Hospital and the National Kure Hospital. They were all inoperable cases. We diagnosed the tumor site and the involved area with many imagings and we decided the target volume. For primary liver cancer, the average survival period was 10.9 months, the 1-year survival rate was 28.6%, the 2-year survival rate was 14.3%, and the 3-year survival rate was 4.7%. Using multivariate analysis, stage, cancer reduction rate, Child classifiction and field size were valuable factors of the prognosis in the arterial infusion group. In the TAE group, cancer reduction rate was the most valuable factor. For metastatic liver cancer, the average survival period was 8.0 months, the 1-year survival rate was 19.5%, and the 5-year survival rate was 2.4%. Using multivariate analysis, pre-treatment K.P.S, distant metastasis, H, Child classification were valuable factors and pre-treatment K.P.S was most valuable factor. Although the indication of hepatic irradiation was generally thought to limit those cases which were Child A or B, H1 or H2 and the cases which have no distant metastasis, the cases which have their main portal tumor thrombus were also the indication of this therapy. (author).

  13. Gene expression profiling and secretome analysis differentiate adult-derived human liver stem/progenitor cells and human hepatic stellate cells.

    Directory of Open Access Journals (Sweden)

    Silvia Berardis

    Full Text Available Adult-derived human liver stem/progenitor cells (ADHLSC are obtained after primary culture of the liver parenchymal fraction. The cells are of fibroblastic morphology and exhibit a hepato-mesenchymal phenotype. Hepatic stellate cells (HSC derived from the liver non-parenchymal fraction, present a comparable morphology as ADHLSC. Because both ADHLSC and HSC are described as liver stem/progenitor cells, we strived to extensively compare both cell populations at different levels and to propose tools demonstrating their singularity. ADHLSC and HSC were isolated from the liver of four different donors, expanded in vitro and followed from passage 5 until passage 11. Cell characterization was performed using immunocytochemistry, western blotting, flow cytometry, and gene microarray analyses. The secretion profile of the cells was evaluated using Elisa and multiplex Luminex assays. Both cell types expressed α-smooth muscle actin, vimentin, fibronectin, CD73 and CD90 in accordance with their mesenchymal origin. Microarray analysis revealed significant differences in gene expression profiles. HSC present high expression levels of neuronal markers as well as cytokeratins. Such differences were confirmed using immunocytochemistry and western blotting assays. Furthermore, both cell types displayed distinct secretion profiles as ADHLSC highly secreted cytokines of therapeutic and immuno-modulatory importance, like HGF, interferon-γ and IL-10. Our study demonstrates that ADHLSC and HSC are distinct liver fibroblastic cell populations exhibiting significant different expression and secretion profiles.

  14. Split-liver transplantation in the high-MELD adult patient: are we being too cautious?

    Science.gov (United States)

    Nadalin, Silvio; Schaffer, Randolph; Fruehauf, Nils

    2009-07-01

    The fear that patients with high-mathematical model for end stage liver disease (MELD) score may not be suitable candidates for segmental grafts because of their need for greater liver mass has continued to push the transplant community toward the use of whole LT (WLT) in preference to split LT (SLT). In order to define the outcome of segmental liver transplantation in a better manner in high-MELD patients (score > or =26), we queried the UNOS registry for graft and patient survival results according to MELD score in adult patients receiving WLT and SLT in the United States from the inception of MELD allocation (February 27, 2002) through March 9, 2007. A total of 316 adult patients received a SLT as compared with 20 778 WLTs. Patient and graft survival rates at 6 and 12 months were comparable for all MELD ranges, including the 'high-MELD' recipients (e.g. at MELD score 31-35, patients' and grafts' survival rates at 12 months was 87.5% in SLT group vs. 84.4% and 76.7% in WLT group respectively). The results even at higher MELD scores (i.e. >35) were more than acceptable. In conclusion, patient and graft survival rates for SLT in high-MELD adult patients are comparable to the same for WLT.

  15. Impact of MELD score in predicting short-term survival after primary liver transplantation

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the efficacy of model for end-stage liver disease (MEL D) in predicting short-term outcomes in patients undergoing liver transplantation (LT). Methods: The consecutive 62 patients who had received primary LT in our hospital from November 2000 to January 2005 were retrospectively analyzed. The pretransplantation MELD and Child-Turcotte-Pugh (CTP) scores of these patients were calculated. Concordance c-statistic was used to assess the efficacies of MELD and CTP scores in predicting the first posttransplantation 3-month survival rate. Results: Among the 62 patients receiving primary LT, 12 died during the first 3-month period and the posttransplantation 3-month survival rate was 80.65%. The 3-month survival rate predicted by using CTP score and MELD score was0.685 and 0.873, respectively. Unlike CTP calssification, MELD score indentified two subgroups of patients with CTP C with different overall survival (0.8824 vs 0.4545, χ2 = 7.00, P = 0.0081). Conclusion: Our present study shows that MELD score could offer more accurate prediction for short-term survival in patients who undergo primary LT than CTP score.

  16. Priorities for young adults when accessing UK primary care: literature review.

    Science.gov (United States)

    Davey, Antoinette; Carter, Mary; Campbell, John L

    2013-10-01

    This literature review focuses on what matters to young adults when they access primary care services in the United Kingdom. Patients' access to and experience of primary care services differs across age groups. Existing research has largely focused on the needs and experiences of children, adolescents, and adults. There is some evidence to suggest the views of young adults (aged 18-25 years) that may differ from the views of other age groups, and research has not previously reported specifically on the views of this group of the population. The literature was reviewed to identify the views and priorities of young UK adults regarding primary healthcare provision, and furthermore, to identify those related topics that would benefit from further research. Relevant academic publications and grey literature published from 2000 onwards was reviewed and synthesised. We identified and reported emerging themes that were of importance to young adults in respect of the UK primary care provision. A total of 19 papers met our inclusion criteria. Young adults access primary care services less frequently than other age groups; this may be because of their experience of primary care throughout childhood and adolescence. Five aspects of primary care provision emerged as being of importance to young adults--the accessibility and availability of services, the confidentiality of health-related information, issues relating to communication with healthcare professionals, continuity of care, and behaviours and attitudes expressed towards young adults by healthcare professionals. There is a lack of focus of current research on the expectations, needs, and primary healthcare experiences of young adults. Young adults may hold views that are distinct from other age groups. Further research is needed to better understand the needs of a young adult population as their needs may impact the future use of services.

  17. Reducing Liver Fat by Low Carbohydrate Caloric Restriction Targets Hepatic Glucose Production in Non-Diabetic Obese Adults with Non-Alcoholic Fatty Liver Disease

    Science.gov (United States)

    Yu, Haoyong; Jia, Weiping; Guo, ZengKui

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) impairs liver functions, the organ responsible for the regulation of endogenous glucose production and thus plays a key role in glycemic homeostasis. Therefore, interventions designed to normalize liver fat content are needed to improve glucose metabolism in patients affected by NAFLD such as obesity. Objective: this investigation is designed to determine the effects of caloric restriction on hepatic and peripheral glucose metabolism in obese humans with NAFLD. Methods: eight non-diabetic obese adults were restricted for daily energy intake (800 kcal) and low carbohydrate ( 0.05). Liver fat is the only independent variable highly correlated to HGP after the removal of confounders. Conclusion: NAFLD impairs HGP but not peripheral glucose disposal; low carbohydrate caloric restriction effectively lowers liver fat which appears to directly correct the HGP impairment. PMID:25411646

  18. Motion – Patients with Primary Sclerosing Cholangitis Should Undergo Early Liver Transplantation: Arguments for the Motion

    Directory of Open Access Journals (Sweden)

    Young-Mee Lee

    2002-01-01

    Full Text Available Primary sclerosing cholangitis (PSC is a condition of unknown etiology that causes progressive inflammation, fibrosis and obliteration of the intrahepatic and extrahepatic biliary tree. There is no medical cure, and ursodeoxycholic acid and other drugs have not been shown to affect the natural history of the disease. Endoscopic dilation is of value only in the relief of symptoms and complications related to dominant strictures. Cholangiocarcinoma occurs in a substantial minority of cases, especially those with ulcerative colitis and cirrhosis, and is often not clinically apparent before surgery. There are no good serologic tests for early cancers. Because this tumour has such a dismal prognosis, some authorities recommend that liver transplantation be undertaken before its development. This procedure is the only curative option for PSC, and excellent survival rates have been reported. There is evidence that early transplantation, before end stage liver disease or cholangiocarcinoma have developed, improves the survival and quality of life of patients with PSC. Because it is the only procedure of proven benefit, patients with PSC should be considered for liver transplantation early in the course of the disease.

  19. The epidemiology of primary liver cancer in a West German population: the Saarland.

    Science.gov (United States)

    Rimkus, K; Dhom, G

    1986-01-01

    The present study is based on the data of 321 cases of primary liver cancer (PLC); 225 hepatocellular carcinomas (HCC), 54 cholangiocellular carcinomas (CCC) and 35 unclassified carcinomas autopsied between 1963 and 1982 or reported to the Saarland Cancer Registry between 1967 and 1981. The age standardized incidence rate for the Saarland was determined as 1.1. We noticed an increase in incidence for both HCC and CCC. The HCC rise was based on a significant (p less than 0.05) increase for women. The incidence maximum in the successive birth cohorts is shifting into younger age groups. The highest rates were observed in men and women born between 1900 and 1909. The regional distribution of PLC in the Saarland shows an accumulation in the urban areas. The mean survival time from diagnosis to death was 3.1 months. Prognosis was only influenced by the grade of differentiation. 88.3% of the HCC, but only 28.6% of CCC occurred in cirrhotic livers. Orcein staining of 55 liver specimens showed evidence of previous HBV infection in 12 out of 38 cases of HCC (31.6%) and no evidence of HBVB in the 17 cases of CCC studied.

  20. Symptomatic osteonecrosis of the femoral head after adult orthotopic liver transplantation

    Institute of Scientific and Technical Information of China (English)

    LI Hua; CHEN Gui-hua; ZHANG Jian; HE Ji-wen; WANG Kun; WANG Gen-shu; JIANG Nan; FU Bin-sheng; WANG Guo-ying; YANG Yang

    2012-01-01

    Background With the increase of survival in liver transplantation recipients,more patients are at a high risk of developing osteonecrosis,especially in the femoral head,due to immunosuppressive treatment.The purpose of this study was to report the incidence,possible risk factors,and outcome of symptomatic osteonecrosis of the femoral head (ONFH) in adult patients with current immunosuppressive agents and individual protocol after liver transplantation in China.Methods A ratrospective analysis was performed on 226 adult patients who underwent orthotopic liver transplantation (OLT) at a single liver transplantation institution between January 2004 and December 2008.The posttransplant survival time (or pre-retransplantation survival time) of all the patients were more than 24 months.The possible pre- and post-transplantation risk factors of symptomatic ONFH were investigated and the curative effects of the treatment were also reported.Results The incidence of ONFH was 1.33% in patients after OLT.ONFH occurred at a mean of (14±6) months (range,10-21 months) after transplantation.Male patients more often presented with osteonecrosis as a complication than female patients.The patients with lower pre-transplantation total bilirubin and direct bilirubin levels (P <0.05).There was no difference in the cumulative dose of corticosteroids or tacrolimus between the patients with or without symptomatic ONFH.Patients were treated either pharmacologically or surgically.All patients showed a nice curative effect without major complications during the 18-63 months post-treatment follow up.Conclusions The symptomatic ONFH does not occur commonly after adult OLT in the current individual immunosuppressive protocol in China.

  1. Non-alcoholic fatty liver disease in obese adults: clinical aspects and current management strategies.

    Science.gov (United States)

    Pallayova, M; Taheri, S

    2014-10-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder whose prevalence is strongly linked to the current epidemic of obesity in many western countries. The prevalence of NAFLD is two to four times higher in populations with pre-existing metabolic comorbidities than in the general population. The diagnosis of primary NAFLD involves establishing the presence of hepatic steatosis or steatohepatitis by imaging or histology, along with establishing the non-alcoholic nature of the disease process and excluding competing aetiologies for hepatic steatosis. Among the indirect serum biomarkers, the NAFLD fibrosis score can help to identify patients with NAFLD and with higher likelihood of having fibrosis or cirrhosis. A liver biopsy should be considered in NAFLD patients at increased risk for steatohepatitis/advanced fibrosis and in cases where a liver biopsy is necessary to exclude co-existing chronic liver diseases and other aetiologies for hepatic steatosis. The treatment and management recommendations for obesity-associated NAFLD are aimed towards weight reduction. The currently available interventions employed to promote weight loss and improve the metabolic responses in NAFLD include lifestyle modification, pharmacotherapy and bariatric surgery.

  2. Effects of increased von Willebrand factor levels on primary hemostasis in thrombocytopenic patients with liver cirrhosis.

    Science.gov (United States)

    Wannhoff, Andreas; Müller, Oliver J; Friedrich, Kilian; Rupp, Christian; Klöters-Plachky, Petra; Leopold, Yvonne; Brune, Maik; Senner, Mirja; Weiss, Karl-Heinz; Stremmel, Wolfgang; Schemmer, Peter; Katus, Hugo A; Gotthardt, Daniel N

    2014-01-01

    In patients with liver cirrhosis procoagulant and anticoagulant changes occur simultaneously. During primary hemostasis, platelets adhere to subendothelial structures, via von Willebrand factor (vWF). We aimed to investigate the influence of vWF on primary hemostasis in patients with liver cirrhosis. Therefore we assessed in-vitro bleeding time as marker of primary hemostasis in cirrhotic patients, measuring the Platelet Function Analyzer (PFA-100) closure times with collagen and epinephrine (Col-Epi, upper limit of normal ≤ 165 s) or collagen and ADP (Col-ADP, upper limit of normal ≤ 118 s). If Col-Epi and Col-ADP were prolonged, the PFA-100 was considered to be pathological. Effects of vWF on primary hemostasis in thrombocytopenic patients were analyzed and plasma vWF levels were modified by adding recombinant vWF or anti-vWF antibody. Of the 72 included cirrhotic patients, 32 (44.4%) showed a pathological result for the PFA-100. They had mean closure times (± SD) of 180 ± 62 s with Col-Epi and 160 ± 70 s with Col-ADP. Multivariate analysis revealed that hematocrit (P = 0.027) and vWF-antigen levels (P = 0.010) are the predictors of a pathological PFA-100 test in cirrhotic patients. In 21.4% of cirrhotic patients with platelet count ≥ 150/nL and hematocrit ≥ 27.0%, pathological PFA-100 results were found. In thrombocytopenic (hemostasis is impaired in cirrhotic patients. The effect of reduced platelet count in cirrhotic patients can at least be partly compensated by increased vWF levels. Recombinant vWF could be an alternative to platelet transfusions in the future.

  3. In vitro culture of isolated primary hepatocytes and stem cell-derived hepatocyte-like cells for liver regeneration.

    Science.gov (United States)

    Hu, Chenxia; Li, Lanjuan

    2015-08-01

    Various liver diseases result in terminal hepatic failure, and liver transplantation, cell transplantation and artificial liver support systems are emerging as effective therapies for severe hepatic disease. However, all of these treatments are limited by organ or cell resources, so developing a sufficient number of functional hepatocytes for liver regeneration is a priority. Liver regeneration is a complex process regulated by growth factors (GFs), cytokines, transcription factors (TFs), hormones, oxidative stress products, metabolic networks, and microRNA. It is well-known that the function of isolated primary hepatocytes is hard to maintain; when cultured in vitro, these cells readily undergo dedifferentiation, causing them to lose hepatocyte function. For this reason, most studies focus on inducing stem cells, such as embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), hepatic progenitor cells (HPCs), and mesenchymal stem cells (MSCs), to differentiate into hepatocyte-like cells (HLCs) in vitro. In this review, we mainly focus on the nature of the liver regeneration process and discuss how to maintain and enhance in vitro hepatic function of isolated primary hepatocytes or stem cell-derived HLCs for liver regeneration. In this way, hepatocytes or HLCs may be applied for clinical use for the treatment of terminal liver diseases and may prolong the survival time of patients in the near future.

  4. Primary sclerosing cholangitis in genetically diverse populations listed for liver transplantation: Unique clinical and HLA associations

    Science.gov (United States)

    Bowlus, Christopher L.; Li, Chin-Shang; Karlsen, Tom H.; Lie, Benedicte A.; Selmi, Carlo

    2010-01-01

    Primary sclerosing cholangitis (PSC) is well characterized in European populations. We aimed to characterize clinical characteristics and human leukocyte antigen (HLA) associations in a population of European American, Hispanic and African-American PSC patients listed for liver transplantation. Demographic, clinical, and HLA data stratified by population from 6,767 liver transplant (LT) registrants of the United Network for Organ Sharing (UNOS) with a diagnosis of PSC (4.7% of registrants) were compared to registrants with other diagnoses. Compared to European Americans and Hispanics, African American cases were significantly younger (46.6 ± 13.7, 42.3 ± 15.9, and 39.7 ± 13.1, respectively; p = 0.002), listed with a higher Model of End Stage Liver Disease (MELD) score (15.2 ± 7.5, 14.9 ± 7.6, and 18.1 ± 9.3, respectively; p = 0.001), and less frequently noted to have inflammatory bowel disease (71.4% versus 60.5%, p < 0.01) compared to European Americans. In multivariate analysis, African origin was a significant factor associated with listing for LT with PSC (OR relative to European Americans 1.33, 95% C.I. 1.27 – 1.41). HLA associations in European Americans, Hispanics and African Americans with PSC compared to alcoholic liver disease were detected for HLA-B8, HLA-DR13 and the protective HLA-DR4. However, HLA-DR3, which is in linkage disequilibrium with HLA-B8, only showed associations in European Americans and Hispanics. African Americans with PSC listed for LT differ clinically from European Americans and Hispanics. The association with HLA-B8 but not HLA-DR3 in African Americans should make possible the refinement of the HLA associations in PSC. PMID:21031548

  5. Gene network activity in cultivated primary hepatocytes is highly similar to diseased mammalian liver tissue.

    Science.gov (United States)

    Godoy, Patricio; Widera, Agata; Schmidt-Heck, Wolfgang; Campos, Gisela; Meyer, Christoph; Cadenas, Cristina; Reif, Raymond; Stöber, Regina; Hammad, Seddik; Pütter, Larissa; Gianmoena, Kathrin; Marchan, Rosemarie; Ghallab, Ahmed; Edlund, Karolina; Nüssler, Andreas; Thasler, Wolfgang E; Damm, Georg; Seehofer, Daniel; Weiss, Thomas S; Dirsch, Olaf; Dahmen, Uta; Gebhardt, Rolf; Chaudhari, Umesh; Meganathan, Kesavan; Sachinidis, Agapios; Kelm, Jens; Hofmann, Ute; Zahedi, René P; Guthke, Reinhard; Blüthgen, Nils; Dooley, Steven; Hengstler, Jan G

    2016-10-01

    It is well known that isolation and cultivation of primary hepatocytes cause major gene expression alterations. In the present genome-wide, time-resolved study of cultivated human and mouse hepatocytes, we made the observation that expression changes in culture strongly resemble alterations in liver diseases. Hepatocytes of both species were cultivated in collagen sandwich and in monolayer conditions. Genome-wide data were also obtained from human NAFLD, cirrhosis, HCC and hepatitis B virus-infected tissue as well as mouse livers after partial hepatectomy, CCl4 intoxication, obesity, HCC and LPS. A strong similarity between cultivation and disease-induced expression alterations was observed. For example, expression changes in hepatocytes induced by 1-day cultivation and 1-day CCl4 exposure in vivo correlated with R = 0.615 (p < 0.001). Interspecies comparison identified predominantly similar responses in human and mouse hepatocytes but also a set of genes that responded differently. Unsupervised clustering of altered genes identified three main clusters: (1) downregulated genes corresponding to mature liver functions, (2) upregulation of an inflammation/RNA processing cluster and (3) upregulated migration/cell cycle-associated genes. Gene regulatory network analysis highlights overrepresented and deregulated HNF4 and CAR (Cluster 1), Krüppel-like factors MafF and ELK1 (Cluster 2) as well as ETF (Cluster 3) among the interspecies conserved key regulators of expression changes. Interventions ameliorating but not abrogating cultivation-induced responses include removal of non-parenchymal cells, generation of the hepatocytes' own matrix in spheroids, supplementation with bile salts and siRNA-mediated suppression of key transcription factors. In conclusion, this study shows that gene regulatory network alterations of cultivated hepatocytes resemble those of inflammatory liver diseases and should therefore be considered and exploited as disease models.

  6. Greater Biosynthetic Liver Dysfunction in Primary Sclerosing Cholangitis Suggests Co-existent or Impending Cholangiocarcinoma

    Science.gov (United States)

    Trilianos, Panagiotis; Agnihotri, Abhishek; Ucbilek, Enver; Gurakar, Ahmet

    2016-01-01

    Background and Aim: Patients with primary sclerosing cholangitis (PSC) who develop cholangiocarcinoma (CCA) have a median survival of less than 6 months. In half of cases, PSC and CCA will be diagnosed either concurrently or within a year of one another. The aim of the present study is to demonstrate that the degree of biochemical liver dysfunction is associated with concomitant or impending CCA. Methods: We did a chart review of patients diagnosed with PSC and CCA up to 18 months from presentation (“CCA” group) as well as patients with PSC that underwent transplantation with no sign of CCA in their explanted liver (“nCCA” group). Along with demographic data and follow-up length, we recorded their presenting liver function tests, including alanine and aspartate aminotransferases (ALT, AST), total bilirubin (TBil), alkaline phosphatase (ALP), international normalization ratio (INR), and serum Ca 19-9 levels. Differences between mean values of the two groups were analyzed with a student’s t-test. Results: Twenty-four patients were included. The “CCA” group consisted of eight patients, and the “non-CCA” group had 16 patients. There was no significant difference between the two groups in their presenting values of ALT, ALP, or serum Ca 19-9. However, the “CCA” group had significantly higher levels of AST, TBil, and INR. Conclusion: Patients with PSC and concurrent or impending CCA appear to exhibit significantly greater biochemical liver dysfunction than those who do not develop CCA. Therefore, newly-diagnosed PSC patients presenting with these findings may warrant more rigorous evaluation. PMID:27047765

  7. The association between MMF and risk of progressive renal dysfunction and death in adult liver transplant recipients with HCV.

    Science.gov (United States)

    Lake, John; Patel, Dharmesh; David, Kristin; Richwine, Jason; Morris, Jonathan

    2009-01-01

    The impact of a three-drug regimen including mycophenolate mofetil (MMF) vs. a two-drug (no MMF) regimen on progressive renal dysfunction (PRD) in liver transplant recipients with hepatitis C virus (HCV) infection has not been well described. Adults with HCV who received a primary liver transplant between January 1, 2000 and December. 31, 2005 and were discharged from the hospital on a three-drug regimen [CNI+MMF+steroids (S)] (n = 4 946) were compared with those discharged on two-drug regimen (CNI+S) (n = 3 884). Time to PRD (defined by a post-transplant 25% decline in estimated GFR, based on the four-variable MDRD equation) and recipient death were evaluated using Kaplan-Meier analysis. Cox proportional hazards regression was used to estimate the risk for post-transplant PRD and death after controlling for baseline characteristics and extended steroid use. The two groups were similar in baseline characteristics. The percentage of recipients on three- vs. two-drug regimen without PRD was higher, 36.8% vs. 31.9%, (p MMF-containing regimen are at a lower risk for PRD and death compared with recipients on a regimen not including MMF.

  8. Evaluation of Risk Factors of Nonalcoholic Fatty Liver Disease in the Adult Population of Zahedan, Iran

    Directory of Open Access Journals (Sweden)

    Alireza Ansari-Moghaddam

    2014-08-01

    Full Text Available Background: Non-alcoholic fatty liver disease (NAFLD is the most common form of chronic liver disease. It has been reported that visceral fat releases free fatty acids and arises fat accumulation in the liver. Therefore, this study aimed to evaluate the some biomarkers of NAFLD risk in adult general population. Materials and Methods: An analytical - descriptive study was carried out on a total of 1529 randomly selected individuals (797 male and 732 female aged 30–88 years in Zahedan. The characteristics of socio-demographic, medical history, food habits and lifestyle factors were obtained by a validated questionnaire, liver ultrasonography and routine laboratory tests were performed with the use of standard techniques. The assessment of waist circumference (WC and waist to hip ratio (WHR was performed as central obesity indices. Results: The mean levels of WC and WHR were 92±11.7 cm and 0.91±0.06 in men, and 91.2±12.4 cm and 0.88±0.07 in women, respectively. 39.7% and 37% of subjects had hypercholesterolemia and hypertriglyceridemia, respectively. Ultrasonography findings demonstrated diffuse fatty liver in 40.9% subjects. Data also showed low consumption of fruits and vegetables and fish, and high consumption of saturated fatty acids (SFAs and fast foods in the majority of obesity and NAFLD subjects compared with normal subjects. Conclusion: The results showed that a large proportion of the study population is at risk of central obesity and NAFLD. The formation of non-alcoholic fatty liver may be associated with obesity and unhealthy dietary patterns which warrants further research.

  9. Hedgehog signaling antagonist promotes regression of both liver fibrosis and hepatocellular carcinoma in a murine model of primary liver cancer.

    Directory of Open Access Journals (Sweden)

    George M Philips

    Full Text Available OBJECTIVE: Chronic fibrosing liver injury is a major risk factor for hepatocarcinogenesis in humans. Mice with targeted deletion of Mdr2 (the murine ortholog of MDR3 develop chronic fibrosing liver injury. Hepatocellular carcinoma (HCC emerges spontaneously in such mice by 50-60 weeks of age, providing a model of fibrosis-associated hepatocarcinogenesis. We used Mdr2(-/- mice to investigate the hypothesis that activation of the hedgehog (Hh signaling pathway promotes development of both liver fibrosis and HCC. METHODS: Hepatic injury and fibrosis, Hh pathway activation, and liver progenitor populations were compared in Mdr2(-/- mice and age-matched wild type controls. A dose finding experiment with the Hh signaling antagonist GDC-0449 was performed to optimize Hh pathway inhibition. Mice were then treated with GDC-0449 or vehicle for 9 days, and effects on liver fibrosis and tumor burden were assessed by immunohistochemistry, qRT-PCR, Western blot, and magnetic resonance imaging. RESULTS: Unlike controls, Mdr2(-/- mice consistently expressed Hh ligands and progressively accumulated Hh-responsive liver myofibroblasts and progenitors with age. Treatment of aged Mdr2-deficient mice with GDC-0449 significantly inhibited hepatic Hh activity, decreased liver myofibroblasts and progenitors, reduced liver fibrosis, promoted regression of intra-hepatic HCCs, and decreased the number of metastatic HCC without increasing mortality. CONCLUSIONS: Hh pathway activation promotes liver fibrosis and hepatocarcinogenesis, and inhibiting Hh signaling safely reverses both processes even when fibrosis and HCC are advanced.

  10. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: There are many indications for hepatic retransplantation. AIM: To identify factors influencing retransplantation needs and outcomes. PATIENTS AND METHODS: Retransplantation records from January 1993 to March 2005 were analysed. Patient and disease characteristics and survival outcomes for retransplantation were compared between various groups. RESULTS: Totally, 286 primary and 42 hepatic retransplantations were performed. Retransplantation indications included primary sclerosing cholangitis (PSC), primary biliary cirrhosis, chronic hepatitis C (HCV), chronic active hepatitis (CAH), and alcohol-related disease. Mean follow-up post-retransplantation was 31 +\\/- 9 months. Actuarial patient survival at 3 months, 1 year, 3 years, 5 years, and at the end of study was 71.4, 69, 59.5, 54.7, and 50%, respectively. Early and late retransplantation had 1-year survival of 73 and 68.5%, respectively. Retransplantation need was significantly higher for PSC, HCV, and CAH. CONCLUSIONS: Hepatic retransplantation remains a successful salvage option for transplant complications; however, its need is significantly influenced by the primary liver disease.

  11. Determination of Radiation Absorbed Dose to Primary Liver Tumors and Normal Liver Tissue Using Post Radioembolization 90Y PET

    Directory of Open Access Journals (Sweden)

    Shyam Mohan Srinivas

    2014-10-01

    Full Text Available Background: Radioembolization with Yttrium-90 (90Y microspheres is becoming a more widely used transcatheter treatment for unresectable hepatocellular carcinoma (HCC. Using post-treatment 90Y PET/CT scans,the distribution of microspheres within the liver can be determined and quantitatively assessesed . We studied the radiation dose of 90Y delivered to liver and treated tumors.Methods: This retrospective study of 56 patients with HCC, including analysis of 98 liver tumors, measured and correlated the dose of radiation delivered to liver tumors and normal liver tissue using glass microspheres (TheraSpheres® to the frequency of complications with mRECIST. 90Y PET/CT and triphasic liver CT scans were used to contour treated tumor and normal liver regions and determine their respective activity concentrations. An absorbed dose factor was used to convert the measured activity concentration (Bq/mL to an absorbed dose (Gy.Results: The 98 studied tumors received a mean dose of 169 Gy (mode 90-120 Gy;range 0-570 Gy. Tumor response by mRECIST criteria was performed for 48 tumors that had follow up scans. There were 21 responders (mean dose 215 Gy and 27 nonresponders (mean dose 167 Gy. The association between mean tumor absorbed dose and response suggests a trend but did not reach statistical significance (p=0.099. Normal liver tissue received a mean dose of 67 Gy (mode 60-70 Gy; range 10-120 Gy. There was a statistically significant association between absorbed dose to normal liver and the presence of two or more severe complications (p=0.036.Conclusion: Our cohort of patients showed a possible dose response trend for the tumors. Collateral dose to normal liver is nontrivial and can have clinical implications. These methods help us understand whether patient adverse events, treatment success, or treatment failure can be attributed to the dose which the tumor or normal liver received.

  12. Study of Silymarin and Vitamin E Protective Effects on Silver Nanoparticle Toxicity on Mice Liver Primary Cell Culture

    Directory of Open Access Journals (Sweden)

    Firouz Faedmaleki

    2016-03-01

    Full Text Available Nanotechnology is a most promising field for generating new applications in medicine, although, only few nano products are currently in use for medical purposes. A most prominent nanoproduct is nanosilver. Nano-silver has biological properties which are significant for consumer products, food technology, textiles, and medical applications (e.g. wound care products, implantable medical devices, in diagnosis, drug delivery, and imaging. For their antibacterial activity, silver nanoparticles (Ag NPs are largely used in various commercially available products. The use of nano-silver is becoming more and more widespread in medicine and related applications, and due to its increasing exposure, toxicological and environmental issues need to be raised. Cytotoxicity induced by silver nanoparticles (AgNPs and the role that oxidative stress plays in this process were demonstrated in human hepatoma cells AgNPs agglomerated in the cytoplasm and nuclei of treated cells, and they induced intracellular oxidative stress. AgNP reduced ATP content of the cell and caused damage to mitochondria and increased production of reactive oxygen species (ROS in a dose-dependent manner. Silymarin was known as a hepatoprotective agent that is used in the treatment of hepatic diseases including viral hepatitis, alcoholic liver diseases, Amanita mushroom poisoning, liver cirrhosis, toxic and drug-induced liver diseases. It promotes protein synthesis, helps in regenerating liver tissue, controls inflammation, enhances glucuronidation, and protects against glutathione depletion. Vitamin E is a well-known antioxidant and has hepatoprotective effect in liver diseases. In this study, we investigated the cytotoxic effects of Ag NPs on primary liver cells of mice. Cell viability (cytotoxicity was examined with MTT assay after primary liver cells of mice exposure to AgNPs at 1, 10, 50, 100, 150, 200, 400 ppm for 24h. AgNPs caused a concentration- dependent decrease of cell viability

  13. Repair of liver mediated by adult mouse liver neuro-glia antigen 2-positive progenitor cell transplantation in a mouse model of cirrhosis

    Science.gov (United States)

    Zhang, Hongyu; Siegel, Christopher T.; Shuai, Ling; Lai, Jiejuan; Zeng, Linli; Zhang, Yujun; Lai, Xiangdong; Bie, Ping; Bai, Lianhua

    2016-01-01

    NG2-expressing cells are a population of periportal vascular stem/progenitors (MLpvNG2+ cells) that were isolated from healthy adult mouse liver by using a “Percoll-Plate-Wait” procedure. We demonstrated that isolated cells are able to restore liver function after transplantation into a cirrhotic liver, and co-localized with the pericyte marker (immunohistochemistry: PDGFR-β) and CK19. Cells were positive for: stem cell (Sca-1, CD133, Dlk) and liver stem cell markers (EpCAM, CD14, CD24, CD49f); and negative for: hematopoietic (CD34, CD45) and endothelial markers (CD31, vWf, von Willebrand factor). Cells were transplanted (1 × 106 cells) in mice with diethylnitrosamine-induced cirrhosis at week 6. Cells showed increased hepatic associated gene expression of alpha-fetoprotein (AFP), Albumin (Alb), Glucose-6-phosphatase (G6Pc), SRY (sex determining region Y)-box 9 (Sox9), hepatic nuclear factors (HNF1a, HNF1β, HNF3β, HNF4α, HNF6, Epithelial cell adhesion molecule (EpCAM), Leucine-rich repeated-containing G-protein coupled receptor 5-positive (Lgr5) and Tyrosine aminotransferase (TAT). Cells showed decreased fibrogenesis, hepatic stellate cell infiltration, Kupffer cells and inflammatory cytokines. Liver function markers improved. In a cirrhotic liver environment, cells could differentiate into hepatic lineages. In addition, grafted MLpvNG2+ cells could mobilize endogenous stem/progenitors to participate in liver repair. These results suggest that MLpvNG2+ cells may be novel adult liver progenitors that participate in liver regeneration. PMID:26905303

  14. Retransplantation of the liver in adults : outcome and predictive factors for survival

    NARCIS (Netherlands)

    Postma, R; Haagsma, EB; Peeters, PMJG; van den Berg, AP; Slooff, MJH

    2004-01-01

    Hepatic retransplantation is considered to carry a higher risk than primary transplantation. Survival might improve with more experience and better immunosuppression. We studied all 55 patients who were adults at the time of their first retransplantation and who underwent retransplantation between 1

  15. Primary liver tumors. Hepatocellular versus intrahepatic cholangiocellular carcinoma; Primaere Lebertumoren. Hepatozellulaeres vs. intrahepatisches cholangiozellulaeres Karzinom

    Energy Technology Data Exchange (ETDEWEB)

    Wengert, G.J.; Bickel, H.; Breitenseher, J.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Allgemeines Krankenhaus, Wien (Austria)

    2015-01-01

    Hepatocellular carcinoma (HCC) and intrahepatic cholangiocellular carcinoma (ICC) are the most commonly occurring and important primary liver tumors. Originating from one pluripotent liver stem cell both tumor entities can occur in a cirrhotic liver and also in patients without cirrhosis. Several risk factors have been identified as causative for both carcinomas; therefore, tumor screening is advantageous, especially for high-risk patients who could be diagnosed in an early stage to allow curative treatment. Surgical resection, interventional procedures and transplantation are available as curative treatment options when diagnosed in time. Common characteristic features and morphology in cross-sectional imaging by ultrasound (US), multidetector computed tomography (CT) and magnetic resonance imaging (MRI) as well as screening aspects are presented and discussed. Recent findings show a better understanding of the carcinogenesis model of both liver tumors originating from one pluripotent liver stem cell. Further developments of modern cross-sectional imaging modalities, especially MRI in combination with diffusion-weighted imaging and intravenous administration of hepatocyte-specific contrast agents enable early detection, exact differentiation, staging and treatment evaluation of HCC and ICC In this article we discuss modern, multiparametric imaging modalities, which allow a complete and reliable diagnosis of the majority of these tumor entities. Contrast-enhanced MRI, using hepatocyte-specific contrast agents, is currently the most accurate procedure for the noninvasive diagnosis and treatment evaluation of HCC and ICC. (orig.) [German] Das hepatozellulaere Karziom (HCC) sowie das intrahepatische cholangiozellulaere Karzinom (ICC) zaehlen zu den wichtigsten primaeren Lebertumoren. Mit dem Ursprung aus einer pluripotenten Stammzelle koennen beide Tumorentitaeten bei bestehender, aber auch bei nicht bestehender Leberzirrhose auftreten. Im Folgenden werden

  16. Explanted diseased livers - a possible source of metabolic competent primary human hepatocytes.

    Science.gov (United States)

    Kleine, Moritz; Riemer, Marc; Krech, Till; DeTemple, Daphne; Jäger, Mark D; Lehner, Frank; Manns, Michael P; Klempnauer, Jürgen; Borlak, Jürgen; Bektas, Hueseyin; Vondran, Florian W R

    2014-01-01

    Being an integral part of basic, translational and clinical research, the demand for primary human hepatocytes (PHH) is continuously growing while the availability of tissue resection material for the isolation of metabolically competent PHH remains limited. To overcome current shortcomings, this study evaluated the use of explanted diseased organs from liver transplantation patients as a potential source of PHH. Therefore, PHH were isolated from resected surgical specimens (Rx-group; n = 60) and explanted diseased livers obtained from graft recipients with low labMELD-score (Ex-group; n = 5). Using established protocols PHH were subsequently cultured for a period of 7 days. The viability and metabolic competence of cultured PHH was assessed by the following parameters: morphology and cell count (CyQuant assay), albumin synthesis, urea production, AST-leakage, and phase I and II metabolism. Both groups were compared in terms of cell yield and metabolic function, and results were correlated with clinical parameters of tissue donors. Notably, cellular yields and viabilities were comparable between the Rx- and Ex-group and were 5.3±0.5 and 2.9±0.7×106 cells/g liver tissue with 84.3±1.3 and 76.0±8.6% viability, respectively. Moreover, PHH isolated from the Rx- or Ex-group did not differ in regards to loss of cell number in culture, albumin synthesis, urea production, AST-leakage, and phase I and II metabolism (measured by the 7-ethoxycoumarin-O-deethylase and uracil-5'-diphosphate-glucuronyltransferase activity). Likewise, basal transcript expressions of the CYP monooxygenases 1A1, 2C8 and 3A4 were comparable as was their induction when treated with a cocktail that consisted of 3-methylcholantren, rifampicin and phenobarbital, with increased expression of CYP 1A1 and 3A4 mRNA while transcript expression of CYP 2C8 was only marginally changed. In conclusion, the use of explanted diseased livers obtained from recipients with low labMELD-score might represent

  17. Primary clear cell carcinoma in the liver:CT and MRI findings

    Institute of Scientific and Technical Information of China (English)

    Qing-Yu Liu; Hai-Gang Li; Ming Gao; Xiao-Feng Lin; Yong Li; Jian-Yu Chen

    2011-01-01

    AIM:To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups.METHODS:Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study.CT or MRI images from these patients were retrospectively analyzed.The following imaging findings were reviewed:the presence of liver cirrhosis,tumor size,the enhancement pattern on dynamic contrast scanning,the presence of pseudo capsules,tumor rupture,portal vein thrombosis and lymph node metastasis.RESULTS:Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis,the association rate of liver cirrhosis was 80.0% and 78.7%,respectively (P > 0.05).The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm,respectively.Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases.No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803,respectively).Compared with CHCC patients,PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%,P = 0.034).Tumor rupture,typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20),72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127),83.6% (97/116) and 17.3% (22/127) of patients with CHCC,respectively.There were no significant differences between the two groups (all P > 0.05).No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05).CONCLUSION:The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such as hemangioma and hepatic

  18. The hemostatic status of pediatric recipients of adult liver grafts suggests that plasma levels of hemostatic proteins are not regulated by the liver

    NARCIS (Netherlands)

    Lisman, Ton; Platto, Marco; Meijers, Joost C. M.; Haagsma, Elizabeth B.; Colledan, Michele; Porte, Robert J.

    2011-01-01

    Plasma levels of coagulation factors differ profoundly between adults and children, but are remarkably stable throughout adulthood. It is unknown which factors determine plasma levels of coagulation factors in a given individual. We hypothesized that the liver, which synthesizes coagulation factors,

  19. Sporadic adult onset primary torsion dystonia is a genetic disorder by the temporal discrimination test.

    LENUS (Irish Health Repository)

    Kimmich, Okka

    2012-02-01

    Adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance; patients with sporadic adult-onset primary torsion dystonia are much more prevalent than familial. The temporal discrimination threshold is the shortest time interval at which two stimuli are detected to be asynchronous and has been shown to be abnormal in adult-onset primary torsion dystonia. The aim was to determine the frequency of abnormal temporal discrimination thresholds in patients with sporadic adult-onset primary torsion dystonia and their first-degree relatives. We hypothesized that abnormal temporal discrimination thresholds in first relatives would be compatible with an autosomal dominant endophenotype. Temporal discrimination thresholds were examined in 61 control subjects (39 subjects <50 years of age; 22 subjects >50 years of age), 32 patients with sporadic adult-onset primary torsion dystonia (cervical dystonia n = 30, spasmodic dysphonia n = 1 and Meige\\'s syndrome n = 1) and 73 unaffected first-degree relatives (36 siblings, 36 offspring and one parent) using visual and tactile stimuli. Z-scores were calculated for all subjects; a Z > 2.5 was considered abnormal. Abnormal temporal discrimination thresholds were found in 1\\/61 (2%) control subjects, 27\\/32 (84%) patients with adult-onset primary torsion dystonia and 32\\/73 (44%) unaffected relatives [siblings (20\\/36; 56%), offspring (11\\/36; 31%) and one parent]. When two or more relatives were tested in any one family, 22 of 24 families had at least one first-degree relative with an abnormal temporal discrimination threshold. The frequency of abnormal temporal discrimination thresholds in first-degree relatives of patients with sporadic adult-onset primary torsion dystonia is compatible with an autosomal dominant disorder and supports the hypothesis that apparently sporadic adult-onset primary torsion dystonia is genetic in origin.

  20. Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ghulam Rehman Mohyuddin

    2016-01-01

    Full Text Available Primary myelofibrosis (PMF commonly results in extramedullary hematopoiesis (EMH in the spleen and liver as well as a variety of other organs. We present a first report of a unique presentation of PMF in a liver transplant recipient patient as EMH in the transplanted liver graft. A 76-year-old man with history of cryptogenic cirrhosis received cadaveric liver transplantation in 1996. He maintained a normal graft function and stable hematologic parameters until 2013 when he presented with anemia and progressive fatigue. Extensive work-up did not identify the etiology of the recent decline in his hemoglobin; thus a liver biopsy was done which showed findings of EMH within the sinusoids with increased megakaryocytes, some with atypical morphology. A BM biopsy revealed a hypercellular marrow, moderately increased reticulin fibrosis, and features consistent with primary myelofibrosis. Abdominal imaging showed a normal-size spleen and did not identify any sites of EMH outside of the liver. The diagnosis of myelofibrosis was thus made, and this case demonstrated predominant tropism to a transplanted liver graft with absence of EMH elsewhere. We would thus like to emphasize that findings of EMH in subjects with no preexisting hematologic neoplasm should warrant close follow-up and assessment.

  1. Characterization of the liver-macrophages isolated from a mixed primary culture of neonatal swine hepatocytes

    Directory of Open Access Journals (Sweden)

    Hiroshi Kitani

    2014-01-01

    Full Text Available We recently developed a novel procedure to obtain liver-macrophages in sufficient number and purity using a mixed primary culture of rat and bovine hepatocytes. In this study, we aim to apply this method to the neonatal swine liver. Swine parenchymal hepatocytes were isolated by a two-step collagenase perfusion method and cultured in T75 culture flasks. Similar to the rat and bovine cells, the swine hepatocytes retained an epithelial cell morphology for only a few days and progressively changed into fibroblastic cells. After 5–13 days of culture, macrophage-like cells actively proliferated on the mixed fibroblastic cell sheet. Gentle shaking of the culture flask followed by the transfer and brief incubation of the culture supernatant resulted in a quick and selective adhesion of macrophage-like cells to a plastic dish surface. After rinsing dishes with saline, the attached macrophage-like cells were collected at a yield of 106 cells per T75 culture flask at 2–3 day intervals for more than 3 weeks. The isolated cells displayed a typical macrophage morphology and were strongly positive for macrophage markers, such as CD172a, Iba-1 and KT022, but negative for cytokeratin, desmin and α-smooth muscle actin, indicating a highly purified macrophage population. The isolated cells exhibited phagocytosis of polystyrene microbeads and a release of inflammatory cytokines upon lipopolysaccharide stimulation. This shaking and attachment method is applicable to the swine liver and provides a sufficient number of macrophages without any need of complex laboratory equipments.

  2. Non-traumatic diaphragmatic hernia of the liver in an adult:a case repor t

    Institute of Scientific and Technical Information of China (English)

    Hai-Feng Luo; Ting Lei; Hong-Jiang Wang; Guang Tan; Zhong-Yu Wang

    2007-01-01

    BACKGROUND: Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. This study was undertaken to elucidate a misdiagnosis of non-traumatic diaphragmatic hernia of the liver in an adult. METHOD: The clinical data of one patient with non-traumatic diaphragmatic hernia of the liver was analyzed. RESULTS:A tumor in the right lower thorax was revealed by chest X-ray and computed tomography. Non-traumatic diaphragmatic hernia of the liver was not identiifed until the operation. Pathological analysis conifrmed the ifnding. The patient recovered well. CONCLUSIONS: Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia, which can move up into the chest cavity. It should be distinguished from lung cancer. The diagnosis and evaluation of non-traumatic diaphragmatic hernia of the liver can help optimize surgical management. 5 Kearney PA, Rouhana SW, Burnay RE. Blunt rupture of the diaphragmatic:mechanism, diagnosis, and treatment. Ann Emerg Med 1989;18:1326-1330. 6 Demos TC, Solomon C, Posniak HV, Flisak MJ. Computed tomography in traumatic defects of the diaphragm. Clin Imaging 1989;13:62-67. 7 Mar Fan MJ, Coulson ML, Siu SK. Adult incarcerated right-sided Bochdalek hernia. Aust N Z J Surg 1999;69:239-241. 8 Arsalane A, Herman D, Bazelly B. Left strangulated diaphragmatic hernia: an unusual complication of gastric bypass. Rev Pneumol Clin 2005;61:374-377. 9 Thomas S, Kapur B. Adult Bochdalek hernia--clinical features, management and results of treatment. Jpn J Surg 1991;21:114-119. 10 Kitano Y, Lally KP, Lally PA; Congenital Diaphragmatic Hernia Study Group. Late-presenting congenital diaphrag-matic hernia. J Pediatr Surg 2005;40:1839-1843. 11 Hubbard AM, Adzick NS, Crombleholme TM, Haselgrove JC. Left-sided congenital diaphragmatic hernia: value of prenatal MR imaging in preparation for fetal surgery. Radiology 1997;203:636-640. 12 Kilian AK, Busing KA, Schaible T, Neff KW. Fetal

  3. Reducing Liver Fat by Low Carbohydrate Caloric Restriction Targets Hepatic Glucose Production in Non-Diabetic Obese Adults with Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Haoyong Yu

    2014-09-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD impairs liver functions, the organ responsible for the regulation of endogenous glucose production and thus plays a key role in glycemic homeostasis. Therefore, interventions designed to normalize liver fat content are needed to improve glucose metabolism in patients affected by NAFLD such as obesity. Objective: this investigation is designed to determine the effects of caloric restriction on hepatic and peripheral glucose metabolism in obese humans with NAFLD. Methods: eight non-diabetic obese adults were restricted for daily energy intake (800 kcal and low carbohydrate (<10% for 8 weeks. Body compositions, liver fat and hepatic glucose production (HGP and peripheral glucose disposal before and after the intervention were determined. Results: the caloric restriction reduced liver fat content by 2/3 (p = 0.004. Abdominal subcutaneous and visceral fat, body weight, BMI, waist circumference and fasting plasma triglyceride and free fatty acid concentrations all significantly decreased (p < 0.05. The suppression of post-load HGP was improved by 22% (p = 0.002 whereas glucose disposal was not affected (p = 0.3. Fasting glucose remained unchanged and the changes in the 2-hour plasma glucose and insulin concentration were modest and statistically insignificant (p > 0.05. Liver fat is the only independent variable highly correlated to HGP after the removal of confounders. Conclusion: NAFLD impairs HGP but not peripheral glucose disposal; low carbohydrate caloric restriction effectively lowers liver fat which appears to directly correct the HGP impairment.

  4. Magnetic resonance imaging findings in primary lymphoma of the liver: a case report

    Directory of Open Access Journals (Sweden)

    Bilaj Fatmir

    2012-09-01

    Full Text Available Abstract Introduction Primary lymphoma of the liver is an extremely rare finding, with the few such cases reported in the literature to date describing indeterminate imaging findings, being focused more on computed tomography. To the best of our knowledge, there is no prior report describing magnetic resonance imaging scan findings with such a lesion. In the case reported here, magnetic resonance imaging gave us the opportunity to ascertain the correct diagnosis, confirmed by histopathology, thus avoiding unnecessary surgery or other treatments. Although this condition is rare, knowledge of magnetic resonance imaging findings will be invaluable for radiologists and other medical subspecialties that may face such cases in the future in helping to provide adequate management for affected patients. Case presentation A focal lesion was incidentally detected by ultrasound in a 75-year-old asymptomatic Albanian man being treated for benign hypertrophy of prostate. Chest and abdomen computed tomography scans did not reveal any abnormal findings besides a solid focal lesion on the right lobe of the liver and a mild homogenous enlargement of the prostate gland. Subsequently, magnetic resonance imaging of the upper abdomen was performed for better characterization of this lesion. Our patient was free of symptoms and his laboratory test results were normal. Conclusions The magnetic resonance imaging scan results showed some distinctive features that helped us to make the correct diagnosis, and were thus very important in helping us provide the correct treatment for our patient.

  5. Establishment and primary clinical application of competitive inhibition for measurement of augmenter of liver regeneration.

    Science.gov (United States)

    Wang, Na; Sun, Hang; Tang, Lin; Deng, Jianchuan; Luo, Ya; Guo, Hui; Liu, Qi

    2014-01-01

    The aim of the present study was to establish a quantitative method for the measurement of serum human augmenter of liver regeneration (hALR) using competitive inhibition that is applicable in the clinic. A monoclonal antibody to hALR was used as the primary antibody and the pure hALR protein was used as a standard for competition with Eu(3+)-labeled hALR (Eu(3+)-hALR) to plot a standard curve. Serum samples from 90 patients with various liver diseases due to hepatitis B virus (HBV) infection were used for a competitive reaction with Eu(3+)-hALR. A regression analysis of the results was performed using the standard curve to calculate the serum concentration of hALR. The minimum detectable value using direct competitive measurement established by Eu(3+)-hALR was 1 ng/ml, with a positive linear correlation within the range of 200 ng/ml. In the sera of the 90 patients, the hALR level in the severe hepatitis group was the highest, followed by that in the acute hepatitis group. The serum hALR levels in the cirrhosis and chronic hepatitis groups were significantly higher compared with those in the normal control groups (Pcompetitive measurement method of serum hALR established in the present study has high sensitivity, specificity, stability and reliability, meets clinical requirements and may be used as potential index in clinical tests.

  6. Maternal nutrition induces pervasive gene expression changes but no detectable DNA methylation differences in the liver of adult offspring.

    Directory of Open Access Journals (Sweden)

    Matthew V Cannon

    Full Text Available AIMS: Epidemiological and animal studies have shown that maternal diet can influence metabolism in adult offspring. However, the molecular mechanisms underlying these changes remain poorly understood. Here, we characterize the phenotypes induced by maternal obesity in a mouse model and examine gene expression and epigenetic changes induced by maternal diet in adult offspring. METHODS: We analyzed genetically identical male mice born from dams fed a high- or low-fat diet throughout pregnancy and until day 21 postpartum. After weaning, half of the males of each group were fed a high-fat diet, the other half a low-fat diet. We first characterized the genome-wide gene expression patterns of six tissues of adult offspring - liver, pancreas, white adipose, brain, muscle and heart. We then measured DNA methylation patterns in liver at selected loci and throughout the genome. RESULTS: Maternal diet had a significant effect on the body weight of the offspring when they were fed an obesogenic diet after weaning. Our analyses showed that maternal diet had a pervasive effect on gene expression, with a pronounced effect in liver where it affected many genes involved in inflammation, cholesterol synthesis and RXR activation. We did not detect any effect of the maternal diet on DNA methylation in the liver. CONCLUSIONS: Overall, our findings highlighted the persistent influence of maternal diet on adult tissue regulation and suggested that the transcriptional changes were unlikely to be caused by DNA methylation differences in adult liver.

  7. Reconstruction of the middle hepatic vein tributary in adult right lobe living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Xiao-Min Shi; Yi-Feng Tao; Zhi-Ren Fu; Guo-Shan Ding; Zheng-Xin Wang; Liang Xiao

    2011-01-01

    BACKGROUND: In adult-to-adult living donor liver trans-plantation (LDLT), the use of a right lobe graft without the middle hepatic vein (MHV) can cause hepatic congestion and disturbance of venous drainage. To solve this problem, we successfully used cadaveric venous allografts preserved in 4 ℃ University of Wisconsin (UW) solution within 10 days as interposition veins for drainage of the paramedian portion of the right lobe in adult LDLT. METHODS: From June 2007 to January 2008, 11 adult LDLT patients received modified right liver grafts. The major MHV tributaries (greater than 5 mm in diameter) of 9 cases were preserved and reconstructed using cadaveric interposition vein allografts that had been stored for 1 to 10 days in 4 ℃ UW solution. The regeneration of the paramedian sector of the grafts and the patency of the interposition vein allografts were examined by Doppler ultrasonography after the operation. RESULTS: MHV tributaries were reconstructed in 9 recipients. Only 1 recipient died of renal failure and severe pulmonary infection on day 9 after transplantation without any hemiliver venous outflow obstruction. The other 8 recipients achieved long-term survival with a median follow-up of 30 months. The cumulative patency rates of the 8 recipients were 63.63% (7/11), 45.45% (5/11), 45.45% (5/11) and 36.36% (4/11) at 3, 6, 12 and 24 months, respectively. Regeneration of the paramedian sectors was equivalent. CONCLUSION: The cadaveric venous allograft preserved in 4 ℃ UW solution within 10 days serves as a useful alternative for interposition veins in facilitating implantation of a right lobe graft and guarantees outflow of the MHV.

  8. Prevalence and Predictors of Change in Adult-Child Primary Caregivers

    Science.gov (United States)

    Szinovacz, Maximiliane E.; Davey, Adam

    2013-01-01

    Family caregiving research is increasingly contextual and dynamic, but few studies have examined prevalence and predictors of change in primary caregivers, those with the most frequent contact with healthcare professionals. We identified prevalence and predictors of 2-year change in primary adult-child caregivers. Data pooled from the 1992-2000…

  9. Primary Care for Adults with Down Syndrome: Adherence to Preventive Healthcare Recommendations

    Science.gov (United States)

    Jensen, K. M.; Taylor, L. C.; Davis, M. M.

    2013-01-01

    Background: Due to significant medical improvements, persons with Down syndrome now live well into adulthood. Consequently, primary care for adults with Down syndrome needs to incorporate routine care with screening for condition-specific comorbidities. This study seeks to evaluate the adherence of primary care physicians to age- and…

  10. Cultivation of adult rat hepatocytes on 3T3 cells: expression of various liver differentiated functions.

    Science.gov (United States)

    Kuri-Harcuch, W; Mendoza-Figueroa, T

    1989-08-01

    Adult rat hepatocytes were maintained in culture for at least 1 month without losing the expression of their differentiated functions; they were cultured on lethally treated 3T3 fibroblasts inoculated at 35,000 cells/cm2 with medium containing 10-25 micrograms/ml hydrocortisone. Hepatocytes showed their typical morphology; they formed bile canaliculi, microvilli, and intercellular junctions with desmosomes and nexus; some formed structures that may resemble the perisinusoidal space of Disse. In addition, they showed DNA synthesis and expressed some liver-specific functions. They synthesized albumin and other proteins, which were exported to the culture medium. Like parenchymal liver cells in vivo, de novo fatty acid synthesis and esterification took place, and more than 80% of the lipids synthesized by the hepatocytes were secreted into the medium as triglycerides; they also showed cytochrome-P450 activity that was inducible with phenobarbital, suggesting that the hepatocytes have the capacity to metabolize drugs. These culture conditions allow the study of various hepatocyte differentiated functions, and they may provide the means to analyze the effect on liver of hormones, viruses and hepatotoxic chemicals and drugs; they may also indicate conditions adequate for serial growth of hepatocytes.

  11. Hepatoprotective activity of bacoside A against N-nitrosodiethylamine-induced liver toxicity in adult rats.

    Science.gov (United States)

    Janani, Panneerselvam; Sivakumari, Kanakarajan; Parthasarathy, Chandrakesan

    2009-10-01

    N-Nitrosodiethylamine (DEN) is a notorious carcinogen, present in many environmental factors. DEN induces oxidative stress and cellular injury due to enhanced generation of reactive oxygen species; free radical scavengers protect the membranes from DEN-induced damage. The present study was designed to evaluate the protective effect of bacoside A (the active principle isolated from Bacopa monniera Linn.) on carcinogen-induced damage in rat liver. Adult male albino rats were pretreated with 15 mg/kg body weight/day of bacoside A orally (for 14 days) and then intoxicated with single necrogenic dose of N-nitrosodiethylamine (200 mg/kg bodyweight, intraperitonially) and maintained for 7 days. The liver weight, lipid peroxidation (LPO), and activity of serum marker enzymes (aspartate transaminases, alanine transaminases, lactate dehydrogenase, alkaline phosphatase, and gamma-glutamyl transpeptidase) were markedly increased in carcinogen-administered rats, whereas the activities of marker enzymes were near normal in bacoside A-pretreated rats. Activities of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutatione-S-transferase, and reduced glutathione) in liver also decreased in carcinogen-administered rats, which were significantly elevated in bacoside A-pretreated rats. It is concluded that pretreatment of bacoside A prevents the elevation of LPO and activity of serum marker enzymes and maintains the antioxidant system and thus protects the rats from DEN-induced hepatotoxicity.

  12. Undifferentiated embryonal sarcoma of the liver presenting as a hemorrhagic cystic tumor in an adult

    Institute of Scientific and Technical Information of China (English)

    Ho Hyun Kim; Jung Chul Kim; Eun Kyu Park; Young Hoe Hur; Yang Seok Koh; Chol Kyoon Cho; Hyung Seok Kim; Hyun Jong Kim

    2011-01-01

    BACKGROUND: Undifferentiated  embryonal  sarcoma  (UES) of the liver is a rare, highly malignant neoplasm with a poor prognosis occurring almost exclusively in late childhood (6-10 years  of  age).  Only  a  few  cases  have  been  reported  in  adults, accounting for less than 1% of all primary liver neoplasms. METHODS: A 47-year-old woman presented with a palpable mass in the left upper abdomen. Magnetic resonance imaging revealed  a  12×10  cm  cystic  mass  with  hemorrhage  in  the left lateral segment of the liver. The initial impression was a hemorrhagic cystic tumor of the liver. The patient underwent a left lateral sectionectomy of the liver. Histopathology and immunohistochemistry helped make a diagnosis of UES. RESULTS: The  patient  recovered  uneventfully  and  received systemic chemotherapy. Radiologic examination for follow-up revealed a metastatic lesion in the lumbar spine (L5). She was subjected to radiotherapy at the lumbar spine. She survived 48 months. CONCLUSION: Although  hepatic  cyst  as  UES  of  the  liver  is difficult  to  diagnose  because  of  its  rarity  in  adults  and  lack of  specific  findings,  it  should  be  considered  in  a  differential diagnosis.

  13. Primary prevention of food allergy in children and adults

    DEFF Research Database (Denmark)

    de Silva, D; Geromi, M; Halken, S

    2014-01-01

    BACKGROUND: Food allergies can have serious physical, social, and financial consequences. This systematic review examined ways to prevent the development of food allergy in children and adults. METHODS: Seven bibliographic databases were searched from their inception to September 30, 2012...... with extensively or partially hydrolyzed whey or casein formulas for infants at high risk for the first 4 months. Soy milk and delaying the introduction of solid foods beyond 4 months did not have preventive benefits in those at high or normal risk. There was very little evidence about strategies for preventing...... food allergy in older children or adults. CONCLUSIONS: There is much to learn about preventing food allergy, and this is a priority given the high societal and healthcare costs involved....

  14. Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

    Directory of Open Access Journals (Sweden)

    Armin D. Goralczyk

    2009-01-01

    Full Text Available Adult living donor liver transplantations (ALDLTs across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR. Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety.

  15. A long-term survival case of adult undifferentiated embryonal sarcoma of liver

    Directory of Open Access Journals (Sweden)

    Noguchi Keita

    2012-04-01

    Full Text Available Abstract Undifferentiated embryonal sarcoma of the liver (USEL is a rare malignant hepatic tumor with a poor prognosis that is usually observed in children (aged 6 to10 years and rarely seen in adults. We present a case of USEL in a 27-year-old woman with no previous history of the disease. Laboratory tests performed on admission showed that the patient had mildly elevated levels of aspartate aminotransferase, alanine transaminase, alkaline phosphatase, lactate dehydrogenase, and γ-glutamyl transpeptidase. The levels of viral hepatitis and tumor serum markers were all within normal limits. Computed tomography showed a large mass involving the right lobe and the medial segment of the liver. Right trisectionectomy was performed. Microscopically, the tumor was composed of pleomorphic and polynuclear dyskaryotic cells in a myxoid stroma with focal eosinophilic globules and no clear differentiation to muscle. Histological diagnosis showed undifferentiated embryonal sarcoma. Adjuvant therapy with cisplatin, vincristine, doxorubicin, cyclophosphamide, and actinomycin D was initiated. We administered a high dose of etoposide to extract the patient’s peripheral blood stem cells and performed radiation therapy and peripheral blood stem cell transplantation. At 5-year follow-up, the patient was alive without any evidence of recurrence. Here, we describe the clinical and histopathological features of USEL as well as the therapeutic options for USEL in adults with this disease.

  16. Giant Primary Mature Retroperitoneal Teratomain in Adult Male Patient

    OpenAIRE

    R. Ebrahimian; D. Tasa

    2015-01-01

    Introduction: Teratomas are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumor and is typically located in either the sacrococcygeal region or in the gonads. Giant retroperitoneal teratomas in adults are even rarer, with only a few cases previously described in the literature. Case report: A 35-year-old male patient with severe nausea and vomiting was taken to the emergency wa...

  17. Giant Primary Retroperitoneal Teratoma in an Adult: A Case Report

    Directory of Open Access Journals (Sweden)

    Poonam Mathur

    2010-01-01

    Full Text Available Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Retroperitoneal teratomas are rare and present challenging management options. We report here the case of a histologically unusual retroperitoneal tumor detected on computed tomography during the workup of abdominal pain in a 32-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper.

  18. Omega-3-enriched lipid emulsion for liver salvage in parenteral nutrition-induced cholestasis in the adult patient.

    Science.gov (United States)

    Jurewitsch, Brian; Gardiner, Geoffrey; Naccarato, Mark; Jeejeebhoy, Khursheed N

    2011-05-01

    The intrahepatic cholestasis attributed to parenteral nutrition (PN) in the adult patient is relatively rare and usually occurs in patients receiving long-term PN. This article reports the first case of an adult patient with cholestatic PN-associated liver disease without sepsis who received almost all her nutrition requirements through PN. Administration of an ω-3-enriched lipid emulsion added to the PN regimen reversed cholestasis and demonstrated histologic improvement on serial liver biopsy. The patient had failed to respond to other modalities of treatment for this condition and was deeply jaundiced. Liver biochemistry profiles returned to baseline, and follow-up liver biopsy showed that cholestasis had resolved and that the only residual changes were mild portal inflammation with no histochemical or ultrastructural progression. The PN regimen for the patient was restored to provide total estimated energy requirements and remains the principle source of the patient's nutrition to date.

  19. Angiotensin-Converting Enzyme Gene Polymophism in Adult Primary Focal Segmental Glomerulosclerosis

    OpenAIRE

    2014-01-01

    Background Primary focal segmental glomerulosclerosis (FSGS) accounts for a third of biopsy-proven primary glomerulonephritis in Malaysia. Pediatric studies have found the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene to be associated with renal disease progression. The aim of this study was to determine the prevalence of the ACE (I/D) genotypes in adult primary FSGS and its association with renal outcome on follow-up. Methods Prospective observational ...

  20. Primary hyperoxaluria in an adult male: A rare cause of end-stage kidney disease yet potentially fatal if misdiagnosed

    Directory of Open Access Journals (Sweden)

    Kamel El-Reshaid

    2016-01-01

    Full Text Available Primary hyperoxaluria is an autosomal recessive disorder due to a deficiency in the activity of the peroxisomal hepatic enzyme alanine-glyoxylate aminotransferase. It is a common cause of urolithiasis and end-stage kidney disease in children contrary to the adult phenotypic presentation which is considered a mild disorder with occasional urolithiasis. In this case report, we describe a 25-year-old man who presented with advanced and irreversible kidney failure within three months following strenuous physical training in the police academy. He had nephrocalcinosis and stones in one kidney. Diagnosis was confirmed by establishing the existence of extensive tubular and interstitial crystal deposition in his kidneys and molecular genetic testing. The case illustrates the need to establish an early diagnosis of this disorder to prevent the need for combined liver and kidney transplantation.

  1. Development of a decision support tool to facilitate primary care management of patients with abnormal liver function tests without clinically apparent liver disease [HTA03/38/02]. Abnormal Liver Function Investigations Evaluation (ALFIE

    Directory of Open Access Journals (Sweden)

    Sullivan Frank M

    2007-04-01

    Full Text Available Abstract Background Liver function tests (LFTs are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF test in primary care and with no obvious liver disease. Further investigations may be dangerous for the patient and expensive for Health Services. The aims of this study are to determine the natural history of abnormalities in LFTs before overt liver disease presents in the population and identify those who require minimal further investigations with the potential for reduction in NHS costs. Methods/Design A population-based retrospective cohort study will follow up all those who have had an incident liver function test (LFT in primary care to subsequent liver disease or mortality over a period of 15 years (approx. 2.3 million tests in 99,000 people. The study is set in Primary Care in the region of Tayside, Scotland (pop approx. 429,000 between 1989 and 2003. The target population consists of patients with no recorded clinical signs or symptoms of liver disease and registered with a GP. The health technologies being assessed are LFTs, viral and auto-antibody tests, ultrasound, CT, MRI and liver biopsy. The study will utilise the Epidemiology of Liver Disease In Tayside (ELDIT database to determine the outcomes of liver disease. These are based on hospital admission data (Scottish Morbidity Record 1, dispensed medication records, death certificates, and examination of medical records from Tayside hospitals. A sample of patients (n = 150 with recent initial ALF tests or invitation to biopsy will complete questionnaires to obtain quality of life data and anxiety measures. Cost-effectiveness and cost utility Markov model analyses will be performed from health service and patient perspectives using standard NHS costs. The findings will also be used to develop a computerised clinical decision

  2. Primary malignant rhabdoid tumour of the brain in an adult

    Energy Technology Data Exchange (ETDEWEB)

    Arrazola, J.; Pedrosa, I.; Mendez, R. [Radiology Department, Hospital Clinico San Carlos, Madrid (Spain); Saldana, C. [Neurosurgery Department, Hospital Clinico San Carlos, Madrid (Spain); Scheithauer, B.W. [Division of Anatomic Pathology, Mayo Clinic, Rochester, MN (United States); Martinez, A. [Anatomic Pathology Department, Hospital Clinico San Carlos, Madrid (Spain)

    2000-05-01

    We report a mass in the left cerebral hemisphere of a 20-year-old man. Histological, ultrastructural and immunohistochemical features of the tumour were consistent with primary malignant rhabdoid tumour. The age of presentation, imaging features prior to histological examination, and prognosis in this case were unusual. (orig.)

  3. Early graft dysfunction following adult-to-adult livingrelated liver transplantation: Predictive factors and outcomes

    Institute of Scientific and Technical Information of China (English)

    Salvatore Gruttadauria; Fabrizio di Francesco; Giovanni Battista Vizzini; Angelo Luca; Marco Spada; Davide Cintorino; Sergio Li Petri; Giada Pietrosi; Duilio Pagano; Bruno Gridelli

    2009-01-01

    AIM: To describe a condition that we define as early graft dysfunction (EGD) which can be identified preoperatively.METHODS: Small-for-size graft dysfunction following living-related liver transplantation (LRLT) is characterized by EGD when the graft-to-recipient body weight ratio (GRBWR) is below 0.8%. However,patients transplanted with GRBWR above 0.8% can develop dysfunction of the graft. In 73 recipients of LRLT (GRBWR > 0.8%), we identified 10 patients who developed EGD. The main measures of outcomes analyzed were overall mortality, number of re-transplants and length of stay in days (LOS). Furthermore we analyzed other clinical pre-transplant variables, intraoperative parameters and post transplant data.RESULTS: A trend in favor of the non-EGD group (3-mo actuarial survival 98% vs 88%, P = 0.09; 3-mo graft mortality 4.7% vs 20%, P = 0.07) was observed as well as shorter LOS (13 d vs 41.5 d; P = 0.001) and smaller requirement of peri-operative Units of Plasma (4 vs 14; P = 0.036). Univariate analysis of pretransplant variables identified platelet count, serum bilirubin, INR and Meld-Na score as predictors of EGD.In the multivariate analysis transplant Meld-Na score (P = 0.025, OR: 1.175) and pre-transplant platelet count (P = 0.043, OR: 0.956) were independently associated with EGD.CONCLUSION: EGD can be identified preoperatively and is associated with increased morbidity after LRLT.A prompt recognition of EGD can trigger a timely treatment.

  4. Protocol for Isolation of Primary Human Hepatocytes and Corresponding Major Populations of Non-parenchymal Liver Cells.

    Science.gov (United States)

    Kegel, Victoria; Deharde, Daniela; Pfeiffer, Elisa; Zeilinger, Katrin; Seehofer, Daniel; Damm, Georg

    2016-03-30

    Beside parenchymal hepatocytes, the liver consists of non-parenchymal cells (NPC) namely Kupffer cells (KC), liver endothelial cells (LEC) and hepatic Stellate cells (HSC). Two-dimensional (2D) culture of primary human hepatocyte (PHH) is still considered as the "gold standard" for in vitro testing of drug metabolism and hepatotoxicity. It is well-known that the 2D monoculture of PHH suffers from dedifferentiation and loss of function. Recently it was shown that hepatic NPC play a central role in liver (patho-) physiology and the maintenance of PHH functions. Current research focuses on the reconstruction of in vivo tissue architecture by 3D- and co-culture models to overcome the limitations of 2D monocultures. Previously we published a method to isolate human liver cells and investigated the suitability of these cells for their use in cell cultures in Experimental Biology and Medicine(1). Based on the broad interest in this technique the aim of this article was to provide a more detailed protocol for the liver cell isolation process including a video, which will allow an easy reproduction of this technique. Human liver cells were isolated from human liver tissue samples of surgical interventions by a two-step EGTA/collagenase P perfusion technique. PHH were separated from the NPC by an initial centrifugation at 50 x g. Density gradient centrifugation steps were used for removal of dead cells. Individual liver cell populations were isolated from the enriched NPC fraction using specific cell properties and cell sorting procedures. Beside the PHH isolation we were able to separate KC, LEC and HSC for further cultivation. Taken together, the presented protocol allows the isolation of PHH and NPC in high quality and quantity from one donor tissue sample. The access to purified liver cell populations could allow the creation of in vivo like human liver models.

  5. Cholangiocarcinoma Secondary to Primary Sclerosing Cholangitis in Explanted Livers: A Single-Center Study in the South of Iran

    Directory of Open Access Journals (Sweden)

    Geramizadeh

    2015-12-01

    Full Text Available Background Primary sclerosing cholangitis (PSC is a chronic disease, characterized by chronic inflammation and fibrosis of bile duct epithelial cells. This is a significant contributory factor to the development of malignancy, most commonly cholangiocarcinoma (CCA, which is the second most common malignant liver tumor. Objectives For the first time in Iran, we intend to describe our experience with cases of PSC, with and without CCA, in explanted livers, and compare our results with those found in other areas of the world. Patients and Methods The study population comprised 181 individuals with a diagnosis of PSC who had undergone liver transplantation in the main liver transplant center of Iran, the largest center of hepatobiliary surgery in the south of that country, over a 3-year period between 2012 and 2014. All explanted livers, with and without CCA, were evaluated. Results Of the 181 patients, 16 were found to have CCA, two of whom had been diagnosed after pathologic study of the explanted livers. Therefore it appeared that 8.8% of the patients with PSC in our center had developed CCA before liver transplantation. Conclusions A comparison of our results with those obtained from other centers in both Western and Asian countries (which reported CCA in 3.6% - 36.5% of patients with PSC, shows that the incidence of CCA in the patients we studied is intermediate.

  6. Primary gastric teratoma on the cardiac orifice in an adult

    Institute of Scientific and Technical Information of China (English)

    Liu Liu; Wen Zhuang; Zhong Chen; Yong Zhou; Xiao-Ran Huang

    2009-01-01

    Gastric teratoma (GT) is a seldom seen congenital abnormality. GT always occurs in children. The greater curvature and posterior wall of the stomach are the most common sites involving GT. We diagnosed a case of GT located on the inferior wall of the cardiac orifice in a 20-year-old man. To the best of our knowledge, this is the first case of GT located on the wall of the cardiac orifice in an adult in the English literature. We report this unusual case as an addition to this rare disease usually found in children. Computed tomography combined with endoscopic ultrasonography can be selected to diagnose GT.

  7. Results of radiation therapy for primary liver cancer. Long-term influence of irradiation on liver function

    Energy Technology Data Exchange (ETDEWEB)

    Wadasaki, Kouichi; Kimura, Fumi; Oomae, Tadayuki; Urashima, Masaki; Mori, Masaki [Hiroshima Atomic Bomb Hospital (Japan)

    1995-06-01

    During the period from June 1991 through May 1993, 6 patients (3 males and 3 females) were treated with radiation therapy of 60 Gy or more for hepatomas complicated with liver cirrhosis type C. They ranged in age from 62 to 76 years with a mean of 70. Tumor size was examined on CT before and 2 months after irradiation. In addition, changes in liver function following irradiation were examined. In 4 of the 6 patients, tumor decreased by 27-90% at 11 to 43 months after irradiation. Although liver function was irreversibly aggravated in one patient, it was slight and recovered 6 months after irradiation in the other 5 patients. High dose irradiation to the limited fields is considered useful in the treatment of hepatoma. (S.Y.).

  8. HLA-G and classical HLA class I expression in primary colorectal cancer and associated liver metastases.

    Science.gov (United States)

    Swets, Marloes; König, Marion H; Zaalberg, Anniek; Dekker-Ensink, Neeltje G; Gelderblom, Hans; van de Velde, Cornelis J H; van den Elsen, Peter J; Kuppen, Peter J K

    2016-09-01

    De novo expression of HLA-G has been demonstrated in colorectal cancer. HLA-G, amongst others, inhibits natural killer cell function, contributing to host immune defense evasion. Another mechanism to escape anti-tumor immunity is loss of HLA class I. Therefore, we determined HLA-G and HLA class I expression on primary colorectal tumors and associated liver metastases, in order to get insight in the metastasizing process regarding escaping anti-tumor immunity. HLA-G expression was evaluated using three mAbs; 4H84, MEM-G/1 and MEM-G/2. In total 81 colorectal cancer patients were evaluated. Formalin-fixed paraffin-embedded tissue sections of primary tumors and associated liver metastases, were immunohistochemically stained. A concordance between expression or loss/downregulation in the primary tumor and associated liver metastasis regarding HLA class I expression was observed in 80% of the cases. In contrast with the hypothesis of escaping NK cell-killing, we demonstrated for each HLA-G detecting mAbs used in this study, that the majority of the primary tumors that positively stained for HLA-G did not express HLA-G in the associated liver metastasis. Furthermore, we revealed the existence of non-specific binding and in addition we found that the different epitopes of HLA-G detected by 4H84, MEM-G/1 and MEM-G/2 mAbs were expressed differentially in colorectal tumor tissues.

  9. Genomic gain of the PRL-3 gene may represent poor prognosis of primary colorectal cancer, and associate with liver metastasis.

    Science.gov (United States)

    Nakayama, N; Yamashita, K; Tanaka, T; Kawamata, H; Ooki, A; Sato, T; Nakamura, T; Watanabe, M

    2016-01-01

    PRL-3 genomic copy number is increased in colorectal cancer (CRC), and PRL-3 expression is closely associated with lymph node and liver metastasis of CRC. However, the clinical significance of PRL-3 genomic gain for CRC remains obscure. Here, PRL-3 genomic status in 109 primary CRC tumors and in 44 CRC tumors that had metastasized to the liver, was quantified using real time PCR. Association of PRL-3 genomic status with clinicopathological factors and prognosis was assessed in detail. PRL-3 genomic gain was identified in 31 primary CRC (27.4 %) and was more frequently seen in stage III than in stage II (p = 0.025). Among the clinicopathological factors assessed, PRL-3 genomic gain was significantly associated with poorly differentiated histology (p = 0.0039). Moreover, CRC patients with PRL-3 genomic gain exhibited poorer prognosis than those with no gain in stage II-IV CRC (p = 0.017). PRL-3 genomic gain was identified in 18 (41 %) of the liver metastasis tumors, and this frequency of gain was significantly increased as compared to that of the corresponding primary CRCs (11 %) (p = 0.001). Our findings suggested that PRL-3 genomic gain may represent an aggressive phenotype of primary CRC, and may associate with liver metastasis.

  10. Polycystic liver in the adult (PLA in Spain: analysis of a structured survey analysing the experience and attitude of gastroenterologists in Spain

    Directory of Open Access Journals (Sweden)

    Javier Ampuero

    2014-04-01

    Full Text Available Background: Polycystic liver in the adult (PLA is a rare disease characterized by chronic liver enlargement. Objective: To analyse gastroenterologists' involvement in, experience with, and attitude toward diagnosing, monitoring, and treating patients with PLA in Spain. Methods: Each of seven study coordinators contacted 15 specialists in their geographic area about participating in the study via an online structured survey. Results: Of the 105 clinics contacted, 88 completed the questionnaire, with a mean of 3 patients being followed per practice, although 6 clinics were following more than 20 patients with PLA. Patients were being followed mainly by the Department of Hepatology (81 % and/or the Department of Gastroenterology (33 %. The majority of patients were diagnosed (98 % and monitored (97 % using liver ultrasound. When diagnosed, 76 % of patients were under 50 years of age, females predominating. The primary treatment objective for the patients was symptomatic management. Pharmacotherapy was prescribed by 28 % of physicians: Somatostatin analogues, primarily, followed by mTOR inhibitors. One-third of the clinics indicated that they had patients who had undergone liver transplant and/or surgery. Conclusions: Ultrasound is the diagnosing and monitoring method of choice. Among the clinics using pharmacotherapy for symptomatic management, somatostatin analogues were the drugs of choice. These clinics' infrequent use of invasive procedures suggests that they perceive the various invasive techniques as not very effective.

  11. Capacity for intracellular pH compensation during hypercapnia in white sturgeon primary liver cells.

    Science.gov (United States)

    Huynh, Khuong Tuyen; Baker, Daniel W; Harris, Robert; Church, John; Brauner, Colin J

    2011-10-01

    Fish, exposed to elevated water CO(2), experience a rapid elevation in blood CO(2) (hypercapnia), resulting in acidification of both intra- and extra-cellular compartments. White sturgeon, Acipenser transmontanus, are exceptionally CO(2) tolerant and can regulate tissue intracellular pH (pH(i)) in the presence of a pronounced hypercapnic acidosis (preferential pH(i) regulation). In this study, pH(i) regulatory capacity of sturgeon liver cells in primary culture was examined to assess the suitability of employing this in vitro system to understand in vivo CO(2) tolerance in sturgeon. Using the pH-sensitive fluoroprobe BCECF, real-time changes in resting pH(i) and rates of pH(i) recovery were investigated during exposure to hypercapnia (3 and 6% CO(2)) in the absence and presence of additional acid loads induced by (20 mM) ammonium prepulse. During short-term (10 min) exposure to hypercapnia (3 and 6% CO(2)), sturgeon cells were acidified and no pH(i) compensation was observed. However, when exposure to 6% CO(2) was extended to over 19 h, the CO(2)-induced intracellular acidosis was partially compensated by a pH(i) increase of over 0.2 pH unit despite the sustained extracellular acidosis, indicative of a capacity for preferential pH(i) regulation in vitro. Since this capacity in sturgeon liver is present both in vivo and in vitro, the transmembrane transporters involved may be the same. Therefore, cell culture may be a suitable tool to identify the transporters (i.e., the cellular mechanisms underlying in vivo CO(2) tolerance) in white sturgeon and possibly in other hypercapnia-tolerant species.

  12. Left Lateral Sectionectomy of the Native Liver and Combined Living-Related Liver–Kidney Transplantation for Primary Hyperoxaluria Type 1

    OpenAIRE

    Chen, Guo-Yong; Wei, Si-Dong; Zou, Zhong-Wu; Tang, Gao-Feng; Sun, Jian-jun; Zhou, Shao-Tang

    2015-01-01

    Abstract Primary hyperoxaluria type I (PH1), the most severe form of primary hyperoxalurias, is a liver disease of the metabolic defect in glyoxylate detoxification that can be corrected by liver transplantation. A 21-year-old man presented to our center after 4 months of regular hemodialysis for kidney failure caused by nephrolithiasis. A diagnosis of PH1 was confirmed by mutations of the AGXT gene. Left lateral sectionectomy of the native liver was performed; and auxiliary partial orthotopi...

  13. Role of whole body FDG-PET in the diagnosis of hidden distant metastasis before liver transplantation in patients with primary liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Woo; Ryu, Jin Sook; Yang, You Jung; Kim, Jae Seung; Yeo, Jeong Seok; Moon, Dae Hyuk; Lee, Sung Gyu [Ulsan University of College of Medicine, Seoul (Korea, Republic of)

    2002-12-01

    Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions of FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had 5 hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.

  14. Biliary strictures and recurrence after liver transplantation for primary sclerosing cholangitis: A retrospective multicenter analysis.

    Science.gov (United States)

    Hildebrand, Tatiana; Pannicke, Nadine; Dechene, Alexander; Gotthardt, Daniel N; Kirchner, Gabriele; Reiter, Florian P; Sterneck, Martina; Herzer, Kerstin; Lenzen, Henrike; Rupp, Christian; Barg-Hock, Hannelore; de Leuw, Philipp; Teufel, Andreas; Zimmer, Vincent; Lammert, Frank; Sarrazin, Christoph; Spengler, Ulrich; Rust, Christian; Manns, Michael P; Strassburg, Christian P; Schramm, Christoph; Weismüller, Tobias J

    2016-01-01

    Liver transplantation (LT) is the only definitive treatment for patients with end-stage liver disease due to primary sclerosing cholangitis (PSC), but a high rate of biliary strictures (BSs) and of recurrent primary sclerosing cholangitis (recPSC) has been reported. In this multicenter study, we analyzed a large patient cohort with a long follow-up in order to evaluate the incidence of BS and recPSC, to assess the impact on survival after LT, and to identify risk factors. We collected clinical, surgical, and laboratory data and records on inflammatory bowel disease (IBD), immunosuppression, recipient and graft outcome, and biliary complications (based on cholangiography and histology) of all patients who underwent LT for PSC in 10 German transplant centers between January 1990 and December 2006; 335 patients (68.4% men; mean age, 38.9 years; 73.5% with IBD) underwent transplantation 8.8 years after PSC diagnosis with follow-up for 98.8 months. The 1-, 5-, and 10-year recipient and graft survival was 90.7%, 84.8%, 79.4% and 79.1%, 69.0%, 62.4%, respectively. BS was diagnosed in 36.1% after a mean time of 3.9 years, and recPSC was diagnosed in 20.3% after 4.6 years. Both entities had a significant impact on longterm graft and recipient survival. Independent risk factors for BS were donor age, ulcerative colitis, chronic ductopenic rejection, bilirubin, and international normalized ratio (INR) at LT. Independent risk factors for recPSC were donor age, IBD, and INR at LT. These variables were able to categorize patients into risk groups for BS and recPSC. In conclusion, BS and recPSC affect longterm graft and patient survival after LT for PSC. Donor age, IBD, and INR at LT are independent risk factors for BS and recPSC and allow for risk estimation depending on the recipient-donor constellation.

  15. Motivational interviewing for older adults in primary care: a systematic review.

    Science.gov (United States)

    Purath, Janet; Keck, Annmarie; Fitzgerald, Cynthia E

    2014-01-01

    Chronic disease is now the leading cause of death and disability in United States. Many chronic illnesses experienced by older adults can be prevented or managed through behavior change, making patient counseling an essential component of disease prevention and management. Motivational Interviewing (MI), a type of conversational method, has been effective in eliciting health behavior changes in people in a variety of settings and may also be a useful tool to help older adults change. This review of the literature analyzes current research and describes potential biases of MI interventions that have been conducted in primary care settings with older adults. MI shows promise as a technique to elicit health behavior change among older adults. However, further study with this population is needed to evaluate efficacy of MI interventions in primary care settings.

  16. Giant Primary Mature Retroperitoneal Teratomain in Adult Male Patient

    Directory of Open Access Journals (Sweden)

    R. Ebrahimian

    2015-07-01

    Full Text Available Introduction: Teratomas are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumor and is typically located in either the sacrococcygeal region or in the gonads. Giant retroperitoneal teratomas in adults are even rarer, with only a few cases previously described in the literature. Case report: A 35-year-old male patient with severe nausea and vomiting was taken to the emergency ward of Hamadan Be’sat Hospital. He had not been feeling well, and had suffering from abdominal pain for a month. A physical examination showed some concretion in the right side of his abdomen. A CT scan of his abdomen and pelvis with IV and oral contrast re-vealed that the concretion was formed by aggregates of solid, cystic, and calcareous compo-nents. It compressed stomach and caused the rotation of the stomach around its longitudinal axis. Conclusion: Following the diagnosis, we performed a laparotomy and respected a concretion with dimension 20?25?22cm. Interestingly, we found out all mature tissues within the con-cretion in the pathology examination of an adequate sample (such as trachea, bone, GI lu-men…. (Sci J Hamadan Univ Med Sci 2015; 22 (2: 165-169

  17. Safety of small-for-size grafts in adult-to-adult living donor liver transplantation using the right lobe.

    Science.gov (United States)

    Moon, Ju Ik; Kwon, Choon Hyuck David; Joh, Jae-Won; Jung, Gum O; Choi, Gyu-Seong; Park, Jae Berm; Kim, Jong Man; Shin, Milljae; Kim, Sung-Joo; Lee, Suk-Koo

    2010-07-01

    The problem of graft size is one of the critical factors limiting the expansion of adult-to-adult living donor liver transplantation (LDLT). We compared the outcome of LDLT recipients who received grafts with a graft-to-recipient weight ratio (GRWR) or = 0.8%, and we analyzed the risk factors affecting graft survival after small-for-size grafts (SFSGs) were used. Between June 1997 and April 2008, 427 patients underwent LDLT with right lobe grafts at the Department of Surgery of Samsung Medical Center. Recipients were divided into 2 groups: group A with a GRWR or = 0.8% (n = 392). We retrospectively evaluated the recipient factors, donor factors, and operative factors through the medical records. Small-for-size dysfunction (SFSD) occurred in 2 of 35 patients (5.7%) in group A and in 14 of 392 patients (3.6%) in group B (P = 0.368). Graft survival rates at 1, 3, and 5 years were not different between the 2 groups (87.8%, 83.4%, and 74.1% versus 90.7%, 84.5%, and 79.4%, P = 0.852). However, when we analyzed risk factors within group A, donor age and middle hepatic vein tributary drainage were significant risk factors for graft survival according to univariate analysis (P = 0.042 and P = 0.038, respectively). Donor age was the only significant risk factor for poor graft survival according to multivariate analysis. The graft survival rates of recipients without SFSD tended to be higher than those of recipients with SFSD (85.3% versus 50.0%, P = 0.074). The graft survival rates of recipients with grafts from donors grafts from donors > or = 44 years old (92.2% versus 53.6%, P = 0.005). In conclusion, an SFSG (GRWR graft from a donor younger than 44 years.

  18. Characterization and enrichment of hepatic progenitor cells in adult rat liver

    Institute of Scientific and Technical Information of China (English)

    Ai-Lan Qin; Xia-Qiu Zhou; Wei Zhang; Hong Yu; Qin Xie

    2004-01-01

    AIM: To detect the markers of oval cells in adult rat liver and to enrich them for further analysis of characterization in vitro.METHODS: Rat model for hepatic oval cell proliferation was established with 2-acetylaminofluorene and two third partial hepatectomy (2-AAF/PH). Paraffin embedded rat liver sections from model (11 d after hepatectomy) and control groups were stained with HE and OV6, cytokeratin19 (CK19),albumin, alpha fetoprotein (AFP), connexin43, and c-kit antibodies by immunohistochemistry. Oval cell proliferation was measured with BrdU incorporation test. C-kit positive oval cells were enriched by using magnetic activated cell sorting (MACS) .The sorted oval cells were cultured in a low density to observe colony formation and to examine their characterization in vitroby immunocytochemistry and RT-PCR. RESULTS: A 2-AAF/PH model was successfully established to activate the oval cell compartment in rat liver. BrdU incorporation test of oval cell was positive. The hepatic oval cells coexpressed oval cell specific marker OV6, hepatocytemarker albumin and cholangiocyte-marker CK19. They also expressed AFP and connexin 43. C-kit, one hematopoietic stem cell receptor, was expressed in hepatic oval cells at high levels. By using c-kit antibody in conjunction with MACS,we developed a rapid oval cell isolation protocol. The sorted cells formed colony when cultured in vitro. Cells in the colony expressed albumin or CK19 or coexpressed both and BrdU incorporation test was positive. RT-PCR on colony showed expression of albumin and CK19 gene.CONCLUSION: Hepatic oval cells in the 2-AAF/PH model had the properties of hepatic stem/progenitor cells. Using MACS, we established a method to isolate oval cells. The sorted hepatic oval cells can form colony in vitro which expresses different combinations of phenotypic markers and genes from both hepatocytes and cholangiocyte lineage.

  19. "Three-Grade Criteria" of Radical Resection for Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    Zengchen Ma; Jia Fan; Zhenggang Ren; Jinglin Xia; Liwen Huang; Zhaoyou Tang; Xinda Zhou; Zhiying Lin; Lunxiu Qin; Qinghai Ye; Huichuan Sun; Zhiquan Wu

    2005-01-01

    OBJECTIVE The present study was designed to develop the "ThreeGrade Criteria" for radical resection of primary liver cancer (PLC) and to evaluate its clinical significance.METHODS Criteria for radical resection of PLC were summed up to 3 grades based on criterion development. Grade I: complete removal of all gross tumors with no residual tumor at the excision margin. Grade Ⅱ: on or the primary branches of the portal vein, the common hepatic duct or its dition to the above criteria, negative postoperative follow-up result including AFP dropping to a normal level (with positive AFP before surgery)within 2 months after operation, and no residual tumor upon diagnostic imaging.The clinical data from 354 patients with PLC who underwent hepatectomy were reviewed retrospectively. Based on the "Three-Grade Criteria" these patients were divided into 6 groups: Grade Ⅰ radical group,Grade Ⅰ palliative group, Grade Ⅱ radical group, Grade Ⅱ palliative group,Grade Ⅲ radical group, Grade Ⅲ palliative group. The survival rate of each group was calculated by the life-table method and the rates compared among the groups.RESULTS The survival rate of patients receiving radical treatment was better than those receiving palliative treatment (P<0.01). Survival improved as more criteria were applied. The 5-year survival rate of the patients in Grade Ⅰ, Ⅱ and Ⅲ who underwent radical resection was 43.2%,51.2% and 64.4%, respectively (P<0.01).CONCLUSION The "Three-Grade Criteria" may be applied for judging the curability of resection therapy for PLC. The stricter the criterion used,the better the survival would be. Adopting high-grade criteria to select cases and guide operations and strengthening postoperative follow-up would improve the results of hepatectomy for PLC.

  20. Transformation of adult rat cardiac myocytes in primary culture.

    Science.gov (United States)

    Banyasz, Tamas; Lozinskiy, Ilya; Payne, Charles E; Edelmann, Stephanie; Norton, Byron; Chen, Biyi; Chen-Izu, Ye; Izu, Leighton T; Balke, C William

    2008-03-01

    We characterized the morphological, electrical and mechanical alterations of cardiomyocytes in long-term cell culture. Morphometric parameters, sarcomere length, T-tubule density, cell capacitance, L-type calcium current (I(Ca,L)), inward rectifier potassium current (I(K1)), cytosolic calcium transients, action potential and contractile parameters of adult rat ventricular myocytes were determined on each day of 5 days in culture. We also analysed the health of the myocytes using an apoptotic/necrotic viability assay. The data show that myocytes undergo profound morphological and functional changes during culture. We observed a progressive reduction in the cell area (from 2502 +/- 70 microm(2) on day 0 to 1432 +/- 50 microm(2) on day 5), T-tubule density, systolic shortening (from 0.11 +/- 0.02 to 0.05 +/- 0.01 microm) and amplitude of calcium transients (from 1.54 +/- 0.19 to 0.67 +/- 0.19) over 5 days of culture. The negative force-frequency relationship, characteristic of rat myocardium, was maintained during the first 2 days but diminished thereafter. Cell capacitance (from 156 +/- 8 to 105 +/- 11 pF) and membrane currents were also reduced (I(Ca,L), from 3.98 +/- 0.39 to 2.12 +/- 0.37 pA pF; and I(K1), from 34.34p +/- 2.31 to 18.00 +/- 5.97 pA pF(-1)). We observed progressive depolarization of the resting membrane potential during culture (from 77.3 +/- 2.5 to 34.2 +/- 5.9 mV) and, consequently, action potential morphology was profoundly altered as well. The results of the viability assays indicate that these alterations could not be attributed to either apoptosis or necrosis but are rather an adaptation to the culture conditions over time.

  1. Meta-analysis of studies using statins as a reducer for primary liver cancer risk

    Science.gov (United States)

    Zhong, Guo-Chao; Liu, Yan; Ye, Yuan-Yuan; Hao, Fa-Bao; Wang, Kang; Gong, Jian-Ping

    2016-01-01

    A protective effect of statins on primary liver cancer (PLC) risk has been suggested. However, issues about the dose–response relationship, the protective effect of individual statins, and PLC risk reduction among at-risk populations remain unsolved. Therefore, a meta-analysis was conducted. PubMed and EMBASE were searched for studies providing the risk ratio (RR) on statins and PLC risk. Summary RRs were calculated using a random-effects model. Twenty-five studies were identified. Stain use was significantly associated with a reduced risk of PLC (RR = 0.60, 95% confidence interval (CI) = 0.53–0.69). The summary RR for every additional 50 cumulative defined daily doses per year was 0.87 (95% CI = 0.83–0.91). Evidence of a non-linear dose–response relationship between statins and PLC risk was found (Pnon-linearity < 0.01). All individual statins significantly reduced PLC risk, and the risk reduction was more evident with rosuvastatin. The inverse association between statins and PLC risk remained among populations with common risk factors. Subgroup analyses revealed more significant reduction in PLC risk by statins in high- versus non-high-risk populations (Pinteraction = 0.02). Overall, these findings add to our understanding of the association between statins and PLC risk. Whether statin use is causally associated with a reduced risk of PLC should be further studied. PMID:27198922

  2. The effect of Jinlong capsule on the immune function for intervened patients with primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Chunsheng Zeng; Lianming Cai; Zuochao Huang; Qingyun Xu

    2014-01-01

    Objective:The aim of this study was to evaluate the ef ect of Jinlong capsule on the immune function for inter-vened patients with primary liver cancer. Methods:Matched the inclusion criteria, 60 patients were selected and randomly divided into two groups. The treatment group had 30 cases treated with Jinlong capsule combined with the transcatheter arterial chemoembolization (TACE);the control group had 30 cases treated with TACE. Each group was treated 30 days as a cycle, which had completed at least two cycles. Indicators of cellular immune function about the activity of CD3, CD4, CD8, CD4/CD8 and natural kil er (NK) cellwere detected before and after treatment, then to compare and analysis with each other. Results:Before treatment, the activity of peripheral blood CD3, CD4, CD8, CD4/CD8 and NK cellin the two groups was no significant dif erence (P>0.05);after treatment, the activity of CD3, CD4 and NK cellin the treatment group was significantly increased, the ratio of CD4/CD8 increased, and the value of CD8 decreased (P0.05), the dif erence between the two groups indicated the statistical significance (P0.05). Conclusion:Jinlong capsule with hepatic arterial infusion chemotherapy can improve the patients’ immune function, and reduce the adverse reactions of interventional chemotherapy. Hence,it deserves to be promoted in clinical y.

  3. The formation of propionate and acetate as terminal processes in the energy metabolism of the adult liver fluke Fasciola hepatica

    NARCIS (Netherlands)

    Vugt, F. van; Meer, P. van der; Bergh, S.G. van den

    1979-01-01

    1. 1. The formation of propionate from succinate occurs in the mitochondria of the adult common liver fluke essentially by a reversal of the pathway operating in mammalian mitochondria in the conversion of propionate into succinate. 2. 2. The conversion of succinate into its CoA ester is linked by

  4. Selection of medium for serum-free primary culture of adult rat hepatocytes.

    Directory of Open Access Journals (Sweden)

    Miyazaki,Masahiro

    1990-02-01

    Full Text Available To select a suitable medium for serum-free primary culture of adult rat hepatocytes, ten commercially-available synthetic media were compared for their ability to maintain the cells under serum-free and serum-supplemented conditions with special reference to attachment, survival and albumin secretion. It was found that Williams' medium E and DM-160 medium were the best among the ten media for maintaining hepatocytes under serum-free conditions in primary culture.

  5. Temporal discrimination threshold: VBM evidence for an endophenotype in adult onset primary torsion dystonia.

    LENUS (Irish Health Repository)

    Bradley, D

    2012-02-01

    Familial adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance. Most adult-onset primary torsion dystonia patients are sporadic cases. Disordered sensory processing is found in adult-onset primary torsion dystonia patients; if also present in their unaffected relatives this abnormality may indicate non-manifesting gene carriage. Temporal discrimination thresholds (TDTs) are abnormal in adult-onset primary torsion dystonia, but their utility as a possible endophenotype has not been examined. We examined 35 adult-onset primary torsion dystonia patients (17 familial, 18 sporadic), 42 unaffected first-degree relatives of both familial and sporadic adult-onset primary torsion dystonia patients, 32 unaffected second-degree relatives of familial adult-onset primary torsion dystonia (AOPTD) patients and 43 control subjects. TDT was measured using visual and tactile stimuli. In 33 unaffected relatives, voxel-based morphometry was used to compare putaminal volumes between relatives with abnormal and normal TDTs. The mean TDT in 26 control subjects under 50 years of age was 22.85 ms (SD 8.00; 95% CI: 19.62-26.09 ms). The mean TDT in 17 control subjects over 50 years was 30.87 ms (SD 5.48; 95% CI: 28.05-33.69 ms). The upper limit of normal, defined as control mean + 2.5 SD, was 42.86 ms in the under 50 years group and 44.58 ms in the over 50 years group. Thirty out of thirty-five (86%) AOPTD patients had abnormal TDTs with similar frequencies of abnormalities in sporadic and familial patients. Twenty-two out of forty-two (52%) unaffected first-degree relatives had abnormal TDTs with similar frequencies in relatives of sporadic and familial AOPTD patients. Abnormal TDTs were found in 16\\/32 (50%) of second-degree relatives. Voxel-based morphometry analysis comparing 13 unaffected relatives with abnormal TDTs and 20 with normal TDTs demonstrated a bilateral increase in putaminal grey matter in unaffected relatives with abnormal

  6. Surgical treatment of double primary liver cancer: An observational study for a rare type of tumor.

    Science.gov (United States)

    Li, Aijun; Ma, Senlin; Pawlik, Timothy; Wu, Bin; Yang, Xiaoyu; Cui, Longjiu; Wu, Mengchao

    2016-08-01

    Double primary liver cancer (DPLC) is a special type of clinical situation. As such, a detailed analysis of the surgical management and prognosis of patients with DPLC is lacking. The objective of the current study was to define the management and outcome of patients undergoing surgery for DPLC at a major hepatobiliary center.A total of 87 patients treated by surgical resection at the Eastern Hepatobiliary Surgery Hospital from January 1st, 2007 to October 31st, 2013 who had DPLC demonstrated by final pathological diagnosis were identified. Among these, 50 patients had complete clinical and prognostic data. Demographic and tumor characteristics as well as the prognosis were analyzed.The proportion of hepatitis B surface antigen (HBsAg) (+) and hepatitis B virus e antigen (HBeAg) (+), HBsAg (+), and HBeAg (-) hepatocirrhosis in all patients was 21.84%, 67.82%, and 63.22%, respectively. Incidental findings accounted for 58.62% of patients; among those who had symptoms, the main symptom was abdominal pain (31.03%). Nonanatomic wedge resection was the main operative approach (62.07%). Postoperatively, the main complications included seroperitoneum (11.49%), hypoproteinemia (10.34%), and pleural effusion (8.05%). Factors associated with disease-free survival (DFS) included intrahepatic cholangiocarcinoma (ICC) tumor size (P = 0.002) and use of postoperative prophylactic transcatheter arterial chemoembolization (TACE) treatment (P = 0.015). Meanwhile, hepatocellular carcinoma (HCC) size (P = 0.045), ICC size (P < 0.001), and liver function (including aspartate aminotransferase [P = 0.001] and r-glutamyl transferase [P < 0.001]) were associated with overall survival (OS).Hepatitis B virus (HBV)-related hepatitis or cirrhosis is also an important factor in the pathogenesis of DPLC and surgical treatment is safe for it with low complication rates. In addition, it is effective to prolong DFS that DPLC patients undergo postoperative prophylactic TACE

  7. Preconditioning of the liver for efficient repopulation by primary hepatocyte transplants.

    Science.gov (United States)

    Krause, Petra; Rave-Frank, Margret; Christiansen, Hans; Koenig, Sarah

    2014-01-01

    The therapeutic potential of liver cell transplantation has been demonstrated in multiple clinical studies to correct hereditary metabolic or chronic liver diseases. However, there are several outstanding issues, which need to be investigated: most notably donor cell engraftment and the subsequent selective expansion of transplanted cells. This protocol describes the preconditioning of the liver in a dipeptidyl peptidase-IV (DPPIV(-))-deficient rat model of efficient repopulation utilizing a selective external beam irradiation technique combined with regional transient portal ischemia (RTPI). Irradiation of the host liver impairs endogenous cell division, and the subsequent RTPI constitutes a strongly proliferative stimulus. Transplanted cells benefit from this stimulus, whereas endogenous cells have no ability to respond, due to a reduction in the mitotic capacity of the host liver. As described here, an effective preparative regime for liver repopulation is external beam liver irradiation in the form of a single dose of 25 Gy applied to the whole organ followed (4 days later) by RTPI of the right liver lobes lasting 90 min. After 1 h of reperfusion, the donor hepatocytes may be transplanted directly into the spleen as implantation site for further redistribution into the portal system and liver. This preparative regime certainly has the potential to be implemented in the clinic, since neither toxins nor highly potent carcinogens are used.

  8. Campylobacter fetus bacteremia with purulent pleurisy in a young adult with primary hypogammaglobulinemia.

    Science.gov (United States)

    Yamagami, Keiko; Miyashita, Tomoko; Nakamura, Tomoyuki; Shirano, Michinori; Nakamura, Tadahiro; Kameda, Kazuaki; Nishijima, Masayoshi; Imanishi, Masahiro; Yang, Xi; Kanegane, Hirokazu

    2014-01-01

    A 24-year-old man presented with fever and pleural effusion predominantly containing lymphocytes. Cultures of the pleural effusion and blood revealed Campylobacter fetus, and laboratory studies showed a low serum level of immunoglobulin. The patient was diagnosed with C. fetus pleuritis, bacteremia and primary hypogammaglobulinemia, and subsequent treatment with meropenem and immunoglobulin improved his condition. Although the underlying cause of the primary hypogammaglobulinemia remains unclear, the patient's status improved under immunoglobulin replacement therapy. C. fetus pleuritis is a rare infectious disease usually observed in immunocompromised hosts. We herein describe the first report of C. fetus pleuritis in a young adult with primary hypogammaglobulinemia.

  9. A Meta-Analysis of Adult-Rated Child Personality and Academic Performance in Primary Education

    Science.gov (United States)

    Poropat, Arthur E.

    2014-01-01

    Background: Personality is reliably associated with academic performance, but personality measurement in primary education can be problematic. Young children find it difficult to accurately self-rate personality, and dominant models of adult personality may be inappropriate for children. Aims: This meta-analysis was conducted to determine the…

  10. Physician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD)

    Science.gov (United States)

    Warfield, Marji Erickson; Crossman, Morgan K.; Delahaye, Jennifer; Der Weerd, Emma; Kuhlthau, Karen A.

    2015-01-01

    We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this…

  11. Reduced corticosteroid use in adult patients with primary immune thrombocytopenia receiving romiplostim

    NARCIS (Netherlands)

    M. Michel (Marc); P.A.W. te Boekhorst (Peter); A. Janssens (Andre); I. Pabinger-Fasching (Ingrid); M.A. Sanz (Miguel Angel); K. Nie (Kun); G. Kreuzbauer (Georg)

    2011-01-01

    textabstractAdult patients with primary immune thrombocytopenia requiring first-line treatment typically receive corticosteroids, which are associated with low response rates and many potential side effects. In a retrospective analysis of two 6-month, placebo-controlled, phase III trials, corticoste

  12. Primary Osteoblastic Osteosarcoma of the Rib in an Adult: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Ah; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ryoo, In Seon [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Hyo Ah; Chung, Jin Haeng [Dept. of Patholgy, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Oh, Joo Han [Dept. of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-12-15

    We report the CT and magnetic resonance (MR) imaging appearances in an adult case of primary osteoblastic osteosarcoma of the rib. Osteosarcoma of the rib presents a diagnostic challenge because of the rarity of the lesion, especially with plain radiographs. The tumor should be suspected if CT and MR images demonstrate mineralization, suggestive of an osteoid matrix.

  13. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study.

    NARCIS (Netherlands)

    Dros, J.; Maarsingh, O.R.; Beem, L.; Horst, H.E. van der; Riet, G. ter; Schellevis, F.G.; Weert, H.C.P.M. van

    2012-01-01

    Objectives: To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design: Prospective cohort study with 6-month follow-up. Setting: Twenty-fou

  14. 黄曲霉毒素与肝癌关系%Relationship between aflatoxin and primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    陆东东

    2001-01-01

    本文综述黄曲霉毒素与肝癌的关系,黄曲霉毒素暴露与p53基因突变一致,AFB1解毒酶变异、AFB1加成物、p53基因突变与肝癌发生有关。%This paper summarizes the relationship between aflatoxin and primary liver cancer. The results show that the exposure to aflatoxin is consistent with p53 gene mutation. The variation of AFB1 detoxicate enzyme,AFB1 adduct and p53 gene mutation are conelated with occurrence of primary liver cancer.

  15. The value of postoperative hepatic regional chemotherapy in prevention of recurrence after radical resection of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Zhi Quan Wu; Jia Fan; Shuang Jian Qiu; Jian Zhou; Zhao You Tang

    2000-01-01

    @@ INTRODUCTION In China, primary liver cancer (PLC) ranks second in cancer mortality since the 1990s. In the field of PLC treatment, surgical resection remains the best,which includes large PLC resection, small PLC resection, re-resection of subclinical recurrence, as well as cytoreduction and sequential resection for unresectable PLC. However, recurrence and metastasis have become the major obstacles for further prolonging survival after resection.

  16. Distribution of liver metastases based on the site of primary pancreatic carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ambrosetti, Maria Chiara; Zamboni, Giulia A.; Mucelli, Roberto Pozzi [Azienda Ospedaliera Universitaria Integrata di Verona, Istituto di Radiologia, Policlinico GB Rossi, Verona (Italy)

    2016-02-15

    To investigate whether the different location of pancreatic adenocarcinoma affects the lobar distribution of metastases to the liver. From all patients who underwent multidetector computed tomography (MDCT) examinations for staging of pancreatic adenocarcinoma in the last 4 years we selected 80 patients (42 men, 38 women; mean age, 60.56 years) with liver metastases and a pancreatic adenocarcinoma of the head (group A, 40 patients; diameter, 32.41 ± 2.28 mm) or body-tail (group B, 40 patients; diameter, 52.21 ± 2.8 mm). We analysed tumour site, diameter, vascular invasion and number of metastases in each lobe of the liver. The total number of metastases was compared between the two groups with an unpaired t-test, while Fisher's test was used to compare the number of metastases within the two lobes. As expected, the number of liver metastases was higher in group B than in group A. The ratio of metastases in the right-to-left hemi-liver was 7.4:1 for group A compared with 3.3:1 for group B (p < 0.0001). Although the number of liver metastases is higher in the right lobe than in the left lobe in both groups, there is a significant difference in the ratio of metastases between the right and the left hemi-liver. This supports the existence of a streamline phenomenon and a selective lobar distribution of metastases within the liver. (orig.)

  17. Cutaneous Metastases from Primary Hepatobiliary Tumors as the First Sign of Tumor Recurrence following Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Adam T. Hauch

    2014-01-01

    Full Text Available Cutaneous metastasis from hepatobiliary tumors is a rare event, especially following liver transplantation. We report our experience with two cases of cutaneous metastases from both hepatocellular carcinoma and mixed hepatocellular/cholangiocarcinoma following liver transplantation, along with a review of the literature.

  18. Aroclor 1254 increases the genotoxicity of several carcinogens to liver primary cell cultures

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza-Figueroa, T.; Lopez-Revilla, R.; Villa-Trevino, S.

    1985-01-01

    The genotoxicity of both direct-acting and precarcinogenic chemicals was evaluated in liver primary cell cultures (LPCC) from untreated and Aroclor 1254 (Ar) pretreated rats. Hepatocytes were isolated from partially hepatectomized rats and their DNA was labeled in vitro with (/sup 3/H) dThd; the molecular weight of single-stranded DNA was determined by alkaline sucrose sedimentation. Two parameters of DNA damage were defined: 1) the mean effective dose (ED50), i.e., the carcinogen concentration that decreased the DNA molecular weight to half the original, and 2) the DNA breaking potency (DBP), i.e., the number of breaks per DNA molecule produced by 2 h exposure to 1mM concentration of the chemical. Two hours exposure of LPCC from untreated rats to the direct-acting alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) (6.8-340..mu..M) and to the precarcinogens benzo(a)pyrene (BaP) (0.05-0.33 mM) and dimethylnitrosamine (DMN) (0.45-16 mM) produced a concentration-dependent decrease in the molecular weight of DNA. Pretreatment of rats with Ar decreased significantly the sedimentation velocity of DNA and increased five, three, and two times the DBP of MNNG, BaP, and DMN, respectively. These results show that Ar-pretreatment of rats increases the genotoxicity of both direct-acting and precarcinogenic chemicals and suggest that Ar might increase the genotoxicity of chemical carcinogens perhaps by enhancing their metabolic activation, by producing direct genotoxic effects, or both. Our results also emphasize the carcinogenic risk that the environmental pollution by polychlorinated biphenyls might represent to humans.

  19. Aroclor 1254 increases the genotoxicity of several carcinogens to liver primary cell cultures.

    Science.gov (United States)

    Mendoza-Figueroa, T; López-Revilla, R; Villa-Treviño, S

    1985-01-01

    The genotoxicity of both direct-acting and precarcinogenic chemicals was evaluated in liver primary cell cultures (LPCC) from untreated and Aroclor 1254 (Ar) pretreated rats. Hepatocytes were isolated from partially hepatectomized rats and their DNA was labeled in vitro with [3H] dThd; the molecular weight of single-stranded DNA was determined by alkaline sucrose sedimentation. Two parameters of DNA damage were defined: the mean effective dose (ED50), i.e., the carcinogen concentration that decreased the DNA molecular weight to half the original, and the DNA breaking potency (DBP), i.e., the number of breaks per DNA molecule produced by 2 h exposure to 1 mM concentration of the chemical. Two hours exposure of LPCC from untreated rats to the direct-acting alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) (6.8-340 microM) and to the precarcinogens benzo[a]pyrene (BaP) (0.05-0.33 mM) and dimethylnitrosamine (DMN) (0.45-16 mM) produced a concentration-dependent decrease in the molecular weight of DNA. Pretreatment of rats with Ar decreased significantly the sedimentation velocity of DNA and increased five, three, and two times the DBP of MNNG, BaP, and DMN, respectively. These results show that Ar-pretreatment of rats increases the genotoxicity of both direct-acting and precarcinogenic chemicals and suggest that Ar might increase the genotoxicity of chemical carcinogens perhaps by enhancing their metabolic activation, by producing direct genotoxic effects, or both. Our results also emphasize the carcinogenic risk that the environmental pollution by polychlorinated biphenyls might represent to humans.

  20. Dimethylnitrosamine genotoxicity in rat liver primary cell cultures with low cytochrome P-450 levels.

    Science.gov (United States)

    Mendoza-Figueroa, T

    1984-12-01

    Liver primary cell cultures (LPCC) with decreasing concentrations of cytochrome P-450 were used to investigate the genotoxicity of the hepatic carcinogen dimethylnitrosamine (DMN) and the correlation between DMN genotoxicity and cytochrome P-450 levels. Hepatocytes were isolated from partially hepatectomized rats and incubated with [3H]thymidine; single-strand DNA molecular weight was determined by alkaline sucrose sedimentation. The molecular weight of DNA decreased 50% in LPCC plated either 2 or 24 h before being treated for 24 h with 70 micron DMN. Cytochrome P-450 content was 188 pmol per mg protein in freshly isolated hepatocytes, whereas it was 70 and 32 pmol per mg protein in hepatocytes that had been cultured 24 and 48 h, respectively. Incorporation of 14C into acid-insoluble material was the same in LPCC exposed 24 h to [14C]DMN starting either 2 or 24 h after cell plating. At non-toxic concentrations (0.01-1 microM), SKF 525-A, an inhibitor of mixed-function oxidase enzymes, inhibited approximately 20% of the binding of 14C from [14C]DMN to acid-insoluble material in LPCC plated either 2 or 24 h before they were exposed to DMN for 24 h. Hepatocyte cultures exposed to the direct-acting alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (at concentrations ranging between 6.8 X 10(-8) and 6.8 X 10(-5) M) starting 2 and 24 h after plating, exhibited significant unscheduled DNA synthesis. These results indicate that DMN genotoxicity was similar in LPCC differing considerably in cytochrome P-450 levels, and they suggest that DMN genotoxicity in these cultures is due mainly to similar DMN activation than to decreased DNA repair.

  1. Dimethylnitrosamine genotoxicity in rat liver primary cell cultures with low cytochrome P-450 levels

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza-Figueroa, T.

    1984-12-01

    Liver primary cell cultures (LPCC) with decreasing concentrations of cytochrome P-450 were used to investigate the genotoxicity of the hepatic carcinogen dimethylnitrosamine (DMN) and the correlation between DMN genotoxicity and cytochrome P-450 levels. Hepatocytes were isolated from partially hepatectomized rats and incubated with (/sup 3/H)thymidine; single-strand DNA molecular weight was determined by alkaline sucrose sedimentation. The molecular weight of DNA decreased 50% in LPCC plated either 2 or 24 h before being treated for 24 h with 70 micron DMN. Cytochrome P-450 content was 188 pmol per mg protein in freshly isolated hepatocytes, whereas it was 70 and 32 pmol per mg protein in hepatocytes that had been cultured 24 and 48 h, respectively. Incorporation of /sup 14/C into acid-insoluble material was the same in LPCC exposed 24 h to (/sup 14/C)DMN starting either 2 or 24 h after cell plating. At non-toxic concentrations (0.01-1 microM), SKF 525-A, an inhibitor of mixed-function oxidase enzymes, inhibited approximately 20% of the binding of /sup 14/C from (/sup 14/C)DMN to acid-insoluble material in LPCC plated either 2 or 24 h before they were exposed to DMN for 24 h. Hepatocyte cultures exposed to the direct-acting alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (at concentrations ranging between 6.8 X 10(-8) and 6.8 X 10(-5) M) starting 2 and 24 h after plating, exhibited significant unscheduled DNA synthesis.

  2. Based on surface-enhanced Raman spectroscopy analysis of serum albumin in different stages of liver disease for early screening primary liver cancer

    Science.gov (United States)

    Liao, Fadian; Ruan, Qiuyong; Lin, Juqiang; Lin, Jinyong; Zeng, Yongyi; Li, Ling; Huang, Zufang; Liu, Nenrong; Chen, Rong

    2014-09-01

    Despite the introduction of high-technology methods of detection and diagnosis, screening of primary liver cancer (PLC) remains imperfect. To diagnosis PLC earlier, Surface-enhanced Raman spectroscopy (SERS) coupled with cellulose-acetate membrane electrophoresis were introduced to separate human serum albumin and SERS spectra. Three groups (15 normal persons' samples, 17 hepatitis/cirrhosis samples, 15 cases of PLC) of serum albumin were tested. Silver colloid was used to obtain SERS spectra of human serum albumin. Principal component analysis (PCA) and linear discriminant analysis (LDA) were also employed for statistical analysis. The mean Raman spectra of three groups and the difference spectra of any two suggested that the albumin has changed in liver patients. Compared to normal groups, some Raman peaks have shifted or even disappeared in hepatitis/cirrhosis and PLCs groups. The sensitivity and specificity between PLCs and normal groups is 80% and 93.3%. Among hepatitis/cirrhosis and normal groups, the sensitivity is 88.2% and specificity is also 93.3%. Besides, the sensitivity and specificity between PLCs and hepatitis/cirrhosis groups is 86.7% and 76.5%. All the above data and results indicated that early screening of PLC is potential by SERS in different stages of liver disease before cancer occurs.

  3. Investigation of liver tissue and biochemical parameters of adult wistar rats treated with Arctium lappa L.

    Directory of Open Access Journals (Sweden)

    Fabrícia Souza Predes

    2009-04-01

    Full Text Available This study was carried out to evaluate the effects of Arctium lappa L. (burdock on the liver of adult male Wistar rats as measured by light microscopy and biochemical parameters. The rats received the extract in water bottles at doses of 10 or 20 g/L daily for 40 days. There were no significant changes in the plasma levels of albumin, aspartate transaminase (AST, alanine transaminase (ALT, gamma glutamyl transferase (GGT, total protein, total cholesterol, urea, uric acid, triacylglycerol, calcium, phosphorus, chlorine and direct bilirubin. The morphological analysis did not reveal histopathological alterations in liver tissue. Both biochemical and morphological data did not indicate A. lappa toxicity.A bardana (Arctium lappa L é uma planta trazida do Japão e aclimatada no Brasil, e é extensamente utilizada na medicina popular em todo mundo. Este estudo foi realizado para avaliar os possíveis efeitos da A. lappa no fígado e nos parâmetros bioquímicos plasmáticos em ratos Wistar adultos. Estes receberam a infusão de bardana nas doses de 10 ou 20 g de folhas secas /L de água, por 40 dias. Não houve alteração significativa nos níveis plasmáticos de albumina, aspartato transaminase (AST, alanina transaminase (ALT, gamma glutamil transferase (GGT, proteínas totais, colesterol total, uréia, ácido úrico, triglicérides, cálcio, fósforo, bilirrubina direta e cloro. A análise morfológica não revelou alterações histopatológicas no fígado. Os dados bioquímicos e morfológicos não indicaram a toxicidade da bardana.

  4. Neonatal androgenization exacerbates alcohol-induced liver injury in adult rats, an effect abrogated by estrogen.

    Directory of Open Access Journals (Sweden)

    Whitney M Ellefson

    Full Text Available Alcoholic liver disease (ALD affects millions of people worldwide and is a major cause of morbidity and mortality. However, fewer than 10% of heavy drinkers progress to later stages of injury, suggesting other factors in ALD development, including environmental exposures and genetics. Females display greater susceptibility to the early damaging effects of ethanol. Estrogen (E2 and ethanol metabolizing enzymes (cytochrome P450, CYP450 are implicated in sex differences of ALD. Sex steroid hormones are developmentally regulated by the hypothalamic-pituitary-gonadal (HPG axis, which controls sex-specific cycling of gonadal steroid production and expression of hepatic enzymes. The aim of this study was to determine if early postnatal inhibition of adult cyclic E2 alters ethanol metabolizing enzyme expression contributing to the development of ALD in adulthood. An androgenized rat model was used to inhibit cyclic E2 production. Control females (Ctrl, androgenized females (Andro and Andro females with E2 implants were administered either an ethanol or isocalorically-matched control Lieber-DeCarli diet for four weeks and liver injury and CYP450 expression assessed. Androgenization exacerbated the deleterious effects of ethanol demonstrated by increased steatosis, lipid peroxidation, profibrotic gene expression and decreased antioxidant defenses compared to Ctrl. Additionally, CYP2E1 expression was down-regulated in Andro animals on both diets. No change was observed in CYP1A2 protein expression. Further, continuous exogenous administration of E2 to Andro in adulthood attenuated these effects, suggesting that E2 has protective effects in the androgenized animal. Therefore, early postnatal inhibition of cyclic E2 modulates development and progression of ALD in adulthood.

  5. Liver, bone marrow, pancreas and pituitary gland iron overload in young and adult thalassemic patients: a T2 relaxometry study

    Energy Technology Data Exchange (ETDEWEB)

    Argyropoulou, Maria I.; Astrakas, Loukas; Metafratzi, Zafiria; Efremidis, Stavros C. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Kiortsis, Dimitrios N. [University of Ioannina, Laboratory of Physiology, Medical School, Ioannina (Greece); Chalissos, Nikolaos [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); University of Ioannina, Laboratory of Physiology, Medical School, Ioannina (Greece)

    2007-12-15

    Thirty-seven patients with {beta}-thalassemia major, including 14 adolescents (15.2 {+-} 3.0 years) and 23 adults (26.4 {+-} 6.9 years), were studied. T2 relaxation time (T2) of the liver, bone marrow, pancreas and pituitary gland was measured in a 1.5-Tesla magnetic resonance (MR) imager, using a multiecho spin-echo sequence (TR/TE 2,000/20, 40, 60, 80, 100, 120, 140, 160 ms). Pituitary gland height was evaluated in a midline sagittal scan of a spin-echo sequence (TR/TE, 500/20 ms). The T2 of the pituitary gland was higher in adolescents (59.4 {+-} 15 ms) than in adults (45.3 {+-} 10.4 ms), P < 0.05. The T2 of the pancreas was lower in adolescents (43.6 {+-} 10.3 ms) than in adults (54.4 {+-} 10.4 ms). No difference among groups was found in the T2 of the liver and bone marrow. There was no significant correlation of the T2 among the liver, pancreas, pituitary gland and bone marrow. There was no significant correlation between serum ferritin and T2 of the liver, pancreas and bone marrow. Pituitary T2 showed a significant correlation with pituitary gland height (adolescents: R = 0.63, adults: R = 0.62, P < 0.05) and serum ferritin (adolescents: R = -0.60, adults: R = -0.50, P < 0.05). In conclusion, iron overload evaluated by T2 is organ specific. After adolescence, age-related T2 changes are predominantly associated with pituitary siderosis and fatty degeneration of the pancreas. Pituitary size decreases with progressing siderosis. (orig.)

  6. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI

    Institute of Scientific and Technical Information of China (English)

    Christoph F Dietrich; Wolfgang Blank; Matthijs Oudkerk; Dietbert Hahn; Christian Greis; Wolfgang Kratzer; Deike Strobel; Etienne Danse; Robert Fessl; Alfred Bunk; Udo Vossas; Karlheinz Hauenstein; Wilhelm Koch

    2006-01-01

    AIM: To evaluate contrast-enhanced ultrasonography (CEUS) using SonoVue(R) in the detection of liver metastases in patients with known extrahepatic primary tumors versus the combined gold standard comprising CT,MRI and clinical/histological data.METHODS: It is an international multicenter study, and there were 12 centres and 125 patients (64 males, 61 females, aged 59 ± 11 years) involved, with 102 patients per protocol. Primary tumors were colorectal in 35%,breast in 27%, pancreatic in 17% and others in 21%.CEUS using SonoVue(R) was employed with a low-mechanical-index technique and contrast-specific software using Siemens Elegra, Philips HDI 5000 and Acuson Sequoia;continuous scanning for at least five minutes.RESULTS: CEUS with SonoVue(R) increased significantly the number of focal liver lesions detected versus unenhanced sonography. In 31.4% of the patients, more lesions were found after contrast enhancement. The total numbers of lesions detected were comparable with CEUS (55), triple-phase spiral CT (61) and MRI with a liverspecific contrast agent (53). Accuracy of detection of metastatic disease (i.e. at least one metastatic lesion) was significantly higher for CEUS (91.2%) than for unenhanced sonography (81.4%) and was similar to that of triple-phase spiral CT (89.2%). In 53 patients whose CEUS examination was negative, a follow-up examination 3-6 months later confirmed the absence of metastatic lesions in 50 patients (94.4 %).CONCLUSION: CEUS is proved to be reliable in the detection of liver metastases in patients with known extrahepatic primary tumors and suspected liver lesions.

  7. Urolithiasis in an Adult with Primary Obstructive Megaureter: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammed S. Al-Marhoon

    2013-09-01

    Full Text Available This is a rare case of adult primary obstructive megaureter complicated by combined uric acid-oxalate lithiasis of the ureter and renal stones. A 24-year-old male patient presented with frank hematuria on exercise of 4 years duration. The patient had an open surgery in the form of excision of stenotic segment of ureter and left ureteric re-implantation with removal of ureteric and renal stones. Congenital megaureter is a diagnosis that urologists and radiologists need to consider in the setting of isolated distal ureteral dilation, as the diagnosis of adult megaureter may require more involved surgical measures to prevent recurrence of adverse symptoms.

  8. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or ...

  9. Low Bone Mineral Density in Chinese Adults with Nonalcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Ran Cui

    2013-01-01

    Full Text Available Aim. To investigate bone metabolic characteristics in Chinese adults with nonalcoholic fatty liver disease (NAFLD. Methods. A total of 224 patients (99 males and 125 postmenopausal females were recruited and divided into 4 groups: males without NAFLD, males with NAFLD, females without NAFLD, and females with NAFLD. Bone mineral density (BMD was evaluated according to body mass index (BMI, waist circumference (WC, and serum biomarkers. β cell function was evaluated by HOMA2%B, HOMA2%S, and HOMA2IR. Results. Males in the NAFLD group had lower BMD of the right hip and the femoral neck (0.852±0.117 versus 0.930±0.123, P=0.002; 0.736±0.119 versus 0.812±0.132, P=0.004, and females had lower BMD of the right hip (0.725±0.141 versus 0.805±0.145, P=0.002 even after adjusted for weight, BMI, waist, HDL, and ALT. There was no significant difference in bone metabolic markers between patients with and without NAFLD. NAFLD was an important factor that affected the bone; moreover, the effect attenuated when HOMA2IR entered into the model (R2=0.160, β=−0.172, and P=0.008. Conclusions. NAFLD exerts a detrimental effect on BMD in both males and females. Insulin resistance may play an important role in this pathophysiological process.

  10. Mapping a gene for adult-onset primary open-angle glaucoma to chromosome 3q

    Energy Technology Data Exchange (ETDEWEB)

    Wirtz, M.K.; Samples, J.R.; Kramer, P.L. [Oregon Health Sciences Univ., Portland, OR (United States)] [and others

    1997-02-01

    Glaucoma is the third-leading cause of blindness in the world, affecting >13.5 million people. Adult-on-set primary open-angle glaucoma (POAG) is the most common form of glaucoma in the United States. We present a family in which adult-onset POAG is inherited as an autosomal dominant trait. Twelve affected family members were identified from 44 at-risk individuals. The disease-causing gene was mapped to chromosome 3q21-24, with analysis of recombinant haplotypes suggesting a total inclusion region of 11.1 cM between markers D3S3637 and D3S1744. This is the first report of mapping of an adult-onset POAG gene to chromosome 3q, gene symbol GLC1C. 57 refs., 3 figs., 3 tabs.

  11. Strong association between non alcoholic fatty liver disease (NAFLD and low 25(OH vitamin D levels in an adult population with normal serum liver enzymes

    Directory of Open Access Journals (Sweden)

    Pozzilli Paolo

    2011-07-01

    Full Text Available Abstract Background Hypovitaminosis D has been recently recognized as a worldwide epidemic. Since vitamin D exerts significant metabolic activities, comprising free fatty acids (FFA flux regulation from the periphery to the liver, its deficiency may promote fat deposition into the hepatocytes. Aim of our study was to test the hypothesis of a direct association between hypovitaminosis D and the presence of NAFLD in subjects with various degree of insulin-resistance and related metabolic disorders. Methods We studied 262 consecutive subjects referred to the Diabetes and Metabolic Diseases clinics for metabolic evaluation. NAFLD (non-alcoholic fatty liver disease was diagnosed by upper abdomen ultrasonography, metabolic syndrome was identified according to the Third Report of National Cholesterol Education Program/Adult Treatment Panel (NCEP/ATPIII modified criteria. Insulin-resistance was evaluated by means of HOMA-IR. Fatty-Liver-Index, a recently identified correlate of NAFLD, was also estimated. Serum 25(OHvitamin D was measured by colorimetric method. Results Patients with NAFLD (n = 162,61.8% had reduced serum 25(OH vitamin D levels compared to subjects without NAFLD (14.8 ± 9.2 vs 20.5 ± 9.7 ng/ml, p Conclusions Low 25(OHvitamin D levels are associated with the presence of NAFLD independently from metabolic syndrome, diabetes and insulin-resistance profile.

  12. Validation of the Primary Care Assessment Tool: PCATool-Brazil for adults

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    Erno Harzheim

    2013-10-01

    Full Text Available Objective: to translate and adapt the PCATool version for adult users to the Brazilian context and assess its validity and reliability. Methods: We conducted a cross-sectional study of 2404 adult users living in areas covered from public services Primary Care in Porto Alegre, and users of a self- management plan. We performed translation, reverse translation and adaptation of the instrument as well as its assessment in respect of content validity, factorial validity and reliability. Results: In the factor analysis were considered 12 factors that explained 50.83% of the total variation. In this way were recognized the attributes of Primary Care: access - accessibility and utilization; longitudinality; coordination - coordination of care and systems of information; comprehensiveness - services available and services provided; family orientation; and community orientation. In terms of internal consistency the values of Cronbach’s alpha ranged from 0.15 to 0.90. The stability over time was not observed for coordination of care (p<0.05, coordination information of system (p<0.05 and comprehensiveness of services provided (p<0.05. The scaling success rate was close to 100% for all attributes, except to coordination of information system. Conclusions: the results indicated that the PCATool-Brazil has adequate validity and reliability, and it can act as a national instrument for the assessment of Primary Care from the perspective of adult users.

  13. Donor safety in adult living donor liver transplantation using the right lobe:Single center experience in China

    Institute of Scientific and Technical Information of China (English)

    Fu-Gui Li; Lu-Nan Yan; Yong Zeng; Jia-Yin Yang; Qi-Yuan Lin; Xiao-Zhong Jiang; Bin Liu

    2007-01-01

    AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China.METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2±7.4years. Residual liver volume was 42.1%±4.7%. Mean operative time was 420±76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4±8.6 d; and mean follow-up period, 6 mo.RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2,and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required reoperation. Return to pre-donation activity occurred within 5-8 wk.CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

  14. 成人标准肝体积预测公式的初步构建%Establishment of formula predicting adult standard liver volume for liver transplantation

    Institute of Scientific and Technical Information of China (English)

    王小飞; 严律南; 李波; 蓝翔; 袁丁; 张鸣; 魏永刚; 曾勇; 文天夫; 赵纪春

    2008-01-01

    目的 建立一个预测中国成人标准肝体积的公式.方法 收集2005年3月至2007年12月90例活体肝移植供者的临床资料,包括供者的性别(G)、年龄(Y)、身高(BH)、体重(BW)和术前CT扫描测量的全肝体积(TLV).分析TLV与上述其他指标的相关性,通过多重逐步线性回归得出预测标准肝体积的回归方程.并比较该公式和文献报道的公式预测的标准肝体积(ESLV)之间是否有差异.结果 90例供者的平均体重为(62.4±8.7)kg,平均TLV为(1319.1±167.0)ml,二者成正相关(r=0.655,P<0.01),可用公式TLV(ml)=12.5×BW(kg)+536.4来表示.与已发表文章中的公式相比,ESLV与TLV的差异均有统计学意义(P<0.05).结论 该研究建立了一个简单的更准确的预测中国成人标准肝体积的公式.%Objective To establish a favorable formula of estimation adult standard liver volume (SLV) based on the data of living donors for liver transplantation. Methods From March 2005 to December 2007,90 Adult-to-Adult living donor liver transplantation were performed. The donors' anthropemetric data of gender,year, body weight and body height was collected prospectively. The total liver volume (TLV) of 90 living donors was measured by computed tomography. The correlation between TLV and several factors including body weight index (BMI) and body surface area (BSA) were analyzed. Then multiple stepwise linear regression analysis was performed and a new equation predicting SLV to improve approximate TLV was determined. TLV was then compared with the estimation standard liver volume (ESLV) calculated using our formula and published formulas in literature previously. Results All the subjects had a mean body weight of (62.4±8.7) kg. The mean total liver volume was (1319.1±167.0) ml. There were positively correlated between TLV and body weight (BW), which could be expressed in the equation: TLV(ml)=12.5×BW (kg)+536.4(r2=0.43, P<0. 01). Compared TLV with ELSV, which were calculated using

  15. Bioprinted 3D Primary Liver Tissues Allow Assessment of Organ-Level Response to Clinical Drug Induced Toxicity In Vitro

    Science.gov (United States)

    Funk, Juergen; Robbins, Justin B.; Crogan-Grundy, Candace; Presnell, Sharon C.; Singer, Thomas; Roth, Adrian B.

    2016-01-01

    Modeling clinically relevant tissue responses using cell models poses a significant challenge for drug development, in particular for drug induced liver injury (DILI). This is mainly because existing liver models lack longevity and tissue-level complexity which limits their utility in predictive toxicology. In this study, we established and characterized novel bioprinted human liver tissue mimetics comprised of patient-derived hepatocytes and non-parenchymal cells in a defined architecture. Scaffold-free assembly of different cell types in an in vivo-relevant architecture allowed for histologic analysis that revealed distinct intercellular hepatocyte junctions, CD31+ endothelial networks, and desmin positive, smooth muscle actin negative quiescent stellates. Unlike what was seen in 2D hepatocyte cultures, the tissues maintained levels of ATP, Albumin as well as expression and drug-induced enzyme activity of Cytochrome P450s over 4 weeks in culture. To assess the ability of the 3D liver cultures to model tissue-level DILI, dose responses of Trovafloxacin, a drug whose hepatotoxic potential could not be assessed by standard pre-clinical models, were compared to the structurally related non-toxic drug Levofloxacin. Trovafloxacin induced significant, dose-dependent toxicity at clinically relevant doses (≤ 4uM). Interestingly, Trovafloxacin toxicity was observed without lipopolysaccharide stimulation and in the absence of resident macrophages in contrast to earlier reports. Together, these results demonstrate that 3D bioprinted liver tissues can both effectively model DILI and distinguish between highly related compounds with differential profile. Thus, the combination of patient-derived primary cells with bioprinting technology here for the first time demonstrates superior performance in terms of mimicking human drug response in a known target organ at the tissue level. PMID:27387377

  16. Bioprinted 3D Primary Liver Tissues Allow Assessment of Organ-Level Response to Clinical Drug Induced Toxicity In Vitro.

    Directory of Open Access Journals (Sweden)

    Deborah G Nguyen

    Full Text Available Modeling clinically relevant tissue responses using cell models poses a significant challenge for drug development, in particular for drug induced liver injury (DILI. This is mainly because existing liver models lack longevity and tissue-level complexity which limits their utility in predictive toxicology. In this study, we established and characterized novel bioprinted human liver tissue mimetics comprised of patient-derived hepatocytes and non-parenchymal cells in a defined architecture. Scaffold-free assembly of different cell types in an in vivo-relevant architecture allowed for histologic analysis that revealed distinct intercellular hepatocyte junctions, CD31+ endothelial networks, and desmin positive, smooth muscle actin negative quiescent stellates. Unlike what was seen in 2D hepatocyte cultures, the tissues maintained levels of ATP, Albumin as well as expression and drug-induced enzyme activity of Cytochrome P450s over 4 weeks in culture. To assess the ability of the 3D liver cultures to model tissue-level DILI, dose responses of Trovafloxacin, a drug whose hepatotoxic potential could not be assessed by standard pre-clinical models, were compared to the structurally related non-toxic drug Levofloxacin. Trovafloxacin induced significant, dose-dependent toxicity at clinically relevant doses (≤ 4uM. Interestingly, Trovafloxacin toxicity was observed without lipopolysaccharide stimulation and in the absence of resident macrophages in contrast to earlier reports. Together, these results demonstrate that 3D bioprinted liver tissues can both effectively model DILI and distinguish between highly related compounds with differential profile. Thus, the combination of patient-derived primary cells with bioprinting technology here for the first time demonstrates superior performance in terms of mimicking human drug response in a known target organ at the tissue level.

  17. Advances of Studies on Mechanisms of Drugs for Activating Blood Circulation and Removing Blood Stasis in Treatment of Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Primary liver cancer is mainly characterized by the mass in hypochondriac region, stabbing pain at a fixative region, tenderness, dim complexion,vascular spider, vein exposure, livid tongue,ecchymosis, taut and uneven pulse and other symptoms of blood stasis. Experimental studies have found that the patient with liver cancer is often accompanied with disturbance of microcirculation,increase of blood viscosity and high blood agglutinative state. Therefore, activating blood circulation to remove blood stasis is clinically an important therapy for primary liver cancer. A great number of studies on the mechanisms have been carried out in China and other countries. The follow is a review about the mechanisms.

  18. Time trends in incidence and prognosis of primary liver cancer and liver metastases of unknown origin in a Danish region, 1985-2004

    DEFF Research Database (Denmark)

    Erichsen, Rune; Jepsen, Peter; Jacobsen, Jacob;

    2008-01-01

    OBJECTIVES: Changes, over the last 20 years, in the diagnostic procedures and treatment of primary liver cancer (PLC) and liver metastases of unknown origin (LMUO) may have affected the clinical course of both cancers. Few longitudinal studies examined this issue. In a population-based setting, we...... studied changes in the incidence and prognosis of PLC and LMUO over time. METHODS: Between 1985 and 2004, we identified 2675 patients with PLC and LMUO in three Danish counties, with a population of 1.4 million. We computed the standardized incidence rate (SIR), ratio of PLC to LMUO diagnoses, median...... survival, and estimated mortality rate ratio adjusted for age, sex, and comorbidity. RESULTS: The SIR of PLC increased from 3.2 in 1985 to 5.0 in 2003, and the SIR of LMUO increased from 3.7 to 6.4. No increase was noted in the PLC-to-LMUO ratio over time (P=0.1 for trend). From 1985 to 2004, the median...

  19. Hepatopulmonary shunting in patients with primary and secondary liver tumors scheduled for radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Powerski, Maciej Janusz, E-mail: maciej.powerski@med.ovgu.de [Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Strasse 44, 39120 Magdeburg (Germany); Erxleben, Christoph, E-mail: christoph.erxleben@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany); Scheurig-Münkler, Christian, E-mail: Christian.Scheurig@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany); Geisel, Dominik, E-mail: dominik.geisel@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany); Heimann, Uwe, E-mail: uwe.heimann@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany); Hamm, Bernd, E-mail: bernd.hamm@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany); Gebauer, Bernhard, E-mail: bernhard.gebauer@charite.de [Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin (Germany)

    2015-02-15

    Purpose: In patients undergoing transarterial radioembolization (RE) of malignant liver tumors, hepatopulmonary shunts (HPS) can lead to nontarget irradiation of the lungs. This study aims at analyzing the HPS fraction in relation to liver volume, tumor volume, tumor-to-liver volume ratio, tumor vascularity, type of tumor, and portal vein occlusion. Materials and methods: In the presented retrospective study the percentage HPS fraction was calculated from SPECT/CT after infusion of Tc-99m macroaggregated albumin (Tc-99m MAA) into the proper hepatic artery of 233 patients evaluated for RE. Results: HPS fractions correlate very weakly with liver volume (r = 0.303), tumor volume (r = 0.345), and tumor-to-liver volume ratio (r = 0.340). Tumors with strong contrast enhancement (HPS{sub median(range)} = 11.7%(46.3%); n = 73) have significantly larger shunt fractions than tumors with little enhancement (HPS = 8.3%(16.4%); n = 61; p < 0.001). Colorectal cancer metastases (HPS = 10.6%(28.6%); n = 68) and hepatocellular cancers (HPS = 11.7%(39.4%); n = 63) have significantly larger HPS fractions than metastases from breast cancer (HPS = 7.4%(16.7%); n = 40; p = 0.012 and p = 0.001). Patients with compression (HPS = 13.9%(43.7%); n = 33) or tumor thrombosis (HPS = 15.8% (31.2%); n = 33) of a major portal vein branch have significantly higher degrees of shunting than patients with normal portal vein perfusion (HPS = 8.1% (47.0%); n = 167; both p < 0.001). The shunt fraction is largest in patients with HCC and thrombosis or occlusion of a major portal vein branch (HPS = 16.6% (31.0%); n = 32). Conclusion: The degree of hepatopulmonary shunting depends on the type of liver tumor, tumor vascularity, and portal vein perfusion. There is little to no correlation of HPS with liver volume, tumor volume, or tumor-to-liver volume ratio.

  20. Suicide risk in primary care: identification and management in older adults.

    Science.gov (United States)

    Raue, Patrick J; Ghesquiere, Angela R; Bruce, Martha L

    2014-09-01

    The National Strategy for Suicide Prevention (2012) has set a goal to reduce suicides by 20% within 5 years. Suicide rates are higher in older adults compared to most other age groups, and the majority of suicide completers have visited their primary care physician in the year before suicide. Primary care is an ideal setting to identify suicide risk and initiate mental health care. We review risk factors for late-life suicide; methods to assess for different levels of suicidality; and recent research developments regarding both effective assessment and management of suicide risk among older primary care patients. We highlight that broader scale screening of suicide risk may be considered in light of findings that suicidality can occur even in the absence of major risk factors like depression. We also highlight collaborative care models targeting suicide risk, and recent innovative interventions that aim to prevent the development of suicidal ideation and suicidal behavior.

  1. The Effect of Myrtus communis Extract on Liver Enzymes and Blood Biochemical Factors in Diabetic Adult Male Rats

    Directory of Open Access Journals (Sweden)

    Habiballah Johari

    2014-10-01

    Full Text Available Background: The aim of this study was the effect of Myrtus communis extract on liver enzymes and blood biochemical factors in diabetic adult male rats. Materials and Methods: This study has been carried out experimentally and completely random. Seventy adult male Wistar rats were divided in 7 groups including: control which received no treatment, sham who received 2 mL of distilled water, the 1st, 2nd and 3rd experimental groups which received 0.75, 1.5 and 3 mg/kg Myrtus communis leaf extract respectively, the 4th experimental group as the diabetic control group who received streptozotocin (60 mg/kg and the 5th experimental group as the diabetic treatment group who received 3 mg/kg of extract. This experiment lasted 14 days with prescript orally. After this period, all the rats, were weighted, anesthetized and blood samples were taken from the heart centrifuged and sera were evaluated for the concentration of various factors. In addition liver were removed and sliced. Results: According to the obtained results, the plasma concentration of liver enzyme (alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, cholesterol and glucose presented a significant decrease at (p≤0.05. Whereas no significant change were seen in body weight, triglyceride, urea, albumin and total protein. Histological studies of the liver tissue showed no significant difference among various groups. Conclusion: Myrtus communis is comprise of collections of flavonoids and other various components with antioxidant and anti inflammatory properties. Thence it can effective in treatment of liver diseases and decrease of blood sugar and cholesterol in diabetes mellitus patients.

  2. Repeated dose liver micronucleus assay using adult mice with multiple genotoxicity assays concurrently performed as a combination test.

    Science.gov (United States)

    Hagio, Soichiro; Furukawa, Satoshi; Abe, Masayoshi; Kuroda, Yusuke; Hayashi, Seigo; Ogawa, Izumi

    2014-06-01

    Recently, the liver micronucleus (MN) assay using young adult rats with repeated administrations has been investigated by employing a new method without partial hepatectomy or in situcollagenase perfusion as the repeated dose liver MN (RDLMN) assay by Narumi et al. (2012). In our study, in order to investigate the possibility of the RDLMN assay using young adult mice instead of rats and the feasibility of employing some genotoxicity assays along with the RDLMN assay as a combination test, two genotoxic carcinogens (N,N-diethylnitrosoamine (DEN) and cisplatin (CIS)) and a nongenotoxic carcinogen (phenobarbital sodium (PHE)) were administered to mice for 15 or 29 days. Then, the liver MN assay, peripheral blood (PB) MN assay and comet assay using the liver and kidney were concurrently performed as a combination test. DEN showed positive responses to all endpoints except MN induction in PB after 15 days of repeat administration. A cross-linking agent, CIS, showed MN induction in liver after 29 days of repeat administration, and in PB after 15 and 29 days of repeat administration, although the comet assay yielded negative responses for both organs at both sampling times. PHE yielded negative responses for all endpoints. In conclusion, it is suggested that the RDLMN assay using mice is a feasible method to be integrated into the general repeated toxicity test along with the combination assays, i.e., comet assay or PB MN assay, which would help in risk assessment for carcinogenicity by comparing the results of combination assays with each other.

  3. Surgical treatment of a rare primary renal carcinoid tumor with liver metastasis

    Directory of Open Access Journals (Sweden)

    Rowland Randall G

    2008-04-01

    Full Text Available Abstract Background Carcinoid tumors are characteristically low grade malignant neoplasms with neuroendocrine differentiation that arise in various body sites, most commonly the lung and gastrointestinal tract, but less frequently the kidneys, breasts, ovaries, testes, prostate and other locations. We report a case of a carcinoid of renal origin with synchronous single liver metastases on radiological studies. Case presentation A 45 year-old patient who presented with abdominal pain was found on CT scan to have lesions in the right ovary, right kidney, and left hepatic lobe. CA-125, CEA, and CA 19-9 were within normal limits, as were preoperative liver function tests and renal function. Biopsy of the liver mass demonstrated metastatic neuroendocrine tumor. At laparotomy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, radical right nephrectomy with lymphadenectomy, and left hepatectomy. Pathology evaluation reported a right ovarian borderline serous tumor, well-differentiated neuroendocrine carcinoma of the kidney (carcinoid with 2 positive retroperitoneal lymph nodes, and a single liver metastasis. Immunohistochemistry revealed that this lesion was positive for synaptophysin and CD56, but negative for chromogranin as well as CD10, CD7, and CD20, consistent with a well-differentiated neuroendocrine tumor. She is doing well one year after her initial surgery, with no evidence of tumor recurrence. Conclusion Early surgical intervention, together with careful surveillance and follow-up, can achieve successful long-term outcomes in patients with this rare malignancy.

  4. Primary Hepatic Lymphoma Is Difficult to Discriminate from a Liver Abscess

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2014-01-01

    Full Text Available An 82-year-old woman presented with a high-grade fever of 40°C and was admitted to our institution for intensive examination and treatment. Noncontrast abdominal computed tomography (CT revealed low-density masses at segments 5 and 8, suggestive of a liver abscess. On further examination, a contrast-enhanced abdominal CT showed a 30×30 mm mass with an enhanced margin at segment 8 in the arterial phase; the contrast agents were washed out in the venous phase. In addition, a 63×52 mm mass with a density lower than that of liver parenchyma was observed at segment 8 in the portal phase. On the basis of these findings, either a liver abscess or hepatocellular carcinoma was suspected. To confirm the diagnosis, a fine needle biopsy was scheduled. Histopathological analysis of the biopsied specimens confirmed the diagnosis of diffuse large B-cell lymphoma. Chemotherapy was not indicated owing to the patient’s age and poor performance status; thus, best supportive care was planned. On day 22 after admission, the patient died of pneumonia. We experienced a case of PHL that was difficult to discriminate from a liver abscess. Imaging alone is insufficient to diagnose PHL; therefore, fine needle biopsy is recommended for a definitive diagnosis.

  5. Rare Case of Adult Undifferentiated (Embryonal Sarcoma of the Liver Treated with Liver Transplantation: Excellent Long-Term Survival

    Directory of Open Access Journals (Sweden)

    Renumathy Dhanasekaran

    2012-01-01

    Full Text Available We present the case of a 54-year-old gentleman who presented with abdominal distension and a CT scan of his abdomen revealed a large (25 cm left hepatic lobe tumor. He received chemotherapy for over 1.5 years. The CT scans at the completion of this therapy revealed that the tumor had actually slightly grown in size. He underwent orthotopic liver transplantation without any major complications. The explant histopathology revealed an undifferentiated embryonal cell sarcoma (UECS composed of relatively bland spindled cells arranged in short fascicles. It is now 10 years and 3 months since his last transplant and the patient remains well with no tumor recurrence.

  6. Liver transplantation versus conservative treatment for adult-onset type II citrullinemia: our experience and a review of the literature.

    Science.gov (United States)

    Kimura, N; Kubo, N; Narumi, S; Toyoki, Y; Ishido, K; Kudo, D; Umehara, M; Yakoshi, Y; Hakamada, K

    2013-11-01

    Adult-onset type II citrullinemia (CTLN2), an autosomal recessive disorder caused by a mutation in the SLC25A13 gene, is characterized by increased serum citrulline and ammonia levels. Patients with CTLN2 also display various neuropsychiatric symptoms. Many individuals with CTLN2 are fond of protein-rich and/or lipid-rich foods with an aversion to carbohydrate-rich foods. We herein report two cases of CTLN2 treated with living donor liver transplantation (LDLT) and provide a review of the pertinent literature. Case 1 was a 43-year-old man admitted to our hospital for repetitive episodes of consciousness disturbance. Case 2 was a 37-year-old man admitted to our hospital because of abnormal behavior associated with hyperammonemia. A definitive diagnosis of CTLN2 was accomplished by DNA analysis in both patients, who successfully underwent LDLT using liver segments from donor siblings with confirmed heterozygous gene expression. Case 2 also underwent conservative therapy with arginine and a high-fat, carbohydrate-restricted diet prior to LDLT. Postoperative recovery was uneventful and food was unrestricted in both patients. We also identified 77 cases of CTLN2 in the literature and reviewed them in terms of outcome of both liver transplantation and conservative therapy. The survival rate in patients treated by liver transplantation was 100%, whereas that in patients treated by conservative treatment showed improvement from 39.5% to 76.5% over the years. Liver transplantation is a practical treatment that fundamentally improves patient quality of life after transplantation. However, recent studies have suggested that arginine and sodium pyruvate administration combined with intensive nutritional support is also an effective therapy for CTLN2. Further development of conservative therapy may provide a safer, more affordable alternative to liver transplantation in the near future.

  7. Arthroscopic Treatment for Primary Septic Arthritis of the Hip in Adults

    Directory of Open Access Journals (Sweden)

    Jörg Hartmut Schröder

    2016-01-01

    Full Text Available Purpose. Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic treatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients. Methods. Seven patients, average age 44±13.7 years with acute hip pain since 4.4±2.9 days in the average, were included. Septic arthritis was confirmed by joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate arthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Results. Patients were treated in hospital for 12.4±3.1 days (range 7–16 days. WBC and CRP returned to physiological levels. During the mean follow-up of 26.4±19.4 months (range 13–66 months no patient showed recurrence of infection. The 5 patients with an unimpaired hip joint prior to the infection had a mean modified Harris Hip Score of 94±5.6 points (range 91–100 at final follow-up. Conclusions. Arthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic arthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection. Level of Evidence. IV.

  8. New criteria for liver transplantation in adults : the combined Groningen and Rotterdam protocol

    NARCIS (Netherlands)

    Jansen, PLM

    1998-01-01

    A combined protocol for liver transplantation has been written by the teams of Groningen and Rotterdam. This is to ensure that the criteria for selection and timing of liver transplantation, and the procedures for patient evaluation, are identical or at least very similar. Also, the waiting list pro

  9. Liver transplant for adult hemophagocytic lymphohistiocytosis: case report and literature review.

    Science.gov (United States)

    Wright, Gavin; Wilmore, Stephanie; Makanyanga, Jessica; McKerrell, Thomas; Watkins, Jennifer; Patch, David; Burroughs, Andrew K

    2012-10-01

    We report the case of a middle-aged man who died from multiorgan failure 3 weeks after orthotopic liver transplant for fulminant hepatic failure, associated with a rare, often fatal, hematologic condition that usually presents in childhood. We discuss the importance of its diagnosis, treatment, and implications for liver transplant.

  10. Second primary malignancies in adults with gastric cancer – A US population-based study

    Directory of Open Access Journals (Sweden)

    Binay Kumar Shah

    2016-04-01

    Full Text Available Background: Multiple studies have examined the incidence of secondary primary malignancies (SPM in gastric cancer patients in Europe and Asia. This retrospective review was conducted to analyze risk of SPM in patients with gastric cancer diagnosed in the United States (US.Methods: We included adult patients diagnosed with gastric cancer from the Surveillance, Epidemiology and End Result (SEER 13 database. We calculated the risk of secondary primary malignancies in these patients using the multiple primary standardized incidence ratio (MP-SIR session of SEER*stat software and performed subset analyses of SPM with regard to age, sex, radiotherapy used, and latency period.Results: Among 33,720 patients, 1838 (5.45% developed 2019 secondary primary malignancies with an observed/expected (O/E ratio of 1.11 (95% confidence interval (CI = 1.06-1.16, p<.001 and an absolute excess risk (AER of 18.16 per 10,000 population. The median time to first SPM from the time of diagnosis of gastric cancer was 46.9 months (range 6-239 months. Significant excess risk was observed for gastrointestinal malignancies [O/E ratio 1.71 (CI = 1.59-1.84, p<.001], thyroid [O/E ratio 2.00 (CI = 1.37-2.8, p<.001] and pancreatic cancer [O/E ratio 1.60 (CI = 1.29-21.96, p<.001]. Risk of secondary melanoma, breast cancer and prostate cancer was lower than in the general population.Conclusions: The risk for secondary primary malignancies is significantly increased in adults with gastric cancer compared to the general population.

  11. Autoantibodies in autoimmune liver diseases.

    Science.gov (United States)

    Sener, Asli Gamze

    2015-11-01

    Autoimmune hepatitis is a chronic hepatitis of unknown etiology characterized by clinical, histological, and immunological features, generally including circulating autoantibodies and a high total serum and/or gamma globulin. Liver-related autoantibodies are very significant for the correct diagnosis and classification of autoimmune liver diseases (AILD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC), and the sclerosing cholangitis types in adults and children. This article intends to review recent studies that investigate autoantibodies in autoimmune liver diseases from a microbiological perspective.

  12. IDH1-associated primary glioblastoma in young adults displays differential patterns of tumour and vascular morphology.

    Directory of Open Access Journals (Sweden)

    Sergey Popov

    Full Text Available Glioblastoma is a highly aggressive tumour with marked heterogeneity at the morphological level in both the tumour cells and the associated highly prominent vasculature. As we begin to develop an increased biological insight into the underlying processes driving the disease, fewer attempts have thus far been made to understand these phenotypic differences. We sought to address this by carefully assessing the morphological characteristics of both the tumour cells and the associated vasculature, relating these observations to the IDH1/MGMT status, with a particular focus on the early onset population of young adults who develop primary glioblastoma. 276 primary glioblastoma specimens were classified into their predominant cell morphological type (fibrillary, gemistocytic, giant cell, small cell, oligodendroglial, sarcomatous, and assessed for specific tumour (cellularity, necrosis, palisades and vascular features (glomeruloid structures, arcades, pericyte proliferation. IDH1 positive glioblastomas were associated with a younger age at diagnosis, better clinical outcome, prominent oligodendroglial and small cell tumour cell morphology, pallisading necrosis and glomeruloid vascular proliferation in the absence of arcade-like structures. These features widen the phenotype of IDH1 mutation-positive primary glioblastoma in young adults and provide correlative evidence for a functional role of mutant IDH1 in the differential nature of neo-angiogenesis in different subtypes of glioblastoma.

  13. Safety and efficacy of Y-90 microsphere treatment in patients with primary and metastatic liver cancer: The tumor selectivity of the treatment as a function of tumor to liver flow ratio

    Directory of Open Access Journals (Sweden)

    Dezarn William A

    2007-03-01

    Full Text Available Abstract Background Treatment records and follow-up data on 40 patients with primary and metastatic liver malignancies who underwent a single whole-liver treatment with Y-90 resin microspheres (SIR-Spheres® Sirtex Medical, Lake Forest, IL were retrospectively reviewed. The objective of the study was to evaluate the anatomic and physiologic determinants of radiation dose distribution, and the dose response of tumor and liver toxicity in patients with liver malignancies who underwent hepatic arterial Y-90 resin microsphere treatment. Methods Liver and tumor volume calculations were performed on pre-treatment CT scans. Fractional tumor and liver flow characteristics and lung shunt fractions were determined using hepatic arterial Tc-99m MAA imaging. Absorbed dose calculations were performed using the MIRD equations. Liver toxicity was assessed clinically and by liver function tests. Tumor response to therapy was assessed by CT and/or tumor markers. Results Of the 40 patients, 5 had hepatocellular cancer (HCC, and 35 had metastatic liver tumors (15 colorectal cancer, 10 neuroendocrine tumors, 4 breast cancer, 2 lung cancer, 1 ovarian cancer, 1 endometrial cancer, and 2 unknown primary adenocarcinoma. All patients were treated in a salvage setting with a 3 to 80 week follow-up (mean: 19 weeks. Tumor volumes ranged from 15.0 to 984.2 cc (mean: 294.9 cc and tumor to normal liver uptake ratios ranged from 2.8 to 15.4 (mean: 5.4. Average administered activity was 1.2 GBq (0.4 to 2.4 GBq. Liver absorbed doses ranged from 0.7 to 99.5 Gy (mean: 17.2 Gy. Tumor absorbed doses ranged from 40.1 to 494.8 Gy (mean: 121.5 Gy. None of the patients had clinical venoocclusive disease or therapy-induced liver failure. Seven patients (17.5 % had transient and 7 patients (17.5 % had persistent LFT abnormalities. There were 27 (67.5% responders (complete response, partial response, and stable disease. Tumor response correlated with higher tumor flow ratio as measured by

  14. Limited T-cell receptor diversity in liver-infiltrating lymphocytes from patients with primary biliary cirrhosis.

    Science.gov (United States)

    Diu, A; Moebius, U; Ferradini, L; Genevée, C; Roman-Roman, S; Claudon, M; Delorme, D; Meuer, S; Hercend, T; Praz, F

    1993-10-01

    Primary biliary cirrhosis is associated with the presence of high-titer anti-mitochondrial autoantibodies as well as T-cell infiltration of the liver, suggesting the involvement of autoimmune mechanisms. We have studied here the sequences of T-cell receptor alpha and beta chains expressed by T-cell clones derived from liver-infiltrating lymphocytes of two patients with primary biliary cirrhosis. Among the eight clones studied from the first patient, four expressed the same member of the V beta 6 subfamily, associated with either V alpha 4 (three clones) or V alpha 21 (one clone) gene segment. Two other clones expressed an identical V beta 12 transcript, and two in-frame alpha chain transcripts, involving V alpha 2 and V alpha 7 gene segments. From the second patient, eight out of the nine clones were found to rearrange V beta 17-J beta 2.1 and V alpha 3 gene segments. The remaining clone expressed distinct T-cell receptor chains, involving V beta 9 and V alpha 11 gene segments. As deduced from the analysis of their junctional regions, the eight T-cell clones expressing V beta 17/V alpha 3 gene segments derived from only three different T cells. Furthermore, conserved amino acid motifs were found to be encoded in both the alpha and the beta-chain junctional regions. Together, these data show a local amplification of unique T lymphocytes in both patients. The use of identical V beta J beta and V alpha gene segments with similar junctional sequences by three different cells, evidenced in one of the two cases, strengthens the view that liver-infiltrating T lymphocytes are selected locally by autoantigens in PBC.

  15. Changes in the contralateral eye in uncomplicated persistent hyperplastic primary vitreous in adults.

    Science.gov (United States)

    Awan, K J; Humayun, M

    1985-02-15

    In two adults (a 62-year-old man and a 71-year-old woman) uncomplicated full-blown unilateral persistent hyperplastic primary vitreous was diagnosed on the basis of characteristic clinical features and ultrasonography. In the contralateral uninvolved eyes, we found open-angle glaucoma, anomalous blood vessels along the entire circumference of the anterior chamber angle, band keratopathy, and heterochromia iridis. The axial length of one involved eye was about 0.85 mm larger than that of the uninvolved eye.

  16. Adult onset primary focal dystonia of the foot: an orthopaedic intervention.

    Science.gov (United States)

    Logan, Loretta; Resseque, Barbara; Dontamsetti, Monica Sakshi

    2016-03-30

    A 54-year-old woman presented to a foot centre with a chief symptom of cramping in her toes, which, she believed, was of a secondary cause originating from a bunion. She was treated conservatively; however, she returned a month later as the symptoms had progressed to painful cramping of toes, toe-curling and instability while walking, due to involuntary movement of her toes. It was believed that the patient presented with a rare case of primary adult onset focal foot dystonia. This case report explains dystonia further in detail and delves into the different treatment and management options available today, including the unique orthopaedic intervention provided for this patient.

  17. Histology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in Adults and Children.

    Science.gov (United States)

    Kleiner, David E; Makhlouf, Hala R

    2016-05-01

    Nonalcoholic fatty liver disease (NAFLD) is the liver disease associated with obesity, diabetes, and the metabolic syndrome. Although steatosis is a key histologic feature, liver biopsies of patients with NAFLD can show a wide range of findings. Nonalcoholic steatohepatitis (NASH) is a progressive subtype of NAFLD first defined by analogy to alcoholic hepatitis. Young children may have an alternate pattern of progressive NAFLD characterized by a zone 1 distribution of steatosis, inflammation, and fibrosis. Several grading and staging systems exist, but all require adequate biopsies. Although NASH generally shows fibrosis progression over time, some patients show regression of disease.

  18. Medical appropriateness of adult calls to Danish out-of-hours primary care

    DEFF Research Database (Denmark)

    Nørøxe, Karen Busk; Huibers, Linda; Moth, Grete

    2017-01-01

    BACKGROUND: Optimal utilisation of the out-of-hours primary care (OOH-PC) services remains a concern in public health policy. We need more knowledge on potentially avoidable contacts. This study examines the frequency of medically assessed inappropriate OOH-PC calls from adults, explores factors...... triage delivered by a general practitioner (GP), we included only telephone contacts. A contact was characterised as medically inappropriate when the triage GP assessed that the request from a medical perspective should have been directed to daytime primary care. Appropriateness was examined in relation...... associated with such assessment, and examines the relation to patient-assessed severity of health problem and fulfilment of expectations. METHODS: We performed secondary analyses of data from a large cross-sectional survey on contacts to Danish OOH-PC. As access to Danish OOH-PC is provided through telephone...

  19. Effects of aluminum sulfate on delta-aminolevulinate dehydratase from kidney, brain, and liver of adult mice

    Directory of Open Access Journals (Sweden)

    Schetinger M.R.C.

    1999-01-01

    Full Text Available The purpose of the present study was to investigate the in vitro and in vivo effects of aluminum sulfate on delta-aminolevulinic acid dehydratase (ALA-D activity from the brain, liver and kidney of adult mice (Swiss albine. In vitro experiments showed that the aluminum sulfate concentration needed to inhibit the enzyme activity was 1.0-5.0 mM (N = 3 in brain, 4.0-5.0 mM (N = 3 in liver and 0.0-5.0 mM (N = 3 in kidney. The in vivo experiments were performed on three groups for one month: 1 control animals (N = 8; 2 animals treated with 1 g% (34 mM sodium citrate (N = 8 and 3 animals treated with 1 g% (34 mM sodium citrate plus 3.3 g% (49.5 mM aluminum sulfate (N = 8. Exposure to aluminum sulfate in drinking water inhibited ALA-D activity in kidney (23.3 ± 3.7%, mean ± SEM, P<0.05 compared to control, but enhanced it in liver (31.2 ± 15.0%, mean ± SEM, P<0.05. The concentrations of aluminum in the brain, liver and kidney of adult mice were determined by graphite furnace atomic absorption spectrometry. The aluminum concentrations increased significantly in the liver (527 ± 3.9%, mean ± SEM, P<0.05 and kidney (283 ± 1.7%, mean ± SEM, P<0.05 but did not change in the brain of aluminum-exposed mice. One of the most important and striking observations was the increase in hepatic aluminum concentration in the mice treated only with 1 g% sodium citrate (34 mM (217 ± 1.5%, mean ± SEM, P<0.05 compared to control. These results show that aluminum interferes with delta-aminolevulinate dehydratase activity in vitro and in vivo. The accumulation of this element was in the order: liver > kidney > brain. Furthermore, aluminum had only inhibitory properties in vitro, while in vivo it inhibited or stimulated the enzyme depending on the organ studied.

  20. Primary mixed germ cell tumor of the liver with sarcomatous components

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Germ cell tumor(GCT)of the liver is extremely rare. Here,we describe a case of hepatic mixed GCT with significant sarcomatous components and elevated serum α-fetoprotein(AFP)in a 34-year-old man.Histopathologically,the tumor was composed of two GCTs components:yolk sac tumor and immature teratoma.The predominant components of immature teratoma consisted of several types of tissue that represented different germinal layers(endoderm,mesoderm and ectoderm) and showed varying degrees of differentiation with sig...

  1. Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults.

    Science.gov (United States)

    Chalmers, James D; Sethi, Sanjay

    2017-12-01

    Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.

  2. Screening for alcohol and drug use disorders among adults in primary care: a review

    Directory of Open Access Journals (Sweden)

    Pilowsky DJ

    2012-04-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu21Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY, 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USABackground: The Patient Protection and Affordable Care Act of 2010 supports integration of substance abuse interventions and treatments into the mainstream health care system. Thus, effective screening and intervention for substance use disorders in health care settings is a priority.Objective: This paper reviews the prevalence of alcohol and drug use disorders (abuse or dependence in primary care settings and emergency departments, as well as current screening tools and brief interventions.Methods: MEDLINE was searched using the following keywords: alcohol use, alcohol use disorder, drug use, drug use disorder, screening, primary care, and emergency departments. Using the related-articles link, additional articles were screened for inclusion. This review focuses on alcohol and drug use and related disorders among adults in primary care settings.Conclusion: Screening, brief intervention, and referral for treatment are feasible and effective in primary care settings, provided that funding for screening is available, along with brief interventions and treatment facilities to which patients can be referred and treated promptly.Keywords: brief intervention, emergency departments

  3. Dual grafts in adult-to-adult living donor liver transplantation: a single center experience in Taiwan.

    Science.gov (United States)

    Yang, Chin-Hsiang; Chen, Chao-Long; Wang, Chih-Chi; Concejero, Allan M; Wang, Shih-Ho; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Tsan-Shiun

    2009-02-01

    Volume mismatch is encountered when a single live donor cannot provide adequate graft volume to the recipient with a remnant liver volume which is safe for donation. Our objective is to present our experience in living donor liver transplantation using dual grafts. Record review of 4 dual graft recipients was done. The results were compared with 122 consecutive patients who received a single right lobe. All dual graft recipients were surviving with satisfactory liver function at a median follow-up of 21 months. Two recipients received 1 right and 1 left lobe graft, while the other 2 recipients received 2 left lobe grafts. One donor developed biloma and was managed by percutaneous drainage. The first recipient required re-laparotomy for postoperative bleeding. The second recipient underwent re-laparotomy for bile leak. The third recipient developed grade II decubitus ulcers due to a prolonged sedentary position. When compared with recipients who received a single right lobe, the operative time was prolonged in the dual graft group. There was no apparent increase in the rate of vascular and biliary complications or the incidence of acute cellular rejection. Actuarial patient survivals were comparable in both groups. Dual graft transplantation provides sufficient volume in the recipient without jeopardizing donor safety.

  4. Selective intraarterial radionuclide therapy with Yttrium-90 (Y-90 microspheres for unresectable primary and metastatic liver tumors

    Directory of Open Access Journals (Sweden)

    Ozkan Elgin

    2011-08-01

    Full Text Available Abstract Background The aim of this study was to evaluate the success of selective intraarterial radionuclide therapy (SIRT with Yttrium-90 (Y-90 microspheres in liver metastases of different tumors. We also interpreted the contribution of SIRT to survival times according to responder- non responder and hepatic- extra hepatic disease. Methods The clinical and follow-up data of 124 patients who were referred to our department for SIRT between June 2006 and October 2010 were evaluated retrospectively. SIRT has been applied to 78 patients who were suitable for treatment. All the patients had primary liver tumor or unresectable liver metastasis of different malignancies. The treatment was repeated at least one more time in 5 patients to the same or other lobes. Metabolic treatment response evaluated by fluorine-18 fluorodeoxyglucose (F18-FDG positron emission tomography/computed tomography (PET/CT in the 6th week after treatment. F18-FDG PET/CT was repeated in per six weeks periods. The response criterion had been described as at least 20% decrease of SUV value. Also in patients with neuroendocrine tumor serial Gallium-68 (Ga-68 PET/CT was used for evaluation of response. Patients were divided into 2 groups according to their treatment response. Results 68 patients received treatment for the right lobe, seven patients received treatment for the left lobe and 3 patients for both lobes. The mean treatment dose was estimated at 1.62 GBq. In the evaluation of treatment response; 43(55% patients were responder (R and 35 (45% patients were non-responder (NR in the sixth week F18-FDG PET/CT. Mean pretreatment SUVmax value of R group was 11.6 and NR group was 10.7. While only 11 (31% out of 35 NR patients had H disease, 30 (69% out of 43 R patients had H disease (p Conclusions SIRT is a useful treatment method which can contribute to the lengthening of survival times in patients with primary or metastatic unresectable liver malignancies. Also F18-FDG PET

  5. Hypofractionated stereotactic body radiotherapy for primary and metastatic liver tumors using the novalis image-guided system: preliminary results regarding efficacy and toxicity.

    Science.gov (United States)

    Iwata, Hiromitsu; Shibamoto, Yuta; Hashizume, Chisa; Mori, Yoshimasa; Kobayashi, Tatsuya; Hayashi, Naoki; Kosaki, Katsura; Ishikawa, Tetsuya; Kuzuya, Teiji; Utsunomiya, Setsuo

    2010-12-01

    www.tcrt.org The purpose of this study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) for primary and metastatic liver tumors using the Novalis image-guided radiotherapy system. After preliminarily treating liver tumors using the Novalis system from July 2006, we started a protocol-based study in February 2008. Eighteen patients (6 with primary hepatocellular carcinoma and 12 with metastatic liver tumor) were treated with 55 or 50 Gy, depending upon their planned dose distribution and liver function, delivered in 10 fractions over 2 weeks. Four non-coplanar and three coplanar static beams were used. Patient age ranged from 54 to 84 years (median: 72 years). The Child-Pugh classification was Grade A in 17 patients and Grade B in 1. Tumor diameter ranged from 12 to 35 mm (median: 23 mm). Toxicities were evaluated according to the Common Terminology Criteria of Adverse Events version 4.0, and radiation-induced liver disease (RILD) was defined by Lawrence's criterion. The median follow-up period was 14.5 months. For all patients, the 1-year overall survival and local control rates were 94% and 86%, respectively. A Grade 1 liver enzyme change was observed in 5 patients, but no RILD or chronic liver dysfunction was observed. SBRT using the Novalis image-guided system is safe and effective for treating primary and metastatic liver tumors. Further investigation of SBRT for liver tumors is warranted. In view of the acceptable toxicity observed with this protocol, we have moved to a new protocol to shorten the overall treatment time and escalate the dose.

  6. Association between noninvasive fibrosis markers and chronic kidney disease among adults with nonalcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Giorgio Sesti

    Full Text Available Evidence suggests that nonalcoholic fatty liver disease (NAFLD and non-alcoholic steatohepatitis (NASH are associated with an increased risk of chronic kidney disease (CKD. In this study we aimed to evaluate whether the severity of liver fibrosis estimated by NAFLD fibrosis score is associated with higher prevalence of CKD in individuals with NAFLD. To this end NAFLD fibrosis score and estimated glomerular filtration rate (eGFR were assessed in 570 White individuals with ultrasonography-diagnosed NAFLD. As compared with subjects at low probability of liver fibrosis, individuals at high and intermediate probability showed an unfavorable cardio-metabolic risk profile having significantly higher values of waist circumference, insulin resistance, high sensitivity C-reactive protein, fibrinogen, uric acid and lower insulin-like growth factor-1 levels. Individuals at high and intermediate probability of liver fibrosis have lower eGFR after adjustment for gender, smoking, glucose tolerance status, homeostasis model assessment index of insulin resistance (HOMA-IR index, diagnosis of metabolic syndrome, statin therapy, anti-diabetes and anti-hypertensive treatments (P = 0.001. Individuals at high probability of liver fibrosis had a 5.1-fold increased risk of having CKD (OR 5.13, 95%CI 1.13-23.28; P = 0.03 as compared with individuals at low probability after adjustment for age, gender, and BMI. After adjustment for glucose tolerance status, statin therapy, and anti-hypertensive treatment in addition to gender, individuals at high probability of liver fibrosis had a 3.9-fold increased risk of CKD (OR 3.94, 95%CI 1.11-14.05; P = 0.03 as compared with individuals at low probability. In conclusion, advanced liver fibrosis, determined by noninvasive fibrosis markers, is associated with CKD independently from other known factors.

  7. Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Basri Johan Jeet [University of Malaya, Department of Biomedical Imaging, Faculty of Medicine, Kuala Lumpur (Malaysia); Yeong, Chai Hong [University of Malaya, University of Malaya Research Imaging Centre, Faculty of Medicine, Kuala Lumpur (Malaysia); Goh, Khean Lee [University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Yoong, Boon Koon [University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur (Malaysia); Ho, Gwo Fuang [University of Malaya, Department of Oncology, Faculty of Medicine, Kuala Lumpur (Malaysia); Yim, Carolyn Chue Wai [University of Malaya, Department of Anesthesia, Faculty of Medicine, Kuala Lumpur (Malaysia); Kulkarni, Anjali [Perfint Healthcare Corporation, Florence, OR (United States)

    2014-01-15

    Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles. We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions). Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff. (orig.)

  8. Toxicity monitoring with primary cultured hepatocytes underestimates the acetaminophen-induced inflammatory responses of the mouse liver.

    Science.gov (United States)

    Tachibana, Shinjiro; Shimomura, Akiko; Inadera, Hidekuni

    2011-01-01

    In vitro gene expression profiling with isolated hepatocytes has been used to assess the hepatotoxicity of certain chemicals because of animal welfare issues. However, whether an in vitro system can completely replace the in vivo system has yet to be elucidated in detail. Using a focused microarray established in our laboratory, we examined gene expression profiles in the mouse liver and primary cultured hepatocytes after treatment with different doses of acetaminophen, a widely used analgesic that frequently causes liver injury. The acute hepatotoxicity of acetaminophen was confirmed by showing the induction of an oxidative stress marker, heme oxygenase-1, elevated levels of serum transaminase, and histopathological findings. In vivo microarray and network analysis showed that acetaminophen treatment provoked alterations in relation to the inflammatory response, and that tumor necrosis factor-α plays a central role in related pathway alterations. By contrast, pathway analyses in in vitro isolated hepatocytes did not find such prominent changes in the inflammation-related networks compared with the in vivo situation. Thus, although in vitro gene expression profiles are useful for evaluating the direct toxicity of chemicals, indirect toxicities including inflammatory responses mediated by cell-cell interactions or secondary toxicity due to pathophysiological changes in the whole body may be overlooked. Our results indicate that the in vitro hepatotoxicity prediction system using isolated hepatocytes does not fully reflect the in vivo cellular response. An in vitro system may be appropriate, therefore, for high throughput screening to detect the direct hepatotoxicity of a test compound.

  9. Gene disruption of Plasmodium falciparum p52 results in attenuation of malaria liver stage development in cultured primary human hepatocytes.

    Directory of Open Access Journals (Sweden)

    Ben C L van Schaijk

    Full Text Available Difficulties with inducing sterile and long lasting protective immunity against malaria with subunit vaccines has renewed interest in vaccinations with attenuated Plasmodium parasites. Immunizations with sporozoites that are attenuated by radiation (RAS can induce strong protective immunity both in humans and rodent models of malaria. Recently, in rodent parasites it has been shown that through the deletion of a single gene, sporozoites can also become attenuated in liver stage development and, importantly, immunization with these sporozoites results in immune responses identical to RAS. The promise of vaccination using these genetically attenuated sporozoites (GAS depends on translating the results in rodent malaria models to human malaria. In this study, we perform the first essential step in this transition by disrupting, p52, in P. falciparum an ortholog of the rodent parasite gene, p36p, which we had previously shown can confer long lasting protective immunity in mice. These P. falciparum P52 deficient sporozoites demonstrate gliding motility, cell traversal and an invasion rate into primary human hepatocytes in vitro that is comparable to wild type sporozoites. However, inside the host hepatocyte development is arrested very soon after invasion. This study reveals, for the first time, that disrupting the equivalent gene in both P. falciparum and rodent malaria Plasmodium species generates parasites that become similarly arrested during liver stage development and these results pave the way for further development of GAS for human use.

  10. Study on TCM Syndrome Differentiation of Primary Liver Cancer Based on the Analysis of Latent Structural Model

    Directory of Open Access Journals (Sweden)

    Zhan Gu

    2015-01-01

    Full Text Available Primary liver cancer (PLC is one of the most common malignant tumors because of its high incidence and high mortality. Traditional Chinese medicine (TCM plays an active role in the treatment of PLC. As the most important part in the TCM system, syndrome differentiation based on the clinical manifestations from traditional four diagnostic methods has met great challenges and questions with the lack of statistical validation support. In this study, we provided evidences for TCM syndrome differentiation of PLC using the method of analysis of latent structural model from clinic data, thus providing basis for establishing TCM syndrome criteria. And also we obtain the common syndromes of PLC as well as their typical clinical manifestations, respectively.

  11. Initial experience in adult-to-adult living donor liver transplantation%成人活体肝移植的早期经验

    Institute of Scientific and Technical Information of China (English)

    董家鸿; 纪文斌; 段伟东; 史宪杰; 王彦斌; 冷建军; 王宏光; 黄志强

    2008-01-01

    目的 总结成人活体肝移植的早期经验,提高活体肝移植效果.方法 回顾性分析解放军总医院肝移植中心2006年6月至2008年2月31例成人活体肝移植资料.结果 31例中慢性乙型肝炎肝硬化失代偿期8例,急性肝功能衰竭7例,肝细胞肝癌12例,肝脏紫癜病2例,肝门部胆管癌1例和Wilson 病1例.含肝中静脉(middle hepatic vein,MHV)的右半肝移植25例,不含MHV的右半肝移植3例,双供肝为含MHV的右半肝+左外叶和含MHV的右半肝+左半肝各1例,左半肝辅助性原位肝移植1例.33例供者中5例发生并发症6例次.9例受者发生并发症11例次,其中胆道并发症4例,血管并发症3例,感染性并发症3例,切口延迟愈合1例.2例肺部感染和1例全身多处曲霉菌感染者死亡.结论 活体肝移植已成为拓展供肝来源的有效途径,合理的供、受者评估,手术方式和术后处理是关键.%Objective To summarize the initial experience in adult-to-adult living donor liver transplantation(ALDLT),so as to improve the efficacy of ALDLT.Methods The clinical data of 31 adult patients who undelwent ALDLT from June 2006 to February 2008 were retrospectively analyzed.Results Of all the patients,8 was with decompensated cirrhosis,7 with acute liver failure,12 with hepatocellular carcinoma,2 with purpura of liver,1 with hilar cholangiocarcinoma,and 1 with Wilson disease.The liver grafts included 25 right lobes with middle hepatic vein(MHV),3 right lobes without MHV,1 right lobe with MHV+left lateral lobe,1 right lobe with MHV+left lobe.The remaining 1 patient underwent auxiliary partial orthotopic liver transplantation with left lobe graft.Six post-transplantation complications occurred in 5 donors. Eleven post-transplantation complications occurred in 9 recipients,including 4 biliary complications,3 vascular complications,3 infection complications and 1 delayed healing of the incision.After ALDLT,2 recipients died of pulmonary infection and 1 of

  12. Molecular changes in Opisthorchis viverrini (Southeast Asian liver fluke during the transition from the juvenile to the adult stage.

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    Aaron R Jex

    Full Text Available BACKGROUND: The Southeast Asian liver fluke (Opisthorchis viverrini chronically infects and affects tens of millions of people in regions of Asia, leading to chronic illness and, importantly, inducing malignant cancer (= cholangiocarcinoma. In spite of this, little is known, at the molecular level, about the parasite itself, its interplay with its hosts or the mechanisms of disease and/or carcinogenesis. METHODOLOGY/PRINCIPAL FINDINGS: Here, we generated extensive RNA-Seq data (Illumina representing adult and juvenile stages of O. viverrini, and combined these sequences with previously published transcriptomic data (454 technology for this species, yielding a combined assembly of significantly increased quality and allowing quantitative assessment of transcription in the juvenile and adult stage. CONCLUSIONS: This enhanced assembly reveals that, despite the substantial biological similarities between the human liver flukes, O. viverinni and Clonorchis sinensis, there are previously unrecognized differences in major aspects of their molecular biology. Most notable are differences among the C13 and cathepsin L-like cysteine peptidases, which play key roles in tissue migration, immune evasion and feeding, and, thus, represent potential drug and/or vaccine targets. Furthermore, these data indicate that major lineages of cysteine peptidases of socioeconomically important trematodes have evolved through a process of gene loss rather than independent radiation, contrasting previous proposals.

  13. Coping, quality of life, and hope in adults with primary antibody deficiencies

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    Stray-Pedersen Asbjørg

    2005-05-01

    Full Text Available Abstract Background Living with a chronic disease, such as primary antibody deficiency, will often have consequences for quality of life. Previous quality-of-life studies in primary antibody deficiency patients have been limited to different treatment methods. We wanted to study how adults with primary antibody deficiencies manage their conditions and to identify factors that are conducive to coping, good quality of life and hope. Methods Questionnaires were sent to all patients ≥20 years of age with primary antibody deficiencies who were served by Rikshospitalet University Hospital. The questionnaires consisted of several standardized scales: Ferrans and Powers Quality of Life Index (QLI, Short Form-36 (SF-36, Jalowiec Coping Scale (JCS, Nowotny Hope Scale (NHS, and one scale we devised with questions about resources and pressures in the past. Of a total of 91, 55 patients (aged 23–76 years answered the questionnaires. The questionnaire study were supplemented with selected interviews of ten extreme cases, five with low and five with high quality of life scores. Results Among the 55 patients, low quality of life scores were related to unemployment, infections in more than four organs, more than two additional diseases, or more than two specific occurrences of stress in the last 2–3 months. Persons with selective IgA deficiency had significantly higher QLI scores than those with other antibody deficiencies. An optimistic coping style was most frequent used, and hope values were moderately high. Based on the interviews, the patients could be divided into three groups: 1 low QLI scores, low hope values, and reduced coping, 2 low QLI scores, moderate hope values, and good coping, and 3 high QLI scores, moderate to strong hope values, and good coping. Coping was related to the patients' sense of closeness and competence. Conclusion Low quality of life scores in adults with primary antibody deficiencies were linked to unemployment and disease

  14. Protein-engineered scaffolds for in vitro 3D culture of primary adult intestinal organoids.

    Science.gov (United States)

    DiMarco, Rebecca L; Dewi, Ruby E; Bernal, Gabriela; Kuo, Calvin; Heilshorn, Sarah C

    2015-10-15

    Though in vitro culture of primary intestinal organoids has gained significant momentum in recent years, little has been done to investigate the impact of microenvironmental cues provided by the encapsulating matrix on the growth and development of these fragile cultures. In this work, the impact of various in vitro culture parameters on primary adult murine organoid formation and growth are analyzed with a focus on matrix properties and geometric culture configuration. The air-liquid interface culture configuration was found to result in enhanced organoid formation relative to a traditional submerged configuration. Additionally, through use of a recombinantly engineered extracellular matrix (eECM), the effects of biochemical and biomechanical cues were independently studied. Decreasing mechanical stiffness and increasing cell adhesivity were found to increase organoid yield. Tuning of eECM properties was used to obtain organoid formation efficiency values identical to those observed in naturally harvested collagen I matrices but within a stiffer construct with improved ease of physical manipulation. Increased ability to remodel the surrounding matrix through mechanical or enzymatic means was also shown to enhance organoid formation. As the engineering and tunability of recombinant matrices is essentially limitless, continued property optimization may result in further improved matrix performance and may help to identify additional microenvironmental cues that directly impact organoid formation, development, differentiation, and functional behavior. Continued culture of primary organoids in recombinant matrices could therefore prove to be largely advantageous in the field of intestinal tissue engineering for applications in regenerative medicine and in vitro tissue mimics.

  15. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center.

    Science.gov (United States)

    Alsenany, Samira; Al Saif, Amer

    2015-06-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors using questions about the history of any disease. [Results] Diabetes mellitus was present in 234 subjects during the data collection period (March-June 2014). Mean patient age was 58 years; diabetes prevalence was 42% in males and 58% in females. The mean age for diabetes onset in males and females was 34 and 39 years, respectively. There was a higher incidence of obesity (75%) associated with a sedentary lifestyle (body mass index ≥25) in females (N= 96; 40%) compared with males (N= 87; 36%). In this study, >44% of individuals aged 55 or older had severe to uncontrolled diabetes with long-term complications. The age-adjusted incidence of hypertension and coronary heart disease was 38% and 24%, respectively, showing a clear incidence of diabetes associated with cardiovascular disease in Saudi Arabia. [Conclusion] This study found that a multifactorial approach to managing diabetes complication risks is needed.

  16. Prenatal ethanol exposure programs an increased susceptibility of non-alcoholic fatty liver disease in female adult offspring rats

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    Shen, Lang; Liu, Zhongfen; Gong, Jun; Zhang, Li [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071 (China); Wang, Linlong [Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071 (China); Magdalou, Jacques [UMR 7561 CNRS-Nancy Université, Faculté de Médicine, Vandoeuvre-lès-Nancy (France); Chen, Liaobin [Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071 (China); Wang, Hui, E-mail: wanghui19@whu.edu.cn [Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071 (China); Research Center of Food and Drug Evaluation, Wuhan University, Wuhan 430071 (China)

    2014-01-15

    Prenatal ethanol exposure (PEE) induces dyslipidemia and hyperglycemia in fetus and adult offspring. However, whether PEE increases the susceptibility to non-alcoholic fatty liver disease (NAFLD) in offspring and its underlying mechanism remain unknown. This study aimed to demonstrate an increased susceptibility to high-fat diet (HFD)-induced NAFLD and its intrauterine programming mechanisms in female rat offspring with PEE. Rat model of intrauterine growth retardation (IUGR) was established by PEE, the female fetus and adult offspring that fed normal diet (ND) or HFD were sacrificed. The results showed that, in PEE + ND group, serum corticosterone (CORT) slightly decreased and insulin-like growth factor-1 (IGF-1) and glucose increased with partial catch-up growth; In PEE + HFD group, serum CORT decreased, while serum IGF-1, glucose and triglyceride (TG) increased, with notable catch-up growth, higher metabolic status and NAFLD formation. Enhanced liver expression of the IGF-1 pathway, gluconeogenesis, and lipid synthesis as well as reduced expression of lipid output were accompanied in PEE + HFD group. In PEE fetus, serum CORT increased while IGF-1 decreased, with low body weight, hyperglycemia, and hepatocyte ultrastructural changes. Hepatic IGF-1 expression as well as lipid output was down-regulated, while lipid synthesis significantly increased. Based on these findings, we propose a “two-programming” hypothesis for an increased susceptibility to HFD-induced NAFLD in female offspring of PEE. That is, the intrauterine programming of liver glucose and lipid metabolic function is “the first programming”, and postnatal adaptive catch-up growth triggered by intrauterine programming of GC-IGF1 axis acts as “the second programming”. - Highlights: • Prenatal ethanol exposure increase the susceptibility of NAFLD in female offspring. • Prenatal ethanol exposure reprograms fetal liver’s glucose and lipid metabolism . • Prenatal ethanol exposure cause

  17. Prenatal ethanol exposure programs an increased susceptibility of non-alcoholic fatty liver disease in female adult offspring rats.

    Science.gov (United States)

    Shen, Lang; Liu, Zhongfen; Gong, Jun; Zhang, Li; Wang, Linlong; Magdalou, Jacques; Chen, Liaobin; Wang, Hui

    2014-01-15

    Prenatal ethanol exposure (PEE) induces dyslipidemia and hyperglycemia in fetus and adult offspring. However, whether PEE increases the susceptibility to non-alcoholic fatty liver disease (NAFLD) in offspring and its underlying mechanism remain unknown. This study aimed to demonstrate an increased susceptibility to high-fat diet (HFD)-induced NAFLD and its intrauterine programming mechanisms in female rat offspring with PEE. Rat model of intrauterine growth retardation (IUGR) was established by PEE, the female fetus and adult offspring that fed normal diet (ND) or HFD were sacrificed. The results showed that, in PEE+ND group, serum corticosterone (CORT) slightly decreased and insulin-like growth factor-1 (IGF-1) and glucose increased with partial catch-up growth; In PEE+HFD group, serum CORT decreased, while serum IGF-1, glucose and triglyceride (TG) increased, with notable catch-up growth, higher metabolic status and NAFLD formation. Enhanced liver expression of the IGF-1 pathway, gluconeogenesis, and lipid synthesis as well as reduced expression of lipid output were accompanied in PEE+HFD group. In PEE fetus, serum CORT increased while IGF-1 decreased, with low body weight, hyperglycemia, and hepatocyte ultrastructural changes. Hepatic IGF-1 expression as well as lipid output was down-regulated, while lipid synthesis significantly increased. Based on these findings, we propose a "two-programming" hypothesis for an increased susceptibility to HFD-induced NAFLD in female offspring of PEE. That is, the intrauterine programming of liver glucose and lipid metabolic function is "the first programming", and postnatal adaptive catch-up growth triggered by intrauterine programming of GC-IGF1 axis acts as "the second programming".

  18. Familial occurrence of autoimmune liver disease with overlapping features of primary biliary cholangitis and autoimmune hepatitis in a mother and her daughter.

    Science.gov (United States)

    Omori, Kaoru; Yoshida, Kanako; Yokota, Masaki; Daa, Tsutomu; Kan, Masahiro

    2016-10-01

    We encountered two patients with overlapping features of primary biliary cholangitis and autoimmune hepatitis within the same family. A 68-year-old woman presented at our hospital from a previous medical institution because of the diagnosis of primary biliary cholangitis. Her 49-year-old daughter was admitted with liver dysfunction 4 years later. When compared, these two related patients were found to have overlapping features of primary biliary cholangitis and autoimmune hepatitis. Their human leukocyte antigen haplotype was DRB1*04:05/DRB1*15:02. The clinical and biochemical findings of these two patients immediately improved following treatment with a combination of prednisolone and ursodeoxycholic acid, in accordance with the Japanese guidelines. It is extremely important to identify such pathological conditions as quickly as possible, particularly with the appearance of severe liver dysfunction due to liver cirrhosis, as observed in our case. The Japanese guidelines are considered to be a realistic and useful clinical policy for the swift and efficient treatment of patients with overlapping features of primary biliary cholangitis and autoimmune hepatitis. We suggest that our two patients presented with a genetic predisposition to autoimmune liver disease with overlapping features of primary biliary cholangitis and autoimmune hepatitis within the same family.

  19. Living donor liver transplantation for an adult patient with situs inversus totalis

    Institute of Scientific and Technical Information of China (English)

    Bong-Wan; Kim; Byong-Ku; Bae; Weiguang; Xu; Hee-Jung; Wang; Myung-Wook; Kim

    2010-01-01

    This recipient with situs inversus totalis(SIT) was a 60-year-old female who had hepatitis B-related endstage liver disease.Preoperative donor evaluation showed that the right posterior section satisfied graft volume and was space-fitting in the recipient hepatic fossa when it was rotated 180 degrees.The operation and postoperative course progressed satisfactorily.Three weeks after living donor liver transplantation(LDLT),the graft function was disturbed by compression of bottom-placed right hepatic vein.Th...

  20. Higher protein kinase C ζ in fatty rat liver and its effect on insulin actions in primary hepatocytes.

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    Wei Chen

    Full Text Available We previously showed the impairment of insulin-regulated gene expression in the primary hepatocytes from Zucker fatty (ZF rats, and its association with alterations of hepatic glucose and lipid metabolism. However, the molecular mechanism is unknown. A preliminary experiment shows that the expression level of protein kinase C ζ (PKCζ, a member of atypical PKC family, is higher in the liver and hepatocytes of ZF rats than that of Zucker lean (ZL rats. Herein, we intend to investigate the roles of atypical protein kinase C in the regulation of hepatic gene expression. The insulin-regulated hepatic gene expression was evaluated in ZL primary hepatocytes treated with atypical PKC recombinant adenoviruses. Recombinant adenovirus-mediated overexpression of PKCζ, or the other atypical PKC member PKCι/λ, alters the basal and impairs the insulin-regulated expressions of glucokinase, sterol regulatory element-binding protein 1c, the cytosolic form of phosphoenolpyruvate carboxykinase, the catalytic subunit of glucose 6-phosphatase, and insulin like growth factor-binding protein 1 in ZL primary hepatocytes. PKCζ or PKCι/λ overexpression also reduces the protein level of insulin receptor substrate 1, and the insulin-induced phosphorylation of AKT at Ser473 and Thr308. Additionally, PKCι/λ overexpression impairs the insulin-induced Prckz expression, indicating the crosstalk between PKCζ and PKCι/λ. We conclude that the PKCζ expression is elevated in hepatocytes of insulin resistant ZF rats. Overexpressions of aPKCs in primary hepatocytes impair insulin signal transduction, and in turn, the down-stream insulin-regulated gene expression. These data suggest that elevation of aPKC expression may contribute to the hepatic insulin resistance at gene expression level.

  1. Histopathological effects of sub-chronic lamivudine-artesunate co-administration on the liver of diseased adult Wistar rats

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    Temidayo Olutoyin Olurishe

    2011-01-01

    Full Text Available Background: Lamivudine and artesunate are sometimes co administered in HIV-malaria co morbidity. Both drugs are used concurrently in presumptive malaria treatment and simultaneous HIV post exposure prophylaxis. Aim: The aim of this study was to investigate the effect of lamivudine-artesunate co administration on the histology of the liver of diseased adult Wistar rats. Materials and Methods: Five groups of rats of both sexes were used for the study and placed on feed and water ad libitum. Disease state consisted of immunosuppression with cyclophosphamide, and infection with Plasmodium berghei. Group 1 animals served as vehicle control, while group 2 were the diseased controls. Group 3 animals received 20 mg/kg lamivudine for three weeks, while group 4 similarly received 20 mg/kg Lamivudine but also received 10 mg/kg artesunate from day 12. Animals in group 5 received 10 mg/kg artesunate from day 12. All drugs were administered intraperitoneally. The animals were treated for twenty-one days, at the end of which they were sacrificed and their livers fixed in 10% formalin for histological studies. Result: Results from the study show the presence of regions of focal necrosis and perivascular cuffing with animals that received artesunate. Hemosiderosis was a common feature in all the parasitized groups, while fatty degeneration was observed in the group that received artesunate alone. Conclusion: Concurrent lamivudine-artesunate administration resulted in some histopathological changes in the liver. This study suggests there may be considerable histological changes with repeated occurrence of malaria and immunosuppression that may warrant intermittent lamivudine-artesunate administration, and may require evaluation as well as monitoring of liver function during such therapeutic interventions.

  2. Standardized surgical techniques for adult living donor liver transplantation using a modified right lobe graft: a video presentation from bench to reperfusion.

    Science.gov (United States)

    Hwang, Shin; Ha, Tae-Yong; Ahn, Chul-Soo; Moon, Deok-Bog; Kim, Ki-Hun; Song, Gi-Won; Jung, Dong-Hwan; Park, Gil-Chun; Lee, Sung-Gyu

    2016-08-01

    After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices. This video clip that shows the surgical technique from bench to reperfusion was a case presentation of adult LDLT using a modified right liver graft from the patient's son. Our intention behind proposing the concept of right liver graft standardization is that it can be universally applicable and may guarantee nearly the same outcomes regardless of the surgeon's experience. We believe that this reconstruction model would be primarily applied to a majority of adult LDLT cases.

  3. Heterogeneity of ductular reactions in adult rat and human liver revealed by novel expression of deleted in malignant brain tumor 1

    DEFF Research Database (Denmark)

    Bisgaard, Hanne Cathrine; Holmskov, Uffe; Santoni-Rugiu, Eric

    2002-01-01

    DNA library screening approach, we identified 48 enriched, nonredundant gene products associated with liver injury and oval cell proliferation in the adult rat liver. Of these, only two, namely alpha-fetoprotein and a novel transcript with high homology to human DMBT1 (deleted in malignant brain tumor 1......), were specifically associated with the emergence of ductular (oval) cell populations in injured liver. Subsequent cloning and characterization of the rat DMBT1 homologue revealed a highly inducible expression in ductular reactions composed of transit-amplifying ductular (oval) cells, but not in ductular...

  4. In-hospital Mobility Variations across Primary Diagnoses among Older Adults

    Science.gov (United States)

    Valiani, Vincenzo; Gao, Shiyao; Chen, Zhiguo; Swami, Sunil; Harle, Christopher A.; Lipori, Gigi; Sourdet, Sandrine; Wu, Samuel; Nayfield, Susan G.; Sabbá, Carlo; Pahor, Marco; Manini, Todd M.

    2016-01-01

    Objectives To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. Design Prospective cohort study. Setting UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. Participants 18,551 older adults (≥65 years) with 29,148 hospitalizations between 1/2009 and 4/2014. Measurements Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change–approximately three times per day. Primary diagnosis ICD-9 codes were used as predictors and re-categorized by using the Agency for Health Care Research and Quality Clinical Classification Software. Results Out of the 15,498 hospital records where the patient was initially observed to “walk frequently”, 3,186 (20.6%) developed incident mobility impairment (chair-fast or bedfast). Primary diagnoses with a surgical or invasive procedure were the most prevalent (77.2 %) among the hospital observations with incident mobility impairment; otherwise primary diagnoses without surgery were much more associated with discharge mobility impairment (59%). The highest incidence of mobility impairment occurred in patients with heart valve disorders and aortic and peripheral/visceral artery aneurysms (6.24 and 6.05 events per 30 person-days, respectively); septicemia showed the highest incidence rate for mobility limitation at discharge (0.94 events per 30 person-days). Mobility impairment was observed in 13,650 (46.8% of total) records at admission and 5,930 (43.44%) were observed to recover to a state of walking occasionally or frequently. Osteoarthritis and cancer of gastrointestinal organs/peritoneum had the highest incidence rate for mobility recovery (7.68 and 5.63 events per 30 person-days respectively). Conclusions Approximately 1 out of 5 patients who were mobile at admission became significantly impaired during

  5. Uptake of liposomes containing phosphatidylserine by liver cells in vivo and by sinusoidal liver cells in primary culture : In vivo-in vitro differences

    NARCIS (Netherlands)

    Kamps, JAAM; Morselt, HWM; Scherphof, GL

    1999-01-01

    The interaction with liver cells of liposomes containing different mol fractions of phosphatidylserine was investigated in vivo and in vitro. Increasing the amount of liposomal phosphatidylserine from 10 to 30 mol% leads to a faster blood disappearance of the liposomes. Within the liver, which is ma

  6. Continual electric field stimulation preserves contractile function of adult ventricular myocytes in primary culture.

    Science.gov (United States)

    Berger, H J; Prasad, S K; Davidoff, A J; Pimental, D; Ellingsen, O; Marsh, J D; Smith, T W; Kelly, R A

    1994-01-01

    To model with greater fidelity the electromechanical function of freshly isolated heart muscle cells in primary culture, we describe a technique for the continual electrical stimulation of adult myocytes at physiological frequencies for several days. A reusable plastic cover was constructed to fit standard, disposable 175-cm2 tissue culture flasks and to hold parallel graphite electrodes along the long axis of each flask, which treated a uniform electric field that resulted in a capture efficiency of ventricular myocytes of 75-80%. Computer-controlled amplifiers were designed to be capable of driving a number of flasks concurrently, each containing up to 4 x 10(6) myocytes, over a range of stimulation frequencies (from 0.1 to 7.0 Hz) with reversal of electrode polarity after each stimulus to prevent the development of pH gradients around each electrode. Unlike quiescent, unstimulated myocytes, the amplitude of contraction, and velocities of shortening and relaxation did not change in myocytes paced at 3-5 Hz for up to 72 h. The maintenance of normal contractile function in paced myocytes required mechanical contraction per se, since paced myocytes that remained quiescent due to the inclusion of 2.5 microM verapamil in the culture medium for 48 h also exhibited a decline in contractility when paced after verapamil removal. Similarly, pacing increased peak calcium current compared with quiescent cells that had not been paced. Thus myocyte contraction at physiological frequencies induced by continual uniform electric field stimulation in short-term primary culture in defining medium maintains some biophysical parameters of myocyte phenotype that are similar to those observed in freshly isolated adult ventricular myocytes.

  7. Occupational and Environmental Risk Factors of Adult Primary Brain Cancers: A Systematic Review

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    A Guzman

    2011-03-01

    Full Text Available The incidence of brain neoplasm has been progressively increasing in recent years in the industrialized countries. One of the reasons for this increased incidence could be better access to health care and improved diagnosis in the industrialized countries. It also appears that Caucasians have a higher incidence than blacks or Hispanics or Asians. A number of risk factors have been identified and described including the genetic, ethnic and age-based factors. Certain occupational and environmental factors are also believed to influence the risk of primary adult brain tumors. Potential occupational and environmental factors include exposure to diagnostic and therapeutic radiations, electromagnetic radiation from cellular phones and other wireless devices, infectious agents, air pollution and residence near landfills and highvoltage power lines and jobs as firefighters, farmers, physician, chemists and jobs in industries such as petrochemical, power generation, synthetic rubber manufacturing, agricultural chemicals manufacturing. The purpose of this systematic review is to examine occupational and environmental risk factors of brain neoplasm. A range of occupational and environmental exposures are evaluated for significance of their relationship with adult primary brain tumors. On the basis of this review we suggest a concurrent evaluation of multiple risk factors both within and beyond occupational and environmental domains. The concurrent approach needs to consider better exposure assessment techniques, lifetime occupational exposures, genotypic and phenotypic characteristics and lifestyle and dietary habits. This approach needs to be interdisciplinary with contributions from neurologists, oncologists, epidemiologists and molecular biologists. Conclusive evidence that has eluded multitude of studies with single focus and single exposure needs to multifaceted and multidisciplinary.

  8. Comparison of the effect of acupressure at spleen 6 and liver 3 points on the anxiety level of patients with primary dysmenorrhea- Blind randomized controlled clinical trial

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    Mahboobeh Kafaei Atrian

    2014-08-01

    Full Text Available Background: Anxiety is a factor that is associated with dysmenorrhea. The purpose of this study was to compare the effect of acupressure at spleen 6 and liver 3 points on the anxiety level of patients with primary dysmenorrhea. Methods: In this randomized clinical trial study, acupressure was applied on spleen 6 and liver 3 points. Sixty seven students were evaluated in three menstrual periods. They were assigned to groups using a randomized block design with allocation ratio of 1:1 based on the severity of pain. Spielberger state-trait anxiety inventory (STAI and visual analogue scale for pain intensity were used. Analysis was performed by SPSS-16 software using chi-square, t-test, Mann–Whitney, paired sample t-test and covariance analysis. Results: In liver 3 and spleen 6 groups, 11 and 17 students were studied, respectively. The mean ±SD values of apparent anxiety before and after intervention for liver 3 group were 45.100±9.769 and 38.100±10.608 and for spleen 6 group were 46.823±12.248 and 44.352±11.942, respectively. Reduction of apparent anxiety was only significant in the liver 3 group (p0.05 in both groups. There was no difference between groups before and after intervention (p>0.05. Conclusion: Since pressure on liver 3 point reduced apparent anxiety, pressure on liver 3 point is recommended in patients with dysmenorrhea.

  9. An autopsy case showing massive fibrinoid necrosis of the portal tracts of the liver with cholangiographic findings similar to those of primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Hiroshi Hano; Ichiro Takagi; Keisuke Nagatsuma; Tomoe Lu; Chenxi Meng; Satoru Chiba

    2007-01-01

    An 81-year-old Japanese man with jaundice was strongly suspected clinically of having primary sclerosing cholangitis based on clinical examinations and later died of hepatic failure. The entire course of the disease lasted about 10 mo. The autopsy revealed extensive fibrinoid necrosis in the liver, kidney, spleen, pancreas,lung, lymph nodes, and pleura. Particularly extensive fibrinoid necrosis in the portal tracts of the liver induced severe stenoses of the intrahepatic bile ducts, resulting in cholestasis in association with prominent liver injury.There were no findings indicating primary sclerosing cholangitis. The hepatic lesions in this case did not coincide with any known disease including collagen diseases. To clarify the cause of irregular stenoses of the intrahepatic biliary trees on cholangiographic findings, we postulate that some form of immunological derangement might be involved in pathogenesis of fibrinoid necrosis.However, the true etiology remains unknown.

  10. Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy

    NARCIS (Netherlands)

    Sutton, Michael E.; Bense, Rico D.; Lisman, Ton; van der Jagt, Eric J.; van den Berg, Aad P.; Porte, Robert J.

    2014-01-01

    There is no consensus on the preferred type of biliary reconstruction for patients undergoing orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC). The aim of this study was to compare long-term outcomes after OLT for PSC using either duct-to-duct anastomosis or Roux-en-Y

  11. Parents in transition: Experiences of parents of young people with a liver transplant transferring to adult services.

    Science.gov (United States)

    Wright, J; Elwell, L; McDonagh, J E; Kelly, D A; Wray, J

    2017-02-01

    Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adult services can be challenging for parents and young people, yet parents' views regarding transition remain largely unexplored. Nine parents of pediatric liver transplant recipients (15.2-25.1 yr) participated in semistructured interviews. Interviews were analyzed using IPA. Analysis revealed three key themes: "emotional impact of transplantation," "protection vs. independence," and "ending relationships and changing roles." Parents expressed the dichotomous nature of the desire to promote independence in their child while still maintaining control and protection, and discussed how changing roles and relationships were difficult to navigate. Parents are important facilitators of young people's development of self-management skills for successful transfer to adult services. Parents should be supported to move from a "managerial" to a "supervisory" role during transition to help young people engage independently with the healthcare team. Findings support the development of interventions for parents to emphasize their role in transition and guide the transfer of self-management skills from parent to young person.

  12. Blood transcriptomic biomarkers in adult primary care patients with major depressive disorder undergoing cognitive behavioral therapy.

    Science.gov (United States)

    Redei, E E; Andrus, B M; Kwasny, M J; Seok, J; Cai, X; Ho, J; Mohr, D C

    2014-09-16

    An objective, laboratory-based diagnostic tool could increase the diagnostic accuracy of major depressive disorders (MDDs), identify factors that characterize patients and promote individualized therapy. The goal of this study was to assess a blood-based biomarker panel, which showed promise in adolescents with MDD, in adult primary care patients with MDD and age-, gender- and race-matched nondepressed (ND) controls. Patients with MDD received cognitive behavioral therapy (CBT) and clinical assessment using self-reported depression with the Patient Health Questionnaire-9 (PHQ-9). The measures, including blood RNA collection, were obtained before and after 18 weeks of CBT. Blood transcript levels of nine markers of ADCY3, DGKA, FAM46A, IGSF4A/CADM1, KIAA1539, MARCKS, PSME1, RAPH1 and TLR7, differed significantly between participants with MDD (N=32) and ND controls (N=32) at baseline (qdepressed. Thus, blood levels of different transcript panels may identify the depressed from the nondepressed among primary care patients, during a depressive episode or in remission, or follow and predict response to CBT in depressed individuals.

  13. Giant Mature Primary Retroperitoneal Teratoma in a Young Adult: Report of a Rare Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Walid Sasi

    2014-01-01

    Full Text Available Teratomas are neoplasms of the embryonic tissues that typically arise in the gonadal and sacrococcygeal regions of adults and children. Primary adult retroperitoneal teratomas are rare and demand challenging management options. We report a case of a unilateral primary retroperitoneal mature cystic teratoma mimicking an adrenal mass in a 28-year-old female patient. Complete resection of the mass was performed by a laparotomy approach. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient remains free of recurrence to date.

  14. Herpes Simplex Virus Hepatitis in an Immunocompetent Adult: A Fatal Outcome due to Liver Failure

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    Rachel A. Poley

    2011-01-01

    Full Text Available Objective. To present a case of a healthy 41-year-old female who developed fulminant hepatic failure leading to death. The cause of hepatic failure identified on postmortem exam was herpes simplex virus hepatitis. Design. Observation of a single patient. Setting. Intensive care unit of a tertiary care university teaching hospital in Canada. Patient. 41-year-old previously healthy female presenting with a nonspecific viral illness and systemic inflammatory response syndrome. Intervention. The patient was treated with intravenous fluids and broad-spectrum antibiotics. On the second day of admission, she was found to have elevated transaminases, and, over 48 hours, she progressed to fulminant liver failure with disseminated intravascular coagulopathy, refractory lactic acidosis, and shock. She progressed to respiratory failure requiring intubation and mechanical ventilation. She was started on N-acetylcysteine, a bicarbonate infusion, hemodialysis, and multiple vasopressors and inotropes. Measurements and Main Results. Despite treatment, the patient died roughly 70 hours after her initial presentation to hospital. Her postmortem liver biopsy revealed herpes simplex virus hepatitis as her cause of death. Conclusions. Herpes simplex virus must be considered in all patients presenting with liver failure of unknown cause. If suspected, prompt treatment with acyclovir should be initiated.

  15. A characterization of the ZFL cell line and primary hepatocytes as in vitro liver cell models for the zebrafish (Danio rerio)

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    Eide, Marta, E-mail: marta.eide@bio.uib.no [Department of Biology, University of Bergen, Bergen (Norway); Rusten, Marte; Male, Rune [Department of Molecular Biology, University of Bergen, Bergen (Norway); Jensen, Knut Helge Midtbø; Goksøyr, Anders [Department of Biology, University of Bergen, Bergen (Norway)

    2014-02-15

    Highlights: •The ZFL cell line and primary hepatocytes were characterized. •Basic and induced expression of nuclear receptors and target genes were found. •The ZFL cell line expresses very low basic levels of most genes. •The ZFL cells have low induction of gene expression following exposures. •Primary hepatocytes show large sex-dependent differences in gene expression. -- Abstract: The zebrafish (Danio rerio) is a widely used model species in biomedical research. The ZFL cell line, established from zebrafish liver, and freshly isolated primary hepatocytes from zebrafish have been used in several toxicological studies. However, no previous report has compared and characterized these two systems at the level of gene expression. The aim of this study was to evaluate the ZFL cell line in comparison to primary hepatocytes as in vitro models for studying effects of environmental contaminants in zebrafish liver. Using quantitative real-time PCR, the basal level and transcriptional induction potential of key genes involved in toxic responses in the ZFL cell line, primary hepatocytes and whole liver from zebrafish were compared. The study showed that the ZFL cells have lower levels of mRNA of most selected genes compared to zebrafish liver. The induced gene transcription following exposure to ligand was much lower in ZFL cells compared to zebrafish primary hepatocytes at the doses tested. Importantly, oestrogen receptor and vitellogenin genes showed low basal transcription and no induction response in the ZFL cell line. In conclusion, it appears that primary hepatocytes are well suited for studying environmental contaminants including xenoestrogens, but may show large sex-dependent differences in gene transcription. The ZFL cell line shows potential in toxicological studies involving the aryl hydrocarbon receptor pathway. However, low potential for transcriptional induction of genes in general should be expected, especially notable when studying estrogenic

  16. Protective Effect of the Persian Gulf brittle star Ophiocoma Erinaceus extract on carbon tetrachloride (CCl4 induced liver damage in adult male Wistar rats

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    Aida Soheili

    2015-12-01

    Full Text Available Background and Aim:  Brittle star possess  bioactive compounds which confer the wound healing capacity and regenerative potency of damaged  arms and organisms to this creature. The aim of the current study was to assess the   protective  effect  of  the  star extract on liver damages induced by carbon tetrachloride in adult male Wistar rats. Materials and Methods: In this experimental study, 32 adult male rats were randomly divided into 4 equal groups: control, Sham exposed, experimental 1 (treated with %25 extract and experimental 2 (treated with %50 extract of star Ophiocoma Erinaceus. The control group received no treatment. The sham exposed groups received carbon tetrachloride .(50% in olive oil .0.5 ml/kg for 7 days. The experimental groups firstly received carbon tetrachloride, then received %25, %50 brittle star extract as intragastric for 7 days. Finally, the animals were sacrificed, and their bodies and livers were weighed. Then, the livers sections were prepared and were examined by means of light microscope. Finally, the obtained  quantitative data was analyzed using SPSS (V; 20, Mini Tab software, ANOVA, and Tukey. at the significant level of P<0.001. Results: Carbon tetrachloride significantly decreased the rats’ body weight, but it increased their livers weight (P<0.001. Histopathological evaluations showed .extensive liver damage. On the other hand, treatment with brittle star extract .ncreased liver weight, reduced. body weight and significantly altered other induced changes by carbon tetrachloride on liver structure such as hepatocytes number, Kupffer cells, and arteritis, which indicated  the improvement of damaged liver tissue (P<0.001. Conclusion: It was found that brittle star extract can exert protective effects on  liver damages induced by carbon tetrachloride on male Wistar rat.

  17. Lifestyle Intervention Involving Calorie Restriction with or without Aerobic Exercise Training Improves Liver Fat in Adults with Visceral Adiposity

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    Eiichi Yoshimura

    2014-01-01

    Full Text Available Objective. To evaluate the effect of calorie restriction-induced weight loss with or without aerobic exercise on liver fat. Methods. Thirty-three adults with visceral adiposity were divided into calorie restriction (CR; n = 18 or CR and aerobic exercise (CR + Ex; n = 15 groups. Target energy intake was 25 kcal/kg of ideal body weight. The CR + Ex group had a targeted exercise time of 300 min/wk or more at lactate threshold intensity for 12 weeks. Results. Reductions in body weight (CR, -5.3 ± 0.8 kg; CR + Ex, -5.1 ± 0.7 kg, fat mass (CR, -4.9± 0.9 kg; CR + Ex, -4.4 ± 0.6 kg, and visceral fat (CR, -24 ± 5 cm2; CR + Ex, -37 ± 5 cm2 were not statistically different between groups. Liver fat decreased significantly in both groups, with no difference between groups. Change in maximal oxygen uptake was significantly greater in the CR + Ex group than in the CR group (CR, -0.7 ± 0.7 mL/kg/min; CR + Ex, 2.9 ± 1.0 mL/kg/min. Conclusion. Both CR and CR + Ex resulted in an improved reduction in liver fat; however, there was no additive effect of exercise training.

  18. Prevalence of nonalcoholic fatty liver disease in an adult population in a rural community of Haryana, India

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    Anindo Majumdar

    2016-01-01

    Full Text Available Background: Though nonalcoholic fatty liver disease (NAFLD is increasingly becoming prevalent in the Indian population, knowledge regarding the burden and risk factors of NAFLD is limited, more so from rural areas. This study was thus conducted to estimate the prevalence of NAFLD among adults in a rural community of Haryana, India and to measure the association of diet, physical activity, and other selected risk factors with NAFLD. Materials and Methods: The present study was conducted in a rural community of Haryana, India among resident adults ≥35 years of age. Eight out of 28 villages were selected by probability proportion to size sampling. The number of eligible and consenting participants randomly selected from each village was 27. Out of 216 participants thus recruited, 184 participants reported for undergoing ultrasonography (USG of the liver, anthropometry, blood pressure recording, and blood sample collection. Finally, 176 participants were analyzed. Results: Prevalence of NAFLD was 30.7%. There was no significant difference in the calorie intake and average total physical activity between participants with and without NAFLD. On multivariate analysis, hypertension [adjusted odds ratio (OR: 2.3, 95% confidence interval (CI: 1.1-5.0, P 0.03] and an increased waist circumference (adjusted OR: 4.9, 95% CI: 1.5-7.0, P < 0.001 were independently associated with NAFLD. A normal high-density lipoprotein (HDL level was protective against NAFLD (adjusted OR: 0.4, 95% CI: 0.2-0.8, P 0.001. Conclusions: The high prevalence of NAFLD is already a public health problem, even in the rural parts of India. Urgent public health interventions are required to prevent its development by controlling the cardiometabolic risk factors associated with it.

  19. Long-term impact of liver transplantation on respiratory function and nutritional status in children and adults with cystic fibrosis.

    Science.gov (United States)

    Dowman, J K; Watson, D; Loganathan, S; Gunson, B K; Hodson, J; Mirza, D F; Clarke, J; Lloyd, C; Honeybourne, D; Whitehouse, J L; Nash, E F; Kelly, D; van Mourik, I; Newsome, P N

    2012-04-01

    Early liver transplant (LT) has been advocated for patients with cystic fibrosis liver disease (CFLD) and evidence of deterioration in nutritional state and respiratory function to prevent further decline. However, the impact of single LT on long-term respiratory function and nutritional status has not been adequately addressed. We performed a retrospective analysis of the outcomes of 40 (21 adult/19 pediatric) patients with CFLD transplanted between 1987 and 2009 with median follow-up of 47.8 months (range 4-180). One and five-year actuarial survival rates were 85%/64% for adult and 90%/85% for pediatric LT cohorts, respectively. Lung function remained stable until 4 years (FEV(1) % predicted; pretransplant 48.4% vs. 45.9%, 4 years posttransplant) but declined by 5 years (42.4%). Up to 4 years posttransplant mean annual decline in FEV(1) % was lower (0.74%; p = 0.04) compared with the predicted 3% annual decline in CF patients with comorbidity including diabetes. Number of courses of intravenous antibiotics was reduced following LT, from 3.9/year pretransplant to 1.1/year, 5 years posttransplant. Body mass index was preserved posttransplant; 18.0 kg/m(2) (range 15-24.3) pretransplant versus 19.6 kg/m(2) (range 16.4-22.7) 5 years posttransplant. In conclusion, LT is an effective treatment for selected patients with cirrhosis due to CFLD, stabilizing aspects of long-term lung function and preserving nutritional status.

  20. 肝移植治疗肝原发性鳞状细胞癌1例%Liver transplantation for treatment of primary squamous cell carcinoma of the liver in one case

    Institute of Scientific and Technical Information of China (English)

    邓荣海; 何晓顺; 巫林伟; 吴成林; 王东平; 鞠卫强; 胡安斌; 邰强; 朱晓峰; 韩安家

    2011-01-01

    背景:肝原发性鳞状细胞癌较罕见,各种治疗方法疗效不佳,预后差.目的:随访观察1例肝移植治疗肝原发性鳞状细胞癌患者的近期疗效.方法:观察中山大学附属第一医院1例肝原发性鳞状细胞癌患者经肝移植治疗后的情况,并回顾性分析迄今为止见于文献报道的国内外65例肝原发性鳞状细胞癌的临床表现、组织来源、治疗方法及预后.结果与结论:该患者经肝移植后肝功能恢复正常,肿瘤标志物癌胚抗原、糖类抗原199、鳞状细胞癌抗原等均降至正常水平,恢复良好.国内外研究表明,肝原发性鳞状细胞癌的临床表现不典型,组织来源多样,手术切除、化疗等治疗方法疗效不佳,预后差.本例结果显示,肝移植治疗肝原发性鳞状细胞癌近期疗效良好.%BACKGROUND: Primary squamous cell carcinoma of the liver (PSCCL) is rare. Various treatments exhibit poor curative effectsand prognosis.OBJECTIVE: To invesHgate the short-term curative effects of liver transplantation in treatment of primary squamous cellMETHODS: We analyzed the effect of liver transplantation in treating one case of primary squamous cell carcinoma of the liver in the First Affiliated Hospital of Sun Yat-sen University and retrospectively analyzed the clinical manifestations, tissue origin, therapeutic method and prognosis of 65 cases of the primary squamous cell carcinoma of the liver at home and abroad. RESULTS AND CONCLUSION: The patient recovered well after liver transplantation, liver function returned to normal, tumor markers such as carcinoembryonic antigen. Carbohydrate199 and squamous cell carcinoma antigen decreased to normal levels. Domestic and foreign data show that primary squamous cell carcinoma of the liver presents atypical clinical manifestations, variety of tissue sources, poor efficacy and prognosis of surgical excision, chemotherapy and other treatments. Results from the present case showed that liver

  1. Extended right liver grafts obtained by an ex situ split can be used safely for primary and secondary transplantation with acceptable biliary morbidity.

    Science.gov (United States)

    Takebe, Atsushi; Schrem, Harald; Ringe, Bastian; Lehner, Frank; Strassburg, Christian; Klempnauer, Juergen; Becker, Thomas

    2009-07-01

    Split liver transplantation (SLT) is clearly beneficial for pediatric recipients. However, the increased risk of biliary complications in adult recipients of SLT in comparison with whole liver transplantation (WLT) remains controversial. The objective of this study was to investigate the incidence and clinical outcome of biliary complications in an SLT group using split extended right grafts (ERGs) after ex situ splitting in comparison with WLT in adults. The retrospectively collected data for 80 consecutive liver transplants using ERGs after ex situ splitting between 1998 and 2007 were compared with the data for 80 liver transplants using whole liver grafts in a matched-pair analysis paired by the donor age, recipient age, indications, Model for End-Stage Liver Disease score, and high-urgency status. The cold ischemic time was significantly longer in the SLT group (P = 0.006). As expected, bile leakage from the transected surface occurred only in the SLT group (15%) without any mortality or graft loss. The incidence of all other early or late biliary complications (eg, anastomotic leakage and stenosis) was not different between SLT and WLT. The 1- and 5-year patient and graft survival rates showed no statistical difference between SLT and WLT [83.2% and 82.0% versus 88.5% and 79.8% (P = 0.92) and 70.8% and 67.5% versus 83.6% and 70.0% (P = 0.16), respectively]. In conclusion, ERGs can be used safely without any increased mortality and with acceptable morbidity, and they should also be considered for retransplantation. The significantly longer cold ischemic time in the SLT group indicates the potential for improved results and should thus be considered in the design of allocation policies.

  2. Reversal of primary root caries lesions after daily intake of milk supplemented with fluoride and probiotic lactobacilli in older adults

    DEFF Research Database (Denmark)

    Petersson, Lars G; Magnusson, Kerstin; Hakestam, Ulf

    2011-01-01

    Abstract Objective. To evaluate the effect of milk supplemented with fluoride and/or probiotic bacteria on primary root caries lesions (PRCL) in older adults. Materials and methods. After informed consent, 160 healthy subjects, 58-84 years of age, with at least two PRCL were recruited and randoml...

  3. STUDY ON THE CLINICAL-PATHOLOGICAL SIGNIFICANCE OF MICROVESSEL DENSITY AND VASCULAR ENDOTHILIAL GROWTH FACTOR EXPRESSION IN PRIMARY LIVER CANCER

    Institute of Scientific and Technical Information of China (English)

    XIA Jing-lin; YANG Bing-hui; YE Sheng-long; LIN Zhi-ying; MA Zeng-chen; ZHOU Xin-da; WU Zhi-quan; TANG Zhao-you

    1999-01-01

    Objective: To evaluate the clinical-pathological significance of intratumoral microvessel density (MVD) and Vascular Endothelial Growth Factor (VEGF) expression in primary liver cancer (PLC). Methods: A retrospective study from 63 postoperative patients all with small PLC (diameter ≤ 5 cm) was done. One group of 29 patients developed recurrence or metastasis within 2 years. The other group of 34 patients had no evidence of recurrence or metastasis within 2 years. Three sections were taken from each patient. One for H.E. staining, the other two for VEGF and Bio-UEA-Ⅰ immunohistochemical staining respectively.MVD was counted by endothelial cells, which were highlighted by Bio-UEA-Ⅰ. Results: The MVD of the recurrence (or metastasis) group (49.6±29.7) were significantly greater than the other group (22.7±28.2) (P<0.01); The VEGF positive rate of the recurrence group was 86.2% (25/29), the rate of the other group was 47.1% (16/34). The difference between the 2 groups was stafistically significant (P<0.01). The stage of the tumor, the positive rate of satellite nodules and the positive rate of the portal vein embolus were all significantly different between the 2 groups. Conclusion: Besides tumor stage, satellite nodule and portal vein embolus, the MVD and VEGF are also of prognostic significance.

  4. Application of a new histological staging and grading system for primary biliary cirrhosis to liver biopsy specimens: Interobserver agreement.

    Science.gov (United States)

    Nakanuma, Yasuni; Zen, Yoh; Harada, Kenichi; Sasaki, Motoko; Nonomura, Akitaka; Uehara, Takeshi; Sano, Kenji; Kondo, Fukuo; Fukusato, Toshio; Tsuneyama, Koichi; Ito, Masahiro; Wakasa, Kenichi; Nomoto, Minoru; Minato, Hiroshi; Haga, Hironori; Kage, Masayoshi; Yano, Hirohisa; Haratake, Joji; Aishima, Shinichi; Masuda, Tomoyuki; Aoyama, Hajime; Miyakawa-Hayashino, Aya; Matsumoto, Toshiharu; Sanefuji, Hayato; Ojima, Hidenori; Chen, Tse-Ching; Yu, Eunsil; Kim, Ji-Hun; Park, Young Nyun; Tsui, Wilson

    2010-03-01

    Recently the authors proposed a new staging and grading system for primary biliary cirrhosis (PBC) that takes into account necroinflammatory activity and histological heterogeneity. Herein is proposed a convenient version of this system. Scores for fibrosis, bile duct loss, and chronic cholestasis were combined for staging: stage 1, total score of 0; stage 2, score 1-3; stage 3, score 4-6; and stage 4, score 7-9. Cholangitis activity (CA) and hepatitis activity (HA) were graded as CA0-3, and HA0-3, respectively. Analysis of interobserver agreement was then conducted. Digital images of 62 needle liver biopsy specimens of PBC were recorded as virtual slides on DVDs that were sent to 28 pathologists, including five located overseas. All participants were able to apply this version in all 62 cases. For staging, kappa was 0.385 (fair agreement) and the concordance rate was 63.9%. For necroinflammatory activity, the kappa and concordance rate were 0.110 (slight agreement) and 36.9% for CA, and 0.197 (slight agreement) and 47% for HA, respectively. In conclusion, this new staging and grading system for PBC seems to be more convenient and practical than those used at present, but more instruction and guidance are recommended for the grading of necroinflammatory activity in practice.

  5. Asymptomatic De Novo Inflammatory Bowel Disease Late After Liver Transplantation for Primary Sclerosing Cholangitis: A Case Report.

    Science.gov (United States)

    Åberg, F; Abdulle, A; Mäkelä, A; Nissinen, M

    2015-11-01

    Guidelines recommend colonoscopy screening for possible asymptomatic inflammatory bowel disease (IBD) in all patients diagnosed with primary sclerosing cholangitis (PSC). PSC-IBD warrants regular dysplasia-surveillance colonoscopy. However, no consensus exists regarding follow-up colonoscopy in PSC patients without IBD who remain asymptomatic. We describe a 43-year-old female who had undergone liver transplantation (LT) due to advanced PSC. Previous colonoscopies had been normal. The post-transplantation course was uneventful, with no rejections and signs of PSC recurrence. Immunosuppression was by tacrolimus monotherapy. She was asymptomatic with normal inflammation markers. A protocol colonoscopy, performed as general dysplasia surveillance 8 years post-transplantation, revealed mucopurulent-covered small superficial ulcerations and erythema diffusely distributed from the cecal to sigmoid colon with intervening normal mucosa and rectal sparing. Histologic examination showed patchy chronic colitis with crypt architectural distortion and mild-moderate inflammation activity. Infection samples were negative. Findings complied with de novo IBD, type unclassified. In conclusion, the link between PSC and clinically silent IBD may manifest after the PSC diagnosis and even several years after LT. Given the increased colorectal cancer risk associated with PSC, IBD, and LT, repeat colonoscopy might be warranted in PSC patients without IBD at initial assessment, and also after LT.

  6. Are the opportunities to prevent alcohol related liver deaths in the UK in primary or secondary care? A retrospective clinical review and prospective interview study

    Directory of Open Access Journals (Sweden)

    Sheron Nick

    2006-06-01

    Full Text Available Abstract Background Deaths from liver cirrhosis have increased at least 8 fold since the 1970's in the UK and further increases are anticipated, whereas in the rest of Europe liver deaths are decreasing. In the UK, we urgently need strategies to detect those who misuse alcohol and are at risk of developing alcoholic liver disease before they get to that point. One potential strategy is to screen admissions to hospital with alcohol related conditions for evidence of alcohol misuse. Surprisingly, there has been no research into the important question of where the opportunities are to detect those who misuse alcohol – primary or secondary care. We attempted to answer this firstly by conducting a retrospective analysis of the medical notes of 94 patients diagnosed with alcohol induced liver cirrhosis between 1st January 1995 and 31st December 2000 at Southampton General Hospital with the purpose of identifying admissions to hospital prior to a diagnosis of alcoholic liver disease. In the second part of the study, we interviewed patients with alcoholic liver disease about their contact with health services. Results Before diagnosis of alcoholic liver disease, 33% (31/94 of the patients had had an admission to hospital for an alcohol related condition. There was a mean of 7 years and 1 month (SD 6 years 3 months between the first alcohol-related admission and presentation with alcoholic liver disease (in those who had had admissions. The commonest reason for alcohol related admission was falls/fractures/injuries, followed by non-variceal gastro-intestinal bleeds. Patients with alcoholic liver disease who were interviewed had seen their General Practitioner on average at least 2 times per year. Conclusion Most patients who develop alcohol-induced cirrhosis do not have an admission to hospital with an alcohol related condition before developing alcoholic liver disease. Therefore, if we screen patients admitted to hospital with alcohol related

  7. Primary goitrous hypothyroidism in a young adult domestic longhair cat: diagnosis and treatment monitoring

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    Mark E Peterson

    2015-11-01

    Full Text Available Case summary Primary goitrous hypothyroidism was diagnosed in a 12-month-old cat examined because of small stature, mental dullness, severe lethargy, generalized weakness and gait abnormalities. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of primary hypothyroidism was confirmed by low serum concentrations of total and free thyroxine (T4 with high thyroid-stimulating hormone (TSH concentrations. Thyroid scintigraphy revealed severe enlargement of both thyroid lobes, as evidenced by a seven-fold increase in calculated thyroid volume above the reference interval. In addition, this bilateral goiter had an extremely high radionuclide uptake, about 10-fold higher than the normal feline thyroid gland. Treatment with twice-daily levothyroxine (L-T4, administered on an empty stomach, resulted in increased alertness, playfulness, strength and improvement in gait, as well as an increase in body length and weight. L-T4 replacement also led to normalization of serum thyroid hormone and TSH concentrations, and complete resolution of goiter. Relevance and novel information Spontaneous hypothyroidism is rarely reported in cats, with congenital hypothyroidism in kittens diagnosed most frequently. Despite the fact that this cat was a young adult, it likely had a form of congenital hypothyroidism caused by dyshormonogenesis (defect in thyroid hormone synthesis that led to compensatory development of goiter. In hypothyroid cats, treatment with L-T4 is best given twice daily on an empty stomach to ensure adequate absorption. Normalization of serum TSH and shrinkage of goiter, as well as improvement in clinical signs, is the goal of treatment for cats with goitrous hypothyroidism.

  8. UNCEMENTED PRIMARY TOTAL HIP ARTHROPLASTY FOR OSTEONECROSIS OF HIP WITH SECONDARY OSTEOARTHRITIS IN YOUNG ADULTS

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    Chatla

    2016-03-01

    Full Text Available BACKGROUND Osteonecrosis of the femoral head is a progressive disease that generally affects patients in the third through fifth decade of life, if left untreated. Currently, 18% of all Total Hip Arthroplasty performed in USA are done for Osteonecrosis.(1 The aetiology for the Osteonecrosis varies from idiopathic, alcohol intoxication, steroid abuse or due to childhood hip disorders and hip trauma. We have selected 40 patients suffering from advanced femoral head osteonecrosis with subchondral collapse leading to Osteoarthritis of hip in young adults, treated by uncemented primary total hip replacement. This study is aimed to suggest that uncemented total hip arthroplasty can be applied predictably to this younger, potentially more active patient population. MATERIAL AND METHODS We have done 54 uncemented primary hips in 40 cases with mean follow-up of 5.5 years. The average age of the patient at the time of surgery was 43 years. All the hips are clinically and radiologically examined both pre- and post-operatively. All the cases are operated through postero-lateral approach and have used the fully Hydroxyapatite coated femoral straight stem designed for press fit insertion and hemispherical HA-coated cup inserted with press fit and in few cases we used an HA-coated screw. The patients are under regular follow-up. RESULTS All the patients are reviewed at 6 weeks, 3 months, 6 months and yearly thereafter. The clinical and functional status was recorded using the Harris Hip Score and WOMAC Hip Score. The mean Harris score has improved from an average of 44 points to an average of 93 points postoperatively; 94% showed good-to-excellent results, 2% of cases had shortening, one case developed hip dislocation after two weeks due to unguarded physiotherapy. CONCLUSION The short-term results of cementless total hip arthroplasty in patients with Osteonecrosis of the femoral head were encouraging. We await further follow-up to see if these promising

  9. Reducing Liver Fat by Low Carbohydrate Caloric Restriction Targets Hepatic Glucose Production in Non-Diabetic Obese Adults with Non-Alcoholic Fatty Liver Disease

    OpenAIRE

    Haoyong Yu; Weiping Jia; ZengKui Guo

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) impairs liver functions, the organ responsible for the regulation of endogenous glucose production and thus plays a key role in glycemic homeostasis. Therefore, interventions designed to normalize liver fat content are needed to improve glucose metabolism in patients affected by NAFLD such as obesity. Objective: this investigation is designed to determine the effects of caloric restriction on hepatic and peripheral glucose metabolism in obese humans w...

  10. Portal vein stenting as a signiifcant risk factor for biliary stricture in adult living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Min-Ho Shin; Gil-Chun Park; Young-In Yun; Wan-Jun Kim; Woo-Hyoung Kang; Seok-Hwan Kim; Gi-Young Ko; Deok-Bog Moon; Sung-Gyu Lee; Shin Hwang; Ki-Hun Kim; Chul-Soo Ahn; Tae-Yong Ha; Gi-Won Song; Dong-Hwan Jung

    2016-01-01

    BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) re-cipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its in-cidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131). RESULTS: The incidence of BAS was higher in patients in the stent group than that in the control group (43.2% vs 17.6%, P=0.001). Cumulative 6-month and 1-, 2- and 5-year BAS rates were 31.8%, 34.1%, 41.4% and 43.2%, respectively, in the stent group and 13.0%, 13.8%, 16.1% and 17.8%, respectively, in the control group (P=0.001). Multivariate analysis revealed that PV stenting was an independent risk factor for BAS. CONCLUSIONS: Although PV stent implantation is a reliable treatment modality for steno-occlusive PV in adult LDLT recipients, innovative methods to prevent the PV stent from crossing the line of PV anastomosis may be necessary to reduce the incidence of postoperative BAS.

  11. Falls in the community-dwelling older adult: A review for primary-care providers

    Directory of Open Access Journals (Sweden)

    Theresa A Soriano

    2008-01-01

    Full Text Available Theresa A Soriano1, Linda V DeCherrie2, David C Thomas11The Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA; 2Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USAAbstract: Falls in the elderly are an important independent marker of frailty. Up to half of elderly people over 65 experience a fall every year. They are associated with high morbidity and mortality and are responsible for greater than 20 billion dollars a year in healthcare costs in the United States. This article presents a review and guide for the primary care provider of the predisposing and situational risk factors for falls; comprehensive assessment for screening and tailored intervention; and discussion of single and multicomponent measures for fall prevention and management in the older person living in the community. Interventions for the cognitively impaired and demented elderly will also be addressed.Keywords: falls, elderly, community-dwelling, review

  12. Ignored adult primary hypothyroidism presenting chiefly with persistent ovarian cysts: a need for increased awareness

    Directory of Open Access Journals (Sweden)

    Fang Suhua

    2011-08-01

    Full Text Available Abstract Background Ovarian cysts are a common cause for gynecological surgery. However, some cysts are a direct result of endocrine disorders and do not require surgery. This report describes an unusual case in which persistent ovarian cysts are associated with primary hypothyroidism in a young woman. The data were collected by history-taking, physical examination, laboratory tests, ultrasound, magnetic resonance imaging and a histo-pathological study. In addition, the exons of the gene encoding the human follicle-stimulating hormone receptor were sequenced. Discussion The patient had markedly elevated levels of thyroid-stimulating hormone and follicle-stimulating hormone and an enlarged pituitary gland. After treatment with thyroid hormone replacement, regression of the enlarged pituitary and the ovarian cysts was observed. The possible mechanisms of the pathophysiology are discussed below. Summary It is necessary to consider hypothyroidism and other endocrine disorders in the differential diagnosis of adult patients with ovarian multiple cyst formation in order to prevent inadvertent ovarian surgery.

  13. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

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    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  14. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

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    Gabriel U.P. Iloh

    2013-01-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046.Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  15. Developmental changes of cytochrome P450 dependent monooxygenase functions after transplantation of fetal liver tissue suspension into spleens of adult syngenic rats.

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    Lupp, A; Trautmann, A K; Krausse, T; Klinger, W

    1998-06-01

    Fetal liver tissue suspensions were transplanted into the spleens of adult male syngenic Fisher 344 inbred rats. Animals were sacrificed at 3 days, 1, 2, 4 weeks, and 2, 4 and 6 months after transplantation and cytochrome P450 (P450) dependent monooxygenase functions in spleen and liver 9000 g supernatants were assessed by measuring three model reactions for different P450 subtypes: ethoxyresorufin O-deethylation (EROD; mainly 1A), ethoxycoumarin O-deethylation (ECOD; predominantly 1A, 2A, 2B) and ethylmorphine N-demethylation (END; mainly 3A). Values of transplant recipients were compared to those of sham operated and age matched control rats. Spleen weights were significantly higher in transplanted rats, compared to controls or sham operated animals, but there was no influence of the transplants within the spleens on liver weights. With fetal livers at the 21st day of gestation, the day of transplantation, a weak EROD and ECOD, but no END activity was seen. Spleens of controls or sham operated animals displayed nearly no P450 mediated monooxygenase functions. In the explant containing spleens a significant and increasing EROD activity was found from 4 weeks after surgery on and an ECOD activity already 2 weeks after transplantation. END was only slightly enhanced at 6 months after surgery. The livers of all three groups of rats displayed normal EROD, ECOD and END activities. Transplantation of fetal liver tissue suspensions into the spleens did not influence the P450 dependent monooxygenase functions within the livers of the animals. From these results it can be concluded that intrasplenically transplanted liver cells originating from syngenic fetal liver tissue suspensions proliferate and differentiate within the host organs. They display P450 dependent monooxygenase functions with some developmental changes during the observed time period of 6 months.

  16. Management of adult attention deficit hyperactivity disorder in UK primary care: a survey of general practitioners

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    McCarthy, Suzanne; Wilton, Lynda; Murray, Macey; Hodgkins, Paul; Asherson, Philip; Wong, Ian CK

    2013-01-01

    Background: Compared to existing literature on childhood attention deficit hyperactivity disorder (ADHD), little published adult data are available, particularly outside of the United States. Using General Practitioner (GP) questionnaires from the United Kingdom, this study aimed to examine a number of issues related to ADHD in adults, across three cohorts of patients, adults who received ADHD drug treatment in childhood/adolescence but stopped prior to adulthood; adults who received ADHD dru...

  17. Surgery for Intermediate and Advanced Hepatocellular Carcinoma: A Consensus Report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014)

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    Ho, Ming-Chih; Hasegawa, Kiyoshi; Chen, Xiao-Ping; Nagano, Hiroaki; Lee, Young-Joo; Chau, Gar-Yang; Zhou, Jian; Wang, Chih-Chi; Choi, Young Rok; Poon, Ronnie Tung-Ping; Kokudo, Norihiro

    2016-01-01

    Background The Barcelona Clinic Liver Cancer (BCLC) staging and treatment strategy does not recommended surgery for treating BCLC stage B and C hepatocellular carcinoma (HCC). However, numerous Asia-Pacific institutes still perform surgery for this patient group. This consensus report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting aimed to share opinions and experiences pertaining to liver resection for intermediate and advanced HCCs and to provide evidence to issue recommendations for surgery in this patient group. Summary Thirteen experts from five Asia-Pacific regions were invited to the meeting; 10 of them (Japan: 2, Taiwan: 3, South Korea: 2, Hong Kong: 1, and China: 2) voted for the final consensus. The discussion focused on evaluating the preoperative liver functional reserve and surgery for large tumors, multiple tumors, HCCs with vascular invasion, and HCCs with distant metastasis. The feasibility of future prospective randomized trials comparing surgery with transarterial chemoembolization for intermediate HCC and with sorafenib for advanced HCC was also discussed. The Child-Pugh score (9/10 experts) and indocyanine green retention rate at 15 min (8/10) were the most widely accepted methods for evaluating the preoperative liver functional reserve. All (10/10) experts agreed that portal hypertension, tumor size >5 cm, portal venous invasion, hepatic venous invasion, and extrahepatic metastasis are not absolute contraindications for the surgical resection of HCC. Furthermore, 9 of the 10 experts agreed that tumor resection may be performed for patients with >3 tumors. The limitations of surgery are associated with a poor liver functional reserve, incomplete tumor resection, and a high probability of recurrence. Key Messages Surgery provides significant survival benefits for Asian-Pacific patients with intermediate and advanced HCCs, particularly when the liver functional reserve is favorable. However, prospective randomized controlled trials

  18. Suppression of graft regeneration, not ischemia/reperfusion injury, is the primary cause of small-for-size syndrome after partial liver transplantation in mice.

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    Ning Pan

    Full Text Available BACKGROUND: Ischemia/reperfusion injury (IRI is commonly considered to play a crucial role in the pathogenesis of small-for-size syndrome (SFSS after liver transplantation. Rapid regeneration is also considered essential for the survival of SFS grafts. METHODS: Mouse models of full-size orthotopic liver transplantation, 50% partial liver transplantation and 30% partial liver transplantation were established. Survival rate and serum alanine aminotransferase were observed. IRI was assessed by hepatic pathologic alterations, apoptosis and necrosis. Regeneration response was detected by mitotic index, BrdU incorporation and PCNA, Cyclin D1 and Cyclin E expression. The expression of mTOR, AKT, ERK, JNK2 and p70S6K, also involved in regeneration signaling pathways, were analyzed as well. RESULTS: 30% partial liver graft resulted in a significantly low 7-day survival rate (P = 0.002 with no marked difference in tissue injury compared with the 50% partial graft group. Serum alanine aminotransferase levels were not significantly different between partial transplantation and full-size transplantation. Western blot analysis of caspase-3 and TUNEL staining also indicated no significant difference in apoptosis response between 30% partial transplantation and half-size or full-size transplantation (P = 0.436, P = 0.113, respectively. However, liver regeneration response indicators, mitotic index (P<0.0001 and BrdU (P = 0.0022, were markedly lower in 30% LTx compared with 50% LTx. Suppressed expression of PCNA, cyclin D1, cyclin E, mTOR, JNK2, AKT, ERK and p70S6K was also detected by western blot. CONCLUSIONS: Liver regeneration is markedly suppressed in SFSS, and is more likely the primary cause of SFSS, rather than ischemia/reperfusion injury. Therapy for recovering graft regeneration could be a potentially important strategy to reduce the incidence of SFSS.

  19. Relationship between grip strength and newly diagnosed nonalcoholic fatty liver disease in a large-scale adult population

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    Meng, Ge; Wu, Hongmei; Fang, Liyun; Li, Chunlei; Yu, Fei; Zhang, Qing; Liu, Li; Du, Huanmin; Shi, Hongbin; Xia, Yang; Guo, Xiaoyan; Liu, Xing; Bao, Xue; Su, Qian; Gu, Yeqing; Yang, Huijun; Bin Yu; Wu, Yuntang; Sun, Zhong; Niu, Kaijun

    2016-01-01

    Enhanced muscle strength is often related to improved insulin sensitivity and secretion, control of lipid metabolism, and increased secretion of myokines. These factors have emerged as important mechanisms involved in the development and progression of nonalcoholic fatty liver disease (NAFLD), implying that muscle strength may be a useful predictor for NAFLD. We aimed to assess the relationship between grip strength (GS) and NAFLD in a large-scale adult population. GS was assessed using an electronic hand-grip dynamometer, and NAFLD was diagnosed by the liver ultrasonography. Multiple logistic regression analysis was used to assess the relationship between the quartiles of GS per body weight and the prevalence of NAFLD. After adjusting for potentially confounding factors, the odds ratios (95% confidence interval) for overall NAFLD, NAFLD with normal alanine aminotransferase levels, and NAFLD with elevated alanine aminotransferase levels across the quartiles of GS were 1.00 (reference), 0.89 (0.78, 1.01), 0.77 (0.67, 0.89), and 0.67 (0.57, 0.79); 1.00 (reference), 0.91 (0.80, 1.04), 0.79 (0.68, 0.92), and 0.72 (0.61, 0.85); 1.00 (reference), 0.77 (0.61, 0.98), 0.67 (0.51, 0.86), and 0.53 (0.40, 0.71) (all P for trend < 0.01), respectively. This is the first study shows that increased GS is independently associated with lower prevalence of NAFLD. PMID:27616599

  20. Impact of e-cigarette refill liquid with or without nicotine on liver function in adult rats.

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    El Golli, Narges; Jrad-Lamine, Aicha; Neffati, Hajira; Rahali, Dalila; Dallagi, Yosra; Dkhili, Houssem; Ba, Nathalie; El May, Michele V; El Fazaa, Saloua

    2016-07-01

    This study was conducted to evaluate the effects of e-cigarette refill liquid administration alone or with nicotine on the antioxidant defense status, functional and histopathological changes in adult rat liver tissue. For this purpose, 32 rats were treated for 28 days as follows: control group was injected intra-peritoneally with physiological saline; e-cigarette 0% treated group received an intra-peritoneal injection of e-liquid without nicotine diluted in physiological saline, e-cigarette-treated group received an intra-peritoneal injection of e-liquid containing 0.5 mg of nicotine/kg of body weight/day diluted in physiological saline and nicotine-treated group received an intra-peritoneal injection of 0.5 mg of nicotine/kg of body weight/day diluted in physiological saline. In e-liquid without nicotine-exposed group, activities of the liver biomarkers aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and lactate dehydrogenase increase. Interestingly, oxidative stress indicators showed decreased total protein content, associated with a reduction in the antioxidant enzymes activities superoxide dismutase, catalase and glutathione-S-transferase, and an elevation in malondialdehyde content, highlighting the promotion of lipid peroxidation and oxidative stress. Histological studies identified inflammatory cells infiltration and cell death. Thus, e-liquid seems to promote oxidative tissue injuries, which in turn lead to the observed histopathological finding. In comparison, nicotine alone induced less oxidative stress and less histopathological disorders, whereas e-liquid with nicotine gave rise to more histopathological injuries. Thereby, e-liquid, per se, is able to induce hepatotoxicity and supplementation with nicotine worsens this state.

  1. Adults with ADHD: use and misuse of stimulant medication as reported by patients and their primary care physicians.

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    Lensing, Michael B; Zeiner, Pål; Sandvik, Leiv; Opjordsmoen, Stein

    2013-12-01

    This study investigated the agreement on treatment for attention-deficit/hyperactivity disorder (ADHD) between adults with ADHD and the primary care physicians responsible for their treatment. Adults with ADHD and the primary care physicians responsible for their ADHD treatment completed a survey. The κ-statistic assessed physician-patient agreement on ADHD treatment variables. The eligible sample consisted of 274 patients with confirmed current or previous psychopharmacological treatment for ADHD and the physicians responsible for their treatment. We received 159 questionnaires (58.0 %) with sufficient information from both sources. There were no significant differences between participants and nonparticipants (N = 115) on ADHD sample characteristics. Participants' mean age was 37.6 years, and 75 (47.2 %) were females. There was high agreement for current pharmacological treatment for ADHD, current and last ADHD drug prescription, treatment for substance use, and misuse of stimulant medication. Agreement for nonpharmacological treatment for ADHD and treatment termination because of the side effects was low. A minority of participants from both sources reported misuse of stimulant medication. There was a moderate correlation between the physicians' clinical judgment and patients' self-report on current functioning. The study showed that primary care physicians and their patients agreed on the pharmacological but not the nonpharmacological, treatments given. They also agreed on patients' current functioning. Physicians and patients reported low levels of misuse of stimulant medication. The results show that pharmacological treatment for adults with ADHD can be safely undertaken by primary care physicians.

  2. Impact of operative and peri-operative factors on the long-term prognosis of primary liver cancer patients undergoing hepatectomy.

    Science.gov (United States)

    Xu, Li-Ning; Xu, Ying-Ying; Gao, De-Wei

    2016-08-01

    This study examined the impact of the operative and peri-operative factors on the long-term prognosis of patients with primary liver cancer undergoing hepatectomy. A total of 222 patients with primary liver cancer who underwent hepatectomy were followed up from January 1986 to December 2010 at Chinese PLA General Hospital. The post-operative complication rate was 14.0% for all cases, 13.7% for hepatocellular carcinoma (HCC), 10.0% for cholangiocarcinoma. The 1-, 3-, 5- and 10-year overall survival rates in patients with primary liver cancer after resection were 76.6%, 57.6%, 41.4%, and 21.0%. The survival rates were significantly higher in the HCC group than in the cholangiocarcinoma group (P=0.000), in the non-anatomical resection group than in the anatomical resection group (P=0.005), in the female group than in the male group (P=0.002), in patients receiving no blood transfusion than in those who were given intra-operative blood transfusion (P=0.000), in patients whose intra-operative blood loss was less than 400 mL than in those who intra-operatively lost more than 400 mL (P=0.000). No significant difference was found in the survival rate between the HBsAg-positive group and the HBsAg-negative group (P=0.532). Our study showed that anatomical resection, blood loss and blood transfusion were predictors of poor survival after hepatectomy for primary liver cancer patients, and concomitant hepatitis B virus infection bore no relation with the post-resection survival.

  3. Antibiotic-Induced Liver Injury in Paediatric Outpatients: A Case-Control Study in Primary Care Databases

    NARCIS (Netherlands)

    C. Ferrajolo (Carmen); K.M.C. Verhamme (Katia); G. Trifirò (Gianluca); ‘T Jong, G.W. (Geert W.); G. Picelli (Gino); C. Giaquinto (Carlo); G. Mazzaglia (Giampiero); B.H.Ch. Stricker (Bruno); F. Rossi (Francesco); A. Capuano (Annalisa); M.C.J.M. Sturkenboom (Miriam)

    2016-01-01

    textabstractIntroduction: Antibiotics are the most commonly prescribed drug class in children. Real-world data mining on the paediatric population showed potential associations between antibiotic use and acute liver injury. Objective: We assessed risk estimates of liver injury associated with antibi

  4. [Primary carcinoma of the liver and hepatitis C virus in Italy. A prospective study in patients with cirrhosis].

    Science.gov (United States)

    Bargiggia, S; Piva, A; Sangiovanni, A; Donato, F

    1989-01-01

    The possibility to detect the antibody to hepatitis C virus (HCV) has allowed to estimate the prevalence of this virus in patients with hepatic disease, mostly in those with hepatitis considered non-A non-B. Literature shows that HCV causes about 75% of cases of cryptogenic hepatitis and more than the 90% of post-transfusional hepatitis. Circumstantial evidence suggests the existence of a relationship between parenterally-transmitted non-A non-B hepatitis (PTH) and primary liver cancer (PLC). With the advent of anti-HCV, it is now possible to assess directly whether or not there is a relationship between PTH and PLC. So anti-HCV was looked for in the sera of 365 patients with cirrhosis prospectively followed-up for early detection the development of PLC, using an enzymatic immunoassay (ELISA Ortho DS). At baseline anti-HCV was detected in 221 patients (60%). During 5-39 month 53 patients developed PLC and anti-HCV was detected in 68% of them. The univariate analysis demonstrated that alcohol abuse, anti-HBs and anti-HBc were the only covariates that were significantly associated with an increase risk of developing PLC. When these factors were introduced in the step wise regression analysis, age and alcohol were found to be the only independent risk factors. The high prevalence of anti-HCV found in patients with cirrhosis and PLC suggests that HCV might play a role in this tumor; the frequent co-occurrence of HCV and HBV markers suggests that HCV-HBV coinfection might be pathogenically important; alcohol was the most important non-viral risk factor for PLC.

  5. DNA breaks induced by micromolar concentrations of dimethylnitrosamine in liver primary cell cultures from untreated and phenobarbital treated rats.

    Science.gov (United States)

    Mendoza-Figueroa, T; López-Revilla, R; Villa-Treviño, S

    1983-05-01

    Direct genotoxic effects of the alkylating agent dimethylnitrosamine (DMN) have been difficult to detect in several short-term tests. We simplified our method to detect DNA breaks induced by DMN in rat liver primary cell cultures, and increased its sensitivity about 150 times by changing the conditions of ultracentrifugation and exposure to DMN. Additionally we increased 4 times the sensitivity of the improved assay by isolating hepatocytes from rats treated with phenobarbital (PB). Treatment for 24 h with 60 microM and 13.5 microM DMN of hepatocytes isolated from untreated and PB-treated rats, respectively, decreased the molecular weight of DNA by 50%. After 24 h exposure to 13.5 microM [14C]DMN, hepatocytes from PB-treated rats incorporated 3 times more radioactivity into trichloroacetic acid precipitable material than hepatocytes from untreated rats. Also PB-treatment increased remarkably cytotoxic effects of DMN while it did not modify the cytotoxicity nor the genotoxicity of the direct-acting alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine. These results show that DMN is more genotoxic for hepatocytes from PB-treated rats, and suggest that the enhanced genotoxicity is probably due to an augmented metabolism of DMN by these cultures. Our improved assay of DNA breaks as an indicator of DMN genotoxicity is now as sensitive but faster to perform than hepatocyte-mediated mutagenesis. It could be used to explore genotoxic effects of other alkylating agents and the action of microsomal enzyme modifiers on genotoxicity.

  6. Incidence of colorectal cancer after liver transplantation for primary sclerosing cholangitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Singh, Siddharth; Edakkanambeth Varayil, Jithinraj; Loftus, Edward V; Talwalkar, Jayant A

    2013-12-01

    Patients with primary sclerosing cholangitis (PSC) and associated inflammatory bowel disease (IBD) have an increased risk of colorectal cancer (CRC). We estimated the pooled incidence of CRC after liver transplantation (LT) in patients with PSC as well as in a subset of patients with associated IBD (PSC-IBD). Through a systematic review of major bibliographic databases up to April 1, 2013, we identified cohort studies reporting the incidence of de novo CRC after LT for PSC. The main outcome measure was CRC incidence rate (IR) per 1000 person-years after LT in all patients with PSC and in a subset of patients with PSC-IBD with an intact colon. According to a meta-analysis of 18 independent cohorts (69 cases of CRC among 1987 patients), the pooled IR of de novo CRC in patients with PSC after LT was 5.8 per 1000 person-years [95% confidence interval (CI) = 3.8-7.8]. According to a meta-analysis of 16 independent cohort studies (66 cases of CRC among 1017 patients), the IR of CRC in patients with PSC-IBD and an intact colon at the time of LT was 13.5 per 1000 person-years (95% CI = 8.7-18.2). A long duration of IBD and extensive colitis were identified as risk factors for CRC. Specific transplant-related factors that can increase the risk of CRC have not been identified. In conclusion, the risk of CRC remains high for patients who undergo LT for PSC, particularly in the subset of patients with associated IBD and an intact colon at the time of LT. Aggressive colonoscopic surveillance for CRC would be prudent for patients with PSC-IBD even after LT.

  7. Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis.

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    Tong-Chun Xue

    Full Text Available The neutrophil-to-lymphocyte ratio (NLR is a useful biomarker that reflects systemic inflammation responses. However, the prognostic value of the NLR in patients with primary liver cancer (PLC remains controversial. We performed a meta-analysis of 26 studies (comprising 4,461 patients to evaluate the association between the pre-treatment NLR and clinical outcomes of overall survival (OS and disease-free survival (DFS in patients with PLC. The correlation between NLR and tumor characteristics or other inflammation-related parameters was also assessed. Data were synthesized using the random-effects model of DerSimonian and Laird, and the hazard ratio (HR or odds ratio (OR with 95% confidence interval (CI was used to estimate effect size. Our analysis indicated that a high NLR predicted poor OS (HR, 2.102; 95% CI: 1.741-2.538 and DFS (HR, 2.474; 95% CI: 1.855-3.300 for PLC. A high NLR was associated with the presence of tumor vascular invasion (OR: 1.889, 95% CI: 1.487-2.400; p<0.001 and an elevated alpha-fetoprotein level (OR: 1.536; 95% CI: 1.152-2.048; p = 0.003. Thus, we conclude that a high NLR indicates a poor prognosis for patients with PLC and may also be predictive for PLC invasion and metastasis. Subgroup analysis suggested that the predictive role of NLR in cholangiocarcinoma is limited, and a further large study to confirm these findings is warranted.

  8. The Association between Dietary Vitamin A and Carotenes and the Risk of Primary Liver Cancer: A Case–Control Study

    Science.gov (United States)

    Lan, Qiu-Ye; Zhang, Yao-Jun; Liao, Gong-Cheng; Zhou, Rui-Fen; Zhou, Zhong-Guo; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-01-01

    Dietary intake of vitamin A (VA) and carotenes has shown beneficial effects for decreasing the risk of some types of cancer, but findings on the risk of primary liver cancer (PLC) are inconsistent. This case–control study explored the associations between the dietary intake of VA and carotenes and the risk of PLC. We recruited 644 incident PLC patients (diagnosed within one month of each other) and 644 age- and gender-matched controls in Guangzhou, China. A food frequency questionnaire was used to assess habitual dietary intake. Logistic regression analyses found that higher intakes of VA and carotenes were independently associated with decreased PLC risk (all P-trend < 0.001). The multivariable-adjusted ORs (95% CI) of PLC for the highest (vs. lowest) quartile were 0.34 (0.24–0.48) for vitamin A and 0.35 (0.25–0.49) for carotenes. The associations were not significantly modified by smoking, alcohol, or tea drinking (P-interactions: 0.062–0.912). Dose–response analysis showed a U-shaped VA–PLC relationship, with sharply decreased risks at the intakes of about 1000 μg retinol equivalent (RE)/day, and then slowly went down toward the flat-bottomed risks with the lowest risk at 2300 μg RE/day. Our findings suggest that greater intake of retinol, carotenes, and total VA may decrease PLC risk among the Chinese population at an intake of 1000 μg RE/day or greater from food sources. PMID:27727160

  9. Neo-lymphoid aggregates in the adult liver can initiate potent cell-mediated immunity.

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    Melanie Greter

    2009-05-01

    Full Text Available Subcutaneous immunization delivers antigen (Ag to local Ag-presenting cells that subsequently migrate into draining lymph nodes (LNs. There, they initiate the activation and expansion of lymphocytes specific for their cognate Ag. In mammals, the structural environment of secondary lymphoid tissues (SLTs is considered essential for the initiation of adaptive immunity. Nevertheless, cold-blooded vertebrates can initiate potent systemic immune responses even though they lack conventional SLTs. The emergence of lymph nodes provided mammals with drastically improved affinity maturation of B cells. Here, we combine the use of different strains of alymphoplastic mice and T cell migration mutants with an experimental paradigm in which the site of Ag delivery is distant from the site of priming and inflammation. We demonstrate that in mammals, SLTs serve primarily B cell priming and affinity maturation, whereas the induction of T cell-driven immune responses can occur outside of SLTs. We found that mice lacking conventional SLTs generate productive systemic CD4- as well as CD8-mediated responses, even under conditions in which draining LNs are considered compulsory for the initiation of adaptive immunity. We describe an alternative pathway for the induction of cell-mediated immunity (CMI, in which Ag-presenting cells sample Ag and migrate into the liver where they induce neo-lymphoid aggregates. These structures are insufficient to support antibody affinity maturation and class switching, but provide a novel surrogate environment for the initiation of CMI.

  10. Histopathology of the Liver Following Administration of Artesunate in Adult Wistar Rats

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    Felix Monday Onyije

    2012-02-01

    Full Text Available Summary In must of the developing countries especially in Africa antimalaria drugs are taken regularly either to treat or prevent malaria. The rats were randomly divided into 3 groups of 5 each and tested as follows: - Group O- control (water, Group A – 2mg/kg and Group B - 6mg/kg. The animals were sacrificed after the 7th day. There was no mortality caused by the drug but dizziness in the animals. In the group administered with 2mg/kg of oral artesunate where was no form of distortion in the tissue architecture of the liver, but in the group administered with 6mg/kg of artesunate, artesunate caused sinusoidal congestion, infiltration of inflammatory cells and there was loss of tissue architecture. Drugs are produce to combat illnesses but may turn out be harmful when administered wrongly. In must of the developing countries especially in Africa antimalaria drugs are taken regularly either to treat or prevent malaria. They are taken such that one could even imaging if it is a food supplement. [J Interdiscipl Histopathol 2012; 1(1.000: 26-29

  11. Prenatal arsenic exposure alters gene expression in the adult liver to a proinflammatory state contributing to accelerated atherosclerosis.

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    J Christopher States

    Full Text Available The mechanisms by which environmental toxicants alter developmental processes predisposing individuals to adult onset chronic disease are not well-understood. Transplacental arsenic exposure promotes atherogenesis in apolipoprotein E-knockout (ApoE(-/- mice. Because the liver plays a central role in atherosclerosis, diabetes and metabolic syndrome, we hypothesized that accelerated atherosclerosis may be linked to altered hepatic development. This hypothesis was tested in ApoE(-/- mice exposed to 49 ppm arsenic in utero from gestational day (GD 8 to term. GD18 hepatic arsenic was 1.2 µg/g in dams and 350 ng/g in fetuses. The hepatic transcriptome was evaluated by microarray analysis to assess mRNA and microRNA abundance in control and exposed pups at postnatal day (PND 1 and PND70. Arsenic exposure altered postnatal developmental trajectory of mRNA and microRNA profiles. We identified an arsenic exposure related 51-gene signature at PND1 and PND70 with several hubs of interaction (Hspa8, IgM and Hnf4a. Gene ontology (GO annotation analyses indicated that pathways for gluconeogenesis and glycolysis were suppressed in exposed pups at PND1, and pathways for protein export, ribosome, antigen processing and presentation, and complement and coagulation cascades were induced by PND70. Promoter analysis of differentially-expressed transcripts identified enriched transcription factor binding sites and clustering to common regulatory sites. SREBP1 binding sites were identified in about 16% of PND70 differentially-expressed genes. Western blot analysis confirmed changes in the liver at PND70 that included increases of heat shock protein 70 (Hspa8 and active SREBP1. Plasma AST and ALT levels were increased at PND70. These results suggest that transplacental arsenic exposure alters developmental programming in fetal liver, leading to an enduring stress and proinflammatory response postnatally that may contribute to early onset of atherosclerosis. Genes

  12. Transcranial direct current stimulation of the primary motor cortex improves word-retrieval in older adults.

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    Marcus eMeinzer

    2014-09-01

    Full Text Available Language facilitation by transcranial direct current stimulation (tDCS in healthy individuals has generated hope that tDCS may also allow improving language impairment after stroke (aphasia. However, current stimulation protocols have yielded variable results and may require identification of residual language cortex using functional magnetic resonance imaging (fMRI, which complicates incorporation into clinical practice. Based on previous behavioral studies that demonstrated improved language processing by motor system pre-activation, the present study assessed whether tDCS administered to the primary motor cortex (M1 can enhance language functions.This proof-of-concept study employed a sham-tDCS controlled, cross-over, within-subject design and assessed the impact of unilateral excitatory (anodal and bihemispheric (dual tDCS in eighteen healthy older adults during semantic word-retrieval and motor speech tasks. Simultaneous fMRI scrutinized the neural mechanisms underlying tDCS effects.Both active tDCS conditions significantly improved word-retrieval compared to sham-tDCS. The direct comparison of activity elicited by word-retrieval vs. motor-speech trials revealed bilateral frontal activity increases during both anodal- and dual-tDCS compared to sham-tDCS. This effect was driven by more pronounced deactivation of frontal regions during the motor-speech task, while activity during word-retrieval trials was unaffected by the stimulation. No effects were found in M1 and secondary motor regions.Our results show that tDCS administered to M1 can improve word-retrieval in healthy individuals, thereby providing a rationale to explore whether M1-tDCS may offer a novel approach to improve language functions in aphasia. fMRI revealed neural facilitation specifically during motor speech trials, which may have reduced switching costs between the overlapping neural systems for lexical retrieval and speech processing, thereby resulting in improved

  13. Adult Opisthorchis felineus major protein fractions deduced from transcripts: comparison with liver flukes Opisthorchis viverrini and Clonorchis sinensis.

    Science.gov (United States)

    Pomaznoy, Mikhail; Tatkov, Sergey; Katokhin, Alexey; Afonnikov, Dmitry; Babenko, Vladimir; Furman, Dagmara; Brusentsov, Ilya; Belavin, Pavel; Najakshin, Alexandr; Guselnikov, Sergey; Vasiliev, Gennady; Sivkov, Anton; Prokhortchouk, Egor; Skryabin, Konstantin; Mordvinov, Viatcheslav

    2013-10-01

    The epidemiologically important liver flukes Opisthorchis felineus, Opisthorchis viverrini, and Clonorchis sinensis are of interest to health professionals, epidemiologists, pharmacologists, and molecular biologists. Recently the transcriptomes of the latter two species were intensively investigated. However our knowledge on molecular biology of O. felineus is scarce. We report the first results of the O. felineus transcriptome analysis. We isolated and annotated a total of 2560 expressed sequence tag (EST) sequences from adult O. felineus (deposited within the database of expressed sequence tags (dbEST), under accession numbers GenBank: JK624271-JK626790, JK006511-JK006547, JK649790-JK649792). Clustering and analysis resulted in the detection of 267 contigs. Of the protein sequences deduced from these, 82% had homologs in the NCBI (nr) protein database and 63% contained conserved domains, allowing the functions to be interpreted using the Gene Ontology terms. Comprehensive analysis of Opisthorchiidae- and Trematoda-specific substitutions within amino acid sequences deduced for the proteins myoglobin, vitelline precursor protein, cathepsin F, and 28kDa glutathione transferase was carried out. The gene set of the 32 ribosomal proteins for the three Opisthorchiidae species with the addition of available Schistosoma and Fasciola orthologs was created and is provided in the supplementary. The orthologous gene set created was used for inferring phylogeny within the Trematoda with special attention to interrelations within the Opisthorchiidae. The phylogenetic analysis revealed a closer relationship between C. sinensis and O. viverrini and some divergence of O. felineus from either O. viverrini or C. sinensis.

  14. Non-invasive sources of cells with primary cilia from pediatric and adult patients

    NARCIS (Netherlands)

    Ajzenberg, H.; Slaats, G.G.; Stokman, M.F.; Arts, H.H.; Logister, I.; Kroes, H.Y.; Renkema, K.Y.; Haelst, M.M. van; Terhal, P.A.; Rooij, I.A.L.M. van; Keijzer-Veen, M.G.; Knoers, N.V.; Lilien, M.R.; Jewett, M.A.; Giles, R.H.

    2015-01-01

    BACKGROUND: Ciliopathies give rise to a multitude of organ-specific pathologies; obtaining relevant primary patient material is useful for both diagnostics and research. However, acquisition of primary ciliated cells from patients, particularly pediatric patients, presents multiple difficulties. Bio

  15. Influence of rat substrain and growth conditions on the characteristics of primary cultures of adult rat spinal cord astrocytes.

    Science.gov (United States)

    Codeluppi, Simone; Gregory, Ebba Norsted; Kjell, Jacob; Wigerblad, Gustaf; Olson, Lars; Svensson, Camilla I

    2011-04-15

    Primary astrocyte cell cultures have become a valuable tool for studies of signaling pathways that regulate astrocyte physiology, reactivity, and function; however, differences in culture preparation affect data reproducibility. The aim of this work was to define optimal conditions for obtaining primary astrocytes from adult rat spinal cord with an expression profile most similar to adult human spinal cord astrocytes. Hence, we examined whether different Sprague-Dawley substrains and culture conditions affect astrocyte culture quality. Medium supplemented with fetal bovine serum from three sources (Sigma, Gibco, Hyclone) or a medium with defined composition (AM medium) was used to culture astrocytes isolated from spinal cords of adult Harlan and Charles River Spraque-Dawley rats. Purity was significantly different between cultures established in media with different sera. No microglia were detected in AM or Hyclone cultures. Gene expression was also affected, with AM cultures expressing the highest level of glutamine synthetase, connexin-43, and glutamate transporter-1. Interestingly, cell response to starvation was substrain dependent. Charles River-derived cultures responded the least, while astrocytes derived from Harlan rats showed a greater decrease in Gfap and glutamine synthetase, suggesting a more quiescent phenotype. Human and Harlan astrocytes cultured in AM media responded similarly to starvation. Taken together, this study shows that rat substrain and growth medium composition affect purity, expression profile and response to starvation of primary astrocytes suggesting that cultures of Harlan rats in AM media have optimal astrocyte characteristics, purity, and similarity to human astrocytes.

  16. Successful treatment of parenteral nutrition-associated liver disease in an adult by use of a fish oil-based lipid source.

    Science.gov (United States)

    Venecourt-Jackson, Esra; Hill, Simon J; Walmsley, Russell S

    2013-01-01

    Liver disease occurs in 15% to 40% of adults on long-term parenteral nutrition, with steatosis being more common than cholestasis in the adult population. This problem has been well reported in the pediatric population, but we describe the case of a man who became profoundly jaundiced after being on parenteral nutrition for 3 y and responded rapidly to a change in lipid source from soybean and olive oil-based emulsion (ClinOleic) to a fish oil-based lipid emulsion (Omegaven).

  17. The lack of protective effects of tea supplementation on liver and jejunal epithelium in adult rats exposed to cadmium and lead.

    Science.gov (United States)

    Tomaszewska, Ewa; Winiarska-Mieczan, Anna; Dobrowolski, Piotr

    2015-11-01

    Adult rats at the age of 12 weeks were divided into the control group and groups supplemented with green (GT), black (BT), red (RT), or white (WT) tea extracts. The diet (except that for the control) was mixed with 7 mg Cd/kg and 50 mg Pb/kg. The experiment lasted 12 weeks. Basal haematology and plasma biochemical parameters as well as the histomorphometrical parameters of jejunal epithelium and liver were determined. The lowest body mass was found in the RT and WT groups. Some functional (increased plasma ALT and AST, and the de Ritis coefficient) and structural changes in the liver (slight fatty degenerative changes, an increase in the intercellular space) were evident irrespective of the type of tea in the Cd and Pb poisoned rats. This toxic effect was visible especially in rats drinking black or red tea. However, the rats had no elevated LDH and ALT activities. The highest content of Cd and Pb in the liver and blood plasma was found in rats drinking red tea. Based on the results obtained, it is clear that long-term exposure of adult rats with a mature intestinal barrier to Cd and Pb contamination, under higher exposure conditions than the current estimates of weekly exposure of the general population to Cd and Pb through diet, causes a toxic effect, especially in the liver, and can change the structure of intestinal mucosa, irrespective of tea administration.

  18. Parvovirus B19 in an Immunocompetent Adult Patient with Acute Liver Failure: An Underdiagnosed Cause of Acute Non-A-E Viral Hepatitis

    Directory of Open Access Journals (Sweden)

    J Kee Ho

    2005-01-01

    Full Text Available There are occasional pediatric reports of parvovirus B19-associated transient acute hepatitis and hepatic failure. A case of a 34-year-old immunocompetent woman who developed severe and prolonged but self-limited acute hepatitis and myelosuppression following acute parvovirus B19 infection is reported. Parvovirus B19 may be the causative agent in some adult cases of acute non-A-E viral hepatitis and acute liver failure.

  19. Adult Visual Experience Promotes Recovery of Primary Visual Cortex from Long-Term Monocular Deprivation

    Science.gov (United States)

    Fischer, Quentin S.; Aleem, Salman; Zhou, Hongyi; Pham, Tony A.

    2007-01-01

    Prolonged visual deprivation from early childhood to maturity is believed to cause permanent visual impairment. However, there have been case reports of substantial improvement of binocular vision in human adults following lifelong visual impairment or deprivation. These observations, together with recent findings of adult ocular dominance…

  20. The first experience of sequential liver-kidney transplantation for the treatment of primary hyperoxaluria type-1 in Iran as a developing country.

    Science.gov (United States)

    Naderi, GholamHossein; Tabassomi, Firouzeh; Latif, AmirHossein; Ganji, MohammadReza

    2016-01-01

    Primary hyperoxaluria Type-1 (PH-1) is caused by a deficiency of alanine-glyoxylate aminotransferase manifesting as urolithiasis, nephrocalcinosis, and end-stage renal disease (ESRD). Among treatment options, best outcomes have been achieved by sequential liver-kidney transplantation (Seq-LKT). Herein, we report a patient with PH-1 and ESRD who underwent Seq-LKT in Iran. Criteria for diagnosis included a history of recurring calcium oxalate renal stones and elevated urine oxalate level combined with liver biopsy and absent enzymatic activity at the age of 13 years. Conservative treatment including pyridoxine, potassium citrate solution, high fluid intake, and hemodialysis was administered initially. Liver transplantation was performed at the age of 17 years from a deceased donor followed 4½ months later by a living-unrelated donor kidney transplantation. After two years of follow-up, the patient experienced no complications and had normal liver and renal function. This is the first successful experience of Seq-LKT in the treatment of PH-1 in Iran as a developing country with limited access to equipment and medications.

  1. Autoimmune liver disease panel

    Science.gov (United States)

    Liver disease test panel - autoimmune ... Autoimmune disorders are a possible cause of liver disease. The most common of these diseases are autoimmune hepatitis and primary biliary cirrhosis. This group of tests helps your health care provider ...

  2. Safety of implanting sustained-release 5-fluorouracil into hepatic cross-section and omentum majus after primary liver cancer resection.

    Science.gov (United States)

    Chen, Jiangtao; Zhang, Junjie; Wang, Chenyu; Yao, Kunhou; Hua, Long; Zhang, Liping; Ren, Xuequn

    2016-09-01

    This study was designed to evaluate the short-term safety of implanting sustained-release 5-fluorouracil (5-FU) into hepatic cross-section and omentum majus after primary liver cancer resection and its impact on related indexes of liver. Forty patients were selected and divided into an implantation group (n = 20) and a control group (n = 20). On the first day after admission, first week after surgery, and first month after surgery, fasting venous blood was extracted from patients for measuring hematological indexes. The reduction rate of alpha fetoprotein (AFP) on the first week and first month after surgery was calculated, and moreover, drainage volume of the abdominal cavity drainage tube, length of stay after surgery, and wound healing condition were recorded. We found that levels of alanine aminotransferase, aspartate amino transferase, blood urea nitrogen, creatinine, total bilirubin, albumin, and white blood cells measured on the first week and first month after surgery, length of stay, and wound healing of patients in the two groups had no significant difference (P >0.05). Drainage volume and reduction rate of AFP of two groups were significantly different on the first week and first month after surgery (P <0.05). Implanting sustained-release 5-FU into hepatic cross-section and omentum majus after primary liver cancer resection is proved to be safe as it has little impact on related indexes.

  3. Primary Sclerosing Cholangitis

    Directory of Open Access Journals (Sweden)

    A Stiehl

    2000-01-01

    Full Text Available Primary sclerosing cholangitis (PSC is a chronic cholestatic liver disease characterized by fibrosing inflammation and obliteration of intra- and/or extrahepatic bile ducts. The disease is one of the most common cholestatic diseases in adults and is diagnosed with increasing frequency. It is very often associated with ulcerative colitis. Patients with PSC have an increased incidence of bile duct carcinomas, and those with ulcerative colitis also have an increased incidence of colonic carcinomas. In end-stage disease, liver transplantation is the treatment of choice. Immunosuppressive treatment has little effect. Ursodeoxycholic acid (UDCA, which has been shown to improve liver histology and survival in patients with primary biliary cirrhosis, has a beneficial effect in PSC, provided that patients who develop major duct stenoses are treated endoscopically. The aim is to treat patients as early as possible to prevent progression to the advanced stages of the disease. During treatment with UDCA, stenoses of major ducts may develop, and early endoscopic dilation is highly effective. Because UDCA treatment improves but does not cure cholestatic liver diseases, permanent treatment seems to be necessary. Such prolonged treatment with UDCA may be recommended because, until now, no side effects have been reported. In patients with end-stage disease, UDCA is not effective and liver transplantation is indicated.

  4. Effect of intermittent hepatic inflow occlusion with the Pringle maneuver during donor hepatectomy in adult living donor liver transplantation with right hemiliver grafts: a prospective, randomized controlled study.

    Science.gov (United States)

    Park, Jae Berm; Joh, Jae-Won; Kim, Sung-Joo; Kwon, Choon-Hyuck David; Chun, Jae Min; Kim, Jong Man; Moon, Ju Ik; Lee, Suk-Koo

    2012-01-01

    To evaluate the effects of intermittent hepatic inflow occlusion (IHIO) during donor hepatectomy for living donor liver transplantation (LDLT) in recipients and donors, we performed a single-center, open-label, prospective, parallel, randomized controlled study. Adult donor-recipient pairs undergoing LDLT with right hemiliver grafts were randomized into IHIO and control groups (1:1). In the IHIO group, IHIO was performed during donor hepatectomy. The primary endpoint was the peak serum alanine aminotransferase (ALT) concentration in the recipients within 5 days after the operation. Blood samples for measurements of interleukin-6 (IL-6), IL-8, tumor necrosis factor α (TNF-α), and hepatocyte growth factor (HGF) were taken from the donors and the recipients during the operation and postoperatively. Biopsy samples for measurements of caspase-3 and malondialdehyde (MDA) were taken from the donors and the recipients. In all, 50 donor-recipient pairs (ie, 25 pairs in each group) completed this study. The mean peak serum ALT levels within 5 days after the operation did not differ in the recipients between the 2 groups (P = 0.32) but were higher in the donors of the IHIO group (P = 0.002). There were no differences in the prothrombin times or total bilirubin levels in the recipients or donors between the 2 groups. The amount of blood loss during donor hepatectomy was significantly lower in the IHIO group versus the control group (P = 0.02). The mean hospital stay for donors was 19.3 ± 7.2 days in the control group and 15.8 ± 4.6 days in the IHIO group (P = 0.046). There were no in-hospital deaths within 1 month and no cases of primary nonfunction or initially poor function in the 2 groups. The concentrations of IL-6, IL-8, TNF-α, and HGF did not differ between the 2 groups, nor did the concentrations of caspase-3 and MDA. In conclusion, although we found differences in postoperative peak serum ALT levels in donors, donor hepatectomy with IHIO for LDLT using a right

  5. Primary adult midgut volvulus mimicking acute appendicitis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Leow

    2016-01-01

    Conclusion: While rare, adult midgut volvulus has the potential for morbidity and mortality if not diagnosed early with intestinal ischaemia and related sequlae. Clinicians should consider this and if in doubt, perform an early contrast CT scan.

  6. MRI for characterization of primary tumors in the non-cirrhotic liver: Added value of Gd-EOB-DTPA enhanced hepatospecific phase

    Energy Technology Data Exchange (ETDEWEB)

    Donati, Olivio F.; Hunziker, Roger; Fischer, Michael A. [Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich (Switzerland); Raptis, Dimitri A.; Breitenstein, Stefan [Department of Visceral and Transplant Surgery, Swiss Hepato-Pancreato-Biliary (HPB) Center, University Hospital Zurich, Zurich (Switzerland); Patak, Michael A., E-mail: Michael.Patak@hirslanden.ch [Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich (Switzerland); Clinic Hirslanden, Hirslanden Hospital Group, Zurich (Switzerland)

    2014-07-15

    Purpose: To evaluate the added value of hepatospecific phase in Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) in patients with primary tumors in non-cirrhotic liver. Methods: Twenty-nine patients (median, 39 years; range, 18–81 years; 11 male) underwent preoperative Gd-EOB-DTPA enhanced MRI including hepatospecific phase after 10 and 20 min of contrast injection at four institutions in Europe, North America and New Zealand. Images were evaluated by three different readers (R1–R3) who characterized liver tumors with and without consultation of the hepatospecific phase images. Confidence in diagnosis was scored on a visual analog scale from 1 to 10. Histopathology (adenoma, n = 5; focal nodular hyperplasia, n = 11 and hepatocellular carcinoma, n = 13) in all patients served as the standard of reference. Differences were evaluated using the McNemar and Wilcoxon signed rank test. Results: Without hepatospecific phase images available, 22 (76%), 19 (66%) and 19 (66%) of 29 tumors were characterized correctly by the three readers respectively. Mean confidence in diagnosis was 6.1, 5.7 and 5.8. With the hepatospecific phase included, characterization of liver tumors did not change significantly with 21 (72%), 23 (79%) and 19 (66%) of 29 tumors diagnosed correctly (p > 0.05). According confidence ratings increased to 6.3, 6.5 and 7.7, respectively. Increase in diagnostic confidence was significant for R2 and R3 (p < 0.05) and independent of reader's experience. Conclusion: The additional hepatospecific phase in Gd-EOB-DTPA enhanced MRI did not significantly increase diagnostic accuracy in characterization of primary tumors in the non-cirrhotic liver. However, 2/3 readers showed a significant increase in diagnostic confidence after consultation of the hepatospecific phase.

  7. A rare presentation of medulloblastoma in adults as primary leptomeningeal involvement

    Directory of Open Access Journals (Sweden)

    Mehrdad Hasibi

    2012-09-01

    Full Text Available Medulloblastoma is one of the most common primarytumors of the central nervous system of children but it isuncommon in adult age. We report a case of young malepresented with a history of generalized headache that wasfound to have medulloblastoma with diffuseleptomeningeal involvement without prominent masslesion. To our knowledge, our patient is the second reportedcase of medulloblastoma in adults identified with primaryleptomeningeal involvement without a prominent masslesion. The clinical, radiological and pathologic features ofthis entity are described.

  8. Acute Liver Failure in an Adult, a Rare Complication of Alagille Syndrome: Case Report and Brief Review.

    Science.gov (United States)

    Frongillo, F; Bianco, G; Silvestrini, N; Lirosi, M C; Sanchez, A M; Nure, E; Gaspari, R; Avolio, A W; Sganga, G; Agnes, S

    2015-09-01

    Alagille syndrome (AS) is an autosomal-dominant, multisystem disorder affecting the liver, heart, eyes, skeleton, and face. The manifestations are predominantly pediatric. Diagnosis is based on findings of a paucity of bile ducts on liver biopsy combined with ≥3 of 5 major clinical criteria. Orthotopic liver transplantation (OLT) is the only option for treating patients who developed liver failure, portal hypertension, severe itching, and xanthomatosis. It is difficult to establish clear criteria for OLT; indications are controversial because of the wide variety of clinical symptoms and the multisystem involvement. Generally, AS-associated liver disease is never an acute illness. We report the case of a 28-year-old woman with AS who underwent urgent OLT for acute liver failure. At 24 months posttransplant, the patient is in good clinical condition and with normal hepatic and renal function.

  9. 927例原发性肝癌证素特征研究%Analysis on Syndrome Elements of 927 Primary Liver Cancer Cases

    Institute of Scientific and Technical Information of China (English)

    史话跃; 吴承玉; 杨涛

    2014-01-01

    应用临床流行病学研究方法,收集927例原发性肝癌临床病例,采用SPSS 13.0统计软件进行病例聚类和主成分分析,探析肝癌病位、病性证素特征,从而规范肝癌的病位、病性特征表现。研究发现,肝癌病位在肝,与胆、脾、胃及肾相关;病性以气滞、血瘀及湿热为主,兼有气虚、血虚、阴虚、痰、水停及阳虚等;临床证型主要为气滞血瘀证、湿热蕴结证及湿瘀搏结证。%Clinical epidemiological method was used in this study. A total of 927 clinical cases of primary liver cancer were collected. The SPSS 13.0 software was used in the cluster analysis and principal component analysis. The exploration was made on the disease-position, syndrome elements of disease characteristics of liver cancer in order to regulate the characteristic manifestations of the disease-position and disease characteristics of liver cancer. This study showed that the disease-position of liver cancer was in the liver, which was also related to the gallbladder, spleen, stomach and kidney. The disease characteristics was mainly due to qi-stagnation, blood-stasis, dampness-heat, which can also be combined with qi-deficiency, blood-deficiency, yin-deficiency, phlegm-water retention, yang-deficiency and etc. Patterns of syndrome differentiation were mainly qi-stagnation and blood-stasis pattern, dampness-heat accumulation pattern, dampness-stasis accumulation pattern.

  10. Percutaneous drainage of hydatid cyst in the liver as a primary treatment: Review of 52 consecutive cases with long-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Bosanac, Zeljko B.; Lisanin, Ljubomir

    2000-11-01

    AIM: To evaluate the suitability of percutaneous drainage as a primary and definitive treatment of hydatid disease of the liver. MATERIALS AND METHODS: Between October 1989 and April 1992, percutaneous drainage was performed on 52 consecutive patients (27 women and 25 men aged 13 to 84 years) with 55 hydatid cysts in the liver. Twenty-five (45%) cysts were type I, 10 (18%) were type II, 14 (25%) were type III, 5 (10%) were type IV and 1 (2%) was type V. All procedures were performed under light sedation and local anaesthetic at the puncture site. The standard Seldinger technique was used. Initial puncture was performed under ultrasound (US) guidance through the liver parenchyma. The rest of the procedure was conducted under fluoroscopic control. Pigtail drainage catheters (size 12-20 Fr) were used, with Betadine (10% povidone iodine; 1% free iodine) being allowed to act within the cyst for 30 min, as a scolicidal agent. RESULTS: All the patients were successfully treated and 6-9 year follow-up involving US, computed tomography (CT) and serology tests showed no local recurrence or spread of the disease. No major (death, cyst rupture, anaphylactic shock) and very few minor complications arose. Two patients had mild skin reaction with nausea requiring no treatment and three patients developed a secondary infection of the cyst, due to prolonged drainage time. These liver abscesses responded successfully to further catheter drainage. Subsequent patients were treated with large bore (18-20 Fr) catheters and none developed secondary infection. Overall drainage time varied from 7-118 days (7-28 days, if we exclude three initial cases who had prolonged drainage). CONCLUSION: It is our strong belief that percutaneous drainage using the above method should be considered a first-line treatment for hydatid disease of the liver. Bosanac, Z.B., Lisanin, L. (2000)

  11. 成人间活体肝肾联合移植一例体会%The experience in one case of adult-to-adult combined liver-kidney transplantation from the same living donor

    Institute of Scientific and Technical Information of China (English)

    朱志军; 崔子林; 王智平; 张雅敏; 沈中阳

    2013-01-01

    Objective To summarize the experience in one case of adult-to-adult combined liver-kidney transplantation.Method In Sep.2007,one case of adult-to-adult liver-kidney transplantation from the same living donor was performed on a patient with liver cirrhosis (liver failure decompensation) and chronic renal failure (uremia).There was a donation of the right liver with the middle hepatic vein and right kidney in the same time from the living donor.The piggyback liver transplantation and ectopic kidney transplantation were performed for the recipient.Basiliximab and methylprednisolone were given for immune induction therapy in operation.Tacrolimus,MMF and prednisone were given for anti-rejection.There were hepatoprotective treatment,anti-infection treatment and nutritional support for the donor and recipient after operation.The follow-up period has now been more than five years.Result The donor and the patient were smooth in the perioperative period.The liver and kidney function of the donor is well so far.There was no significant influence on quality of life of the donor.The transplanted liver and kidney function of the recipient is well so far.There were no significant complications for the recipient.Conclusion The living liver-kidney transplantation is an effective means for the treatment of liver and kidney failure.The safety can be ensured for the donors that donate the right liver and one kidney simultaneously.%目的 总结活体肝肾联合移植1例的体会.方法 2007年9月对1例乙型肝炎后肝硬化(失代偿期)合并慢性肾功能衰竭(尿毒症期)的患者施行了成人间亲属活体肝肾联合移植.切取供者带肝中静脉的右半肝和右侧肾脏,受者手术采用背驮式肝移植及异位肾移植.受者给予巴利昔单抗联合他克莫司+吗替麦考酚酯+甲泼尼龙的方案抗排斥反应,供、受者术后加强护肝治疗、抗感染治疗和营养支持治疗.结果 供、受者均顺利渡过围手术期,术后肝、

  12. Hepatic toxicology following single and multiple exposure of engineered nanomaterials utilising a novel primary human 3D liver microtissue model

    DEFF Research Database (Denmark)

    Kermanizadeh, Ali; Løhr, Mille; Roursgaard, Martin

    2014-01-01

    microtissue model to investigate the toxicological effects associated with a single or multiple exposure of a panel of engineered NMs (Ag, ZnO, MWCNT and a positively charged TiO2).ResultsHere we demonstrate that the repeated exposure of the NMs is more damaging to the liver tissue as in comparison...... with accumulative production of nanomaterials, there is an urgent need to consider the possibility of detrimental health consequences of engineered NM exposure. It has been shown that exposure via inhalation, intratracheal instillation or ingestion can result in NM translocation to the liver. Traditional in vitro......BackgroundThe liver has a crucial role in metabolic homeostasis as well as being the principal detoxification centre of the body, removing xenobiotics and waste products which could potentially include some nanomaterials (NM). With the ever increasing public and occupational exposure associated...

  13. Establishment of human-rhesus chimeric liver using adult bone marrow mesenchymal stem cells%应用成人骨髓间充质干细胞建立人-猴肝脏嵌合体

    Institute of Scientific and Technical Information of China (English)

    何保丽; 马丽花; 陈丽玲; 刘汝文; 杨仁华

    2013-01-01

    BACKGROUND:Human-mammal chimeric liver chimera has been a vital significance for the proliferation and differentiation of bone marrow mesenchymal stem cells. OBJECTIVE:To establish an animal model of human-rhesus chimeric liver using adult bone marrow mesenchymal stem cells. METHODS:Adult bone marrow mesenchymal stem cells were isolated, purified and cultured for the sixth generation. The number of bone marrow mesenchymal stem cells was no less than 5×108. Bone marrow mesenchymal stem cells labeled with green fluorescent protein were transplanted into the liver of the embryo rhesus with pregnancy of 10 weeks under guided by type-B ultrasound. At the 1st and 3rd months of birth, the liver tissue of the infant rhesus was taken for biopsy. After routine pathological section, histological specimens were observed under fluorescence microscope to confirm if there were adult bone marrow mesenchymal stem cells positive for green fluorescent protein and their distribution, and detected by immunohistochemical staining to identify if human albumin expressed in the liver of infant rhesus. RESULTS AND CONCLUSION:Fluorescence microscope observation indicated that at the 1st and 3rd months after birth, there were surviving bone marrow mesenchymal stem cells derived from human with green fluorescence in the liver of infant rhesus, and these cells migrated to form more concentrated distribution. The immunohistochemical results demonstrated that functional liver cells expressing human albumin were observed in the liver of infant rhesus at the 1st and 3rd months after birth, and their distribution was in accordance with bone marrow mesenchymal stem cells with green fluorescence. Human-rhesus chimeric liver can be established using adult bone marrow mesenchymal stem cells, which can generate functional liver cells in the liver of infant rhesus.%BACKGROUND:Human-mammal chimeric liver chimera has been a vital significance for the proliferation and differentiation of bone marrow

  14. Prolonged rest period enables the detection of micronucleated hepatocytes in the liver of young adult rats after a single dose of diethylnitrosamine or mitomycin C.

    Science.gov (United States)

    Shimada, Keisuke; Yamamoto, Mika; Takashima, Miyuki; Seki, Jiro; Miyamae, Yoichi; Wakata, Akihiro

    2015-09-01

    A repeated-dose micronucleus assay utilizing young adult rat hepatocytes was recently developed to evaluate the genotoxicity. In this assay, accumulation of micronucleated hepatocytes (MNHEPs) induced by repeated dosing of genotoxic chemicals is considered to be a key factor in the detection of micronuclei induction. Then, we hypothesized that the period following chemical exposure enable the detection of MNHEP induction in young adult rats, namely that MNHEPs can be generated from chromosomally damaged cells and accumulate following initiation of chemical exposure until sampling. We therefore measured MNHEP induction at 2 or 4 weeks after a single oral administration of 12.5, 50, or 100mg/kg of diethylnitrosamine (DEN) or an intraperitoneal administration of 0.5, 1.0, or 2.0mg/kg of mitomycin C (MMC) to young adult rats. Results showed a statistically significant, dose-dependent increase in the numbers of MNHEPs in DEN- or MMC-treated rats, indicating that prolonged rest period following a single dose of a genotoxic chemical enables the detection of MNHEP induction in the liver of young adult rats. From these results, a single oral administration of 50mg/kg of DEN with a 2- or 4- week rest period can be used as a positive control in repeated-dose liver micronucleus assays. This procedure is superior in terms of labor saving and animal welfare to repeated dosing of DEN.

  15. Medicine frequency analysis of traditional Chinese medicine in improving primary liver cancer combined with liver function damage%中药改善原发性肝癌并肝功能损害的药味频率分析

    Institute of Scientific and Technical Information of China (English)

    蒋梅; 陈露; 周岱翰

    2012-01-01

    Objective To explore the flavor, resistance and principle of diagnosis and the treatment of frequently-used traditional Chinese medicine which could improve primary liver cancer combined with liver function damage, through a review of the literature, thus it could provide a reference basis for rational clinical use of traditional Chinese medicine to protect liver. Methods 256 literatures from Chinese science and technology periodicals database (CNKI 1979-2011.10) and Chinese biological and medical disk (CBM 1978-2011.10) were electronic searched, then 83 articles on protective effect of traditional Chinese medicine in treating primary liver cancer combined with liver function damage were screened to analyze the medicines use frequency. Results In those literatures, 87% literatures had a randomized controlled trial, 5% literatures had no randomized controlled trial. 11% literatures were effective just using traditional Chinese medicine to protect liver, protection of traditional Chinese medicine on liver function damage caused by intervention operation accounted for 71%. In those traditional Chinese medicine which could improve primary liver cancer combined with liver function damage, use frequency of dampand-eliminating and jaundice-removing drugs, heat-clearing and detoxicating drugs, qi-boosting and yin-enriching drugs, spleen-fortifying and qi-boosting drugs, blood-quickening and stasis-transforming drugs were wide. The traditional Chinese medicine with high use frequency were, in order, Rhizoma Atractylodis Macrocephalae, Radix Astragali, Poria, Radix Codonopsis, Herba Artemisiae Scopariae, Radix Bupleuri, Radix Curcumae, Rhizoma Pinelliae, Rhizoma Corydalis, Herba Hedyotis, Herba Scutellariae Barbatae. Their use frequency were, in order, 46%, 43%, 42%, 36%, 36%, 34%, 30%, 28%, 28%, 25%, 25%. Conclusion Traditional Chinese medicine in the treatment of primary liver cancer combined with liver function damage should keep pathogenesis to protect the spleen and

  16. Transplantation of fetal liver tissue suspension into the spleens of adult syngenic rats: inducibility of cytochrome P450 dependent monooxygenase functions by beta-naphthoflavone, phenobarbital and dexamethasone.

    Science.gov (United States)

    Lupp, A; Lau, K; Trautmann, A K; Krausse, T; Klinger, W

    1999-01-01

    In the present study the effects of beta-naphthoflavone (BNF), phenobarbital (PB) and dexamethasone (DEX) on cytochrome P450 (P450) dependent monooxygenase functions were investigated in intrasplenic liver cell explants in comparison to adult liver. Fetal liver tissue suspensions were transplanted into the spleens of 60-90 days old adult male syngenic Fisher 344 inbred rats. 2, 4 or 6 months after surgery, transplant recipients and age matched controls were orally treated with BNF (1x50 mg/kg body weight (b.wt.)), PB (1x50 mg/kg b.wt.), DEX (for 3 days 4 mg/kg b.wt. per day), or the respective solvents (dimethylsulfoxide or 0.9% NaCl). The animals were sacrificed 24 (BNF, DEX) or 48 (PB) hours after the last treatment. P450 mediated monooxygenase functions were measured in spleen and liver 9000 g supernatants by three model reactions for different P450 subtypes: ethoxyresorufin O-deethylation (EROD; 1A), ethoxycoumarin O-deethylation (ECOD; 1A, 2A, 2B), and ethylmorphine N-demethylation (END; 3A). Spleen weights were significantly higher in transplanted rats, compared to controls, at all three time points after surgery. Induction with PB or DEX, and in some cases also with BNF, lead to a significant increase in liver weights of transplant recipients and control rats independent of the time after transplantation. In contrast, there was no influence on spleen weights due to BNF or PB. At all time points after surgery, with DEX a marked decrease in body weights, weights of adrenal glands and of lymphatic organs like thymus glands and spleens was observed, with the weights of the transplant containing spleens being still higher in comparison to control organs. Spleens of control animals displayed nearly no P450 mediated monooxygenase functions neither without nor with induction. After transplantation, however, significant EROD and ECOD, but hardly any END activities were seen in the host organs at all three time points after surgery. In transplant containing spleens

  17. Sleep paralysis and trauma, psychiatric symptoms and disorders in an adult African American population attending primary medical care.

    Science.gov (United States)

    Mellman, Thomas A; Aigbogun, Notalelomwan; Graves, Ruth Elaine; Lawson, William B; Alim, Tanya N

    2008-01-01

    The occurrence of sleep paralysis (SP) absent narcolepsy appears to not be uncommon in African Americans and probably other non-European groups. Prior research has linked SP to trauma and psychiatric disorders and suggested a specific relationship to panic disorder in African Americans. The objective of our study was to evaluate relationships of SP with trauma, concurrent psychiatric symptoms and lifetime psychiatric diagnoses in an adult African American population recruited from primary care. Cross sectional study with surveys and diagnostic interviews; Patients attending primary care clinics filled out a survey that determined the 6 month prevalence and associated features of SP, a panic disorder screen, the self-rated Hamilton Depression Scale, and an inventory of trauma exposure. A subset of trauma-exposed participants (N = 142) received comprehensive diagnostic interviews that incorporated the Structured Clinical Interview for DSM-IV and the Clinician Assessed PTSD Scale. Four hundred and forty-one adults participated (mean age-40.0 SD = 13.3, 68% female, 95% African American). Fourteen percent endorsed recent SP. In approximately 1/3 of those with SP, episodes also featured panic symptoms. SP was strongly associated with trauma history, and concurrent anxiety and mood symptoms. SP was not associated with specific psychiatric disorders other than lifetime (but not current) alcohol or substance use disorders. Our findings suggest that SP is not uncommon in adult African Americans and is associated with trauma and concurrent distress but not with a specific psychiatric diagnosis.

  18. Serum liver fatty acid binding protein levels correlate positively with obesity and insulin resistance in Chinese young adults.

    Directory of Open Access Journals (Sweden)

    Juan Shi

    Full Text Available BACKGROUND: Liver fatty acid-binding protein (FABP1 plays an inconclusive role in adiposity. We investigated the association of serum FABP1 levels with obesity and insulin resistance in Chinese young people under 30 years old. METHODOLOGY AND PRINCIPAL FINDINGS: Cross-sectional analysis including 200 obese and 172 normal-weight subjects matched for age and sex, anthropometric measurements were performed and serum FABP1 and biochemical characteristics were measured. Insulin resistance was determined by homeostasis model assessment of insulin resistance (HOMA-IR and by the insulin sensitivity index (S(i derived from Bergman's minimal model. FABP1 levels in obese subjects were significantly higher than those in normal-weight subjects (p<0.001 and the significance remained after adjustment for age, gender, alanine and aspartate aminotransferases (p<0.001. Serum FABP1 levels were significantly correlated with many metabolic-related parameters, with BMI and triglycerides as the independent determinants. FABP1 levels remained an independent risk factor of insulin resistance assessed by binary S(i (OR = 1.868 per SD unit, 95% CI [1.035-3.373], p = 0.038 after adjustment for age, sex, BMI, waist circumference, systolic blood pressure, serum triacylglycerol, total cholesterol, HDL- and LDL-cholesterol,. FABP1 levels were also elevated with an increasing number of components of the metabolic syndrome (p for trend <0.001. Multiple regression modeling for the MetS and its components demonstrated that hypertriglyceridemia and low HDL-cholesterol were significantly correlated to serum FABP1 levels. CONCLUSIONS AND SIGNIFICANCE: Serum FABP1 correlates positively with obesity and insulin resistance in Chinese young adults. Our data supports the fact that FABP1 might be an important mediator participating in fatty acid metabolism and energy balance.

  19. Imaging in liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Settimo Caruso; Roberto Miraglia; Luigi Maruzzelli; Salvatore Gruttadauria; Angelo Luca; Bruno Gridelli

    2009-01-01

    The aim of this study was to illustrate the role of noninvasive imaging tools such as ultrasonography, multidetector row computed tomography, and magnetic resonance imaging in the evaluation of pediatric and adult liver recipients and potential liver donors, and in the detection of potential complications arising from liver transplantation.

  20. Study origin of germ cells and formation of new primary follicles in adult human and rat ovaries.

    Science.gov (United States)

    Bukovsky, Antonin; Gupta, Satish K; Virant-Klun, Irma; Upadhyaya, Nirmala B; Copas, Pleas; Van Meter, Stuart E; Svetlikova, Marta; Ayala, Maria E; Dominguez, Roberto

    2008-01-01

    The central thesis regarding the human ovaries is that, although primordial germ cells in embryonal ovaries are of extraovarian origin, those generated during the fetal period and in postnatal life are derived from the ovarian surface epithelium (OSE) bipotent cells. With the assistance of immune system-related cells, secondary germ cells and primitive granulosa cells originate from OSE stem cells in the fetal and adult human gonads. Fetal primary follicles are formed during the second trimester of intrauterine life, prior to the end of immune adaptation, possibly to be recognized as self-structures and renewed later. With the onset of menarche, a periodical oocyte and follicular renewal emerges to replace aging primary follicles and ensure that fresh eggs for healthy babies are always available during the prime reproductive period. The periodical follicular renewal ceases between 35 and 40 yr of age, and the remaining primary follicles are utilized during the premenopausal period until exhausted. However, the persisting oocytes accumulate genetic alterations and may become unsuitable for ovulation and fertilization. The human OSE stem cells preserve the character of embryonic stem cells, and they may produce distinct cell types, including new eggs in vitro, particularly when derived from patients with premature ovarian failure or aging and postmenopausal ovaries. Our observations also indicate that there are substantial differences in follicular renewal between adult human and rat ovaries. As part of this chapter, we present in detail protocols utilized to analyze oogenesis in humans and to study interspecies differences when compared to the ovaries of rat females.

  1. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    Science.gov (United States)

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided.

  2. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

    Directory of Open Access Journals (Sweden)

    David O Riordan

    2016-06-01

    Full Text Available Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid, Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect, ClinicalTrials.gov, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America. Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of

  3. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review

    Science.gov (United States)

    Riordan, David O; Walsh, Kieran A; Galvin, Rose; Sinnott, Carol; Kearney, Patricia M; Byrne, Stephen

    2016-01-01

    Objective: To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention. Data sources: An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid), Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect, ClinicalTrials.gov, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America). Review methods: Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed. Results: A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness. Conclusion: Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of patients. PMID

  4. Effects of dietary phenochlor DP5 on microsomal enzymes, liver, and blood lipids in adult male and female rats after subchronic and perinatal exposures

    Energy Technology Data Exchange (ETDEWEB)

    Poul, J.M.

    1987-08-01

    PCBs have numerous toxic effects on laboratory animals, namely hepatotoxicity, immunotoxicity, reproductive and hormonal effects, mutagenic and carcinogenic potency (Safe 1984). They have been recognized as potent inducers of many microsomal drug metabolizing enzymes in several species. Moreover, treatment of rats with PCBs gave rise to altered lipid metabolism with accumulation of lipids in the liver. In most of these studies male rats have been used. However, sex differences in the effects of xenobiotics on microsomal drug metabolizing enzymes have been shown particularly with PCBs and little was known about differences in the effects of PCBs on lipid metabolism. This study was designed to investigate the effects of a subchronic treatment with Phenochlor DP5 on some microsomal drug metabolizing enzyme activities and on liver and blood lipids of male and female rats. The long-term effects of DP5 administration during pre and postnatal period on adult microsomal enzyme activities and liver and blood lipids of both sexes have also been studied. A possible xenobiotic imprinting of the hepatic monooxygenase system during neonatal period has been shown recently, and it has been recognized that some functional defects which often manifest themselves in adult period may be induced prenatally or before weaning.

  5. Differential effects of long-term exposure to Aroclor 1254 on lipid secretion by primary cultures of adult rat hepatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza-Figueroa, T.; Hernandez, A.; Lopez, L. [Centro de Investigacion y de Estudios Avanzados del Instituto Politecnico Nacional (Mexico)

    1992-06-01

    PCBs produce hepatic triglyceride (TG) accumulation (fatty liver) in experimental animals and humans exposed accidentally and occupationally. It has been suggested that this effect could be due to a block in TG secretion. On the other hand, increased levels of plasmatic TG and cholesterol have been described in rats after dietary exposure to Aroclor 1254 (Aro) and other PCBs; hypertriglyceridemia and hypertension have been also described in humans exposed for long periods to low concentrations of PCBs. Since the study of hepatic lipid metabolism and its alteration by toxic chemicals is complicated in the whole animal, short term cultures of adult rat hepatocytes have been used. We have described a system for the long term culture of adult rat hepatocytes which for several weeks maintain differentiated functions, like fatty acid and TG synthesis and their export to the culture medium. In this paper we used this culture system to study the effect of long-term exposure to micromolar concentrations of Aro on the secretion of lipids by cultured hepatocytes. 27 refs., 4 figs., 1 tab.

  6. The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

    Science.gov (United States)

    Bahar, Ismail F. S.

    A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

  7. Evaluation of in vivo genotoxicity by thioacetamide in a 28-day repeated-dose liver micronucleus assay using male young adult rats.

    Science.gov (United States)

    Sui, Hajime; Matsumoto, Hirotaka; Wako, Yumi; Kawasako, Kazufumi

    2015-03-01

    The repeated-dose liver micronucleus (RDLMN) assay has the potential to detect liver carcinogens and can be integrated into general toxicological studies. In this study, thioacetamide (TAA) was tested in 14- and 28-day RDLMN assays to assess the performance of the assay. The test substance, TAA, was administered orally to 6-week-old male Crl:CD (SD) rats once daily for 14 or 28 days at a dosage of 5, 10 or 20mg/kg/day. Hepatocytes were collected approximately 24h after the last TAA administration, and the incidence of micronuclei was assessed. In this study, bone marrow micronucleus assays were also conducted in the same animals. The 14- and 28-day RDLMN assays indicated that none of the TAA dosages significantly increased the proportion of micronucleated hepatocytes. Bone marrow micronucleus assays with TAA also provided negative results. It is known that TAA is a liver carcinogen in mice and rats. In the previous genotoxic studies, the Ames test and the chromosomal aberration test using CHL/IU cells have yielded negative results [1-4]. The liver micronucleus assay using young adult rats singly dosed with TAA (75 and 150mg/kg) also produced negative results [5]. TAA gave positive results only in the mouse bone marrow micronucleus assays [6,7].

  8. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

    Energy Technology Data Exchange (ETDEWEB)

    Frericks, Bernd B.J. [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); University of Berlin, Department of Radiology, Berlin (Germany); Charite - University Medicine Berlin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Schenk, Andrea; Peitgen, Heinz-Otto [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); MeVis - Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Klempnauer, Juergen [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Nashan, Bjoern [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Dalhousie University, Multi Organ Transplant Program, Halifax, Nova Scotia (Canada)

    2006-12-15

    The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT). CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings. Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r=0.86,P<0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n=11); segment 5 MHV tributaries: 100 ml (n=16); segment 8 MHV tributaries: 110 ml (n=20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%. The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution. (orig.)

  9. THE SUCCESSFUL TREATMENT OF A PERIPHERAL VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE ACUTE RESPIRATORY FAILURE IN THE EARLY PERIOD AFTER ADULT LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2014-01-01

    Full Text Available Aim: of our clinical study was to present own experience of veno-venous extracorporeal membrane oxygenation (VV ECMO for the treatment of an adult patient (female, 28 yrs, 150 cm, 35 kg with acute respiratory distress syndrome (ARDS in the early period after liver transplantation against satisfactory liver graft function. Materials and methods. Double-lumen cannula 22 F was placed percutaneously in the right internal jugular vein. The ext- racorporeal contour reduced in length and the polymethylpeptene oxygenator (priming volume 175 ml were also. Results. In 1 hour after the beginning of VV ECMO, we registered the noted improvement of arterial blood gas and acid-base balance (regress of respiratory acidosis, improvement of arterial oxygenation which allowed us to use the «protective» mode of mechanical ventilation. Improvement of gas exchange and regress of clinical and radiological manifestations of ARDS allowed for VV ECMO weaning and decannulation on day 7. The patient was discharged from ICU and then from our Centre to a homestay respectively on the 9th and 16th day after VV ECMO weaning with the satisfactory liver graft and lungs function. Conclusion. VV ECMO can be successfully applied to correct the life-threatening acute respiratory failure in the early period after liver transplantation. 

  10. Microscopy, culture, and sensitive management of uncomplicated urinary tract infections in adults in the primary care setting.

    Science.gov (United States)

    Sivathasan, Niroshan; Rakowski, Krzysztof R

    2011-06-01

    The high prevalence of urinary tract infections (UTIs) places a significant burden on healthcare systems. Clinicians may over-manage the issue, and there is great variability in practice, with economic- and resource- implications. Up to 40% of patients with a suspected UTI do not have an infection. Using PubMed (Medline) to shortlist relevant papers in English from the last 30 years, and further sub-selection to include only uncomplicated UTIs in adults in primary care, we reviewed the literature pertaining to uncomplicated UTIs, and how it should be managed efficiently in the primary care setting. In general practice, there is no advantage to routinely request microscopy and culture of urine samples in the presence of an appropriate history and urinalysis reagent-strip testing. If antibiotics are required, then a 3-day course shall suffice. Larger epidemiological studies focusing on more susceptible sub-populations may provide better guidance for discriminatory factors to produce an algorithm for treatment.

  11. Liver transplant

    Science.gov (United States)

    Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant ... The donated liver may be from: A donor who has recently died and has not had liver injury. This type of ...

  12. Effects of HGF gene polymorphisms and protein expression on transhepatic arterial chemotherapeutic embolism efficacy and prognosis in patients with primary liver cancer

    Science.gov (United States)

    Chen, Hai-Yong; Chen, Yao-Min; Wu, Jian; Yang, Fu-Chun; Lv, Zhen; Qian, Yi-Gang; Zheng, Shu-Sen

    2017-01-01

    Objective To investigate the correlations of two hepatocyte growth factor (HGF) gene polymorphisms (rs5745652 and rs2074725) and their protein expression levels with the efficacy of transhepatic arterial chemotherapeutic embolism (TACE) and prognosis in patients with primary liver cancer (PLC). Methods From March 2011 to June 2012, 109 PLC patients (the case group) who chose TACE as primary treatment and 80 healthy people (the control group) who had undergone physical examination in The First Affiliated Hospital, Zhejiang University were selected during the same period. Gene polymorphisms of HGF rs5745652 and HGF rs2074725 were detected. Serum HGF level, treating efficacy, survival quality, and 3-year survival rate for PLC patients who received TACE were observed. Results There were significant differences in genotype and allele frequencies of HGF rs5745652 and HGF rs2074725, between the case and control groups (all PCancer stage were independent prognostic factors for PLC (Pprognosis after TACE treatment.

  13. Primary Prevention for Mental Health: A Stress Inoculation Training Course for Functioning Adults.

    Science.gov (United States)

    Schiraldi, Glenn R.; Brown, Stephen L.

    2001-01-01

    Describes a college course that taught preventive mental health skills to adults by exploring diverse cognitive-behavioral skills that facilitate coping, are preventive in nature, and are suitable for learning by healthy individuals in educational settings. It focused on anger management, anxiety and worry management, self-esteem enhancement,…

  14. Adoption of Evidence-Based Fall Prevention Practices in Primary Care for Older Adults with a History of Falls

    Directory of Open Access Journals (Sweden)

    Elizabeth A Phelan

    2016-09-01

    Full Text Available A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ with a history of repeated falls or fall-related healthcare use received multifactorial risk assessment and interventions. The setting was an academic primary care clinic in the Pacific Northwest. Among the 116 patients meeting our inclusion criteria, 48% had some type of documented assessment. Their mean age was 79±8 years; 68% were female, and 10% were non-white. They averaged 6 primary care visits over a 12-month period subsequent to their index fall. Frequency of assessment of fall risk factors varied from 24% (for home safety to 78% (for vitamin D. An evidence-based intervention was recommended for identified risk factors 73% of the time, on average. Two risk factors were addressed infrequently: medications (21% and home safety (24%. Use of a structured visit note template independently predicted assessment of fall risk factors (P=0.003. Geriatrics specialists were more likely to use a structured note template (p=.04 and perform more fall risk factor assessments (4.6 vs. 3.6, p=.007 than general internists. These results suggest opportunities for improving multifactorial fall risk assessment and management of older adults at high fall risk in primary care. A structured visit note template facilitates assessment. Given that high-risk medications have been found to be independent risk factors for falls, increasing attention to medications should become a key focus of both public health educational efforts and fall prevention in primary care practice.

  15. Humoral Immunity to Primary Smallpox Vaccination: Impact of Childhood versus Adult Immunization on Vaccinia Vector Vaccine Development in Military Populations.

    Science.gov (United States)

    Slike, Bonnie M; Creegan, Matthew; Marovich, Mary; Ngauy, Viseth

    2017-01-01

    Modified Vaccinia virus has been shown to be a safe and immunogenic vector platform for delivery of HIV vaccines. Use of this vector is of particular importance to the military, with the implementation of a large scale smallpox vaccination campaign in 2002 in active duty and key civilian personnel in response to potential bioterrorist activities. Humoral immunity to smallpox vaccination was previously shown to be long lasting (up to 75 years) and protective. However, using vaccinia-vectored vaccine delivery for other diseases on a background of anti-vector antibodies (i.e. pre-existing immunity) may limit their use as a vaccine platform, especially in the military. In this pilot study, we examined the durability of vaccinia antibody responses in adult primary vaccinees in a healthy military population using a standard ELISA assay and a novel dendritic cell neutralization assay. We found binding and neutralizing antibody (NAb) responses to vaccinia waned after 5-10 years in a group of 475 active duty military, born after 1972, who were vaccinated as adults with Dryvax®. These responses decreased from a geometric mean titer (GMT) of 250 to baseline (vaccination. This contrasted with a comparator group of adults, ages 35-49, who were vaccinated with Dryvax® as children. In the childhood vaccinees, titers persisted for >30 years with a GMT of 210 (range 112-3234). This data suggests limited durability of antibody responses in adult vaccinees compared to those vaccinated in childhood and further that adult vaccinia recipients may benefit similarly from receipt of a vaccinia based vaccine as those who are vaccinia naïve. Our findings may have implications for the smallpox vaccination schedule and support the ongoing development of this promising viral vector in a military vaccination program.

  16. Successful orthotopic liver transplantation in an adult patient with sickle cell disease and review of the literature

    Directory of Open Access Journals (Sweden)

    Morey Blinder

    2013-05-01

    Full Text Available Sickle cell disease can lead to hepatic complications ranging from acute hepatic crises to chronic liver disease including intrahepatic cholestasis, and iron overload. Although uncommon, intrahepatic cholestasis may be severe and medical treatment of this complication is often ineffective. We report a case of a 37 year-old male patient with sickle cell anemia, who developed liver failure and underwent successful orthotopic liver transplantation. Both pre and post-operatively, he was maintained on red cell transfusions. He remains stable with improved liver function 42 months post transplant. The role for orthotopic liver transplantation is not well defined in patients with sickle cell disease, and the experience remains limited. Although considerable challenges of post-transplant graft complications remain, orthotopic liver transplantation should be considered as a treatment option for sickle cell disease patients with end-stage liver disease who have progressed despite conventional medical therapy. An extended period of red cell transfusion support may lessen the post-operative complications.

  17. The Impact of Checking the Health of Adults with Intellectual Disabilities on Primary Care Consultation Rates, Health Promotion and Contact with Specialists

    Science.gov (United States)

    Felce, David; Baxter, Helen; Lowe, Kathy; Dunstan, Frank; Houston, Helen; Jones, Glyn; Grey, Jill; Felce, Janet; Kerr, Michael

    2008-01-01

    Background: Studies have found that health checking in primary care led to the identification of previously unrecognized morbidity among adults with intellectual disabilities. The aim here was to evaluate whether health checking stimulated increased consultation with the general practitioner or another member of the primary care team, increased…

  18. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Spector, Seth, E-mail: sspector@med.miami.edu [University of Miami, Department of Surgery, VA Hospital (Veterans Affairs Medical Center) (United States); Echenique, Ana, E-mail: aechenique@med.miami.edu; Froud, Tatiana, E-mail: tfroud@med.miami.edu; Suthar, Rekha, E-mail: rsuthar@med.miami.edu; Lawson, Ivy, E-mail: i.lawson1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Dinh, Vy, E-mail: vdinh@med.miami.edu [VA Hospital (Veterans Affairs Medical Center), Department of Medicine (United States); Yrizarry, Jose, E-mail: jyrizarr@med.miami.edu; Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States)

    2015-08-15

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis.

  19. Liver Expression of Sulphotransferase 2A1 Enzyme Is Impaired in Patients with Primary Sclerosing Cholangitis: Lack of the Response to Enhanced Expression of PXR

    Directory of Open Access Journals (Sweden)

    Ewa Wunsch

    2015-01-01

    Full Text Available Background/Aim. Sulphotransferase 2A1 (SULT2A1 exerts hepatoprotective effects. Transcription of SULT2A1 gene is induced by pregnane-X-receptor (PXR and can be repressed by miR-378a-5p. We studied the PXR/SULT2A1 axis in chronic cholestatic conditions: primary sclerosing cholangitis (PSC and primary biliary cirrhosis (PBC. Materials/Methods. Western-blot/PCRs for SULT2A1/PXR were performed in PSC (n=11, PBC (n=19, and control liver tissues (n=19. PXR and SULT2A1 mRNA was analyzed in intestinal tissues from 22 PSC patients. Genomic DNA was isolated from blood of PSC patients (n=120 and an equal number of healthy volunteers. Liver miRNA expression was evaluated using Affymetrix-Gene-Chip miRNA4.0. Results. Increased PXR protein was observed in both PSC and PBC compared to controls and was accompanied by a significant increase of SULT2A1 in PBC but not in PSC. Decreased expression of SULT2A1 mRNA was also seen in ileum of patients with PSC. Unlike PBC, miRNA analysis in PSC has shown a substantial increase in liver miR-378a-5p. Conclusions. PSC is characterized by disease-specific impairment of SULT2A1 expression following PXR activation, a phenomenon which is not noted in PBC, and may account for the impaired hepatoprotection in PSC. miRNA analysis suggests that SULT2A1 expression in PSC may be regulated by miR-378a-5p, connoting its pathogenic role.

  20. Primary hypogammaglobulinemia complicated with liver cirrhosis and literature review%抗体缺陷病并发肝硬化一例并文献复习

    Institute of Scientific and Technical Information of China (English)

    邓朝晖; 蒋丽蓉; 张斌; 徐亚珍; 沈丛欢; 周韬; 夏强; 张天遨

    2016-01-01

    目的 总结抗体缺陷病并发肝硬化患儿的病因、治疗及预后.方法 回顾性分析上海儿童医学中心收治的1例X连锁无丙种球蛋白血症并发肝硬化患儿的临床资料.应用维普及万方数据库,以“抗体缺陷病”“肝硬化”作为关键词对2015年1月以前15年文献进行检索;应用Pubmed医学检索,以“primary hypogammaglobulinaemia”“liver cirrhosis"为关键词,检索由1988年1月1日至2015年1月1日的文献,对文献病例资料进行总结.结果 患儿男,12岁,因“确诊X连锁无丙种球蛋白血症7年,吐血3次”于2014年12月入院.患儿有静脉输注丙种球蛋白6年病史,无丙型肝炎(丙肝)病毒感染,自身抗体阴性,乙型肝炎(乙肝)病毒表面抗体、e抗体及核心抗体阳性.胃镜示食管胃底静脉曲张,肝脏病理示肝细胞变性,坏死,纤维组织增生,假小叶形成.入院后接受肝移植,术后口服他克莫司3 mg/d,甲泼尼松5 mg/d,拉米夫定150 mg/d及阿昔洛韦900 mg/d,随访3个月,患儿病情稳定,肝功能正常.符合条件的中文文献0篇,英文文献13篇,共计19例患者,其中12例普通变异型免疫缺陷病,3例X连锁无丙种球蛋白血症,2例高IgM血症,2例先天性低丙种球蛋白血症.17例丙肝病毒感染,2例自身免疫性肝炎.17例丙肝病毒感染者中有15例静脉输注丙种球蛋白.19例病例中,7例存活.肝移植治疗5例,死亡3例.结论 除了传统认识的丙肝病毒感染及自身免疫性两大因素是抗体缺陷病并发肝硬化病因以外,乙肝病毒感染也是病因之一.静脉输注丙种球蛋白可能是传播丙肝及乙肝病毒感染的重要途径.抗体缺陷病并发肝硬化预后差,病死率高.%Objective To explore the pathogenesis,treatment and prognosis of primary hypogammaglobulinemia complicated with liver cirrhosis in a child.Method Pathogenesis,treatment and prognosis of X-linked agammaglobulinemia (XLA) complicated with liver cirrhosis in a

  1. Adult-to-adult right lobe living donor liver transplantation: Comparison of endoscopic retrograde cholangiography with standard T2-weighted magnetic resonance cholangiography for evaluation of donor biliary anatomy

    Institute of Scientific and Technical Information of China (English)

    Perdita Wietzke-Braun; Felix Braun; Dieter Müller; Thomas Lorf; Burckhardt Ringe; Giuliano Ramadori

    2006-01-01

    AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications,postoperatively.METHODS: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared usingthe Ohkubo classification.RESULTS: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%)with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation.Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3recipients with biliary leak received a graft with multiple (≥2) bile ducts.CONCLUSION: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.

  2. Multiple primary malignancies including colon, stomach, lung, breast, and liver cancer: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Nien-Chih Hu; Shih-Chung Hsieh; Tong-Jong Chen; Jun-Yih Chang

    2009-01-01

    @@ Multiple primary malignancies in a single patient are relatively rare but have increase in frequency in recent decades. This may be a result of medical advancements in diagnostic and therapeutic strategies, a possible effect of new carcinogens in the industrial environment, and longer life span allowing another primary cancer to develop. Among those with multiple primary malignancies, double cancer is commonly seen, while triple cancers occur in 0.5% of patients, and quadruple or quintuple cancers occur in only less than 0.1% of the population.~1 This report describes a rare case of a patient with five metachronous primary malignancies. The time interval between each of the malignancies is more than 2 years. Literatures about at least four primary malignancies are also discussed.

  3. Primary Cutaneous Lymphoma-Associated Pseudoepitheliomatous Hyperplasia Masquerading as Squamous Cell Carcinoma in a Young Adult.

    Science.gov (United States)

    Ansari, Mahsa; Azmoodeh Ardalan, Farid; Najafi, Masoumeh; Goodarzi, Azadeh; Ghanadan, Alireza

    2015-12-01

    Primary cutaneous anaplastic large cell lymphoma is a T-cell malignancy with atypical CD30 positive lymphocytes. Pseudoepitheliomatous hyperplasia is an uncommon finding in primary cutaneous anaplastic large cell lymphoma, and may mimic squamous cell carcinoma as pseudomalignancy. Careful attention of a pathologist to correct diagnosis of pseudoepitheliomatous hyperplasia and its underlying causes will help physicians to avoid inappropriate management. Here, we present a 22-year-old man referred to our hospital with a solitary nodule persistent on his forearm which was diagnosed as squamous cell carcinoma in the first biopsy. The lesion recurred after two months and histopathologic and immunohistochemistry examination revealed anaplastic large cell lymphoma with florid pseudoepitheliomatous hyperplasia which masquerading as well-differentiated squamous cell carcinoma. Diagnosis of pseudoepitheliomatous hyperplasia must guide the pathologist to search for underlying causes, such as primary cutaneous lymphoma. Pseudoepitheliomatous hyperplasia may mimic squamous cell carcinoma and this can result in inappropriate diagnosis and management.

  4. Comparative effects of contraction and angiotensin II on growth of adult feline cardiocytes in primary culture

    Science.gov (United States)

    Wada, H.; Zile, M. R.; Ivester, C. T.; Cooper, G. 4th; McDermott, P. J.

    1996-01-01

    The purposes of this study were 1) to determine whether angiotensin II causes growth of adult feline cardiocytes in long-term culture, 2) to compare the growth effects of angiotensin II with those resulting from electrically stimulated contraction, and 3) to determine whether the anabolic effects of contraction are exerted via the angiotensin type 1 receptor. Adult feline cardiocytes were cultured on laminin-coated trays in a serum-free medium. Cardiocytes were either electrically stimulated to contract (1 Hz, 5-ms pulse duration, alternating polarity) or were nonstimulated and quiescent. Quiescent cells were studied as controls and after treatment with angiotensin II (10(-8) M), losartan (10(-6) M; an angiotensin type 1-receptor antagonist), or angiotensin II plus losartan. Contracting cells were studied in the presence and absence of angiotensin II or losartan. In quiescent cardiocytes, angiotensin II treatment on day 7 significantly increased protein synthesis rates by 22% and protein content per cell by 17%. The effects of angiotensin II were completely blocked by losartan. Electrically stimulated contraction on days 4 and 7 in culture significantly increased protein synthesis rate by 18 and 38% and protein content per cell by 19 and 46%, respectively. Angiotensin II treatment did not further increase protein synthesis rate or protein content in contracting cardiocytes. Furthermore, losartan did not block the anabolic effects of contraction on protein synthesis rates or protein content. In conclusion, angiotensin II can exert a modest anabolic effect on adult feline cardiocytes in culture. In contracting feline cardiocytes, angiotensin II has no effect on growth. Growth caused by electrically stimulated contraction occurs more rapidly and is greater in magnitude than that caused by angiotensin II. Growth of contracting adult feline cardiocytes is not dependent on activation of the angiotensin receptor.

  5. Overlap syndromes among autoimmune liver diseases

    Institute of Scientific and Technical Information of China (English)

    Christian Rust; Ulrich Beuers

    2008-01-01

    The three major immune disorders of the liver are autoimmune hepatitis (AIH),primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC).Variant forms of these diseases are generally called overlap syndromes,although there has been no standardised definition.Patients with overlap syndromes present with both hepatitic and cholestatic serum liver tests and have histological features of AIH and PBC or PSC.The AIH-PBC overlap syndrome is the most common form,affecting almost 10% of adults with AIH or PBC.Single cases of AIH and autoimmune cholangitis (AMA-negative PBC) overlap syndrome have also been reported.The AIH-PSC overlap syndrome is predominantly found in children,adolescents and young adults with AIH or PSC.Interestingly,transitions from one autoimmune to another have also been reported in a minority of patients,especially transitions from PBC to AIH-PBC overlap syndrome.Overlap syndromes show a progressive course towards liver cirrhosis and liver failure without treatment.Therapy for overlap syndromes is empiric,since controlled trials are not available in these rare disorders.Anticholestatic therapy with ursodeoxycholic acid is usually combined with immunosuppressive therapy with corticosteroids and/or azathioprine in both AIH-PBC and AIH-PSC overlap syndromes.In end-stage disease,liver transplantation is the treatment of choice.

  6. Retorno ao trabalho de pacientes adultos submetidos a transplante de fígado Return to work of adults after liver transplantation

    Directory of Open Access Journals (Sweden)

    Mônica Beatriz PAROLIN

    2001-09-01

    Full Text Available Racional — O transplante hepático é hoje o tratamento de eleição das doenças hepáticas avançadas. A melhoria da qualidade de vida após o transplante hepático tem sido objeto de inúmeros estudos e o restabelecimento da capacidade laborativa do indivíduo é um de seus indicadores. Objetivo - Avaliar o índice de retorno ao trabalho em adultos submetidos a transplante hepático e as causas para inatividade no pós-transplante. Pacientes e Métodos - Quarenta e um pacientes adultos (idade ³ 18 anos submetidos a transplante hepático, entre setembro de 1991 a junho de 1999, com sobrevida pós-transplante ³ 9 meses, boa função do enxerto e seguimento clínico regular foram avaliados em relação ao grau de inatividade no período pré e pós-transplante mediante aplicação de questionário. Resultados - Vinte e oito dos 41 pacientes transplantados (68% retornaram ao trabalho após o transplante hepático; o tempo médio decorrido entre a cirurgia do transplante e o retorno ao trabalho foi de 5,9 meses. Onze dos 28 pacientes ativos após o transplante (39% contribuíam efetivamente para a renda familiar. As causas de inatividade após o transplante hepático em 13 pacientes foram: aposentadoria precoce (n = 5, desemprego (n = 4 e incapacidade física (n = 4. Conclusão - O transplante hepático bem sucedido permite a um número considerável de pacientes retornar à atividade laborativa, reassumindo suas funções sociais.Background — Orthotopic liver transplantation is an established therapy for patients with end-stage liver disease. In the last years more attention has been given for the improvement of the quality of life after liver transplantation, and the return to important life pursuits, such as employment, are important goals of this type of therapy. Aim - To assess the work's return rate in liver transplant recipients and the reasons for inability after liver transplant. Patients and Methods - Forty-one adults (age ³ 18

  7. Association between primary headaches and depression in young adults in southern Brazil

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2013-12-01

    Full Text Available OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI and Migraine Disability Assessment (MIDAS were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI > 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headacherelated disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

  8. A liver abscess deprived a healthy adult of eyesight: endogenous endophthalmitis associated with a pyogenic liver abscess caused by serotype K1 Klebsiella pneumonia.

    Science.gov (United States)

    Maruno, Takahisa; Ooiwa, Yoko; Takahashi, Ken; Kodama, Yuzo; Takakura, Shunji; Ichiyama, Satoshi; Chiba, Tsutomu

    2013-01-01

    Klebsiella pneumonia usually causes urinary tract infections, pneumonia, and other infectious diseases in hospitalized and immunocompromised patients. Among the types of Klebsiella pneumonia, serotype K1 is known to be a highly virulent pathogen. We herein report the case of a healthy 63-year-old man with a pyogenic liver abscess and bilateral endogenous endophthalmitis caused by serotype K1 Klebsiella pneumonia. Although the patient received percutaneous abscess drainage and antibiotic therapy, he lost his eyesight. To improve the poor prognoses of ocular complications, providing both an earlier diagnosis and treatment is critical.

  9. Inhibition of NADPH-cytochrome P450 reductase by tannic acid in rat liver microsomes and primary hepatocytes: methodological artifacts and application to ischemia-reperfusion injury.

    Science.gov (United States)

    Pillai, Venkateswaran C; Mehvar, Reza

    2011-08-01

    Tannic acid (TA) inhibits nicotinamide adenine dinucleotide phosphate (NADPH)-cytochrome P450 reductase (CPR) activity, which is measured by reduction of cytochrome c, in rat liver microsomes (RLMs). In the current study, we noticed that TA directly reduces cytochrome c in the absence of microsomes, thus confounding the CPR activity assay. A method is presented that measures CPR activity in the presence of TA by subtracting the cytochrome c reduction in the absence of NADPH (TA effect) from that in the presence of NADPH (TA plus CPR effect). The method was used to determine the inhibitory effect of TA in RLMs, recombinant CPR enzyme, and primary hepatocytes. Additionally, application of TA in a study of role of CPR in a primary rat hepatocyte model of ischemia-reperfusion (IR) was investigated. TA showed concentration-dependent, complete inhibition of CPR with half maximal inhibitory concentration (IC(50) ) values of 58.2 μM in RLMs and 54.6 and 275 μM in primary rat hepatocytes in the absence and presence of serum in the medium, respectively. Additionally, inhibition of CPR by TA was associated with a significant reduction in reactive oxygen species and cell death after IR injury. These data may be useful in future studies using TA as an inhibitor of CPR in microsomes and primary hepatocytes.

  10. Alcohol and liver

    Institute of Scientific and Technical Information of China (English)

    Natalia Osna

    2009-01-01

    @@ Liver is a primary site of ethanol metabolism, which makes this organ susceptible to alcohol-induced damage.Alcoholic liver disease (ALD) has many manifestations and complicated pathogenesis. In this Topic Highlight, we included the key reviews that characterize new findings about the mechanisms of ALD development and might be of strong interest for clinicians and researchers involved in liver alcohol studies.

  11. Care of Older Adults: Role of Primary Care Physicians in the Treatment of Cataracts and Macular Degeneration.

    Science.gov (United States)

    Marra, Kyle V; Wagley, Sushant; Kuperwaser, Mark C; Campo, Rafael; Arroyo, Jorge G

    2016-02-01

    This article aims to facilitate optimal management of cataracts and age-related macular degeneration (AMD) by providing information on indications, risk factors, referral guidelines, and treatments and to describe techniques to maximize quality of life (QOL) for people with irreversible vision loss. A review of PubMed and other online databases was performed for peer-reviewed English-language articles from 1980 through August 2012 on visual impairment in elderly adults. Search terms included vision loss, visual impairment, blind, low vision, QOL combined with age-related, elderly, and aging. Articles were selected that discussed vision loss in elderly adults, effects of vision impairment on QOL, and care strategies to manage vision loss in older adults. The ability of primary care physicians (PCPs) to identify early signs of cataracts and AMD in individuals at risk of vision loss is critical to early diagnosis and management of these common age-related eye diseases. PCPs can help preserve vision by issuing aptly timed referrals and encouraging behavioral modifications that reduce risk factors. With knowledge of referral guidelines for soliciting low-vision rehabilitation services, visual aids, and community support resources, PCPs can considerably increase the QOL of individuals with uncorrectable vision loss. By offering appropriately timed referrals, promoting behavioral modifications, and allocating low-vision care resources, PCPs may play a critical role in preserving visual health and enhancing the QOL for the elderly population.

  12. Effects of Feiji Decoction for Soothing the Liver Combined with Psychotherapy 
on Quality of Life in Primary Lung Cancer Patients

    Directory of Open Access Journals (Sweden)

    Yilin YAO

    2012-01-01

    Full Text Available Background and objective Primary lung cancer is one of the most common malignant tumors. It causes great pain and mood disorders to patients, and significantly reduces their quality of life. The aim of the current study is to evaluate the effect of Feiji Decoction for soothing the liver combined with psychotherapy on quality of life (QoL and physical status of patients with primary lung cancer. Methods A total of 118 patients with primary non-small cell lung cancer were randomly divided into two groups. The 57 patients in the combined therapy group were treated with Feiji Decoction for soothing the liver and psychotherapy combined with chemotherapy, whereas the 61 patients in the control group were treated with chemotherapy only. Both groups were observed for the two treatment courses. The European Organization for Research and Treatment of Cancer QoL Questionnaire LC-43 (EORTC QLQ-LC43 was used to assess the QoL of every patient in both groups before and after treatment scales. At the same time, physical status was assessed using the Karnofsky performance status (KPS and East Cooperative Oncology Group performance status (ECOG. Results The scores of physiology function, role function, emotion function, cognize function, society function, and general health in the therapy group were higher than that of the control group. The therapy group also showed better QoL results than the contol group. Significant differences were observed between the two groups (P<0.01. Meanwhile, the scores of fatigue, vomit, pain, polypnea, insomnia, anorexia, constipation, and specific manifestation of lung cancer in the therapy group were obviously lower than that of the control group; more patients were observed to be relieved. Significant differences between the two groups were observed (P<0.01. The KPS and ECOG scores of the patients were observed to have improved and stabilized in the therapy group than that of the control group; the differences were statistically

  13. A Systematic Review of Depression Treatments in Primary Care for Latino Adults

    Science.gov (United States)

    Cabassa, Leopoldo J.; Hansen, Marissa C.

    2007-01-01

    Objective: A systematic literature review of randomized clinical trials (RCTs) assessing depression treatments in primary care for Latinos is conducted. The authors rate the methodological quality of studies, examine cultural and linguistic adaptations, summarize clinical outcomes and cost-effectiveness findings, and draw conclusions for improving…

  14. Primary and secondary implantation of scleral-fixated posterior chamber intraocular lenses in adult patients

    Directory of Open Access Journals (Sweden)

    Zuleyha Yalniz-Akkaya

    2014-01-01

    Conclusion: Both primary and secondary scleral-fixated PCIOL implantations can provide favorable visual outcomes with lower complication rates. An important consideration is the appropriate timing for scleral fixation, taking into account the patient′s characteristics and the course of the operation.

  15. Regular Exercise Is Associated with a Reduction in the Risk of NAFLD and Decreased Liver Enzymes in Individuals with NAFLD Independent of Obesity in Korean Adults

    Science.gov (United States)

    Park, Se Eun; Rhee, Eun Jung; Park, Cheol Young; Oh, Ki Won; Park, Sung Woo; Kim, Sun Woo; Hur, Kyu Yeon; Kim, Jae Hyeon; Lee, Myung-Shik; Lee, Moon Kyu; Kim, Kwang-Won; Lee, Won-Young

    2012-01-01

    Background We evaluated the association of regular physical exercise with the presence of non-alcoholic fatty liver disease (NAFLD) and liver enzymes in relation to obesity and insulin resistance. Methodology/Principal Findings A cross-sectional analysis was conducted in 72,359 healthy Korean adults without diabetes who participated in a comprehensive health check-up. Subjects who have been exercising regularly (more than 3 times per week, at least for 30 minutes each time and for consecutive 3 month) were categorized into exercise group. All subjects were categorized into deciles based on their body mass index (BMI) and we estimated the odds ratios (ORs) for having NAFLD according to exercise regularity in each decile. The diagnosis of NAFLD was based on ultrasonography findings. Individuals with NAFLD (n = 19,921) were analyzed separately to evaluate ORs for having elevated liver enzymes based on regularity of exercise. The risk for NAFLD was significantly reduced in exercise group with age- and sex-adjusted ORs of 0.53–0.72 for all BMI deciles except at BMI categories of <19.6 and 20.7–21.6 kg/m2. While no difference was seen in BMI between subjects in exercise and non-exercise group across the BMI deciles, the values of body fat percentage and metabolic risk factors differed. Among NAFLD patients, subjects in exercise group had a lower risk for having elevated liver enzymes with multivariable adjusted OR of 0.85 (95% CI 0.74–0.99, for AST) and 0.74 (95% CI 0.67–0.81, for ALT) than did subjects in non-exercise group. Conclusions/Significance Regular exercise was associated with a reduced risk for having NAFLD and decreased liver enzymes in patients with NAFLD, and this relationship was also independent of obesity. PMID:23110056

  16. Regular exercise is associated with a reduction in the risk of NAFLD and decreased liver enzymes in individuals with NAFLD independent of obesity in Korean adults.

    Directory of Open Access Journals (Sweden)

    Ji Cheol Bae

    Full Text Available BACKGROUND: We evaluated the association of regular physical exercise with the presence of non-alcoholic fatty liver disease (NAFLD and liver enzymes in relation to obesity and insulin resistance. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional analysis was conducted in 72,359 healthy Korean adults without diabetes who participated in a comprehensive health check-up. Subjects who have been exercising regularly (more than 3 times per week, at least for 30 minutes each time and for consecutive 3 month were categorized into exercise group. All subjects were categorized into deciles based on their body mass index (BMI and we estimated the odds ratios (ORs for having NAFLD according to exercise regularity in each decile. The diagnosis of NAFLD was based on ultrasonography findings. Individuals with NAFLD (n = 19,921 were analyzed separately to evaluate ORs for having elevated liver enzymes based on regularity of exercise. The risk for NAFLD was significantly reduced in exercise group with age- and sex-adjusted ORs of 0.53-0.72 for all BMI deciles except at BMI categories of <19.6 and 20.7-21.6 kg/m(2. While no difference was seen in BMI between subjects in exercise and non-exercise group across the BMI deciles, the values of body fat percentage and metabolic risk factors differed. Among NAFLD patients, subjects in exercise group had a lower risk for having elevated liver enzymes with multivariable adjusted OR of 0.85 (95% CI 0.74-0.99, for AST and 0.74 (95% CI 0.67-0.81, for ALT than did subjects in non-exercise group. CONCLUSIONS/SIGNIFICANCE: Regular exercise was associated with a reduced risk for having NAFLD and decreased liver enzymes in patients with NAFLD, and this relationship was also independent of obesity.

  17. Effect of culture conditions on microRNA expression in primary adult control and COPD lung fibroblasts in vitro.

    Science.gov (United States)

    Ikari, Jun; Smith, Lynette M; Nelson, Amy J; Iwasawa, Shunichiro; Gunji, Yoko; Farid, Maha; Wang, Xingqi; Basma, Hesham; Feghali-Bostwick, Carol; Liu, Xiangde; DeMeo, Dawn L; Rennard, Stephen I

    2015-04-01

    In vitro cell cultures, including lung fibroblasts, have been used to identify microRNAs (miRNAs) associated with chronic obstructive pulmonary disease (COPD) pathogenesis. However, culture conditions may affect miRNA expression. We examined whether miRNA expression in primary adult lung fibroblasts varies with cell density or passage in vitro and whether culture conditions confound the identification of altered miRNA expression in COPD lung fibroblasts. Primary adult control and COPD lung fibroblasts were cultured until passage 3 or 8, after which cells were further cultured for 3 or 7 d (low vs. high density). Then, cells at low density were cultured with serum-free media, and those at high density were cultured with serum-free media in the absence or presence of interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) for 24 h. RNA was extracted to perform miRNA microarray from which 1.25-fold differential expression and 10% false discovery rate were applied to identify "invariant" and "variant" miRNA for the various culture conditions. Of the 2226 miRNAs evaluated, 39.0% for cell density, 40.7% for cell passage, and 29.4% for both conditions were identified as "invariant" miRNAs. Furthermore, 38.1% of the evaluated miRNAs were "invariant" for cell passage with IL-1β and TNF-α. Differentially expressed miRNAs between control and COPD lung fibroblasts were identified with and without IL-1β and TNF-α, and of these, 32 out of the 34 top-ranked miRNAs exceeded the differences due to culture conditions. Thus, culture conditions may affect miRNA expression of adult human lung fibroblasts. Nevertheless, in vitro cultures can be used to assess differential miRNA expression in COPD lung fibroblasts.

  18. Primary care providers' perspective on prescribing opioids to older adults with chronic non-cancer pain: A qualitative study

    Directory of Open Access Journals (Sweden)

    Turner Barbara J

    2011-07-01

    Full Text Available Abstract Background The use of opioid medications as treatment for chronic non-cancer pain remains controversial. Little information is currently available regarding healthcare providers' attitudes and beliefs about this practice among older adults. This study aimed to describe primary care providers' experiences and attitudes towards, as well as perceived barriers and facilitators to prescribing opioids as a treatment for chronic pain among older adults. Methods Six focus groups were conducted with a total of 23 physicians and three nurse practitioners from two academically affiliated primary care practices and three community health centers located in New York City. Focus groups were audiotape recorded and transcribed. The data were analyzed using directed content analysis; NVivo software was used to assist in the quantification of identified themes. Results Most participants (96% employed opioids as therapy for some of their older patients with chronic pain, although not as first-line therapy. Providers cited multiple barriers, including fear of causing harm, the subjectivity of pain, lack of education, problems converting between opioids, and stigma. New barriers included patient/family member reluctance to try an opioid and concerns about opioid abuse by family members/caregivers. Studies confirming treatment benefit, validated tools for assessing risk and/or dosing for comorbidities, improved conversion methods, patient education, and peer support could facilitate opioid prescribing. Participants voiced greater comfort using opioids in the setting of delivering palliative or hospice care versus care of patients with chronic pain, and expressed substantial frustration managing chronic pain. Conclusions Providers perceive multiple barriers to prescribing opioids to older adults with chronic pain, and use these medications cautiously. Establishing the long-term safety and efficacy of these medications, generating improved prescribing methods

  19. Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

    Directory of Open Access Journals (Sweden)

    Omar Khairani

    2009-06-01

    Full Text Available Abstract Background Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ. Methods This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period. Results The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%, somatoform disorder (n = 32, 12.2%, panic and anxiety disorders (n = 17, 6.5%, binge eating disorder (n = 9, 3.4% and alcohol abuse (n = 6, 2.3%. Younger age (18 to 29 years and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively with PHQ positive scores. Conclusion These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.

  20. Endovascular management in liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Kyu-Bo Sung

    2006-01-01

    @@ Liver transplantation was developed for the treatment of hepatic failure, and the first human liver transplantation was done in 1963. From the 1990 s,liver transplantation was generally accepted as a treatment modality for both end-stage liver disease and selected liver malignancies. Initially, liver transplantation was started with deceased donor whole-size liver transplantation (whole-size LT) as in other organ transplantation, but there is now a shortage of deceased liver donors has occurred. As a solution, deceased donor split liver transplantation (split LT) began in 1989 and living donor liver transplantation (LDLT) in the early 1990 s. Current liver transplantation techniques include whole-size LT, reduced-size liver transplantation (reduced-size LT), split LT and single or dual LDLT. Two donors give a part of their livers to one adult recipient simultaneously in dual LDLT.

  1. Inhibition of bile salt transport by drugs associated with liver injury in primary hepatocytes from human, monkey, dog, rat, and mouse.

    Science.gov (United States)

    Zhang, Jie; He, Kan; Cai, Lining; Chen, Yu-Chuan; Yang, Yifan; Shi, Qin; Woolf, Thomas F; Ge, Weigong; Guo, Lei; Borlak, Jürgen; Tong, Weida

    2016-08-05

    Interference of bile salt transport is one of the underlying mechanisms for drug-induced liver injury (DILI). We developed a novel bile salt transport activity assay involving in situ biosynthesis of bile salts from their precursors in primary human, monkey, dog, rat, and mouse hepatocytes in suspension as well as LC-MS/MS determination of extracellular bile salts transported out of hepatocytes. Glycine- and taurine-conjugated bile acids were rapidly formed in hepatocytes and effectively transported into the extracellular medium. The bile salt formation and transport activities were time‒ and bile-acid-concentration‒dependent in primary human hepatocytes. The transport activity was inhibited by the bile salt export pump (BSEP) inhibitors ketoconazole, saquinavir, cyclosporine, and troglitazone. The assay was used to test 86 drugs for their potential to inhibit bile salt transport activity in human hepatocytes, which included 35 drugs associated with severe DILI (sDILI) and 51 with non-severe DILI (non-sDILI). Approximately 60% of the sDILI drugs showed potent inhibition (with IC50 values drugs showed this strength of inhibition in primary human hepatocytes and these drugs are associated only with cholestatic and mixed hepatocellular cholestatic (mixed) injuries. The sDILI drugs, which did not show substantial inhibition of bile salt transport activity, are likely to be associated with immune-mediated liver injury. Twenty-four drugs were also tested in monkey, dog, rat and mouse hepatocytes. Species differences in potency were observed with mouse being less sensitive than other species to inhibition of bile salt transport. In summary, a novel assay has been developed using hepatocytes in suspension from human and animal species that can be used to assess the potential for drugs and/or drug-derived metabolites to inhibit bile salt transport and/or formation activity. Drugs causing sDILI, except those by immune-mediated mechanism, are highly associated with potent

  2. 原发性肝癌诊断中CT值直方图的应用解析%Application of CT histogram in diagnosis of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    冯雷

    2015-01-01

    Objectiveto study the value of ct histogram in the diagnosis of primary hepatic carcinoma by analyzing the ct histogram in different character of the liver lesions of the liver.Methodsthe data of 486 patients with imaging data were analyzed, according to the type of disease will the into 3 groups, a group of hepatic cyst, a group of hepatic hemangioma, a group for primary liver cancer, through ct histogram analysis of the different groups of patients in the lfat scanning phase, arterial phase, portal venous phase and delayed phase data and analysis within the group and between groups.Results most accounted for ct value histograms for the normal distribution curve and within the tumor appeared calciifcation for positive skewness distribution curve, necrosis and liquefaction was negative skewness distribution curve in the tumor; ct value histogram in different nature of space occupying lesions between mean value (the average ct value), max value (max), min value (minimum) and sd values (standard deviation) and r value (range) have their own characteristics.Conclusion in the diagnosis of primary liver cancer, the speciifcity of the partial distribution curve is high, and the ct value of Mean histogram is signiifcantly lower, and the r value is signiifcantly higher, which shows that it is likely to be the primary liver cancer.%目的:通过分析ct值直方图在不同性质肝脏占位性病变中的表现,研究原发性肝癌诊断中ct值直方图的价值。方法选取486例患者影像学资料进行研究分析,根据患者疾病类型将其分为3组,一组为肝囊肿,一组为肝血管瘤,一组为原发性肝癌,通过ct值直方图分析不同组别患者在平扫期、动脉期、门脉期和延迟期的数据,并分析组内和组间数据。结果多数占位ct值直方图为正态分布曲线,在癌肿内出现大范围钙化时为正偏态分布曲线,在癌肿内出现坏死并液化时为负偏态分布曲线;ct值直方图在

  3. The Effects of Three Sessions of Running on a Negative Slope on Serum Levels of Liver Enzymes in Adult Male Rats

    Directory of Open Access Journals (Sweden)

    Mohsen Rezaei

    2013-05-01

    Full Text Available Background: The purpose of this study was to investigate the effects of three sessions of running on a negative slope (eccentric contraction on changes of the serum levels of aspartate aminotransferase (AST and alanin aminotransferaze (ALT in adult male rats. Materials and Methods: 20 adult male rats were divided randomly into two equal groups (exercise and control. Levels of AST and ALT in both groups were measured in a fasting state, 24 hours before and 24 hours after the last session of training.Results: Exercise increased the levels of serum AST and ALT enzymes, significantly (p<0.05.Conclusion: Eccentric exercise, without allowing enough time for returning to the pre-exercise state, leads to the damage of some body organs such as the liver.

  4. Obeticholic acid for the treatment of primary biliary cholangitis in adult patients: clinical utility and patient selection

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    Bowlus CL

    2016-09-01

    Full Text Available Christopher L Bowlus Division of Gastroenterology and Hepatology, University of California Davis, Davis, CA, USA Abstract: Primary biliary cholangitis (PBC, previously known as primary biliary “cirrhosis”, is a rare autoimmune liver disease characterized by the hallmark autoantibodies to mitochondrial antigens and immune-mediated destruction of small bile duct epithelial cells leading to cholestasis and cirrhosis. Surprisingly, while immune modulators have not been effective in the treatment of PBC, supplementation with the hydrophilic bile acid (BA ursodeoxycholic acid (UDCA has been demonstrated to slow the disease progression. However, a significant minority of PBC patients do not have a complete response to UDCA and remain at risk of continued disease progression. Although the mechanisms of action are not well understood, UDCA provided proof of concept for BA therapy in PBC. Obeticholic acid (OCA, a novel derivative of the human BA chenodeoxycholic acid, is a potent agonist of the nuclear hormone receptor farnesoid X receptor, which regulates BA synthesis and transport. A series of clinical trials of OCA in PBC, primarily in combination with UDCA, have established that OCA leads to significant reductions in serum alkaline phosphatase that are predicted to lead to improved clinical outcomes, while dose-dependent pruritus has been the most common adverse effect. On the basis of these studies, OCA was given conditional approval by the US Food and Drug Administration with plans to establish the long-term clinical efficacy of OCA in patients with advanced PBC. Keywords: primary biliary cholangitis, nuclear receptors, farnesoid X receptor, bile acid, obeticholic acid, ursodeoxycholic acid

  5. 'SIMPLES': a structured primary care approach to adults with difficult asthma.

    Science.gov (United States)

    Ryan, Dermot; Murphy, Anna; Ställberg, Björn; Baxter, Noel; Heaney, Liam G

    2013-09-01

    The substantial majority of patients with asthma can expect minimal breakthrough symptoms on standard doses of inhaled corticosteroids with or without additional add-on therapies. SIMPLES is a structured primary care approach to the review of a person with uncontrolled asthma which encompasses patient education monitoring, lifestyle and pharmacological management and addressing support needs which will achieve control in most patients. The small group of patients presenting with persistent asthma symptoms despite being prescribed high levels of treatment are often referred to as having 'difficult asthma'. Some will have difficult, 'therapy resistant' asthma, some will have psychosocial problems which make it difficult for them to achieve asthma control and some may prove to have an alternative diagnosis driving their symptoms. A few patients will benefit from referral to a 'difficult asthma' clinic. The SIMPLES approach, aligned with close co-operation between primary and specialist care, can identify this patient group, avoid inappropriate escalation of treatment, and streamline clinical assessment and management.

  6. Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte; Krag, Aleksander

    2012-01-01

    Non-selective beta-blockers are used as a first-line treatment for primary prevention in patients with medium- to high-risk oesophageal varices. The effect of non-selective beta-blockers on mortality is debated and many patients experience adverse events. Trials on banding ligation versus non......-selective beta-blockers for patients with oesophageal varices and no history of bleeding have reached equivocal results....

  7. Screening for Hypertension Among Older Adults: A Primary Care “High Risk” Approach

    OpenAIRE

    John Jacob; Muliyil Jayaprakash; Balraj Vinohar

    2010-01-01

    Background: Recommendations for early detection and management of elevated blood pressure through opportunistic clinic-based screening may be inadequate for the rural population in India as access to health facilities is limited. Materials and Methods: Sixteen Health Aides (trained primary care workers) were trained to measure blood pressure using a standardized training procedure. Six of those assessed competent in initial evaluation were allotted a stratified random sample of about 150 per...

  8. Occurrence of artificial sweeteners in human liver and paired blood and urine samples from adults in Tianjin, China and their implications for human exposure.

    Science.gov (United States)

    Zhang, Tao; Gan, Zhiwei; Gao, Chuanzi; Ma, Ling; Li, Yanxi; Li, Xiao; Sun, Hongwen

    2016-09-14

    In this study, acesulfame (ACE), saccharin (SAC) and cyclamate (CYC) were found in all paired urine and blood samples collected from healthy adults, with mean values of 4070, 918 and 628 ng mL(-1), respectively, in urine and 9.03, 20.4 and 0.72 ng mL(-1), respectively, in blood. SAC (mean: 84.4 ng g(-1)) and CYC (4.29 ng g(-1)) were detectable in all liver samples collected from liver cancer patients, while ACE was less frequently detected. Aspartame (ASP) was not found in any analyzed human sample, which can be explained by the fact that this chemical metabolized rapidly in the human body. Among all adults, significantly positive correlations between SAC and CYC levels were observed (p < 0.001), regardless of human matrices. Nevertheless, no significant correlations between concentrations of SAC (or CYC) and ACE were found in any of the human matrices. Our results suggest that human exposure to SAC and CYC is related, whereas ACE originates from a discrete source. Females (or young adults) were exposed to higher levels of SAC and CYC than males (or elderly). The mean renal clearance of SAC was 730 mL per day per kg in adults, which was significantly (p < 0.001) lower than those for CYC (10 800 mL per day per kg) and ACE (10 300 mL per day per kg). The average total daily intake of SAC and ACE was 9.27 and 33.8 μg per kg bw per day, respectively.

  9. A Kazal-type serine proteinase inhibitor from chicken liver (clTI-1): purification, primary structure, and inhibitory properties.

    Science.gov (United States)

    Kubiak, Agnieszka; Jakimowicz, Piotr; Polanowski, Antoni

    2009-08-01

    Low-molecular-mass trypsin inhibitor (clTI-1; chicken liver Trypsin Inhibitor-1) was purified from chicken liver by extraction with perchloric acid, ammonium sulfate precipitation, a combination of ethanol-acetone fractionation followed by gel filtration, ion-exchange chromatography and RP-HPLC on a C18 column. The inhibitor occurs in two isoforms with molecular masses of 5938.56 and 6026.29 Da (determined by MALDI TOFF mass spectrometry). The complete amino acid sequences of both isoforms were determined (UniProtKB/Swiss-Prot P85000; ISK1L_CHICK). The inhibitor shows a high homology to Kazal-type family inhibitors, especially to trypsin/acrosin inhibitors and pancreatic secretory trypsin inhibitors. clTI-1 inhibits both bovine and porcine trypsin (K(a)=1.1 x 10(9) M(-1) and 2.5 x 10(9) M(-1), respectively). Significant differences were shown in the inhibition of the anionic and cationic forms of chicken trypsin (K(a)=4.5 x 10(8) M(-1) and 1.2 x 10(10) M(-1)). Weak interaction with human plasmin (K(a)=1.2 x 10(7) M(-1)) was also revealed.

  10. Effects of HGF gene polymorphisms and protein expression on transhepatic arterial chemotherapeutic embolism efficacy and prognosis in patients with primary liver cancer

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    Chen HY

    2017-02-01

    Full Text Available Hai-Yong Chen,1,2 Yao-Min Chen,3 Jian Wu,1,2 Fu-Chun Yang,1,2 Zhen Lv,1,2 Yi-Gang Qian,1,2 Shu-Sen Zheng1,2 1Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 3Department of Breast Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China Objective: To investigate the correlations of two hepatocyte growth factor (HGF gene polymorphisms (rs5745652 and rs2074725 and their protein expression levels with the efficacy of transhepatic arterial chemotherapeutic embolism (TACE and prognosis in patients with primary liver cancer (PLC. Methods: From March 2011 to June 2012, 109 PLC patients (the case group who chose TACE as primary treatment and 80 healthy people (the control group who had undergone physical examination in The First Affiliated Hospital, Zhejiang University were selected during the same period. Gene polymorphisms of HGF rs5745652 and HGF rs2074725 were detected. Serum HGF level, treating efficacy, survival quality, and 3-year survival rate for PLC patients who received TACE were observed. Results: There were significant differences in genotype and allele frequencies of HGF rs5745652 and HGF rs2074725, between the case and control groups (all P<0.05. Compared with CT+TT genotype of HGF rs5745652, patients carrying CC genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate (all P<0.05. In rs2074725, patients carrying CA+AA genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate compared with patients carrying rs2074725 CC genotype (all P<0.05. Gene polymorphisms of HGF rs5745652 and HGF rs2074725, tumor size, and Barcelona Clinic Liver Cancer stage were independent prognostic factors for PLC (P<0.05. Conclusion: Our

  11. Relationship between Notch signaling pathway and primary liver cancer%Notch信号通路与原发性肝癌关系的研究进展

    Institute of Scientific and Technical Information of China (English)

    胡彦建; 韩明子; 胡彦华

    2013-01-01

    Notch信号通路作为一种相对保守的细胞信号,对细胞命运起决定性作用.迄今已基本阐明Notch信号通路的主要成员及核心转导过程,随着研究的深入,人们逐渐认识到该信号通路影响肿瘤的生长和转移.原发性肝癌是临床上常见的消化系统恶性肿瘤之一,具有较高的发病率和病死率.目前研究表明Notch信号通路与肝癌的关系密切.本文除回顾Notch信号通路组件、转导过程及调控外,主要就肝癌中Notch信号通路组件的异常表达,调控Notch信号通路对肝癌细胞增殖、凋亡和转移的影响,以及Notch信号通路介导乙肝病毒HBx蛋白促进肝癌的发生等方面作一综述.%Notch signaling pathway is an evolutionary conservative cell signaling and it is crucial for cell fate.We have known the main members and core transduction process of Notch signaling pathway,and also gradually realized that the Notch signaling pathway influenced tumor growth and metastasis.Primary liver cancer is one of clinically common digestive system malignant tumors and has higher morbidity and mortality.Recently,several independent research works revealed that the close relationship between Notch signaling pathway and primary liver cancer.This article will review Notch signaling pathway components and transduction process,and focus on summarizing the abnormal expression of Notch signaling components in the primary liver cancer,the effect of Notch signaling on proliferation,apoptosis and mi gration of hepatic cells,and the hepatitis B virus X protein promoting the growth of hepatocellular carcinoma by modulation of the Notch signaling pathway.

  12. Influence of levamisole and Freund's adjuvant on mouse immunisation with antigens of adults of the liver fluke Fasciola hepatica Linnaeus, 1758.

    Science.gov (United States)

    Gutierrez-Sanchez, Maria de Los Angeles; Luna-Herrera, Julieta; Trejo-Castro, Lauro; Montenegro-Cristino, Natividad; Almanza-Gonzalez, Alfredo; Escobar-Gutierrez, Alejandro; de la Rosa-Arana, Jorge Luis

    2015-08-28

    We have studied the influence of both levamisole (AL) and Freund's adjuvant (AF) on the immunisation of mice with the secretory antigens of adults of the liver fluke Fasciola hepatica Linnaeus, 1758. Total IgG antibodies were detected in all groups where the F. hepatica antigen was administered, been levels of IgG1 increased respect to IgG2a antibodies. During immunisation, IL-4 and IFN-γ were only detected in AL and AF groups, but after infection, IL-4 boosted in all groups. IFN-γ increased two fold in AF and AL groups compared to the saline solution (AS) group. Worm recovering was of 32-35% in groups administered without antigen whereas in AS, AL and AF groups recovering was of 25%, 12% and 8%, respectively. Macroscopical lesions in the liver were scarce in AL and AF groups. Our data suggest that immunisation of mice with antigens of F. hepatica enhances the immune response avoiding both liver damage and worm establishment after challenge infection. The murine model of fasciolosis has appeared to be useful to elucidate the mechanism by which the parasite modulates immune responses toward a Th2 type but also the development of Th1 type-inducing vaccines.

  13. Primary Neuronal Precursors in Adult Crayfish Brain: Replenishment from a Non-neuronal Source

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    Sandeman David C

    2011-06-01

    Full Text Available Abstract Background Adult neurogenesis, the production and integration of new neurons into circuits in the brains of adult animals, is a common feature of a variety of organisms, ranging from insects and crustaceans to birds and mammals. In the mammalian brain the 1st-generation neuronal precursors, the astrocytic stem cells, reside in neurogenic niches and are reported to undergo self-renewing divisions, thereby providing a source of new neurons throughout an animal's life. In contrast, our work shows that the 1st-generation neuronal precursors in the crayfish (Procambarus clarkii brain, which also have glial properties and lie in a neurogenic niche resembling that of vertebrates, undergo geometrically symmetrical divisions and both daughters appear to migrate away from the niche. However, in spite of this continuous efflux of cells, the number of neuronal precursors in the crayfish niche continues to expand as the animals grow and age. Based on these observations we have hypothesized that (1 the neuronal stem cells in the crayfish brain are not self-renewing, and (2 a source external to the neurogenic niche must provide cells that replenish the stem cell pool. Results In the present study, we tested the first hypothesis using sequential double nucleoside labeling to track the fate of 1st- and 2nd-generation neuronal precursors, as well as testing the size of the labeled stem cell pool following increasing incubation times in 5-bromo-2'-deoxyuridine (BrdU. Our results indicate that the 1st-generation precursor cells in the crayfish brain, which are functionally analogous to neural stem cells in vertebrates, are not a self-renewing population. In addition, these studies establish the cycle time of these cells. In vitro studies examining the second hypothesis show that Cell Tracker™ Green-labeled cells extracted from the hemolymph, but not other tissues, are attracted to and incorporated into the neurogenic niche, a phenomenon that appears to

  14. Case of primary pontine hemorrhage of the young adult followed by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Mashiyama, Shoji; Higuchi, Hiroshi; Takahashi, Akira

    1985-01-01

    A case of primary pontine hemorrhage of the young was reported. He was 22 years of age, who did not have the history of hypertension. He suddenly noticed disturbance of skilled act of his right hand and speech disturbance. He was admitted to our clinic two days after the onset. Neurological examination revealed right facial palsy, disturbance of delicate movement of his right hand and slight dysarthria. Lumbar puncture, after six days from the onset, yielded watery clear cerebrospinal fluid containing 6/3 cells/mm/sup 3/, 27mg/dl of protein and 65.1 mg/dl of sugar. An opening pressure was 75 mmH/sub 2/O. The vertebral angiography revealed no evidence of mass lesion and vascular anomalies. CT scan demonstrated a pontine hematoma, the size of this hematoma sequentially enlarged in follow-up CT scan. His clinical symptoms were gradually aggravated, i.e. cerebellar sign, urinary disturbance and involuntary movement. Conservative therapy was performed and his symptoms gradually improved. The size of hematoma was reduced in follow-up CT scan. The genesis, diagnosis and treatment of primary pontine hemorrhage of the young were discussed. (author).

  15. Adult-onset vanishing white matter disease as differential diagnosis of primary progressive multiple sclerosis: a case report.

    Science.gov (United States)

    Herwerth, Marina; Schwaiger, Benedikt J; Kreiser, Kornelia; Hemmer, Bernhard; Ilg, Rüdiger

    2015-04-01

    We report the case of a 4