WorldWideScience

Sample records for normothermic perfused liver

  1. Normothermic machine perfusion for donor liver preservation

    NARCIS (Netherlands)

    Tolboom, H.

    2012-01-01

    Currently, liver transplantation is the only treatment for end-stage liver failure. Unfortunately, a sever shortage of donor organs causes significant mortality amongst patients awaiting transplantation. The donor organ shortage could be alleviated by using organs that are normally not accepted for

  2. Resuscitation of ischemic donor livers with normothermic machine perfusion: a metabolic flux analysis of treatment in rats.

    Directory of Open Access Journals (Sweden)

    Maria-Louisa Izamis

    Full Text Available Normothermic machine perfusion has previously been demonstrated to restore damaged warm ischemic livers to transplantable condition in animal models. However, the mechanisms of recovery are unclear, preventing rational optimization of perfusion systems and slowing clinical translation of machine perfusion. In this study, organ recovery time and major perfusate shortcomings were evaluated using a comprehensive metabolic analysis of organ function in perfusion prior to successful transplantation. Two groups, Fresh livers and livers subjected to 1 hr of warm ischemia (WI received perfusion for a total preservation time of 6 hrs, followed by successful transplantation. 24 metabolic fluxes were directly measured and 38 stoichiometrically-related fluxes were estimated via a mass balance model of the major pathways of energy metabolism. This analysis revealed stable metabolism in Fresh livers throughout perfusion while identifying two distinct metabolic states in WI livers, separated at t = 2 hrs, coinciding with recovery of oxygen uptake rates to Fresh liver values. This finding strongly suggests successful organ resuscitation within 2 hrs of perfusion. Overall perfused livers regulated metabolism of perfusate substrates according to their metabolic needs, despite supraphysiological levels of some metabolites. This study establishes the first integrative metabolic basis for the dynamics of recovery during perfusion treatment of marginal livers. Our initial findings support enhanced oxygen delivery for both timely recovery and long-term sustenance. These results are expected to lead the optimization of the treatment protocols and perfusion media from a metabolic perspective, facilitating translation to clinical use.

  3. A model for normothermic preservation of the rat liver

    NARCIS (Netherlands)

    Tolboom, Herman; Pouw, Roos; Uygun, Korkut; Tanimura, Yoko; Izamis, Maria-Louisa; Berthiaume, François; Yarmush, Martin L.

    2007-01-01

    Current techniques for the preservation of donor livers typically rely on cold temperatures (approximately 0-4 degrees C) to slow down metabolic processes. Recently, normothermic extracorporeal liver perfusion (NELP) has regained interest as a potentially promising approach for long-term liver

  4. Viability testing and transplantation of marginal livers (VITTAL) using normothermic machine perfusion: study protocol for an open-label, non-randomised, prospective, single-arm trial.

    Science.gov (United States)

    Laing, Richard W; Mergental, Hynek; Yap, Christina; Kirkham, Amanda; Whilku, Manpreet; Barton, Darren; Curbishley, Stuart; Boteon, Yuri L; Neil, Desley A; Hübscher, Stefan G; Perera, M Thamara P R; Muiesan, Paolo; Isaac, John; Roberts, Keith J; Cilliers, Hentie; Afford, Simon C; Mirza, Darius F

    2017-11-28

    The use of marginal or extended criteria donor livers is increasing. These organs carry a greater risk of initial dysfunction and early failure, as well as inferior long-term outcomes. As such, many are rejected due to a perceived risk of use and use varies widely between centres. Ex situ normothermic machine perfusion of the liver (NMP-L) may enable the safe transplantation of organs that meet defined objective criteria denoting their high-risk status and are currently being declined for use by all the UK transplant centres. Viability testing and transplantation of marginal livers is an open-label, non-randomised, prospective, single-arm trial designed to determine whether currently unused donor livers can be salvaged and safely transplanted with equivalent outcomes in terms of patient survival. The procured rejected livers must meet predefined criteria that objectively denote their marginal condition. The liver is subjected to NMP-L following a period of static cold storage. Organs metabolising lactate to ≤2.5 mmol/L within 4 hours of the perfusion commencing in combination with two or more of the following parameters-bile production, metabolism of glucose, a hepatic arterial flow rate ≥150 mL/min and a portal venous flow rate ≥500 mL/min, a pH ≥7.30 and/or maintain a homogeneous perfusion-will be considered viable and transplanted into a suitable consented recipient. The coprimary outcome measures are the success rate of NMP-L to produce a transplantable organ and 90-day patient post-transplant survival. The protocol was approved by the National Research Ethics Service (London-Dulwich Research Ethics Committee, 16/LO/1056), the Medicines and Healthcare Products Regulatory Agency and is endorsed by the National Health Service Blood and Transplant Research, Innovation and Novel Technologies Advisory Group. The findings of this trial will be disseminated through national and international presentations and peer-reviewed publications. NCT02740608

  5. The Hepatoprotection Provided by Taurine and Glycine against Antineoplastic Drugs Induced Liver Injury in an Ex Vivo Model of Normothermic Recirculating Isolated Perfused Rat Liver

    Directory of Open Access Journals (Sweden)

    Reza Heidari

    2016-03-01

    Full Text Available Taurine (2-aminoethane sulfonic acid is a non-protein amino acid found in high concentration in different tissues. Glycine (Amino acetic acid is the simplest amino acid incorporated in the structure of proteins. Several investigations indicate the hepatoprotective properties of these amino acids. On the other hand, antineoplastic agents-induced serum transaminase elevation and liver injury is a clinical complication. The current investigation was designed to screen the possible hepatoprotective properties of taurine and glycine against antineoplastic drugs-induced hepatic injury in an ex vivo model of isolated perfused rat liver. Rat liver was perfused with different concentration (10 μM, 100 μM and 1000 μM of antineoplastic drugs (Mitoxantrone, Cyclophosphamide, Cisplatin, 5 Fluorouracil, Doxorubicin and Dacarbazine via portal vein. Taurine and glycine were administered to drug-treated livers and liver perfusate samples were collected for biochemical measurements (ALT, LDH, AST, and K+. Markers of oxidative stress (reactive oxygen species formation, lipid peroxidation, total antioxidant capacity and glutathione were also assessed in liver tissue. Antineoplastic drugs caused significant pathological changes in perfusate biochemistry. Furthermore, markers of oxidative stress were significantly elevated in drug treated livers. It was found that taurine (5 and 10 mM and glycine (5 and 10 mM administration significantly mitigated the biomarkers of liver injury and attenuated drug induced oxidative stress. Our data indicate that taurine and glycine supplementation might help as potential therapeutic options to encounter anticancer drugs-induced liver injury.

  6. Successful transplantation of porcine liver grafts following 48-hour normothermic preservation.

    Directory of Open Access Journals (Sweden)

    Thomas Vogel

    Full Text Available Current cold storage organ preservation technique fails to preserve marginal donor grafts sufficiently. Evidence from large animal experiments suggests superiority of normothermic machine preservation of liver allografts. Long-term organ preservation using normothermic perfusion might not only allow organ viability assessment before transplantation, but also provide the means for further organ modifications under physiologic conditions. Previous research has shown that porcine livers can be transplanted successfully after normothermic preservation of 20 hours. In the present study we investigate whether similar methodology is capable of further extending the safe limit to 48 hours. In this study, livers from White Landrace pigs were preserved by normothermic, oxygenated sanguineous perfusion. After a 48-hour period of preservation, livers were transplanted into recipient pigs and followed for 5 days. Outcome parameters measured included markers of synthetic and metabolic liver function as well as hepatocellular injury and blood gas analysis during perfusion and follow-up. Histological assessment of morphological liver integrity was performed. All livers showed sustained bile production and metabolic activity throughout the preservation period. Low levels of hepatocellular damage were found. Following transplantation all liver grafts revealed excellent graft function and death-censored graft survival was 100%. Porcine livers were transplanted successfully following 48 hours normothermic machine preservation.

  7. Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation.

    Science.gov (United States)

    Kaths, J Moritz; Spetzler, Vinzent N; Goldaracena, Nicolas; Echeverri, Juan; Louis, Kristine S; Foltys, Daniel B; Strempel, Mari; Yip, Paul; John, Rohan; Mucsi, Istvan; Ghanekar, Anand; Bagli, Darius; Robinson, Lisa; Selzner, Markus

    2015-07-15

    Kidney transplantation has become a well-established treatment option for patients with end-stage renal failure. The persisting organ shortage remains a serious problem. Therefore, the acceptance criteria for organ donors have been extended leading to the usage of marginal kidney grafts. These marginal organs tolerate cold storage poorly resulting in increased preservation injury and higher rates of delayed graft function. To overcome the limitations of cold storage, extensive research is focused on alternative normothermic preservation methods. Ex vivo normothermic organ perfusion is an innovative preservation technique. The first experimental and clinical trials for ex vivo lung, liver, and kidney perfusions demonstrated favorable outcomes. In addition to the reduction of cold ischemic injury, the method of normothermic kidney storage offers the opportunity for organ assessment and repair. This manuscript provides information about kidney retrieval, organ preservation techniques, and isolated ex vivo normothermic kidney perfusion (NEVKP) in a porcine model. Surgical techniques, set up for the perfusion solution and the circuit, potential assessment options, and representative results are demonstrated.

  8. Ex Vivo Normothermic Perfusion Induces Donor-Derived Leukocyte Mobilization and Removal Prior to Renal Transplantation

    Directory of Open Access Journals (Sweden)

    John P. Stone

    2016-11-01

    Discussion: We demonstrate that ex vivo normothermic perfusion initiates an inflammatory cytokine storm and release of mitochondrial and genomic DNA. This is likely to be responsible for immune cell activation and mobilization into the circuit prior to transplantation. Interestingly this did not have an impact on renal function. These data therefore suggest that normothermic perfusion can be used to immunodeplete and to saturate the pro-inflammatory capacity of donor kidneys prior to transplantation.

  9. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

    2017-08-01

    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. THE USE OF NORMOTHERMIC EXTRACORPOREAL PERFUSION IN SITU IN KIDNEY ASYSTOLIC DONORS

    Directory of Open Access Journals (Sweden)

    Y.. A. Shcherbuk

    2010-01-01

    Full Text Available Deficit of donor organs is the limiting factor in organ transplantation. One way of solving this problem is the use of donors with sudden irreversible circulatory arrest. Obtaining organs from this category of donors is pos- sible only through the use of normothermic extracorporal perfusion in situ (NECP with oxygenation and leu- cocyte depletion. The article presents the implementation of NECP in 11 uncontrolled non heart beating donor (uNHBD kidneys (age of 43,1 ± 2,98 years and the results of transplantation in 22 recipients of such transplants in comparison with the results of the 20 recipients of kidney transplants from 20 donors to the death of the brain (age 45,65 ± 1,8 years. Despite the initially high rate of delayed function and more significant number of hemo- dialysis in uNHBD group (group of investigation, serum creatinine at 21st day was the same level as in BDD group (comparison group: 0,198 ± 0,002 mmol/L and 0,151 ± 0,002 mmol/L (p > 0,05. The use of NECP with oxygenation and leucocyte depletion is an effective practice for recovery kidney from donors with a sudden ir- reversible circulatory arrest with warm ischemic time one hour and more before the operation explantation. 

  11. Heart donation after cardiac death: preliminary study on an isolated, perfused swine heart after 20 minutes of normothermic ischemia.

    Science.gov (United States)

    Desrois, M; Piccardo, A; Zogheib, E; Dalmasso, C; Lan, C; Fourré, D; Cozzone, P J; Caus, T; Bernard, M

    2014-12-01

    We measured the functional and metabolic status of hearts submitted to normothermic ischemia before preservation through the use of an ex vivo pig heart model to assess the feasibility of donation after cardiac death (DCD) in heart transplantation. Ten pigs were separated into 2 groups: control (n = 6, brain-dead group) and DCD (n = 4, heart donation after cardiac death). In the control group, hearts were excised 20 minutes after the brachiocephalic trunk cross-clamping and were immediately reperfused. In DCD, hearts were excised 20 minutes after exsanguination and asphyxia, stored in the Centre de Résonance Magnétique Biologique et Médicale (CRMBM) solution for 2 hours, and then were reperfused. Cardioplegic arrest was induced with the use of 1 L of CRMBM solution (4°C) and the heart was reperfused for 60 minutes through the use of an ex vivo perfusion system in Langendorff mode with normothermic autologous blood. During reperfusion, functional parameters were analyzed. Biochemical assays were performed in myocardial effluents and freeze-clamped hearts. No electromechanical activity was found in DCD compared with control. Creatine kinase (CK) was higher at 2 minutes of reperfusion in DCD versus control (P = .005). Adenosine triphosphate was lower in DCD versus control (P = .0019). Malondialdehyde, an oxidative stress index, was present only in DCD. The nitric oxide (NO) pathway was impaired in DCD versus control, with lower eNOS expression (P heart preservation are necessary for recruiting heart donation after cardiac death. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Standard donor lung procurement with normothermic ex vivo lung perfusion: A prospective randomized clinical trial.

    Science.gov (United States)

    Slama, Alexis; Schillab, Lukas; Barta, Maximilian; Benedek, Aris; Mitterbauer, Andreas; Hoetzenecker, Konrad; Taghavi, Shahrokh; Lang, Gyoergy; Matilla, Jose; Ankersmit, Hendrik; Hager, Helmut; Roth, Georg; Klepetko, Walter; Aigner, Clemens

    2017-07-01

    Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx). This prospective randomized clinical trial compared patients who underwent Tx with ex vivo evaluated donor lungs with an equivalent patient population without previous EVLP. From October 2013 to May 2015, 193 lung Tx were performed at the Medical University of Vienna. During this period, 80 recipient/donor pairs that met the inclusion criteria were included in this trial, 41 pairs in the control group, and 39 in the EVLP group. In the EVLP group, 4 lungs (10.2%) ultimately did not qualify for Tx and were rejected for lung Tx owing to technical reasons (n = 2) and quality criteria (n = 2). Donor and recipient characteristics were comparable in both groups. Total cold ischemic time in the EVLP group was significantly longer for both implanted lungs (first side, 372 minutes vs 291 minutes, p 1 was lower in the EVLP group at all time points compared with the control group (24 hours, 5.7% vs 19.5%, p = 0.10), and need for post-operative prolonged extracorporeal membrane oxygenation was lower in the EVLP group (5.7% vs 12.2%, p = 0.44). Short-term clinical outcomes did not differ between recipients in the 2 groups. Patients remained intubated (1.6 days vs 1.6 days, p = 0.67), in the intensive care unit (6 days vs 6 days, p = 0.76), and in the hospital (23 days vs 19 days, p = 0.42) for a comparable period of time. The 30-day survival was 97.1% vs 100% (p = 0.46). This study provides evidence that EVLP can safely be used in standard donor lungs. Functional results and perioperative

  13. An experimental study of the recovery of injured porcine lungs with prolonged normothermic cellular ex vivo lung perfusion following donation after circulatory death.

    Science.gov (United States)

    Spratt, John R; Mattison, Lars M; Iaizzo, Paul A; Brown, Roland Z; Helms, Haylie; Iles, Tinen L; Howard, Brian; Panoskaltsis-Mortari, Angela; Loor, Gabriel

    2017-09-01

    Donation after circulatory death (DCD) is an underused source of donor lungs. Normothermic cellular ex vivo lung perfusion (EVLP) is effective in preserving standard donor lungs but may also be useful in the preservation and assessment of DCD lungs. Using a model of DCD and prolonged EVLP, the effects of donor warm ischemia and postmortem ventilation on graft recovery were evaluated. Adult male swine underwent general anesthesia and heparinization. In the control group (n = 4), cardioplegic arrest was induced and the lungs were procured immediately. In the four treatment groups, a period of agonal hypoxia was followed by either 1 h of warm ischemia with (n = 4) or without (n = 4) ventilation or 2 h of warm ischemia with (n = 4) or without (n = 4) ventilation. All lungs were studied on an EVLP platform for 24 h. Hemodynamic measures, compliance, and oxygenation on EVLP were worse in all DCD lungs compared with controls. Hemodynamics and compliance normalized in all lungs after 24 h of EVLP, but DCD lungs demonstrated impaired oxygenation. Normothermic cellular EVLP is effective in preserving and monitoring of DCD lungs. Early donor postmortem ventilation and timely procurement lead to improved graft function. © 2017 Steunstichting ESOT.

  14. Effect of nutritional status on oxidative stress in an ex vivo perfused rat liver.

    Science.gov (United States)

    Stadler, Michaela; Nuyens, Vincent; Seidel, Laurence; Albert, Adelin; Boogaerts, Jean G

    2005-11-01

    Normothermic ischemia-reperfusion is a determinant in liver injury occurring during surgical procedures, ischemic state, and multiple organ failure. The preexisting nutritional status of the liver might contribute to the extent of tissue injury and primary nonfunction. The aim of this study was to determine the role of starvation on hepatic ischemia-reperfusion injury in normal rat livers. Rats were randomly divided into two groups: one had free access to food, the other was fasted for 16 h. The portal vein was cannulated, and the liver was removed and perfused in a closed ex vivo system. Two modes of perfusion were applied in each series of rats, fed and fasting. In the ischemia-reperfusion mode, the experiment consisted of perfusion for 15 min, warm ischemia for 60 min, and reperfusion during 60 min. In the nonischemia mode, perfusion was maintained during the 135-min study period. Five rats were included in each experimental condition, yielding a total of 20 rats. Liver enzymes, potassium, glucose, lactate, free radicals, i.e., dienes and trienes, and cytochrome c were analyzed in perfusate samples. The proportion of glycogen in hepatocytes was determined in tissue biopsies. Transaminases, lactate dehydrogenase, potassium, and free radical concentrations were systematically higher in fasting rats in both conditions, with and without ischemia. Cytochrome c was higher after reperfusion in the fasting rats. Glucose and lactate concentrations were greater in the fed group. The glycogen content decreased in both groups during the experiment but was markedly lower in the fasting rats. In fed rats, liver injury was moderate, whereas hepatocytes integrity was notably impaired both after continuous perfusion and warm ischemia in fasting animals. Reduced glycogen store in hepatocytes may explain reduced tolerance.

  15. Cold storage of liver microorgans in ViaSpan and BG35 solutions: study of ammonia metabolism during normothermic reoxygenation.

    Science.gov (United States)

    Pizarro, María Dolores; Mediavilla, María Gabriela; Berardi, Florencia; Tiribelli, Claudio; Rodríguez, Joaquín V; Mamprin, María Eugenia

    2014-01-01

    This work focuses on ammonia metabolism of Liver Microorgans (LMOs) after cold preservation in a normothermic reoxygenation system (NRS). We have previously reported the development of a novel preservation solution, Bes-Gluconate-PEG 35 kDa (BG35) that showed the same efficacy as ViaSpan to protect LMOs against cold preservation injury. The objective of this work was to study mRNA levels and activities of two key Urea Cycle enzymes, Carbamyl Phosphate Synthetase I (CPSI) and Ornithine Transcarbamylase (OTC), after preservation of LMOs in BG35 and ViaSpan and the ability of these tissue slices to detoxify an ammonia overload in a NRS model. After 48 h of cold storage (0°C in BG35 or ViaSpan) LMOs were rewarmed in KHR containing an ammonium chloride overload (1 mM). We determined ammonium detoxification capacity (ADC), urea synthesis and enzyme activities and relative mRNA levels for CPSI and OTC. At the end of reoxygenation LMOs cold preserved in BG35 have ADC and urea synthesis similar to controls. ViaSpan group demonstrated a lower capacity to detoxify ammonia and to synthesize urea than fresh LMOs during the whole reoxygenation period which correlated with the lower mRNA levels and activities for CPSI and OTC observed for this group. We demonstrate that our preservation conditions (48 hours, BG35 solution, anoxia, 0ºC) did not affect ammonia metabolism of cold preserved LMOs maintaining the physiological and biochemical liver functions tested, which allows their future use as biological component of a BAL system.

  16. Increased sinusoidal volume and solute extraction during retrograde liver perfusion

    International Nuclear Information System (INIS)

    Bass, N.M.; Manning, J.A.; Weisiger, R.A.

    1989-01-01

    Retrograde isolated liver perfusion has been used to probe acinar functional heterogeneity, but the hemodynamic effects of backward flow have not been characterized. In this study, extraction of a long-chain fatty acid derivative, 12-N-methyl-7-nitrobenzo-2-oxa-1,3-diazol-amino stearate (12-NBDS), was greater during retrograde than during anterograde perfusion of isolated rat liver. To determine whether hemodynamic differences between anterograde and retrograde perfused livers could account for this finding, the hepatic extracellular space was measured for both directions of flow by means of [ 14 C]sucrose washout during perfusion as well as by direct measurement of [ 14 C]sucrose entrapped during perfusion. A three- to fourfold enlargement of the total hepatic extracellular space was found during retrograde perfusion by both approaches. Examination of perfusion-fixed livers by light microscopy and morphometry revealed that marked distension of the sinusoids occurred during retrograde perfusion and that this accounts for the observed increase in the [ 14 C]sucrose space. These findings support the hypothesis that maximum resistance to perfusate flow in the isolated perfused rat liver is located at the presinusoidal level. In addition, increased transit time of perfusate through the liver and greater sinusoidal surface area resulting from sinusoidal distension may account for the higher extraction of 12-NBDS and possibly other compounds by retrograde perfused liver

  17. Liver function during extracorporeal whole liver perfusion in a pig model of acute ischemic liver failure.

    Science.gov (United States)

    Méchet, Isabelle; Lhuillier, Franck; Blanchet, Marie Cécile; Pouyet, Michel; Viale, Jean-Paul; Goudable, Joelle; Annat, Guy; Scoazec, Jean Yves; Boillot, Olivier; Liotard, Dominique; Merle, Eric; Delafosse, Bertrand

    2004-01-01

    The shortage of livers for transplant has renewed interest in the potential of temporary liver support such as extra corporeal whole liver perfusion. In an ischemic induced liver failure model we perfused an extra corporeal liver through only a portal vein and assessed the function of this ex vivo liver by using hepatic tests to estimate elimination as well as synthesis capacities. Acute liver failure was performed in five control pigs by a hepatic devascularization associated to an end to side portocaval shunt. In a treated group, 5 to 6 h after this hepatic devascularization, animals were connected to an extra corporeal liver perfused via the portal vein with blood withdrawn from the ischemic liver animal from its portal vein. Devascularization of the liver induced an increase in liver enzymes and ammonia, a drop in the ratio of branched chain amino acids to aromatic amino acids, and a decrease in blood urea and indocyanine green and galactose clearances. In treated animals, urea, amino acid ratio, and clearances increased after the ex vivo liver perfusion. In this group, mean bile production and mean liver oxygen consumption were 13.7 +/- 3.6 ml/h and 16.1 +/- 7.7 ml/min, respectively. In an acute ischemic liver failure pig model, an extra corporeal whole liver perfusion demonstrated detoxification properties as well as synthesis capacities.

  18. Perfusion CT imaging of the liver: review of clinical applications

    Science.gov (United States)

    Oğul, Hayri; Kantarcı, Mecit; Genç, Berhan; Pirimoğlu, Berhan; Çullu, Neşat; Kızrak, Yeşim; Yılmaz, Ömer; Karabulut, Nevzat

    2014-01-01

    Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemotherapy, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. PMID:24834487

  19. A Review of Liver Perfusion Method in Toxicology Studies

    Directory of Open Access Journals (Sweden)

    M karami

    2014-06-01

    Full Text Available Introduction: The isolated perfused rat liver is an accepted method in toxicology studies. The isolated perfused rat liver (IPRL is a useful experimental system for evaluating hepatic function without the influence of other organ systems, undefined plasma constituents, and neural-hormonal effects. Methods: The untreated male rats (180-220gr body weight were anesthetised with ether and then surgery with proper method. The abdomen was opened through a midline and one transversal incision and the bile duct was cannulated. Heparin sodium solution (0.5 ml; 500 U/ml in 0.9% NaCl was injected via the abdominal vena cava to prevent blood clotting. The liver inferior venacava was cannulated with PE-10 tubing and secured. The portal vein was immediately cannulated with an 23gr catheter which was secured and then liver was perfused in situ by Krebs- Henseleit buffer (pH 7.4; saturated with 95% O2 and 5% CO2; 37°C at a flow rate of 20 ml/min for 3hr. Temperature, perfusion pressure, flow rate and perfusion fluid pH were closely monitored during the perfusion. Results: Transferase enzymes (ALT, AST alterations can be widely used as a measure of biochemical alterations in order to assess liver damage due to use of drugs such as isoniazid (INH and animal and plant toxins. Accumulated material in gallbladder are valuable samples to assess the level of Glutathione (GSH. Sections of perfused liver tissue can also be effectively analyzed for pathological aspects such as necrosis, fibrosis, cellularity. Conclusion: The isolated perfused rat liver (IPRL is a useful and Sutible experimental system for evaluating hepatic function. In this system, the effects of adjacent organs, on the liver is minimized

  20. EFFECT ON PERFUSION VALUES OF SAMPLING INTERVAL OF CT PERFUSION ACQUISITIONS IN NEUROENDOCRINE LIVER METASTASES AND NORMAL LIVER

    Science.gov (United States)

    Ng, Chaan S.; Hobbs, Brian P.; Wei, Wei; Anderson, Ella F.; Herron, Delise H.; Yao, James C.; Chandler, Adam G.

    2014-01-01

    Objective To assess the effects of sampling interval (SI) of CT perfusion acquisitions on CT perfusion values in normal liver and liver metastases from neuroendocrine tumors. Methods CT perfusion in 16 patients with neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction, for tumor and normal liver. CT perfusion values for the reference sampling interval of 0.5s (SI0.5) were compared with those of SI datasets of 1s, 2s, 3s and 4s, using mixed-effects model analyses. Results Increases in SI beyond 1s were associated with significant and increasing departures of CT perfusion parameters from reference values at SI0.5 (p≤0.0009). CT perfusion values deviated from reference with increasing uncertainty with increasing SIs. Findings for normal liver were concordant. Conclusion Increasing SIs beyond 1s yield significantly different CT perfusion parameter values compared to reference values at SI0.5. PMID:25626401

  1. CT perfusion of the liver during selective hepatic arteriography. Pure arterial blood perfusion of liver tumor and parenchyma

    International Nuclear Information System (INIS)

    Komemushi, Atsushi; Tanigawa, Noboru; Kojima, Hiroyuki; Kariya, Shuji; Sawada, Satoshi

    2003-01-01

    The purpose of this study was to quantify pure arterial blood perfusion of liver tumor and parenchyma by using CT perfusion during selective hepatic arteriography. A total of 44 patients underwent liver CT perfusion study by injection of contrast medium via the hepatic artery. CT-perfusion parameters including arterial blood flow, arterial blood volume, and arterial mean transit time in the liver parenchyma and liver tumor were calculated using the deconvolution method. The CT-perfusion parameters and vascularity of the tumor were compared. A complete analysis could be performed in 36 of the 44 patients. For liver tumor and liver parenchyma, respectively, arterial blood flow was 184.6±132.7 and 41.0±27.0 ml/min/100 g, arterial blood volume was 19.4±14.6 and 4.8±4.2 ml/100 g, and arterial mean transit time was 8.9±4.2 and 10.2±5.3 sec. Arterial blood flow and arterial blood volume correlated significantly with the vascularity of the tumor; however no correlation was detected between arterial mean transit time and the vascularity of the tumor. This technique could be used to quantify pure hepatic arterial blood perfusion. (author)

  2. CT Perfusion of the Liver: Principles and Applications in Oncology

    Science.gov (United States)

    Kim, Se Hyung; Kamaya, Aya

    2014-01-01

    With the introduction of molecularly targeted chemotherapeutics, there is an increasing need for defining new response criteria for therapeutic success because use of morphologic imaging alone may not fully assess tumor response. Computed tomographic (CT) perfusion imaging of the liver provides functional information about the microcirculation of normal parenchyma and focal liver lesions and is a promising technique for assessing the efficacy of various anticancer treatments. CT perfusion also shows promising results for diagnosing primary or metastatic tumors, for predicting early response to anticancer treatments, and for monitoring tumor recurrence after therapy. Many of the limitations of early CT perfusion studies performed in the liver, such as limited coverage, motion artifacts, and high radiation dose of CT, are being addressed by recent technical advances. These include a wide area detector with or without volumetric spiral or shuttle modes, motion correction algorithms, and new CT reconstruction technologies such as iterative algorithms. Although several issues related to perfusion imaging—such as paucity of large multicenter trials, limited accessibility of perfusion software, and lack of standardization in methods—remain unsolved, CT perfusion has now reached technical maturity, allowing for its use in assessing tumor vascularity in larger-scale prospective clinical trials. In this review, basic principles, current acquisition protocols, and pharmacokinetic models used for CT perfusion imaging of the liver are described. Various oncologic applications of CT perfusion of the liver are discussed and current challenges, as well as possible solutions, for CT perfusion are presented. © RSNA, 2014 Online supplemental material is available for this article. PMID:25058132

  3. CT Perfusion Characteristics Identify Metastatic Sites in Liver

    Directory of Open Access Journals (Sweden)

    Yuan Wang

    2015-01-01

    Full Text Available Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF, blood volume (BV, mean transit time (MTT, permeability (PS, and hepatic arterial fraction (HAF, for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  4. CT Perfusion Characteristics Identify Metastatic Sites in Liver.

    Science.gov (United States)

    Wang, Yuan; Hobbs, Brian P; Ng, Chaan S

    2015-01-01

    Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT) perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PS), and hepatic arterial fraction (HAF), for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  5. [Portal perfusion with right gastroepiploic vein flow in liver transplant].

    Science.gov (United States)

    Mendoza-Sánchez, Federico; Javier-Haro, Francisco; Mendoza-Medina, Diego Federico; González-Ojeda, Alejandro; Cortés-Lares, José Antonio; Fuentes-Orozco, Clotilde

    Liver transplantation in patients with liver cirrhosis, portal vein thrombosis, and cavernous transformation of the portal vein, is a complex procedure with high possibility of liver graft dysfunction. It is performed in 2-19% of all liver transplants, and has a significantly high mortality rate in the post-operative period. Other procedures to maintain portal perfusion have been described, however there are no reports of liver graft perfusion using right gastroepiploic vein. A 20 year-old female diagnosed with cryptogenic cirrhosis, with a Child-Pugh score of 7 points (class "B"), and MELD score of 14 points, with thrombosis and cavernous transformation of the portal vein, severe portal hypertension, splenomegaly, a history of upper gastrointestinal bleeding due to oesophageal varices, and left renal agenesis. The preoperative evaluation for liver transplantation was completed, and the right gastroepiploic vein of 1-cm diameter was observed draining to the infrahepatic inferior vena cava and right suprarenal vein. An orthotopic liver transplantation was performed from a non-living donor (deceased on January 30, 2005) using the Piggy-Back technique. Portal vein perfusion was maintained using the right gastroepiploic vein, and the outcome was satisfactory. The patient was discharged 13 days after surgery. Liver transplantation was performed satisfactorily, obtaining an acceptable outcome. In this case, the portal perfusion had adequate blood flow through the right gastroepiploic vein. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Perfusion computed tomography evaluation of angiogenesis in liver cancer.

    Science.gov (United States)

    Yang, Han Feng; Du, Yong; Ni, Jia Xiang; Zhou, Xiang Ping; Li, Jin Dong; Zhang, Qing; Xu, Xiao Xue; Li, Yang

    2010-06-01

    To investigate the value of computed tomography (CT) perfusion imaging for assessment of angiogenesis in liver cancer. Twenty-one patients with histologically proven liver cancer underwent CT perfusion examination. We compared the following perfusion parameters in the tumour area versus the non-tumour area: total blood flow (TBF), hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic arterial perfusion index (HAPI). Slices of postoperative specimen were stained with haematoxylin-eosin and anti-CD34 immunohistochemistry. The slices were evaluated with emphasis on the CD34-positive neovasculature in the tumour parenchyma. Tumour microvascular density (MVD) was calculated according to the Weidner method. Pearson correlation was used to detect correlations between tumour MVD and tumour perfusion parameters. TBF and HPP in the tumour area were lower than in the non-tumour area (P HAP and HAPI in the tumour area were higher than those of the non-tumour area (P HAP in the tumour area correlated with MVD in the tumour (P cancer. TBF or HAP may be a useful parameter in assessing angiogenesis of liver cancer.

  7. CT perfusion image processing: analysis of liver tumors

    OpenAIRE

    D’Antò, Michela

    2013-01-01

    Perfusion CT imaging of the liver has potential to improve evaluation of tumour angiogenesis. Quantitative parameters can be obtained applying mathematical models to Time Attenuation Curve (TAC). However, there are still some difficulties for an accurate quantification of perfusion parameters due, for example, to algorithms employed, to mathematical model, to patient’s weight and cardiac output and to the acquisition system. In this thesis, new parameters and alternative methodologies ab...

  8. Enhanced gluconeogenesis from lactate in perfused livers after endurance training.

    Science.gov (United States)

    Sumida, K D; Urdiales, J H; Donovan, C M

    1993-02-01

    The effects of endurance training (running 90 min/day at 30 m/min, 10% grade) on hepatic gluconeogenesis were studied in 24-h-fasted rats with use of the isolated liver perfusion technique. After isolation, the liver was perfused (single pass) for 30 min with Krebs-Henseleit bicarbonate buffer and fresh bovine erythrocytes (hematocrit 22-24%) with no added substrate. Subsequent to the "washout" period, the reservoir was elevated with various concentrations of lactate and [U-14C]lactate (10,000 dpm/ml) to assess hepatic glucose production. Relative flow rates were not significantly different between trained (1.94 +/- 0.05 ml/g liver) and control livers (1.91 +/- 0.05 ml/g liver). Furthermore, no significant differences were observed in perfusate pH, hematocrit, bile production, or serum alanine aminotransferase effluxing from trained or control livers. At saturating arterial lactate concentrations (> 2 mM), the maximal rate (Vmax) for hepatic glucose production was significantly higher for trained (0.91 +/- 0.04 mumol.min-1 x g liver-1) than for control livers (0.73 +/- 0.02 mumol.min-1 x g liver-1). That this reflected increased gluconeogenesis is supported by a significant elevation in the Vmax for [14C]glucose production from trained (13,150 +/- 578 dpm.min-1 x g liver-1) compared with control livers (10,712 +/- 505 dpm.min-1 x g liver-1). Significant increases were also observed in the Vmax for lactate uptake (25%), O2 consumption (19%), and 14CO2 production (23%) from endurance-trained livers. The Km for hepatic glucose output, approximately 1.05 mM lactate, was unchanged after endurance training. These findings demonstrate that chronic physical activity results in an elevated capacity for hepatic gluconeogenesis, as assessed in situ at saturating lactate concentrations.

  9. Inducing Hepatitis C Virus Resistance After Pig Liver Transplantation-A Proof of Concept of Liver Graft Modification Using Warm Ex Vivo Perfusion.

    Science.gov (United States)

    Goldaracena, N; Spetzler, V N; Echeverri, J; Kaths, J M; Cherepanov, V; Persson, R; Hodges, M R; Janssen, H L A; Selzner, N; Grant, D R; Feld, J J; Selzner, M

    2017-04-01

    Normothermic ex vivo liver perfusion (NEVLP) offers the potential to optimize graft function prior to liver transplantation (LT). Hepatitis C virus (HCV) is dependent on the presence of miRNA(microRNA)-122. Miravirsen, a locked-nucleic acid oligonucleotide, sequesters miR-122 and inhibits HCV replication. The aim of this study was to assess the efficacy of delivering miravirsen during NEVLP to inhibit miR-122 function in a pig LT model. Pig livers were treated with miravirsen during NEVLP or cold storage (CS). Miravirsen absorption, miR-122 sequestration, and miR-122 target gene derepression were determined before and after LT. The effect of miravirsen treatment on HCV infection of hepatoma cells was also assessed. NEVLP improved miravirsen uptake versus CS. Significant miR-122 sequestration and miR-122 target gene derepression were seen with NEVLP but not with CS. In vitro data confirmed miravirsen suppression of HCV replication after established infection and prevented HCV infection with pretreatment of cells, analogous to the pretreatment of grafts in the transplant setting. In conclusion, miravirsen delivery during NEVLP is a potential strategy to prevent HCV reinfection after LT. This is the first large-animal study to provide "proof of concept" for using NEVLP to modify and optimize liver grafts for transplantation. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. A microfluidically perfused three dimensional human liver model.

    Science.gov (United States)

    Rennert, Knut; Steinborn, Sandra; Gröger, Marko; Ungerböck, Birgit; Jank, Anne-Marie; Ehgartner, Josef; Nietzsche, Sandor; Dinger, Julia; Kiehntopf, Michael; Funke, Harald; Peters, Frank T; Lupp, Amelie; Gärtner, Claudia; Mayr, Torsten; Bauer, Michael; Huber, Otmar; Mosig, Alexander S

    2015-12-01

    Within the liver, non-parenchymal cells (NPCs) are critically involved in the regulation of hepatocyte polarization and maintenance of metabolic function. We here report the establishment of a liver organoid that integrates NPCs in a vascular layer composed of endothelial cells and tissue macrophages and a hepatic layer comprising stellate cells co-cultured with hepatocytes. The three-dimensional liver organoid is embedded in a microfluidically perfused biochip that enables sufficient nutrition supply and resembles morphological aspects of the human liver sinusoid. It utilizes a suspended membrane as a cell substrate mimicking the space of Disse. Luminescence-based sensor spots were integrated into the chip to allow online measurement of cellular oxygen consumption. Application of microfluidic flow induces defined expression of ZO-1, transferrin, ASGPR-1 along with an increased expression of MRP-2 transporter protein within the liver organoids. Moreover, perfusion was accompanied by an increased hepatobiliary secretion of 5(6)-carboxy-2',7'-dichlorofluorescein and an enhanced formation of hepatocyte microvilli. From this we conclude that the perfused liver organoid shares relevant morphological and functional characteristics with the human liver and represents a new in vitro research tool to study human hepatocellular physiology at the cellular level under conditions close to the physiological situation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Renal perfusion in chronic liver diseases: Evaluation by radiotechnetium renography

    International Nuclear Information System (INIS)

    Fanfani, G.; Fratello, A.; Mele, M.; Conte, E.; D'Addabbo, A.; Greco, L.

    1985-01-01

    Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patient groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r=0.275) and not significant (P>0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload. (orig.)

  12. Determination of an adequate perfusion pressure for continuous dual vessel hypothermic machine perfusion of the rat liver

    NARCIS (Netherlands)

    't Hart, Nils A.; der van Plaats, Arjan; Leuvenink, Henri G. D.; van Goor, Harry; Wiersema-Buist, Janneke; Verkerke, Gijsbertus J.; Rakhorst, Gerhard; Ploeg, Rutger J.

    Hypothermic machine perfusion (HMP) provides better protection against ischemic damage of the kidney compared to cold-storage. The required perfusion pressures needed for optimal HMP of the liver are, however, unknown. Rat livers were preserved in University of Wisconsin organ preservation solution

  13. Liver perfusion in sepsis, septic shock, and multiorgan failure.

    Science.gov (United States)

    Spapen, Herbert

    2008-06-01

    Sepsis causes significant alterations in the hepatic macro- and microcirculation. Diverging views exist on global hepatic blood flow during experimental sepsis because of the large variety in animal and sepsis models. Fluid-resuscitated clinical sepsis is characterized by ongoing liver ischemia due to a defective oxygen extraction despite enhanced perfusion. The effects of vasoactive agents on the hepatosplanchnic circulation are variable, mostly anecdotal, and depend on baseline perfusion, time of drug administration, and use of concomitant medication. Microvascular blood flow disturbances are thought to play a pivotal role in the development of sepsis-induced multiorgan failure. Redistribution of intrahepatic blood flow in concert with a complex interplay between sinusoidal endothelial cells, liver macrophages, and passing leukocytes lead to a decreased perfusion and blood flow velocity in the liver sinusoids. Activation and dysfunction of the endothelial cell barrier with subsequent invasion of neutrophils and formation of microthrombi further enhance liver tissue ischemia and damage. Substances that regulate (micro)vascular tone, such as nitric oxide, endothelin-1, and carbon monoxide, are highly active during sepsis. Possible interactions between these mediators are not well understood, and their therapeutic manipulation produces equivocal or disappointing results. Whether and how standard resuscitation therapy influences the hepatic microvascular response to sepsis is unknown. Indirect evidence supports the concept that improving the microcirculation may prevent or ameliorate sepsis-induced organ failure.

  14. Hyperoxia and glutathione depletion in the isolated perfused rat liver.

    Science.gov (United States)

    Shattuck, K E; Grinnell, C D; Keeney, S E; Noworyta, K; Rassin, D K

    1997-12-01

    Hepatic stores of glutathione may be depleted by hyperoxic exposure or poor nutritional status. We studied the effects of hyperoxia or hepatic glutathione depletion on bile flow rates, and on biliary concentrations of glutathione and amino acids. Glutathione depletion was induced in vivo by 1) hyperoxic exposure (O2) for 48 hours, 2) inhibition of glutathione synthesis by treatment with buthionine sulfoximine (BSO), 3) a combination of BSO + O2, or 4) inhibition of cysteine synthesis by propargyglycine (PPG). Livers were then isolated and perfused. Glutathione concentrations in bile, liver, and perfusate were significantly decreased by all treatments. Bile flow was significantly decreased in groups treated with BSO or O2 + BSO, and perfusate LDH was increased by O2 + BSO or PPG. Significant changes in biliary amino acid concentrations included decreased sulfur-containing amino acids and increased branched-chain amino acids in groups treated with BSO, PPG, or O2; and increased essential amino acids in groups treated with O2 or PPG. Oxygen exposure or inhibition of glutathione synthesis results in significant decreases in hepatic, perfusate and biliary glutathione concentrations, and increases in biliary amino acids. A decrease in bile flow rate was associated only with the most severe glutathione depletion.

  15. NORMOTHERMIC EXTRACORPOREAL PERFUSION IN SITU IN DECEASED ORGAN DONORS WITH IRREVERSIBLE CARDIAC ARREST AND ONE HOUR OF ASYSTOLE. 5-YEAR OUTCOMES OF KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. E. Skvortsov

    2016-01-01

    Full Text Available Aim. The global shortage of deceased organ donors caused increasing interest to the transplant program based on the use of organs from the donors with sudden irreversible cardiac arrest, or asystolic donors (DCD. Ischemia-reperfusion injury as a result of cardiac arrest remains a key problem that limits the use of organs from DCD. Our clinical study was intended to determine the acceptability of renal transplants derived from the DCD using extracorporeal perfusion in situ after 60 minutes of asystole. Materials and methods. In 2009–2014, St. Petersburg Organ Procurement Organization (OPO obtained kidneys from 29 DCD with critically expanded warm ischemic time (WIT. The design of this study was approved by the Scientifi c Board and Ethics Committee of the State Research Institute for Emergency Medicine (Decision 7/0615/09. Initially, no one of died patients was considered as potential organ donors. In case of failed advanced CPR the death of a patient was declared initiating the protocol of subnormothermic extracorporeal abdominal perfusion with ECMO, thrombolytics (strepokinase 1.5 mln U, and LD. The procedures were established by the authorized OPO team which arrived with perfusion equipment in 30–40 minutes after declaration of donors’ death. Mean WIT was 58.1 (19.39 minutes (Mean (SD. Resuscitated grafts were transplanted into 58 recipients. The outcomes of transplantation of resuscitated kidneys were compared to those of 112 KTx from 115 brain death donors (BDDs. Results. Immediate functioning of kidney grafts was observed in 28 (48.3% of 58 recipients. There were 4 cases of primary graft non-function. By the end of the fi rst post-transplant year there was an acute rejection rate of 12.1% (9 episodes of rejection in the DCD group vs. 23.2% (26 episodes of rejection in the BDD group (p < 0.05. The actuarial 5-year graft survival rate was 82.8% (n = 48 in DCD group, and 87.5% (n = 98 in BDD group (p > 0.05. Creatinine levels at the end

  16. 31P-NMR studies on perfused mouse liver

    International Nuclear Information System (INIS)

    McLaughlin, A.C.; Takeda, H.; Chance, B.

    1978-01-01

    From a metabolic viewpoint, the most important organ in the body is the liver. In contrast to more specialized organs such as heart and kidney which perform only one major function, the liver performs a number of major metabolic functions. Two of the most important functions are the catabolism and storage of foodstuffs (in the form of glycogen) and the control of most of the constituents of the blood (in particular, the blood glucose level). Most of these functions are localized within a single type of cell. One way that the liver is able to regulate these diverse reactions is by the control of the ATP level in the cell. Encouraged by the recent success of many groups in using 31 P-NMR to provide a continuous and non-destructive monitor of ATP levels in isolated cells, skeletal muscle, and perfused organs such as heart and kidney, 31 P-NMR was used to investigate ATP levels in perfused liver of mice

  17. Disposition kinetics of diclofenac in the dual perfused rat liver.

    Science.gov (United States)

    Sahin, Selma; Rowland, Malcolm

    2013-09-01

    This study investigates the hepatic disposition of diclofenac as a function of route of input: portal vein (PV) versus hepatic artery (HA) in the presence of its binding protein, albumin. The in situ dual perfused rat liver was performed using Krebs bicarbonate buffer containing human serum albumin (HSA, 0.25%-1%) at constant PV (12 mL/min) and HA (3 mL/min) flow rates. Bolus doses of [(14) C]-diclofenac and (125) I-labeled HSA were injected randomly into the HA or PV and then, after an appropriate interval, into the alternate vessel. Regardless of route of input and perfusion medium protein concentration, the hepatic outflow profile of diclofenac displayed a characteristic sharp peak followed by a slower eluting tail, indicating that its radial distribution is not instantaneous. Based on the estimated effective permeability-surface area product/blood flow ratio, hepatic uptake of diclofenac is governed by both perfusion and permeability. Fractional effluent recovery (F) increased as unbound diclofenac fraction in the perfusate decreased. Although no significant difference in hepatic clearance of diclofenac as a function of route of delivery at 0.5% and 1% HSA, it was demonstrable at 0.25% HSA (p < 0.001), when the extraction ratio is higher. Copyright © 2013 Wiley Periodicals, Inc.

  18. Michaëlis--Menten kinetics of phenazone elimination in the perfused pig liver

    DEFF Research Database (Denmark)

    Andreasen, B; Tonnesen, K; Rabol, A

    1977-01-01

    The purpose of the present study was to define the elimination kinetics of phenazone (NFN) in the isolated perfused pig liver. In five experiments phenazone was administered as constant infusion to obtain steady-state periods over a wide range of concentrations. The elimination of phenazone...... found to be considerably lower than in the perfused liver. The hepatic elimination of phenazone during perfusion of pig liver at phenazone concentrations corresponding to human therapeutic doses follows first-order kinetics....

  19. Addressing the Donor Liver Shortage with EX VIVO Machine Perfusion

    Directory of Open Access Journals (Sweden)

    Maria-Louisa Izamis

    2012-01-01

    Full Text Available Despite a critical shortage of viable donor livers for transplantation, only a fraction of the available organs are used. Donor organ defects, which in the majority of cases are caused by extensive exposure to ischemia, cannot be reversed by static cold storage, the current gold standard of organ preservation. In this review, the role of machine perfusion (MP in the recovery of non-transplantable ischemic donor organs is discussed. Though still in the experimental phase, various models of MP have consistently demonstrated that ischemic donor organs can be recovered to a transplantable state through continuous perfusion. MP can also provide dynamic quantitative assessments of the extent of ischemia, in addition to predicting the likelihood of organ recovery. Continued endeavors to translate MP into clinical use and eventually incorporate it into routine donor organ care will have a significant impact on the quality and availability of transplantable donor organs.

  20. Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cao Yue, E-mail: yuecao@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Wang Hesheng [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Johnson, Timothy D. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Pan, Charlie [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hussain, Hero [Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Normolle, Daniel; Ben-Josef, Edgar; Ten Haken, Randall K.; Lawrence, Theodore S.; Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-01-01

    Purpose: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. Methods and Materials: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. Results: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. Conclusions: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which

  1. Possibilities of differentiation of solitary focal liver lesions by computed tomography perfusion

    Directory of Open Access Journals (Sweden)

    Irmina Sefić Pašić

    2015-08-01

    Full Text Available Aim To evaluate possibilities of computed tomography (CT perfusion in differentiation of solitary focal liver lesions based on their characteristic vascularization through perfusion parameters analysis. Methods Prospective study was conducted on 50 patients in the period 2009-2012. Patients were divided in two groups: benign and malignant lesions. The following CT perfusion parameters were analyzed: blood flow (BF, blood volume (BV, mean transit time (MTT, capillary permeability surface area product (PS, hepatic arterial fraction (HAF, and impulse residual function (IRF. During the study another perfusion parameter was analyzed: hepatic perfusion index (HPI. All patients were examined on Multidetector 64-slice CT machine (GE with application of perfusion protocol for liver with i.v. administration of contrast agent. Results In both groups an increase of vascularization and arterial blood flow was noticed, but there was no significant statistical difference between any of 6 analyzed parameters. Hepatic perfusion index values were increased in all lesions in comparison with normal liver parenchyma. Conclusion Computed tomography perfusion in our study did not allow differentiation of benign and malignant liver lesions based on analysis of functional perfusion parameters. Hepatic perfusion index should be investigated in further studies as a parameter for detection of possible presence of micro-metastases in visually homogeneous liver in cases with no lesions found during standard CT protocol

  2. Hepatic perfusion parameters of contrast-enhanced ultrasonography correlate with the severity of chronic liver disease.

    Science.gov (United States)

    Liu, Dong; Qian, Linxue; Wang, Jinrui; Hu, Xiangdong; Qiu, Lanyan

    2014-11-01

    In the study described here, we introduced a new ratio acquired with contrast-enhanced ultrasonography (CEUS): a liver parenchyma blood supply ratio that differentiates arterial and portal phases. Our purpose was to determine whether this ratio and other liver parenchyma perfusion parameters acquired with CEUS can be correlated with the severity of chronic liver disease. Twelve patients with non-cirrhotic chronic liver disease, 35 patients with cirrhosis (child class A: n = 10; child class B: n = 13; child class C: n = 12) and 21 healthy volunteers were examined by CEUS. Time-intensity curves were drawn for regions of interest located in liver parenchyma and right kidney cortex using QLAB quantification software. The arterial and portal phases were differentiated by the time to the maximum enhancement of right kidney and liver parenchyma perfusion data acquired from the time-intensity curves: the intensity of liver parenchyma perfused by hepatic arterial flow (I(ap)), the intensity of total perfusion of liver parenchyma (I(peak)), the intensity of liver parenchyma perfused by portal venous flow (I(pp)) and the ratio of portal perfusion to total perfusion of liver parenchyma expressed by the parameters I(pp)/I(peak), I(peak), I(pp) and I(pp)/I(peak) significantly decreased in patients with cirrhosis and in patients with non-cirrhotic chronic liver disease, whereas Iap increased. The parameters I(pp), I(peak), I(pp)/I(peak) and Iap correlated with the severity of chronic liver disease (r = -0.938, p Liver parenchyma perfusion parameters obtained by CEUS were correlated with the severity of chronic liver disease and have the potential to assess cirrhosis non-invasively. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  3. Metabolomic Modularity Analysis (MMA) to Quantify Human Liver Perfusion Dynamics.

    Science.gov (United States)

    Sridharan, Gautham Vivek; Bruinsma, Bote; Bale, Shyam Sundhar; Swaminathan, Anandh; Saeidi, Nima; Yarmush, Martin L; Uygun, Korkut

    2017-11-13

    Large-scale -omics data are now ubiquitously utilized to capture and interpret global responses to perturbations in biological systems, such as the impact of disease states on cells, tissues, and whole organs. Metabolomics data, in particular, are difficult to interpret for providing physiological insight because predefined biochemical pathways used for analysis are inherently biased and fail to capture more complex network interactions that span multiple canonical pathways. In this study, we introduce a nov-el approach coined Metabolomic Modularity Analysis (MMA) as a graph-based algorithm to systematically identify metabolic modules of reactions enriched with metabolites flagged to be statistically significant. A defining feature of the algorithm is its ability to determine modularity that highlights interactions between reactions mediated by the production and consumption of cofactors and other hub metabolites. As a case study, we evaluated the metabolic dynamics of discarded human livers using time-course metabolomics data and MMA to identify modules that explain the observed physiological changes leading to liver recovery during subnormothermic machine perfusion (SNMP). MMA was performed on a large scale liver-specific human metabolic network that was weighted based on metabolomics data and identified cofactor-mediated modules that would not have been discovered by traditional metabolic pathway analyses.

  4. Partial Liver Ischemia Is Followed by Metabolic Changes in the Normally Perfused Part of the Liver during Reperfusion

    DEFF Research Database (Denmark)

    Kannerup, Anne-Sofie; Grønbæk, Henning; Funch-Jensen, Peter

    2010-01-01

    occlusion of part of the liver on the metabolism of the normally perfused parenchyma of the same liver measured by microdialysis. Methods:Eight pigs underwent laparotomy. A microdialysis catheter was inserted into the left and right part of the liver, respectively. Microdialysis samples were collected every...

  5. A Study of Normothermic Hemoperfusion of the Porcine Pancreas and Kidney.

    Science.gov (United States)

    Kuan, Kean Guan; Wee, Mau Nam; Chung, Wen Yuan; Kumar, Rohan; Mees, Soeren Torge; Dennison, Ashley; Maddern, Guy; Trochsler, Markus

    2017-05-01

    Normothermic machine perfusion has enormous potential to improve organ preservation and expand the organ donor pool. It is well established in other organs but not the pancreas, which has especially strict organ acceptance criteria. We established a model of normothermic hemoperfusion of the porcine pancreas with and without addition of the kidney as a dialysis organ. Four pancreases were harvested and perfused for 120 min with autologous whole blood at body temperature, two with parallel perfusion of the kidney and two without. The organs and perfusion circuit were evaluated for gross appearance, pH, histology and perfusion parameters. The organs maintained steadily increasing flow rate and perfusion pressure. Gross appearance of the organs was stable but appeared grossly ischemic toward the end of the perfusion period. Histology demonstrated necrosis centered in acinar tissue but islet cells were preserved. pH was significantly alkalotic toward the end of the perfusion, likely due to pancreatic tissue damage. Addition of the kidney did not result in significant improvement of the acid-base environment in this small series. In conclusion, normothermic perfusion of the pancreas is still in the experimental stages but holds great potential. Further studies to optimize perfusion parameters will significantly improve results. Parallel perfusion of the kidney may facilitate improvement in the acid-base environment. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  6. Partial liver ischemia is followed by metabolic changes in the normally perfused part of the liver during reperfusion

    DEFF Research Database (Denmark)

    Kannerup, A-S; Grønbæk, H; Funch-Jensen, P

    2010-01-01

    BACKGROUND: Temporary vascular in- and outflow occlusion is an effective technique for bleeding control during liver resection. However, occlusion can result in ischemia/reperfusion (I/R) injury to the liver. The aim of this study in a porcine model was to investigate the effect of in- and outflow...... occlusion of part of the liver on the metabolism of the normally perfused parenchyma of the same liver measured by microdialysis. METHODS: Eight pigs underwent laparotomy. A microdialysis catheter was inserted into in the left and right part of the liver, respectively. Microdialysis samples were collected....... No significant changes in liver parameters or blood glucose levels were seen. CONCLUSIONS: Partial ischemia of the liver is without effects on metabolism in the normally perfused part. Metabolic changes in the ischemic part of the liver were reversible. However, partial liver ischemia was followed by similar...

  7. Reproducibility of CT Perfusion Parameters in Liver Tumors and Normal Liver

    Science.gov (United States)

    Ng, Chaan S.; Chandler, Adam G.; Wei, Wei; Herron, Delise H.; Anderson, Ella F.; Kurzrock, Razelle; Charnsangavej, Chusilp

    2011-01-01

    Purpose: To assess the reproducibility of computed tomographic (CT) perfusion measurements in liver tumors and normal liver and effects of motion and data acquisition time on parameters. Materials and Methods: Institutional review board approval and written informed consent were obtained for this prospective study. The study complied with HIPAA regulations. Two CT perfusion scans were obtained 2–7 days apart in seven patients with liver tumors with two scanning phases (phase 1: 30-second breath-hold cine; phase 2: six intermittent free-breathing cines) spanning 135 seconds. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability–surface area product (PS) for tumors and normal liver were calculated from phase 1 with and without rigid registration and, for combined phases 1 and 2, with manually and rigid-registered phase 2 images, by using deconvolution modeling. Variability was assessed with within-patient coefficients of variation (CVs) and Bland-Altman analyses. Results: For tumors, BF, BV, MTT, and PS values and reproducibility varied by analytical method, the former by up to 11%, 23%, 21%, and 138%, respectively. Median PS values doubled with the addition of phase 2 data to phase 1 data. The best overall reproducibility was obtained with rigidly registered phase 1 and phase 2 images, with within-patient CVs for BF, BV, MTT, and PS of 11.2%, 14.4%, 5.5% and 12.1%, respectively. Normal liver evaluations were similar, except with marginally lower variability. Conclusion: Absolute values and reproducibility of CT perfusion parameters were markedly influenced by motion and data acquisition time. PS, in particular, probably requires data acquisition beyond a single breath hold, for which motion-correction techniques are likely necessary. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110331/-/DC1 PMID:21788525

  8. Study on 64-layer Spiral Computed Tomography Perfusion Imaging in Patients with Fatty Liver

    Directory of Open Access Journals (Sweden)

    RAO Xiao-hui

    2014-12-01

    Full Text Available Objective: To analyze the changes of hemodynamics of patients with fatty liver by detecting their blood perfusion parameter changes with Philips Brilliance 64-layer spiral computed tomography (CT perfusion technique. Methods: A total of 74 patients undergoing 64-layer spiral CT perfusion imaging were selected as study objects, in which 39 were with fatty liver and the other 35 were healthy people. The parameters of liver blood perfusion were observed. Results: Hepatic arterial perfusion (Art.Perf, portal perfusion (Port.Perf and total perfusion (Total.Perf values as well as hepatic perfusion index (HPI were (18.4±4.1, (71.5±14.2 and (93.2±6.7 mL/100 g·min as well as (25.15±5.22% in control group, in which the Art.Perf, Port.Perf and Total.Perf were in close association with the severity of fatty liver and of great significance. Art.Perf of patients with mild, moderate and severe fatty liver was (15.4±4.0, (7.3±9.6 and (4.1±1.3 mL/100 g·min, Port.Perf was (56.5±10.7, (48.6±6.8 and (37.0±4.1 mL/100 g·min and Total.Perf was (71.3±5.7, (55.7±5.8 and (40.2±5.0 mL/100 g·min, respectively. However, HPI could not be considered as the evaluation index for the severity of fatty liver. Conclusion: CT perfusion imaging of liver can reflect blood changes of patients with fatty liver, which can be used to evaluate their blood-supply condition, thus providing more diagnostic evidences for the clinic.

  9. Cell volume regulation in the perfused liver of a freshwater air ...

    Indian Academy of Sciences (India)

    Madhu

    To study the rate of K+, Na+ and Cl– fluxes in the effluent, livers were initially perfused for 20 min with isotonic medium, followed by infusion of hypo- (–80 mOsmol/l) or hypertonic (+80 mOsmol/l) medium. The K+ efflux/uptake during anisotonic conditions from the perfused liver was also studied in the presence of various ion ...

  10. Preconditioning-Like Properties of Short-Term Hypothermia in Isolated Perfused Rat Liver (IPRL System

    Directory of Open Access Journals (Sweden)

    Norma Alva

    2018-03-01

    Full Text Available Hypothermia may attenuate the progression of ischemia-induced damage in liver. Here, we determined the effects of a brief cycle of hypothermic preconditioning applied before an ischemic/reperfusion (I/R episode in isolated perfused rat liver (IPRL on tissue damage and oxidative stress. Rats (male, 200–250 g were anaesthetised with sodium pentobarbital (60 mg·kg−1 i.p and underwent laparatomy. The liver was removed and perfused in a temperature-regulated non-recirculating system. Livers were randomly divided into two groups (n = 6 each group. In the hypothermia-preconditioned group, livers were perfused with hypothermic buffer (cycle of 10 min at 22 °C plus 10 min at 37 °C and the other group was perfused at 37 °C. Both groups were then submitted to 40 min of warm ischemia and 20 min of warm reperfusion. The level of tissue-damage indicators (alanine amino transferase, ALT; lactate dehydrogenase, LDH; and proteins, oxidative stress markers (thiobarbituric acid-reactive substances, TBARS; advanced oxidation protein products, AOPP; and glutathione, GSH were measured in aliquots of perfusate sampled at different time intervals. Histological determinations and oxidative stress biomarkers in homogenized liver (AOPP; TBARS; nitric oxide derivatives, NOx; GSH and glutathione disulphide, GSSG were also made in the tissue at the end. Results showed that both damage and oxidant indicators significantly decreased while antioxidant increased in hypothermic preconditioned livers. In addition, homogenized liver determinations and histological observations at the end of the protocol corroborate the results in the perfusate, confirming the utility of the perfusate as a non-invasive method. In conclusion, hypothermic preconditioning attenuates oxidative damage and appears to be a promising strategy to protect the liver against IR injury.

  11. Viability of the vascularly perfused, recirculating rat intestine and intestine-liver preparations

    Energy Technology Data Exchange (ETDEWEB)

    Hirayama, H.; Xu, X.; Pang, K.S. (Univ. of Toronto, Ontario (Canada))

    1989-08-01

    Function and stability of vascularly perfused, recirculating in situ rat intestine (I) and intestine-liver (IL) preparations were evaluated in fasted and nonfasted rats because these techniques may be readily applied in drug metabolism studies. The rat intestine was perfused with blood medium (7.5 ml/min) via the superior mesenteric artery, with the venous outflow draining into the portal vein, which, together with hepatic arterial flow (2.5 ml/min), constituted the total blood flow (10 ml/min) to the liver. Maintenance of intestinal membrane integrity was observed. Rapid ({sup 14}C)glucose absorption against a concentration gradient and a lack of ({sup 3}H)-polyethylene glycol 4000 (PEG 4000, less than 4%) and Evans blue absorption by the recirculating I and IL preparations resulted after bolus injections of these markers into the pyloric end of the duodenum. Other indexes that revealed stable intestinal and liver functions were the following: preservation of reservoir perfusate volume, constancy in perfusion pressure, bile flow, and hemoglobin concentrations, evidence of intestinal glucose utilization and liver glucose production, and a lack of significant leakage of serum glutamic oxalic transaminase. The intestine and liver consumed oxygen at relatively constant rates, but the consumption rates for the fasted tissues (I or L) were significantly higher than those for nonfasted tissues. These results indicate that the vascularly perfused I and IL preparations were maintained in a viable and stable state for a 2-h perfusion period.

  12. Cell-swelling-induced taurine release from isolated perfused rat liver

    NARCIS (Netherlands)

    Brand, H. S.; Meijer, A. J.; Gustafson, L. A.; Jörning, G. G.; Leegwater, A. C.; Maas, M. A.; Chamuleau, R. A.

    1994-01-01

    Astrocytes and lymphocytes are able to release significant amounts of taurine during periods of hypotonicity to reduce the increase in cell volume. To investigate this mechanism in the liver, we studied the release of free amino acids from isolated perfused rat liver during hypotonicity. The

  13. Liver fat content in type 2 diabetes: relationship with hepatic perfusion and substrate metabolism

    NARCIS (Netherlands)

    Rijzewijk, Luuk J.; van der Meer, Rutger W.; Lubberink, Mark; Lamb, Hildo J.; Romijn, Johannes A.; de Roos, Albert; Twisk, Jos W.; Heine, Robert J.; Lammertsma, Adriaan A.; Smit, Johannes W. A.; Diamant, Michaela

    2010-01-01

    Hepatic steatosis is common in type 2 diabetes. It is causally linked to the features of the metabolic syndrome, liver cirrhosis, and cardiovascular disease. Experimental data have indicated that increased liver fat may impair hepatic perfusion and metabolism. The aim of the current study was to

  14. Liver fat content in type 2 diabetes: relationship with hepatic perfusion and substrate metabolism

    NARCIS (Netherlands)

    Rijzewijk, L.J.; van der Meer, R.W.; Lubberink, J.M.; Lamb, H.J.; Romijn, J.A.; de Roos, A.; Twisk, J.W.R.; Heine, R.J.; Lammertsma, A.A.; Smit, J.W.A.; Diamant, M.

    2010-01-01

    OBJECTIVE - Hepatic steatosis is common in type 2 diabetes. It is causally linked to the features of the metabolic syndrome, liver cirrhosis, and cardiovascular disease. Experimental data have indicated that increased liver fat may impair hepatic perfusion and metabolism. The aim of the current

  15. A relative study of hepatic perfusion and portal vein pressure in rats with liver cirrhosis

    International Nuclear Information System (INIS)

    Li Jiaping; Yang Jianyong; Chen Wei; Huang Yonghui

    2006-01-01

    Objective: To evaluate spiral CT perfusion in assessing portal vein pressure in rats with different stages of liver cirrhosis. Methods Seventeen rats with early stage of liver cirrhosis, 18 with intermediate stage, 12 with advanced stage, and 13 healthy rats as a control group were selected and recieved hepatic perfusion on a single-row spiral CT scanner. The parameters of hepatic perfusion were calculated using the deconvolution method. The portal vein pressure was measured by multi-physiographer. Results: (1) In study group, the PVP (portal venous perfusion) and THBP (total hepatic blood perfusion) were negatively correlated with FPP, while positively correlated with the HPI (hepatic perfusion index) and MTT (mean transit time). The FPP had a close relation with PVP. The equation, Y 20.671-3.195X, could be conducted with linear regression analysis. (2) According to the linear regression equation mentioned above, the FPP in 47 rats were 16.090±2.150 cmH 2 0, which was highly correlated with the observed valuel6.108±3.662 cmH 2 O (r=0.823 P<0.01). Conclusion: CT perfusion is a new non-invasive and efficient modality for assessment of the portal pressure in liver cirrhosis in various stages. (authors)

  16. Impact of flow rate on lactate uptake and gluconeogenesis in glucagon-stimulated perfused livers.

    Science.gov (United States)

    Sumida, Ken D; Urdiales, Jerry H; Donovan, Casey M

    2006-01-01

    The impact of reduced hepatic flow on lactate uptake and gluconeogenesis was examined in isolated glucagon-stimulated perfused livers from 24-h-fasted rats. After surgical isolation, livers were perfused (single pass) for 30 min with Krebs-Henseleit (KH) bicarbonate buffer, fresh bovine erythrocytes (hematocrit approximately 20%), and no added substrate. After this "washout" period, steady-state perfusions were initiated with a second reservoir containing the KH buffer, bovine erythrocytes, [U-(14)C]lactate (10,000 dpm/ml), lactate (2.5 mM), and glucagon (250 microg/ml). Perfusion flow rate was adjusted to one of five rates (i.e., 1.8, 2.7, 3.9, 7.4, and 11.0 ml.min(-1).100 g body wt(-1)). After the perfusion, the liver was dissected out and weighed so as to establish the actual flow rate per gram of liver. The resulting flow rates ranged from 0.52 to 4.03 ml.min(-1).g liver(-1). As a function of flow rate, lactate uptake rose in a hyperbolic fashion to an apparent plateau of 2.34 micromol.min(-1).g liver(-1). Fractional extraction (FX) of lactate from the perfusate demonstrated an exponential decline with increased flow rates (r=0.97). At flow rates above 1.0 ml.min(-1).g liver(-1), adjustments in FX compensated for changes in lactate delivery, resulting in steady rates of lactate uptake and gluconeogenesis. Below 1.0.min(-1).g liver(-1) the increased FX was unable to compensate for the decline in lactate delivery and lactate uptake declined rapidly. Gluconeogenesis demonstrated similar kinetics to lactate uptake, reflecting its dominant role among pathways for lactate removal under the current conditions.

  17. Metabolism of 1-[14C]nitropyrene in isolated perfused rat livers

    International Nuclear Information System (INIS)

    Bond, J.A.; Medinsky, M.A.; Dutcher, J.S.

    1984-01-01

    1-Nitropyrene (1-NP), a constituent of diesel exhaust, is carcinogenic to rats and is a bacterial and mammalian mutagen. Biliary and fecal excretion of 1-NP metabolites are the major routes of excretion in rats, suggesting that hepatic metabolism plays a dominant role in determining the biological fate of 1-NP. The purpose of this investigation was to quantitate 1-[14C]NP metabolites formed in isolated perfused rat livers and excreted in bile from rats. Perfused rat livers displayed a capacity for oxidation, reduction, acetylation, and conjugation of 1-NP (or its metabolites). Reduction of 1-NP followed by N-acetylation was the major metabolic pathway observed in the perfused livers. Acetylaminopyrene (AAP) was the major metabolite detected, with total quantities (150 nmol) accounting for about 60% of the total 1-[14C]NP dose (258 nmol) added to the perfusate. Considerably smaller quantities of aminopyrene and hydroxynitropyrenes were also detected. Livers perfused with 1-[14C]NP excreted about 36 nmol equivalents of 1-[14C]NP (12% of the total 1-NP dose) in bile after 60 min. Some of the biliary metabolites were tentatively identified as metabolites of the mercapturic acid pathway. The spectrum of biliary metabolites was qualitatively identical to that seen in bile from intact rats. Quantities of 14C covalently bound to hepatic macromolecules from perfused livers were 0.4 nmol 1-NP eq/g liver. The data from this study indicate that the liver may be an important site for metabolism of 1-NP

  18. Feasibility of 4D perfusion CT imaging for the assessment of liver treatment response following SBRT and sorafenib

    Directory of Open Access Journals (Sweden)

    Catherine Coolens, PhD

    2016-07-01

    Conclusions: The proposed methodology demonstrated feasibility of evaluating spatiotemporal changes in liver tumor perfusion and normal liver function following antiangiogenic therapy and radiation treatment warranting further evaluation of biomarker prognostication.

  19. A fitness index for transplantation of machine-perfused cadaveric rat livers

    Directory of Open Access Journals (Sweden)

    Perk Sinem

    2012-06-01

    Full Text Available Abstract Background The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD that are disqualified because of extensive ischemic injury, may prove transplantable after machine perfusion treatment, fundamentally impacting the availability of treatment for end-stage organ failure. Machine perfusion is an ex-vivo organ preservation and treatment procedure that has the capacity to quantitatively evaluate and resuscitate cadaveric organs for transplantation. Methods To diagnose whether an organ was fresh or ischemic, an initial assessment of liver quality was conducted via dynamic discriminant analysis. Subsequently, to determine whether the organs were sufficiently viable for successful implantation, fitness indices for transplantation were calculated based on squared prediction errors (SPE for fresh and ischemic livers. Results With just three perfusate metabolites, glucose, urea and lactate, the developed MPLSDA model distinguished livers as fresh or ischemic with 90% specificity. The SPE analyses revealed that fresh livers with SPEF WI  Conclusions The statistical methods used here can discriminate between fresh and ischemic livers based on simple metabolic indicators measured during perfusion. The result is a predictive fitness index for transplantation of rat livers procured after cardiac death. The translational implications of this study are that any donor organ procured from controlled, but most especially from uncontrolled cardiac death donors, will be objectively assessed and its recovery monitored over time, minimizing the critical loss of otherwise viable organs.

  20. Current perspectives in transplant medicine: hypothermic oxygenated perfusion

    Directory of Open Access Journals (Sweden)

    Michel SG

    2016-11-01

    Full Text Available Sebastian G Michel,1 Joren C Madsen2,3 1Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany; 2Department of Surgery, Center for Transplantation Sciences, 3Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA Abstract: The purpose of this review was to provide an update on hypothermic oxygenated perfusion as a preservation technique for whole organ allografts. Clinical and experimental data in heart, lung, liver, kidney, and pancreas/islet transplantation are summarized with a special emphasis on marginal donors and donation after circulatory death. The rationale behind hypothermic machine perfusion as well as its advantages and disadvantages compared to conventional cold storage and the competing technique, normothermic machine perfusion, are reviewed. Keywords: organ transplantation, organ preservation, hypothermic perfusion

  1. Cell volume changes affect gluconeogenesis in the perfused liver of ...

    Indian Academy of Sciences (India)

    Unknown

    In conclusion, gluconeogenesis appears to play a vital role in C. batrachus in maintaining glucose homeostasis, which is influenced by cell volume changes possibly for proper energy supply under osmotic stress. [Goswami C, Datta S, Biswas K and Saha N 2004 Cell volume changes affect gluconeogenesis in the perfused ...

  2. Safety and effect on ablation size of hydrochloric acid-perfused radiofrequency ablation in animal livers.

    Science.gov (United States)

    Zhang, Tian-Qi; Huang, Sen-Miao; Gu, Yang-Kui; Gao, Fei; Huang, Zhi-Mei; Jiang, Xiong-Ying; Liu, Ding-Xin; Huang, Jin-Hua

    2018-02-26

    Our objective was to determine the safety and ablation size of hydrochloric acid-perfused radiofrequency ablation (HCl-RFA) in liver tissues, prospectively using in vivo rabbit and ex vivo porcine liver models. The livers in 30 rabbits were treated in vivo with perfusions of normal saline (controls) and HCl concentrations of 5%, 10%, 15%, and 20%, during RFA at 103 °C and 30 W for 3 min. For each experimental setting, six ablations were created. Safety was assessed by comparing baseline weight and selected laboratory values with those at 2, 7, and 14 days' post-ablation, and by histopathological analysis. The livers in 25 pigs were treated ex vivo with the same five perfusions during RFA at 103 °C, at both 30 W and 60 W, for 30 min. Ablation diameters and volumes were measured by two examiners. Rabbit weights and selected laboratory values did not differ significantly from baseline to 7 and 14 days' post-ablation, liver tissues outside the ablation zones were normal histologically, and adjacent organs showed no macroscopic damage. The mean ablation volumes in the porcine livers treated with HCl-RFA were all larger than those treated with normal saline perfusion during RFA (NS-RFA), at both 30 W and 60 W (p < 0.001). The largest ablation volume and transverse diameter were observed in the porcine livers during 10% HCl-RFA at 60 W, measuring 179.22 (SD = 24.79) cm 3 and 6.84 (SD = 0.36) cm, respectively. Based on our experiments, HCl-RFA in the liver appears to be as safe as NS-RFA while also resulting in larger ablation zones.

  3. Control of ketogenesis in the perfused rat liver by the sympathetic innervation

    NARCIS (Netherlands)

    Beuers, U.; BECKH, K.; JUNGERMANN, K.

    1986-01-01

    The regulation of ketogenesis by the hepatic nerves was investigated in the rat liver perfused in situ. Electrical stimulation of the hepatic nerves around the portal vein and the hepatic artery caused a reduction of basal ketogenesis owing to a decrease in acetoacetate release to 30% with

  4. Cell volume regulation in the perfused liver of a freshwater air ...

    Indian Academy of Sciences (India)

    Madhu

    Cell volume regulation in the perfused liver of a freshwater air-breathing catfish Clarias batrachus under aniso-osmotic conditions: Roles of inorganic ions and taurine. CARINA GOSWAMI and NIRMALENDU SAHA*. Biochemical Adaptation Laboratory, Department of Zoology, North-Eastern Hill University, Shillong 793 022, ...

  5. Application of dual-source CT perfusion imaging and MRI for the diagnosis of primary liver cancer.

    Science.gov (United States)

    Zhang, Dongwen; Xu, Aixia

    2017-11-01

    The objective of the present study was to evaluate the application of dual-source CT perfusion imaging and MRI for the diagnosis of primary liver cancer. Sixty-three patients with primary liver cancer were selected between February 2015 and May 2016. All patients underwent examinations by dual-source CT perfusion imaging and MRI. The perfusion parameters of the focus center and normal liver parenchyma by CT examination and the hemodynamic parameters of the focus center and normal liver parenchyma by MRI examination were analyzed. The accuracy rates of the three detection methods (CT perfusion imaging, MRI, and combined examination) were analyzed and compared by ROC curves. Dual-source CT perfusion imaging revealed that blood flow and blood volume of the focus center were significantly higher than those of normal liver parenchyma (Pperfusion and hepatic perfusion index of the focus center were significantly higher than those of normal liver parenchyma; portal venous perfusion of the focus center was significantly lower than that of normal liver parenchyma (Pperfusion between the focus center and normal liver parenchyma was not significant (P>0.05); the accuracy rates of CT perfusion imaging, MRI, and combined examination were 76.19, 85.71, and 95.24% respectively; the area under the curve of CT perfusion imaging was 0.753 (PCT combined with MRI was 0.947 (PCT perfusion imaging combined with MRI for examination of primary liver cancer is superior to that of single use of CT or MRI, and has high clinical application and popularization value.

  6. Perfusion computed tomography for detection of hepatocellular carcinoma in patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Michael A.; Kartalis, Nikolaos; Grigoriadis, Aristeidis; Loizou, Louiza; Leidner, Bertil; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institute, Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Stockholm (Sweden); Karolinska University Hospital, Department of Radiology, Stockholm (Sweden); Staal, Per [Karolinska University Hospital, Department of Hepatology, Stockholm (Sweden)

    2015-11-15

    To evaluate the diagnostic performance of dynamic perfusion CT (P-CT) for detection of hepatocellular carcinoma (HCC) in the cirrhotic liver. Twenty-six cirrhotic patients (19 men, aged 69 ± 10 years) with suspicion of HCC prospectively underwent P-CT of the liver using the 4D spiral-mode (100/80 kV; 150/175mAs/rot) of a dual-source system. Two readers assessed: (1) arterial liver-perfusion (ALP), portal-venous liver-perfusion (PLP) and hepatic perfusion-index (HPI) maps alone; and (2) side-by-side with maximum-intensity-projections of arterial time-points (art-MIP) for detection of HCC using histopathology and imaging follow-up as standard of reference. Another reader quantitatively assessed perfusion maps of detected lesions. A total of 48 HCCs in 21/26 (81 %) patients with a mean size of 20 ± 10 mm were detected by histopathology (9/48, 19 %) or imaging follow-up (39/48, 81 %). Detection rates (Reader1/Reader2) of HPI maps and side-by-side analysis of HPI combined with arterial MIP were 92/88 % and 98/96 %, respectively. Positive-predictive values were 63/63 % and 68/71 %, respectively. A cut-off value of ≥85 % HPI and ≥99 % HPI yielded a sensitivity and specificity of 100 %, respectively, for detection of HCC. P-CT shows a high sensitivity for detection of HCC in the cirrhotic liver. Quantitative assessment has the potential to reduce false-positive findings improving the specificity of HCC diagnosis. (orig.)

  7. Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Burgmans, Mark C., E-mail: m.c.burgmans@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Leede, Eleonora M. de, E-mail: e.m.de-leede@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Martini, Christian H., E-mail: c.h.martini@lumc.nl [Leiden University Medical Centre, Department of Anesthesiology (Netherlands); Kapiteijn, Ellen, E-mail: h.w.kapiteijn@lumc.nl [Leiden University Medical Centre, Department of Medical Oncology (Netherlands); Vahrmeijer, Alexander L., E-mail: a.l.vahrmeijer@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Erkel, Arian R. van, E-mail: a.r.van-erkel@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands)

    2016-06-15

    Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

  8. Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

    International Nuclear Information System (INIS)

    Burgmans, Mark C.; Leede, Eleonora M. de; Martini, Christian H.; Kapiteijn, Ellen; Vahrmeijer, Alexander L.; Erkel, Arian R. van

    2016-01-01

    Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

  9. The acute effects of TNF-alpha on the isolated perfused rat liver.

    Science.gov (United States)

    Shattuck, K E; Grinnell, C D; Goldman, A S; Rassin, D K

    1996-02-01

    TNF-alpha mediates the hepatic response to sepsis by mechanisms which are not well understood. TNF-alpha is known to stimulate the hepatocellular uptake of specific amino acids in vivo; however, little is known about the direct effects of TNF-alpha on hepatic amino acid or glutathione homeostasis, which is a potential factor in the acute hepatic response to sepsis. Using the isolated perfused rat liver, we characterized the effects of TNF-alpha on the secretion of amino acids and glutathione into bile and perfusate. Livers taken from adult male Sprague-Dawley rats were perfused with TNF-alpha at a dose of 1 or 2 micrograms. Bile and perfusate were collected for the quantitation of amino acid and glutathione concentrations. Administration of 2 micrograms TNF-alpha resulted in significant increases in biliary and perfusate concentrations of branched chain, gluconeogenic, and total amino acids. TNF-alpha was also associated with dose-related increases in oxygen uptake, and greater biliary concentrations of glutathione. TNF-alpha has direct effects upon hepatic amino acid metabolism, which represent some of the early events involved in the mechanism of response to sepsis.

  10. Protective effect of magnesium and selenium on cadmium toxicity in the isolated perfused rat liver system.

    Directory of Open Access Journals (Sweden)

    Ali Ghaffarian-Bahraman

    2014-12-01

    Full Text Available The isolated perfused rat liver (IPRL model has been used into toxicology study of rat liver. This model provides an opportunity at evaluation of liver function in an isolated setting. Studies showed that Cd, in a dose-dependent manner, induced toxic effects in IPRL models, and these effects were associated with aminotransferase activity and lipid peroxidation. The aim of this study was to investigate whether Mg  and/or Se could have protective effects against the Cd toxicity in the IPRL model. Male Wistar rats (9-10 weeks weighing 260-300 gr were used in this study. They were randomly divided into 8 groups of 4-6 rats per cage. In group 1, liver was perfused by Krebs-Henseleit buffer without MgSO4 (Control. Groups 2-8 were exposed to Mg, Se, Cd, Mg +Se, Cd + Mg, Cd + Se, Cd + Mg + Se respectively in Krebs-Henseleit buffer with no added MgSo4. Biochemical changes in the liver were examined within 90 minutes, and the result showed that the exposure to Cd, lowered glutathione level, while it increased malondialdehyde level and aminotransferase activities in IPRL model. Mg administration during exposure to Cd reduces the toxicity of Cd in the liver isolated while Se administration during exposure to Cd did not decrease Cd hepatotoxicity. Nevertheless, simultaneous treatment with Se and Mg on Cd toxicity have strengthened protective effects than the supplementation of Se alone in the liver.

  11. The correlation of contrast-enhanced ultrasound and MRI perfusion quantitative analysis in rabbit VX2 liver cancer.

    Science.gov (United States)

    Xiang, Zhiming; Liang, Qianwen; Liang, Changhong; Zhong, Guimian

    2014-12-01

    Our objective is to explore the value of liver cancer contrast-enhanced ultrasound (CEUS) and MRI perfusion quantitative analysis in liver cancer and the correlation between these two analysis methods. Rabbit VX2 liver cancer model was established in this study. CEUS was applied. Sono Vue was applied in rabbits by ear vein to dynamically observe and record the blood perfusion and changes in the process of VX2 liver cancer and surrounding tissue. MRI perfusion quantitative analysis was used to analyze the mean enhancement time and change law of maximal slope increasing, which were further compared with the pathological examination results. Quantitative indicators of liver cancer CEUS and MRI perfusion quantitative analysis were compared, and the correlation between them was analyzed by correlation analysis. Rabbit VX2 liver cancer model was successfully established. CEUS showed that time-intensity curve of rabbit VX2 liver cancer showed "fast in, fast out" model while MRI perfusion quantitative analysis showed that quantitative parameter MTE of tumor tissue increased and MSI decreased: the difference was statistically significant (P quantitative analysis were not significantly different (P > 0.05). However, the quantitative parameter of them were significantly positively correlated (P quantitative analysis can both dynamically monitor the liver cancer lesion and surrounding liver parenchyma, and the quantitative parameters of them are correlated. The combined application of both is of importance in early diagnosis of liver cancer.

  12. Quantitative dual energy CT measurements in rabbit VX2 liver tumors: Comparison to perfusion CT measurements and histopathological findings

    International Nuclear Information System (INIS)

    Zhang, Long Jiang; Wu, Shengyong; Wang, Mei; Lu, Li; Chen, Bo; Jin, Lixin; Wang, Jiandong; Larson, Andrew C.; Lu, Guang Ming

    2012-01-01

    Purpose: To evaluate the correlation between quantitative dual energy CT and perfusion CT measurements in rabbit VX2 liver tumors. Materials and methods: This study was approved by the institutional animal care and use committee at our institution. Nine rabbits with VX2 liver tumors underwent contrast-enhanced dual energy CT and perfusion CT. CT attenuation for the tumors and normal liver parenchyma and tumor-to-liver ratio were obtained at the 140 kVp, 80 kVp, average weighted images and dual energy CT iodine maps. Quantitative parameters for the viable tumor and adjacent liver were measured with perfusion CT. The correlation between the enhancement values of the tumor in iodine maps and perfusion CT parameters of each tumor was analyzed. Radiation dose from dual energy CT and perfusion CT was measured. Results: Enhancement values for the tumor were higher than that for normal liver parenchyma at the hepatic arterial phase (P < 0.05). The highest tumor-to-liver ratio was obtained in hepatic arterial phase iodine map. Hepatic blood flow of the tumor was higher than that for adjacent liver (P < 0.05). Enhancement values of hepatic tumors in the iodine maps positively correlated with permeability of capillary vessel surface (r = 0.913, P < 0.001), hepatic blood flow (r = 0.512, P = 0.010), and hepatic blood volume (r = 0.464, P = 0.022) at the hepatic arterial phases. The effective radiation dose from perfusion CT was higher than that from DECT (P < 0.001). Conclusions: The enhancement values for viable tumor tissues measured in iodine maps were well correlated to perfusion CT measurements in rabbit VX2 liver tumors. Compared with perfusion CT, dual energy CT of the liver required a lower radiation dose.

  13. Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study.

    Science.gov (United States)

    Otto, Gerd; Heise, Michael; Thies, Jochen; Pitton, Michael; Schneider, Jens; Kaiser, Gernot; Neuhaus, Peter; Kollmar, Otto; Barthels, Michael; Geks, Josef; Bechstein, Wolf Otto; Hellinger, Achim; Klempnauer, Jürgen; Padberg, Winfried; Frühauf, Nils; Ebbing, Andre; Mauer, Dietmar; Schneider, Astrid; Kwiecien, Robert; Kronfeld, Kai

    2017-07-01

    Arterial ex situ back-table perfusion (BP ) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and functional biliary parameters at 6 months after transplantation. A total of 75 livers preserved via standard aortic perfusion and 75 preserved via standard aortic perfusion plus arterial BP were treated using a standardized protocol. The incidence of clinically apparent biliary lesions after liver transplantation (n = 9 for both groups; P = 0.947), the 2-year graft survival rate (standard aortic perfusion, 74%; standard aortic perfusion plus arterial BP, 68%; P = 0.34), and incidence of initial graft injury did not differ between the 2 perfusion modes. Although 33 of the 77 patients with cholangiography workups exhibited injured bile ducts, only 10 had clinical symptoms. Contrary to previous findings, the present study indicated that additional ex situ BP did not prevent ischemic-type biliary lesions or ischemia-reperfusion injury after liver transplantation. Moreover, there was considerable discrepancy between cholangiography findings regarding bile duct changes and clinically apparent cholangiopathy after transplantation, which should be considered when assessing ischemic-type biliary lesions.

  14. Interrelations between C4 Ketogenesis, C5 Ketogenesis, and Anaplerosis in the Perfused Rat Liver*

    OpenAIRE

    Deng, Shuang; Zhang, Guo-Fang; Kasumov, Takhar; Roe, Charles R.; Brunengraber, Henri

    2009-01-01

    We investigated the interrelations between C4 ketogenesis (production of β-hydroxybutyrate + acetoacetate), C5 ketogenesis (production of β-hydroxypentanoate + β-ketopentanoate), and anaplerosis in isolated rat livers perfused with 13C-labeled octanoate, heptanoate, or propionate. Mass isotopomer analysis of C4 and C5 ketone bodies and of related acyl-CoA esters reveal that C4 and C5 ketogenesis share the same pool of acetyl-CoA. Although the uptake of octanoate and heptanoate by the liver ar...

  15. Isolated Liver Perfusion Using Percutaneous Methods:[ql An Experimental Study in the Pig

    International Nuclear Information System (INIS)

    Harnek, Jan; Cwikiel, Wojciech; Bergqvist, Lennart; Persson, Bo; Stridbeck, Hans

    1996-01-01

    Purpose: To develop a method for isolated perfusion of the liver using radiological methods. Methods: Twenty-one pigs, weighing about 20 kg, were divided into three groups. By transjugular and transfemoral approaches two occlusion balloons were placed in the inferior vena cava cranial and caudal, respectively, to the origin of the hepatic veins. One occlusion balloon was placed transfemorally in the common hepatic artery. Another occlusion balloon was inserted in the main branch of the portal vein via the transjugular-transhepatic approach in 11 pigs (groups 1 and 2), and in 10 pigs (group 3) by a percutaneous transhepatic route. After inflation of the balloons, patency of the isolated liver circulation was evaluated by recirculation of 99 Tc m -labelled human albumin during 30 min. Blood tests were obtained after 1, 3, 5, 10, 15, and 30 min to evaluate leakage from the liver to the systemic circulation. Results: Increasing leakage to the systemic circulation from the isolated liver circulation was observed in groups 1 and 2. In the third group the leakage was less than 10%. Conclusion: In an experimental animal model, isolated perfusion of the liver with minor leakage to the systemic circulation may be achieved using radiological methods

  16. Cell-swelling-induced taurine release from isolated perfused rat liver.

    Science.gov (United States)

    Brand, H S; Meijer, A J; Gustafson, L A; Jörning, G G; Leegwater, A C; Maas, M A; Chamuleau, R A

    1994-01-01

    Astrocytes and lymphocytes are able to release significant amounts of taurine during periods of hypotonicity to reduce the increase in cell volume. To investigate this mechanism in the liver, we studied the release of free amino acids from isolated perfused rat liver during hypotonicity. The osmolarity of the perfusion medium was reduced from 305 to 255 or 205 mosM by decreasing the NaCl concentration 25 or 50 mM, respectively. This induced an 6-8% increase in liver mass and was associated with a specific 1.7-fold (-50 mosM) and 14-fold (-100 mosM) increase of the taurine release. None of the other amino acids measured showed a significant increase in their concentration in the effluent. The increase in taurine release occurred within 30 s after exposure to hypotonicity (maximal after 1-1.5 min) and followed closely the changes in liver mass. The taurine release declined gradually during successive exposures of the isolated liver to -100 mosM. This release was 29 and 17% of the original during the second and third exposure, respectively.

  17. EFFECT OF ETHANOL ON HEPATOBILIARY TRANSPORT OF CATIONIC DRUGS - A STUDY IN THE ISOLATED-PERFUSED RAT-LIVER, RAT HEPATOCYTES AND RAT MITOCHONDRIA

    NARCIS (Netherlands)

    STEEN, H; MEIJER, DKF; Merema, M.T.

    The effect of ethanol on the hepatic uptake of various cationic drugs was studied in isolated perfused rat livers, isolated rat hepatocytes and isolated rat liver mitochondria. In isolated rat hepatocytes and in isolated perfused rat livers, the uptake of the model organic cation

  18. AMC-Bio-Artificial Liver culturing enhances mitochondrial biogenesis in human liver cell lines: The role of oxygen, medium perfusion and 3D configuration

    NARCIS (Netherlands)

    Adam, Aziza A. A.; van Wenum, Martien; van der Mark, Vincent A.; Jongejan, Aldo; Moerland, Perry D.; Houtkooper, Riekelt H.; Wanders, Ronald J. A.; Oude Elferink, Ronald P.; Chamuleau, Robert A. F. M.; Hoekstra, Ruurdtje

    2017-01-01

    Human liver cell lines, like HepaRG and C3A, acquire higher functionality when cultured in the AMC-Bio-Artificial Liver (AMC-BAL). The three main differences between BAL and monolayer culture are the oxygenation (40% vs 20%O2), dynamic vs absent medium perfusion and 3D vs 2D configuration. Here, we

  19. Investigation of source-detector separation optimization for an implantable perfusion and oxygenation sensor for liver blood vessels

    Energy Technology Data Exchange (ETDEWEB)

    Baba, Justin S [ORNL; Akl, Tony [Texas A& M University; Cote, Gerard L. [Texas A& M University; Wilson, Mark A. [University of Pittsburgh School of Medicine, Pittsburgh PA; Ericson, Milton Nance [ORNL

    2011-01-01

    An implanted system is being developed to monitor transplanted liver health during the critical 7-10 day period posttransplantation. The unit will monitor organ perfusion and oxygen consumption using optically-based probes placed on both the inflow and outflow blood vessels, and on the liver parenchymal surface. Sensing probes are based on a 3- wavelength LED source and a photodiode detector. Sample diffuse reflectance is measured at 735, 805, and 940 nm. To ascertain optimal source-to-photodetector spacing for perfusion measurement in blood vessels, an ex vivo study was conducted. In this work, a dye mixture simulating 80% blood oxygen saturation was developed and perfused through excised porcine arteries while collecting data for various preset probe source-to-photodetector spacings. The results from this study demonstrate a decrease in the optical signal with decreasing LED drive current and a reduction in perfusion index signal with increasing probe spacing. They also reveal a 2- to 4-mm optimal range for blood vessel perfusion probe source-to-photodetector spacing that allows for sufficient perfusion signal modulation depth with maximized signal to noise ratio (SNR). These findings are currently being applied to guide electronic configuration and probe placement for in vivo liver perfusion porcine model studies.

  20. CT Perfusion for Early Response Evaluation of Radiofrequency Ablation of Focal Liver Lesions: First Experience

    Energy Technology Data Exchange (ETDEWEB)

    Marquez, Herman P., E-mail: hermanpaulo.marquezmasquiaran@usz.ch; Puippe, Gilbert; Mathew, Rishi Philip; Alkadhi, Hatem; Pfammatter, Thomas; Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Institute of Diagnostic and Interventional Radiology (Switzerland)

    2017-01-15

    PurposeTo investigate the value of perfusion CT (P-CT) for early assessment of treatment response in patients undergoing radiofrequency ablation (RFA) of focal liver lesions.Methods and Materials20 consecutive patients (14 men; mean age 64 ± 14) undergoing P-CT within 24 h after RFA of liver metastases (n = 10) or HCC (n = 10) were retrospectively included. Two readers determined arterial liver perfusion (ALP, mL/min/100 mL), portal liver perfusion (PLP, mL/min/100 mL), and hepatic perfusion index (HPI, %) in all post-RFA lesions by placing a volume of interest in the necrotic central (CZ), the transition (TZ), and the surrounding parenchymal (PZ) zone. Patients were classified into complete responders (no residual tumor) and incomplete responders (residual/progressive tumor) using imaging follow-up with contrast-enhanced CT or MRI after a mean of 57 ± 30 days. Prediction of treatment response was evaluated using the area under the curve (AUC) from receiver operating characteristic analysis.ResultsMean ALP/PLP/HPI of both readers were 4.8/15.4/61.2 for the CZ, 9.9/16.8/66.3 for the TZ and 20.7/29.0/61.8 for the PZ. Interreader agreement of HPI was fair for the CZ (intraclass coefficient 0.713), good for the TZ (0.813), and excellent for the PZ (0.920). For both readers, there were significant differences in HPI of the CZ and TZ between responders and nonresponders (both, P < 0.05). HPI of the TZ showed the highest AUC (0.911) for prediction of residual tumor, suggesting a cut-off value of 76 %.ConclusionIncreased HPI of the transition zone assessed with P-CT after RFA might serve as an early quantitative biomarker for residual tumor in patients with focal liver lesions.

  1. Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver.

    Science.gov (United States)

    de Leede, Eleonora M; Burgmans, Mark C; Martini, Christian H; Tijl, Fred G J; van Erkel, Arian R; Vuyk, Jaap; Kapiteijn, Ellen; Verhoef, Cornelis; van de Velde, Cornelis J H; Vahrmeijer, Alexander L

    2016-07-31

    Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn unresectable metastases into resectable ones. Some patients however, suffer from side effects or progression under systemic treatment. For patients with metastasized uveal melanoma there are no standard systemic therapy options. For patients without extrahepatic disease, isolated liver perfusion (IHP) may enable local disease control with limited systemic side effects. Previously, this was performed during open surgery with satisfying results, but morbidity and mortality related to the open procedure, prohibited a widespread application. Therefore, percutaneous hepatic perfusion (PHP) with simultaneous chemofiltration was developed. Besides decreasing morbidity and mortality, this procedure can be repeated, hopefully leading to a higher response rate and improved survival (by local control of disease). During PHP, catheters are placed in the proper hepatic artery, to infuse the chemotherapeutic agent, and in the inferior caval vein to aspirate the chemosaturated blood returning through the hepatic veins. The caval vein catheter is a double balloon catheter that prohibits leakage into the systemic circulation. The blood returning from the hepatic veins is aspirated through the catheter fenestrations and then perfused through an extra-corporeal filtration system. After filtration, the blood is returned to the patient by a third catheter in the right internal jugular vein. During PHP a high dose of melphalan is infused into the liver, which is toxic and would lead to life threatening complications when administered systemically. Because of the significant hemodynamic instability resulting from the combination of caval vein occlusion and chemofiltration, hemodynamic monitoring and hemodynamic support is of paramount importance during this complex procedure.

  2. Inhibition of mirtazapine metabolism by Ecstasy (MDMA) in isolated perfused rat liver model.

    Science.gov (United States)

    Jamshidfar, Sanaz; Ardakani, Yalda H; Lavasani, Hoda; Rouini, Mohammadreza

    2017-06-28

    Nowadays MDMA (3,4-methylendioxymethamphetamine), known as ecstasy, is widely abused among the youth because of euphoria induction in acute exposure. However, abusers are predisposed to depression in chronic consumption of this illicit compound. Mirtazapine (MRZ), an antidepressant agent, may be prescribed in MDMA-induced depression. MRZ is extensively metabolized in liver by CYP450 isoenzymes. 8-hydroxymirtazapine (8-OH) is mainly produced by CYP2D6. N-desmethylmirtazapine (NDES) is generated by CYP3A4. MDMA is also metabolized by the mentioned isoenzymes and demonstrates mechanism-based inhibition (MBI) in association with CYP2D6. Several studies revealed that MDMA showed inhibitory effects on CYP3A4. In the present study, our aim was to evaluate the impact of MDMA on the metabolism of MRZ in liver. Therefore, isolated perfused rat liver model was applied as our model of choice in this assessment. The subjects of the study were categorized into two experimental groups. Rats in the control group received MRZ-containing Krebs-Henselit buffer (1 μg/ml). Rats in the treatment group received aqueous solution of 1 mg/ml MDMA (3 mg/kg) intraperitoneally 1 hour before receiving MRZ. Perfusate samples were analyzed by HPLC. Analyses of perfusate samples showed 80% increase in the parent drug concentrations and 50% decrease in the concentrations of both metabolites in our treatment group compared to the control group. In the treatment group compared to the control group, AUC (0-120) of the parent drug demonstrated 50% increase and AUC (0-120) of 8-OH and NDES showed 70% and 60% decrease, respectively. Observed decrease in metabolic ratios were 83% and 79% for 8-OH and NDES in treatment group compared to control group, respectively. Hepatic clearance (CL h ) and intrinsic clearance (Cl int ) showed 20% and 60% decrease in treatment group compared to control group. All findings prove the inhibitory effects of ecstasy on both CYP2D6 and CYP3A4 hepatic isoenzymes. In

  3. Multiple-indicator dilution technique for characterization of normal and retrograde flow in once-through rat liver perfusions

    International Nuclear Information System (INIS)

    St-Pierre, M.V.; Schwab, A.J.; Goresky, C.A.; Lee, W.F.; Pang, K.S.

    1989-01-01

    The technique of normal and retrograde rat liver perfusion has been widely used to probe zonal differences in drug-metabolizing activities. The validity of this approach mandates the same tissue spaces being accessed by substrates during both normal and retrograde perfusions. Using the multiple-indicator dilution technique, we presently examine the extent to which retrograde perfusion alters the spaces accessible to noneliminated references. A bolus dose of 51Cr-labeled red blood cells, 125I-albumin, 14C-sucrose and 3H2O was injected into the portal (normal) or hepatic (retrograde) vein of rat livers perfused at 10 ml per min per liver. The outflow perfusate was serially collected over 220 sec to characterize the transit times and the distribution spaces of the labels. During retrograde perfusion, red blood cells, albumin and sucrose profiles peaked later and lower than during normal perfusion, whereas the water curves were similar. The transit times of red blood cells, albumin and sucrose were longer (p less than 0.005), whereas those for water did not change. Consequently, retrograde flow resulted in significantly larger sinusoidal blood volumes (45%), albumin Disse space (42%) and sucrose Disse space (25%) than during normal flow, whereas the distribution spaces for total and intracellular water remained unaltered. The distension of the vascular tree was confirmed by electron microscopy, by which occasional isolated foci of widened intercellular recesses and spaces of Disse were observed. Cellular ultrastructure was otherwise unchanged, and there was no difference found between normal and retrograde perfusion for bile flow rates, AST release, perfusion pressure, oxygen consumption and metabolic removal of ethanol, a substrate with flow-limited distribution, which equilibrates rapidly with cell water (hepatic extraction ratios were virtually identical: normal vs. retrograde, 0.50 vs. 0.48 at 6 to 7.4 mM input concentration)

  4. Management of isolated nonresectable liver metastases in colorectal cancer patients: a case-control study of isolated hepatic perfusion with melphalan versus systemic chemotherapy

    NARCIS (Netherlands)

    van Iersel, L. B. J.; Koopman, M.; van de Velde, C. J. H.; Mol, L.; van Persijn van Meerten, E. L.; Hartgrink, H. H.; Kuppen, P. J. K.; Vahrmeijer, A. L.; Nortier, J. W. R.; Tollenaar, R. A. E. M.; Punt, C.; Gelderblom, H.

    2010-01-01

    To compare the median overall survival of patients with isolated nonresectable liver metastases in comparable groups of patients treated with either isolated hepatic perfusion (IHP) with melphalan or systemic chemotherapy. Colorectal cancer patients with isolated liver metastases, who underwent IHP,

  5. Arterio-portal shunts in the cirrhotic liver: perfusion computed tomography for distinction of arterialized pseudolesions from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Karolinska Institutet, Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Marquez, Herman P.; Gordic, Sonja; Alkadhi, Hatem [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Leidner, Bertil; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institutet, Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Klotz, Ernst [Computed Tomography and Radiation Oncology, Siemens Healthcare, Forchheim (Germany)

    2017-03-15

    To determine perfusion computed tomography (P-CT) findings for distinction of arterial pseudolesions (APL) from hepatocellular carcinoma (HCC) in the cirrhotic liver. 32 APL and 21 HCC in 20 cirrhotic patients (15 men; 65 ± 10 years), who underwent P-CT for evaluation of HCC pre- (N = 9) or post- (N = 11) transarterial chemoembolization, were retrospectively included using CT follow-up as the standard of reference. All 53 lesions were qualitatively (visual) and quantitatively (perfusion parameters) analysed according to their shape (wedge, irregular, nodular), location (not-/adjunct to a fistula), arterial liver perfusion (ALP), portal venous liver perfusion (PLP), hepatic perfusion index (HPI). Accuracy for diagnosis of HCC was determined using receiver operating characteristics. 18/32 (56 %) APL were wedge shaped, 10/32 (31 %) irregular and 4/32 (12 %) nodular, while 11/21 (52 %) HCC were nodular or 10/21 (48 %) irregular, but never wedge shaped. Significant difference between APL and HCC was seen for lesion shape in pretreated lesions (P < 0.001), and for PLP and HPI in both pre- and post-treated lesions (all, P < 0.001). Diagnostic accuracy for HCC was best for combined assessment of lesion configuration and PLP showing an area under the curve of 0.901. Combined assessment of lesion configuration and portal venous perfusion derived from P-CT allows best to discriminate APL from HCC with high diagnostic accuracy. (orig.)

  6. Uptake and degradation of cytoplasmic RNA by lysosomes in the perfused rat liver

    Energy Technology Data Exchange (ETDEWEB)

    Heydrick, S.J.; Lardeux, B.; Mortimore, G.E.

    1987-05-01

    The release of (/sup 14/C)cytidine has been shown previously to be a valid marker for RNA degradation in rat hepatocytes. The breakdown of RNA measured with this marker in perfused livers prelabeled in vivo with (6-/sup 14/C)orotic acid was found to be regulated acutely by perfusate amino acids over a wide range, from 0.29 to 3.48%/h. This regulation paralleled that of lysosomal proteolysis. Chloroquine inhibited RNA degradation 60-70%. In subsequent cell fractionation studies labelled cytidine was released; the distribution of this release paralleled that of a lysosomal marker enzyme. The release plateaued after two hours, defining a distinct lysosomal pool of RNA. The lysosomal location of the RNA pool was confirmed in experiments where a 22% increase in the apparent pool size was obtained by lowering the homogenate pH from 7.0 to 5.5. The pool size correlated linearly with the rate of RNA degradation measured during perfusion, giving a turnover constant in reasonable agreement with values reported for autophagy. These results indicate that cytoplasmic RNA degradation occurs primarily in the lysosome and is regulated under these conditions by the amino acid control of lysosomal sequestration of cytoplasm.

  7. Hypothermic oxygenated machine perfusion prevents arteriolonecrosis of the peribiliary plexus in pig livers donated after circulatory death.

    Directory of Open Access Journals (Sweden)

    Sanna Op den Dries

    Full Text Available BACKGROUND: Livers derived from donation after circulatory death (DCD are increasingly accepted for transplantation. However, DCD livers suffer additional donor warm ischemia, leading to biliary injury and more biliary complications after transplantation. It is unknown whether oxygenated machine perfusion results in better preservation of biliary epithelium and the peribiliary vasculature. We compared oxygenated hypothermic machine perfusion (HMP with static cold storage (SCS in a porcine DCD model. METHODS: After 30 min of cardiac arrest, livers were perfused in situ with HTK solution (4°C and preserved for 4 h by either SCS (n = 9 or oxygenated HMP (10°C; n = 9, using pressure-controlled arterial and portal venous perfusion. To simulate transplantation, livers were reperfused ex vivo at 37°C with oxygenated autologous blood. Bile duct injury and function were determined by biochemical and molecular markers, and a systematic histological scoring system. RESULTS: After reperfusion, arterial flow was higher in the HMP group, compared to SCS (251±28 vs 166±28 mL/min, respectively, after 1 hour of reperfusion; p = 0.003. Release of hepatocellular enzymes was significantly higher in the SCS group. Markers of biliary epithelial injury (biliary LDH, gamma-GT and function (biliary pH and bicarbonate, and biliary transporter expression were similar in the two groups. However, histology of bile ducts revealed significantly less arteriolonecrosis of the peribiliary vascular plexus in HMP preserved livers (>50% arteriolonecrosis was observed in 7 bile ducts of the SCS preserved livers versus only 1 bile duct of the HMP preserved livers; p = 0.024. CONCLUSIONS: Oxygenated HMP prevents arteriolonecrosis of the peribiliary vascular plexus of the bile ducts of DCD pig livers and results in higher arterial flow after reperfusion. Together this may contribute to better perfusion of the bile ducts, providing a potential advantage in the post

  8. Studies on blood supply of liver metastasis with DSA, CT and portal vein perfusion CT during superior mesenteric arterial portography

    International Nuclear Information System (INIS)

    Li Zhigang; Shi Gaofeng; Huang Jingxiang; Li Shunzong; Liang Guoqing; Wang Hongguang; Han Pengyin; Wang Qi; Gu Tieshu

    2008-01-01

    Objective: To probe the blood supply of liver metastasis by celiac artery, proper hepatic artery DSA, portal vein perfusion CT during superior mesenteric arterial portography (PCTAP). Methods: One hundred patients with liver metastases were examined prospectively by plain CT scan, multiphase enhanced CT scan, celiac arteriography and proper hepatic arteriography. Of them, 56 patients were examined by PCTAP. All primary lesions were confirmed by operation and (or) pathology examination. In order to investigate the blood supply of metastasis lesions, the software of Photoshop was used to obtain the time-attenuation curves (TDC) of tumor center, tumor edge, portal vein and normal liver parenchyma adjacent to the tumor to calculate liver perfusion for DSA image analysis, while a deconvolution model from CT perfusion software was designed for the dual blood supply. Results: DSA findings: TDC of proper hepatic arteriography showed: the mean peak concentration (K value) in tumor centers was (67 ± 12)%, and it was (76 ± 15)% for peritumor tissue, (51 ± 10)% in normal liver parenchyma. TDC of celiac arteriogaphy showed that the contrast concentration of tumor centers and tumor edge increased fast in early stage, then maintained a slight upward plateau, in the meanwhile, the contrast concentration of normal liver parenchyma kept increasing slowly. PCTAP findings: tumors exhibited no enhancement during 30 s continued scans. Conclusion: The blood supply of liver metastasis mainly comes from hepatic artery, but barely from portal vein. (authors)

  9. The Role of TNF-α in Aflatoxin B-1 Induced Hepatic Toxicity in Isolated Perfused Rat Liver Model

    Directory of Open Access Journals (Sweden)

    Kazem Koohi Mohammad

    2017-09-01

    Full Text Available Aflatoxin B-1 (AFB1 is one of the major mycotoxins causing food contamination. Previous studies have shown that AFB1 can induce carcinogenicity and toxic effects in the isolated perfused rat liver and these effects are associated with its metabolites and peroxidation activity. Here we surveyed whether these pathogenic effects of AFB1 are associated with TNF-α as an inflammatory cytokine in general liver damages. In this study, we used twenty male Wistar rats (250-300 g. Rats were divided into four groups. Control group was pre-treated with LPS and then perfused with KHBB. The second group was pretreated with PTX and LPS and then perfused with KHB. The third group was pre-treated with LPS and then perfused with AFB-1 and KHB. The last group was pretreated with LPS and PTX and then perfused with AFB1 and KHB. Results revealed that aflatoxin B1 significantly increased the enzyme activity of aminotransferase and levels of lipid peroxidation. Also, the levels of Glutathione decreased in the aflatoxin group significantly. TNF-α released in perfusate and increased in aflatoxin B1 group significantly and decreased in AFB-1+PTX. Exposure to Aflatoxin B1 may induce reactive oxygen species, so these species may induce overproduction of proinflammatory cytokines such as TNF-α and may cause more damage to hepatic cells.

  10. Machine Perfusion of Porcine Livers with Oxygen-Carrying Solution Results in Reprogramming of Dynamic Inflammation Networks

    Directory of Open Access Journals (Sweden)

    David Sadowsky

    2016-11-01

    Full Text Available Background: Ex vivo machine perfusion (MP can better preserve organs for transplantation. We have recently reported on the first application of a MP protocol in which liver allografts were fully oxygenated, under dual pressures and subnormothermic conditions, with a new hemoglobin-based oxygen carrier solution specifically developed for ex vivo utilization. In those studies, MP improved organ function post-operatively and reduced inflammation in porcine livers. Herein, we sought to refine our knowledge regarding the impact of MP by defining dynamic networks of inflammation in both tissue and perfusate. Methods: Porcine liver allografts were preserved either with MP (n = 6 or with cold static preservation (CSP; n = 6, then transplanted orthotopically after 9 h of preservation. Fourteen inflammatory mediators were measured in both tissue and perfusate during liver preservation at multiple time points, and analyzed using Dynamic Bayesian Network (DyBN inference to define feedback interactions, as well as Dynamic Network Analysis (DyNA to define the time-dependent development of inflammation networks.Results: Network analyses of tissue and perfusate suggested an NLRP3 inflammasome-regulated response in both treatment groups, driven by the pro-inflammatory cytokine interleukin (IL-18 and the anti-inflammatory mediator IL-1 receptor antagonist (IL-1RA. Both DyBN and DyNA suggested a reduced role of IL-18 and increased role of IL-1RA with MP, along with increased liver damage with CSP. DyNA also suggested divergent progression of responses over the 9 h preservation time, with CSP leading to a stable pattern of IL-18-induced liver damage and MP leading to a resolution of the pro-inflammatory response. These results were consistent with prior clinical, biochemical, and histological findings after liver transplantation. Conclusion: Our results suggest that analysis of dynamic inflammation networks in the setting of liver preservation may identify novel

  11. The Isolated Perfused Rat Liver and its use in the Study of Chemical Kinetics: Quality and Performance Parameters

    Science.gov (United States)

    1999-04-01

    in the IPRL using BSP kinetics as a biomarker by peroxisome proliferators (James and Ahokas, 1992 a,b), paracetamol (Khedun et al., 1993), and...Khedun SM, Maharaj B, Leary WP, and Naicker T, The effect of therapeutic doses of paracetamol on liver function in the rat perfused liver. J. Pharm...ether overdosing ). 5.5.4 Sterilize surgical field with 70% alcohol. 5.5.5 Xiphoid-pubis midline incision along the linea alba with lateral flaps (clip

  12. Effect of transarterial pulsed perfusion with heated saline on tumor vascular permeability in a rabbit VX2 liver tumor model

    International Nuclear Information System (INIS)

    Cao Wei; Li Jinghua; Feng Dayun; Wan Yi; Liu Yufeng; Yang Qingfeng; Cheng Jianwei; Zhao Siyuan; Zhang Hongxin

    2012-01-01

    Purpose: To evaluate the effect of transarterial pulsed perfusion with 60 °C saline on vascular permeability of tumor tissue, as well as its hepatic and renal toxicity, in a rabbit VX2 liver model. Materials and methods: VX2 carcinomas were grown in rabbit livers, forty male New Zealand white tumor-bearing rabbits were randomly divided into four groups, followed by transarterial perfusion with 37 °C saline 60 ml (n = 10) (control 1 group), transarterial pulsed perfusion with 37 °C saline 60 ml (n = 10) (control 2 group), transarterial continuous perfusion with 60 °C saline 60 ml (n = 10) (TCP group), transarterial pulsed perfusion with 60 °C saline 60 ml (n = 10) (TPP group), the duration of time for tumor tissues in the range 43–45 °C of the treated groups was measured with needle thermometer during perfusion. Vascular permeability was assessed using the extravasation of Evans blue (EB) dye in the tumor or normal liver tissues of the four groups separately, the tumor or normal liver tissues of the four groups were estimated by histopathologic examination, and hepatic and renal toxicity was evaluated by means of blood biochemical analysis. The vascular endothelial cells in the tumor were observed by transmission electron microscopy (TEM). Results: The duration of time for tumor tissues in the range 43–45 °C of TPP group showed significantly longer than that of TCP group (12.3 ± 3.3 min vs. 5.7 ± 2.5 min) (P 0.05), and there was no significant difference in the serum BUN, Cr levels among the four groups at 1, 2, 4, 8, 24 h after perfusion. Observed by hematoxylin and eosin staining, there were no obvious signs of tissue destruction in liver tissue and tumor tissue. TEM indicating the endothelial cell gap was broadened and the endothelial cells’ microvillus was decreased after heated perfusion. Conclusions: The vascular permeability of the rabbit VX2 tumor was significantly increased after transarterial pulsed perfusion with 60 °C saline without

  13. Isolated perfused liver as a tool to study the disposition of peptides, liver first-pass effects, and cell-specific drug delivery

    NARCIS (Netherlands)

    Meijer, D.K F; Swart, P.J

    1997-01-01

    The isolated perfused liver technique has been widely used in drug disposition studies. This versatile methodology in which many experimental conditions can be easily manipulated, allows one to investigate the various rate limiting steps in peptide transport and drug metabolism: plasma flow, protein

  14. Intracellular mechanism of action of sympathetic hepatic nerves on glucose and lactate balance in perfused rat liver

    NARCIS (Netherlands)

    Ballé, C.; Beuers, U.; ENGELHARDT, R.; JUNGERMANN, K.

    1987-01-01

    In rat liver perfused in situ stimulation of the nerve plexus around the hepatic artery and the portal vein caused an increase in glucose output and a shift from lactate uptake to output. The effects of nerve stimulation on some key enzymes, metabolites and effectors of carbohydrate metabolism were

  15. Liver ex situ machine perfusion preservation : A review of the methodology and results of large animal studies and clinical trials

    NARCIS (Netherlands)

    Marecki, Hazel; Bozorgzadeh, Adel; Porte, Robert J.; Leuvenink, Henri G.; Uygun, Korkut; Martins, Paulo N.

    Ex vivo machine perfusion (MP) is a promising way to better preserve livers prior to transplantation. Currently, no methodology has a verified benefit over simple cold storage. Before becoming clinically feasible, MP requires validation in models that reliably predict human performance. Such a model

  16. Possible role of the scintigraphic estimation of the relative liver perfusion in the choice of treatment of liver carcinomas

    International Nuclear Information System (INIS)

    Artiko, V.; Obradovic, V.; Davidovic, B.; Petrovic, N.; Vlajkoviae, M.; Kostic, K.

    2005-01-01

    Full text: In the pre-evaluation and diagnosis of the patients with liver tumors, significant nuclear medicine methods used are: radiocolloid, blood pool, hepatobiliary scintigraphy, angioscintigraphy with radiolabeled microspheres as well as 'first pass' radionuclide angiography, which can precede all of the above mentioned methods, during single injection application. The aim of the study is evaluation of the possible role of the scintigraphic estimation of the relative liver perfusion in the choice of treatment of liver carcinomas. The study was performed in 120 patients: 24 controls (C), 35 with benign liver tumors (BT), 35 with hepatocellular carcinomas (HCC), 19 with metastases of colorectal carcinomas (MCC) as well as 7 with metastases of other tumors (MOT-bronchus, lung carcinoma and lymphoma). 7/35 HCC had cavernous portal vein developed after tumor thrombosis, 2 had complete thrombosis and 5 had incomplete thrombosis (thrombosis of the either of portal venous branches (3) and incomplete portal venous thrombosis -2). 2/19 patients with MCC had cavernous portal vein developed after tumor thrombosis, 3 had complete portal venous occlusion and 4 incomplete thrombosis (thrombosis of the either of branches). The study was performed with ROTA scintillation camera and Micro Delta computer, during 60 sec (1f/sec) from i.v.application of 740 MBq 99mTc-pertecnetate. TA curves were generated using liver ROI, spleen ROI and left kidney ROI, and curves were generated. Hepatic perfusion index was calculated using slope analysis (Portal slope Ps and arterial slope As) method according to following formula HPI=Ps/(Ps+As). Complementary methods used were Doppler ultrasonography, CT, MRI, tumor marker assays (CEA, Ca19-9, AFP) laboratory analyses, pathohistological finding and clinical diagnosis. In C, HPI was 0.68±0.06 which did not differ from the value in BT (0.64 ±0.08) (p>0.05). However, in HCC ( X=0.26±0.20), and LM (X=0.40±0.28), HPI values were significantly

  17. Perfusion CT Changes in Liver Metastases from Pancreatic Neuroendocrine Tumors During Everolimus Treatment.

    Science.gov (United States)

    D'Onofrio, Mirko; Cingarlini, Sara; Ortolani, Silvia; Crosara, Stefano; DE Robertis, Riccardo; Vallerio, Paola; Grego, Elisabetta; Ciaravino, Valentina; Ruzzenente, Andrea; Landoni, Luca; Scarpa, Aldo; Bassi, Claudio; Tortora, Giampaolo

    2017-03-01

    To evaluate modifications of perfusional parameters assessed by perfusion computed tomography (P-CT) of liver metastases (LM) from pancreatic neuroendocrine tumors (PanNETs) during everolimus treatment. All patients with LMs from G1-2 PanNETs undergoing everolimus treatment between January 2013 and January 2015 were prospectively evaluated with P-CT at baseline, and after 2 and 4 months of therapy. Size, perfusion, blood volume (BV), peak enhancement intensity (PEI) and time to peak for each lesion were calculated. A total of 33 LMs in nine patients with G1-2 PanNETs were prospectively evaluated: 23/33 (69.7%) were responders, 10/33 (30.3%) were non-responders. Among perfusional parameters, only numerical peak enhancement intensity values significantly differed between the two groups at baseline (p=0.043). BV increase was the most significant perfusional modification identifying responding lesions, even at an early stage of treatment, with a high positive predictive value (89.47%). P-CT seems to be useful for prediction of response to everolimus of LMs from PanNETs. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  18. Isolated hepatic perfusion as a treatment for uveal melanoma liver metastases (the SCANDIUM trial)

    DEFF Research Database (Denmark)

    Olofsson, Roger; Ny, Lars; Eilard, Malin Sternby

    2014-01-01

    for patients with liver metastases is between 6 and 12 months, and no treatment has in randomized trials ever been shown to prolong survival. A previous phase II trial using isolated hepatic perfusion (IHP) has suggested a 14-month increase in overall survival compared with a historic control group consisting...... metastases (verified by biopsy) and no evidence of extra-hepatic tumor manifestations by positron emission tomography-computed tomography (PET-CT). The primary endpoint is overall survival at 24 months, with secondary endpoints including response rate, progression-free survival, and quality of life...... survival being the primary endpoint. TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT01785316 (registered 1 February 2013). EudraCT registration number: 2013-000564-29....

  19. Correlation Between Dual-energy and Perfusion CT in Patients with Focal Liver Lesions Using Third-generation Dual-source CT Scanner.

    Science.gov (United States)

    Xu, Jia; Zheng, Yongchang; Wang, Xuan; Xue, Huadan; Wang, Shitian; Liang, Jixiang; Jin, Zhengyu

    2017-02-20

    Objective To compare measurements of dual-energy CT iodine map parameters and liver perfusion CT parameters in patients with focal liver lesions using a third-generation dual-source CT scanner. Methods Between November 2015 and August 2016,33 patients with non-cystic focal lesions of liver were enrolled in this study. CT examinations were performed with a third-generation dual-source CT. The study CT protocol included a perfusion CT and dual-energy arterial and portal venous scans,with a time interval of 15 minutes. Iodine attenuation was measured at five region of interests including areas of high,medium,and low density within the lesion,as well as right and left liver parenchyma from the iodine map,while arterial liver perfusion (ALP),portal venous liver perfusion (PVP),and hepatic perfusion index (HPI) at the same location were measured from perfusion CT. The Pearson product-moment correlation coefficient was used to evaluate the relationship between iodine attenuation and perfusion parameters. Results The iodine attenuation at arterial phase showed significant intra-individual correlation with ALP (r=0.812,95% CI=0.728-0.885,PCT together [(3.53±1.17)mSv] was significantly lower than that of the perfusion CT [(14.53±0.45)mSv](t=25.212,PCT demonstrates significant correlation with ALP and PVP,and iodine attenuation from portal venous phase demonstrates significant correlation with PVP.

  20. [Evaluation of the blood flow in common hepatic tumors by multi-slice spiral CT whole-liver perfusion imaging].

    Science.gov (United States)

    Li, Mengdi; Chen, Yong; Gao, Zhiling; Zhu, Kai; Yin, Xin

    2015-12-01

    To study the characteristics of blood flow in common hepatic tumors by 256-slice spiral CT whole-liver perfusion imaging. Seventy-one patients with hepatic tumors were examined retrospectively by 256-slice spiral CT whole-liver perfusion. Among them, twenty-seven cases were of primary hepatic cancer, twenty-four cases of hepatic hemangioma, and twenty cases of hepatic metastases.Regions of interest (ROIs) were placed in the tumor parenchyma (Area A), peritumoral hepatic parenchyma (Area B), and normal hepatic parenchyma (Area C), respectively. The time density curves (TDC) were drawn, and perfusion parameters including hepatic arterial perfusion(HAP), portal venous perfusion(PVP), total liver perfusion(TLP) and hepatic erfusion index(HPI) were obtained. The values of ROIs were measured, and the perfusion parameters in the areas A, B, C of different hepatic tumors were statistically analyzed. The values of HAP, PVP, HPI in the tumor parenchyma of primary hepatic carcinoma were (20.00 ± 11.41)ml · min(-1) · 100 ml(-1,) (32.31 ± 21.06)ml · min(-1) · 100 ml(-1,) (52.31 ± 30.55)ml · min(-1) · 100 ml(-1,) and (39.67 ± 11.19)%, showing significant difference as compared with those in peritumoral hepatic parenchyma and in normal hepatic parenchyma(PHAP, TLP, and HPI in the tumor parenchyma of hepatic hemangioma were (40.39 ± 29.23)ml · min(-1) · 100 ml(-1,) (132.72 ± 132.65) ml · min(-1) · 100 ml(-1,) and (35.51 ± 15.12)%, were significantly different as compared with those in the peritumoral hepatic parenchyma and in normal hepatic parenchyma(PHAP, PVP, HPI in the tumor parenchyma of hepatic metastases were (17.43 ± 12.27)ml · min(-1) · 100 ml(-1,) (36.19 ± 34.99) ml · min(-1) · 100 ml(-1,) and (37.86 ± 14.49)%, significantly different as compared normal hepatic parenchyma (PHAP, PVP, and TLP of tumor tissue and the PVP and HPI of peritumoral tissue in different hepatic tumors were statistically significantly different (P<0.05). The multi

  1. Cytoplasmic binding and disposition kinetics of diclofenac in the isolated perfused rat liver

    Science.gov (United States)

    Weiss, Michael; Kuhlmann, Olaf; Hung, Daniel Y; Roberts, Michael S

    2000-01-01

    The binding kinetics of diclofenac to hepatocellular structures were evaluated in the perfused rat liver using the multiple indicator dilution technique and a stochastic model of organ transit time density.The single-pass, in situ rat liver preparation was perfused with buffer solution (containing 2% albumin) at 30 ml min−1. Diclofenac and [14C]-sucrose (extracellular reference) were injected simultaneously as a bolus dose into the portal vein (six experiments in three rats). An analogous series of experiments was performed with [14C]-diclofenac and [3H]-sucrose.The diclofenac outflow data were analysed using three models of intracellular distribution kinetics, assuming (1) instantaneous distribution and binding (well-mixed model), (2) ‘slow' binding at specific intracellular sites after instantaneous distribution throughout the cytosol (slow binding model), and (3) ‘slowing' of cytoplasmic diffusion due to instantaneous binding (slow diffusion model).The slow binding model provided the best description of the data. The rate constants for cellular influx and sequestration were 0.126±0.026 and 0.013±0.009 s−1, respectively. The estimated ratio of cellular initial distribution volume to extracellular volume of 2.82 indicates an almost instantaneous distribution in the cellular water space, while the corresponding ratio of 5.54 estimated for the apparent tissue distribution volume suggests a relatively high hepatocellular binding. The non-instantaneous intracellular equilibration process was characterized by time constants of the binding and unbinding process of 53.8 and 49.5 s, respectively. The single-pass availability of diclofenac was 86%. The results obtained with [14C]-diclofenac and [3H]-sucrose were not statistically different. PMID:10903973

  2. Control of ketogenesis in the perfused rat liver by the sympathetic innervation.

    Science.gov (United States)

    Beuers, U; Beckh, K; Jungermann, K

    1986-07-01

    The regulation of ketogenesis by the hepatic nerves was investigated in the rat liver perfused in situ. Electrical stimulation of the hepatic nerves around the portal vein and the hepatic artery caused a reduction of basal ketogenesis owing to a decrease in acetoacetate release to 30% with essentially no change in 3-hydroxybutyrate release. At the same time, as observed before [Hartmann et al. (1982) Eur. J. Biochem. 123, 521-526], nerve stimulation increased glucose output, shifted lactate uptake to output and decreased perfusion flow. Ketogenesis from oleate, which enters the mitochondria via the carnitine system, was also lowered after nerve stimulation owing to a decrease of acetoacetate release to 30% with no alteration in 3-hydroxybutyrate release. Ketogenesis from octanoate, which enters the mitochondria independently of the carnitine system, was decreased after nerve stimulation as a result of a drastic decrease of acetoacetate output to 15% and a less pronounced decrease of 3-hydroxybutyrate release to 65%. Noradrenaline mimicked the metabolic nerve effects on ketogenesis only at the highly unphysiological concentration of 0.1 microM under basal conditions and in the presence of oleate as well as partly in the presence of octanoate. It was essentially not effective at a concentration of 0.01 microM, which might be reached in the sinusoids owing to overflow from the hepatic vasculature. Sodium nitroprusside prevented the hemodynamic changes after nerve stimulation; it did not affect the nerve-dependent reduction of ketogenesis under basal conditions and in the presence of oleate, yet it diminished the nerve effect on octanoate-dependent ketogenesis. Phentolamine clearly reduced the metabolic and hemodynamic nerve effects, while propranolol was without effect. The present data suggest that hepatic ketogenesis was inhibited by stimulation of alpha-sympathetic liver nerves directly rather than indirectly via hemodynamic changes or noradrenaline overflow from

  3. Hepatic Differentiation of Human Induced Pluripotent Stem Cells in a Perfused 3D Porous Polymer Scaffold for Liver Tissue Engineering

    DEFF Research Database (Denmark)

    Hemmingsen, Mette; Muhammad, Haseena Bashir; Mohanty, Soumyaranjan

    A huge shortage of liver organs for transplantation has motivated the research field of tissue engineering to develop bioartificial liver tissue and even a whole liver. The goal of NanoBio4Trans is to create a vascularized bioartificial liver tissue, initially as a liver-support system. Due...... to limitations of primary hepatocytes regarding availability and maintenance of functionality, stem cells and especially human induced pluripotent stem cells (hIPS cells) are an attractive cell source for liver tissue engineering. The aim of this part of NanoBio4Trans is to optimize culture and hepatic...... differentiation of hIPS-derived definitive endoderm (DE) cells in a 3D porous polymer scaffold built-in a perfusable bioreactor. The use of a microfluidic bioreactor array enables the culture of 16 independent tissues in one experimental run and thereby an optimization study to be performed....

  4. The value of 64-slice spiral CT perfusion imaging in the treatment of liver cancer with argon-helium cryoablation.

    Science.gov (United States)

    Lv, Yinggang; Jin, Yurong; Yan, Qiaohuan; Yuan, Dingling; Wang, Yanling; Li, Xianping; Shen, Yanfeng

    2016-12-01

    We analyzed the effectiveness of using 64-slice spiral computed tomography (CT) and perfusion imaging to guide argon-helium cryoablation treatment of liver cancer. In total, 60 cases of advanced hepatocellular carcinoma before surgery treated with argon-helium cryoablation were inlcuded in the present study. Retrospective summary of the 60 cases of metaphase and advanced liver cancer were used as the control group. The control group were treated using cryoablation with argon-helium knife. We used enhanced scanning with 64-slice spiral CT to define the extent of their lesions and prepared a plan of percutaneous cryoablation for the treatment. Intraoperatively, we used the dynamics of CT perfusion imaging to observe the frozen ablation range and decreased the rate of complications. After surgery, the patients were followed-up regularly by 64-slice CT. We used conventional X-ray, CT and magnetic resonance imaging (MRI) for pre-operative lateralization. Intraoperative X-ray or ultrasound guidance and follow-up with CT or MTI were added to determine the clinical effectiveness and prognosis. The results showed that the total effective rate was improved significantly and incidence rate of overall complications decreased markedly in the observation group. Following treatment, AFP decreased significantly while the total freezing area and time were reduced significantly. The median survival time was increased significantly in the observation group. The numeric values of hepatic arterial perfusion, portal vein perfusion and hepatic arterial perfusion index were all markedly lowered after treatment. Differences were statistically significant (PCT perfusion imaging may considerably improve the effects of liver cancer treatment using the argon-helium cryoablation. It extended the survival time and reduced complications.

  5. Interrelations between C4 ketogenesis, C5 ketogenesis, and anaplerosis in the perfused rat liver.

    Science.gov (United States)

    Deng, Shuang; Zhang, Guo-Fang; Kasumov, Takhar; Roe, Charles R; Brunengraber, Henri

    2009-10-09

    We investigated the interrelations between C(4) ketogenesis (production of beta-hydroxybutyrate + acetoacetate), C(5) ketogenesis (production of beta-hydroxypentanoate + beta-ketopentanoate), and anaplerosis in isolated rat livers perfused with (13)C-labeled octanoate, heptanoate, or propionate. Mass isotopomer analysis of C(4) and C(5) ketone bodies and of related acyl-CoA esters reveal that C(4) and C(5) ketogenesis share the same pool of acetyl-CoA. Although the uptake of octanoate and heptanoate by the liver are similar, the rate of C(5) ketogenesis from heptanoate is much lower than the rate of C(4) ketogenesis from octanoate. This results from the channeling of the propionyl moiety of heptanoate into anaplerosis of the citric acid cycle. C(5) ketogenesis from propionate is virtually nil because acetoacyl-CoA thiolase does not favor the formation of beta-ketopentanoyl-CoA from propionyl-CoA and acetyl-CoA. Anaplerosis and gluconeogenesis from heptanoate are inhibited by octanoate. The data have implications for the design of diets for the treatment of long chain fatty acid oxidation disorders, such as the triheptanoin-based diet.

  6. Interrelations between C4 Ketogenesis, C5 Ketogenesis, and Anaplerosis in the Perfused Rat Liver*

    Science.gov (United States)

    Deng, Shuang; Zhang, Guo-Fang; Kasumov, Takhar; Roe, Charles R.; Brunengraber, Henri

    2009-01-01

    We investigated the interrelations between C4 ketogenesis (production of β-hydroxybutyrate + acetoacetate), C5 ketogenesis (production of β-hydroxypentanoate + β-ketopentanoate), and anaplerosis in isolated rat livers perfused with 13C-labeled octanoate, heptanoate, or propionate. Mass isotopomer analysis of C4 and C5 ketone bodies and of related acyl-CoA esters reveal that C4 and C5 ketogenesis share the same pool of acetyl-CoA. Although the uptake of octanoate and heptanoate by the liver are similar, the rate of C5 ketogenesis from heptanoate is much lower than the rate of C4 ketogenesis from octanoate. This results from the channeling of the propionyl moiety of heptanoate into anaplerosis of the citric acid cycle. C5 ketogenesis from propionate is virtually nil because acetoacyl-CoA thiolase does not favor the formation of β-ketopentanoyl-CoA from propionyl-CoA and acetyl-CoA. Anaplerosis and gluconeogenesis from heptanoate are inhibited by octanoate. The data have implications for the design of diets for the treatment of long chain fatty acid oxidation disorders, such as the triheptanoin-based diet. PMID:19666922

  7. Prevalence of myocardial perfusion abnormalities in end-stage liver disease

    International Nuclear Information System (INIS)

    Fathala, Ahmed; Safar, Bander; Al Muhaideb, Ahmed

    2011-01-01

    The prevalence of coronary artery disease (CAD) in end-stage liver disease (ESLD) being evaluated for orthotopic liver transplantation (OLT) is unclear based on variable definition used for CAD. The aim of this study to investigate the prevalence of abnormal stress myocardial perfusion single-photon emission computed tomography (MPS) imaging, as a marker for CAD, among patients with ESLD who were referred for stress MPS imaging as a routine work up before OLT. This was a single-center, retrospective study. We reviewed data on 167 patients who were referred for MPS as a routine work up before OLT over the last 2 years. All patients underwent evaluation for CAD risk factors [age, hypercholesterolemia, diabetes mellitus (DM), hypertension (HTN), and smoking], and stress MPS as per standard protocol. The total number of patients referred for stress MPS was 167. Seven patients (4% of total study population) were excluded from the study due to poor and/or nondiagnostic studies. 147 patients (92%) had normal, but only 13 patients (8%) had abnormal MPS scans. DM and male gender were the most independent risk factors for abnormal MPS with P value of 0.046, and 0.26, respectively. There was no significant association between the abnormal MPS result and HTN, hypercholesterolemia, smoking, age or etiology of the liver disease. Based on our data, the prevalence of abnormal MPS and left ventricular ejection fraction in patients with ESLD was found to be 8%. DM and male gender were the most independent predictor factors for abnormal MPS. True prevalence of CAD and usefulness of MPS in patients with ESLD can only be studied using a very large and randomized prospective study

  8. Metastases to the Liver from Neuroendocrine Tumors: Effect of Duration of Scan Acquisition on CT Perfusion Values

    Science.gov (United States)

    Hobbs, Brian P.; Chandler, Adam G.; Anderson, Ella F.; Herron, Delise H.; Charnsangavej, Chusilp; Yao, James

    2013-01-01

    Purpose To assess the effects of acquisition duration on computed tomographic (CT) perfusion parameter values in neuroendocrine liver metastases and normal liver tissue. Materials and Methods This retrospective study was institutional review board approved, with waiver of informed consent. CT perfusion studies in 16 patients (median age, 57.5 years; range, 42.0–69.7 years), including six men (median, 54.1 years; range, 42.0–69.7), and 10 women (median, 59.3 years; range 43.6–66.3), with neuroendocrine liver metastases were analyzed by means of distributed parametric modeling to determine tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction for tumors and normal liver tissue. Analyses were undertaken with acquisition time of 12–590 seconds. Nonparameteric regression analyses were used to evaluate the functional relationships between CT perfusion parameters and acquisition duration. Evidence for time invariance was evaluated for each parameter at multiple time points by inferring the fitted derivative to assess its proximity to zero as a function of acquisition time by using equivalence tests with three levels of confidence (20%, 70%, and 90%). Results CT perfusion parameter values varied, approaching stable values with increasing acquisition duration. Acquisition duration greater than 160 seconds was required to obtain at least low confidence stability in any of the CT perfusion parameters. At 160 seconds of acquisition, all five CT perfusion parameters stabilized with low confidence in tumor and normal tissues, with the exception of hepatic arterial fraction in tumors. After 220 seconds of acquisition, there was stabilization with moderate confidence for blood flow, blood volume, and hepatic arterial fraction in tumors and normal tissue, and for mean transit time in tumors; however, permeability values did not satisfy the moderate stabilization criteria in both tumors and normal tissue until 360 seconds of

  9. A novel hypothermic machine perfusion system using a LifePort Kidney Transporter for the preservation of rat liver

    Science.gov (United States)

    Zeng, Cheng; Hu, Xiaoyan; Wang, Yanfeng; Zeng, Xianpeng; Xiong, Yan; Li, Ling; Ye, Qifa

    2018-01-01

    The protective mechanisms for liver preservation associated with hypothermic machine perfusion (HMP) remain unclear. However, the lack of a common and portable HMP system for rat livers limits the study of HMP. The present study aimed to develop a novel, modified HMP system using a LifePort Kidney Transporter for preserving rat livers. A simple ‘Y’ shunt combined with a pressoreceptor for flow and pressure regulation was adapted to perfuse rat livers via the portal vein continuously using a LifePort Kidney Transporter under its ‘prime mode’ setting. An electronic scale was installed under the liver container to calculate the portal inflow according to the association with weight, density and volume of the perfusate. A total of 10 rat livers underwent 6 h of HMP using histidine-tryptophan-ketoglutarate solution enriched with acridine orange (AO) and propidium iodide (PI). The perfusion status of HMP was assessed by comparison of AO+PI-positive cell count in core region (CR) and peripheral region (PR) of rat liver under fluorescence microscopy. The dynamics (inflow, pressure and intrahepatic resistance of perfusion) were assessed to identify whether this system met the demands for HMP of rat livers. Biochemical [alanine transaminase (ALT), lactate dehydrogenase (LDH) and endothelin levels] and histological parameters (sinusoidal dilatation, endothelial cell detachment and vacuolization) were measured to determine cellular damage associated with HMP. No significant difference was observed between the CR and PR according to the comparison of the AO+PI-positive cell count, which indicated that complete perfusion was achieved. Intrahepatic resistance significantly decreased during the initial 3 h of HMP (P<0.01), but remained stable during the final 3 h. ALT and LDH levels significantly increased over the 6 h HMP duration: ALT (0 h, 42.67±5.81 U/l; 3 h, 90.67±6.74 U/l; 6 h, 164.33±7.31 U/l; P<0.01) and LDH (0 h, 492.90±90.20 U/l; 3 h, 973.53±97.4; 6 h, 1

  10. Correlation between serum VEGF level and CT perfusion imaging in patients with primary liver cancer pre-and post TACE

    International Nuclear Information System (INIS)

    Jia Zhongzhi; Huang Yuanquan; Feng Yaoliang; Shi Haibin

    2010-01-01

    Objective: To investigate the correlation between serum vascular endothelial growth factor(VEGF) level and CT perfusion parameters in patients with primary liver cancer (PLC) pre-and post-transcatheter arterial chemoembolization (TACE) treatment. Methods: Serum VEGF level was measured and CT perfusion imaging was performed 1 day before and 6 ∼ 8, 32 ∼ 40 days after TACE in 18 patients with PLC. Before and after TACE, the serum VEGF level, the tumor's artery liver perfusion (ALP), the portal vein perfusion (PVP) and the hepatic artery perfusion index (HPI) were measured pre-and post-TACE. The pre-TACE and post-TACE results were compared and statistically analyzed. Results: Based on the therapeutic results, the patients were divided into complete response (CR) group and partial response or stable disease(PR+SD) group. Although no significant difference in serum VEGF level, tumor's ALP, PVP and HPI existed between two groups pre-TACE, there was significant difference in ALP, HPI 6-8 days after TACE (P<0.05). Significant difference in serum VEGF level also existed in CR group (P<0.05), but not in (PR+SD) group, at (32-40) days post-TACE (P=0.221). The serum VEGF level carried a positive correlation with the tumor's ALP and HPI. Conclusion: The serum VEGF level can indirectly reflect the neovascularization of the tumor, while the CTPI can directly and quantitatively reflect the hemodynamic changes of the tumor post-TACE. Moreover, a positive correlation exists between serum VEGF level and ALP, HPI. Therefore, the determination of serum VEGF level together with CTPI is very useful in both evaluating TACE efficacy and making therapeutic schedule. (authors)

  11. Perfusion maps of the whole liver based on high temporal and spatial resolution contrast-enhanced MRI (4D THRIVE): Feasibility and initial results in focal liver lesions

    International Nuclear Information System (INIS)

    Coenegrachts, Kenneth; Ghekiere, Johan; Denolin, Vincent; Gabriele, Beck; Herigault, Gwen; Haspeslagh, Marc; Daled, Peter; Bipat, Shandra; Stoker, Jaap; Rigauts, Hans

    2010-01-01

    Purpose: To prospectively evaluate a new imaging sequence (4D THRIVE) for whole liver perfusion in high temporal and spatial resolution. Feasibility of parametric mapping and its potential for characterizing focal liver lesions (FLLs) are investigated. Materials and methods: Fifteen patients suspected for colorectal liver metastases (LMs) were included. Parametric maps were evaluated qualitatively (ring-enhancement and lesion heterogeneity) and compared to three-phased contrast-enhanced MRI. Quantitative analysis was based on average perfusion values of entire FLLs. Reference standard comprised surgery with histopathology or follow-up imaging. Fisher's exact test was used for qualitative and Kruskal-Wallis test for quantitative analysis. Results: In total 29 LMs, 17 hemangiomas and 4 focal nodular hyperplasias were evaluated. FLLs could be differentiated by qualitative assessment of parametric maps respectively three-phased contrast-enhanced MRI (Fisher's p < 0.001 for comparisons between LMs and hemangiomas and LMs and FNHs for both ring-enhancement and lesion heterogeneity) rather than by quantitative analysis of parametric maps (Chi-square for Kep = 0.33 (p = 0.847) and Chi-square for Kel = 1.35 (p = 0.509)). Conclusion: This preliminary study shows potential of 4D THRIVE for whole liver imaging enabling calculation of parametric maps. Qualitative rather than quantitative analysis was accurate for differentiating malignant and benign FLLs.

  12. Zonation of the action of ethanol on gluconeogenesis and ketogenesis studied in the bivascularly perfused rat liver.

    Science.gov (United States)

    Lopez, Carlos Henrique; Suzuki-Kemmelmeier, Fumie; Constantin, Jorgete; Bracht, Adelar

    2009-01-27

    Zonation of the actions of ethanol on gluconeogenesis and ketogenesis from lactate were investigated in the bivascularly perfused rat liver. Livers from fasted rats were perfused bivascularly in the antegrade and retrograde modes. Ethanol and lactate were infused into the hepatic artery (antegrade and retrograde) and portal vein. A previously described quantitative analysis that takes into account the microcirculatory characteristics of the rat liver was extended to the analysis of zone-specific effects of inhibitors. Confirming previous reports, gluconeogenesis and the corresponding oxygen uptake increment due to saturable lactate infusions were more pronounced in the periportal region. Arterially infused ethanol inhibited gluconeogenesis more strongly in the periportal region (inhibition constant=3.99+/-0.22mM) when compared to downstream localized regions (inhibition constant=8.64+/-2.73mM). The decrease in oxygen uptake caused by ethanol was also more pronounced in the periportal zone. Lactate decreased ketogenesis dependent on endogenous substrates in both regions, periportal and perivenous, but more strongly in the former. Ethanol further inhibited ketogenesis, but only in the periportal zone. Stimulation was found for the perivenous zone. The predominance of most ethanol effects in the periportal region of the liver is probably related to the fact that its transformation is also clearly predominant in this region, as demonstrated in a previous study. The differential effect on ketogenesis, on the other hand, suggest that the net effects of ethanol are the consequence of a summation of several partial effects with different intensities along the hepatic acini.

  13. Gluconeogenesis and ketogenesis in perfused liver of rats submitted to short-term insulin-induced hypoglycaemia.

    Science.gov (United States)

    Albuquerque, G G; Gazola, V A F G; Garcia, R F; Souza, K L A; Barrena, H C; Curi, R; Bazotte, R B

    2008-01-01

    Gluconeogenesis and ketogenesis of in situ rat perfused liver submitted to short-term insulin-induced hypoglycaemia (IIH) were investigated. For this purpose, 24-h fasted rats that received intraperitoneal (ip) regular insulin (1.0 U kg(-1)) or saline were compared. The studies were performed 30 min after insulin (IIH group) or saline (COG group) injection. For gluconeogenesis studies, livers from the IIH and COG groups were perfused with increasing concentrations (from basal blood concentrations until saturating concentration) of glycerol, L-lactate (Lac) or pyruvate (Pyr). Livers of the IIH group showed maintained efficiency to produce glucose from glycerol and higher efficiency to produce glucose from Lac and Pyr. In agreement with these results the oral administration of glycerol (100 mg kg(-1)), Lac (100 mg kg(-1)), Pyr (100 mg kg(-1)) or glycerol (100 mg kg(-1)) + Lac (100 mg kg(-1)) + Pyr (100 mg kg(-1)) promoted glycaemia recovery. It can be inferred that the increased portal availability of Lac, Pyr and glycerol could help glycaemia recovery by a mechanism mediated, partly at least, by a maintained (glycerol) or increased (Lac and Pyr) hepatic efficiency to produce glucose. Moreover, in spite of the fact that insulin inhibits ketogenesis, the capacity of the liver to produce ketone bodies from octanoate during IIH was maintained. Copyright 2007 John Wiley & Sons, Ltd.

  14. A detoxication route for acetaldehyde: metabolism of diacetyl, acetoin, and 2,3-butanediol in liver homogenate and perfused liver of rats.

    Science.gov (United States)

    Otsuka, M; Mine, T; Ohuchi, K; Ohmori, S

    1996-02-01

    The metabolism of diacetyl (2,3-butanedione), acetoin (3-hydroxy-2-butanone), and 2,3-butanediol, which are metabolites of acetaldehyde was quantitatively investigated using rat liver homogenate, liver perfusion, and in vivo experiments. Diacetyl and acetoin were reduced to 2,3-butanediol in these experiments, but acetoin and 2,3-butanediol were scarcely oxidized to diacetyl, indicating that the reduction reaction to 2,3-butanediol from diacetyl occurs actively in rat liver. The formation of acetoin from diacetyl required either NADH or NADPH as a reductant, while the reduction of acetoin to 2,3-butanediol required NADH. Acetoin and 2,3-butanediol were more readily accumulated than diacetyl in brain tissue.

  15. Comparative study of rabbit VX2 hepatic implantation tumor and normal liver tissue on magnetic resonance perfusion weighted imaging

    International Nuclear Information System (INIS)

    Jiao Zimei; Wang Xizhen; Wang Bin; Liu Feng; Li Haiqing; Sun Yequan; Dong Peng

    2012-01-01

    Objective: To investigate the value of magnetic resonance (MR) perfusion weighted imaging (PWI) in evaluating the blood perfusion of tumor by analyzing the features and indexes of PWI on rabbit VX2 hepatic implantation tumor and normal liver tissue. Methods: Twenty-four New Zealand White rabbits with VX2 carcinoma were established under direct surgical vision embedding tumor tissue. MR examination was performed at 21 days after the tumor implantation. The signal intensity -time curve of hepatic tumor and normal liver tissue were obtained. Mean time to enhance (MTE), negative enhancement integral (NEI), time to minimum (TM), maximum slope of decrease (MSD) and maximum slope of increase (MSI) were measured. Results: MTE, NEI, TM, MSD, and MSI of the normal liver tissue were 208.341±2.226 ms, 78.334±8.152, 24.059±1.927 ms, 38.221±2.443, and 15.389±2.526, respectively. MTE, NEI, TM, MSD, and MSI of the tumor tissue were 175.437±4.182 ms, 123.203±19.455, 17.061±1.834 ms, 125.740±4.842, and 67.832±2.882, respectively. The MTE and TM of tumor were shorter than those of normal hepatic tissue (P<0.05). NEI, MSD, and MSI of tumor were higher than those of normal hepatic tissue (P<0.05). Conclusion: PWI can distinguish the normal liver tissue from the tumor tissue, which is helpful in evaluating blood perfusion of different hepatic tissues. (authors)

  16. MRI-based assessment of liver perfusion and hepatocyte injury in the murine model of acute hepatitis.

    Science.gov (United States)

    Byk, Katarzyna; Jasinski, Krzysztof; Bartel, Zaneta; Jasztal, Agnieszka; Sitek, Barbara; Tomanek, Boguslaw; Chlopicki, Stefan; Skorka, Tomasz

    2016-12-01

    To assess alterations in perfusion and liver function in the concanavalin A (ConA)-induced mouse model of acute liver failure (ALF) using two magnetic resonance imaging (MRI)-based methods: dynamic contrast-enhanced MRI (DCE-MRI) with Gd-EOB-DTPA contrast agent and arterial spin labelling (ASL). BALB/c mice were studied using a 9.4 T MRI system. The IntraGateFLASH TM and FAIR-EPI pulse sequences were used for optimum mouse abdomen imaging. The average perfusion values for the liver of the control and ConA group were equal to 245 ± 20 and 200 ± 32 ml/min/100 g (p = 0.008, respectively). DCE-MRI showed that the time to the peak of the image enhancement was 6.14 ± 1.07 min and 9.72 ± 1.69 min in the control and ConA group (p < 0.001, respectively), while the rate of the contrast wash-out in the control and ConA group was 0.037 ± 0.008 and 0.021 ± 0.008 min -1 (p = 0.004, respectively). These results were consistent with hepatocyte injury in the ConA-treated mice as confirmed by histopathological staining. Both the ASL and DCE-MRI techniques represent a reliable methodology to assess alterations in liver perfusion and hepatocyte integrity in murine hepatitis.

  17. The effect of carnitine on ketogenesis in perfused livers from juvenile visceral steatosis mice with systemic carnitine deficiency.

    Science.gov (United States)

    Nakajima, T; Horiuchi, M; Yamanaka, H; Kizaki, Z; Inoue, F; Kodo, N; Kinugasa, A; Saheki, T; Sawada, T

    1997-07-01

    Juvenile visceral steatosis (JVS) mice have been reported to have systemic carnitine deficiency, and the carnitine concentration in the liver of JVS mice was markedly lower than that of controls (11.6 +/- 2.6 versus 393.5 +/- 56.4 nmol/g of wet liver). To evaluate the role of carnitine in mitochondrial beta-oxidation in liver, we examined the effects of carnitine on ketogenesis in perfused liver from control and JVS mice. In control mice, ketogenesis was increased by the infusion of 0.3 mM oleate, but not by L-carnitine. In contrast, although ketogenesis in JVS mice was not increased by the infusion of oleate, it was increased 2.5-fold by the addition of 1000 microM L-carnitine. Addition of 50, 100, and 200 microM L-carnitine increased ketogenesis in a dose-dependent manner. The infusion of 0.3 mM octanoate or butyrate increased ketogenesis in a carnitine-independent fashion in both control and JVS mice. These findings suggest that endogenous long chain fatty acids from accumulated triglycerides may be used as substrates in the presence of carnitine in JVS mice. The relationship between ketogenesis and free carnitine concentration was examined in livers from JVS mice. Ketogenesis increased as free carnitine levels increased until concentrations exceeded about 100 nmol/g of wet liver (340 microM). The free carnitine concentration required for half-maximal ketone body production in liver of JVS mice was 45 microM (13 nmol/g of wet liver), which corresponds to a K(m) value of carnitine palmitoyltransferase I. We conclude that carnitine is a rate-limiting factor for beta-oxidation in liver only when the carnitine level in liver is very low.

  18. Portal venous perfusion steal causing graft dysfunction after orthotopic liver transplantation: serial imaging findings in a successfully treated patient

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Su; Chung, Yong Eun; Choi, Jin Young; Park, Mi Suk; Lim, Joon Seok; Kim, Myeong Jin; Kim, Hon Soul [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Kyun [Dept. of Pathology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    A 53-year-old male with hepatocellular carcinoma underwent orthotopic liver transplantation. Preoperative computed tomography revealed main portal vein luminal narrowing by flat thrombi and the development of cavernous transformation. On post-transplantation day 1, thrombotic portal venous occlusion occurred, and emergency thrombectomy was performed. Subsequent Doppler ultrasonography and contrast-enhanced ultrasonography confirmed the restoration of normal portal venous flow. The next day, however, decreased portal venous velocity was observed via Doppler ultrasonography, and serum liver enzymes and bilirubin levels remained persistently elevated. Direct portography identified massive perfusion steal through prominent splenorenal collateral veins. Stent insertion and balloon angioplasty of the portal vein were performed, and subsequent Doppler ultrasonography demonstrated normalized portal flow parameters. Afterwards, the serum liver enzymes and bilirubin levels rapidly normalized.

  19. Cerebral blood flow measured by positron emission tomography during normothermic cardiopulmonary bypass: an experimental porcine study.

    Science.gov (United States)

    Thomassen, Sisse Anette; Kjærgaard, Benedict; Alstrup, Aage Kristian Olsen; Munk, Ole Lajord; Frøkiær, Jørgen; Larsson, Anders; Rasmussen, Bodil Steen

    2018-01-01

    Mean arterial blood pressure (MAP) and/or pump flow during normothermic cardiopulmonary bypass (CPB) are the most important factors of cerebral perfusion. The aim of this study was to explore the influence of CPB blood flow on cerebral blood flow (CBF) measured by dynamic positron emission tomography (PET) using 15 O-labelled water with no pharmacological interventions to maintain the MAP. Eight pigs (69-71 kg) were connected to normothermic CPB. After 60 minutes (min) with a CPB pump flow of 60 mL/kg/min, the pigs were changed to either 35 mL/kg/min or 47.5 mL/kg/min for 60 min and, thereafter, all the pigs returned to 60 mL/kg/min for another 60 min. The MAP was measured continuously and the CBF was measured by positron emission tomography (PET) during spontaneous circulation and at each CPB pump flow after 30 min of steady state. Two pigs were excluded due to complications. CBF increased from spontaneous circulation to a CPB pump flow of 60 mL/kg/min. A reduction in CPB pump flow to 47.5 mL/kg/min (n=3) resulted in only minor changes in CBF while a reduction to 35 mL/kg/min (n=3) caused a pronounced change (correlation coefficient (R 2 ) 0.56). A return of CPB pump flow to 60 mL/kg/min was followed by an increase in CBF, except in the one pig with the lowest CBF during low flow (R 2 =0.44). CBF and MAP were not correlated (R 2 =0.20). In this experimental porcine study, a relationship was observed between pump flow and CBF under normothermic low-flow CPB. The effect of low pump flow on MAP showed substantial variations, with no correlation between CBF and MAP.

  20. Comparison of microvascular perfusion evaluation among IVIM-DWI, CT perfusion imaging and histological microvessel density in rabbit liver VX2 tumors.

    Science.gov (United States)

    Li, Jing-Lei; Ye, Wei-Tao; Liu, Zai-Yi; Yan, Li-Fen; Luo, Wei; Cao, Xi-Ming; Liang, Changhong

    2018-02-01

    To explore microcirculation features with intravoxel incoherent motion (IVIM) and to compare IVIM with CT perfusion imaging (CTPI) and microvessel density (MVD). Hepatic CTPI and IVIM were performed in 16 rabbit liver VX2 tumor models. Hepatic arterial perfusion (HAP), hepatic arterial perfusion index (HPI), Blood flow (BF), and blood volume (BV) from CTPI were measured. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudo-diffusion coefficient (D*) from IVIM were measured. MVD was counted with CD34 stain. The microcirculation features with IVIM were compared with CTPI parameters and MVD. Strong linear correlations were found between D value (0.89±0.21×10 -3 mm 2 /s) and HAP (15.83±6.97ml/min/100mg) (r=0.755, P=0.001) and between f value (12.64±6.66%) and BV (9.74±5.04ml/100mg) (r=0.693, P=0.004). Moderate linear correlations were observed between ADC (1.07±0.32×10 -3 mm 2 /s) and HAP (r=0.538, P=0.039), respectively; and between D value and MVD (9.31±2.57 vessels at 400×magnification) (r=0.509, P=0.044). No correlations were found between D* (119.90±37.67×10 -3 mm 2 /s) and HAP, HPI (68.34±12.91%), BF (4.95±2.16ml/min/100mg), BV. IVIM parameters can characterize microcirculation to certain extent and separate it from pure water molecular diffusion. There is fair correlation between D or ADC value and CTPI parameters or MVD, but no correlation between D* or f value and CTPI parameters or MVD except f value and BV, which is still unclear and need further clinical studies to validate. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Short fasting does not protect perfused ex vivo rat liver against ischemia-reperfusion. On the importance of a minimal cell energy charge.

    Science.gov (United States)

    Papegay, Bérengère; Stadler, Michaela; Nuyens, Vincent; Kruys, Véronique; Boogaerts, Jean G; Vamecq, Joseph

    2017-03-01

    Dietary restriction or reduced food intake was supported to protect against renal and hepatic ischemic injury. In this vein, short fasting was recently shown to protect in situ rat liver against ischemia-reperfusion. Here, perfused ex vivo instead of in situ livers were exposed to ischemia-reperfusion to study the impact of disconnecting liver from extrahepatic supply in energetic substrates on the protection given by short-term fasting. Perfused ex vivo livers using short (18 h) fasted compared with fed rats were submitted to ischemia-reperfusion and studied for release of cytolysis markers in the perfusate. Energetic stores are differently available in time and cell energetic charges (ratio of adenosine triphosphate plus half of the adenosine diphosphate concentrations to the sum of adenosine triphosphate + adenosine diphosphate + adenosine monophosphate concentrations), adenosine phosphates, and glycogen, which were further measured at different time points in livers. Short fasting versus feeding failed to protect perfused ex vivo rat livers against ischemia/reperfusion, increasing the release of cytolysis markers (potassium, cytochrome c, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase) in the perfusate during reoxygenation phase. Toxicity of short fasting versus feeding was associated with lower glycogen and energetic charges in livers and lower lactate levels in the perfusate. High energetic charge, intracellular content in glycogen, and glycolytic activity may protect liver against ischemia/reperfusion injury. This work does not question how much the protective role previously demonstrated in the literature for dietary restriction and short fasting. In fact, it suggests that exceeding the energy charge threshold value of 0.3 might trigger the effectiveness of this protective role. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Cerebral blood flow measured by positron emission tomography during normothermic cardiopulmonary bypass: An experimental porcine study

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Kjaergaard, Benedict; Alstrup, Aage Kristian Olsen

    2018-01-01

    min and, thereafter, all the pigs returned to 60 mL/kg/min for another 60 min. The MAP was measured continuously and the CBF was measured by positron emission tomography (PET) during spontaneous circulation and at each CPB pump flow after 30 min of steady state. Results: Two pigs were excluded due...... emission tomography (PET) using 15O-labelled water with no pharmacological interventions to maintain the MAP. Methods: Eight pigs (69-71 kg) were connected to normothermic CPB. After 60 minutes (min) with a CPB pump flow of 60 mL/kg/min, the pigs were changed to either 35 mL/kg/min or 47.5 mL/kg/min for 60......Background: Mean arterial blood pressure (MAP) and/or pump flow during normothermic cardiopulmonary bypass (CPB) are the most important factors of cerebral perfusion. The aim of this study was to explore the influence of CPB blood flow on cerebral blood flow (CBF) measured by dynamic positron...

  3. Comparison of four physiological models for analysis of glucose wash-in curves in the perfused rat liver

    International Nuclear Information System (INIS)

    Le Couteur, D.G.; McLean, A.J.; Yin, Z.L.; Rivory, L.P.

    2001-01-01

    Full text: Oxygen diffusion may be involved in the pathogenesis of impaired drug metabolism by the aged (Le Couteur and McLean 1998) and cirrhotic (McLean and Morgan 1991) liver. To measure the barrier for oxygen transfer between the sinusoid and hepatocyte, we developed a carbon monoxide wash-in technique (Le Couteur et al 1999). The modelling of wash-in curves has been investigated much less intensively than multiple indicator dilution experiments, which utilize bolus injection of substrates. To investigate the effectiveness of various physiological models to fit wash-in curves, we performed wash-in experiments on the livers of male Wistar rats perfused in situ and single-pass with Krebs Henseleit buffer. Test perfusate contained 14 C-sucrose as the extracellular marker and 3 H-glucose. Liver perfusions were performed with background glucose concentrations of 6, 11, 51 or 109 mM. Outflow time-activity curves were analysed using four models. The V max and K m , for the influx of glucose were 1.1±0.03 μg/s/ml and 41.1±3.3 mM using the Crone-Renkin early extraction model; 1.4±0.04 μg/s/ml and 36.3±2.6 mM with dispersion model analysis; 1.8±0.1 μg/s/ml and 24.9±4.2 mM using the Goresky distributed model to fit differentiated wash-in curves; and 2.3±0.5 μg/s/ml and 29.3±16.5 mM using compartmental analysis. There was reasonable agreement between the four models and they yielded results that are similar to those reported for glucose uptake in other preparations. The differences between the models probably reflect differences in assumptions about the effects of efflux, mixing of glucose in the compartments and vascular hetereogeneity. The compartmental model that we used previously to examine gas disposition in the perfused liver gave higher estimates for transport than the other three models. Copyright (2001) Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists

  4. Kinetics of the transformation of n-propyl gallate and structural analogs in the perfused rat liver

    Energy Technology Data Exchange (ETDEWEB)

    Eler, Gabrielle Jacklin; Santos, Israel Souza; Giaretta de Moraes, Amarilis; Mito, Márcio Shigueaki; Comar, Jurandir Fernando; Peralta, Rosane Marina; Bracht, Adelar, E-mail: adebracht@uol.com.br

    2013-11-15

    n-Propyl gallate and its analogs are used in foods and other products to prevent oxidation. In the liver the compound exerts several harmful effects, especially gluconeogenesis inhibition. The mode of transport and distribution of n-propyl gallate and its kinetics of biotransformation have not yet been investigated. To fill this gap the transformation, transport and distribution of n-propyl gallate and two analogs were investigated in the rat liver. Isolated perfused rat liver was used. n-Propyl gallate, methyl gallate, n-octyl gallate and transformation products were quantified by high pressure-liquid chromatography coupled to fluorescence detection. The interactions of n-propyl gallate and analogs with the liver presented three main characteristics: (1) the hydrolytic release of gallic acid from n-propyl gallate and methyl gallate was very fast compared with the subsequent transformations of the gallic acid moiety; (2) transport of the esters was very fast and flow-limited in contrast to the slow and barrier-limited transport of gallic acid; (3) the apparent distribution volume of n-propyl gallate, but probably also of methyl gallate and n-octyl gallate, greatly exceeded the water space in the liver, contrary to the gallic acid space which is smaller than the water space. It can be concluded that at low portal concentrations (< 50 μM) the gallic acid esters are 100% extracted during a single passage through the liver, releasing mainly gallic acid into the systemic circulation. For the latter a considerable time is required until complete biotransformation. The exposure of the liver to the esters, however, is quite prolonged due to extensive intracellular binding. - Highlights: • The liver binds very strongly n-propyl gallate and releases basically gallic acid. • n-propyl gallate and analogs undergo concentrative flow-limited distribution. • Gallic acid undergoes barrier-limited distribution and is slowly transformed. • The long residence time of n

  5. CT Perfusion Imaging Can Predict Patients' Survival and Early Response to Transarterial Chemo-Lipiodol Infusion for Liver Metastases from Colorectal Cancers

    OpenAIRE

    Lv, Wei-Fu; Han, Jian-Kui; Cheng, De-Lei; Zhou, Chun-Ze; Ni, Ming; Lu, Dong

    2015-01-01

    Objective To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). Materials and Methods Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified...

  6. Ketogenesis evaluation in perfused liver of diabetic rats submitted to short-term insulin-induced hypoglycemia.

    Science.gov (United States)

    Barrena, Helenton Cristhian; Gazola, Vilma Aparecida Ferreira Godoi; Furlan, Maria Montserrat Diaz Pedrosa; Garcia, Rosângela Fernandes; de Souza, Helenir Medri; Bazotte, Roberto Barbosa

    2009-08-01

    Ketogenesis, inferred by the production of acetoacetate plus ss-hydroxybutyrate, in isolated perfused livers from 24-h fasted diabetic rats submitted to short-term insulin-induced hypoglycemia (IIH) was investigated. For this purpose, alloxan-diabetic rats that received intraperitoneal regular insulin (IIH group) or saline (COG group) injection were compared. An additional group of diabetic rats which received oral glucose (gavage) (100 mg kg(-1)) 15 min after insulin administration (IIH + glucose group) was included. The studies were performed 30 min after insulin (1.0 U kg(-1)) or saline injection. The ketogenesis before octanoate infusion was diminished (p ketogenesis, livers from diabetic rats submitted to short-term IIH which received insulin or insulin plus glucose showed maintained capacity to produce acetoacetate and ss-hydroxybutyrate from octanoate. (c) 2009 John Wiley & Sons, Ltd.

  7. Studying Closed Hydrodynamic Models of “In Vivo” DNA Perfusion in Pig Liver for Gene Therapy Translation to Humans

    Science.gov (United States)

    Sendra, Luis; Miguel, Antonio; Pérez-Enguix, Daniel; Montalvá, Eva; García-Gimeno, María Adelaida; Noguera, Inmaculada; Díaz, Ana; Pérez, Judith; Sanz, Pascual; López-Andújar, Rafael; Martí-Bonmatí, Luis; Aliño, Salvador F.

    2016-01-01

    Introduction Expressing exogenous genes after naked DNA delivery into hepatocytes might achieve sustained and high expression of human proteins. Tail vein DNA injection is an efficient procedure for gene transfer in murine liver. Hydrodynamic procedures in large animals require organ targeting, and improve with liver vascular exclusion. In the present study, two closed liver hydrofection models employing the human alpha-1-antitrypsin (hAAT) gene are compared to reference standards in order to evaluate their potential clinical interest. Material and Methods A solution of naked DNA bearing the hAAT gene was retrogradely injected in 7 pig livers using two different closed perfusion procedures: an endovascular catheterization-mediated procedure (n = 3) with infrahepatic inferior vena cava and portal vein blockage; and a surgery-mediated procedure (n = 4) with completely sealed liver. Gene transfer was performed through the suprahepatic inferior cava vein in the endovascular procedure and through the infrahepatic inferior vena cava in the surgical procedure. The efficiency of the procedures was evaluated 14 days after hydrofection by quantifying the hAAT protein copies per cell in tissue and in plasma. For comparison, samples from mice (n = 7) successfully hydrofected with hAAT and healthy human liver segments (n = 4) were evaluated. Results Gene decoding occurs efficiently using both procedures, with liver vascular arrest improving its efficiency. The surgically closed procedure (sealed organ) reached higher tissue protein levels (4x10^5- copies/cell) than the endovascular procedure, though the levels were lower than in human liver (5x10^6- copies/cell) and hydrofected mouse liver (10^6- copies/cell). However, protein levels in plasma were lower (p<0.001) than the reference standards in all cases. Conclusion Hydrofection of hAAT DNA to “in vivo” isolated pig liver mediates highly efficient gene delivery and protein expression in tissue. Both endovascular and

  8. Studying Closed Hydrodynamic Models of "In Vivo" DNA Perfusion in Pig Liver for Gene Therapy Translation to Humans.

    Directory of Open Access Journals (Sweden)

    Luis Sendra

    Full Text Available Expressing exogenous genes after naked DNA delivery into hepatocytes might achieve sustained and high expression of human proteins. Tail vein DNA injection is an efficient procedure for gene transfer in murine liver. Hydrodynamic procedures in large animals require organ targeting, and improve with liver vascular exclusion. In the present study, two closed liver hydrofection models employing the human alpha-1-antitrypsin (hAAT gene are compared to reference standards in order to evaluate their potential clinical interest.A solution of naked DNA bearing the hAAT gene was retrogradely injected in 7 pig livers using two different closed perfusion procedures: an endovascular catheterization-mediated procedure (n = 3 with infrahepatic inferior vena cava and portal vein blockage; and a surgery-mediated procedure (n = 4 with completely sealed liver. Gene transfer was performed through the suprahepatic inferior cava vein in the endovascular procedure and through the infrahepatic inferior vena cava in the surgical procedure. The efficiency of the procedures was evaluated 14 days after hydrofection by quantifying the hAAT protein copies per cell in tissue and in plasma. For comparison, samples from mice (n = 7 successfully hydrofected with hAAT and healthy human liver segments (n = 4 were evaluated.Gene decoding occurs efficiently using both procedures, with liver vascular arrest improving its efficiency. The surgically closed procedure (sealed organ reached higher tissue protein levels (4x10^5- copies/cell than the endovascular procedure, though the levels were lower than in human liver (5x10^6- copies/cell and hydrofected mouse liver (10^6- copies/cell. However, protein levels in plasma were lower (p<0.001 than the reference standards in all cases.Hydrofection of hAAT DNA to "in vivo" isolated pig liver mediates highly efficient gene delivery and protein expression in tissue. Both endovascular and surgically closed models mediate high tissue protein

  9. Studying Closed Hydrodynamic Models of "In Vivo" DNA Perfusion in Pig Liver for Gene Therapy Translation to Humans.

    Science.gov (United States)

    Sendra, Luis; Miguel, Antonio; Pérez-Enguix, Daniel; Herrero, María José; Montalvá, Eva; García-Gimeno, María Adelaida; Noguera, Inmaculada; Díaz, Ana; Pérez, Judith; Sanz, Pascual; López-Andújar, Rafael; Martí-Bonmatí, Luis; Aliño, Salvador F

    2016-01-01

    Expressing exogenous genes after naked DNA delivery into hepatocytes might achieve sustained and high expression of human proteins. Tail vein DNA injection is an efficient procedure for gene transfer in murine liver. Hydrodynamic procedures in large animals require organ targeting, and improve with liver vascular exclusion. In the present study, two closed liver hydrofection models employing the human alpha-1-antitrypsin (hAAT) gene are compared to reference standards in order to evaluate their potential clinical interest. A solution of naked DNA bearing the hAAT gene was retrogradely injected in 7 pig livers using two different closed perfusion procedures: an endovascular catheterization-mediated procedure (n = 3) with infrahepatic inferior vena cava and portal vein blockage; and a surgery-mediated procedure (n = 4) with completely sealed liver. Gene transfer was performed through the suprahepatic inferior cava vein in the endovascular procedure and through the infrahepatic inferior vena cava in the surgical procedure. The efficiency of the procedures was evaluated 14 days after hydrofection by quantifying the hAAT protein copies per cell in tissue and in plasma. For comparison, samples from mice (n = 7) successfully hydrofected with hAAT and healthy human liver segments (n = 4) were evaluated. Gene decoding occurs efficiently using both procedures, with liver vascular arrest improving its efficiency. The surgically closed procedure (sealed organ) reached higher tissue protein levels (4x10^5- copies/cell) than the endovascular procedure, though the levels were lower than in human liver (5x10^6- copies/cell) and hydrofected mouse liver (10^6- copies/cell). However, protein levels in plasma were lower (p<0.001) than the reference standards in all cases. Hydrofection of hAAT DNA to "in vivo" isolated pig liver mediates highly efficient gene delivery and protein expression in tissue. Both endovascular and surgically closed models mediate high tissue protein expression

  10. Behavior of cholinesterase and liver mitochondrial function in dogs submitted to normothermic ischemia and reperfusion Colinesterase e função mitocondrial hepática em cães submetidos a isquemia normotérmica e reperfusão do fígado

    Directory of Open Access Journals (Sweden)

    Luis Pinto Fernandes

    2003-01-01

    Full Text Available PURPOSE: The plasmatic activity of the cholinesterase (CHE and the liver mitochondrial function, expressed by the ratio of respiratory control (RCR, were studied during normothermic ischemia. METHODS: Sixteen adult mongrels, eight females and eight males were submitted to ischemia by clamping of the hepatic artery, portal vein and infrahepatic inferior vena cava, infra-hepatic, for two h, follwed by reperfusion for 1 h. The CHE and the mitochondrial function were evaluated at 60 and 120 min. of ischemia and at 15 and 60 minutes of reperfusion. RESULTS: The CHE decreased, significantly, during ischemia and in reperfusion. The RCR was decreased at 120 min. of ischemia, returning to the initial values on reperfusion. CONCLUSION: In this study, the CHE was a sensitive indicator of ischemic injury , suggesting irreversibility of ischemia injury. The RCR, by other side, showed a greater sensibility than the CHE in detection sense, during the studied period, the reversibility of the hepatic ischemic injury.OBJETIVO: A atividade plasmática da colinesterase (CHE e a função mitocondrial do fígado expressa pela RCR- razão de controle respiratório mitocondrial foram estudadas durante a isquemia/reperfusão hepáticas. MÉTODOS: Dezesseis cães adultos sem raça definida (oito machos e oito fêmeas foram submetidos a isquemia normotérmica por pinçamento do pedículo hepático e da veia cava inferior infra-hepática por 2 horas, seguida de 15 e 60 minutos de reperfusão.A CHE e a RCR foram avaliadas após 60 e 120 minutos de isquemia e após 15 e 60 minutos de reperfusão. RESULTADOS: Os níveis de CHE diminuíram significativamente na isquemia e reperfusão.A RCR diminuiu após 120 minutos de isquemia retornando a níveis semelhantes ao controle após a reperfusão. CONCLUSÃO: A CHE foi sensível para indicar a lesão isquêmica, sugerindo irreversibilidade da lesão. Já a RCR foi mais sensível no sentido de detectar a reversibilidade da les

  11. Is liver perfusion CT reproducible? A study on intra- and interobserver agreement of normal hepatic haemodynamic parameters obtained with two different software packages.

    Science.gov (United States)

    Bretas, Elisa Almeida Sathler; Torres, Ulysses S; Torres, Lucas Rios; Bekhor, Daniel; Saito Filho, Celso Fernando; Racy, Douglas Jorge; Faggioni, Lorenzo; D'Ippolito, Giuseppe

    2017-10-01

    To evaluate the agreement between the measurements of perfusion CT parameters in normal livers by using two different software packages. This retrospective study was based on 78 liver perfusion CT examinations acquired for detecting suspected liver metastasis. Patients with any morphological or functional hepatic abnormalities were excluded. The final analysis included 37 patients (59.7 ± 14.9 y). Two readers (1 and 2) independently measured perfusion parameters using different software packages from two major manufacturers (A and B). Arterial perfusion (AP) and portal perfusion (PP) were determined using the dual-input vascular one-compartmental model. Inter-reader agreement for each package and intrareader agreement between both packages were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics. Inter-reader agreement was substantial for AP using software A (ICC = 0.82) and B (ICC = 0.85-0.86), fair for PP using software A (ICC = 0.44) and fair to moderate for PP using software B (ICC = 0.56-0.77). Intrareader agreement between software A and B ranged from slight to moderate (ICC = 0.32-0.62) for readers 1 and 2 considering the AP parameters, and from fair to moderate (ICC = 0.40-0.69) for readers 1 and 2 considering the PP parameters. At best there was only moderate agreement between both software packages, resulting in some uncertainty and suboptimal reproducibility. Advances in knowledge: Software-dependent factors may contribute to variance in perfusion measurements, demanding further technical improvements. AP measurements seem to be the most reproducible parameter to be adopted when evaluating liver perfusion CT.

  12. Lactate-Induced Glucose Output Is Unchanged by Metformin at a Therapeutic Concentration – A Mass Spectrometry Imaging Study of the Perfused Rat Liver

    Directory of Open Access Journals (Sweden)

    Giulio Calza

    2018-02-01

    Full Text Available Metformin is the first line drug for type 2 diabetes but its molecular mechanisms remain unclear. Here, we have studied the acute effect of a therapeutically relevant intrahepatic concentration of metformin on glucose production from lactate. We selected the perfused rat liver as experimental system since it enables the complete control of drug dosage. We used MALDI (matrix-assisted laser desorption/ionization mass spectrometry imaging to estimate the concentration of metformin in the livers and we measured the concentration of glucose in the effluent medium under basal conditions and following lactate addition. MALDI mass spectra of thin-sections of freeze-clamped rat liver perfused with metformin showed a peak at 130.16 m/z which was unambiguously assigned to metformin. The mass spectrometric detection limit was at a tissue concentration of about 250 nM, and uptake of metformin from the perfusion medium to the liver occurred with a Km of 0.44 mM. Metformin was evenly distributed in the liver irrespective of its concentration in the perfusion medium and the duration of a perfusion. At a parenchymal concentration of 30 μM, metformin did not induce any significant suppression of the basal or lactate-induced glucose release from the liver. These results show that matrix-assisted laser desorption/ionization mass spectrometry imaging can be applied to estimate the tissue concentration and distribution of metformin in a therapeutically relevant micromolar concentration range. Our findings challenge the view that metformin causes an inhibition of glucose release from the liver by an acute inhibition of mitochondrial glycerol 3-phosphate dehydrogenase (EC 1.1.5.3.

  13. Optimizing Perfusion-Decellularization Methods of Porcine Livers for Clinical-Scale Whole-Organ Bioengineering

    Directory of Open Access Journals (Sweden)

    Qiong Wu

    2015-01-01

    Full Text Available Aim. To refine the decellularization protocol of whole porcine liver, which holds great promise for liver tissue engineering. Methods. Three decellularization methods for porcine livers (1% sodium dodecyl sulfate (SDS, 1% Triton X-100 + 1% sodium dodecyl sulfate, and 1% sodium deoxycholate + 1% sodium dodecyl sulfate were studied. The obtained liver scaffolds were processed for histology, residual cellular content analysis, and extracellular matrix (ECM components evaluation to investigate decellularization efficiency and ECM preservation. Rat primary hepatocytes were seeded into three kinds of scaffold to detect the biocompatibility. Results. The whole liver decellularization was successfully achieved following all three kinds of treatment. SDS combined with Triton had a high efficacy of cellular removal and caused minimal disruption of essential ECM components; it was also the most biocompatible procedure for primary hepatocytes. Conclusion. We have refined a novel, standardized, time-efficient, and reproducible protocol for the decellularization of whole liver which can be further adapted to liver tissue engineering.

  14. A new iterative method for liver segmentation from perfusion CT scans

    Science.gov (United States)

    Draoua, Ahmed; Albouy-Kissi, Adélaïde; Vacavant, Antoine; Sauvage, Vincent

    2014-03-01

    Liver cancer is the third most common cancer in the world, and the majority of patients with liver cancer will die within one year as a result of the cancer. Liver segmentation in the abdominal area is critical for diagnosis of tumor and for surgical procedures. Moreover, it is a challenging task as liver tissue has to be separated from adjacent organs and substantially the heart. In this paper we present a novel liver segmentation iterative method based on Fuzzy C-means (FCM) coupled with a fast marching segmentation and mutual information. A prerequisite for this method is the determination of slice correspondences between ground truth that is, a few images segmented by an expert, and images that contain liver and heart at the same time.

  15. Assessment of intratumor hypoxia by integrated 18F-FDG PET / perfusion CT in a liver tumor model.

    Directory of Open Access Journals (Sweden)

    Yong Wang

    Full Text Available Hypoxia in solid tumors occurs when metabolic demands in tumor cells surpass the delivery of oxygenated blood. We hypothesize that the 18F-fluorodeoxyglucose (18F-FDG metabolism and tumor blood flow mismatch would correlate with tumor hypoxia.Liver perfusion computed tomography (CT and 18F-FDG positron emission tomography (PET imaging were performed in twelve rabbit livers implanted with VX2 carcinoma. Under CT guidance, a fiber optic probe was inserted into the tumor to measure the partial pressure of oxygen (pO2. Tumor blood flow (BF and standardized uptake value (SUV were measured to calculate flow-metabolism ratio (FMR. Tumor hypoxia was further identified using pimonidazole immunohistochemical staining. Pearson correlation analysis was performed to determine the correlation between the imaging parameters and pO2 and pimonidazole staining.Weak correlations were found between blood volume (BV and pO2 level (r = 0.425, P = 0.004, SUV and pO2 (r = -0.394, P = 0.007, FMR and pimonidazole staining score (r = -0.388, P = 0.031. However, there was stronger correlation between tumor FMR and pO2 level (r = 0.557, P < 0.001.FMR correlated with tumor oxygenation and pimonidazole staining suggesting it may be a potential hypoxic imaging marker in liver tumor.

  16. Modulation of the sympathetic nerve action on carbohydrate and ketone body metabolism by fatty acids, glucagon und insulin in perfused rat liver

    NARCIS (Netherlands)

    Küster, J.; Beuers, U.; JUNGERMANN, K.

    1989-01-01

    Rat liver was perfused in situ via the portal vein without recirculation: 1) Nerve stimulation (20 Hz, 2 ms, 20 V) increased glucose output and shifted lactate uptake to output; the alterations were diminished by oleate but not octanoate. 2) Glucagon (1nM) stimulated glucose output maximally also in

  17. Actions of p-synephrine on hepatic enzyme activities linked to carbohydrate metabolism and ATP levels in vivo and in the perfused rat liver.

    Science.gov (United States)

    Maldonado, Marcos Rodrigues; Bracht, Lívia; de Sá-Nakanishi, Anacharis Babeto; Corrêa, Rúbia Carvalho Gomes; Comar, Jurandir Fernando; Peralta, Rosane Marina; Bracht, Adelar

    2018-01-01

    p-Synephrine is one of the main active components of the fruit of Citrus aurantium (bitter orange). Extracts of the bitter orange and other preparations containing p-synephrine have been used worldwide to promote weight loss and for sports performance. The purpose of the study was to measure the action of p-synephrine on hepatic enzyme activities linked to carbohydrate and energy metabolism and the levels of adenine mononucleotides. Enzymes and adenine mononucleotides were measured in the isolated perfused rat liver and in vivo after oral administration of the drug (50 and 300 mg/kg) by using standard techniques. p-Synephrine increased the activity of glycogen phosphorylase in vivo and in the perfused liver. It decreased, however, the activities of pyruvate kinase and pyruvate dehydrogenase also in vivo and in the perfused liver. p-Synephrine increased the hepatic pools of adenosine diphosphate and adenosine triphosphate. Stimulation of glycogen phosphorylase is consistent with the reported increased glycogenolysis in the perfused liver and increased glycemia in rats. The decrease in the pyruvate dehydrogenase activity indicates that p-synephrine is potentially capable of inhibiting the transformation of carbohydrates into lipids. The capability of increasing the adenosine triphosphate-adenosine diphosphate pool indicates a beneficial effect of p-synephrine on the cellular energetics. Copyright © 2017 John Wiley & Sons, Ltd.

  18. The effect of laser power, blood perfusion, thermal and optical properties of human liver tissue on thermal damage in LITT.

    Science.gov (United States)

    Shibib, Khalid Salem; Munshid, Mohammed A; Lateef, Hind Ali

    2017-12-01

    In this work, the finite-element method (FEM) was used to predict the temperature distribution, and the thermal damage volume in human liver tissue subjected to laser in laser-induced interstitial thermotherapy (LITT). The effect of laser power, blood perfusion, and thermal and optical properties on maximum temperature and thermal damage volume were predicted using the finite-element method. A computer program was written in visual basic language, which was verified by comparing its result with data published elsewhere. The bio-heat equation together with the effect of linear laser source were used to simulate heat transfer through tissue from which the temperature distributions, and the subsequent thermal damage, were obtained based on Arrhenius equation. In this mathematical model for LITT, it was found that increasing laser power, absorption, and scattering coefficient increased the damage zone while increasing tissue water content, perfusion rate, and tissue anisotropy factor decreased the damage zone. These findings are important aspects for doctors in the pre-estimation of the damage zone before starting the therapy so as to kill only the desired zone.

  19. CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

    Energy Technology Data Exchange (ETDEWEB)

    Talakic, Emina; Schoellnast, Helmut [Medical University of Graz, Division of General Radiology, Department of Radiology, Graz (Austria); Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut [Medical University of Graz, Department of Surgery, Division of Transplantation Surgery, Graz (Austria); Stauber, Rudolf [Medical University of Graz, Department of Internal Medicine, Division of Gastoenterology and Hepatology, Graz (Austria); Quehenberger, Franz [Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, Graz (Austria)

    2017-10-15

    To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p < 0.05) between SAF and HVPG, and -0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. (orig.)

  20. CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

    Science.gov (United States)

    Talakić, Emina; Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut; Stauber, Rudolf; Quehenberger, Franz; Schoellnast, Helmut

    2017-10-01

    To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p perfusion parameters and HVPG. CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. • SAF and SCL are statistically significantly correlated with HVPG • SCL showed stronger correlation with HVPG than SAF • 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH • HAF, PVF and HPI showed no statistically significant correlation with HVPG.

  1. Evaluation of blood perfusion in liver cirrhosis by dynamic contrast enhanced computed tomography

    DEFF Research Database (Denmark)

    Andersen, Mette L.; Fallentin, Eva; Lauridsen, Carsten Ammitzbøl

    2017-01-01

    -CT), in patients with varying degrees of cirrhosis categorised by Child Pugh score (CP). We compared the perfusion values and the hepatic perfusion index (HPI) ((AP/AP+PP) x 100) in between the three respective CP groups, to evaluate if AP, PP and HPI correlated with the CP level and hepatic venous pressure...... patients, and C in six patients. The mean values of AP were significantly increased in patients with CP C vs. A+B, (70,4 ml/ vs. 43.1) ml/min/100ml tissue (p=0.0003). Patients with Child Pugh A tended to have higher PP values, 117,7 and Child B+C 105.3 ml/min/100ml tissue, respectively (p=0,44). The HPI...... increased significant with the degree of cirrhosis (mean A 29.6/B 30,96/C 44.9 ml/min/100ml tissue ANOVA p=0,046). Testing for linear regression with PP and HVPG values, the r-values raised with CP score (CP A r=0,137 p=0,049, CP B r=0,314 p=0,215 and CP C r=0,427 p=0,12). We found no correlation between...

  2. Accuracy of a Cone-Beam CT Virtual Parenchymal Perfusion Algorithm for Liver Cancer Targeting during Intra-arterial Therapy.

    Science.gov (United States)

    Derbel, Haytham; Kobeiter, Hicham; Pizaine, Guillaume; Ridouani, Fourat; Luciani, Alain; Radaelli, Alessandro; Van der Sterren, William; Chiaradia, Mélanie; Tacher, Vania

    2018-02-01

    To evaluate accuracy of virtual parenchymal perfusion (VPP) algorithm developed for targeting liver cancer during intra-arterial therapy (IAT) using cone-beam CT guidance. VPP was retrospectively applied to 15 patients who underwent IAT for liver cancer. Virtual territory (VT) was estimated after positioning a virtual injection point on nonselective dual-phase (DP) cone-beam CT images acquired during hepatic arteriography at the same position chosen for selective treatment. Targeted territory (TT) was used as the gold standard and was defined by parenchymal phase enhancement of selective DP cone-beam CT performed before treatment start. Qualitative evaluation of anatomic conformity between VT and TT was performed using a 3-rank scale (poor, acceptable, excellent) by 3 double-blinded readers. VT and TT were also quantitatively compared using spatial overlap-based (Dice similarity coefficient [DSC], sensitivity, and positive predictive value), distance-based (mean surface distance [MSD]), and volume-based (absolute volume error and correlation between pairwise volumes) metrics. Interreader agreement was evaluated for the 2 evaluation methods. Eighteen DP cone-beam CT scans were performed. Qualitative evaluation showed excellent overlap between VT and TT in 88.9%-94.4%, depending on the readers. DSC was 0.78 ± 0.1, sensitivity was 80%, positive predictive value was 83%, and MSD was 5.1 mm ± 2.4. Absolute volume error was 15%, and R 2 Pearson correlation factor was 0.99. Interreader agreement was good for both qualitative and quantitative evaluations. VPP algorithm is accurate and reliable in identification of liver arterial territories during IAT using cone-beam CT guidance. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  3. Influence of dietary fat on metabolism of (14-14C)erucic acid in the perfused rat liver. Distribution of metabolites in lipid classes

    International Nuclear Information System (INIS)

    Holmer, G.; Ronneberg, R.

    1986-01-01

    Two groups of rats were fed diets containing 20% by weight of either partially hydrogenated marine oil supplemented with sunflower seed oil (PHMO) or palm oil (PO) for 8 wk. Using a liver perfusion system, the effect of dietary long chain monoenoic fatty acids on the uptake and metabolism of [14- 14 C]erucic acid was studied. The perfusion times were 15 and 60 min, respectively. The two groups showed equal ability for erucic acid uptake in the liver but differed in the channeling of the fatty acids into various metabolic pathways. A higher metabolic turnover of 22:1 in the PHMO livers relative to the PO livers was demonstrated by an increased recovery of total [ 14 C]labeling in the triglyceride (TG) and phospholipid (PL) fractions, already evident after 15 min of perfusion. The chain-shortening capacity was highest in the PHMO group, reflected by a higher [ 14 C]18:1 incorporation in both TG and PL, and increasing from 15 to 60 min of perfusion. The amount of [ 14 C]18:1 found in PL and TG after 60 min of perfusion of livers from rats fed PO corresponded to that shown for the PHMO group after 15 min. The PL demonstrated a discrimination against 22:1 compared to TG, and, when available, 18:1 was highly preferred for PL-synthesis. The total fatty acid distribution in the TG, as determined by gas liquid chromatography (GLC), reflected the composition of the dietary fats. In the total liver PL, 22:1 and 20:1 were present in negligible amounts, although the PHMO diet contained 12-13% of both 22:1 and 20:1. In the free fatty acid fraction (FFA), the major part of the radioactivity (approximately 80%) was [14- 14 C]erucic acid, and only small amounts of [ 14 C]18:1 (less than 2%) were present, even after 60 min of perfusion. The shortened-chain 18:1 was readily removed from the FFA pool and preferentially used for lipid esterification

  4. Macro- and microelements in the rat liver, kidneys, and brain tissues; sex differences and effect of blood removal by perfusion in vivo.

    Science.gov (United States)

    Orct, Tatjana; Jurasović, Jasna; Micek, Vedran; Karaica, Dean; Sabolić, Ivan

    2017-03-01

    Concentrations of macro- and microelements in animal organs indicate the animal health status and represent reference data for animal experiments. Their levels in blood and tissues could be different between sexes, and could be different with and without blood in tissues. To test these hypotheses, in adult female and male rats the concentrations of various elements were measured in whole blood, blood plasma, and tissues from blood-containing (nonperfused) and blood-free liver, kidneys, and brain (perfused in vivo with an elements-free buffer). In these samples, 6 macroelements (Na, Mg, P, S, K, Ca) and 14 microelements (Fe, Mn, Co, Cu, Zn, Se, I, As, Cd, Hg, Pb, Li, B, Sr) were determined by inductively coupled plasma mass spectrometry following nitric acid digestion. In blood and plasma, female- or male-dominant sex differences were observed for 6 and 5 elements, respectively. In nonperfused organs, sex differences were observed for 3 (liver, brain) or 9 (kidneys) elements, whereas in perfused organs, similar differences were detected for 9 elements in the liver, 5 in the kidneys, and none in the brain. In females, perfused organs had significantly lower concentrations of 4, 5, and 2, and higher concentrations of 10, 4, and 7 elements, respectively, in the liver, kidneys, and brain. In males, perfusion caused lower concentrations of 4, 7, and 2, and higher concentrations of 1, 1, and 7 elements, respectively, in the liver, kidneys, and brain. Therefore, the residual blood in organs can significantly influence tissue concentrations of various elements and their sex-dependency. Copyright © 2017 Elsevier GmbH. All rights reserved.

  5. Metabolite kinetics: formation of acetaminophen from deuterated and nondeuterated phenacetin and acetanilide on acetaminophen sulfation kinetics in the perfused rat liver preparation

    International Nuclear Information System (INIS)

    Pang, K.S.; Waller, L.; Horning, M.G.; Chan, K.K.

    1982-01-01

    The role of hepatic intrinsic clearance for metabolite formation from various precursors on subsequent metabolite elimination was was investigated in the once-through perfused rat liver preparation. Two pairs of acetaminophen precursors: [ 14 C] phenacetin-d5 and [ 3 H] phenacetin-do, [ 14 C] acetanilide and [ 3 H] phenacetin were delivered by constant flow (10 ml/min/liver) either by normal or retrograde perfusion to the rat liver preparations. The extents of acetaminophen sulfation were compared within the same preparation. The data showed that the higher the hepatocellular activity (intrinsic clearance) for acetaminophen formation, the greater the extent of subsequent acetaminophen sulfation. The findings were explained on the basis of blood transit time and metabolite duration time. Because of blood having only a finite transit time in liver, the longer the drug requires for metabolite formation, the less time will remain for metabolite sulfation and the less will be the degree of subsequent sulfation. Conversely, when the drug forms the primary metabolite rapidly, a longer time will remain for the metabolite to be sulfated in liver to result in a greater degree of metabolite sulfation. Finally, the effects of hepatic intrinsic clearances for metabolite formation and zonal distribution of enzyme systems for metabolite formation and elimination in liver are discussed

  6. Optimisation of reconstruction for the registration of CT liver perfusion sequences

    Science.gov (United States)

    Romain, B.; Letort, V.; Lucidarme, O.; d'Alché-Buc, F.; Rouet, L.

    2012-02-01

    Objective. CT abdominal perfusion is frequently used to evaluate tumor evolution when patients are undergoing antiangiogenic therapy. Parameters depending on longer-term dynamics of the diffusion of the contrast medium (e. g. permeability) could help assessing the treatment efficacy. To this end, dynamic image sequences are obtained while patients breath freely. Prior to any analysis, one needs to compensate the respiratory motion. The goal of our study is to optimize the CT reconstruction parameters (filter of reconstruction, thickness of image volumes) for our registration method. We also aim at proposing relevant criteria allowing to quantify the registration quality. Methods. Registration is computed in 4 steps: z-global rigid registration, local refinements with multiresolution blockmatching, regularization and warping. Two new criteria are defined to evaluate the quality of registration: one for spatial evaluation and the other for temporal evaluation. Results. The two measures decrease after registration (58% and 10% average decrease for the best reconstruction parameters for the spatial and temporal criteria respectively) which is consistent with visual inspection of the images. They are therefore used to determine the best combination of reconstruction parameters.

  7. Perfusion CT of the Brain and Liver and of Lung Tumors: Use of Monte Carlo Simulation for Patient Dose Estimation for Examinations With a Cone-Beam 320-MDCT Scanner.

    Science.gov (United States)

    Cros, Maria; Geleijns, Jacob; Joemai, Raoul M S; Salvadó, Marçal

    2016-01-01

    The purpose of this study was to estimate the patient dose from perfusion CT examinations of the brain, lung tumors, and the liver on a cone-beam 320-MDCT scanner using a Monte Carlo simulation and the recommendations of the International Commission on Radiological Protection (ICRP). A Monte Carlo simulation based on the Electron Gamma Shower Version 4 package code was used to calculate organ doses and the effective dose in the reference computational phantoms for an adult man and adult woman as published by the ICRP. Three perfusion CT acquisition protocols--brain, lung tumor, and liver perfusion--were evaluated. Additionally, dose assessments were performed for the skin and for the eye lens. Conversion factors were obtained to estimate effective doses and organ doses from the volume CT dose index and dose-length product. The sex-averaged effective doses were approximately 4 mSv for perfusion CT of the brain and were between 23 and 26 mSv for the perfusion CT body protocols. The eye lens dose from the brain perfusion CT examination was approximately 153 mGy. The sex-averaged peak entrance skin dose (ESD) was 255 mGy for the brain perfusion CT studies, 157 mGy for the lung tumor perfusion CT studies, and 172 mGy for the liver perfusion CT studies. The perfusion CT protocols for imaging the brain, lung tumors, and the liver performed on a 320-MDCT scanner yielded patient doses that are safely below the threshold doses for deterministic effects. The eye lens dose, peak ESD, and effective doses can be estimated for other clinical perfusion CT examinations from the conversion factors that were derived in this study.

  8. A combination therapy with preoperative full-dose gemcitabine, concurrent 3-dimensional conformal radiation, surgery and postoperative liver perfusion chemotherapy for pancreatic cancer

    International Nuclear Information System (INIS)

    Ohigashi, Hiroaki; Eguchi, Hidetoshi; Takahashi, Hidenori

    2009-01-01

    Due to the high incidence of local recurrence and liver metastasis, long-term outcomes for patients after resection of pancreatic cancer are extremely poor. For improving the survival of the patients, a combination of preoperative chemoradiation, surgery, and postoperative liver-perfusion chemotherapy (LPC) were performed. Postoperative histopathologic study revealed a marked degenerative change in cancer tissue, showing negative surgical margins (R0) in 98% of patients and negative nodal involvement in 85% of patients. The 5-year survival rate after pancreatectomy was 56%, with low incidences of both local recurrence (11%) and liver metastasis (9%). This combination therapy were able to effectively reduce the incidence of both local and liver recurrence and improved long-term outcomes for patients with T3-4 cancers of the pancreas. (author)

  9. Effects of registration error on parametric response map analysis: a simulation study using liver CT-perfusion images

    Science.gov (United States)

    Lausch, A.; Jensen, N. K. G.; Chen, J.; Lee, T. Y.; Lock, M.; Wong, E.

    2014-03-01

    Purpose: To investigate the effects of registration error (RE) on parametric response map (PRM) analysis of pre and post-radiotherapy (RT) functional images. Methods: Arterial blood flow maps (ABF) were generated from the CT-perfusion scans of 5 patients with hepatocellular carcinoma. ABF values within each patient map were modified to produce seven new ABF maps simulating 7 distinct post-RT functional change scenarios. Ground truth PRMs were generated for each patient by comparing the simulated and original ABF maps. Each simulated ABF map was then deformed by different magnitudes of realistic respiratory motion in order to simulate RE. PRMs were generated for each of the deformed maps and then compared to the ground truth PRMs to produce estimates of RE-induced misclassification. Main findings: The percentage of voxels misclassified as decreasing, no change, and increasing, increased with RE For all patients, increasing RE was observed to increase the number of high post-RT ABF voxels associated with low pre-RT ABF voxels and vice versa. 3 mm of average tumour RE resulted in 18-45% tumour voxel misclassification rates. Conclusions: RE induced misclassification posed challenges for PRM analysis in the liver where registration accuracy tends to be lower. Quantitative understanding of the sensitivity of the PRM method to registration error is required if PRMs are to be used to guide radiation therapy dose painting techniques.

  10. Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia.

    Science.gov (United States)

    Nardini, Giordano; Di Girolamo, Nicola; Leopardi, Stefania; Paganelli, Irene; Zaghini, Anna; Origgi, Francesco C; Vignoli, Massimo

    2014-05-13

    Contrast-enhanced diagnostic imaging techniques are considered useful in veterinary and human medicine to evaluate liver perfusion and focal hepatic lesions. Although hepatic diseases are a common occurrence in reptile medicine, there is no reference to the use of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) to evaluate the liver in lizards. Therefore, the aim of this study was to evaluate the pattern of change in echogenicity and attenuation of the liver in green iguanas (Iguana iguana) after administration of specific contrast media. An increase in liver echogenicity and density was evident during CEUS and CECT, respectively. In CEUS, the mean ± SD (median; range) peak enhancement was 19.9% ± 7.5 (18.3; 11.7-34.6). Time to peak enhancement was 134.0 ± 125.1 (68.4; 59.6-364.5) seconds. During CECT, first visualization of the contrast medium was at 3.6 ± 0.5 (4; 3-4) seconds in the aorta, 10.7 ± 2.2 (10.5; 7-14) seconds in the hepatic arteries, and 15 ± 4.5 (14.5; 10-24) seconds in the liver parenchyma. Time to peak was 14.1 ± 3.4 (13; 11-21) and 31 ± 9.6 (29; 23-45) seconds in the aorta and the liver parenchyma, respectively. CEUS and dynamic CECT are practical means to determine liver hemodynamics in green iguanas. Distribution of contrast medium in iguana differed from mammals. Specific reference ranges of hepatic perfusion for diagnostic evaluation of the liver in iguanas are necessary since the use of mammalian references may lead the clinician to formulate incorrect diagnostic suspicions.

  11. Evolving technology in bipolar perfused radiofrequency ablation: assessment of efficacy, predictability and safety in a pig liver model.

    Science.gov (United States)

    Burdío, Fernando; Navarro, Ana; Sousa, Ramón; Burdío, José M; Güemes, Antonio; Gonzalez, Ana; Cruz, Ignacio; Castiella, Tomás; Lozano, Ricardo; Berjano, Enrique; Figueras, Joan; de Gregorio, Miguel A

    2006-08-01

    Bipolar radiofrequency (RF) ablation, especially with perfusion of saline, has been shown to increase volume over monopolar conventional methods. The aims of this study are to study whether this method is linked to too flattened thermal lesions and premature rise of impedance and to elucidate some safety concerns. Eighteen RF ablations were performed using a 1.8-mm-diameter bipolar applicator in the liver of nine healthy pigs through laparotomy with or without temporary vascular occlusion [the Pringle maneuver (PGM)]: group A (n=9), without PGM; group B (n=9), with PGM. Hypertonic saline solutions (3% and 20 %) were injected through the applicator at a rate of 400 ml/h during the procedure. The pigs were followed up and they were euthanased on the 15th day. Impedance, current, power output, energy output, temperatures, diameters of thermal lesion, volume, sphericity ratio of thermal lesion were correlated among groups. Impedance at the end of the procedure (50.00 Omega+/-28.39 and 52.88 Omega+/-26.77, for groups A and B, respectively) was very similar to the starting impedance (50 Omega). In a median of 1 (range, 0-6) time per RF ablation procedure a reduction of 30 W from the selected power supply was observed during the RF ablation procedure linked to a slight increase of impedance. Volume and short diameter of thermal lesion were 21.28 cm3+/-11.78 and 2.85 cm+/-0.87 for group A, 87.51 cm3+/-25.20 and 4.31 cm+/-0.65 for group B. Continuous thermal between both electrodes were described with a global sphericity ratio of 1.91. One major complication (thermal injury to the stomach) was encountered in a case of cross-sectional necrosis of the targeted liver and attributed to heat diffusion after the procedure. This method has been shown to determine: (1) the relative control of impedance during the procedure; (2) ovoid and relatively large thermal lesions with less dependence upon closest vessels.

  12. Effects of insulin on perfused liver from streptozotocin-diabetic and untreated rats: 13C NMR assay of pyruvate kinase flux

    International Nuclear Information System (INIS)

    Cohen, S.M.

    1987-01-01

    The effects of insulin in vitro on perfused liver from streptozotocin-diabetic rats and their untreated littermates during gluconeogenesis from either [3- 13 C]alanine + ethanol or [2- 13 C]pyruvate + NH 4 Cl + ethanol were studied by 13 C NMR. A 13 C NMR determination of the rate of pyruvate kinase flux under steady-state conditions of active gluconeogenesis was developed; this assay includes a check on the reuse of recycled pyruvate. The preparations studied provided gradations of pyruvate kinase flux within the confines of the assay's requirement of active gluconeogenesis. By this determination, the rate of pyruvate kinase flux was 0.74 +/- 0.04 of the gluconeogenic rate in liver from 24-h-fasted controls; in liver from 12-h fasted controls, relative pyruvate kinase flux increased to 1.0 +/- 0.2. In diabetic liver, this flux was undetectable by the authors NMR method. Insulin's hepatic influence in vitro was greatest in the streptozotocin model of type 1 diabetes: upon treatment of diabetic liver with 7 nM insulin in vitro, a partial reversal of many of the differences noted between diabetic and control liver was demonstrated by 13 C NMR. A major effect of insulin in vitro upon diabetic liver was the induction of a large increase in the rate of pyruvate kinase flux, bringing relative and absolute fluxes up to the levels measured in 24-h-fasted controls. By way of comparison, the effects of ischemia on diabetic liver were studied by 13 C NMR to test whether changes in allosteric effectors under these conditions could also increase pyruvate kinase flux. A large increase in this activity was demonstrated in ischemic diabetic liver

  13. Basic considerations in organ perfusion physiology.

    Science.gov (United States)

    Zimmerman, Michael A; Martin, Alicia; Hong, Johnny C

    2016-06-01

    Owing to a severe shortage of organs for patients with end-stage diseases, novel techniques in organ preservation and perfusion need to be studied and reviewed to increase the number of available organs for transplant. Many patients will die while waiting for an organ. To make organs from extended-criteria donors feasible, optimal conditions for pulsatile perfusion and the potential for organ reconditioning at implantation need to be addressed. Many techniques in organ preservation and perfusion are being studied. Several laboratories are studying the effects of temperature for organ perfusion. Two areas being studied are hypothermic and normothermic machine perfusion. In the area of organ preservation, new solutions are being studied such as a substrate-enriched, oxygen-saturated, and leukocyte-depleted perfusate to help with organ quality. Even with the strides being made in organ preservation and perfusion, there are still many unanswered questions. More studies will need to be done to find the optimal conditions for duration of perfusion in the cold phase, optimal perfusion solution, degree of oxygenation, and the addition of pharmacologic agents, to improve organ function and expand the organ pool.

  14. CT Perfusion Imaging Can Predict Patients' Survival and Early Response to Transarterial Chemo-Lipiodol Infusion for Liver Metastases from Colorectal Cancers.

    Science.gov (United States)

    Lv, Wei-Fu; Han, Jian-Kui; Cheng, De-Lei; Zhou, Chun-Ze; Ni, Ming; Lu, Dong

    2015-01-01

    To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified as responders and non-responders based on 4-month CT scans after TACLI. The percentage change of CTPI parameters of target lesions were compared between responders and non-responders at 1 month after TACLI. The optimal parameter and cutoff value were determined. The patients were divided into 2 subgroups according to the cutoff value. The log-rank test was used to compare the survival rates of the 2 subgroups. Four-month images were obtained from 58 patients, of which 39.7% were responders and 60.3% were non-responders. The percentage change in hepatic arterial perfusion (HAP) 1 month after TACLI was the optimal predicting parameter (p = 0.003). The best cut-off value was -21.5% and patients who exhibited a ≥ 21.5% decrease in HAP had a significantly higher overall survival rate than those who exhibited a HAP after TACLI with a cutoff value of -21.5% is the optimal predictor.

  15. Clinical effect of plasma perfusion combined with plasma exchange in treatment of patients with acute-on-chronic liver failure

    Directory of Open Access Journals (Sweden)

    ZHOU Jian

    2017-04-01

    Full Text Available ObjectiveTo investigate the clinical effect of plasma perfusion (PP combined with plasma exchange (PE in the treatment of acute-on-chronic liver failure (ACLF. MethodsA total of 72 patients with ACLF who were admitted to The Second People’s Hospital of Lanzhou from January 2014 to December 2015 were enrolled. In addition to internal medication, all the patients were treated with the artificial liver support system (once every 3-4 days based on the patients’ conditions, 1-3 times on average for each patient. According to the difference in therapies, the patients were divided into combination group with 40 patients (PP combined with PE and a total of 107 case times and control group with 32 patients (PE alone and a total of 85 case times. Total bilirubin (TBil, alanine aminotransferase (ALT, and prothrombin time were recorded before treatment, after surgery, and at 72 hours after surgery. Clinical outcome was evaluated after 4 weeks of treatment. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe overall response rate of all patients was 63.89% (46/72. At 72 hours after surgery, there was a significant difference in the level of ALT between the combination group and the control group (319.54±86.23 U/L vs 354.75±100.76 U/L, t=2.60, P<0.05. Both groups had significant reductions in TBil and ALT after surgery (combination group: t=6.69 and 15.84, P<0.05; control group: t=5.34 and 14.38, P<0.05 and at 72 hours after surgery (combination group: t=3.24 and 8.83, P<0.05; control group: t=2.40 and 4.61, P<0.05. Both groups had significant changes in prothrombin time activity after surgery (t=4.83 and 5.01, both P<0.05. There were no significant differences in the incidence rates of pruritus and rash between the two groups, while there was a significant difference in the incidence rate of perioral or limb numbness between the

  16. Competing pathways in drug metabolism. I. Effect of input concentration on the conjugation of gentisamide in the once-through in situ perfused rat liver preparation

    International Nuclear Information System (INIS)

    Morris, M.E.; Yuen, V.; Tang, B.K.; Pang, K.S.

    1988-01-01

    Sulfation and glucuronidation are two parallel pathways for the metabolism of phenolic substrates. Gentisamide (GAM) was used as a model compound to examine the effects of parallel competing pathways on drug disappearance and metabolite formation in the once-through perfused rat liver preparation. GAM was found to form one glucuronide (GAM-5G) and two sulfate (GAM-2S and GAM-5S) conjugates. These GAM conjugates were biosynthesized in recirculating rat liver preparations, and were isolated by preparative high-performance liquid chromatography. Specific incorporation of 35S-sodium sulfate and [14C]glucose into GAM sulfate and glucuronide conjugates revealed corresponding elution patterns as labeled GAM metabolites. Their identities were characterized by enzymatic and acid hydrolyses and by NMR spectroscopy. Gentisamide-5-sulfate (GAM-5S) and gentisamide-5-glucuronide (GAM-5G) are major metabolites, and gentisamide-2-sulfate (GAM-2S) is a minor metabolite. Single-pass rat liver perfusions were used to examine the effect of stepwise increases/decreases of input GAM concentration (CIn) on the extraction ratio (E) of GAM and formation of metabolites. The E of GAM remained constant (about 0.89) at input concentrations from 0.9 to 120 microM and decreased at CIn greater than 120 microM. Metabolite patterns, however, changed with GAM CIn, even when E was constant at CIn up to 120 microM. GAM-5S was present as the major metabolite of GAM at all GAM CInS in most liver preparations but the proportions of GAM-5S and GAM-2S decreased at increasing CIn; the proportion of GAM-5G, a minor metabolite at low CIn, increased with increasing CIn. Biliary excretion rates at steady state accounted for 5.3 +/- 2.7% (mean +/- S.D.) of the input rate: GAM-5G was the predominant metabolite found

  17. Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD)

    Science.gov (United States)

    Czigany, Zoltan; Schöning, Wenzel; Ulmer, Tom Florian; Bednarsch, Jan; Amygdalos, Iakovos; Cramer, Thorsten; Rogiers, Xavier; Popescu, Irinel; Botea, Florin; Froněk, Jiří; Kroy, Daniela; Koch, Alexander; Tacke, Frank; Trautwein, Christian; Tolba, Rene H; Hein, Marc; Koek, Ger H; Dejong, Cornelis H C; Neumann, Ulf Peter; Lurje, Georg

    2017-01-01

    Introduction Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts. Hypothermic oxygenated machine perfusion (HOPE) has been successfully tested in preclinical experiments and in few clinical series of donation after cardiac death OLT. Methods and analysis HOPE ECD-DBD is an investigator-initiated, open-label, phase-II, prospective multicentre randomised controlled trial on the effects of HOPE on ECD allografts in donation after brain death (DBD) OLT. Human whole organ liver grafts will be submitted to 1–2 hours of HOPE (n=23) via the portal vein before implantation and are going to be compared with a control group (n=23) of patients transplanted after conventional cold storage. Primary (peak and Δ peak alanine aminotransferase within 7 days) and secondary (aspartate aminotransferase, bilirubin and international normalised ratio, postoperative complications, early allograft dysfunction, duration of hospital and intensive care unit stay, 1-year patient and graft survival) endpoints will be analysed within a 12-month follow-up. Extent of ischaemia–reperfusion (I/R) injury will be assessed using liver tissue, perfusate, bile and serum samples taken during the perioperative phase of OLT. Ethics and dissemination The study was approved by the institutional review board of the RWTH Aachen University, Aachen, Germany (EK 049/17). The current paper represent the pre-results phase. First results are expected in 2018. Trial registration number NCT03124641. PMID:29018070

  18. Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study

    Directory of Open Access Journals (Sweden)

    Gerd Otto, MD

    2017-07-01

    Conclusions. Contrary to previous findings, the present study indicated that additional ex situ BP did not prevent ischemic-type biliary lesions or ischemia-reperfusion injury after liver transplantation. Moreover, there was considerable discrepancy between cholangiography findings regarding bile duct changes and clinically apparent cholangiopathy after transplantation, which should be considered when assessing ischemic-type biliary lesions.

  19. Influence of black cohosh (Cimicifuga racemosa) use by postmenopausal women on total hepatic perfusion and liver functions.

    Science.gov (United States)

    Nasr, Ahmed; Nafeh, Hanan

    2009-11-01

    In this prospective longitudinal clinical trial, 87 postmenopausal women receiving for 12 consecutive months a daily dose of 40 mg of a dry extract preparation of Cimicifuga racemosa (Klimadynon) for relief of vasomotor symptoms were followed up by evaluation of total hepatic blood flow, assessed by color Doppler ultrasound, as well as prothrombin time and concentration, serum albumin, bilirubin, gamma-glutamyltransferase, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase. Because no significant changes in total hepatic blood flow or any of the liver functions tested were reported, we concluded that use of C. racemosa for 1 year by healthy postmenopausal women without evidence of liver disease does not seem to influence the liver.

  20. Short Oxygenated Warm Perfusion With Prostaglandin E1 Administration Before Cold Preservation as a Novel Resuscitation Method for Liver Grafts From Donors After Cardiac Death in a Rat In Vivo Model.

    Science.gov (United States)

    Maida, Kai; Akamatsu, Yorihiro; Hara, Yasuyuki; Tokodai, Kazuaki; Miyagi, Shigehito; Kashiwadate, Toshiaki; Miyazawa, Koji; Kawagishi, Naoki; Ohuchi, Noriaki

    2016-05-01

    We previously demonstrated that short oxygenated warm perfusion (SOWP) prevented warm ischemia-reperfusion injury in rat livers from donors after cardiac death (DCDs) in an ex vivo model. In the present study, we aimed to examine the in vivo effects of SOWP and SOWP with prostaglandin E1 (PGE1) in DCD rat liver transplants. We performed liver transplantation after 6-hour cold preservation using grafts retrieved from DCD rats, divided into nontreatment (NT), SOWP, and SOWP with PGE1 (SOWP + PG) treatment groups. The SOWP grafts were perfused with oxygenated buffer at 37°C for 30 minutes before cold preservation. Prostaglandin E1 was added to the SOWP + PG group perfusate. Eleven liver transplants from each group were performed to evaluate graft function and survival; 5 rats were used for data collection after 1-hour reperfusion, and 6 rats were used for the survival study. As a positive control, the same experiment was performed in a heart-beating donor group. In both the SOWP and SOWP + PG groups, serum liver enzymes, intercellular adhesion molecule 1 levels, and cellular damage were significantly decreased compared with the NT group. In the SOWP + PG group, bile production and energy status were significantly improved compared with the NT group. The 4-week survival was 0% (0/6), 67% (4/6), 83% (5/6), and 100% (6/6) in the NT, SOWP, SOWP + PG, and heart-beating donor group, respectively. Short oxygenated warm perfusion before cold preservation and the addition of PGE1 to SOWP were thus beneficial in an in vivo rat model.

  1. 13C NMR study of effects of fasting and diabetes on the metabolism of pyruvate in the tricarboxylic acid cycle and of the utilization of pyruvate and ethanol in lipogenesis in perfused rat liver

    International Nuclear Information System (INIS)

    Cohen, S.M.

    1987-01-01

    13 C NMR has been used to study the competition of pyruvate dehydrogenase with pyruvate carboxylase for entry of pyruvate into the tricarboxylic acid (TCA) cycle in perfused liver from streptozotocin-diabetic and normal donor rats. The relative proportion of pyruvate entering the TCA cycle by these two routes was estimated from the 13 C enrichments at the individual carbons of glutamate when [3- 13 C]alanine was the only exogenous substrate present. In this way, the proportion of pyruvate entering by the pyruvate dehydrogenase route relative to the pyruvate carboxylase route was determined to be 1:1.2 +/- 0.1 in liver from fed controls, 1:7.7 +/- 2 in liver from 24-fasted controls, and 1:2.6 +/- 0.3 in diabetic liver. Pursuant to this observation that conversion of pyruvate to acetyl coenzyme A (acetyl-CoA) was greatest in perfused liver from fed controls, the incorporation of 13 C label into fatty acids was monitored in this liver preparation. With the exception of the repeating methylene carbons, fatty acyl carbons labeled by [1- 13 C]acetyl-CoA (from [2- 13 C]pyruvate) gave rise to resonances distinguishable on the basis of chemical shift from those observed when label was introduced by [3- 13 C]alanine plus [2- 13 C]ethanol, which are converted to [2- 13 C]acetyl-CoA. Thus, measurement of 13 C enrichment at several specific sites in the fatty acyl chains in time-resolved spectra of perfused liver offers a novel way of monitoring the kinetics of the biosynthesis of fatty acids. In addition to obtaining the rate of lipogenesis, it was possible to distinguish the contributions of chain elongation from those of the de novo synthesis pathway and to estimate the average chain length of the 13 C-labeled fatty acids produced

  2. Development of a fatal noncompressible truncal hemorrhage model with combined hepatic and portal venous injury in normothermic normovolemic swine.

    Directory of Open Access Journals (Sweden)

    Ujwal R Yanala

    Full Text Available Noncompressible truncal hemorrhage and brain injury currently account for most early mortality of warfighters on the battlefield. There is no effective treatment for noncompressible truncal hemorrhage, other than rapid evacuation to a surgical facility. The availability of an effective field treatment for noncompressible truncal hemorrhage could increase the number of warfighters salvaged from this frequently-lethal scenario. Our intent was to develop a porcine model of noncompressible truncal hemorrhage with a ∼ 50% one-hour mortality so that we could develop new treatments for this difficult problem. Normovolemic normothermic domestic swine (barrows, 3 months old, 34-36 kg underwent one of three injury types through a midline incision: 1 central stellate injury (N = 6; 2 excision of a portal vein branch distal to the main PV trunk (N = 6; or 3 hemi-transection of the left lateral lobe of the liver at its base (N = 10. The one-hour mortality of these injuries was 0, 82, and 40%, respectively; the final mean arterial pressure was 65, 24, and 30 mm Hg, respectively; and the final hemoglobin was 8.3, 2.3, and 3.6 g/dL, respectively. Hemi-transection of the left lateral lobe of the liver appeared to target our desired mortality rate better than the other injury mechanisms.

  3. Some processes of energy saving and expenditure occurring during ethanol perfusion in the isolated liver of fed rats; a Nuclear Magnetic Resonance study.

    Directory of Open Access Journals (Sweden)

    Gin Henri

    2004-03-01

    Full Text Available Abstract Background In the isolated liver of fed rats, a 10 mM ethanol perfusion rapidly induced a rapid 25% decrease in the total ATP content, the new steady state resulting from both synthesis and consumption. The in situ rate of mitochondrial ATP synthesis without activation of the respiration was increased by 27%, implying an increased energy demand. An attempt to identify the ethanol-induced ATP-consuming pathways was performed using 31P and 13C Nuclear Magnetic Resonance. Results Ethanol (i transiently increased sn-glycerol-3-phosphate formation whereas glycogenolysis was continuously maintained; (ii decreased the glycolytic ATP supply and (iii diminished the intracellular pH in a dose-dependent manner in a slight extend. Although the cytosolic oxidation of ethanol largely generated H+ (and NADH, intracellular pHi was maintained by (i the large and passive excretion of cellular acetic acid arising from ethanol oxidation (evidenced by exogenous acetate administration, without energetic cost or (ii proton extrusion via the Na+-HCO3- symport (implying the indirect activation of the Na+-K+-ATPase pump and thus an energy use, demonstrated during the addition of their specific inhibitors SITS and ouabaïn, respectively. Conclusion Various cellular mechanisms diminish the cytosolic concentration of H+ and NADH produced by ethanol oxidation, such as (i the large but transient contribution of the dihydroxyacetone phosphate / sn-glycerol-3-phosphate shuttle between cytosol and mitochondria, mainly implicated in the redox state and (ii the major participation of acetic acid in passive proton extrusion out of the cell. These processes are not ATP-consuming and the latter is a cellular way to save some energy. Their starting in conjunction with the increase in mitochondrial ATP synthesis in ethanol-perfused whole liver was however insufficient to alleviate either the inhibition of glycolytic ATP synthesis and/or the implication of Na+-HCO3- symport and

  4. Normothermic Versus Hypothermic Heart Surgery: Evaluation of Post-Operative Complications

    Directory of Open Access Journals (Sweden)

    H Akhlagh

    2012-04-01

    Full Text Available Introduction: The recently introduced technique of warm heart surgery may be a very effective method of myocardial protection. Although the systemic effects of hypothermic cardiopulmonary bypass are well known, the effects of warm heart surgery are not. Methods: In a prospective trial, 60 patients undergoing an elective coronary artery bypass grafting were randomly allocated to normothermic(30 patients and hypothermic(30 patients group and assessments regarding renal, respiratory and neurologic complications and bleeding volume was done. Resulst: Eighty percent of hypothermic group and 86% of normothermic group were males (p=0/36. Mean age was 56.4 and 56.1 years in hypothermic and normothermic groups, respectively. Groups had similar central temperature, shivering, nipride usage, intake and output, bleeding volume, neurologic complications and ICU staying(p>0/05 but inotrop usage and incidence of phrenic nerve palsy were higher in hypothermic group(p<0/05. Conclusion: Hypothermic procedure leads to a lower rate of respiratory complications, therefore we recommend replacing hypothermic procedure by normothermic one.

  5. Use of radioactive glucosamine in the perfused rat liver to prepare α1-acid glycoprotein (orosomucoid) with 3H- or 14C-labelled sialic acid and N-acetylglucosamine residues

    International Nuclear Information System (INIS)

    Aronson, N.N. Jr.

    1982-01-01

    A method was developed whereby [1- 14 C]glucosamine was used in a perfused rat liver system to prepare over 2 mg of α 1 -acid glycoprotein with highly radioactive sialic acid and glucosamine residues. The liver secreted radioactive α 1 -acid glycoprotein over a 4-6 h period, and this glycoprotein was purified from the perfusate by chromatography on DEAE-cellulose at pH3.6. The sialic acid on the isolated glycoprotein had a specific radioactivity of 3.1 Ci/mol, whereas the glucosamine-specific radioactivity was 4.3 Ci/mole. The latter amino-sugar residues on the isolated protein were only 13-fold less radioactive than the initially added [1- 14 C]glucosamine. Orosomucoid with a specific radioactivity of 31.3 μCi/mg of protein was obtainable by using [6- 3 H]glucosamine. Many other radioactive glycoproteins were found to be secreted into the perfusate by the liver. Thus this experimental system should prove useful for obtaining other serum glycoproteins with highly radioactive sugar moieties. (author)

  6. Hepatic sinusoid is not well-stirred: estimation of the degree of axial mixing by analysis of lobular concentration gradients formed during uptake of thyroxine by the perfused rat liver

    International Nuclear Information System (INIS)

    Weisiger, R.A.; Mendel, C.M.; Cavalieri, R.R.

    1986-01-01

    Two general models have been proposed for predicting the effects of metabolism, protein binding, and plasma flow on the removal of drugs by the liver. These models differ in the degree of plasma mixing assumed to exist within each hepatic sinusoid. The venous equilibrium model treats the sinusoid as a single well-stirred compartment, whereas the sinusoidal model effectively breaks up the sinusoid into a large number of sequentially perfused compartments which do not exchange their contents except through plasma flow. As a consequence, the sinusoidal model, but not the venous equilibrium model, predicts that the concentration of highly extracted drugs will decline as the plasma flows through the hepatic lobule. To determine which of these alternative models best describes the hepatic uptake process, we looked for evidence that concentration gradients are formed during the uptake of [ 125 I]thyroxine by the perfused rat liver. Autoradiography of tissue slices after perfusion of the portal vein at physiologic flow rates with protein-free buffer containing [ 125 I]thyroxine demonstrated a rapid exponential fall in grain density with distance from the portal venule, declining by half for each 8% of the mean length of the sinusoid. Reversing the direction of perfusate flow reversed the direction of the autoradiographic gradients, indicating that they primarily reflect differences in the concentration of thyroxine within the hepatic sinusoids rather than differences in the uptake capacity of portal and central hepatocytes. Analysis of the data using models in which each sinusoid was represented by different numbers of sequentially perfused compartments (1-20) indicated that at least eight compartments were necessary to account for the magnitude of the gradients seen

  7. Extracts from the Mongolian traditional medicinal plants Dianthus versicolorFisch. and Lilium pumilum Delile stimulate bile flow in an isolated perfused rat liver model.

    Science.gov (United States)

    Obmann, Astrid; Tsendayush, Damba; Thalhammer, Theresia; Zehl, Martin; Vo, Thanh Phuong Nha; Purevsuren, Sodnomtseren; Natsagdorj, Damdinsuren; Narantuya, Samdan; Kletter, Christa; Glasl, Sabine

    2010-10-05

    Dianthus versicolor (Caryophyllaceae) and Lilium pumilum (Liliaceae) are two medicinal plants used in traditional Mongolian medicine to treat hepatic and gastrointestinal disorders. In this study aqueous (AE) and methanolic (ME) extracts of Dianthus versicolor and Lilium pumilum were investigated for their influence on the bile flow. The aqueous extracts of both plants were tested in absence and presence of 10 μM taurocholic acid at three different concentrations (100, 250, and 500 mg/L). The aqueous extract of Dianthus versicolor was further purified in order to locate the active principles. Two resulting fractions, one enriched in flavonoids and the other in sugars, were investigated for their influence on the bile flow in absence of taurocholic acid at 10, 20, and 40 mg/L. The aqueous extracts of both plants were analysed qualitatively by LC-MS(n) and quantitatively by UV-spectrophotometry. The bile flow experiments were performed in the isolated perfused rat liver. The compounds were identified by LC-DAD-MS(n) and TLC using references. The UV-spectrophotometric analysis was based on the monograph "Passiflorae herba" of the European Pharmacopoeia, and the total flavonoid contents were calculated and expressed as vitexin. AE and ME of both plants increased the bile flow dose-dependently (between 9% and 30%), and no hepatotoxic effect was seen even during longer perfusions. Stimulation of bile secretion was comparable in the presence and in the absence of taurocholic acid. The flavonoid fraction of Dianthus versicolor increased the bile flow by 18% (pLilium pumilum (total flavonoid content 1.04%) the flavonoids rutoside, kaempferol-3-O-rutinoside, and isorhamnetin-3-O-rutinoside were detected. The results show that choleresis under extract application is due to a stimulation of the bile-salt-independent bile flow which might be caused by the osmotic power of the extracts (hydrocholeresis). The flavonoids seem to contribute to the bile-flow-stimulating effect of

  8. Assessment of liver circulation by quantitative scintiangiography: Evaluation of the relative contribution of the hepatic arterial and portal venous blood flows to liver perfusion

    International Nuclear Information System (INIS)

    Molino, G.; Squadrone, E.; Baccegal, M.; Magnani, C.

    1989-01-01

    Quantitative hepatic scintiangiography was previously used for evaluating the relative contribution of hepatic arterial and portal venous blood flows to the hepatic circulation. The present study compares 3 different procedures (automatic and manual integration, and slope fitting methods) for analyzing the hepatic time activity curves obtained after bolus i.v. injection of 370 MBq 99m Tc-diethylentriaminopentacetic acid. Twenty five subjects were studied: Five controls, ten cirrhotics, and ten portal hypertensive patients previously submitted to side to side portacaval anastomosis. The correspondence between results given by the different methods was satisfactory only in shunted patients, and the reproducibility of computed parameters was quite poor for all procedures. Accordingly, none of the methods can be considered as supporting reliable quantitative pathophysiological evaluations. However, the hepatic arterial/portal venous flow ratio was found to be increased in liver cirrhosis and in shunted patients and therefore, in spite of the limitations underlined before and of the absence of data on the reproducibility of consecutive injections, hepatic scintiangiography may be of some clinical utility. (orig.)

  9. The effect of normothermic recirculation before cold preservation on post-transplant injury of ischemically damaged donor kidneys

    NARCIS (Netherlands)

    Moers, Cyril; van Rijt, Geert; Ploeg, Rutger J.; Leuvenink, Henri G. D.

    Kidneys recovered from donation after cardiac death (DCD) are increasingly used to enlarge the deceased donor pool. Such renal grafts, especially those derived from uncontrolled DCD, have inevitably sustained profound warm ischemic injury, which compromises post-transplant function. Normothermic

  10. Hepatic necro-inflammation and elevated liver enzymes: Evaluation with MRI perfusion imaging with gadoxetic acid in chronic hepatitis patients

    International Nuclear Information System (INIS)

    Chen, B.-B.; Hsu, C.-Y.; Yu, C.-W.; Kao, J.-H.; Lee, H.-S.; Liang, P.-C.; Wei, S.-Y.; Hwang, R.-M.; Shih, T.T.-F.

    2014-01-01

    Aim: To evaluate liver necro-inflammation and function by using gadoxetic acid-enhanced dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with histological analysis as the reference standard. Materials and methods: Seventy-nine subjects (21 healthy subjects; 58 chronic hepatitis patients) who received gadoxetic acid-enhanced DCE-MRI were divided into three subgroups: no (A0, n = 31), mild (A1, n = 27), and moderate–severe (A2–A3, n = 21) activities. Two DCE-MRI models were measured: (1) a dual-input single-compartment model to obtain absolute arterial, portal venous, and total blood flow, arterial fraction (ART), distribution volume, and mean transit time; (2) a curve analysis method to obtain peak, slope, and AUC (area under curve). The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels also obtained. Statistical testing included Kruskal–Wallis tests for continuous data, Pearson's correlation tests, and multiple linear regression analyses. Results: Hepatic necro-inflammatory activity grades were significantly correlated with fibrotic stages, serum ALT level, ART and AUC. ART was helpful to predict the mild activity (≤A1 versus >A1; Az = 0.728), whereas AUC could differentiate no activity from any activity (A0 versus >A0; Az = 0.703). Peak, slope and AUC were all associated with AST and ALT (p < 0.05). Conclusion: Gadoxetic acid-enhanced DCE-MRI parameters may be used to evaluate the severity of hepatic necro-inflammation and function

  11. Donation after cardio-circulatory death liver transplantation

    Science.gov (United States)

    Le Dinh, Hieu; de Roover, Arnaud; Kaba, Abdour; Lauwick, Séverine; Joris, Jean; Delwaide, Jean; Honoré, Pierre; Meurisse, Michel; Detry, Olivier

    2012-01-01

    The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT. PMID:22969222

  12. Evaluation of Texture Analysis Parameter for Response Prediction in Patients with Hepatocellular Carcinoma Undergoing Drug-eluting Bead Transarterial Chemoembolization (DEB-TACE) Using Biphasic Contrast-enhanced CT Image Data: Correlation with Liver Perfusion CT.

    Science.gov (United States)

    Kloth, Christopher; Thaiss, Wolfgang M; Kärgel, Rainer; Grimmer, Rainer; Fritz, Jan; Ioanoviciu, Sorin Dumitru; Ketelsen, Dominik; Nikolaou, Konstantin; Horger, Marius

    2017-11-01

    This study aimed to evaluate the potential role of computed tomography texture analysis (CTTA) of arterial and portal-venous enhancement phase image data for prediction and accurate assessment of response of hepatocellular carcinoma undergoing drug-eluting bead transarterial chemoembolization (TACE) by comparison to liver perfusion CT (PCT). Twenty-eight patients (27 male; mean age 67.2 ± 10.4) with 56 hepatocellular carcinoma-typical liver lesions were included. Arterial and portal-venous phase CT data obtained before and after TACE with a mean time of 39.93 ± 62.21 days between examinations were analyzed. TACE was performed within 48 hours after first contrast-enhanced CT. CTTA software was a prototype. CTTA analysis was performed blinded (for results) by two observers separately. Combined results of modified Response Evaluation Criteria In Solid Tumors (mRECIST) and PCT of the liver were used as the standard of reference. Time to progression was additionally assessed for all patients. CTTA parameters included heterogeneity, intensity, average, deviation, skewness, and entropy of co-occurrence. Each parameter was compared to those of PCT (blood flow [BF], blood volume, arterial liver perfusion [ALP], portal-venous perfusion, and hepatic perfusion index) measured before and after TACE. mRECIST + PCT yielded 28.6% complete response (CR), 42.8% partial response, and 28.6% stable disease. Significant correlations were registered in the arterial phase in CR between changes in mean heterogeneity and BF (P = .004, r = -0.815), blood volume (P = .002, r = -0.851), and ALP (P = .002, r = -0.851), respectively. In the partial response group, changes in mean heterogeneity correlated with changes in ALP (P = .003) and to a lesser degree with hepatic perfusion index (P = .027) in the arterial phase. In the stable disease group, BF correlated with entropy of nonuniformity (P = .010). In the portal-venous phase, no statistically

  13. The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation

    Directory of Open Access Journals (Sweden)

    Israel Grilo

    Full Text Available Background: The macro-aggregated albumin lung perfusion scan (99mTc-MAA is a diagnostic method for hepatopulmonary syndrome (HPS. Aim: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. Methods: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT were prospectively analyzed. A transthoracic contrast echocardiography and 99mTc-MAA were performed in 85 patients, and 74 patients were diagnosed with HPS. Results: The overall sensitivity of 99mTc-MAA for the diagnosis of HPS was 18.9% (14/74 in all of the HPS cases and 66.7% (4/6 in the severe to very severe cases. In HPS patients who did not have lung disease, the degree of brain uptake of 99mTc-MAA was correlated with the alveolar-arterial oxygen gradient (A-a PO2 (r = 0.32, p < 0.05 and estimated oxygen shunt (r = 0.41, p < 0.05 and inversely correlated with partial pressure of arterial oxygen (PaO2 while breathing 100% O2 (r = -0.43, p < 0.05. The 99mTc-MAA was positive in 20.6% (7/36 of the patients with HPS and lung disease. The brain uptake of 99mTc-MAA was not associated with mortality and normalized in all cases six months after LT. Conclusions: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT.

  14. Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage

    DEFF Research Database (Denmark)

    Schlader, Zachary J; Seifert, Thomas; Wilson, Thad E

    2013-01-01

    Hyperthermia reduces the capacity to withstand a simulated hemorrhagic challenge, but volume loading preserves this capacity. This study tested the hypotheses that acute volume expansion during hyperthermia increases cerebral perfusion and attenuates reductions in cerebral perfusion during...... a simulated hemorrhagic challenge induced by lower-body negative pressure (LBNP). Eight healthy young male subjects underwent a supine baseline period (pre-LBNP), followed by 15- and 30-mmHg LBNP while normothermic, hyperthermic (increased pulmonary artery blood temperature ~1.1°C), and following acute volume...

  15. Pronounced effect of minor changes in body temperature on ischemia and reperfusion injury in rat liver

    NARCIS (Netherlands)

    Heijnen, B. H.; van Veen, S. Q.; Straatsburg, I. H.; van Gulik, T. M.

    2001-01-01

    This study examined the effects of 1 degrees C hypo- or hyperthermia on in vivo liver ischemia and reperfusion (I/R) injury in 15 fasted male Wistar rats. Rats were ventilated, and rectal temperature was maintained at 36, 37 (normothermic), or 38 degrees C. In all rats, 70% liver ischemia was

  16. A novel microthermal probe for the measurement of perfusion

    Science.gov (United States)

    Yi, Ming; Kausik, Aditya; Podhajsky, Ronald J.; Mahajan, Roop L.

    2009-02-01

    Using micro-fabrication techniques a micro thermal probe has been developed in our laboratory to measure the thermal conductivity of biological tissues. This paper presents our latest experimental results which demonstrate the usefulness of the micro thermal probe in mapping the complicated perfusion field inside biological tissues. A perfused pig liver model has been constructed to simulate in vivo conditions. The portal vein and hepatic artery of a porcine liver were intubated and connected to a perfusion circuit. Saline water was perfused through the liver driven by a peristaltic pump. By varying the pumping rate of the perfused model, we measured the effective thermal conductivity at different perfusion rates in different locations. The results show that the effective thermal conductivity varies with the square root of the perfusion rate. Also, by rotating the micro probes, we observed a strong directional dependence of the effective thermal conductivity, revealing that perfusion is not a scalar but a vector field.

  17. Effects of Contrast-Enhanced Ultrasonography in Monitoring Hepatic Microcirculation After Rat Liver Ischemia-Reperfusion Injury.

    Science.gov (United States)

    Zhang, Yun-Fei; Li, Hong; Zhang, Bao-Hui; Fang, Xiu-Bin

    2016-06-01

    Our objective was to evaluate the effects of contrast-enhanced ultrasonography in monitoring microcirculation after rat liver ischemia-reperfusion injury. Male Wistar rats (n = 36) were divided into sham-operated and ischemia-reperfusion groups. Rats in the ischemia-reperfusion groups underwent normothermic liver ischemia for 15 minutes followed by 1, 6, or 24 hours of reperfusion. At different time points, contrast-enhanced ultrasonography was performed to determine peak intensity in monitoring hepatic microcirculation. In addition, serum levels of alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor α, and interleukin 1β levels were measured. Histopathologic changes were also observed. One hour after reperfusion, peak intensity values decreased, and serum levels of alanine aminotransferase, tumor necrosis factor α, and interleukin 1β increased significantly in the ischemia-reperfusion group compared with the sham-operated group. Histology results showed mild injury. Six hours after reperfusion, peak intensity values decreased continuously, serum levels of alanine aminotransferase, tumor necrosis factor α, and interleukin 1β decreased, and aspartate aminotransferase levels increased. Histology results showed severe injury compared with 1 hour after reperfusion. Twenty-four hours after reperfusion, peak intensity values increased, alanine aminotransferase and aspartate aminotransferase levels decreased, and histology results showed moderate injury compared with 6 hours after reperfusion. Peak intensity values were negatively correlated to alanine aminotransferase (P liver ischemia-reperfusion injury can be monitored by contrast-enhanced ultrasonography. The perfusion of contrast agents negatively correlates to the severity of injuries.

  18. : Myocardial Perfusion

    OpenAIRE

    Dacher, Jean-Nicolas; Lefebvre, V.; Dubourg, Bernard; Deux, Jean-François; Caudron, Jérôme

    2013-01-01

    International audience; The analysis of myocardial perfusion is a key step in the cardiac MRI examination. In routine work, this exploration carried out at rest is based on the qualitative first pass study of gadolinium with an ECG-triggered saturation recovery bFFE sequence. In view of recent knowledge, the analysis of the myocardial perfusion under vasodilator stress may be carried out by scintigraphy or MRI, the latter benefiting from the absence of exposure to ionizing rays and a lower co...

  19. Effect of post-exercise hydrotherapy water temperature on subsequent exhaustive running performance in normothermic conditions.

    Science.gov (United States)

    Dunne, Alan; Crampton, David; Egaña, Mikel

    2013-09-01

    Despite the widespread use of cold water immersion (CWI) in normothermic conditions, little data is available on its effect on subsequent endurance performance. This study examined the effect of CWI as a recovery strategy on subsequent running performance in normothermic ambient conditions (∼22°C). Nine endurance-trained men completed two submaximal exhaustive running bouts on three separate occasions. The running bouts (Ex1 and Ex2) were separated by 15min of un-immersed seated rest (CON), hip-level CWI at 8°C (CWI-8) or hip-level CWI at 15°C (CWI-15). Intestinal temperature, blood lactate and heart rate were recorded throughout and V˙O2, running economy and exercise times were recorded during the running sessions. Running time to failure (min) during Ex2 was significantly (p<0.05, ES=0.7) longer following CWI-8 (27.7±6.3) than CON (23.3±5) but not different between CWI-15 (26.3±3.4) and CON (p=0.06, ES=0.7) or CWI-8 and CWI-15 (p=0.4, ES=0.2). Qualitative analyses showed a 95% and 89% likely beneficial effect of CWI-8 and CWI-15 during Ex2 compared with CON, respectively. Time to failure during Ex2 was significantly shorter than Ex1 only during the CON condition. Intestinal temperature and HR were significantly lower for most of Ex2 during CWI-8 and CWI-15 compared with CON but they were similar at failure for the three conditions. Blood lactate, running economy and V˙O2 were not altered by CWI. These data indicate that a 15min period of cold water immersion applied between repeated exhaustive exercise bouts significantly reduces intestinal temperature and enhances post-immersion running performance in normothermic conditions. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Alterations in the perfusion and distribution after normo- and hypothermic ischemia of the kidneys

    International Nuclear Information System (INIS)

    Pfeifer, K.J.; Heinze, H.G.; Eisenberger, F.; Chaussy, C.; Wirth, H.; Muenchen Univ.; Muenchen Univ.

    1976-01-01

    Experimental examinations were performed in 22 dogs to find out the mechanism which leads to a permanent or a reversible damage of the renal parenchyma after normo- and hypothermic ischemia. For this reason the perfusion and the distribution were examined with 133 Xe, the vasculat changes by angiography, and the parenchymal function with 131 I-Hippuran. After normothermic ischemia a short-term reactive hyperemia appeared, which however could not compensate the damage of the renal tubular cells and the resulting excretory insufficiency. After hypothermic ischemia the perfusion was reduced, probably as a consequence of a vasoconstriction by cold, however, the function of the tubular cells remained intact, because of the protective mechanism of the hypothermia. The importance of these findings for the development of the so called 'shock-kidney' (acute tubular necrosis) and for the conservative renal surgery in hypothermia is discussed and the application of measures beneficial to perfusion, are suggested. (orig.) [de

  1. GPU-accelerated voxelwise hepatic perfusion quantification.

    Science.gov (United States)

    Wang, H; Cao, Y

    2012-09-07

    Voxelwise quantification of hepatic perfusion parameters from dynamic contrast enhanced (DCE) imaging greatly contributes to assessment of liver function in response to radiation therapy. However, the efficiency of the estimation of hepatic perfusion parameters voxel-by-voxel in the whole liver using a dual-input single-compartment model requires substantial improvement for routine clinical applications. In this paper, we utilize the parallel computation power of a graphics processing unit (GPU) to accelerate the computation, while maintaining the same accuracy as the conventional method. Using compute unified device architecture-GPU, the hepatic perfusion computations over multiple voxels are run across the GPU blocks concurrently but independently. At each voxel, nonlinear least-squares fitting the time series of the liver DCE data to the compartmental model is distributed to multiple threads in a block, and the computations of different time points are performed simultaneously and synchronically. An efficient fast Fourier transform in a block is also developed for the convolution computation in the model. The GPU computations of the voxel-by-voxel hepatic perfusion images are compared with ones by the CPU using the simulated DCE data and the experimental DCE MR images from patients. The computation speed is improved by 30 times using a NVIDIA Tesla C2050 GPU compared to a 2.67 GHz Intel Xeon CPU processor. To obtain liver perfusion maps with 626 400 voxels in a patient's liver, it takes 0.9 min with the GPU-accelerated voxelwise computation, compared to 110 min with the CPU, while both methods result in perfusion parameters differences less than 10(-6). The method will be useful for generating liver perfusion images in clinical settings.

  2. GPU-Accelerated Voxelwise Hepatic Perfusion Quantification

    Science.gov (United States)

    Wang, H; Cao, Y

    2012-01-01

    Voxelwise quantification of hepatic perfusion parameters from dynamic contrast enhanced (DCE) imaging greatly contributes to assessment of liver function in response to radiation therapy. However, the efficiency of the estimation of hepatic perfusion parameters voxel-by-voxel in the whole liver using a dual-input single-compartment model requires substantial improvement for routine clinical applications. In this paper, we utilize the parallel computation power of a graphics processing unit (GPU) to accelerate the computation, while maintaining the same accuracy as the conventional method. Using CUDA-GPU, the hepatic perfusion computations over multiple voxels are run across the GPU blocks concurrently but independently. At each voxel, non-linear least squares fitting the time series of the liver DCE data to the compartmental model is distributed to multiple threads in a block, and the computations of different time points are performed simultaneously and synchronically. An efficient fast Fourier transform in a block is also developed for the convolution computation in the model. The GPU computations of the voxel-by-voxel hepatic perfusion images are compared with ones by the CPU using the simulated DCE data and the experimental DCE MR images from patients. The computation speed is improved by 30 times using a NVIDIA Tesla C2050 GPU compared to a 2.67 GHz Intel Xeon CPU processor. To obtain liver perfusion maps with 626400 voxels in a patient’s liver, it takes 0.9 min with the GPU-accelerated voxelwise computation, compared to 110 min with the CPU, while both methods result in perfusion parameters differences less than 10−6. The method will be useful for generating liver perfusion images in clinical settings. PMID:22892645

  3. Synergistic suppression of pre-perfusion of donor livers with recipient serum and cobra venom factor treatment on hyperacute rejection following liver xenotransplantation Supressão sinérgica da rejeição hiperaguda no xenotransplante hepático com uso da pre-perfusão dos fígados doadores tratados com soro do receptor e com fator veneno de cobra

    Directory of Open Access Journals (Sweden)

    Baohua Zhu

    2012-05-01

    Full Text Available PURPOSE: To investigate synergistic suppression of donor liver pre-perfusion with recipient serum (RS and cobra venom factor (CVF treatment on hyperacute rejection (HAR following liver xenotransplantation. METHODS: Guinea-pigs (GP, n=24 and Sprague-Dawley rats (SD, n=24 were recruited. Before transplantation, serum was collected from SD rats and used for preparation of inactivated complements. GP and SD rats were randomly assigned into four groups (n=6, respectively: RS group, CVF group, RS+CVF group and control group. Orthotopic liver xenotransplantation was performed with modified two-cuff technique. The survival time and liver function of recipients, morphological and pathological changes in rat livers were investigated. RESULTS: There was no piebald like change in the recipient livers in all experiment groups. The survival time of recipients in all experiment groups was longer than that in control group (pOBJETIVO: Investigar a supressão sinérgica da pré-perfusão do doador de fígado com soro do receptor (SR e tratamento com fator veneno de cobra (FVC na rejeição hiperaguda (RHA após o xenotransplante de fígado. MÉTODOS: Foram utilizados Cobaias (GP, n=24 e ratos Sprague-Dawley (SD, n=24. Antes do transplante foram coletadas amostras de soro dos ratos SD e usados para a preparação dos complementos inativados. Cobaias GP e ratos SD foram randomicamente distribuídos em quatro grupos (n=6, respectivamente: grupo RS, grupo FVC, grupo SR+FVC e grupo controle. Xenotransplante ortotópico do fígado foi realizado com a técnica de dois cuffs modificados. Foram investigados o de tempo de sobrevida, a função hepática dos receptores e alterações morfopatológicas em fígados de ratos. RESULTADOS: Não houve alteração na coloração do parênquima dos fígados nos receptores. O tempo de sobrevida dos receptores em todos os grupos experimentais foi mais longo do que o grupo controle (p<0,05. Além disso, o tempo de sobrevida do grupo

  4. Cerebral blood flow measured by positron emission tomography during normothermic cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Kjærgaard, Benedict; Alstrup, Aage Kristian Olsen

    2018-01-01

    emission tomography (PET) using 15O-labelled water with no pharmacological interventions to maintain the MAP. METHODS: Eight pigs (69-71 kg) were connected to normothermic CPB. After 60 minutes (min) with a CPB pump flow of 60 mL/kg/min, the pigs were changed to either 35 mL/kg/min or 47.5 mL/kg/min for 60...... to complications. CBF increased from spontaneous circulation to a CPB pump flow of 60 mL/kg/min. A reduction in CPB pump flow to 47.5 mL/kg/min (n=3) resulted in only minor changes in CBF while a reduction to 35 mL/kg/min (n=3) caused a pronounced change (correlation coefficient (R2) 0.56). A return of CPB pump...

  5. Development of an Ex-Situ Limb Perfusion System for a Rodent Model.

    Science.gov (United States)

    Gok, Emre; Alghanem, Fares; Moon, Ruth; Guy, Erin; Rojas-Pena, Alvaro; Bartlett, Robert H; Ozer, Kagan

    2018-03-26

    Ex-situ perfusion (ESP) is a promising method in preserving vascularized composite tissue allografts (VCAs) with potential to widen donor procurement to larger geographic areas. To optimize the method of preservation, we developed a small animal model to conduct biomolecular investigations. Twenty rat hind limbs (18.2 ± 1.3 g) were procured and connected to our custom-made ESP system. Perfusion pressure and flow parameters were measured with hourly blood gas analysis under near-normothermic (30-35˚C) conditions. Perfusate was prepared with swine hemoglobin (6-9 g/dL) and STEEN Solution. After 6 hours of perfusion, gastrocnemius muscles were evaluated for their histology and metabolomic profiling. Following 3 sets of experiments, perfusion was maintained at an average flow of 0.9 ± 0.24 mL/min and resulted in lactate levels of 3.78 ± 1.02 mmol/L. Metabolomic analysis revealed maintained cellular energy stores (total adenylates perfusion 0.698 ± 0.052 versus baseline 0.685 ± 0.091 umols/ug, p = 0.831), and histologic analysis revealed no evidence of barotrauma or myodegeneration. Rat hind limbs were viable after 6 hours of ESP on our miniaturized ESP system. This study is the first to document the ex-situ hind limb perfusion platform on a rodent model. These experimental findings have potential to guide future research to extend the viable duration of VCA preservation.

  6. Selective hypertrophy of the lobus caudatus as a novel approach enabling extended right hepatectomy in the presence of a non-perfused left lateral liver lobe.

    Science.gov (United States)

    Atanasov, Georgi; Schmelzle, Moritz; Thelen, Armin; Wiltberger, Georg; Hau, Hans-Michael; Krenzien, Felix; Petersen, Tim-Ole; Moche, Michael; Jonas, Sven

    2014-08-01

    Portal vein embolization (PVE) is a well-established technique to enhance functional hepatic reserves of segments II and III before curative extended right hepatectomy for tumors of the right liver lobe. However, an adequate hepatopetal flow of the left lateral portal vein branches is required for a sufficient PVE-associated hypertrophy. Here, we report a 65-year old patient suffering from a locally advanced intrahepatic cholangiocarcinoma in the right liver lobe and segment IV. A curative extended right hepatectomy after preoperative PVE of liver segments IV-VIII was initially impossible because of partial thrombosis of the left lateral portal vein branches resulting in an ischemic-type atrophy of segments II and III. However, due to a massive hypertrophy of the caudate lobe following PVE of liver segments IV-VIII, subsequent extended right hepatectomy with intraoperative thrombectomy of segments II and III was made possible. To our knowledge this is the first case in which an extended right hepatectomy for a liver malignancy, in the presence of atrophic left lateral section, was made possible by a massive PVE-associated hypertrophy of the caudate lobe.

  7. Comparison of organ-specific-radiation dose levels between 70 kVp perfusion CT and standard tri-phasic liver CT in patients with hepatocellular carcinoma using a Monte-Carlo-Simulation-based analysis platform.

    Science.gov (United States)

    Gawlitza, J; Haubenreisser, H; Meyer, M; Hagelstein, C; Sudarski, S; Schoenberg, S O; Henzler, T

    2016-01-01

    The aim of this study was to systematically compare organ-specific-radiation dose levels between a radiation dose optimized perfusion CT (dVPCT) protocol of the liver and a tri-phasic standard CT protocol of the liver using a Monte-Carlo-Simulation-based analysis platform. The complete CT data of 52 patients (41 males; mean age 65 ± 12) with suspected HCC that underwent dVPCT examinations on a 3rd generation dual-source CT (Somatom Force, Siemens) with a dose optimized tube voltage of 70 kVp or 80 kVp were exported to an analysis platform (Radimetrics, Bayer). The dVPCT studies were matched with a reference group of 50 patients (35 males; mean age 65 ± 14) that underwent standard tri-phasic CT (sCT) examinations of the liver with 130 kVp using the calculated water-equivalent-diameter of the patients. The analysis platform was used for the calculation of the organ-specific effective dose (ED) as well as global radiation-dose parameters (ICRP103). The organ-specific ED of the dVPCT protocol was statistically significantly lower when compared to the sCT in 14 of 21, and noninferior in a total of 18 of 21 examined items (all p examinations were especially in the dose sensitive organs such as the red marrow (17.3 mSv vs 24.6 mSv, p = effective organ dose levels, especially in dose sensitive organs, while providing additional functional information which is of paramount importance in patients undergoing novel targeted therapies.

  8. The effect of pregnancy and estradiol-17 beta treatment on the biliary transport maximum of dibromosulfophthalein, and the glucuronide conjugates of 5-phenyl-5-p-hydroxyphenyl[14C]hydantoin and [14C]morphine in the isolated perfused rat liver

    International Nuclear Information System (INIS)

    Auansakul, A.C.; Vore, M.

    1982-01-01

    The biliary transport maximum (Tm) of three organic axions was determined in the isolated perfused livers of untreated female (control), estradiol-17 beta (E2)-treated female (1 mg/kg/day, s.c. for 14 days), and pregnant (19-21 days of gestation) rats. Dibromosulfophthalein (DBSP), 5-phenyl-5-p-hydroxyphenyl[ 14 C]hydantoin (HPPH) and [ 14 C]morphine were infused continuously into the perfusate for a total dose of 41.2, 18, or 40.5 mumol, respectively. The concentration of [ 14 C]HPPH and [ 14 C]morphine declined in the perfusate, whereas the concentrations of [ 14 C]HPPH glucuronide and [ 14 C]morphine glucuronide increased during the 90-min experiment, indicating that the rate of formation of the glucuronide exceeded its rate of excretion in bile. E2 treatment decreased the Tm (nmol/min/g liver) for [ 14 C]HPPH glucuronide and [ 14 C]morphine glucuronide but not for DBSP, whereas pregnancy decreased the Tm for all three organic anions. Pregnancy, and to a lesser extent E2 treatment, increased liver weight. When expressed per whole liver, the Tm was not altered by pregnancy for any of three organic anions. E2 treatment increased the Tm for DBSP, had no effect on the Tm for HPPH glucuronide and decreased the Tm for [ 14 C]morphine glucuronide. These data suggest the presence of multiple carriers for organic anions which are differentially affected by estrogen treatment and pregnancy

  9. Hepatic vascular isolation and perfusion for patients with progressive unresectable liver metastases from colorectal carcinoma refractory to previous systemic and regional chemotherapy

    Czech Academy of Sciences Publication Activity Database

    Alexander, HR.; Libutti, S. K.; Barlett, D. L.; Pingpank, J. F.; Kranda, Karel; Helsabeck, C.; Beresnev, T.

    2002-01-01

    Roč. 95, č. 4 (2002), s. 730-736 ISSN 0008-543X R&D Projects: GA AV ČR KSK4055109 Keywords : colorectal carcinoma * liver metastases * regional chemotherapy Subject RIV: FD - Oncology ; Hematology Impact factor: 1.000, year: 2002

  10. Hepatic perfusion changes in an experimental model of acute pancreatitis: Evaluation by perfusion CT

    Energy Technology Data Exchange (ETDEWEB)

    Tutcu, Semra [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Serter, Selim, E-mail: serterselim@gmail.co [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Kaya, Yavuz; Kara, Eray [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Nese, Nalan [Department of Pathology, Celal Bayar University, School of Medicine, Manisa (Turkey); Pekindil, Goekhan [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Coskun, Teoman [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey)

    2010-08-15

    Purpose: It is known that acute pancreatitis may cause secondary changes in several organs. Liver is one of these involved organs. In different experimental studies hepatic damages were shown histopathologically in acute pancreatitis but there are a few studies about perfusion disorders that accompany these histopathologic changes. Perfusion CT (pCT) provides the ability to detect regional and global alterations in organ blood flow. The purpose of the study was to describe hepatic perfusion changes in experimental acute pancreatitis model with pCT. Materials and methods: Forty Sprague-Dawley rats of both genders with average weights of 250 g were used. Rats were randomized into two groups. Twenty rats were in control group and 20 in acute pancreatitis group. pCT was performed. Perfusion maps were formed by processing the obtained images with perfusion CT software. Blood flow (BF) and blood volume (BV) values were obtained from these maps. All pancreatic and liver tissues were taken off with laparotomy and histopathologic investigation was performed. Student's t test was used for statistical analyses. Results: In pCT we found statistically significant increase in blood volume in both lobes of liver and in blood flow in right lobe of the liver (p < 0.01). Although blood flow in left lobe of the liver increased, it did not reach statistical significance. Conclusion: The quantitative analysis of liver parenchyma with pCT showed that acute pancreatitis causes a significant perfusion changes in the hepatic tissue. Systemic mediators seem to be effective as well as local inflammatory changes in perfusion changes.

  11. Combined liver-thoracic transplantation: single-center experience with introduction of the 'Liver-first' principle.

    Science.gov (United States)

    Ceulemans, Laurens J; Strypstein, Sébastien; Neyrinck, Arne; Verleden, Stijn; Ruttens, David; Monbaliu, Diethard; De Leyn, Paul; Vanhaecke, Johan; Meyns, Bart; Nevens, Frederik; Verleden, Geert; Van Raemdonck, Dirk; Pirenne, Jacques

    2016-06-01

    Combined liver/thoracic transplantation (cLiThTx) is a complex procedure for end-stage/advanced liver and heart(H)/lung(Lu) disease. To avoid futile use of multiple organs in single recipients, results should be scrutinously analyzed. Single-center cLiThTx (04/2000-12/2015) were reviewed for the following: demographics, indications, surgical technique, complications, rejection, and five-year patient survival. Results are reported as median (range). Fourteen consecutive patients underwent cLiThTx: 3 cLiHTx, 10 cLiLuTx, and 1 cLiHLuTx. Recipient age was 42 years (17-63 years). Most frequent indications were cystic fibrosis (n = 5), hepatopulmonary fibrosis (n = 2), amyloidosis (n = 2), and epithelioid hemangio-endothelioma (n = 2). Thoracic organs were transplanted first, except in three where LiTx preceded LuTx. In the latter, lungs were preserved by normothermic ex vivo lung perfusion. Stenting was performed for stenosis of bile duct (n = 4), hepatic artery (n = 2), and bronchus (n = 2). Abdominal interventions were required for bleeding (n = 3), evisceration (n = 1), and adhesiolysis (n = 1). One liver (cLiLuTx) was lost to hepatic artery thrombosis 3 months post-transplant and successfully retransplanted. One patient (cLiHTx) died 4 months post-transplant (myocardial infarction). Follow-up was 4 years (2 months-16 years). One liver and 5 pulmonary rejections occurred, all mild and reversible. Two patients developed bronchiolitis obliterans, one is clinically well 16 years post-transplant, and the other successfully retransplanted. Estimated 5-year patient survival is 90%. CLiThTx is safe with excellent short-/long-term surgical and immunological results. © 2016 Steunstichting ESOT.

  12. Time sequence of changes in the responsiveness of glycogen breakdown to adrenergic agonists in perfused liver of rats with insulin-induced hypoglycemia

    Directory of Open Access Journals (Sweden)

    M. Vardanega-Peicher

    2000-07-01

    Full Text Available The time-course changes of the responsiveness of glycogen breakdown to a- and ß-adrenergic agonists during insulin-induced hypoglycemia (IIH were investigated. Blood glucose levels were decreased prior to the alteration in the hepatic responsiveness to adrenergic agonists. The activation of hepatic glucose production and glycogenolysis by phenylephrine (2 µM and isoproterenol (20 µM was decreased in IIH. The changes in the responsiveness of glycogen catabolism were first observed for isoproterenol and later for phenylephrine. Hepatic ß-adrenergic receptors showed a higher degree of adrenergic desensitization than did a-receptors. Liver glycogen synthase activity, glycogen content and the catabolic effect of dibutyryl cyclic AMP (the ß-receptor second messenger were not affected by IIH.

  13. Preservation of Myocardial Perfusion and Function by Keeping Hypertrophied Heart Empty and Beating for Valve Surgery: An In Vivo MR Study of Pig Hearts.

    Science.gov (United States)

    Wang, Jian; Xiang, Bo; Deng, Jixian; Lin, Hung-Yu; Freed, Darren H; Arora, Rakesh C; Tian, Ganghong

    2017-01-01

    Objectives . Normothermic hyperkalemic cardioplegia arrest (NHCA) may not effectively preserve hypertrophied myocardium during open-heart surgery. Normothermic normokalemic beating perfusion (NNBP), keeping hearts empty-beating, was utilized as an alternative to evaluate its cardioprotective role. Materials and Methods . Twelve hypertrophied pig hearts at 58.6 ± 7.2 days after ascending aorta banding underwent NNBP and NHCA, respectively. Near infrared myocardial perfusion imaging with indocyanine green (ICG) was conducted to assess myocardial perfusion. Left ventricular (LV) contractile function was assessed by cine MRI. TUNEL staining and western blotting for caspase-3 cleavage and cardiac troponin I (cTnI) degradation were conducted in LV tissue samples. Results . Ascending aortic diameter was reduced by 52.7% ± 0.4% at approximately fifty-eight days after banding. LV wall thickness was significantly higher in aorta banding than in sham operation. Myocardial blood flow reflected by maximum ICG absorbance value was markedly higher in NNBP than in NHCA. The amount of apoptotic cardiomyocyte was significantly lower in NNBP than in NHCA. NNBP alleviated caspase-3 cleavage and cTnI degradation associated with NHCA. NNBP displayed a substantially increased postoperative ejection fraction relative to NHCA. Conclusions . NNBP was better than NHCA in enhancing myocardial perfusion, inhibiting cardiomyocyte apoptosis, and preserving LV contractile function for hypertrophied hearts.

  14. Liver perfusion in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI): comparison of enhancement in Gd-BT-DO3A and Gd-EOB-DTPA in normal liver parenchyma

    Energy Technology Data Exchange (ETDEWEB)

    Schalkx, Hanke J.; Bosch, Maurice A.A.J. van den; Veldhuis, Wouter B.; Leeuwen, Maarten S. van [University Medical Center Utrecht, Department of Radiology, PO Box 58800, Utrecht (Netherlands); Stralen, Marijn van; Pluim, Josien P.W. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Coenegrachts, Kenneth [Department of Radiology, Bruges (Belgium); Kessel, Charlotte S. van; Hillegersberg, Richard van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); Erpecum, Karel J. van [University Medical Center Utrecht, Department of Gastroenterology, Utrecht (Netherlands); Verkooijen, Helena M. [University Medical Center Utrecht, Clinical epidemiologist, Department of Radiology, Utrecht (Netherlands)

    2014-09-15

    Within-patient comparison of the enhancement patterns of normal liver parenchyma after gadobutrol and gadoxetate disodium, with emphasis on the start of hepatocytic uptake of gadoxetate disodium. Twenty-one patients (12 female, 9 male) without chronic liver disease underwent 1.5-T contrast-enhanced MRI twice, once with an extracellular contrast agent (gadobutrol) and once with a hepatospecific agent (gadoxetate disodium), using a T1-weighted keyhole sequence. Fifteen whole-liver datasets were acquired up to 5 min for both contrast agents and two additional datasets, up to 20 min, for gadoxetate. Signal intensities (SI) of the parenchyma, aorta and portal vein were measured and analysed relative to pre-contrast parenchymal SI. After gadoxetate, in 29 % of the patients the parenchymal SI decreased by ≥5 % after the initial vascular-phase-induced peak, while in the other 71 % the parenchymal SI remained stable or gradually increased until up to 20 min after the initial peak. The hepatocytic gadoxetate uptake started at a mean of 37.8 s (SD 14.7 s) and not later than 76 s after left ventricle enhancement. Parenchymal enhancement due to hepatocytic uptake of gadoxetate can start as early as in the late arterial phase. This may confound the assessment of lesion appearance as compared to extracellular contrast such as gadobutrol. (orig.)

  15. CT Perfusion of the Head

    Science.gov (United States)

    ... Site Index A-Z CT Perfusion of the Head Computed tomography (CT) perfusion of the head uses ... the Head? What is CT Perfusion of the Head? Computed tomography (CT) perfusion imaging shows which areas ...

  16. Liver transplantation from Maastricht category 2 non-heart-beating donors.

    Science.gov (United States)

    Otero, Alejandra; Gómez-Gutiérrez, Manuel; Suárez, Francisco; Arnal, Francisco; Fernández-García, Antón; Aguirrezabalaga, Javier; García-Buitrón, José; Alvarez, Joaquín; Máñez, Rafael

    2003-10-15

    The demand for liver transplantation has increasingly exceeded the supply of cadaver donor organs. Non-heart-beating donors (NHBDs) may be an alternative to increase the cadaver donor pool. The outcome of 20 liver transplants from Maastricht category 2 NHBDs is compared with 40 liver transplants from heart-beating donors (HBDs). After unsuccessful cardiopulmonary resuscitation (CPR), cardiopulmonary support (CPS) with simultaneous application of chest and abdominal compression (n=6), and cardiopulmonary bypass (CPB; n=14), which was hypothermic (n=7) or normothermic (n=7), were used to preserve the organs from NHBDs. Factors that may influence the outcome of livers from Maastricht category 2 NHBDs were also investigated. With a minimum follow-up of 2 years, actuarial patient and graft survivals with livers from Maastricht category 2 NHBDs were 80% and 55%, respectively. Transplantation of organs from these donors was associated with a significantly higher incidence of primary nonfunction, biliary complications, and more severe initial liver dysfunction compared with livers from HBDs. Graft survival was 83% in livers from NHBDs preserved with CPS and 42% in those maintained with CPB. No graft failed if the duration of warm ischemia did not exceed 130 min with CPR or CPS, and if the period of CPB did not surpass 150 min when this method was used after CPR, regardless if it was hypothermic or normothermic. Livers from Maastricht type 2 NHBDs may be used for transplantation if the period of warm ischemia during CPR or CPS does not exceed 130 min. Hypothermic or normothermic CPB after CPR preserves liver viability for an additional 150 min.

  17. Impact of Normothermic Preservation with Extracellular Type Solution Containing Trehalose on Rat Kidney Grafting from a Cardiac Death Donor

    Science.gov (United States)

    Iwai, Satomi; Kikuchi, Takeshi; Kasahara, Naoya; Teratani, Takumi; Yokoo, Takashi; Sakonju, Iwao; Okano, Shouzou; Kobayashi, Eiji

    2012-01-01

    Background The aim of this study was to investigate factors that may improve the condition of a marginal kidney preserved with a normothermic solution following cardiac death (CD) in a model of rat kidney transplantation (RTx). Methods Post-euthanasia, Lewis (LEW) donor rats were left for 1 h in a 23°C room. These critical kidney grafts were preserved in University of Wisconsin (UW), lactate Ringer's (LR), or extracellular-trehalose-Kyoto (ETK) solution, followed by intracellular-trehalose-Kyoto (ITK) solution at 4, 23, or 37°C for another 1 h, and finally transplanted into bilaterally nephrectomized LEW recipient rats (n = 4–6). Grafts of rats surviving to day 14 after RTx were evaluated by histopathological examination. The energy activity of these marginal rat kidneys was measured by high-performance liquid chromatography (HPLC; n = 4 per group) and fluorescence intensity assay (n = 6 per group) after preservation with UW or ETK solutions at each temperature. Finally, the transplanted kidney was assessed by an in vivo luciferase imaging system (n = 2). Results Using the 1-h normothermic preservation of post-CD kidneys, five out of six recipients in the ETK group survived until 14 days, in contrast to zero out of six in the UW group (pPreservation with ITK rather than ETK at 23°C tended to have an inferior effect on recipient survival (p = 0.12). Energy activities of the fresh donor kidneys decreased in a temperature-dependent manner, while those of post-CD kidneys remained at the lower level. ETK was superior to UW in protecting against edema of the post-CD kidneys at the higher temperature. Luminescence intensity of successful grafts recovered within 1 h, while the intensity of grafts of deceased recipients did not change at 1 h post-reperfusion. Conclusions Normothermic storage with extracellular-type solution containing trehalose might prevent reperfusion injury due to temperature-dependent tissue edema. PMID:22457739

  18. Intestinal Conditioning After Cardiac Arrest: The Use of Normothermic Extracorporeal Membrane Oxygenation in the Non-Heart-Beating Animal Model.

    Science.gov (United States)

    Guo, Mingxiao; Yao, Danhua; Li, Linlin; Lu, Chunlei; Li, Yousheng; Li, Jieshou

    2016-08-01

    The effect of normothermic extracorporeal membrane oxygenation (NECMO) on small bowel preservation in a clinically relevant large animal model of expected donation after cardiac death (eDCD) was evaluated. Thirty domestic crossbred donor pigs were divided into five groups. The first group served as the live donation (LD) group, the second group served as the donation after cardiac death (DCD) group, and the remaining were further assigned into three subgroups: E1 group (1 h NECMO support), E3 group (3 h NECMO support), and E5 group (5 h NECMO support). Pathology, electron microscopy, energy metabolism, cell apoptosis, and tight junction (TJ) protein expression level of intestinal mucosa and the level of plasma d-lactic acid were evaluated in normal, cardiac death and at the end of extracorporeal support, respectively. The mean arterial pressure and PaO2 were maintained over 60 and 267 mm Hg during NECMO support, respectively. One hour of extracorporeal support could improve the energy status in intestines of the DCD group. Although the histologic damage and apoptosis of the E1 group had no significant difference with those of the LD and DCD groups (P > 0.05), the levels of intestinal mucosa TJ protein decreased (P intestinal mucosa damage and intestinal permeability gradually increased, as well as the content of adenosine triphosphate in intestinal mucosa. The normothermic extracorporeal support for 1 h in DCD is beneficial for improving the energy status and viability of the bowel. However, the integrity of intestinal mucosa was destroyed gradually as extracorporeal support time went by. And the activation of intestinal epithelial apoptosis and hyperoxia might be the factors that lead to intestinal mucosa injury. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  19. Development of analytical methods for the gas chromatographic determination of 1,2-epoxy-3-butene, 1,2:3,4-diepoxybutane, 3-butene-1,2-diol, 3,4-epoxybutane-1,2-diol and crotonaldehyde from perfusate samples of 1,3-butadiene exposed isolated mouse and rat livers

    Energy Technology Data Exchange (ETDEWEB)

    Bhowmik, S.; Schuster, A.; Filser, J.G.

    2003-07-01

    Mutagenicity and carcinogenicity of 1,3-butadiene (BD) highly probably results from epoxide metabolites as 1,2-epoxy-3-butene (EB), 1,2:3,4-diepoxybutane (DEB) and 3,4-epoxybutane-1,2-diol (EBD). A further metabolite crotonaldehyde (CA) has also been discussed to be relevant. So far, in BD exposed rodents only EB and DEB concentrations had been quantified. However, the methods used were either not very sensitive or instrumentally expensive. Therefore, the goal of the present work was to establish simple analytical methods selective and sensitive enough to determine all of these compounds and a further secondary BD intermediate, 3-butene-1,2-diol (B-diol), in BD exposed rodent livers. The once-through perfused liver system was chosen for testing the applicability of the methods to be developed, since it enables BD exposures of this quantitatively most relevant metabolising organ near to the in-vivo situation. All the metabolites were extracted from the aqueous perfusion medium and analysed using a gas chromatograph equipped with a mass selective detector (GC/MS) in the PCI mode. (orig.)

  20. Laser doppler perfusion imaging

    International Nuclear Information System (INIS)

    Waardell, K.

    1992-01-01

    Recording of tissue perfusion is important in assessing the influence of peripheral vascular diseases on the microcirculation. This thesis reports on a laser doppler perfusion imager based on dynamic light scattering in tissue. When a low power He-Ne laser beam sequentally scans the tissue, moving blood cells generate doppler components in the back-scattered light. A fraction of this light is detected by a photodetector and converted into an electrical signal. In the processor, a signal proportional to the tissue perfusion at each measurement site is calculated and stored. When the scanning procedure is completed, a color-coded perfusion image is presented on a monitor. To convert important aspects of the perfusion image into more quantitative parameters, data analysis functions are implemented in the software. A theory describing the dependence of the distance between individual measurement points and detector on the system amplification factor is proposed and correction algorithms are presented. The performance of the laser doppler perfusion imager was evaluated using a flow simulator. A linear relationship between processor output signal and flow through the simulator was demonstrated for blood cell concentrations below 0.2%. The median sampling depth of the laser beam was simulated by a Monte Carlo technique and estimated to 235 μm. The perfusion imager has been used in the clinic to study perfusion changes in port wine stains treated with argon laser and to investigate the intensity and extension of the cutaneous axon reflex response after electrical nerve stimulation. The fact that perfusion can be visualized without touching the tissue implies elimination of sterilization problems, thus simplifying clinical investigations of perfusion in association with diagnosis and treatment of peripheral vascular diseases. 22 refs

  1. The heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Dümcke, Christine Winkler; Krag, Aleksander

    2009-01-01

    to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities, termed cirrhotic cardiomyopathy. Pathophysiological mechanisms include reduced......Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek...

  2. CT-based liver volumetry in a porcine model: impact on clinical volumetry prior to living donated liver transplantation

    International Nuclear Information System (INIS)

    Frericks, B.B.J.; Kiene, T.; Stamm, G.; Shin, H.; Galanski, M.

    2004-01-01

    Purpose: Exact preoperative determination of the liver volume is of great importance prior to hepatobiliary surgery, especially in living donated liver transplantation (LDLT). In the current literature, a strong correlation between preoperatively calculated and intraoperatively measured liver volumes has been described. Such accuracy seems questionable, primarily due to a difference in the perfusion state of the liver in situ versus after explantation. Purpose of the study was to asses the influence of the perfusion state on liver volume and the validity of the preoperative liver volumetry prior to LDLT. Methods: In an experimental study, 20 porcine livers were examined. The livers were weighted and their volumes were determined by water displacement prior and after fluid infusion to achieve a pressure physiologically found in the liver veins. The liver volumes in the different perfusion states were calculated based on CT-data. The calculated values were compared with the volume measured by water displacement and the weight of the livers. Results: Assessment of calculated CT volumes and water displacements at identical perfusion states showed a tight correlation and differed on average by 4 ± 5%. However, livers before and after fluid infusion showed a 33 ± 8% (350 ± 150 ml) difference in volume. Conclusion: CT-volumetry acquires highly accurate data as confirmed by water displacement studies. However, the perfusion state has major impact on liver volume, which has to be accounted for in clinical use. (orig.) [de

  3. MRI of myocardial perfusion.

    Science.gov (United States)

    Jerosch-Herold, Michael; Muehling, Olaf; Wilke, Norbert

    2006-02-01

    An overwhelming number of myocardial perfusion studies are done by nuclear isotope imaging. Magnetic resonance imaging during the first pass of an injected, contrast bolus has some significant advantages for detection of blood flow deficits, namely higher spatial resolution, absence of ionizing radiation, and speed of the test. Previous clinical studies have demonstrated that excellent sensitivity and specificity can be achieved with MR myocardial perfusion imaging for detecting coronary artery disease, and assessment of patients with acute chest pain. Furthermore, an absolute quantification of myocardial blood flow is feasible, as was demonstrated by comparison of MR perfusion imaging, to measurements with isotope labeled microspheres in experimental models. An integrated assessment of perfusion, function, and viability, is thus feasible by MRI to answer important clinical challenges such as the identification of stunned or hibernating, but viable myocardium.

  4. Measuring myocardial perfusion

    DEFF Research Database (Denmark)

    Qayyum, A A; Kastrup, J

    2015-01-01

    Recently, focus has changed from anatomical assessment of coronary arteries towards functional testing to evaluate the effect of stenosis on the myocardium before intervention. Besides positron-emission tomography (PET), cardiac MRI (CMR), and cardiac CT are able to measure myocardial perfusion......-known and is used in routine clinical practice. However, PET uses radioactive tracers and has a lower spatial resolution compared to CMR and CT. CMR and CT are emerging techniques in the field of myocardial perfusion imaging. CMR uses magnetic resonance to obtain images, whereas CT uses x-rays during first....... Myocardial perfusion abnormalities are the first sign of the ischaemic cascade in the development of coronary artery disease (CAD). PET is considered the non-invasive clinical reference standard for absolute quantification of myocardial perfusion. The diagnostic and prognostic value of PET is well...

  5. PHARMACOKINETIC ANALYSIS AND CELLULAR-DISTRIBUTION OF THE ANTI-HIV COMPOUND SUCCINYLATED HUMAN SERUM-ALBUMIN (SUC-HSA) IN-VIVO AND IN THE ISOLATED-PERFUSED RAT-LIVER

    NARCIS (Netherlands)

    JANSEN, RW; OLINGA, P; HARMS, G; MEIJER, DKF

    1993-01-01

    After intravenous injection of a low dose (25 mug/kg) in rats, the anti HIV-1 compound succinylated human serum albumin (Suc-HSA) is taken up mainly in the liver and spleen and is proteolytically degraded. Ten minutes after injection of I-125-Suc-HSA, 72 and 14% of the dose were found in the liver

  6. [MSCT perfusion imaging and its correlation with perfusion parameters, survivin expression, MVD, and pathologic grade in hepatocellular carcinomas].

    Science.gov (United States)

    Long, Xueying; Cao, Jue; Shi, Linbo; Li, Wenzheng; Liu, Hui

    2009-11-01

    (1)To obtain the perfusion parameters of hepatocellular carcinomas(HCCs), peritumour livers and normal livers by multi-slice CT(MSCT)and to investigate their characteristics and clinical significances;(2)To investigate the correlation among perfusion parameters, survivin expression, microvessel density(MVD)and pathologic grade of HCCs. A total of 31 patients with HCC (5 well-differentiated HCCs, 17 moderately differentiated HCCs, and 9 poorly differentiated HCCs) and 10 normal liver were studied. All underwent CT plain scan, perfusion scan, and conventional enhancement scan of the whole liver using 16-slice spiral CT (Philips Brilliance 16). Perfusion parameters were obtained by time-density curves (TDC) of region of interest (ROI) through the perfusion scans. Tissue sections of HCCs and their corresponding peritumour liver tissues of the 31 patients were detected by immunohistochemistry (SABC methods) for protein expression of survivin and MVD, and 10 normal liver tissue sections were as used as negative controls. The correlation among the perfusion parameters, survivin expression, MVD and pathology grade were analysed. (1)The mean values of HAP, HPP, TLP, and HAI of HCCs were 27.50 mL/(min.100 mL), 19.37 mL/(min.100 mL), 46.87 mL/(min.100 mL), and 60.38%, respectively. The mean values of those of the peritumour livers were 14.93 mL/(min.100 mL), 55.70 mL/(min.100 mL), 69.63 mL/(min.100 mL), and 21.51%, respectively. The mean value of those of the normal livers were 12.22 mL/(min.100mL), 74.56 mL/(min.100 mL), 86.78 mL/(min.100 mL), and 14.00%, respectively. The values of HAP and HAI of HCCs were significantly higher than those of the peritumor livers and the normal livers(PHAP and decrease of HPP of peritumor livers were both significant compared with that of the normal livers(PHAP, HPP, and HAI of HCCs were significantly different from those of peritumor livers (Pcancerous adjacent liver tissues and normal liver tissues (PHAP values were significantly and

  7. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  8. Isolated limb perfusion.

    Science.gov (United States)

    Gillespie, Rosalyn; Chantier, Nariane

    1994-12-08

    Growing concern over the rising incidence of malignant melanoma has brought about a need for information on this disorder and the treatment available. Isolated limb perfusion is a relatively new technique used in only a few hospitals. An increased knowledge base will lead to a better understanding of the nursing care required and to a more in-depth care plan.

  9. Renal versus splenic maximum slope based perfusion CT modelling in patients with portal-hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Brehmer, Katharina [Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden); Svensson, Anders; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden)

    2016-11-15

    To assess liver perfusion-CT (P-CT) parameters derived from peak-splenic (PSE) versus peak-renal enhancement (PRE) maximum slope-based modelling in different levels of portal-venous hypertension (PVH). Twenty-four patients (16 men; mean age 68 ± 10 years) who underwent dynamic P-CT for detection of hepatocellular carcinoma (HCC) were retrospectively divided into three groups: (1) without PVH (n = 8), (2) with PVH (n = 8), (3) with PVH and thrombosis (n = 8). Time to PSE and PRE and arterial liver perfusion (ALP), portal-venous liver perfusion (PLP) and hepatic perfusion-index (HPI) of the liver and HCC derived from PSE- versus PRE-based modelling were compared between the groups. Time to PSE was significantly longer in PVH groups 2 and 3 (P = 0.02), whereas PRE was similar in groups 1, 2 and 3 (P > 0.05). In group 1, liver and HCC perfusion parameters were similar for PSE- and PRE-based modelling (all P > 0.05), whereas significant differences were seen for PLP and HPI (liver only) in group 2 and ALP in group 3 (all P < 0.05). PSE is delayed in patients with PVH, resulting in a miscalculation of PSE-based P-CT parameters. Maximum slope-based P-CT might be improved by replacing PSE with PRE-modelling, whereas the difference between PSE and PRE might serve as a non-invasive biomarker of PVH. (orig.)

  10. Interactions of the heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Bernardi, Mauro

    2013-01-01

    There is a mutual interaction between the function of the heart and the liver and a broad spectrum of acute and chronic entities that affect both the heart and the liver. These can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting...... the heart and the liver at the same time. In chronic and acute cardiac hepatopathy, owing to cardiac failure, a combination of reduced arterial perfusion and passive congestion leads to cardiac cirrhosis and cardiogenic hypoxic hepatitis. These conditions may impair the liver function and treatment should...... be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities termed cirrhotic...

  11. Hypoxic stop-flow liver perfusion: Preliminary results in the treatment of multiple hepatic metastases; Perfusione antiblastica ipossica con blocco del flusso nella terapia delle metastasi epatiche: Risultati preliminari

    Energy Technology Data Exchange (ETDEWEB)

    Roversi, Rigoantonio; Ricci, Stefano; Rossi, Giuseppe; Roversi, Marina [Ospedale ``Bellaria - C.A. Pizzardi``, Bologna (Italy). Servizio di Radiologia Diagnostica; Cavallo, Giovanna [Ospedale ``Bellaria - C.A. Pizzardi``, Bologna (Italy). Divisione di Radioterapia e Oncologia; Fiorentini, Gianmaria [Ospedale ``S. Maria delle Croci``, Ravenna (Italy). Divisione di Oncologia

    1997-04-01

    Patients and methods: 27 patients (14 men and 13 women aged 35 to 71 years; average: 59 years), with 3-11 months` follow-up (average: 5 months) were treated for hepatic metastases (17/22 from colorectal, 10/22 from other primary tumors) with hypoxic locoregional hepatic perfusion. Sixteen of 22 patients had been pretreated with resection, systemic chemotherapy or free flow locoregional infusion. Their protocol consists in blocking arterial flow with an occlusion balloon catheter inflated in the hepatic artery; the main catheter channel is connected with a pump system and 250-300 ml saline with 30-40 mg Mitomycin C are perfused in the arterial hepatic system. Results: 19/27 patients are still alive, and 8/27 are dead but death was caused by the progression of intrahepatic disease in only 2/27 (7 %). Iatrogenic lesions of the arterial wall were shown at follow-up DSA in 15/22 patients (56 %). Thirteen CR (48 %) and 9 PR (33 %) were demonstrated at CT follow-up amounting to 81 % of objective responses. Follow-up showed a clinical CR in 12/18 symptomatic patients (66 %). No case of hematologic toxicity was observed. Mean CEA values changed from 129 to 10.60. Twelve of 27 patients exhibited mild posttreatment sequels, none of them lasting longer than three days; ischemic cholecystitis was seen in 3/15 cases (14 %). Conclusions: The occlusion catheters on the market are not optimal for this procedure; the axillary percutaneous approach is advantageous. CR rate was very high in their series but the objective response rate doses do not differ from those in the series with free-flow procedures. The highest CR rate was observed in untreated patients; the rate of clinical sequels was low, clinical CR rates were high and there was non hematologic toxicity. This well-tolerated procedure provides good local disease control, but the high rate of deaths from extrahepatic progression suggests that systemic chemotherapy and long-step intraarterial perfusion be combined.

  12. Early response evaluation using CT-perfusion one day after transarterial chemoembolization for HCC predicts treatment response and long-term disease control.

    Science.gov (United States)

    Tamandl, Dietmar; Waneck, Fredrik; Sieghart, Wolfgang; Unterhumer, Sylvia; Kölblinger, Claus; Baltzer, Pascal; Ba-Ssalamah, Ahmed; Loewe, Christian

    2017-05-01

    To determine the value of CT perfusion (CTP) for early response assessment after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Between April 2013 and April 2015, 41 HCC (16 patients) were included in this study. CT perfusion was performed before and one day after TACE. Blood flow (BF), blood volume (BV), time to start (TTS), arterial liver perfusion (ALP), portal liver perfusion (PVP) and hepatic perfusion index (HPI) were measured. Quantitative perfusion values before and after TACE were compared to the response assessed using mRECIST criteria six weeks after TACE and long-term outcome was assessed. Twenty-one lesions (51%) had complete remission (CR) and five (12%) had partial response (PR) six weeks after TACE. CTP parameters were significantly reduced after TACE in responders (PR, CR, pCT perfusion detects lesions with complete response one day after TACE, and is a feasible tool for early response assessment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Combined in situ hypothermic liver preservation and cardioplegia for resection of hepatoblastoma with intra-atrial extension in a 3 year old child

    Directory of Open Access Journals (Sweden)

    Julian Thalhammer

    2016-09-01

    Full Text Available Cure of hepatoblastoma requires complete macro- and microscopic resection of the tumor, without tumor rupture. In case of hepatoblastoma with intra-atrial tumor extension (ITE, “en bloc” resection of the hepatic tumor and ITE, with minimal risk of postoperative liver failure, constitutes a surgical challenge. We report on a 3 year old child with hepatoblastoma of the right liver lobe, and ITE through the upper Inferior Vena Cava. Initial chemotherapy (SIOPEL IV HR induced good response, but tumor persisted inside the right atrium with tight adhesions to the cardiac wall. “En bloc” right extended hepatectomy and removal of the ITE with reconstruction of the atrial and caval wall with autologous pericardial patch was performed under normothermic extracorporeal circulation and cardioplegia, combined with in situ hypothermic liver preservation of the remaining left liver. Complete tumor resection was achieved without tumor rupture. Postoperative liver function was immediately good and adjuvant chemotherapy was resumed per protocol. Eleven months after the end of treatment the child is in complete tumor remission. In children with hepatic tumor and ITE, combination of normothermic extracorporeal circulation with cardioplegia and in situ hypothermic liver preservation allows “en bloc” extended hepatectomy and removal of ITE, with limited risk of postoperative liver failure.

  14. Quantitative hepatic CT perfusion measurement: Comparison of Couinaud's hepatic segments with dual-source 128-slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xuan [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Xue, Hua-dan, E-mail: bjdanna95@hotmail.com [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Jin, Zheng-yu, E-mail: jin_zhengyu@163.com [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China); Su, Bai-yan; Li, Zhuo; Sun, Hao; Chen, Yu; Liu, Wei [The Department of Radiology, Peking Union Medical College Hospital, Dongcheng District, Beijing, 100730 (China)

    2013-02-15

    Purpose: To compare the quantitative liver computed tomography perfusion (CTP) differences among eight hepatic segments. Materials and methods: This retrospective study was based on 72 acquired upper abdomen CTP scans for detecting suspected pancreas tumor. Patients with primary or metastatic liver tumor, any focal liver lesions except simple cyst (<3 cm in diameter), history of liver operation or splenectomy, evidence of liver cirrhosis or invasion of portal vein were excluded. The final analysis included 50 patients (M:F = 21:29, mean age = 43.2 years, 15–76 years). Arterial liver perfusion (ALP), portal-venous perfusion (PVP), total hepatic perfusion (THP = ALP + PVP), and hepatic perfusion index (HPI) of each hepatic segment were calculated and compared by means of one-way analysis of variance (ANOVA) and the Bonferonni correction method. Results: Compared to hepatic segments 5, 6, 7 and 8, segments 2 and 3 showed a tendency of higher ALPs, lower PVPs, and higher HPIs, most of which were statistically significant (p < 0.05). Hepatic segments 1 and 4 had higher mean values of ALP and HPI and lower mean values of PVP than segments 5, 6, 7 and 8 as well, although no significant differences were detected except for ALP and HPI for liver segments 1 and 7 (p = 0.001 and 0.035 respectively), and ALP for liver segments 1 and 5 (p = 0.039). Higher ALP and HPI were showed in hepatic segment 3 compared to segment 4 (p = 0.000 and 0.000 respectively). No significant differences were found for THP among eight segments. Conclusions: Intra-hepatic perfusion differences exist in normal hepatic parenchyma especially between lateral sector (segments 2 and 3) and right lobe (segments 5, 6, 7 and 8). This might have potential clinical significance in liver-perfusion-related protocol design and result analysis.

  15. Perfusion based cell culture chips

    DEFF Research Database (Denmark)

    Heiskanen, Arto; Emnéus, Jenny; Dufva, Martin

    2010-01-01

    Performing cell culture in miniaturized perfusion chambers gives possibilities to experiment with cells under near in vivo like conditions. In contrast to traditional batch cultures, miniaturized perfusion systems provide precise control of medium composition, long term unattended cultures...... and tissue like structuring of the cultures. However, as this chapter illustrates, many issues remain to be identified regarding perfusion cell culture such as design, material choice and how to use these systems before they will be widespread amongst biomedical researchers....

  16. Reverse ventilation--perfusion mismatch

    Energy Technology Data Exchange (ETDEWEB)

    Palmaz, J.C.; Barnett, C.A.; Reich, S.B.; Krumpe, P.E.; Farrer, P.A.

    1984-01-01

    Patients having lobar airway obstruction or consolidation usually have decreases of both ventilation and perfusion on lung scans. We report three patients in whom hypoxic vasoconstriction was apparently incomplete, resulting in a ''reversed'' ventilation-perfusion mismatch. Perfusion of the hypoxic lobe on the radionuclide scan was associated with metabolic alkalosis, pulmonary venous and pulmonary arterial hypertension in these patients.

  17. Liver metastases

    Science.gov (United States)

    ... Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver metastases ... through the probe that causes ice crystals to form around the probe. The cancer cells are frozen ...

  18. Advances in imaging diagnosis of liver cancer

    Directory of Open Access Journals (Sweden)

    ZHANG Chunyu

    2017-07-01

    Full Text Available Liver biopsy is the gold standard for the diagnosis of primary liver cancer, but it is an invasive examination. At present, imaging has become the preferred method for the diagnosis of liver cancer. This article summarizes new imaging methods and techniques for the diagnosis and evaluation of primary liver cancer, including contrast-enhanced ultrasound, CT perfusion imaging, diffusion-weighted imaging-intravoxel incoherent motion, IDEAL IQ sequence, dynamic contrast-enhanced MRI, and hepatocyte-specific contrast-enhanced imaging, and points out that diagnostic imaging can not only evaluate the degree of tumor differentiation, blood supply and perfusion, and invasiveness of lesions, but also predict the prognosis and evaluate liver function. Therefore, it can provide a reference for clinical diagnosis and treatment.

  19. The effect of PaCO2 on cerebral perfusion: an experimental swine model.

    Science.gov (United States)

    Trowbridge, C C; Stammers, A H; Niimi, K S; Glogowski, K R; Tremain, K D; Muhle, M L

    2001-09-01

    Adequate cerebral perfusion is of particular concern to the clinician and is a major factor in postoperative morbidity. Cerebral circulation has the ability to autoregulate blood flow in order to maintain nutrient delivery and prevent high intravascular pressures. The focus of this study was to characterize the impact of gradually changing arterial CO2 levels on cerebral perfusion. A total of eight porcine subjects were placed into either a normothermic group (NG, N = 4, rectal temperature = 35.4+/-1.2 degrees C) or a hypothermic group (HG, N = 4, 30.6+/-0.6 degrees C). After initiation of cardiopulmonary bypass, the PaCO2 values sequentially varied between 24 and 56 mmHg. Arterial, venous, and internal jugular blood gas data were collected at 4 mmHg increments, and relative cerebral blood flow was calculated as CBF = 1 (CarterialO2-CjugularO2)(-1) Physiological parameters were similar in both groups across all test conditions: mean arterial pressure-NG 81.6+/-11.9 mmHg versus HG 73.4+/-7.0 mmHg, p = NS, and systemic oxygen consumption-HG 110.6+/-30.0 mL min versus NG 136.4+/-37.9 mL min(-1), p = NS. No significant differences were found in CBF in the NG (21.8+/-4.4 mL min(-1) 100 gL at PaCO2 = 56 mmHg versus 20.5+/-5.0 mL min(-1) 100 g(-1) at PaCO2 = 24 mmHg) or the HG (24.3+/-9.5 mL min(-1) 100 g(-1) at PaCO2 = 56 mmHg versus 25.6+/-12.0 mL min(-1) 100 g(-1) at PaCO2 = 24 mmHg). In conclusion, the alteration of PaCO2 under both hypothermic and normothermic conditions resulted in no significant differences in 1 (CarterialO2 - CjugularO2)(-1) in this model.

  20. Perfusion Bioreactor Module

    Science.gov (United States)

    Morrison, Dennis R.

    1990-01-01

    Perfusion bioreactor module, self-contained, closed-loop cell-culture system that operates in microgravity or on Earth. Equipment supports growth or long-term maintenance of cultures of human or other fragile cells for experiments in basic cell biology or process technology. Designed to support proliferation (initially at exponential rates of growth) of cells in complex growth medium and to maintain confluent cells in defined medium under conditions optimized to permit or encourage selected functions of cells, including secretion of products of cells into medium.

  1. The impact of an hematocrit of 20% during normothermic cardiopulmonary bypass for elective low risk coronary artery bypass graft surgery on oxygen delivery and clinical outcome – a randomized controlled study [ISRCTN35655335

    Science.gov (United States)

    von Heymann, Christian; Sander, Michael; Foer, Achim; Heinemann, Anja; Spiess, Bruce; Braun, Jan; Krämer, Michael; Grosse, Joachim; Dohmen, Pascal; Dushe, Simon; Halle, Jürgen; Konertz, Wolfgang F; Wernecke, Klaus-Dieter; Spies, Claudia

    2006-01-01

    Introduction Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery. Methods This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A nonparametric multivariate analysis of variance for repeated measurements and small sample sizes was performed. Results In a total of 54 patients (25% Hct, n = 28; 20% Hct, n = 26), calculated oxygen delivery (p = 0.11), oxygen consumption (p = 0.06) and blood lactate (p = 0.60) were not significantly different between groups. Clinical outcomes were not different between groups. Conclusion These data indicate that an Hct of 20% during normothermic CPB maintained calculated whole body oxygen delivery above a critical level after elective CABG surgery in low risk patients. The question of whether a transfusion trigger in excess of 20% Hct during normothermic CPB is still supported requires a larger prospective and randomized trial. PMID:16606474

  2. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...

  3. Effect of in situ hypothermic perfusion on intrahepatic pO(2) and reactive oxygen species formation after partial hepatectomy under total hepatic vascular exclusion in pigs

    NARCIS (Netherlands)

    Heijnen, Bob H. M.; Straatsburg, Irene H.; Kager, Liesbeth M.; van der Kleij, Ad J.; Gouma, Dirk J.; van Gulik, Thomas M.

    2003-01-01

    Aim: This study examined attenuation of ischemia and reperfusion (I/R) induced liver injury during liver resections by hypothermic perfusion of the liver under total hepatic vascular exclusion (THVE). Method: Reactive oxygen species (ROS) formation, microcirculatory integrity and endothelial cell

  4. Perfusion patterns of metastatic gastrointestinal stromal tumor lesions under specific molecular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schlemmer, Marcus [Department of Internal Medicine III, University Hospitals-Grosshadern, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich (Germany); Sourbron, Steven P. [Institute of Clinical Radiology, University Hospitals-Grosshadern, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich (Germany); Schinwald, Nicole [Department of Internal Medicine III, University Hospitals-Grosshadern, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich (Germany); Nikolaou, Konstantin; Becker, Christoph R.; Reiser, Maximilian F. [Institute of Clinical Radiology, University Hospitals-Grosshadern, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich (Germany); Berger, Frank, E-mail: Frank.Berger@med.uni-muenchen.de [Institute of Clinical Radiology, University Hospitals-Grosshadern, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich (Germany)

    2011-02-15

    Rationale and objective: The aim of this pilot study was the evaluation of CT perfusion patterns in metastatic GIST lesions under specific molecular therapy with sunitinib or imatinib both in responders and non-responders. Patients and methods: 24 patients with metastatic GIST under tyrosine kinase inhibition were retrospectively evaluated. A total of 46 perfusion and venous phase CT scans were acquired. Volume of distribution, blood flow, blood volume, permeability and hepatic perfusion index measurements of metastatic lesions were carried out. Lesions were classified as 'good response' or 'poor response' to therapy, and perfusion parameters were compared for these two types of lesions. Results: 24 patients were evaluated. In the extrahepatic abdominal lesions (N = 15), good responders showed significant lower perfusion values than poor responders (volume of distribution: 3.3 {+-} 2.0 vs. 13.0 {+-} 1.8 ml/100 ml, p = 0.001). The same tendency was observed in intrahepatic lesions (N = 31) (liver volume of distribution: 2.1 {+-} 0.3 vs. 7.1 {+-} 1.3 ml/100 ml, p = 0.003); (hepatic perfusion index: 24.3 {+-} 7.9 vs. 76.1 {+-} 1.5%, p = 0.0001). Conclusion: Our data indicate that there are characteristic perfusion patterns of metastatic GIST lesions showing a good or poor response to molecular pharmacotherapy. Perfusion should be further evaluated in cross-sectional imaging studies as a possible biomarker for treatment response in targeted therapies of GIST.

  5. Perfusion CT in acute stroke

    International Nuclear Information System (INIS)

    Eckert, Bernd; Roether, Joachim; Fiehler, Jens; Thomalla, Goetz

    2015-01-01

    Modern multislice CT scanners enable multimodal protocols including non-enhanced CT, CT angiography, and CT perfusion. A 64-slice CT scanner provides 4-cm coverage. To cover the whole brain, a 128 - 256-slice scanner is needed. The use of perfusion CT requires an optimized scan protocol in order to reduce exposure to radiation. As compared to non-enhanced CT and CT angiography, the use of CT perfusion increases detection rates of cerebral ischemia, especially small cortical ischemic lesions, while the detection of lacunar and infratentorial stroke lesions remains limited. Perfusion CT enables estimation of collateral flow in acute occlusion of large intra- or extracranial arteries. Currently, no established reliable thresholds are available for determining infarct core and penumbral tissue by CT perfusion. Moreover, perfusion parameters depend on the processing algorithms and the software used for calculation. However, a number of studies point towards a reduction of cerebral blood volume (CBV) below 2 ml/100 g as a critical threshold that identifies infarct core. Large CBV lesions are associated with poor outcome even in the context of recanalization. The extent of early ischemic signs on non-enhanced CT remains the main parameter from CT imaging to guide acute reperfusion treatment. Nevertheless, perfusion CT increases diagnostic and therapeutic certainty in the acute setting. Similar to stroke MRI, perfusion CT enables the identification of tissue at risk of infarction by the mismatch between infarct core and the larger area of critical hypoperfusion. Further insights into the validity of perfusion parameters are expected from ongoing trials of mechanical thrombectomy in stroke.

  6. Perfusion measurement in acute pancreatitis using dynamic perfusion MDCT.

    Science.gov (United States)

    Bize, Pierre E; Platon, Alexandra; Becker, Christoph D; Poletti, Pierre-Alexandre

    2006-01-01

    Our objective was to determine whether MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis in the initial phase of the disease. One hundred six patients with abdominal pain were prospectively enrolled in this study. Patients were separated into two groups: P1 (severe) and P2 (mild) acute pancreatitis. Mean perfusion value was 24.8 mL/100 mL/min in the P1 group and 50.5 mL/100 mL/min in the P2 group (p = 0.0016, significant). Our preliminary data suggest that pancreatic perfusion measurement using MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis.

  7. Perfusion defects in pulmonary perfusion iodine maps: causes and semiology.

    Science.gov (United States)

    Bustos Fiore, A; González Vázquez, M; Trinidad López, C; Mera Fernández, D; Costas Álvarez, M

    2017-12-14

    to describe the usefulness of dual-energy CT for obtaining pulmonary perfusion maps to provide morphological and functional information in patients with pulmonary embolisms. To review the semiology of perfusion defects due to pulmonary embolism so they can be differentiated from perfusion defects due to other causes: alterations outside the range used in the iodine map caused by other diseases of the lung parenchyma or artifacts. CT angiography of the pulmonary arteries is the technique of choice for the diagnosis of pulmonary embolisms. New dual-energy CT scanners are useful for detecting perfusion defects secondary to complete or partial obstruction of pulmonary arteries and is most useful for detecting pulmonary embolisms in subsegmental branches. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Quantitative lung perfusion evaluation using Fourier decomposition perfusion MRI.

    Science.gov (United States)

    Kjørstad, Åsmund; Corteville, Dominique M R; Fischer, Andre; Henzler, Thomas; Schmid-Bindert, Gerald; Zöllner, Frank G; Schad, Lothar R

    2014-08-01

    To quantitatively evaluate lung perfusion using Fourier decomposition perfusion MRI. The Fourier decomposition (FD) method is a noninvasive method for assessing ventilation- and perfusion-related information in the lungs, where the perfusion maps in particular have shown promise for clinical use. However, the perfusion maps are nonquantitative and dimensionless, making follow-ups and direct comparisons between patients difficult. We present an approach to obtain physically meaningful and quantifiable perfusion maps using the FD method. The standard FD perfusion images are quantified by comparing the partially blood-filled pixels in the lung parenchyma with the fully blood-filled pixels in the aorta. The percentage of blood in a pixel is then combined with the temporal information, yielding quantitative blood flow values. The values of 10 healthy volunteers are compared with SEEPAGE measurements which have shown high consistency with dynamic contrast enhanced-MRI. All pulmonary blood flow (PBF) values are within the expected range. The two methods are in good agreement (mean difference = 0.2 mL/min/100 mL, mean absolute difference = 11 mL/min/100 mL, mean PBF-FD = 150 mL/min/100 mL, mean PBF-SEEPAGE = 151 mL/min/100 mL). The Bland-Altman plot shows a good spread of values, indicating no systematic bias between the methods. Quantitative lung perfusion can be obtained using the Fourier Decomposition method combined with a small amount of postprocessing. Copyright © 2013 Wiley Periodicals, Inc.

  9. Protective effect of N2-mercaptopropionylglycine on rats and dogs liver during ischemia/reperfusion process Efeito protetor do N2-mercaptopropionilglicina em ratos e cães submetidos a isquemia/reperfusão normotécnica do fígado

    OpenAIRE

    Emilio Elias Abdo; José Eduardo Monteiro Cunha; Pérsio Deluca; Ana Maria Mendonça Coelho; Telesforo Bacchella; Marcel Cerqueira César Machado

    2003-01-01

    BACKGROUND: N2-mercaptopropionylglycine is a powerful super oxide synthesis inhibitor and has been tested as a preventive agent of metabolic and structural hepatic damage in the ischemia/reperfusion process. AIM: To analyze some effects of N2-mercaptopropionylglycine administration to animals of two species submitted to normothermic liver ischemia/reperfusion. MATERIAL AND METHODS: Twenty-two rats and 22 dogs were divided into four groups: group I: rats that received intravenous saline 0.9%; ...

  10. Liver Hemangioma

    Science.gov (United States)

    Liver hemangioma Overview A liver hemangioma (he-man-jee-O-muh) is a noncancerous (benign) mass in the liver. A liver hemangioma is made up of a tangle of blood vessels. Other terms for a liver hemangioma are hepatic hemangioma and cavernous hemangioma. Most ...

  11. Multi-detector CT perfusion

    Directory of Open Access Journals (Sweden)

    Ashraf M. Enite

    2016-09-01

    Conclusion: CTP is a promising non-invasive technique assessing the efficacy, predicting early response to local treatment therapies and monitoring tumor recurrence. It assesses the degree of post therapy tumor perfusion especially the degree of arterialization.

  12. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  13. Characterisation of focal liver lesions with contrast enhanced ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Dietrich, Christoph F. E-mail: christoph.dietrich@ckbm.de

    2004-06-01

    Ultrasound contrast agents (USCA) have improved the detection rate of liver tumours in recent years. Conventional ultrasound has been reported to be relatively unreliable in the characterisation of liver tumours. SonoVue{sup [reg]} (Bracco Imaging Spa) has been shown to be particularly advantageous in the differentiation of benign and malignant liver tumours and, therefore, possibly represents a new cost-effective competitive alternative to other liver imaging modalities (e.g. computed tomography and magnetic resonance imaging), thus allowing these important technologies to be available for other indications (e.g. brain, thorax). More detailed and specific liver tumour characterisation is possible in about 80% of liver tumours due to typical vascularity and perfusion patterns. The role of USCA for better characterisation, which is possible through the analysis of flow characteristics in real time, places a particular emphasis on agent use. Contrast enhanced real-time imaging techniques with SonoVue{sup [reg]} allow real-time analysis of tumour perfusion in patients with liver lesions. Liver tumours known to be hyperperfused in the arterial phase (e.g. focal nodular hyperplasia, hepatocellular adenoma and carcinoma, and hyperperfused metastases) can be better detected and characterised. Hypoperfused tumours (e.g. liver metastases of the gastrointestinal tract) can be recognised in the portal venous phase as less perfused 'black spots'. In this article we discuss liver tumour characterisation by contrast enhanced ultrasonography.

  14. Haemoadsorption reduces the inflammatory response and improves blood flow during ex vivo renal perfusion in an experimental model

    Directory of Open Access Journals (Sweden)

    Sarah A. Hosgood

    2017-10-01

    Full Text Available Abstract Background Ex-vivo normothermic perfusion strategies are a promising new instrument in organ transplantation. The perfusion conditions are designed to be protective however the artificial environment can induce a local inflammatory response. The aim of this study was to determine the effect of incorporating a Cytosorb adsorber into an isolated kidney perfusion system. Methods Porcine kidneys were subjected to 22 h of cold ischaemia then reperfused for 6 h on an ex vivo reperfusion circuit. Pairs of kidneys were randomised to either control (n = 5 or reperfusion with a Cytosorb adsorber (n = 5 integrated into the circuit. Tissue, blood and urine samples were taken for the measurement of inflammation and renal function. Results Baseline levels of cytokines (IL-6, TNFα, IL-8, IL-10, IL-1β, IL-1α were similar between groups. Levels of IL-6 and IL-8 in the perfusate significantly increased during reperfusion in the control group but not in the Cytosorb group (P = 0.023, 0.049. Levels of the other cytokines were numerically lower in the Cytosorb group; however, this did not reach statistical significance. The mean renal blood flow (RBF was significantly higher in the Cytosorb group (162 ± 53 vs. 120 ± 35 mL/min/100 g; P = 0.022. Perfusate levels of prostaglandin E2 were significantly lower in the Cytosorb group (642 ± 762 vs. 3258 ± 980 pg/mL; P = 0.0001. Levels of prostacyclin were significantly lower in the Cytosorb group at 1, 3 and 6 h of reperfusion (P = 0.008, 0.003, 0.0002. Levels of thromboxane were also significantly lower in the Cytosorb group throughout reperfusion (P = 0.005. Haemoadsorption had no effect on creatinine clearance (P = 0.109. Conclusion Haemoadsorption can reduce the inflammatory response and improve renal blood flow during perfusion. Nonetheless, in this model haemoadsorption had no influence on renal function and this may relate to the broad-spectrum action of the Cytosorb

  15. Organ perfusion during voluntary pulmonary hyperinflation; a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Kristensen, Kasper Kyhl; Drvis, Ivan; Barak, Otto

    2016-01-01

    . Myocardial, pulmonary, skeletal muscle, kidney, and liver perfusion were evaluated by magnetic resonance imaging in 10 elite breath-hold divers at rest and during moderate GPI. Cardiac chamber volumes, stroke volume, and thus CO were determined from cardiac short-axis cine images. Organ volumes were assessed...

  16. THE SINUSOIDAL EFFLUX OF DIBROMOSULFOPHTHALEIN FROM RAT-LIVER IS STIMULATED BY ALBUMIN, LIGANDIN AND FATTY-ACID-BINDING PROTEIN BUT NOT BY OTHER DIBROMOSULFOPHTHALEIN BINDING-PROTEINS

    NARCIS (Netherlands)

    NIJSSEN, HMJ; PIJNING, T; PROOST, JH; MEIJER, DKF; GROOTHUIS, GMM

    Organic anions can be excreted from the liver into the bile or back into the general circulation (sinusoidal efflux). It has previously been shown that the net sinusoidal efflux rate of dibromosulfophthalein from the perfused liver into the perfusate is the result of actual efflux from and reuptake

  17. Dietary conjugated linoleic acid reciprocally modifies ketogenesis and lipid secretion by the rat liver.

    Science.gov (United States)

    Sakono, M; Miyanaga, F; Kawahara, S; Yamauchi, K; Fukuda, N; Watanabe, K; Iwata, T; Sugano, M

    1999-09-01

    The effects of dietary conjugated linoleic acid (CLA) and linoleic acid (LA) on ketone body production and lipid secretion were compared in isolated perfused rat liver. After feeding the 1% CLA diet for 2 wk, the concentration of post-perfused liver cholesterol was significantly reduced by CLA feeding, whereas that of triacylglycerol remained unchanged. Livers from CLA-fed rats produced significantly more ketone bodies; and the ratio of beta-hydroxybutyrate to acetoacetate, an index of mitochondrial redox potential, tended to be consistently higher in the liver perfusate. Conversely, cumulative secretions of triacylglycerol and cholesterol were consistently lower in the livers of rats fed CLA, and the reduction in the latter was statistically significant. Thus dietary CLA appeared to exert its hypolipidemic effect at least in part through an enhanced beta-oxidation of fatty acids at the expense of esterification of fatty acid in the liver.

  18. Helping prometheus: liver protection in acute hemorrhagic shock.

    Science.gov (United States)

    Veith, Nils T; Histing, Tina; Menger, Michael D; Pohlemann, Tim; Tschernig, Thomas

    2017-05-01

    Acute hemorrhagic hypovolemic shock is caused by a significant high blood loss and leads to hemodynamic instability. The decrease in intravascular volume results in cellular hypoxia and finally in damage to organs such as the liver and the kidney. The liver plays a decisive role in the development or prevention of multiple organ failure after hemorrhagic shock. Despite the large number of experimental studies, the knowledge of pathophysiological mechanisms in the liver after hemorrhagic shock is incomplete. The aim of this mini review was to provide an overview of the pathophysiological changes in liver function after acute hemorrhagic shock and to address treatment options to improve liver perfusion.

  19. Lung perfusion scintigraphy by SPECT

    International Nuclear Information System (INIS)

    Hirayama, Takanobu

    1990-01-01

    The initial study reports the characteristic performance using lung segmental phantom filled in Tc-99m pertechnetate. To evaluate the segmental defect in lung perfusion scintigraphy, we applied Bull's-eye analysis in addition to planar image set. Bull's-eye analysis especially facilitated the interpretation in both middle and lower lobes. Subsequently, to evolute the clinical application of Bull's-eye analysis, pulmonary scintigraphy was performed on 10 normal subjects and 60 patients with several pulmonary diseases. Of interest, Bull's-eye analysis, however, encouraged the interpretation in both lower lobes. To calculate the extention and severity of perfusion defect, the present study describes Bull's-eye analysis. Quantitative scoring showed higher in patients with lung cancer than those with pulmonary tuberculosis. The present study focus that Bull's-eye analysis can be useful for evaluating perfusion in patients with a couple of pulmonary diseases. (author)

  20. Dynamic CT myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome “Sapienza”, Latina (Italy); Eid, Marwen [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Mangold, Stefanie [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen (Germany); and others

    2016-10-15

    Highlights: • CT myocardial perfusion provides functional assessment of the myocardium. • CCTA is limited in determining the hemodynamic significance of coronary stenosis. • CT-MPI can accurately detect hemodynamically significant coronary artery stenosis. - Abstract: Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  1. Using ultrasonography to monitor liver blood flow for liver transplant from donors supported on extracorporeal membrane oxygenation.

    Science.gov (United States)

    Zhu, Xian-Sheng; Wang, Sha-Sha; Cheng, Qi; Ye, Chuang-Wen; Huo, Feng; Li, Peng

    2016-02-01

    Extracorporeal membrane oxygenation (ECMO) has been used to support brain-dead donors for liver procurement. This study investigated the potential role of ultrasonographic monitoring of hepatic perfusion as an aid to improve the viability of liver transplants obtained from brain-dead donors who are supported on ECMO. A total of 40 brain-dead patients maintained on ECMO served as the study population. Hepatic blood flow was monitored using ultrasonography, and perioperative optimal perfusion was maintained by calibrating ECMO. Liver function tests were performed to assess the viability of the graft. The hepatic arterial blood flow was well maintained with no significant changes observed before and after ECMO (206 ± 32 versus 241 ± 45 mL/minute; P = 0.06). Similarly, the portal venous blood flow was also maintained throughout (451 ± 65 versus 482 ± 77 mL/minute; P = 0.09). No significant change in levels of total bilirubin, alanine transaminase, and lactic acid were reported during ECMO (P = 0.17, P = 0.08, and P = 0.09, respectively). Before the liver is procured, ultrasonographic monitoring of hepatic blood flow could be a valuable aid to improve the viability of a liver transplant by allowing for real-time calibration of ECMO perfusion in brain-dead liver donors. In our study, ultrasonographic monitoring helped prevent warm ischemic injury to the liver graft by avoiding both overperfusion and underperfusion of the liver. © 2015 American Association for the Study of Liver Diseases.

  2. Dynamic CT myocardial perfusion imaging identifies early perfusion abnormalities in diabetes and hypertension : Insights from a multicenter registry

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; De Cecco, Carlo N.; Wichmann, Julian L.; Meinel, Felix G.; Pelgrim, Gert Jan; Tesche, Christian; Ebersberger, Ullrich; Pugliese, Francesca; Bamberg, Fabian; Choe, Yeon Hyeon; Wang, Yining; Schoepf, U. Joseph

    2016-01-01

    Background: To identify patients with early signs of myocardial perfusion reduction, a reference base for perfusion measures is needed. Objective: To analyze perfusion parameters derived from dynamic computed tomography perfusion imaging (CTPI) in patients with suspected coronary artery disease

  3. Placental perfusion - a human alternative

    DEFF Research Database (Denmark)

    Mose, Tina; Knudsen, Lisbeth E

    2006-01-01

    between the mother and foetus. Dual perfusion of a single cotyledon in the human placenta can contribute to a better understanding of the placental barrier, transport rate and mechanisms of different substances and placental metabolism. The perfusion system has recently been established in Copenhagen...... and represents a supplement and alternative to animal testing, bypassing the animal to human extrapolation. Placentas are readily obtainable from most births upon informed consent from the mothers and are considered a promising tissue alternative/supplement to animal experiments. The system is validated...... as a part of work package 2 of the integrated project ReProTect....

  4. Automatic assessment of cardiac perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Stegmann, Mikkel Bille; Larsson, Henrik B.W.

    2004-01-01

    In this paper, a method based on Active Appearance Models (AAM) is applied for automatic registration of myocardial perfusion MRI. A semi-quantitative perfusion assessment of the registered image sequences is presented. This includes the formation of perfusion maps for three parameters; maximum up...

  5. [IV drug perfusions: safety principles].

    Science.gov (United States)

    Lelieur, Florence; Cabelguenne, Delphine; Marcel, Marie; Favier, Claudine; Piriou, Vincent

    2017-05-01

    An intravenous perfusion is a procedure which comprises infection and medication risks. To manage these risks, caregivers must respect, in addition to the usual hygiene rules, a series of best practices, ensuring the proper use and management of the medical devices and administered drugs. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Pulmonary ventilation/perfusion scan

    Science.gov (United States)

    ... to stop eating (fast), be on a special diet, or take any medicines before the test. A chest x-ray is usually done before or after a ventilation and perfusion scan. You wear a hospital gown or comfortable clothing that does not have ...

  7. Cardiovascular magnetic resonance: myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Nagel, E.; Al-Saadi, N.; Fleck, E. [Dept. of Internal Medicine/Cardiology, German Heart Inst. Berlin and Charite, Campus Virchow, Humboldt Univ. (Germany)

    2000-06-01

    There is growing evidence that the noninvasive assessment of myocardial perfusion with cardiovascular magnetic resonance is a valid and accurate tool for the assessment of ischemic heart disease and its introduction into routine clinical evaluation of patients is rapidly expected. Magnetic resonance measurements allow the evaluation of reversible and irreversible myocardial ischemia, the assessment of acute myocardial infarction, as well as the recognition and detection of viable myocardium. Magnetic resonance perfusion measurements are mainly performed with T1-shortening contrast agents such as gadolinium-DTPA either by visual analysis or based on the analyses of signal intensity time curves. For the detection of myocardial ischemia the first pass kinetics of a gadolinium-DTPA bolus and for the detection of myocardial necrosis and the definition of viable myocardium steady state distribution kinetics are assessed. Quantitative analysis of myocardial perfusion can be performed but requires complex modeling due to the characteristics of gadolinium-DTPA. Thus, semi-quantitative parameters are preferred. There is accumulating evidence in the literature that magnetic resonance imaging can be used for the detection of coronary artery stenosis with high diagnostic accuracy both with semi-quantitative or visual analysis. Myocardial infarction can be reliably detected and the infarcted area determined. Non-reperfused infarcted myocardium can be differentiated from reperfused myocardium by different enhancement patterns that correlates with viability. (orig.) [German] Die Magnetresonanztomographie (MR) erlangt bei der nichtinvasiven Diagnostik der koronaren Herzerkrankung eine zunehmende Bedeutung. Mit dieser Technik koennen sowohl die globale und regionale Myokardfunktion als auch die myokardiale Perfusion exakt beurteilt werden. Bisher liegen die meisten Daten fuer die Analyse von Wandbewegungsstoerun-gen unter Belastung vor, wobei sich eine deutliche diagnostische

  8. Fatty liver change as a result of hepatic artery infusion chemotherapy.

    Science.gov (United States)

    Zeiss, J; Merrick, H W; Savolaine, E R; Woldenberg, L S; Kim, K; Schlembach, P J

    1990-04-01

    Direct hepatic arterial infusion of floxuridine (FUDR) (Roche Laboratories, Division of Hoffman-LaRoche Inc., Nutley, NJ, U.S.A.) has been used extensively in the treatment of metastases of colorectal tumors to the liver. The effectiveness of infusion and tolerance of the chemotherapy has been improved utilizing a totally implantable infusion pump delivery system. However, unequal distribution of drug infusion may occur to different parts of the liver parenchyma as demonstrated by hepatic arterial infusion scintigraphy (HAPS). We present a case of such unequal perfusion in which fatty metamorphosis of the liver occurred in the overperfused liver segment after FUDR therapy. The liver parenchymal changes were followed by serial computerized tomography scans and proven by biopsy during a minilaparotomy. Serial HAPS examinations show redirection of subsequent infusion to the opposite liver lobe due to parenchymal damage and vascular sclerosis. The importance of uniform liver perfusion and a rare dose-related effect of FUDR on liver parenchyma are thereby demonstrated.

  9. Liver Immunology

    Science.gov (United States)

    Bogdanos, Dimitrios P.; Gao, Bin; Gershwin, M. Eric

    2014-01-01

    The liver is the largest organ in the body and is generally regarded by non-immunologists as not having lymphoid function. However, such is far from accurate. This review highlights the importance of the liver as a lymphoid organ. Firstly, we discuss experimental data surrounding the role of liver as a lymphoid organ. The liver facilitates a tolerance rather than immunoreactivity, which protects the host from antigenic overload of dietary components and drugs derived from the gut and is also instrumental to fetal immune tolerance. Loss of liver tolerance leads to autoaggressive phenomena which if are not controlled by regulatory lymphoid populations may lead to the induction of autoimmune liver diseases. Liver-related lymphoid subpopulations also act as critical antigen-presenting cells. The study of the immunological properties of liver and delineation of the microenvironment of the intrahepatic milieu in normal and diseased livers provides a platform to understand the hierarchy of a series of detrimental events which lead to immune-mediated destruction of the liver and the rejection of liver allografts. The majority of emphasis within this review will be on the normal mononuclear cell composition of the liver. However, within this context, we will discus select, but not all, immune mediated liver disease and attempt to place these data in the context of human autoimmunity. PMID:23720323

  10. Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity

    International Nuclear Information System (INIS)

    Ketelsen, Dominik; Horger, Marius; Buchgeister, Markus; Fenchel, Michael; Thomas, Christoph; Boehringer, Nadine; Schulze, Maximilian; Tsiflikas, Ilias; Claussen, Claus D.; Heuschmid, Martin

    2010-01-01

    We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity. An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D Perfusion-CT. Phantom measurements were performed on a 128-slice single source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans). Perfusion measurements were simulated for the lung, liver, and pelvis under the following conditions: lung (80 kV, 60 mAs), liver (80 kV/80 mAs and 80 kV/120 mAs), pelvis (100 kV/80 mAs and 100 kV/120 mAs). Depending on gender, the evaluated body region and scan protocol, an effective whole-body dose between 2.9-12.2 mSv, was determined. The radiation exposure administered to gender-specific organs like the female breast tissue (lung perfusion) or to the ovaries (pelvic perfusion) led to an increase in the female specific dose by 86% and 100% in perfusion scans of the lung and the pelvis, respectively. Due to a significant radiation dose of 4D-perfusion-CT protocols, the responsible use of this new promising technique is mandatory. Gender- and organ-specific differences should be considered for indication and planning of tumor perfusion scans

  11. Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity

    Science.gov (United States)

    Horger, Marius; Buchgeister, Markus; Fenchel, Michael; Thomas, Christoph; Boehringer, Nadine; Schulze, Maximilian; Tsiflikas, Ilias; Claussen, Claus D.; Heuschmid, Martin

    2010-01-01

    Objective We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity. Materials and Methods An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D-Perfusion-CT. Phantom measurements were performed on a 128-slice single-source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans). Perfusion measurements were simulated for the lung, liver, and pelvis under the following conditions: lung (80 kV, 60 mAs), liver (80 kV/80 mAs and 80 kV/120 mAs), pelvis (100 kV/80 mAs and 100 kV/120 mAs). Results Depending on gender, the evaluated body region and scan protocol, an effective whole-body dose between 2.9-12.2 mSv, was determined. The radiation exposure administered to gender-specific organs like the female breast tissue (lung perfusion) or to the ovaries (pelvic perfusion) led to an increase in the female specific dose by 86% and 100% in perfusion scans of the lung and the pelvis, respectively. Conclusion Due to a significant radiation dose of 4D-perfusion-CT protocols, the responsible use of this new promising technique is mandatory. Gender- and organ-specific differences should be considered for indication and planning of tumor perfusion scans. PMID:20808699

  12. Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, Dominik; Horger, Marius; Buchgeister, Markus; Fenchel, Michael; Thomas, Christoph; Boehringer, Nadine; Schulze, Maximilian; Tsiflikas, Ilias; Claussen, Claus D.; Heuschmid, Martin [University Hospital Tuebingen, Tuebingen (Germany)

    2010-10-15

    We aimed to estimate the effective dose of 4D-Perfusion-CT protocols of the lung, liver, and pelvis for the assessment of tumor vascularity. An Alderson-Rando phantom equipped with thermoluminescent dosimeters was used to determine the effective dose values of 4D Perfusion-CT. Phantom measurements were performed on a 128-slice single source scanner in adaptive 4D-spiral-mode with bidirectional table movement and a total scan range of 69 mm over a time period of nearly 120 seconds (26 scans). Perfusion measurements were simulated for the lung, liver, and pelvis under the following conditions: lung (80 kV, 60 mAs), liver (80 kV/80 mAs and 80 kV/120 mAs), pelvis (100 kV/80 mAs and 100 kV/120 mAs). Depending on gender, the evaluated body region and scan protocol, an effective whole-body dose between 2.9-12.2 mSv, was determined. The radiation exposure administered to gender-specific organs like the female breast tissue (lung perfusion) or to the ovaries (pelvic perfusion) led to an increase in the female specific dose by 86% and 100% in perfusion scans of the lung and the pelvis, respectively. Due to a significant radiation dose of 4D-perfusion-CT protocols, the responsible use of this new promising technique is mandatory. Gender- and organ-specific differences should be considered for indication and planning of tumor perfusion scans

  13. Cell volume changes affect gluconeogenesis in the perfused liver of ...

    Indian Academy of Sciences (India)

    ... occurs through an inverse regulation of enzyme proteins and/or a regulatory protein synthesis in this catfish. In conclusion, gluconeogenesis appears to play a vital role in C. batrachus in maintaining glucose homeostasis, which is influenced by cell volume changes possibly for proper energy supply under osmotic stress.

  14. Liver disease

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000205.htm Liver disease To use the sharing features on this page, please enable JavaScript. The term "liver disease" applies to many conditions that stop the ...

  15. Liver Diseases

    Science.gov (United States)

    Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. There are many kinds of liver diseases: Diseases caused by viruses, such as hepatitis ...

  16. Fatty Liver

    Science.gov (United States)

    ... Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News ... Rarely, fat accumulates in the liver during late pregnancy. This disorder, called fatty liver of pregnancy or ...

  17. Contralateral thalamic hypoperfusion on brain perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Seok Mo; Bae, Sang Kyun; Yoo, Kyung Moo; Yum, Ha Yong

    2000-01-01

    Brain perfusion single photon emission computed tomography (SPECT) is useful for the localization of cerebrovascular lesion and sometimes reveals more definite lesion than radiologic imaging modality such as CT or MRI does. The purpose of this study was to evaluate the diagnostic usefulness of brain perfusion SPECT in patients with hemisensory impairment. Thirteen consecutive patients (M:F= 8:5, mean age = 48) who has hemisensory impairment were included. Brain perfusion SPECT was performed after intravenous injection of 1110 MBq of Tc-99m ECD. The images were obtained using a dual-head gamma camera with ultra-high resolution collimator. Semiquantitative analysis was performed after placing multiple ROIs on cerebral cortex, basal ganglia, thalamus and cerebellum. There were 10 patients with left hemisensory impairment and 3 patients with right-sided symptom. Only 2 patients revealed abnormal signal change in the thalamus on MRI. But brain perfusion SPECT showed decreased perfusion in the thalamus in 9 patients. Six patients among 10 patients with left hemisensory impairment revealed decreased perfusion in the contralateral thalamus on brain SPECT. The other 4 patients revealed no abnormality. Two patients among 3 patients with right hemisensory impairment also showed decreased perfusion in the contralateral thalamus on brain SPECT. One patients with right hemisensory impairment showed ipsilateral perfusion decrease. Two patients who had follow-up brain perfusion SEPCT after treatment revealed normalization of perfusion in the thalamus. Brain perfusion SPECT might be a useful tool in diagnosing patients with hemisensory impairment

  18. Magnetic resonance perfusion imaging without contrast media

    International Nuclear Information System (INIS)

    Martirosian, Petros; Graf, Hansjoerg; Schick, Fritz; Boss, Andreas; Schraml, Christina; Schwenzer, Nina F.; Claussen, Claus D.

    2010-01-01

    Principles of magnetic resonance imaging techniques providing perfusion-related contrast weighting without administration of contrast media are reported and analysed systematically. Especially common approaches to arterial spin labelling (ASL) perfusion imaging allowing quantitative assessment of specific perfusion rates are described in detail. The potential of ASL for perfusion imaging was tested in several types of tissue. After a systematic comparison of technical aspects of continuous and pulsed ASL techniques the standard kinetic model and tissue properties of influence to quantitative measurements of perfusion are reported. For the applications demonstrated in this paper a flow-sensitive alternating inversion recovery (FAIR) ASL perfusion preparation approach followed by true fast imaging with steady precession (true FISP) data recording was developed and implemented on whole-body scanners operating at 0.2, 1.5 and 3 T for quantitative perfusion measurement in various types of tissue. ASL imaging provides a non-invasive tool for assessment of tissue perfusion rates in vivo. Images recorded from kidney, lung, brain, salivary gland and thyroid gland provide a spatial resolution of a few millimetres and sufficient signal to noise ratio in perfusion maps after 2-5 min of examination time. Newly developed ASL techniques provide especially high image quality and quantitative perfusion maps in tissues with relatively high perfusion rates (as also present in many tumours). Averaging of acquisitions and image subtraction procedures are mandatory, leading to the necessity of synchronization of data recording to breathing in abdominal and thoracic organs. (orig.)

  19. Liver Biopsy

    Science.gov (United States)

    ... instrument called a cannula to remove the liver tissue sample. What is the liver and what does it do? ... who specializes in diagnosing diseases—looks at the tissue with a microscope and sends a report to the person's health care provider. What are the risks of liver biopsy? The risks ...

  20. Uncontrolled non-heartbeating donors (types i-ii) with normothermic recirculation vs. heartbeating donors: evaluation of functional results and survival.

    Science.gov (United States)

    Miranda-Utrera, N; Medina-Polo, J; Pamplona-Casamayor, M; Passas-Martínez, J B; Rodríguez-Antolín, A; de la Rosa Kehrmann, F; Duarte-Ojeda, J M; Tejido-Sánchez, A; Villacampa Aubá, F; Andrés Belmonte, A

    2015-09-01

    Non-heartbeating donors (NHBD) are an alternative to heartbeating donors (HBD). Our objective was to compare functional results and kidney survival from NHBDs and HBDs. A retrospective study comparing the results of 236 normothermically preserved kidneys from type i and ii type NHBDs with the results of 250 from HBDs that were transplanted in our center between 2005 and 2012. Homogeneity between groups was tested and we evaluated the presence of delayed graft function (DGF) associated with pretransplant variables of the donor and recipient. Both groups show homogeneity in pretransplant characteristics in terms of: age, HLA incompatibilities, and recipient hemodialysis time. Average follow-up time was 33 months (range 0-87) for NHBDs and 38 months (range 0-90) for HBDs. 5.5% of NHBDs showed primary non-function (PNF) vs. 4% of HBDs (P=.42) and 80.9% of DGF vs. 46.8% of HBDs (P<.001). At the end of the follow-up, there were no statistically significant differences in the survival of grafts (92.8% for NHBD vs. 93.6% for HBD, P=.71) and recipients (99.1% NHBD vs. 98.6% HBD, P=.28). Although the DGF percentage was greater for NHBDs, final creatinine as well as graft and recipient survival were similar for both groups. Therefore, in our experience, kidneys from NHBDs have similar results to those from HBDs and are an excellent source of organs for transplantation. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...... of Gd-DTPA (lambda), the vascular blood volume (Vb), and the time delay through the coronary arteries (delta T). The model was evaluated by computer simulation and used on experimental results from seven healthy subjects. The results in the healthy volunteers for a region of interest placed...... in the anterior myocardial wall were (mean +/- SD) Ki = 54 +/- 10 ml/100 g/min, lambda = 30 +/- 3 ml/100 g, Vb = 9 +/- 2 ml/100 g, delta T = 3.2 +/- 1.1 s. These results are in good agreement with similar results obtained by other methods....

  2. Dosimetry in myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C.

    2011-01-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  3. Dosimetry in myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  4. Intrahepatic arterioportal shunting and anomalous venous drainage: understanding the CT features in the liver

    International Nuclear Information System (INIS)

    Breen, David J.; Rutherford, Elizabeth E.; Stedman, Brian; Lee-Elliott, Catherine; Hacking, C. Nigel

    2004-01-01

    The increased use of high-contrast volume, arterial-phase studies of the liver has demonstrated the frequent occurrence of arterioportal shunts within both the cirrhotic and non-cirrhotic liver. This article sets out to explain the underlying microcirculatory mechanisms behind these commonly encountered altered perfusion states. Similarly, well-recognised portal perfusion defects occur around the perifalciform and perihilar liver and are largely caused by anomalous venous drainage via the paraumbilical and parabiliary venous systems. The underlying anatomy will be discussed and illustrated. These vascular anomalies are all caused by or result in diminished portal perfusion and are often manifest in the setting of portal venous thrombosis. The evolving concept of zonal re-perfusion following portal vein thrombosis will be discussed. (orig.)

  5. Standardized perfusion value of the esophageal carcinoma and its correlation with quantitative CT perfusion parameter values.

    Science.gov (United States)

    Djuric-Stefanovic, A; Saranovic, Dj; Sobic-Saranovic, D; Masulovic, D; Artiko, V

    2015-03-01

    Standardized perfusion value (SPV) is a universal indicator of tissue perfusion, normalized to the whole-body perfusion, which was proposed to simplify, unify and allow the interchangeability among the perfusion measurements and comparison between the tumor perfusion and metabolism. The aims of our study were to assess the standardized perfusion value (SPV) of the esophageal carcinoma, and its correlation with quantitative CT perfusion measurements: blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) of the same tumor volume samples, which were obtained by deconvolution-based CT perfusion analysis. Forty CT perfusion studies of the esophageal cancer were analyzed, using the commercial deconvolution-based CT perfusion software (Perfusion 3.0, GE Healthcare). The SPV of the esophageal tumor and neighboring skeletal muscle were correlated with the corresponding mean tumor and muscle quantitative CT perfusion parameter values, using Spearman's rank correlation coefficient (rS). Median SPV of the esophageal carcinoma (7.1; range: 2.8-13.4) significantly differed from the SPV of the skeletal muscle (median: 1.0; range: 0.4-2.4), (Z=-5.511, pCT perfusion measurements and statistically significant correlation was proved. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Fatty Liver

    International Nuclear Information System (INIS)

    Filippone, A.; Digiovandomenico, V.; Digiovandomenico, E.; Genovesi, N.; Bonomo, L.

    1991-01-01

    The authors report their experience with the combined use of US and CT in the study of diffuse and subtotal fatty infiltration of the liver. An apparent disagreement was initially found between the two examinations in the study of fatty infiltration. Fifty-five patients were studied with US and CT of the upper abdomen, as suggested by clinics. US showed normal liver echogenicity in 30 patients and diffuse increased echogenicity (bright liver) in 25 cases. In 5 patients with bright liver, US demonstrated a solitary hypoechoic area, appearing as a 'skip area', in the quadrate lobe. In 2 patients with bright liver, the hypoechoic area was seen in the right lobe and exhibited no typical US features of 'Skip area'. Bright liver was quantified by measuring CT density of both liver and spleen. The relative attenuation values of spleen and liver were compared on plain and enhanced CT scans. In 5 cases with a hypoechoic area in the right lobe, CT findings were suggestive of hemangioma. A good correlation was found between broght liver and CT attenuation values, which decrease with increasing fat content of the liver. Moreover, CT attenuation values confirmed US findings in the study of typical 'skip area', by demonstrating normal density - which suggests that CT can characterize normal tissue in atypical 'skip area'

  7. Role of mitogen-activated protein kinases in tauroursodeoxycholic acid-induced bile formation in cholestatic rat liver

    NARCIS (Netherlands)

    Denk, Gerald Ulrich; Hohenester, Simon; Wimmer, Ralf; Boehland, Claudia; Rust, Christian; Beuers, Ulrich

    2008-01-01

    Aim: Ursodeoxycholic acid exerts anticholestatic effects in various cholestatic disorders and experimental models of cholestasis. Its taurine conjugate (TUDCA) stimulates bile salt secretion in isolated perfused rat livers (IPRL) under physiological, non-cholestatic conditions, in part by

  8. Assessment of hepatic function, operative candidacy, and medical management after liver resection in the patient with underlying liver disease.

    Science.gov (United States)

    Wagener, Gebhard

    2013-08-01

    Liver resection in patients with underlying liver disease remains a formidable challenge. It requires adequate patient selection, a precise surgical plan, and avoidance of additional ischemic insults during surgery. Precise estimation of the residual liver volume using computed tomography or magnetic resonance imaging and computer-assisted volumetry allows the calculation of residual to total liver volume (RLV/TLV) ratios. Although RLV/TLV ratios over 20 to 25% are considered sufficient in healthy livers, patients with cirrhosis may only tolerate resections that result in RLV/TLV ratios over 40% and higher. Conventional laboratory tests may not be able to sufficiently predict liver reserve after resection. Dynamic tests such as indocyanine green clearance have been used to assess residual liver function and assist in deciding about operability of patients with underlying liver disease undergoing extensive resections. Intraoperative management should focus on avoiding blood loss and ischemic injury to the liver. Low central venous pressure may reduce blood loss and is recommended if tolerated without impeding renal perfusion. Portal vein and hepatic artery occlusion during resection can reduce blood loss, but will cause ischemic insult to the liver that may jeopardize residual liver function and induce postoperative hepatic failure. When feasible, vascular occlusion should be avoided in patients with underlying liver disease. The postoperative recovery is usually fast if sufficient liver remains. However, vigilance is required to detect liver dysfunction and treat its complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Etiology of pediatric acute liver failure

    OpenAIRE

    GUO Jing; SUN Mei

    2017-01-01

    Pediatric acute liver failure (PALF) is a complex syndrome with rapid progression, and the cause of PALF is age-dependent. This article analyzes the common causes of PALF in clinical practice, including infection factors, inherited metabolic factors, poisoning and drugs, abnormal perfusion, and autoimmune diseases, among which infection factors are the most common cause. With the improvement in diagnosis and treatment techniques, the diagnostic rate of PALF caused by inherited metabolic disea...

  10. Liver Transplant

    Science.gov (United States)

    ... Nutrition Clinical Trials Primary Biliary Cholangitis Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Wilson Disease Liver Transplant View or Print All Sections Definition & ...

  11. Hypothermic machine preservation in liver transplantation revisited : Concepts and criteria in the new millennium

    NARCIS (Netherlands)

    van der Plaats, A; t'Hart, NA; Verkerke, GJ; Leuvenink, HGD; Ploeg, RJ; Rakhorst, G

    To overcome the present shortage of liver donors by expansion of the existing donor pool and possibly lengthening of the storage time, hypothermic machine perfusion of the liver as a dynamic preservation method is revisited. The three most important aspects are defined to be the type of preservation

  12. Hepatic perfusion disorders: a pictorial review of CT and MR imaging

    International Nuclear Information System (INIS)

    Yim, Nam Yeol; Jeong, Yong Yeon; Shin, Sang Soo; Song, Sang Gook; Lim, Hyo Soon; Heo, Suk Hee; Chang, Nam Kyu; Yoon, Woong; Kang, Heoung Keun; Lan, Shen Yu

    2005-01-01

    The liver has a unique dual blood supply through the portal vein and the hepatic artery. There are several communications between these two vessels under various conditions such as in hepatic tumors, trauma and liver cirrhosis, vascular compromise, among others. When vascular compromise occurs, this dual blood supply system can cause changes in the volume of blood flow in individual vessels or even in the direction of blood flow. With rapid image acquisition and increased resolution available in multislice CT and MR imaging, hepatic perfusion disorders are now more frequently encountered than in the past. Familiarity with imaging findings of these perfusion disorders will be helpful in characterizing focal hepatic lesions and will also help to avoid false positive diagnoses

  13. Boron biodistribution study in colorectal liver metastases patients in Argentina.

    Science.gov (United States)

    Cardoso, J; Nievas, S; Pereira, M; Schwint, A; Trivillin, V; Pozzi, E; Heber, E; Monti Hughes, A; Sanchez, P; Bumaschny, E; Itoiz, M; Liberman, S

    2009-07-01

    Ex-situ BNCT for multifocal unresectable liver metastases employing whole or partial autograft techniques requires knowledge of boron concentrations in healthy liver and metastases following perfusion and immersion in Wisconsin solution (W), the procedure employed for organ preservation during ex-situ irradiation. Measurements of boron concentration in blood, liver and metastases following an intravenous infusion of BPA-F in five colorectal liver metastases patients scheduled for surgery were performed. Tissue samples were evaluated for boron content pre and post perfusion and immersion in W. Complementary histological studies were performed. The data showed a dose-dependent BPA uptake in liver, a boron concentration ratio liver/blood close to 1 and a wide spread in the metastases/liver concentration ratios in the range 0.8-3.6, partially attributable to histological variations between samples. Based on the boron concentrations and dose considerations (liver or =40 Gy-Eq) at the RA-3 thermal neutron facility (mean flux of about (6+/-1) x 10(9) n cm(-2)s(-1)), ex-situ treatment of liver metastases at RA-3 would be feasible.

  14. Modelling of FDG metabolism in liver voxels.

    Science.gov (United States)

    Baker, C; Dowson, N; Thomas, P; Rose, S

    2015-01-21

    Kinetic analysis is a tool used to glean additional information from positron emission tomography (PET) data by exploiting the dynamics of tissue metabolism. The standard irreversible and reversible two compartment models used in kinetic analysis were initially developed to analyse brain PET data. The application of kinetic analysis to PET of the liver presents the opportunity to move beyond the generic standard models and develop physiologically informed pharmacokinetic models that incorporate structural and functional features in particular to the liver. In this paper, we develop a new compartment model, called the tubes model, which is informed by the liver׳s sinusoidal architecture, high fractional blood volume, high perfusion rate, and large hepatocyte surface area facing the space of Disse. The tubes model distributes tracer between the blood and intracellular compartments in more physiologically faithful proportions than the standard model, producing parametric images with improved contrast between healthy and neoplastic tissue. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  15. Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass

    Science.gov (United States)

    Soller, Babs R.; Idwasi, Patrick O.; Balaguer, Jorge; Levin, Steven; Simsir, Sinan A.; Vander Salm, Thomas J.; Collette, Helen; Heard, Stephen O.

    2003-01-01

    OBJECTIVE: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass. DESIGN: Prospective clinical study. SETTING: Academic medical center. SUBJECTS: Eighteen elective cardiac surgical patients. INTERVENTION: Cardiac surgery under cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: A near infrared spectroscopic fiber optic probe was placed over the hypothenar eminence. Reference Po2 and pH sensors were inserted in the abductor digiti minimi (V). Data were collected every 30 secs during surgery and for 6 hrs following cardiopulmonary bypass. Calibration equations developed from one third of the data were used with the remaining data to investigate sensitivity of the near infrared spectroscopic measurement to physiologic changes resulting from cardiopulmonary bypass. Near infrared spectroscopic and reference pH and Po2 measurements were compared for each subject using standard error of prediction. Near infrared spectroscopic pH and Po2 at baseline were compared with values during cardiopulmonary bypass just before rewarming commenced (hypotensive, hypothermic), after rewarming (hypotensive, normothermic) just before discontinuation of cardiopulmonary bypass, and at 6 hrs following cardiopulmonary bypass (normotensive, normothermic) using mixed-model analysis of variance. Near infrared spectroscopic pH and Po2 were well correlated with the invasive measurement of pH (R2 =.84) and Po2 (R 2 =.66) with an average standard error of prediction of 0.022 +/- 0.008 pH units and 6 +/- 3 mm Hg, respectively. The average difference between the invasive and near infrared spectroscopic measurement was near zero for both the pH and Po2 measurements. Near infrared spectroscopic Po2 significantly decreased 50% on initiation of cardiopulmonary bypass and remained depressed throughout the bypass and

  16. Whole-Organ CT Perfusion of the Pancreas: Impact of Iterative Reconstruction on Image Quality, Perfusion Parameters and Radiation Dose in 256-Slice CT-Preliminary Findings

    Science.gov (United States)

    Xie, Qian; Wu, Juan; Tang, Ying; Dou, Yafang; Hao, Sijie; Xu, Feijia; Feng, Xiaoyuan; Liang, Zonghui

    2013-01-01

    Background This study was performed to assess whether iterative reconstruction can reduce radiation dose while maintaining acceptable image quality, and to investigate whether perfusion parameters vary from conventional filtered back projection (FBP) at the low-tube-voltage (80-kVp) during whole-pancreas perfusion examination using a 256-slice CT. Methods 76 patients with known or suspected pancreatic mass underwent whole-pancreas perfusion by a 256-slice CT. High- and low-tube-voltage CT images were acquired. 120-kVp image data (protocol A) and 80-kVp image data (protocol B) were reconstructed with conventional FBP, and 80-kVp image data were reconstructed with iDose4 (protocol C) iterative reconstruction. The image noise; contrast-to-noise ratio (CNR) relative to muscle for the pancreas, liver, and aorta; and radiation dose of each protocol were assessed quantitatively. Overall image quality was assessed qualitatively. Among 76 patients, 23 were eventually proven to have a normal pancreas. Perfusion parameters of normal pancreas in each protocol including blood volume, blood flow, and permeability-surface area product were measured. Results In the quantitative study, protocol C reduced image noise by 36.8% compared to protocol B (Pperfusion values among three different protocols. Conclusion Low-tube-voltage and iDose4 iterative reconstruction can dramatically decrease the radiation dose with acceptable image quality during whole-pancreas CT perfusion and have no significant impact on the perfusion parameters of normal pancreas compared to the conventional FBP reconstruction using a 256-slice CT scanner. PMID:24303017

  17. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...

  18. Liver regeneration

    NARCIS (Netherlands)

    Chamuleau, R. A.; Bosman, D. K.

    1988-01-01

    Despite great advances in analysing hemodynamic, morphological and biochemical changes during the process of liver regeneration, the exact (patho)physiological mechanism is still unknown. A short survey of literature is given of the kinetics of liver regeneration and the significance of different

  19. Dietary red palm oil supplementation reduces myocardial infarct size in an isolated perfused rat heart model

    Directory of Open Access Journals (Sweden)

    Esterhuyse Adriaan J

    2010-06-01

    Full Text Available Abstract Background and Aims Recent studies have shown that dietary red palm oil (RPO supplementation improves functional recovery following ischaemia/reperfusion in isolated hearts. The main aim of this study was to investigate the effects of dietary RPO supplementation on myocardial infarct size after ischaemia/reperfusion injury. The effects of dietary RPO supplementation on matrix metalloproteinase-2 (MMP2 activation and PKB/Akt phosphorylation were also investigated. Materials and methods Male Wistar rats were divided into three groups and fed a standard rat chow diet (SRC, a SRC supplemented with RPO, or a SRC supplemented with sunflower oil (SFO, for a five week period, respectively. After the feeding period, hearts were excised and perfused on a Langendorff perfusion apparatus. Hearts were subjected to thirty minutes of normothermic global ischaemia and two hours of reperfusion. Infarct size was determined by triphenyltetrazolium chloride staining. Coronary effluent was collected for the first ten minutes of reperfusion in order to measure MMP2 activity by gelatin zymography. Results Dietary RPO-supplementation decreased myocardial infarct size significantly when compared to the SRC-group and the SFO-supplemented group (9.1 ± 1.0% versus 30.2 ± 3.9% and 27.1 ± 2.4% respectively. Both dietary RPO- and SFO-supplementation were able to decrease MMP2 activity when compared to the SRC fed group. PKB/Akt phosphorylation (Thr 308 was found to be significantly higher in the dietary RPO supplemented group when compared to the SFO supplemented group at 10 minutes into reperfusion. There was, however, no significant changes observed in ERK phosphorylation. Conclusions Dietary RPO-supplementation was found to be more effective than SFO-supplementation in reducing myocardial infarct size after ischaemia/reperfusion injury. Both dietary RPO and SFO were able to reduce MMP2 activity, which suggests that MMP2 activity does not play a major role in

  20. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

  1. Dynamic contrast enhanced MRI for perfusion quantification

    DEFF Research Database (Denmark)

    Andersen, Irene Klærke

    2002-01-01

    Magnetic resonance imaging, during bolus passage of a paramagnetic contrast agent, is used world-wide to obtain parameters that reflect the pathological state of tissue. Abnormal perfusion occurs in diseases such as stoke and tumour. Consequently, perfusion quantication could have signi cant...... the contrastagent concentration, [Ca], and the changes in R2 or R 2 has been questioned. In this thesis, an MRI scanner sequence for detection of the longitudinal relaxation rate, R1 during bolus passage was modied for brain perfusion measurements, since the linearity between the changes in R1 and [Ca] is expected...... to be more robust. Successful brain perfusion quantication based on R1 weighted signals has not previously been reported, due to the poor signal to noise ratio of the images. Initial experiments reported in this thesis show that improved sequence may provide more accurate perfusion estimates in the brain...

  2. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

  3. Brain Perfusion Changes in Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    Mititelu, R.; Mazilu, C.; Ghita, S.; Rimbu, A.; Marinescu, G.; Codorean, I.; Bajenaru, O.

    2006-01-01

    Full text: Purpose: Despite the latest advances in medical treatment and neuro critical care, patients suffering spontaneous intracerebral hemorrhage (SICH) still have a very poor prognosis, with a greater mortality and larger neurological deficits at the survivors than for ischemic stroke. Many authors have shown that there are many mechanisms involved in the pathology of SICH: edema, ischemia, inflammation, apoptosis. All of these factors are affecting brain tissue surrounding hematoma and are responsible of the progressive neurological deterioration; most of these damages are not revealed by anatomical imaging techniques. The aim of our study was to asses the role of brain perfusion SPECT in demonstrating perfusion changes in SICH patients. Method: 17 SICH pts were studied. All pts underwent same day CT and brain SPECT with 99mTcHMPAO, 24h-5d from onset of stroke. Results: 14/17 pts showed a larger perfusion defect than expected after CT. In 2 pts hematoma diameter was comparable on CT and SPECT; 1pt had quasinormal aspect of SPECT study. In pts with larger defects, SPECT revealed a large cold spot with similar size compared with CT, and a surrounding hypo perfused area. 6/17 pts revealed cortical hyper perfusion adjacent to hypo perfused area and corresponding to a normal-appearing brain tissue on CT. In 3 pts we found crossed cerebellar diaskisis.In 2 pts we found cortical hypo perfused area in the contralateral cortex, with normal appearing brain tissue on CT. Conclusions: Brain perfusion SPECT revealed different types of perfusion changes in the brain tissue surrounding hematoma. These areas contain viable brain tissue that may be a target for future ne uroprotective strategies. Further studies are definitely required to demonstrate prognostic significance of these changes, but we can conclude that brain perfusion SPECT can play an important role in SICH, by early demonstrating functional changes responsible of clinical deterioration, thus allowing prompt

  4. Liver transplant

    Science.gov (United States)

    ... a liver becomes available. Make sure that, no matter where you are going, you can be contacted ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  5. Liver Transplant

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Liver Transplant Back In ...

  6. Enlarged Liver

    Science.gov (United States)

    ... of liver damage. Medicinal herbs. Certain herbs, including comfrey, ma huang and mistletoe, can increase your risk ... herbs to avoid include germander, chaparral, senna, mistletoe, comfrey, ma huang, valerian root, kava, celandine and green ...

  7. Riboflavin (vitamin B-2) reduces hepatocellular injury following liver ischaemia and reperfusion in mice.

    Science.gov (United States)

    Sanches, Sheila Cristina; Ramalho, Leandra Naira Z; Mendes-Braz, Mariana; Terra, Vânia Aparecida; Cecchini, Rubens; Augusto, Marlei Josiele; Ramalho, Fernando Silva

    2014-05-01

    Riboflavin has been shown to exhibit anti-inflammatory and antioxidant properties in the settings of experimental sepsis and ischaemia/reperfusion (I/R) injury. We investigated the effect of riboflavin on normothermic liver I/R injury. Mice were submitted to 60 min of ischaemia plus saline or riboflavin treatment (30 μmoles/kg BW) followed by 6 h of reperfusion. Hepatocellular injury was evaluated by aminotransferase levels, reduced glutathione (GSH) content and the histological damage score. Hepatic neutrophil accumulation was assessed using the naphthol method and by measuring myeloperoxidase activity. Hepatic oxidative/nitrosative stress was estimated by immunohistochemistry. Liver endothelial and inducible nitric oxide synthase (eNOS/iNOS) and nitric oxide (NO) amounts were assessed by immunoblotting and a chemiluminescence assay. Riboflavin significantly reduced serum and histological parameters of hepatocellular damage, neutrophil infiltration and oxidative/nitrosative stress. Furthermore, riboflavin infusion partially recovered hepatic GSH reserves and decreased the liver contents of eNOS/iNOS and NO. These data indicate that riboflavin exerts antioxidant and anti-inflammatory effects in the ischaemic liver, protecting hepatocytes against I/R injury. The mechanism of these effects appears to be related to the intrinsic antioxidant potential of riboflavin/dihydroriboflavin and to reduced hepatic expression of eNOS/iNOS and reduced NO levels, culminating in attenuation of oxidative/nitrosative stress and the acute inflammatory response. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Selective Cerebro-Myocardial Perfusion in Complex Neonatal Aortic Arch Pathology: Midterm Results.

    Science.gov (United States)

    Hoxha, Stiljan; Abbasciano, Riccardo Giuseppe; Sandrini, Camilla; Rossetti, Lucia; Menon, Tiziano; Barozzi, Luca; Linardi, Daniele; Rungatscher, Alessio; Faggian, Giuseppe; Luciani, Giovanni Battista

    2018-03-06

    Aortic arch repair in newborns and infants has traditionally been accomplished using a period of deep hypothermic circulatory arrest. To reduce neurologic and cardiac dysfunction related to circulatory arrest and myocardial ischemia during complex aortic arch surgery, an alternative and novel strategy for cerebro-myocardial protection was recently developed, where regional low-flow perfusion is combined with controlled and independent coronary perfusion. The aim of the present retrospective study was to assess short-term and mid-term results of selective and independent cerebro-myocardial perfusion in neonatal aortic arch surgery. From April 2008 to August 2015, 28 consecutive neonates underwent aortic arch surgery under cerebro-myocardial perfusion. There were 17 male and 11 female, with median age of 15 days (3-30 days) and median body weight of 3 kg (1.6-4.2 kg), 9 (32%) of whom with low body weight (cerebro-myocardial perfusion was 30 ± 11 min (15-69 min). Renal dysfunction, requiring a period of peritoneal dialysis was observed in 10 (36%) patients, while liver dysfunction was noted only in 3 (11%). There were three (11%) early and two late deaths during a median follow-up of 2.9 years (range 6 months-7.7 years), with an actuarial survival of 82% at 7 years. At latest follow-up, no patient showed signs of cardiac or neurologic dysfunction. The present experience shows that a strategy of selective and independent cerebro-myocardial perfusion is safe, versatile, and feasible in high-risk neonates with complex congenital arch pathology. Encouraging outcomes were noted in terms of cardiac and neurological function, with limited end-organ morbidity. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  9. Adrenergic Metabolic and Hemodynamic Effects of Octopamine in the Liver

    Directory of Open Access Journals (Sweden)

    Adelar Bracht

    2013-11-01

    Full Text Available The fruit extracts of Citrus aurantium (bitter orange are traditionally used as weight-loss products and as appetite suppressants. A component of these extracts is octopamine, which is an adrenergic agent. Weight-loss and adrenergic actions are always related to metabolic changes and this work was designed to investigate a possible action of octopamine on liver metabolism. The isolated perfused rat liver was used to measure catabolic and anabolic pathways and hemodynamics. Octopamine increased glycogenolysis, glycolysis, oxygen uptake, gluconeogenesis and the portal perfusion pressure. Octopamine also accelerated the oxidation of exogenous fatty acids (octanoate and oleate, as revealed by the increase in 14CO2 production derived from 14C labeled precursors. The changes in glycogenolysis, oxygen uptake and perfusion pressure were almost completely abolished by α1-adrenergic antagonists. The same changes were partly sensitive to the β-adrenergic antagonist propranolol. It can be concluded that octopamine accelerates both catabolic and anabolic processes in the liver via adrenergic stimulation. Acceleration of oxygen uptake under substrate-free perfusion conditions also means acceleration of the oxidation of endogenous fatty acids, which are derived from lipolysis. All these effects are compatible with an overall stimulating effect of octopamine on metabolism, which is compatible with its reported weight-loss effects in experimental animals.

  10. Regional heterogeneity of myocardial perfusion in healthy human myocardium: assessment with magnetic resonance perfusion imaging.

    Science.gov (United States)

    Muehling, Olaf M; Jerosch-Herold, Michael; Panse, Prasad; Zenovich, Andrey; Wilson, Betsy V; Wilson, Robert F; Wilke, Norbert

    2004-01-01

    The knowledge of myocardial perfusion in healthy volunteers is fundamental for evaluation of patients with ischemic heart disease. The study was conducted to determine range, regional variability, and transmural gradient of myocardial perfusion in normal volunteers with Magnetic Resonance Perfusion Imaging (MRPI). Perfusion was assessed in 17 healthy volunteers (age: 20-47 yr, 11 males) at rest and adenosine-induced hyperemia using a 1.5 T MR scanner. Perfusion was quantified (mL/g/min) for the transmural myocardium and separately for the endo- and epimyocardium in the anterior, lateral, posterior, and septal left ventricular wall using the Fermi model for constrained deconvolution. Regional variabilities for resting, hyperemic perfusion, and perfusion reserve were 22 +/- 8%, 21 +/- 10%, and 35 +/- 18%. Mean resting, hyperemic perfusion, and perfusion reserve were 1.1 +/- 0.4 mL/g/min, 4.2 +/- 1.1 mL/g/min, and 4.1 +/- 1.4. Perfusion in the septum was higher at rest (1.3 +/- 0.3 mL/g/min vs. 1.0 +/- 0.3 mL/g/min, p < 0.05) and lower during hyperemia (3.6 +/- 0.8 mL/g/min vs. 4.5 +/- 1.1 mL/g/min, p < 0.03), resulting in a reduced perfusion reserve (PR) (3.2 +/- 0.9 vs. 4.5 +/- 1.4, p < 0.01) in the septum vs. the combined anterior, lateral, and posterior segments. Resting (0.9 +/- 0.3 mL/g/min vs. 1.4 +/- 0.5 mL/g/min, p < 0.01), but not hyperemic perfusion, was lower in the epi- vs. endomyocardium, resulting in a higher epimyocardial PR (4.8 +/- 1.8 vs. 3.5 +/- 1.4, p < 0.01) in all regions but the septum, where endo- and epimyocardial perfusion and perfusion reserve were not different. A considerable regional variability of myocardial perfusion was confirmed with MRPI. The exceptional anatomical position of the septum is reflected by the lack of a perfusion gradient, which was demonstrated in all other regions but the septum.

  11. MRI of pulmonary perfusion; MRT der Lungenperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Fink, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany); Risse, F.; Semmler, W. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Medizinische Physik in der Radiologie, Heidelberg (Germany); Schoenberg, S.O.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen (Germany). Institut fuer Klinische Radiologie; Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologie, Heidelberg (Germany)

    2006-04-15

    Lung perfusion is a crucial prerequisite for effective gas exchange. Quantification of pulmonary perfusion is important for diagnostic considerations and treatment planning in various diseases of the lungs. Besides disorders of pulmonary vessels such as acute pulmonary embolism and pulmonary hypertension, these also include diseases of the respiratory tract and lung tissue as well as pulmonary tumors. This contribution presents the possibilities and technical requirements of MRI for diagnostic work-up of pulmonary perfusion. (orig.) [German] Die Perfusion der Lunge ist eine entscheidende Voraussetzung fuer einen effektiven Gasaustausch. Die Bestimmung der Lungenperfusion ist bei verschiedenen Erkrankungen der Lunge fuer Diagnostik und Therapieplanung bedeutsam. Hierzu zaehlen neben Erkrankungen der Lungengefaesse wie akute Lungenembolie und pulmonale Hypertension ebenso Erkrankungen der Atemwege, des Lungengeruests und Lungentumoren. In diesem Beitrag werden die Moeglichkeiten und technischen Voraussetzungen der MRT zur Diagnostik der Lungenperfusion dargestellt. (orig.)

  12. Reciprocal effects of dietary sesamin on ketogenesis and triacylglycerol secretion by the rat liver.

    Science.gov (United States)

    Fukuda, N; Miyagi, C; Zhang, L; Jayasooriya, A P; Sakono, M; Yamamoto, K; Ide, T; Sugano, M

    1998-10-01

    The effects of dietary sesamin (a mixture of sesamin and episesamin, 1:1, w/w) on ketone body production and lipid secretion were studied in isolated perfused liver from rats given sesamin. Feeding sesamin at the dietary level of 0.2% from 14 to 16 d resulted in an enlargement of liver weight. Ketone body production was significantly elevated in the livers perfused with oleic acid in comparison with those perfused without an exogenous-free fatty acid, and sesamin feeding caused a stimulation of ketone body production, especially when exogenous oleic acid was provided. On the other hand, the ratio of beta-hydroxybutyrate to acetoacetate, an index of mitochondrial redox potential, tended to increase in the livers perfused with oleic acid compared with those without fatty acid, thought it was consistently lowered by dietary sesamin. The cumulative secretion of triacylglycerol, but not of cholesterol, by the livers from sesamin-fed rats was decreased markedly, especially when exogenous oleic acid was provided, suggesting an inverse relationship between the rates of ketogenesis and triacylglycerol secretion. These results suggest that dietary sesamin exerts its hypotriglyceridemic effect at least in part through an enhanced metabolism of exogenous-free fatty acid to oxidation at the expense of esterification in rat liver.

  13. Ventilation-perfused studies using SPECT

    International Nuclear Information System (INIS)

    Zwijnenburg, A.

    1989-01-01

    A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

  14. Vicarious audiovisual learning in perfusion education.

    Science.gov (United States)

    Rath, Thomas E; Holt, David W

    2010-12-01

    Perfusion technology is a mechanical and visual science traditionally taught with didactic instruction combined with clinical experience. It is difficult to provide perfusion students the opportunity to experience difficult clinical situations, set up complex perfusion equipment, or observe corrective measures taken during catastrophic events because of patient safety concerns. Although high fidelity simulators offer exciting opportunities for future perfusion training, we explore the use of a less costly low fidelity form of simulation instruction, vicarious audiovisual learning. Two low fidelity modes of instruction; description with text and a vicarious, first person audiovisual production depicting the same content were compared. Students (n = 37) sampled from five North American perfusion schools were prospectively randomized to one of two online learning modules, text or video.These modules described the setup and operation of the MAQUET ROTAFLOW stand-alone centrifugal console and pump. Using a 10 question multiple-choice test, students were assessed immediately after viewing the module (test #1) and then again 2 weeks later (test #2) to determine cognition and recall of the module content. In addition, students completed a questionnaire assessing the learning preferences of today's perfusion student. Mean test scores from test #1 for video learners (n = 18) were significantly higher (88.89%) than for text learners (n = 19) (74.74%), (p learning module than text learners. Vicarious audiovisual learning modules may be an efficacious, low cost means of delivering perfusion training on subjects such as equipment setup and operation. Video learning appears to improve cognition and retention of learned content and may play an important role in how we teach perfusion in the future, as simulation technology becomes more prevalent.

  15. Measurement of myocardial perfusion using magnetic resonance

    DEFF Research Database (Denmark)

    Fritz-Hansen, T.; Jensen, L.T.; Larsson, H.B.

    2008-01-01

    Cardiac magnetic resonance imaging (MRI) has evolved rapidly. Recent developments have made non-invasive quantitative myocardial perfusion measurements possible. MRI is particularly attractive due to its high spatial resolution and because it does not involve ionising radiation. This paper reviews...... myocardial perfusion imaging with MR contrast agents: methods, validation and experiences from clinical studies. Unresolved issues still restrict the use of these techniques to research although clinical applications are within reach Udgivelsesdato: 2008/12/8...

  16. Early modifications of hepatic perfusion measured by functional CT in a rat model of hepatocellular carcinoma using a blood pool contrast agent

    International Nuclear Information System (INIS)

    Fournier, Laure S.; Cuenod, Charles Andre; Bazelaire, Cedric de; Siauve, Nathalie; Frija, Guy; Clement, Olivier; Rosty, Christophe; Tran, Phuong Lan

    2004-01-01

    Macromolecular contrast-enhanced functional CT was performed to characterize early perfusion changes in hepatocellular carcinoma (HCC). Fourteen rats with chemically induced primary liver tumors ranging pathologically from hyperplasia to HCC and 15 control rats were investigated. Two dynamic CT scans using an experimental macromolecular contrast agent were performed on a single slice 11 and 18 weeks after tumor induction followed by pathological examination. A deconvolution mathematical model was applied, yielding the hepatic perfusion index (HPI), mean transit time (MTT), liver distribution volume (LDV) and arterial, portal and total blood flows (FA, FP, FT). Analysis was performed on one slice per rat, containing overall two hyperplasia, six dysplasia and 15 HCC. On the first scans, HCC at an early pathological stage had a low FP (-30%, P=0.002) but a normal arterial-portal balance. On the scan contemporary to pathology, HCC perfusion parameters showed an inversion of the arterial-portal balance (HPI +212%, P<0.0001), with a high FA (+56%, P=0.002) and a low FP (-69%, P<0.0001). Sensitivity and specificity of detection of HCC by perfusion CT were high (87 and 80%) on late scans; but also on the earlier scans (86 and 65%), even though only one (7%) was visible to the eye. Perfusion-CT allowed early detection of HCC. This technique could contribute in the detection and characterization of liver lesions in clinical studies. (orig.)

  17. CT perfusion study of neck lymph nodes

    International Nuclear Information System (INIS)

    Zhong Jin; Liu Jun; Hua Rui; Qiao Hui; Gong Yi

    2011-01-01

    Objective: To study the CT perfusion features of various lymph nodes in the neck. Methods: Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology, including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes, and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results: The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28.13±5.08), (31.08±5.82), and (11.24±5.31) s, respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P -1 · 100 g -1 , respectively. The values of BV were (24.68±2.84), (25.30±3.16), and (25.15± 8.81) ml·100 g -1 respectively. The values of TTP were (40.90±8.85), (40.67±6.45), and (40.98±6.62) s, respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes (P>0.05). Conclusion: CT perfusion, especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes. (authors)

  18. Evaluation of liver hemodynamics using SPIO-enhanced dynamic MRI. Comparison between cirrhotic liver and normal liver

    International Nuclear Information System (INIS)

    Shimada, Kotaro; Kobayashi, Hisato; Furuta, Akihiro; Nunoura, T.; Takahashi, Takahiro; Ogasawara, Nobuhiko; Akuta, Keizo

    2006-01-01

    SPIO, ferucarbotran (Resovist), which enables rapid bolus injection is well suited for the evaluation of liver hemodynamics. Our study aimed to assess the difference of hemodynamics associated with progression of chronic liver disease using SPIO-enhanced dynamic MRI. Ten patients with normal liver function, 10 patients with chronic hepatitis, and 16 patients with liver cirrhosis were examined. The MR perfusion studies were performed by 1.5T MR system with a single-shot GRE-EPI with spectral presaturation inversion recovery (SPIR) and sensitivity encoding (SENSE) technique. After the bolus injection of SPIO (0.016 ml/kg) followed by a 20 ml saline flush, 30 sequential dynamic echo planar images were obtained under the condition of 30 seconds breath hold. From the ROI set in the right lobe of the liver, time-to-signal intensity curves (TICs) were obtained. TICs were converted to time-to-R2 * curves, and the slope at hepatic arterial phase (Sa) and at portal predominant phase (Sp) were calculated by the linear regression. Sp/Sa (portal/arterial ratio) of each group was analyzed statistically. (unpaired T-test) In comparing Sp/Sa of each group, there was a significant difference between normal liver and advanced liver cirrhosis. The decrease of Sp/Sa was seen in severe cirrhosis, but this change was unclear in chronic hepatitis and mild cirrhosis. In extremely severe cirrhosis, there was a bizarre phenomenon that Sp became minus number. In conclusion, SPIO-enhanced dynamic MRI was useful to assess the difference of liver hemodynamics associated with progression of chronic liver disease. (author)

  19. Technical aspects of MR perfusion

    International Nuclear Information System (INIS)

    Sourbron, Steven

    2010-01-01

    The most common methods for measuring perfusion with MRI are arterial spin labelling (ASL), dynamic susceptibility contrast (DSC-MRI), and T 1 -weighted dynamic contrast enhancement (DCE-MRI). This review focuses on the latter approach, which is by far the most common in the body and produces measures of capillary permeability as well. The aim is to present a concise but complete overview of the technical issues involved in DCE-MRI data acquisition and analysis. For details the reader is referred to the references. The presentation of the topic is essentially generic and focuses on technical aspects that are common to all DCE-MRI measurements. For organ-specific problems and illustrations, we refer to the other papers in this issue. In Section 1 'Theory' the basic quantities are defined, and the physical mechanisms are presented that provide a relation between the hemodynamic parameters and the DCE-MRI signal. Section 2 'Data acquisition' discusses the issues involved in the design of an optimal measurement protocol. Section 3 'Data analysis' summarizes the steps that need to be taken to determine the hemodynamic parameters from the measured data.

  20. Contrast-enhanced ultrasonography for the evaluation of liver fibrosis after biliary obstruction.

    Science.gov (United States)

    Shin, Hyun Joo; Chang, Eun Young; Lee, Hye Sun; Hong, Jung Hwa; Park, Gyuri; Kim, Hyun Gi; Kim, Myung-Joon; Lee, Mi-Jung

    2015-03-07

    To investigate perfusion change in contrast-enhanced ultrasonography (CEUS) to evaluate liver fibrosis based on biliary obstruction using an animal model. New Zealand white rabbits (3-4 kg) underwent bile duct ligation to form a biliary obstruction model. We performed liver CEUS and laboratory tests on the day before the operation (day 0) and every 7 postoperative days until the rabbits were sacrificed. After CEUS, signal intensity of liver parenchyma with a time-intensity curve was analyzed. Perfusion parameters were automatically calculated from region-of-interests, including peak signal intensity, mean transit time, area under the curve and time to peak. Histological grades of liver fibrosis were assessed according to the Metavir score system immediately after sacrifice. Generalized estimating equations were used to analyze the association between liver fibrosis grades and perfusion parameters for statistical analysis. The perfusion parameters were measured on the last day and the difference between day 0 and the last day were evaluated. From the nine rabbits, histological grades of liver fibrosis were grade 1 in one rabbit, grade 2 and 3 in three rabbits each, and grade 4 in two rabbits. Among the four CEUS parameters, only the peak signal intensity measured on the last day demonstrated a significant association with liver fibrosis grades (OR = 1.392, 95%CI: 1.114-1.741, P = 0.004). The difference in peak signal intensity between day 0 and the last day also demonstrated an association with liver fibrosis (OR = 1.191, 95%CI: 0.999-1.419, P = 0.051). The other parameters tested, including mean transit time, area under the curve, and time to peak, showed no significant correlation with liver fibrosis grades. This animal study demonstrates that CEUS can be used to evaluate liver fibrosis from biliary obstruction using peak signal intensity as a parameter.

  1. Assessment of myocardial perfusion using a new scanning agent

    Energy Technology Data Exchange (ETDEWEB)

    Khalil, M.N

    1987-01-01

    This work assessed a new compound: Tc-99m tertiary butyl isonitrile (T-BIN) in scanning the normal myocardium in dogs. Experimentally induced myocardial infarcts (M.I.) were detected. The compound cleared significantly from the blood within 15 minutes and from the lungs within an hour after intravenous administration. Liver uptake was high and remained so. Cardiac uptake occurred quickly and continued for 6 hours. Comparable results were obtained in normal humans and patients. Myocardial scanning was best after 60 minutes at rest or 30 minutes after exercise. Liver uptake sometimes obscured the detection of inferior M.I. but this problem was reduced using a 45/sup 0/ left anterior oblique view with a 20/sup 0/ cranial tilt. At rest 9/10 patients with M.I. showed defects corresponding to the infarct sites. In 20 patients with angina pectoris 16 had perfusion defects on exercise. In 15/16 patients reversible ischaemia was demonstrated. The reperfusion scans were best obtained at 4 hours post exercise. Both Tl-201 and T-BIN detected equally the infarcts (3/3) but in patients with angina 8/10 with T-BIN and 6/10 with Tl-201 showed defects. ECG gating of the T-BIN scans was also studied.

  2. Diagnostic value of dynamic contrast-enhanced CT with perfusion imaging in the quantitative assessment of tumor response to sorafenib in patients with advanced hepatocellular carcinoma: A feasibility study.

    Science.gov (United States)

    Ippolito, Davide; Querques, Giulia; Okolicsanyi, Stefano; Franzesi, Cammillo Talei; Strazzabosco, Mario; Sironi, Sandro

    2017-05-01

    To investigate the feasibility of perfusion-CT (p-CT) measurements in quantitative assessment of hemodynamic changes related to sorafenib in patients with advanced hepatocellular carcinoma (HCC). Twenty-two patients with advanced HCC underwent p-CT study (256-MDCT scanner) before and 2 months after sorafenib administration. Dedicated perfusion software generated a quantitative map of arterial and portal perfusion and calculated the following perfusion parameters in target liver lesion: hepatic perfusion (HP), time-to-peak (TTP), blood volume (BV), arterial perfusion (AP), and hepatic perfusion index (HPI). After the follow-up scan, patients were categorized as responders and non-responders, according to mRECIST. Perfusion values were analyzed and compared in HCC lesions and in the cirrhotic parenchyma (n=22), such as between baseline and follow-up in progressors and non-progressors. Before treatment, all mean perfusion values were significantly higher in HCC lesions than in the cirrhotic parenchyma (HP 47.8±17.2 vs 13.3±6.3mL/s per 100g; AP 47.9±18.1 vs 12.9±10.7mL/s; pCT technique can be used for HCC quantitative assessment of changes related to anti-angiogenic therapy. Identification of response predictors might help clinicians in selection of patients who may benefit from targeted-therapy allowing for optimization of individualized treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Abnormal perfusion on myocardial perfusion SPECT in patients with WPW syndrome: clinical implications

    International Nuclear Information System (INIS)

    Kang, Do Young; Cha, Kwang Soo; Kim, Moo Hyun; Kim, Young Dae; Kim, Duk Kyu

    2001-01-01

    Myocardial perfusion is altered significantly in patients with rhythm disturbances such as CLBBB and right ventricular pacing rhythm. Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on SPECT in patients with WPW syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial SPECT with or without coronary angiography were performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG or electrophysiologic study. Small to large extent (11.0 8.5%, range: 0 35%) and mild to moderate severity (-71.8 42.7%, range: -217 0%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall AP showed normal. Other defect locations were as follows. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. It was not specifically correlated with location of accessory pathway, but most of all patients were abnormal perfusion pattern. Therefore myocardial perfusion SPECT was interpreted carefully in patients with WPW syndrome

  4. Elevated Liver Enzymes

    Science.gov (United States)

    Symptoms Elevated liver enzymes By Mayo Clinic Staff Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or ... than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated ...

  5. 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 ...

  6. Non-invasive estimation of hepatic blood perfusion from H215O PET images using tissue-derived arterial and portal input functions

    International Nuclear Information System (INIS)

    Kudomi, N.; Slimani, L.; Jaervisalo, M.J.; Lautamaeki, R.; Naum, G.A.; Knuuti, J.; Kiss, J.; Savunen, T.; Iida, H.; Nuutila, P.; Iozzo, P.

    2008-01-01

    The liver is perfused through the portal vein and the hepatic artery. When its perfusion is assessed using positron emission tomography (PET) and 15 O-labeled water (H 2 15 O), calculations require a dual blood input function (DIF), i.e., arterial and portal blood activity curves. The former can be generally obtained invasively, but blood withdrawal from the portal vein is not feasible in humans. The aim of the present study was to develop a new technique to estimate quantitative liver perfusion from H 2 15 O PET images with a completely non-invasive approach. We studied normal pigs (n=14) in which arterial and portal blood tracer concentrations and Doppler ultrasonography flow rates were determined invasively to serve as reference measurements. Our technique consisted of using model DIF to create tissue model function and the latter method to simultaneously fit multiple liver time-activity curves from images. The parameters obtained reproduced the DIF. Simulation studies were performed to examine the magnitude of potential biases in the flow values and to optimize the extraction of multiple tissue curves from the image. The simulation showed that the error associated with assumed parameters was 2 15 O PET imaging. This suggests the possibility to enable completely non-invasive technique to assess liver perfusion in patho-physiological studies. (orig.)

  7. Acute Liver Failure

    Science.gov (United States)

    ... begins in or spreads to your liver can cause your liver to fail. Shock. Overwhelming infection (sepsis) and shock can severely impair blood flow to the liver, causing liver failure. Many cases of acute liver failure have no apparent ... liver failure often causes complications, including: ...

  8. The Relation Between Perfusion Pattern of Hepatic Artery Perfusion Scintigraphy and Response to Y-90 Microsphere Therapy

    Directory of Open Access Journals (Sweden)

    Bilge Volkan-Salancı

    2013-12-01

    Full Text Available Objective: Hepatic artery perfusion scintigraphy is a routine procedure for patient evaluation before Y-90 radiomicrosphere therapy and mostly used for prediction of extrahepatic leakage. Moreover, it also displays perfusion pattern of tumours, which is an important parameter on success of the therapy. The aim of this study is to assess the relation between the perfusion pattern on hepatic artery perfusion scintigraphy and radiomicrosphere therapy response. Methods: A total of 99 radiomicrosphere therapy applications were carried out in 80 patients (M/F: 55/25. Results: Heterogeneous and diffuse perfusion patterns were observed in 47 patients and 52 patients, respectively. The patients with diffuse perfusion pattern had better therapy response both on FDG PET/CT (p= 0.04 and CT (p=0.008 when compared to those with heterogenous perfusion pattern. Conclusion: Perfusion pattern observed on hepatic artery perfusion scintigraphy may be a successful predictor of early response to radiomicrosphere therapy

  9. Myocardial perfusion imaging with dual energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); De Cecco, Carlo N. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”, Rome (Italy); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Spandorfer, Adam; Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States)

    2016-10-15

    Highlights: • Stress dual-energy sCTMPI offers the possibility to directly detect the presence of myocardial perfusion defects. • Stress dual-energy sCTMPI allows differentiating between reversible and fixed myocardial perfusion defects. • The combination of coronary CT angiography and dual-energy sCTMPI can improve the ability of CT to detect hemodynamically relevant coronary artery disease. - Abstract: Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

  10. Measurement of ventilation- and perfusion-mediated cooling during laser ablation in ex vivo human lung tumors.

    Science.gov (United States)

    Vietze, Andrea; Koch, Franziska; Laskowski, Ulrich; Linder, Albert; Hosten, Norbert

    2011-11-01

    Perfusion-mediated tissue cooling has often been described in the literature for thermal ablation therapies of liver tumors. The objective of this study was to investigate the cooling effects of both perfusion and ventilation during laser ablation of lung malignancies. An ex vivo lung model was used to maintain near physiological conditions for the specimens. Fourteen human lung lobes containing only primary lung tumors (non-small cell lung cancer) were used. Laser ablation was carried out using a Nd:YAG laser with a wavelength of 1064 nm and laser fibers with 30 mm diffusing tips. Continuous invasive temperature measurement in 10 mm distance from the laser fiber was performed. Laser power was increased at 2 W increments starting at 10 W up to a maximum power of 12-20 W until a temperature plateau around 60 °C was reached at one sensor. Ventilation and perfusion were discontinued for 6 min each to assess their effects on temperature development. The experiments lead to 25 usable temperature profiles. A significant temperature increase was observed for both discontinued ventilation and perfusion. In 6 min without perfusion, the temperature rose about 5.5 °C (mean value, Pcooling are significant influencing factors on temperature development during thermal ablation. They should be taken into account during the planning and preparation of minimally invasive lung tumor treatment in order to achieve complete ablation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Standardized perfusion value of the esophageal carcinoma and its correlation with quantitative CT perfusion parameter values

    Energy Technology Data Exchange (ETDEWEB)

    Djuric-Stefanovic, A., E-mail: avstefan@eunet.rs [Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Saranovic, Dj., E-mail: crvzve4@gmail.com [Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Sobic-Saranovic, D., E-mail: dsobic2@gmail.com [Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade (Serbia); Masulovic, D., E-mail: draganmasulovic@yahoo.com [Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade (Serbia); Artiko, V., E-mail: veraart@beotel.rs [Faculty of Medicine, University of Belgrade, Belgrade (Serbia); Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade (Serbia)

    2015-03-15

    Purpose: Standardized perfusion value (SPV) is a universal indicator of tissue perfusion, normalized to the whole-body perfusion, which was proposed to simplify, unify and allow the interchangeability among the perfusion measurements and comparison between the tumor perfusion and metabolism. The aims of our study were to assess the standardized perfusion value (SPV) of the esophageal carcinoma, and its correlation with quantitative CT perfusion measurements: blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) of the same tumor volume samples, which were obtained by deconvolution-based CT perfusion analysis. Methods: Forty CT perfusion studies of the esophageal cancer were analyzed, using the commercial deconvolution-based CT perfusion software (Perfusion 3.0, GE Healthcare). The SPV of the esophageal tumor and neighboring skeletal muscle were correlated with the corresponding mean tumor and muscle quantitative CT perfusion parameter values, using Spearman's rank correlation coefficient (r{sub S}). Results: Median SPV of the esophageal carcinoma (7.1; range: 2.8–13.4) significantly differed from the SPV of the skeletal muscle (median: 1.0; range: 0.4–2.4), (Z = −5.511, p < 0.001). The cut-off value of the SPV of 2.5 enabled discrimination of esophageal cancer from the skeletal muscle with sensitivity and specificity of 100%. SPV of the esophageal carcinoma significantly correlated with corresponding tumor BF (r{sub S} = 0.484, p = 0.002), BV (r{sub S} = 0.637, p < 0.001) and PS (r{sub S} = 0.432, p = 0.005), and SPV of the skeletal muscle significantly correlated with corresponding muscle BF (r{sub S} = 0.573, p < 0.001), BV (r{sub S} = 0.849, p < 0.001) and PS (r{sub S} = 0.761, p < 0.001). Conclusions: We presented a database of the SPV for the esophageal cancer and proved that SPV of the esophageal neoplasm significantly differs from the SPV of the skeletal muscle, which represented a sample of healthy

  12. Amino acid infusions induce reversible, dose-related decreases in bile flow in the isolated rat liver.

    Science.gov (United States)

    Shattuck, K E; Grinnell, C D; Rassin, D K

    1993-01-01

    Parenteral infusion of amino acid solutions is known to produce cholestasis in experimental animal models and in the isolated perfused rat liver. To characterize the dose responsiveness and reversibility of amino acid-induced cholestasis, isolated rat livers were perfused with solutions containing 1.5, 3.0, or 6.0 g of amino acids for 1 hour and allowed to recover for 30 minutes. Perfusion of livers resulted in a rapid, dose-related decrease in bile flow (p < .0001 at doses of 3.0 and 6.0 g). When the amino acid solution was discontinued, bile flow recovered to near control rates. Infusion of taurocholate reduced the magnitude of the decrease in bile flow associated with amino acid infusion but did not prevent it. Infusion of amino acid solutions was associated with the following changes in bile: (1) dose-related increases in total free amino acid concentrations; (2) increased osmolarity; (3) increased glucose concentrations; (4) increased potassium concentrations; (5) decreased chloride concentrations; (6) increased oxygen uptake in livers not perfused with added taurocholate; and (7) increased total bile acid concentrations in livers perfused with added taurocholate. Additional investigations are needed to determine whether these associations are attributable to individual amino acids or the total metabolic load of the amino acids.

  13. Local and Global Function Model of the Liver

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hesheng, E-mail: hesheng@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Jackson, Andrew [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ten Haken, Randall K.; Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Cao, Yue [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan (United States)

    2016-01-01

    Purpose: To develop a local and global function model in the liver based on regional and organ function measurements to support individualized adaptive radiation therapy (RT). Methods and Materials: A local and global model for liver function was developed to include both functional volume and the effect of functional variation of subunits. Adopting the assumption of parallel architecture in the liver, the global function was composed of a sum of local function probabilities of subunits, varying between 0 and 1. The model was fit to 59 datasets of liver regional and organ function measures from 23 patients obtained before, during, and 1 month after RT. The local function probabilities of subunits were modeled by a sigmoid function in relating to MRI-derived portal venous perfusion values. The global function was fitted to a logarithm of an indocyanine green retention rate at 15 minutes (an overall liver function measure). Cross-validation was performed by leave-m-out tests. The model was further evaluated by fitting to the data divided according to whether the patients had hepatocellular carcinoma (HCC) or not. Results: The liver function model showed that (1) a perfusion value of 68.6 mL/(100 g · min) yielded a local function probability of 0.5; (2) the probability reached 0.9 at a perfusion value of 98 mL/(100 g · min); and (3) at a probability of 0.03 [corresponding perfusion of 38 mL/(100 g · min)] or lower, the contribution to global function was lost. Cross-validations showed that the model parameters were stable. The model fitted to the data from the patients with HCC indicated that the same amount of portal venous perfusion was translated into less local function probability than in the patients with non-HCC tumors. Conclusions: The developed liver function model could provide a means to better assess individual and regional dose-responses of hepatic functions, and provide guidance for individualized treatment planning of RT.

  14. Nitric oxide and liver microcirculation during autoregulation and haemorrhagic shock in rabbit model.

    Science.gov (United States)

    Lhuillier, F; Robert, M-O; Crova, P; Goudable, J; Arnal, F; Cespuglio, R; Annat, G; Viale, J-P

    2006-08-01

    Direct evidence of nitric oxide (NO) involvement in the regulation of hepatic microcirculation is not yet available under physiological conditions nor in haemorrhagic shock. A laser Doppler flowmetry was used to measure liver perfusion index and a specific NO-sensitive electrode was inserted into liver parenchyma of anaesthetized rabbits. Hepatic autoregulation during moderate hypovolaemia {mean arterial pressure at 50 mm Hg without liver perfusion alteration; blood withdrawal 17.7 (4.2) ml [mean (SD)]} or haemorrhagic shock [mean arterial pressure at 20 mm Hg associated with liver perfusion impairment and lactic acidosis; blood withdrawal 56.0 (6.8) ml] were investigated over 60 min and were followed by a rapid infusion of the shed blood. Involvement of NO synthases was evaluated using a non-specific inhibitor, NAPNA (Nomega-nitro-L-arginine P-nitro-anilide). In the autoregulation group, a decrease [30.0 (4.0) mm Hg] of mean arterial pressure did not alter liver perfusion index, whereas the liver NO concentration increased and reached a plateau [125 (10)%; compared with baseline; P<0.05]. This NO concentration was reduced to zero by the administration of NO synthase inhibitor. Haemorrhagic shock led to a rapid decrease in liver perfusion index [60 (7)%; compared with baseline; P<0.05] before an immediate and continuous increase in NO concentration [250 (50)%; compared with baseline; P<0.05]. Infusion of NO inhibitor before haemorrhagic shock reduced the NO concentration to zero and hepatic perfusion by 60 (8)% (P<0.05) of the baseline. Mean arterial pressure increased simultaneously. In these animals, during haemorrhage, a continuous increase in NO concentration still occurred and liver perfusion slightly increased. In all groups but NAPNA+haemorrhagic shock, blood replacement induced recovery of baseline values. NO plays a physiological role in the liver microcirculation during autoregulation. Its production is enzyme-dependent. Conversely, haemorrhagic shock

  15. Etiology of pediatric acute liver failure

    Directory of Open Access Journals (Sweden)

    GUO Jing

    2017-10-01

    Full Text Available Pediatric acute liver failure (PALF is a complex syndrome with rapid progression, and the cause of PALF is age-dependent. This article analyzes the common causes of PALF in clinical practice, including infection factors, inherited metabolic factors, poisoning and drugs, abnormal perfusion, and autoimmune diseases, among which infection factors are the most common cause. With the improvement in diagnosis and treatment techniques, the diagnostic rate of PALF caused by inherited metabolic diseases and autoimmune diseases keeps increasing. Due to the small number of PALF patients, there lacks experience in etiological diagnosis. This article summarizes related reports, in order to provide a reference for screening the causes of PALF.

  16. Evaluation of Pulmonary Perfusion Scan in Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. T.; Kim, C. K.; Park, C. Y.; Choi, B. S. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1973-09-15

    Pulmonary perfusion scan with radioactive {sup 113m}In-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of artial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductras arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

  17. Evaluation of Pulmonary Perfusion Scan in Heart Disease

    International Nuclear Information System (INIS)

    Lee, J. T.; Kim, C. K.; Park, C. Y.; Choi, B. S.

    1973-01-01

    Pulmonary perfusion scan with radioactive 113m In-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of artial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductras arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

  18. Isolation of Kupffer Cells and Hepatocytes from a Single Mouse Liver

    DEFF Research Database (Denmark)

    Aparicio-Vergara, Marcela; Tencerova, Michaela; Morgantini, Cecilia

    2017-01-01

    one viable hepatic cellular fraction from a single mouse; either parenchymal (hepatocytes) or non-parenchymal cells (i.e., Kupffer cells or hepatic stellate cells). Here, we describe a method to isolate both hepatocytes and Kupffer cells from a single mouse liver, thereby providing the unique......Liver perfusion is a common technique used to isolate parenchymal and non-parenchymal liver cells for in vitro experiments. This method allows hepatic cells to be separated based on their size and weight, by centrifugation using a density gradient. To date, other methods allow the isolation of only...... advantage of studying different liver cell types that have been isolated from the same organism....

  19. Non-invasive estimation of hepatic blood perfusion from H{sub 2} {sup 15}O PET images using tissue-derived arterial and portal input functions

    Energy Technology Data Exchange (ETDEWEB)

    Kudomi, N.; Slimani, L.; Jaervisalo, M.J.; Lautamaeki, R.; Naum, G.A.; Knuuti, J. [University of Turku, Turku PET Centre (Finland); Kiss, J.; Savunen, T. [University of Turku, Department on Surgery, Turku (Finland); Iida, H. [National Cardiovascular Center-Research Institute, Department of Investigative Radiology, Advanced Medical-Engineering Center, Suita, Osaka (Japan); Nuutila, P. [University of Turku, Turku PET Centre (Finland); University of Turku, Department of Medicine, Turku (Finland); Iozzo, P. [University of Turku, Turku PET Centre (Finland); National Research Council, Institute of Clinical Physiology, Pisa (Italy)

    2008-10-15

    The liver is perfused through the portal vein and the hepatic artery. When its perfusion is assessed using positron emission tomography (PET) and {sup 15}O-labeled water (H{sub 2}{sup 15}O), calculations require a dual blood input function (DIF), i.e., arterial and portal blood activity curves. The former can be generally obtained invasively, but blood withdrawal from the portal vein is not feasible in humans. The aim of the present study was to develop a new technique to estimate quantitative liver perfusion from H{sub 2}{sup 15}O PET images with a completely non-invasive approach. We studied normal pigs (n=14) in which arterial and portal blood tracer concentrations and Doppler ultrasonography flow rates were determined invasively to serve as reference measurements. Our technique consisted of using model DIF to create tissue model function and the latter method to simultaneously fit multiple liver time-activity curves from images. The parameters obtained reproduced the DIF. Simulation studies were performed to examine the magnitude of potential biases in the flow values and to optimize the extraction of multiple tissue curves from the image. The simulation showed that the error associated with assumed parameters was <10%, and the optimal number of tissue curves was between 10 and 20. The estimated DIFs were well reproduced against the measured ones. In addition, the calculated liver perfusion values were not different between the methods and showed a tight correlation (r=0.90). In conclusion, our results demonstrate that DIF can be estimated directly from tissue curves obtained through H{sub 2}{sup 15}O PET imaging. This suggests the possibility to enable completely non-invasive technique to assess liver perfusion in patho-physiological studies. (orig.)

  20. Increasing heel skin perfusion by elevation.

    Science.gov (United States)

    Huber, Jacqueline; Reddy, Raj; Pitham, Tom; Huber, David

    2008-01-01

    To determine the efficacy of elevation in the primary prevention and treatment of pressure ulcers by studying the blood flow in tissue at risk of ulceration. A prospective study was used to compare different preventative devices with an elevating prosthesis. : Wollongong Hospital Wollongong, New South Wales, Australia. Normal subjects and subjects with vasculopathy were tested with their heel resting on a hospital bed, medical-grade lamb's wool, or a viscoelastic gel overlay, with or without the test prosthesis. Skin perfusion was measured throughout using a laser Doppler monitor. A device designed to elevate the heel off the bed and distribute the weight of the leg and foot on the calf. Heel capillary blood perfusion. Perfusion in the heel was significantly greater when elevated than when using the other devices tested. The differences in mean red blood cell flux were significant, with P pressure ulcer prevention and treatment and should be incorporated into health care practice.

  1. Dynamic perfusion patterns in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Dupont, Patrick; Paesschen, Wim van [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); Zaknun, John J. [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Maes, Alex [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); AZ Groeninge, Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn; Locharernkul, Chaichon [Chulalongkorn University, Nuclear Medicine and Neurology, Bangkok (Thailand); Vasquez, Silvia; Carpintiero, Silvina [Fleni Instituto de Investigaciones Neurologicas, Nuclear Medicine, Buenos Aires (Argentina); Bal, C.S. [All India Institute of Medical Sciences, Nuclear Medicine, New Delhi (India); Dondi, Maurizio [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); Ospedale Maggiore, Nuclear Medicine, Bologna (Italy)

    2009-05-15

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  2. Pulmonary perfusion patterns and pulmonary arterial pressure.

    Science.gov (United States)

    Scott, James A

    2002-08-01

    To use artificial intelligence methods to determine whether quantitative parameters describing the perfusion image can be synthesized to make a reasonable estimate of the pulmonary arterial (PA) pressure measured at angiography. Radionuclide perfusion images were obtained in 120 patients with normal chest radiographs who also underwent angiographic PA pressure measurement within 3 days of the radionuclide study. An artificial neural network (ANN) was constructed from several image parameters describing statistical and boundary characteristics of the perfusion images. With use of a leave-one-out cross-validation technique, this method was used to predict the PA systolic pressure in cases on which the ANN had not been trained. A Pearson correlation coefficient was determined between the predicted and measured PA systolic pressures. ANN predictions correlated with measured pulmonary systolic pressures (r = 0.846, P artificial intelligence methods helps to reveal physiologic information not readily apparent at visual image inspection. Copyright RSNA, 2002

  3. CT-based Techniques for Brain Perfusion.

    Science.gov (United States)

    Krishnan, Pradeep; Murphy, Amanda; Aviv, Richard I

    2017-06-01

    Recent rapid advances in endovascular treatment for acute ischemic stroke highlight the crucial role of neuroimaging especially multimodal computed tomography (CT) including CT perfusion in stroke triage and management decisions. With an increasing focus on changes in cerebral physiology along with time-based matrices in clinical decisions for acute ischemic stroke, CT perfusion provides a rapid and practical modality for assessment and identification of salvageable tissue at risk and infarct core and provides a better understanding of the changes in cerebral physiology. Although there are challenges with the lack of standardization and accuracy of quantitative assessment, CT perfusion is evolving as a cornerstone for imaging-based strategies in the rapid management of acute ischemic stroke.

  4. Extracorporeal lung perfusion and ventilation to improve donor lung function and increase the number of organs available for transplantation.

    Science.gov (United States)

    Valenza, F; Rosso, L; Gatti, S; Coppola, S; Froio, S; Colombo, J; Dossi, R; Pizzocri, M; Salice, V; Nosotti, M; Reggiani, P; Tosi, D; Palleschi, A; Pappalettera, M; Ferrero, S; Perazzoli, A; Costantini, D; Scalamogna, M; Rossi, G; Colombo, C; Santambrogio, L; Gattinoni, L

    2012-09-01

    Ex vivo lung perfusion (EVLP) has been validated as a valuable technique to increase the pool of organs available for lung transplantation. After a preclinical experience, we obtained permission from the Ethics Committee of our institution to transplant lungs after EVLP reconditioning. ABO compatibility, size match, and donor arterial oxygen pressure (PaO(2))/fraction of inspired oxygen (FiO(2)) ≤ 300 mm Hg were considered to be inclusion criteria, whereas the presence of chest trauma and lung contusion, evidence of gastric content aspiration, pneumonia, sepsis, or systemic disease were exclusion criteria. We only considered subjects on an extra corporeal membrane oxygenation (ECMO) bridge to transplantation with rapid functional deterioration. Using Steen solution with packed red blood cells oxygenated with 21% O(2), 5% to 7% CO(2) was delivered, targeted with a blood flow of approximately 40% predicted cardiac output. Once normothermic, the lungs were ventilated with a tidal volume of 7 mL/kg a PEEP of 5 cmH(2)O and a respiratory rate of 7 bpm. Lungs were considered to be suitable for transplantation if well oxygenated [P(v-a) O(2) > 350 mm Hg on FiO(2) 100%], in the absence of deterioration of pulmonary vascular resistance and lung mechanics over the perfusion time. From March to September 2011, six lung transplantations were performed, including two with EVLP. The functional outcomes were similar between groups: at T72 posttransplantation, the median PaO(2)/FiO(2) were 306 mm Hg (range, 282 to 331 mm Hg) and 323 mm Hg (range, 270 to 396 mm Hg) (P = 1, EVLP versus conventional). Intensive care unit ICU and hospital length of stay were similar (P = .533 and P = .663, respectively) with no mortality at 60 days in both groups. EVLP donors were older (49 ± 6 y versus 21 ± 7 y, P organs available for transplantation with short-term outcomes comparable to conventional transplantations. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Optimization of perfusion studies using Atropine

    International Nuclear Information System (INIS)

    Alvarado, A.N.; Valle, V.M.; Montoya, M.J.; Eskenazi, E.S.; Montiel, M.L.; Cueto, C.C.

    2002-01-01

    The studies of myocardial perfusion require an adequate stress; exercise or pharmacological. Every day, more pharmacological studies are performed, specially in some group of patients (women, AMI, etc). There some drugs that are used for this purpose, as adenosine and dobutamine. However, their cost and the lack of availability and infrastructure in our country do not allow there routinely use. We performed dipyridamol as a pharmacological stress, however in some patients there is a doubt regarding if the pharmacological effect was adequate. Atropine is a drug that is frequently used for different purpose and it is well know its tachycardic response. We present and alternative technique, using dipyridamol-atropine as a protocol of stress perfusion study. Our goal was to correlate the standard dipyridamol -thallium perfusion study and the dipyridamol -atropine-perfusion in patients with chronic coronary disease. We evaluated 6 patients (5 males) with stable angina and chronic coronary disease. A standard dipyridamol-thallium study was performed in all of them. Dipyridamole was administered intravenously at a rate of 0.14 mg/kg/min over 6 min for a total of 0.84 mg/kg body weight. Blood pressure, heart rate, EKG and symptoms were monitored before, during and after the pharmacological infusion. Two minutes after the infusion was completed, the radiotracer was injected intravenously. In the next 6 months, without any modification of the clinical situation (symptoms and therapy) a new dipyridamol study was performed, using 1 mg of atropine after the administration of dipyridamol. There were no differences in the collateral effects and we observed and average increase of 30% in the heart rate in relation with the study using dipyridamol alone. The addition of atropine to the standard dipyridamol perfusion study is safe, cheaper and improved the detection of perfusion defects in patients with coronary artery disease

  6. Cerebral perfusion imaging in HIV positive patients

    International Nuclear Information System (INIS)

    Kundley, Kshama; Chowdhury, D.; Lele, V.R.; Lele, R.D.

    1998-01-01

    Full text: Twelve human immunodeficiency virus (HIV) positive patients were studied by SPECT cerebral perfusion imaging 1 hour post injection of 15 mCi of 99m Tc-ECD under ideal conditions with a triple head gamma camera (Prism 3000 X P LEUHR), fanbeam collimators followed by Folstein Mini Mental Status Examination (FMMSE) and AIDS dementia complex (ADC) staging on the same day. All 12 patients were male, in the age range of 23-45 y (mean 31 y). The infected status was diagnosed by ELISA (10 patients) or Western blot (5 patients). The interval between diagnosis and imaging ranged from 1 month - 35 months (mean 15.3 months). Two patients were alcoholic and 2 were smokers. None of them had CNS disorder clinically. ADC staging and FMMSE could be performed in 4 patients. Two patients were normal (stage 0) and 2 were subclinical (stage 0.5) on ADC staging. FMMSE revealed normal or near normal status (mean score 35; maximum score 36). Cerebral perfusion images were interpreted simultaneously by 3 observers blind towards history and examination using semi-quantitative and quantitative methods by consensus. It revealed multiple areas of hypoperfusion, viz. temporal (11 patients (91 %), parietal 10 patients (83%), frontal 9 patients (75%, pre and post central gyrus 7 patients (58%), occipital 6 patients (50%) cingulate gyrus and cerebellum 5 patients (41%) and thalamic in 2 patients (16%). Hyper perfusion in caudate nuclei was noted in 10 patients (83%). The study reveals presence of multiple perfusion abnormalities on cerebral perfusion imaging in HIV positive patients who have normal/near normal mental status suggesting precedence of perfusion abnormality over clinically apparent mental deficit

  7. Effects of Electroacupuncture Stimulation at “Zusanli” Acupoint on Hepatic NO Release and Blood Perfusion in Mice

    Directory of Open Access Journals (Sweden)

    Shu-you Wang

    2015-01-01

    Full Text Available The study is to observe the influence of electroacupuncture (EA stimulation at “Zusanli” (ST36 on the release of nitric oxide (NO and blood perfusion (BP in the liver and further explore whether the hepatic blood perfusion (HBP changes were regulated by EA ST36 induced NO in nitric oxide synthase inhibited mice. The HBP change of the mice was detected by laser speckle perfusion imaging (LSPI before and after being given interventions, and the NO in liver tissue was detected by nitric acid reductase in each group. The NO levels and HBP in the L-NAME group were significantly lower than those in the control group (P<0.01. The NO level and HBP increase in EA group were significantly higher than those in control group (P<0.05. The NO level in the L-NAME EA group was slightly higher than that in the L-NAME group. The HBP increase in the L-NAME EA group was not statistically significant. These results showed that EA could accelerate the synthesis of NO and thereby increase HBP via vasodilation in liver tissue.

  8. Meta-Analysis of Stress Myocardial Perfusion Imaging

    Science.gov (United States)

    2017-06-06

    Coronary Disease; Echocardiography; Fractional Flow Reserve, Myocardial; Hemodynamics; Humans; Magnetic Resonance Imaging; Myocardial Perfusion Imaging; Perfusion; Predictive Value of Tests; Single Photon Emission Computed Tomography; Positron Emission Tomography; Multidetector Computed Tomography; Echocardiography, Stress; Coronary Angiography

  9. Curative effect of transbronchoscopic perfusion combined with conventional chemotherapy on multi-drug resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    Yang Li

    2016-12-01

    Full Text Available Objective: To analyze the curative effect of transbronchoscopic perfusion combined with conventional chemotherapy on multi-drug resistant tuberculosis. Methods: A total of 70 patients with multi-drug resistant tuberculosis treated in our hospital between April 2012 and April 2015 were selected and randomly divided into two groups, control group received conventional chemotherapy and observation group received transbronchoscopic perfusion + conventional chemotherapy. After treatment, negative conversion ratio of sputum mycobacterium tuberculosis, immune function, disease-specific indexes, oxidative stress indexes and liver function indexes were compared between two groups of patients. Results: After 6 months and 12 months of treatment, negative conversion ratio of sputum mycobacterium tuberculosis of observation group were significantly higher than those of control group; after 12 months of treatment, CD3+ , CD4+ , CD4+ /CD8+ , IgA, IgM and IgG levels in peripheral blood of observation group were significantly higher than those of control group while disease-specific indexes ADA and LDH content in serum were lower than those of control group; oxidative stress indexes TOS, MAOA and OSI content in serum were lower than those of control group while TAS and GSH-Px content were higher than those of control group; liver function indexes STB, ALP, ALT and AST content in serum were lower than those of control group while TP content was higher than that of control group. Conclusions: Transbronchoscopic perfusion combined with conventional chemotherapy can improve the treatment effectiveness, improve immune function as well as reduce oxidative stress and liver damage in patients with multi-drug resistant tuberculosis, and is advantageous in optimizing long-term treatment outcome.

  10. Comparison between acoustic radiation force impulse quantification data and perfusion-CT parameters in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Esser, Michael, E-mail: michael.esser@med.uni-tuebingen.de; Schneeweiß, Sven, E-mail: sven.schneeweiss@med.uni-tuebingen.de; Kolb, Manuel, E-mail: manuel.kolb@med.uni-tuebingen.de; Kurucay, Mustafa, E-mail: mustafa.kurucay@med.uni-tuebingen.de; Ruff, Christer, E-mail: christer.ruff@med.uni-tuebingen.de; Nikolaou, Konstantin, E-mail: konstantin.nikolaou@med.uni-tuebingen.de; Horger, Marius, E-mail: marius.horger@med.uni-tuebingen.de

    2017-04-15

    Highlights: • HCC tissue stiffness did not correlate with the degree of tumor vascularization. • HCC tissue stiffness declined while increasing HCC distance to the skin surface. • HCC tissue stiffness showed higher values the larger the respective tumor was. • Poorly differentiated HCCs showed increased values of tumor tissue stiffness. - Abstract: Objective: To find out, if ultrasound elastography of hepatocellular carcinoma (HCC) can predict patterns of tumor perfusion in volume perfusion computed tomography (VPCT). Material and methods: 25 consecutive patients (mean age, 68.9; range, 51–85 years) with liver cirrhosis suspected of HCC underwent VPCT and acoustic radiation force impulse (ARFI) elastography the same day. Quantitative elasticity values were registered, while blood flow (BF), blood volume (BV) and hepatic perfusion index (HPI) of the HCC lesions were calculated. Additionally, we identified histologic WHO grading, lesion size and localization. The Siemens Acuson S 3000 HELX-System with Virtual Touch™-Software and Siemens Somatom Definition Flash with Syngo{sup ®} software were used. Results: A total of 43 HCC lesions were assessed. Mean shear wave velocity was 2.6 m/s (range, 1.1–4.3 m/s). There was no significant linear correlation between the elasticity values and BF (p = 0.751), BV (p = 0.426) and HPI (p = 0.437). However, elasticity values were higher, the larger the tumor was (p = 0.008). Shear wave velocity declined with increasing distance of the HCC to the skin surface (p = 0.028) and depending on liver segment. In addition, elasticity values were higher in less differentiated HCCs. This trend was not statistically significant (p = 0.842). Conclusion: Tissue elasticity in HCC does not correlate with the degree of tumor vascularization, but calculated values are influenced both by the tumor size and localization inside the liver.

  11. Improved visualization of delayed perfusion in lung MRI

    International Nuclear Information System (INIS)

    Risse, Frank; Eichinger, Monika; Kauczor, Hans-Ulrich; Semmler, Wolfhard; Puderbach, Michael

    2011-01-01

    Introduction: The investigation of pulmonary perfusion by three-dimensional (3D) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was proposed recently. Subtraction images are generated for clinical evaluation, but temporal information is lost and perfusion defects might therefore be masked in this process. The aim of this study is to demonstrate a simple analysis strategy and classification for 3D-DCE-MRI perfusion datasets in the lung without omitting the temporal information. Materials and methods: Pulmonary perfusion measurements were performed in patients with different lung diseases using a 1.5 T MR-scanner with a time-resolved 3D-GRE pulse sequence. 25 3D-volumes were acquired after iv-injection of 0.1 mmol/kg KG Gadolinium-DTPA. Three parameters were determined for each pixel: (1) peak enhancement S n,max normalized to the arterial input function to detect regions of reduced perfusion; (2) time between arterial peak enhancement in the large pulmonary artery and tissue peak enhancement τ to visualize regions with delayed bolus onset; and (3) ratio R = S n,max /τ was calculated to visualize impaired perfusion, irrespectively of whether related to reduced or delayed perfusion. Results: A manual selection of peak perfusion images is not required. Five different types of perfusion can be found: (1) normal perfusion; (2) delayed non-reduced perfusion; (3) reduced non-delayed perfusion; (4) reduced and delayed perfusion; and (5) no perfusion. Types II and IV could not be seen in subtraction images since the temporal information is necessary for this purpose. Conclusions: The analysis strategy in this study allows for a simple and observer-independent visualization and classification of impaired perfusion in dynamic contrast-enhanced pulmonary perfusion MRI by using the temporal information of the datasets.

  12. Cultivation of porcine hepatocytes in polyurethane nonwovens as part of a biohybrid liver support system.

    Science.gov (United States)

    Linti, C; Zipfel, A; Schenk, M; Dauner, M; Doser, M; Viebahn, R; Becker, H D; Planck, H

    2002-10-01

    Many patients suffering from end-stage liver disease cannot be transplanted within reasonable time due to the shortage of donor organs. Bioartificial liver support systems may contribute to the liver regeneration or bridging the time until a liver graft for transplantation becomes available. Nonwovens with integrated oxygenation capacity have been developed and manufactured by melt blow technology using thermoplastic polyurethane. Capillary membranes for oxygenation were integrated into the nonwoven during the processing. The polyurethane nonwoven structures with adapted pore size and high pore volume allow high cell densities in the hepatocyte culture. The three-dimensional cell culture was housed by a flow bioreactor system and was integrated in a closed loop circulation with monitoring possibilities for pressure, pH, temperature, ammonia, and oxygen. Hepatocytes were isolated from rats or pigs by collagenase perfusion and infused into the medium-perfused circulation. Cells showed high viability and hepatocyte specific cytochrome P450-dependent metabolic function in culture (MEGX test).

  13. CT angiography and CT perfusion in acute ischemic stroke

    NARCIS (Netherlands)

    Seeters, T. van

    2016-01-01

    CT angiography and CT perfusion are used in patients with acute ischemic stroke for diagnostic purposes and to select patients for treatment. In this thesis, the reproducibility of CT angiography and CT perfusion is examined, the additional value of CT angiography and CT perfusion for stroke outcome

  14. Automatic Detection of Myocardial Boundaries in MR Cardio Perfusion Images

    NARCIS (Netherlands)

    Spreeuwers, Luuk; Breeuwer, Marcel

    2001-01-01

    Cardiovascular diseases often result in reduced blood perfusion of the myocardium (MC). Recent advances in MR allow fast recordingof contrast enhanced myocardial perfusion scans. For perfusion analysis the myocardial boundaries must be traced. Currently this is done manually. In this paper a method

  15. An alternative method for neonatal cerebro-myocardial perfusion

    Science.gov (United States)

    Luciani, Giovanni Battista; De Rita, Fabrizio; Faggian, Giuseppe; Mazzucco, Alessandro

    2012-01-01

    Several techniques have already been described for selective cerebral perfusion during repair of aortic arch pathology in children. One method combining cerebral with myocardial perfusion has also been proposed. A novel technique is reported here for selective and independent cerebro-myocardial perfusion for neonatal and infant arch surgery. Technical aspects and potential advantages are discussed. PMID:22307393

  16. Adipose derived mesenchymal stem cells transplantation via portal vein improves microcirculation and ameliorates liver fibrosis induced by CCl4 in rats

    Directory of Open Access Journals (Sweden)

    Wang Yu

    2012-06-01

    Full Text Available Abstract Introduction Adipose derived mesenchymal stem cells (ADMSCs, carrying the similar characteristics to bone marrow mesenchymal stem cells, only much more abundant and easier to obtain, may be a promising treatment for liver fibrosis. We aim to investigate the therapeutic potential of ADMSCs transplantation in liver fibrosis caused by carbon tetrachloride (CCl4 in rats as well as its underlying mechanism, and to further explore the appropriate infusion pathway. Methods ADMSCs were isolated, cultured and identified. Placebo and ADMSCs were transplanted via portal vein and tail vein respectively into carbon tetrachloride (CCl4-induced liver fibrosis rats. Computed tomography (CT perfusion scan and microvessel counts were performed to measure the alteration of liver microcirculation after therapy. Liver function tests and histological findings were estimated. Results CT perfusion scan shown significant decrease of hepatic arterial perfusion index, significant increased portal vein perfusion, total liver perfusion in rats receiving ADMSCs from portal vein, and Factor VIII (FVIII immunohistochemical staining shown significant decrease of microvessels in rats receiving ADMSCs from portal vein, indicating microcirculation improvement in portal vein group. Vascular endothelial growth Factor (VEGF was significantly up-regulated in fibrosis models, and decreased after ADMSCs intraportal transplantation. A significant improvement of liver functional test and histological findings in portal vein group were observed. No significance was found in rats receiving ADMSCs from tail vein. Conclusions ADMSCs have a therapeutic effect against CCl4-mediated liver fibrosis. ADMSCs may benefit the fibrotic liver through alteration of microcirculation, evidenced by CT perfusion scan and down-regulation of VEGF. Intraportal transplantation is a better pathway than tail vein transplantation.

  17. A direct comparison of the sensitivity of CT and MR cardiac perfusion using a myocardial perfusion phantom.

    OpenAIRE

    Otton, James; Morton, Geraint; Schuster, Andreas; Bigalke, Boris; Marano, Riccardo; Olivotti, Luca; Nagel, Eike; Chiribiri, Amedeo

    2013-01-01

    BACKGROUND: Direct comparison of CT and magnetic resonance (MR) perfusion techniques has been limited and in vivo assessment is affected by physiological variability, timing of image acquisition, and parameter selection. OBJECTIVE: We precisely compared high-resolution k-t SENSE MR cardiac perfusion at 3 T with single-phase CT perfusion (CTP) under identical imaging conditions. METHODS: We used a customized MR imaging and CT compatible dynamic myocardial perfusion phantom to represe...

  18. Red blood cells augment transport of reactive metabolites of monocrotaline from liver to lung in isolated and tandem liver and lung preparations

    Energy Technology Data Exchange (ETDEWEB)

    Pan, L.C.; Lame, M.W.; Morin, D.; Wilson, D.W.; Segall, H.J. (Department of Veterinary Pharmacology, University of California, Davis (United States))

    1991-09-01

    Monocrotaline (MCT) is a pyrrolizidine alkaloid that causes pulmonary hypertension in rats by mechanisms which remain largely unknown. MCT is thought to be activated in the liver to a reactive intermediate that is transported to the lung where it causes endothelial injury. The authors previous pharmacokinetic work demonstrated significant sequestration of radioactivity in red blood cells (RBCs) of rats treated with (14C)MCT. To determine whether this RBC sequestration might be important in the transport of reactive MCT metabolites, they compared the effect of inclusion of RBCs in the perfusion buffer on the extent of covalent binding of (14C)MCT to rat lungs in tandem liver-lung preparations. The potential effect of RBCs in stabilizing reactive intermediates was evaluated by preperfusion of isolated liver preparations with (14C)MCT with and without RBCs, separation and washing of the RBC fraction, and subsequent (90 min later) perfusion of washed RBCs or buffer alone in isolated perfused lungs. Covalent binding to lung tissues was determined by exhaustive methanol/chloroform extractions of unbound label from homogenized lung tissue followed by scintillation counting of residual 14C. Covalent binding was expressed as picomole MCT molecular weight equivalents/mg protein. Comparison of the relative capability of these isolated organ preparations for conversion of MCT to polar metabolites was done by extraction and HPLC analysis of perfusate at the end of the experiment. Isolated livers converted 65-85% of MCT to polar metabolites compared with less than 5% conversion in the isolated lungs. Inclusion of RBCs in the buffer of tandem lung liver preparations perfused with 400 microM (14C)MCT increased the covalent binding to the lung from 97 {plus minus} 25 (buffer alone) to 182 {plus minus} 36 (buffer + RBC) pmol/mg protein.

  19. Red blood cells augment transport of reactive metabolites of monocrotaline from liver to lung in isolated and tandem liver and lung preparations

    International Nuclear Information System (INIS)

    Pan, L.C.; Lame, M.W.; Morin, D.; Wilson, D.W.; Segall, H.J.

    1991-01-01

    Monocrotaline (MCT) is a pyrrolizidine alkaloid that causes pulmonary hypertension in rats by mechanisms which remain largely unknown. MCT is thought to be activated in the liver to a reactive intermediate that is transported to the lung where it causes endothelial injury. The authors previous pharmacokinetic work demonstrated significant sequestration of radioactivity in red blood cells (RBCs) of rats treated with [14C]MCT. To determine whether this RBC sequestration might be important in the transport of reactive MCT metabolites, they compared the effect of inclusion of RBCs in the perfusion buffer on the extent of covalent binding of [14C]MCT to rat lungs in tandem liver-lung preparations. The potential effect of RBCs in stabilizing reactive intermediates was evaluated by preperfusion of isolated liver preparations with [14C]MCT with and without RBCs, separation and washing of the RBC fraction, and subsequent (90 min later) perfusion of washed RBCs or buffer alone in isolated perfused lungs. Covalent binding to lung tissues was determined by exhaustive methanol/chloroform extractions of unbound label from homogenized lung tissue followed by scintillation counting of residual 14C. Covalent binding was expressed as picomole MCT molecular weight equivalents/mg protein. Comparison of the relative capability of these isolated organ preparations for conversion of MCT to polar metabolites was done by extraction and HPLC analysis of perfusate at the end of the experiment. Isolated livers converted 65-85% of MCT to polar metabolites compared with less than 5% conversion in the isolated lungs. Inclusion of RBCs in the buffer of tandem lung liver preparations perfused with 400 microM [14C]MCT increased the covalent binding to the lung from 97 ± 25 (buffer alone) to 182 ± 36 (buffer + RBC) pmol/mg protein

  20. Value of liver elastography and abdominal ultrasound for detection of complications of allogeneic hemopoietic SCT.

    Science.gov (United States)

    Karlas, T; Weber, J; Nehring, C; Kronenberger, R; Tenckhoff, H; Mössner, J; Niederwieser, D; Tröltzsch, M; Lange, T; Keim, V

    2014-06-01

    Hepatic complications contribute to morbidity and mortality after allogeneic hemopoietic SCT. Liver Doppler ultrasound and elastography represent promising methods for pretransplant risk assessment and early detection of complications. Ultrasound (liver and spleen size, liver perfusion) and elastography (transient elastography (TE); right liver lobe acoustic radiation force impulse imaging (r-ARFI); left liver lobe ARFI (l-ARFI)) were prospectively evaluated in patients with indications for allo-SCT. Measurements were performed before and repeatedly after SCT. Results were compared with the incidence of life-threatening complications and death during the first 150 days after SCT. Of 59 included patients, 16 suffered from major complications and 9 of them died within the follow-up period. At baseline, liver and spleen size, liver perfusion, TE and r-ARFI did not differ significantly between patients with and without severe complications. In contrast, l-ARFI was significantly elevated in patients who later developed severe complications (1.58±0.30 m/s vs 1.37±0.27 m/s, P=0.030). After SCT, l-ARFI values remained elevated and TE showed increasing liver stiffness in patients with complications. The value of conventional liver ultrasound for prediction of severe SCT complications is limited. Increased values for TE and l-ARFI are associated with severe SCT complications and demand further evaluation.

  1. Study of lung perfusion in colagenosis

    International Nuclear Information System (INIS)

    Macedo de Carvalho, A.C.; Calegaro, J.U.M.

    1982-01-01

    The lung involvement in the various types of colagenosis has been widely described in the literature. However, the study of lung perfusion utilizing radionuclides has been only mentioned in a few papers. With the intention of ascertaining the importance of the lung perfusion scanning in colagenosis, ten cases were studied, seven of which were females and three males, with the following pathologies: 4 rheumatoid arthritis, 4 systemic lupus eritematosous, 1 scleroderma and 1 scleroderma plus dermatomyositis. The ages of the patients varied from 20 to 73 years, and the duration of the disease from 1 month to 39 years. The lung scanning showed perfusion defects in 100% of the cases, not related with the type of colagenosis, duration of the disease, sex or age. On the other hand, the X rays study showed alterations in only 2 patients (20% of the cases). The ventilatory and respiratory functions were tested on 7 patients showing alteration (mixed pattern with predominance of the restrictive factor) in only one (14.3%), while the other patients were normal (85.7%). The importance of the lung perfusion scanning study in all patients with collagen vascular diseases is emphasized. (author) [es

  2. Hypothermic machine perfusion in kidney transplantation

    NARCIS (Netherlands)

    De Deken, Julie; Kocabayoglu, Peri; Moers, Cyril

    Purpose of reviewThis article summarizes novel developments in hypothermic machine perfusion (HMP) as an organ preservation modality for kidneys recovered from deceased donors.Recent findingsHMP has undergone a renaissance in recent years. This renewed interest has arisen parallel to a shift in

  3. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    in all projections as well as in rotating volume images based upon maximum intensity projections. Probabilistic interpretation of V/Q SPECT should be replaced by a holistic interpretation strategy on the basis of all relevant information about the patient and all ventilation/perfusion patterns. PE...

  4. Nonrigid registration of myocardial perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur

    2005-01-01

    This paper describes a fully automatic registration of 10 multi-slice myocardial perfusion magnetic resonance image sequences. The registration of these sequences is crucial for the clinical interpretation, which currently is subjected to manual labour. The approach used in this study is a nonrig...

  5. Quality assessment of a placental perfusion protocol

    DEFF Research Database (Denmark)

    Mathiesen, Line; Mose, Tina; Mørck, Thit Juul

    2010-01-01

    Validation of in vitro test systems using the modular approach with steps addressing reliability and relevance is an important aim when developing in vitro tests in e.g. reproductive toxicology. The ex vivo human placental perfusion system may be used for such validation, here presenting...

  6. Computed Tomography (CT) Perfusion in Abdominal Cancer

    DEFF Research Database (Denmark)

    Hansen, Martin Lundsgaard; Norling, Rikke; Lauridsen, Carsten

    2013-01-01

    for assessment of vascularity. CT perfusion has also been used for tumor characterization, staging of disease, response evaluation of newer drugs targeted towards angiogenesis and as a method for early detection of recurrence after radiation and embolization. There are several software solutions available...

  7. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...

  8. Study of lung perfusion in colagenosis

    Energy Technology Data Exchange (ETDEWEB)

    Macedo de Carvalho, A.C.; Calegaro, J.U.M. (Fundacao Hospitalar do Distrito Federal, Distrito Federal (Brazil). Unidade de Medicina Nuclear)

    1982-07-01

    The lung involvement in the various types of colagenosis has been widely described in the literature. However, the study of lung perfusion utilizing radionuclides has been only mentioned in a few papers. With the intention of ascertaining the importance of the lung perfusion scanning in colagenosis, ten cases were studied, seven of which were females and three males, with the following pathologies: 4 rheumatoid arthritis, 4 systemic lupus eritematosous, 1 scleroderma and 1 scleroderma plus dermatomyositis. The ages of the patients varied from 20 to 73 years, and the duration of the disease from 1 month to 39 years. The lung scanning showed perfusion defects in 100% of the cases, not related with the type of colagenosis, duration of the disease, sex or age. On the other hand, the X rays study showed alterations in only 2 patients (20% of the cases). The ventilatory and respiratory functions were tested on 7 patients showing alteration (mixed pattern with predominance of the restrictive factor) in only one (14.3%), while the other patients were normal (85.7%). The importance of the lung perfusion scanning study in all patients with collagen vascular diseases is emphasized.

  9. Nuclear cardiology: Myocardial perfusion and function

    International Nuclear Information System (INIS)

    Seldin, D.W.

    1991-01-01

    Myocardial perfusion studies continue to be a major focus of research, with new investigations of the relationship of exercise-redistribution thallium imaging to diagnosis, prognosis, and case management. The redistribution phenomenon, which seemed to be fairly well understood a few years ago, is now recognized to be much more complex than originally thought, and various strategies have been proposed to clarify the meaning of persistent defects. Pharmacologic intervention with dipyridamole and adenosine has become available as an alternative to exercise, and comparisons with exercise imaging and catheterization results have been described. Thallium itself is no longer the sole single-photon perfusion radiopharmaceutical; two new technetium agents are now widely available. In addition to perfusion studies, advances in the study of ventricular function have been made, including reports of studies performed in conjunction with technetium perfusion studies, new insights into cardiac physiology, and the prognostic and case-management information that function studies provide. Finally, work has continued with monoclonal antibodies for the identification of areas of myocyte necrosis. 41 references

  10. Volume perfusion CT imaging of cerebral vasospasm: diagnostic performance of different perfusion maps

    Energy Technology Data Exchange (ETDEWEB)

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Afat, Saif; Nikoubashman, Omid; Mueller, Marguerite; Wiesmann, Martin; Brockmann, Carolin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Schubert, Gerrit Alexander [RWTH Aachen University, Department of Neurosurgery, Aachen (Germany); Bier, Georg [Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Brockmann, Marc A. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); University Hospital Mainz, Department of Neuroradiology, Mainz (Germany)

    2016-08-15

    In this study, we aimed to evaluate the diagnostic performance of different volume perfusion CT (VPCT) maps regarding the detection of cerebral vasospasm compared to angiographic findings. Forty-one datasets of 26 patients (57.5 ± 10.8 years, 18 F) with subarachnoid hemorrhage and suspected cerebral vasospasm, who underwent VPCT and angiography within 6 h, were included. Two neuroradiologists independently evaluated the presence and severity of vasospasm on perfusion maps on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting <50 %, 2 - vasospasm affecting >50 % of vascular territory). A third neuroradiologist independently assessed angiography for the presence and severity of vasospasm on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting < 50 %, 2 - vasospasm affecting > 50 % of vessel diameter). Perfusion maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to drain (TTD) were evaluated regarding diagnostic accuracy for cerebral vasospasm with angiography as reference standard. Correlation analysis of vasospasm severity on perfusion maps and angiographic images was performed. Furthermore, inter-reader agreement was assessed regarding findings on perfusion maps. Diagnostic accuracy for TTD and MTT was significantly higher than for all other perfusion maps (TTD, AUC = 0.832; MTT, AUC = 0.791; p < 0.001). TTD revealed higher sensitivity than MTT (p = 0.007). The severity of vasospasm on TTD maps showed significantly higher correlation levels with angiography than all other perfusion maps (p ≤ 0.048). Inter-reader agreement was (almost) perfect for all perfusion maps (kappa ≥ 0.927). The results of this study indicate that TTD maps have the highest sensitivity for the detection of cerebral vasospasm and highest correlation with angiography regarding the severity of vasospasm. (orig.)

  11. Basic consideration of diffusion/perfusion imaging

    International Nuclear Information System (INIS)

    Tamagawa, Yoichi; Kimura, Hirohiko; Matsuda, Tsuyoshi; Kawamura, Yasutaka; Nakatsugawa, Shigekazu; Ishii, Yasushi; Sakuma, Hajime; Tsukamoto, Tetsuji.

    1990-01-01

    In magnetic resonance imaging (MRI), microscopic motion of biological system such as molecular diffusion of water and microcirculation of blood in the capillary network (perfusion) has been proposed to cause signal attenuation as an intravoxel incoherent motion (IVIM). Quantitative imaging of the IVIM phenomenon was attempted to generate from a set of spin-echo (SE) sequences with or without sensitization by motion probing gradient (MPG). The IVIM imaging is characterized by a parameter, apparent diffusion coefficient (ADC), which is an integration of both the diffusion and the perfusion factor on voxel-by-voxel basis. Hard ware was adjusted to avoid image artifact mainly produced by eddy current. Feasibility of the method was tested using bottle phantom filled with water at different temperature and acetone, and the calculated ADC values of these media corresponded well with accepted values of diffusion. The method was then applied to biological system to investigate mutual participation of diffusion/perfusion on the ADC value. The result of tumor model born on nude mouse suggested considerable participation of perfusion factor which immediately disappeared after sacrificing the animal. Meanwhile, lower value of sacrificed tissue without microcirculation was suggested to have some restriction of diffusion factor by biological tissue. To substantiate the restriction effect on the diffusion, a series of observation have made on a fiber phantom, stalk of celory with botanical fibers and human brain with nerve fibers, in applying unidirectional MPG along the course of these banch of fiber system. The directional restriction effect of diffusion along the course of fiber (diffusion anisotrophy) was clearly visualized as directional change of ADC value. The present method for tissue characterization by diffusion/perfusion on microscopic level will provide a new insight for evaluation of functional derangement in human brain and other organs. (author)

  12. Ventilation-perfusion distribution in normal subjects.

    Science.gov (United States)

    Beck, Kenneth C; Johnson, Bruce D; Olson, Thomas P; Wilson, Theodore A

    2012-09-01

    Functional values of LogSD of the ventilation distribution (σ(V)) have been reported previously, but functional values of LogSD of the perfusion distribution (σ(q)) and the coefficient of correlation between ventilation and perfusion (ρ) have not been measured in humans. Here, we report values for σ(V), σ(q), and ρ obtained from wash-in data for three gases, helium and two soluble gases, acetylene and dimethyl ether. Normal subjects inspired gas containing the test gases, and the concentrations of the gases at end-expiration during the first 10 breaths were measured with the subjects at rest and at increasing levels of exercise. The regional distribution of ventilation and perfusion was described by a bivariate log-normal distribution with parameters σ(V), σ(q), and ρ, and these parameters were evaluated by matching the values of expired gas concentrations calculated for this distribution to the measured values. Values of cardiac output and LogSD ventilation/perfusion (Va/Q) were obtained. At rest, σ(q) is high (1.08 ± 0.12). With the onset of ventilation, σ(q) decreases to 0.85 ± 0.09 but remains higher than σ(V) (0.43 ± 0.09) at all exercise levels. Rho increases to 0.87 ± 0.07, and the value of LogSD Va/Q for light and moderate exercise is primarily the result of the difference between the magnitudes of σ(q) and σ(V). With known values for the parameters, the bivariate distribution describes the comprehensive distribution of ventilation and perfusion that underlies the distribution of the Va/Q ratio.

  13. Ventilation and perfusion display in a single image

    International Nuclear Information System (INIS)

    Lima, J.J.P. de; Botelho, M.F.R.; Pereira, A.M.S.; Rafael, J.A.S.; Pinto, A.J.; Marques, M.A.T.; Pereira, M.C.; Baganha, M.F.; Godinho, F.

    1991-01-01

    A new method of ventilation and perfusion display onto a single image is presented. From the data on regions of interest of the lungs, three-dimensional histograms are created, containing as parameters X and Y for the position of the pixels, Z for the perfusion and colour for local ventilation. The perfusion value is supplied by sets of curves having Z proportional to the local perfusion count rate. Ventilation modulates colour. Four perspective views of the histogram are simultaneously displayed to allow visualization of the entire organ. Information about the normal ranges for both ventilation and perfusion is also provided in the histograms. (orig.)

  14. Liver transplant - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100090.htm Liver transplant - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The liver is in the right upper abdomen. The liver ...

  15. Pyogenic liver abscess

    Science.gov (United States)

    Liver abscess; Bacterial liver abscess ... There are many possible causes of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the blood Infection of the bile draining tubes ...

  16. Fatty Liver Disease

    Science.gov (United States)

    What is fatty liver disease? Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up ...

  17. C-Arm Conebeam CT Perfusion Imaging in the Angiographic Suite: A Comparison with Multidetector CT Perfusion Imaging.

    Science.gov (United States)

    Niu, K; Yang, P; Wu, Y; Struffert, T; Doerfler, A; Schafer, S; Royalty, K; Strother, C; Chen, G-H

    2016-07-01

    Perfusion imaging in the angiography suite may provide a way to reduce time from stroke onset to endovascular revascularization of patients with large-vessel occlusion. Our purpose was to compare conebeam CT perfusion with multidetector CT perfusion. Data from 7 subjects with both multidetector CT perfusion and conebeam CT perfusion were retrospectively processed and analyzed. Two algorithms were used to enhance temporal resolution and temporal sampling density and reduce the noise of conebeam CT data before generating perfusion maps. Two readers performed qualitative image-quality evaluation on maps by using a 5-point scale. ROIs indicating CBF/CBV abnormalities were drawn. Quantitative analyses were performed by using the Sørensen-Dice coefficients to quantify the similarity of abnormalities. A noninferiority hypothesis was tested to compare conebeam CT perfusion against multidetector CT perfusion. Average image-quality scores for multidetector CT perfusion and conebeam CT perfusion images were 2.4 and 2.3, respectively. The average confidence score in diagnosis was 1.4 for both multidetector CT and conebeam CT; the average confidence scores for the presence of a CBV/CBF mismatch were 1.7 (κ = 0.50) and 1.5 (κ = 0.64). For multidetector CT perfusion and conebeam CT perfusion maps, the average scores of confidence in making treatment decisions were 1.4 (κ = 0.79) and 1.3 (κ = 0.90). The area under the visual grading characteristic for the above 4 qualitative quality scores showed an average area under visual grading characteristic of 0.50, with 95% confidence level cover centered at the mean for both readers. The Sørensen-Dice coefficient for CBF maps was 0.81, and for CBV maps, 0.55. After postprocessing methods were applied to enhance image quality for conebeam CT perfusion maps, the conebeam CT perfusion maps were not inferior to those generated from multidetector CT perfusion. © 2016 by American Journal of Neuroradiology.

  18. FAIR true-FISP perfusion imaging of the thyroid gland.

    Science.gov (United States)

    Schraml, Christina; Boss, Andreas; Martirosian, Petros; Schwenzer, Nina F; Claussen, Claus D; Schick, Fritz

    2007-07-01

    To evaluate the feasibility of quantitative perfusion MRI of the thyroid gland using an arterial spin labeling (ASL) method. An ASL technique with flow-sensitive alternating inversion-recovery (FAIR) spin preparation and a true fast imaging in the steady state (TrueFISP) signal readout strategy was implemented on a 1.5T whole-body unit. Anatomical and perfusion imaging of the thyroid gland was performed in eight healthy volunteers and one patient with functioning adenoma. Quantitative perfusion maps were calculated using the extended Bloch equations. In all subjects the perfusion images showed diagnostic image quality. The mean examination time was 24 minutes for multiplanar perfusion imaging of the entire thyroid gland. Individual perfusion values ranged between 341 +/- 91 and 640 +/- 90 mL/100 g/minute, with a mean perfusion of 461 +/- 90 mL/100 g/minute. The functioning adenoma showed markedly reduced perfusion compared to normal thyroidal parenchyma. No perfusion was noticeable inside four detected thyroid cysts. Quantitative ASL perfusion imaging of the thyroid gland using a FAIR-TrueFISP sequence leads to perfusion maps that may provide important information for assessing thyroid gland pathologies and monitoring therapeutic treatment. Copyright 2007 Wiley-Liss, Inc.

  19. Prediction of liver cirrhosis, using diagnostic imaging tools.

    Science.gov (United States)

    Yeom, Suk Keu; Lee, Chang Hee; Cha, Sang Hoon; Park, Cheol Min

    2015-08-18

    Early diagnosis of liver cirrhosis is important. Ultrasound-guided liver biopsy is the gold standard for diagnosis of liver cirrhosis. However, its invasiveness and sampling bias limit the applicability of the method. Basic imaging for the diagnosis of liver cirrhosis has developed over the last few decades, enabling early detection of morphological changes of the liver by ultrasonography (US), computed tomography, and magnetic resonance imaging (MRI). They are also accurate diagnostic methods for advanced liver cirrhosis, for which early diagnosis is difficult. There are a number of ways to compensate for this difficulty, including texture analysis to more closely identify the homogeneity of hepatic parenchyma, elastography to measure the stiffness and elasticity of the liver, and perfusion studies to determine the blood flow volume, transit time, and velocity. Amongst these methods, elastography using US and MRI was found to be slightly easier, faster, and able to provide an accurate diagnosis. Early diagnosis of liver cirrhosis using MRI or US elastography is therefore a realistic alternative, but further research is still needed.

  20. A pump-free microfluidic 3D perfusion platform for the efficient differentiation of human hepatocyte-like cells.

    Science.gov (United States)

    Ong, Louis Jun Ye; Chong, Lor Huai; Jin, Lin; Singh, Pawan Kumar; Lee, Poh Seng; Yu, Hanry; Ananthanarayanan, Abhishek; Leo, Hwa Liang; Toh, Yi-Chin

    2017-10-01

    The practical application of microfluidic liver models for in vitro drug testing is partly hampered by their reliance on human primary hepatocytes, which are limited in number and have batch-to-batch variation. Human stem cell-derived hepatocytes offer an attractive alternative cell source, although their 3D differentiation and maturation in a microfluidic platform have not yet been demonstrated. We develop a pump-free microfluidic 3D perfusion platform to achieve long-term and efficient differentiation of human liver progenitor cells into hepatocyte-like cells (HLCs). The device contains a micropillar array to immobilize cells three-dimensionally in a central cell culture compartment flanked by two side perfusion channels. Constant pump-free medium perfusion is accomplished by controlling the differential heights of horizontally orientated inlet and outlet media reservoirs. Computational fluid dynamic simulation is used to estimate the hydrostatic pressure heads required to achieve different perfusion flow rates, which are experimentally validated by micro-particle image velocimetry, as well as viability and functional assessments in a primary rat hepatocyte model. We perform on-chip differentiation of HepaRG, a human bipotent progenitor cell, and discover that 3D microperfusion greatly enhances the hepatocyte differentiation efficiency over static 2D and 3D cultures. However, HepaRG progenitor cells are highly sensitive to the time-point at which microperfusion is applied. Isolated HepaRG cells that are primed as static 3D spheroids before being subjected to microperfusion yield a significantly higher proportion of HLCs (92%) than direct microperfusion of isolated HepaRG cells (62%). This platform potentially offers a simple and efficient means to develop highly functional microfluidic liver models incorporating human stem cell-derived HLCs. Biotechnol. Bioeng. 2017;114: 2360-2370. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    International Nuclear Information System (INIS)

    Dowdle, S.C.; Human, D.G.; Mann, M.D.

    1990-01-01

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis

  2. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    Energy Technology Data Exchange (ETDEWEB)

    Dowdle, S.C.; Human, D.G.; Mann, M.D. (Univ. of Cape Town (South Africa))

    1990-08-01

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis.

  3. Amebic liver abscess

    Science.gov (United States)

    Hepatic amebiasis; Extraintestinal amebiasis; Abscess - amebic liver ... Amebic liver abscess is caused by Entamoeba histolytica. This parasite causes amebiasis , an intestinal infection that is also called ...

  4. Enhancement of liver regeneration and liver surgery

    NARCIS (Netherlands)

    Olthof, P.B.

    2017-01-01

    Liver regeneration allows surgical resection of up to 75% of the liver and enables curative treatment potential for patients with primary or secondary hepatic malignancies. Liver surgery is associated with substantial risks, reflected by considerable morbidity and mortality rates. Optimization of

  5. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  6. New imaging techniques for liver diseases.

    Science.gov (United States)

    Van Beers, Bernard E; Daire, Jean-Luc; Garteiser, Philippe

    2015-03-01

    Newly developed or advanced methods of ultrasonography and MR imaging provide combined anatomical and quantitative functional information about diffuse and focal liver diseases. Ultrasound elastography has a central role for staging liver fibrosis and an increasing role in grading portal hypertension; dynamic contrast-enhanced ultrasonography may improve tumor characterization. In clinical practice, MR imaging examinations currently include diffusion-weighted and dynamic MR imaging, enhanced with extracellular or hepatobiliary contrast agents. Moreover, quantitative parameters obtained with diffusion-weighted MR imaging, dynamic contrast-enhanced MR imaging and MR elastography have the potential to characterize further diffuse and focal liver diseases, by adding information about tissue cellularity, perfusion, hepatocyte transport function and visco-elasticity. The multiparametric capability of ultrasonography and more markedly of MR imaging gives the opportunity for high diagnostic performance by combining imaging biomarkers. However, image acquisition and post-processing methods should be further standardized and validated in multicenter trials. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  7. Rat Liver Enzyme Release Depends on Blood Flow-Bearing Physical Forces Acting in Endothelium Glycocalyx rather than on Liver Damage

    Directory of Open Access Journals (Sweden)

    Julieta A. Díaz-Juárez

    2017-01-01

    Full Text Available We have found selective elevation of serum enzyme activities in rats subjected to partial hepatectomy (PH, apparently controlled by hemodynamic flow-bearing physical forces. Here, we assess the involvement of stretch-sensitive calcium channels and calcium mobilization in isolated livers, after chemical modifications of the endothelial glycocalyx and changing perfusion directionality. Inhibiting in vivo protein synthesis, we found that liver enzyme release is influenced by de novo synthesis of endothelial glycocalyx components, and released enzymes are confined into a liver “pool.” Moreover, liver enzyme release depended on extracellular calcium entry possibly mediated by stretch-sensitive calcium channels, and this endothelial-mediated mechanotransduction in liver enzyme release was also evidenced by modifying the glycocalyx carbohydrate components, directionality of perfusing flow rate, and the participation of nitric oxide (NO and malondialdehyde (MDA, leading to modifications in the intracellular distribution of these enzymes mainly as nuclear enrichment of “mitochondrial” enzymes. In conclusion, the flow-induced shear stress may provide fine-tuned control of released hepatic enzymes through mediation by the endothelium glycocalyx, which provides evidence of a biological role of the enzyme release rather to be merely a biomarker for evaluating hepatotoxicity and liver damage, actually positively influencing progression of liver regeneration in mammals.

  8. Effects of L-arginine pretreatment on nitric oxide metabolism and hepatosplanchnic perfusion during porcine endotoxemia.

    Science.gov (United States)

    Poeze, Martijn; Bruins, Maaike J; Kessels, Fons; Luiking, Yvette C; Lamers, Wouter H; Deutz, Nicolaas E P

    2011-06-01

    Sepsis is accompanied by an increased need for and a decreased supply of arginine, reflecting a condition of arginine deficiency. The objective was to evaluate the effects of l-arginine pretreatment on arginine-nitric oxide (NO) production and hepatosplanchnic perfusion during subsequent endotoxemia. In a randomized controlled trial, pigs (20-25 kg) received 3 μg . kg(-1) . min(-1) lipopolysaccharide (LPS; 5 endotoxin units/ng) intravenously and saline resuscitation. l-Arginine (n = 8; 5.3 μmol . kg(-1) . min(-1)) or saline (n = 8) was infused starting 12 h before LPS infusion and continued for 24 h after the endotoxin infusion ended. Whole-body appearance rates, portal-drained viscera (PDV), and liver fluxes of arginine, citrulline, NO, and arginine de novo synthesis were measured by using stable-isotope infusion of [(15)N(2)]arginine and [(13)C-(2)H(2)]citrulline. Hepatosplanchnic perfusion was assessed by using a primed continuous infusion of para-aminohippuric acid and jejunal intramucosal partial pressure of carbon dioxide and was related to systemic hemodynamics. Arginine supplementation before LPS increased whole-body NO production in the PDV but not in the liver. Furthermore, it increased blood flow in the portal vein but not in the aorta and hepatic artery. During endotoxin infusion, arginine pretreatment was associated with an increased whole-body arginine appearance and NO production in the gut. Additional effects included a preserved mean arterial pressure, the prevention of an increase in pulmonary arterial pressure, an attenuated metabolic acidosis, and an attenuated increase in the intramucosal partial pressure of carbon dioxide. Arginine treatment starting before endotoxemia appears to be beneficial because it improves hepatosplanchnic perfusion and oxygenation during prolonged endotoxemia, probably through an enhancement in NO synthesis, without causing deleterious systemic side effects.

  9. Insulin resistance and delayed clearance of peptide hormones in cirrhotic rat liver

    International Nuclear Information System (INIS)

    Shankar, T.P.; Drake, S.; Solomon, S.S.

    1987-01-01

    Clearance of porcine insulin, glucagon, and human growth hormone was measured in intact perfused cirrhotic and normal rat livers. Binding and degradation of 125 I-insulin by hepatocytes isolated from cirrhotic and normal livers were also studied. The half-lives (t/sub 1/2/) of immunoreactive insulin and glucagon were 14.0 +/- 3.1 and 9.6 +/- 2.1 min in normal livers and 26.0 +/- 6.1 and 25.0 +/- 7.1 min in cirrhotic livers. Insulin binding and degradation by hepatocytes from control and cirrhotic livers showed no significant differences. Intraportal insulin infusion in perfusion studies suppressed glucagon-stimulated increases in glucose output from control livers but failed to suppress glucose production by cirrhotic livers, suggesting the presence of hepatic insulin resistance in cirrhosis. Impaired clearance of insulin and glucagon by the intact cirrhotic liver and normal binding and degradation of insulin by isolated hepatocytes suggest that factors such as intrahepatic fibrosis and shunting and postbinding defects may be responsible for the impaired hormone clearance and hepatic insulin resistance

  10. In vivo efficiency of four commercial monopolar radiofrequency ablation systems: a comparative experimental study in pig liver.

    Science.gov (United States)

    Brieger, Jens; Pereira, Philippe L; Trübenbach, Jochen; Schenk, Martin; Kröber, Stefan-Martin; Schmidt, Diethard; Aubé, Christophe; Claussen, Claus D; Schick, Fritz

    2003-10-01

    To evaluate the efficiency of 4 radiofrequency (RF) systems by assessing the amount of delivered energy for each thermal induced lesion after perfusion mediated RF ablation and to compare the influence of perfusion mediation types on the energy efficiency. A total of 43 ablations in 16 male landrace pigs with 4 RF devices were performed strictly according to the manufacturers' instructions. Total absorbed energy was computed and then related to 3D volumetry obtained after histopathological evaluation. Sixteen ablations were performed under physiological liver perfusion and 27 ablations with occlusion of portal vein, hepatic artery, or both vessels. Energy efficiency values of the RF systems for different vascular occlusion techniques were compared and analyzed by a nonparametrical rank sum test. Under physiological perfusion, the average energy delivered to produce 1-cm3 lesion size was calculated to 1650 +/- 929, 3097 +/- 389, 8312 +/- 2068, and 5493 +/- 2306 Watt x s/cm3 for the Berchtold, Radionics, Radiotherapeutics, and RITA system, respectively. After perfusion-mediated RF ablation, artery occlusion was not as effective as portal vein occlusion, which reduced the energy to 587 +/- 148, 869 +/- 276, and 903 +/- 394 Watt. s/cm3 for the Berchtold, Radionics, and Radiotherapeutics system, respectively. The occlusion of vessels, portal vein, and artery or portal vein alone increased the energy efficiency compared with physiological liver perfusion or occlusion of the artery (P = 0,003). Under physiological liver perfusion the open perfused system and the internally cooled system provided the best efficiency values with lowest standard deviations. The energy efficiency was increased markedly for all systems after occlusion of the portal vein either alone or in combination with arterial occlusion. Occlusion of the hepatic artery did not improve the efficiency.

  11. VEGFR-2 expression in HCC, dysplastic and regenerative liver nodules, and correlation with pre-biopsy Dynamic Contrast Enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Thaiss, W.M., E-mail: wolfgang.thaiss@med.uni-tuebingen.de [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, D-72076 Tuebingen (Germany); Kaufmann, S., E-mail: sascha.kaufmann@med.uni-tuebingen.de [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, D-72076 Tuebingen (Germany); Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, D-72076 Tuebingen (Germany); Nikolaou, K., E-mail: konstantin.nikolaou@med.uni-tuebingen.de [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, D-72076 Tuebingen (Germany); Bösmüller, H., E-mail: hans.boesmueller@med.uni-tuebingen.de [Eberhard Karls University, Department of Pathology, Liebermeisterstraße 8, D-72076 Tuebingen (Germany); Horger, M., E-mail: Marius.Horger@med.uni-tuebingen.de [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Hoppe-Seyler-Str. 3, D-72076 Tuebingen (Germany)

    2016-11-15

    Highlights: • VEGFR-2-expression levels vary between HCC, dysplastic and regenerative liver nodules. • Perfusion parameters vary between these groups in blood flow, blood volume and HPI. • Strong correlations were observed between perfusion parameters and VEGFR-2-expression. • The results might influence diagnosis and therapy of anti-vascular therapeutic regimes. - Abstract: Purpose: To evaluate whether VEGFR-2-expression in hepatocellular carcinoma (HCC), dysplastic (DLN) and regenerative liver nodules (RLN) correlates with pre-histology, in vivo Dynamic Contrast Enhanced-Computed Tomography (DCE-CT) data as VEGFR-2-expression affects prognosis and therapeutic options. Materials and methods: 34 patients (63.6 ± 8.9 years, 7 females) underwent liver biopsy or surgery due to suspected HCC or dysplastic nodules after DCE-CT between 2009 and 2015 with no previous chemo- or interventional therapy. Immunohistochemistry staining for VEGFR-2 was performed using Immunoreactive-Remmele-Stegner-Score (IRS) for quantification. A 128-row CT-scanner was used for DCE-CT with assessment of perfusion parameters blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI). Results: Histology confirmed HCC (n = 10), DLN (n = 7) and RLN (n = 34). Mean IRS for VEGFR-2 in HCCs was 9.1 ± 3.0, 7.3 ± 1.6 for DLN and 5.2 ± 2.8 for RLN (p = 0.0004 for HCC vs. RLN). Perfusion values varied significantly between all three groups for BF and HPI (p < 0.001 and p < 0.0001) and for BV in HCC vs. RLN (p < 0.0001) and DLN vs. RLN (p = 0.0019). Strong correlations between VEGFR-2-IRS and perfusion parameters were observed for BF in HCC (r = 0.88, p < 0.01) and HPI in HCC and DLN (r = 0.85, p < 0.04; r = 0.9, p < 0.01). Conclusion: Immunostaining revealed different VEGFR-2-expression levels in HCC, dysplastic and regenerative liver nodules. Perfusion markers blood flow, blood volume and hepatic perfusion index

  12. VEGFR-2 expression in HCC, dysplastic and regenerative liver nodules, and correlation with pre-biopsy Dynamic Contrast Enhanced CT

    International Nuclear Information System (INIS)

    Thaiss, W.M.; Kaufmann, S.; Kloth, C.; Nikolaou, K.; Bösmüller, H.; Horger, M.

    2016-01-01

    Highlights: • VEGFR-2-expression levels vary between HCC, dysplastic and regenerative liver nodules. • Perfusion parameters vary between these groups in blood flow, blood volume and HPI. • Strong correlations were observed between perfusion parameters and VEGFR-2-expression. • The results might influence diagnosis and therapy of anti-vascular therapeutic regimes. - Abstract: Purpose: To evaluate whether VEGFR-2-expression in hepatocellular carcinoma (HCC), dysplastic (DLN) and regenerative liver nodules (RLN) correlates with pre-histology, in vivo Dynamic Contrast Enhanced-Computed Tomography (DCE-CT) data as VEGFR-2-expression affects prognosis and therapeutic options. Materials and methods: 34 patients (63.6 ± 8.9 years, 7 females) underwent liver biopsy or surgery due to suspected HCC or dysplastic nodules after DCE-CT between 2009 and 2015 with no previous chemo- or interventional therapy. Immunohistochemistry staining for VEGFR-2 was performed using Immunoreactive-Remmele-Stegner-Score (IRS) for quantification. A 128-row CT-scanner was used for DCE-CT with assessment of perfusion parameters blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI). Results: Histology confirmed HCC (n = 10), DLN (n = 7) and RLN (n = 34). Mean IRS for VEGFR-2 in HCCs was 9.1 ± 3.0, 7.3 ± 1.6 for DLN and 5.2 ± 2.8 for RLN (p = 0.0004 for HCC vs. RLN). Perfusion values varied significantly between all three groups for BF and HPI (p < 0.001 and p < 0.0001) and for BV in HCC vs. RLN (p < 0.0001) and DLN vs. RLN (p = 0.0019). Strong correlations between VEGFR-2-IRS and perfusion parameters were observed for BF in HCC (r = 0.88, p < 0.01) and HPI in HCC and DLN (r = 0.85, p < 0.04; r = 0.9, p < 0.01). Conclusion: Immunostaining revealed different VEGFR-2-expression levels in HCC, dysplastic and regenerative liver nodules. Perfusion markers blood flow, blood volume and hepatic perfusion index

  13. Perfusion lung scintigraphy in primary pulmonary hypertension

    International Nuclear Information System (INIS)

    Ogawa, Y.; Hayashida, K.; Uehara, T.; Shimonagata, T.; Nishimura, T.; Osaka Univ., Suita

    1993-01-01

    15 cases of primary pulmonary hypertension were classified into two groups by patterns of perfusion lung scintigraphy. Perfusion scintigrams showed multiple, small, ill-defined defects (mottled + ve) pattern in eight cases, and the remaining seven cases had a normal (mottled - ve) pattern. The mean pulmonary arterial pressure in patients with a mottled pattern (54 ± 10 mmHg) was higher than in those with a normal pattern (42 ± 9 mmHg, p < 0.05). There were no significant differences between the two groups in right ventricular ejection fraction, partial pressures of oxygen in the arterial blood or alveolo-arterial oxygen difference. All the patients with a mottled pattern died within 2 years following the lung scintigraphy. There was a significant difference in the survival curves between the two groups. (author)

  14. Perfusion lung scintigraphy in primary pulmonary hypertension

    International Nuclear Information System (INIS)

    Ogawa, Yoji; Nishimura, Tsunehiko; Kumita, Shin-ichirou; Hayashida, Kohei; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Ohno, Akira

    1991-01-01

    Fifteen cases with primary pulmonary hypertension (PPH) were classified into two groups by using the perfusion lung scan pattern. Eight cases had multiple, small, ill-defined defects (mottled pattern), and remaining seven cases had no mottled pattern. These two groups were compared with mean pulmonary arterial pressure (mean PAP), right ventricular ejection fraction (RVEF), blood gas at room air (PaO 2 ), and alveolar-arterial O 2 difference (A-aDo 2 ). The cases with mottled pattern showed a significant increase in mean PAP. There were no significant differences in RVEF, PaO 2 , and A-aDo 2 , between the groups. The survival rate of the patients with mottled pattern was significantly lower than that without mottled pattern (p<0.05). We concluded that perfusion lung scan is very useful for evaluation of the prognosis in primary pulmonary hypertension. (author)

  15. Quantitative aspects of myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Vogel, R.A.

    1980-01-01

    Myocardial perfusion measurements have traditionally been performed in a quantitative fashion using application of the Sapirstein, Fick, Kety-Schmidt, or compartmental analysis principles. Although global myocardial blood flow measurements have not proven clinically useful, regional determinations have substantially advanced our understanding of and ability to detect myocardial ischemia. With the introduction of thallium-201, such studies have become widely available, although these have generally undergone qualitative evaluation. Using computer-digitized data, several methods for the quantification of myocardial perfusion images have been introduced. These include orthogonal and polar coordinate systems and anatomically oriented region of interest segmentation. Statistical ranges of normal and time-activity analyses have been applied to these data, resulting in objective and reproducible means of data evaluation

  16. Non-contrast MRI perfusion angiosome in diabetic feet

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Jie [Cardiovascular Imaging Lab, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Hastings, Mary K.; Mueller, Michael J. [Washington University School of Medicine, The Program in Physical Therapy, St. Louis, MO (United States); Muccigross, David; Hildebolt, Charles F. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Fan, Zhaoyang [Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA (United States); Gao, Fabao [West China Hospital, Sichuan University, Department of Radiology, Chengdu (China); Curci, John [Washington University School of Medicine, The Department of Surgery, St. Louis, MO (United States)

    2015-01-15

    The purpose of this study is to develop a non-contrast magnetic resonance imaging (MRI) approach to evaluate skeletal muscle perfusion in the diabetic foot based on the concept of angiosomes of the foot. Five healthy volunteers and five participants with diabetes (HbA1c = 7.2 ± 1.8 %) without a history of peripheral artery disease were examined. The non-contrast perfusion measurements were performed during a toe flexion challenge. Absolute perfusion maps were created and two regions (medial and lateral) on the maps were segmented based on angiosomes. Regional difference in the perfusion of foot muscle was readily visualized in the MRI perfusion angiosomes during the challenge. In the participants with diabetes, the perfusion during toe flexion challenge was significantly lower than in healthy volunteers (P < 0.01). The average perfusion for the medial plantar region of the right foot was lower in subjects with diabetes (38 ± 9 ml/min/100 g) than in healthy subjects (93 ± 33 ml/min/100 g). Non-contrast MRI perfusion angiosome maps demonstrate the feasibility of determining regional perfusion in foot muscles during toe challenge and may facilitate evaluation of muscle perfusion in diabetic feet. (orig.)

  17. VEGFR-2 expression in HCC, dysplastic and regenerative liver nodules, and correlation with pre-biopsy Dynamic Contrast Enhanced CT.

    Science.gov (United States)

    Thaiss, W M; Kaufmann, S; Kloth, C; Nikolaou, K; Bösmüller, H; Horger, M

    2016-11-01

    To evaluate whether VEGFR-2-expression in hepatocellular carcinoma (HCC), dysplastic (DLN) and regenerative liver nodules (RLN) correlates with pre-histology, in vivo Dynamic Contrast Enhanced-Computed Tomography (DCE-CT) data as VEGFR-2-expression affects prognosis and therapeutic options. 34 patients (63.6±8.9years, 7 females) underwent liver biopsy or surgery due to suspected HCC or dysplastic nodules after DCE-CT between 2009 and 2015 with no previous chemo- or interventional therapy. Immunohistochemistry staining for VEGFR-2 was performed using Immunoreactive-Remmele-Stegner-Score (IRS) for quantification. A 128-row CT-scanner was used for DCE-CT with assessment of perfusion parameters blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI). Histology confirmed HCC (n=10), DLN (n=7) and RLN (n=34). Mean IRS for VEGFR-2 in HCCs was 9.1±3.0, 7.3±1.6 for DLN and 5.2±2.8 for RLN (p=0.0004 for HCC vs. RLN). Perfusion values varied significantly between all three groups for BF and HPI (pHCC vs. RLN (pHCC (r=0.88, pHCC and DLN (r=0.85, pHCC, dysplastic and regenerative liver nodules. Perfusion markers blood flow, blood volume and hepatic perfusion index correlated well with VEGFR-2-immunostaining. This non-invasive discrimination between regenerative and dysplastic/HCC nodules might open new perspectives for diagnosis, therapy planning, and anti-VEGFR therapy monitoring. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Dynamic CT perfusion measurement in a cardiac phantom.

    Science.gov (United States)

    Ziemer, Benjamin P; Hubbard, Logan; Lipinski, Jerry; Molloi, Sabee

    2015-10-01

    Widespread clinical implementation of dynamic CT myocardial perfusion has been hampered by its limited accuracy and high radiation dose. The purpose of this study was to evaluate the accuracy and radiation dose reduction of a dynamic CT myocardial perfusion technique based on first pass analysis (FPA). To test the FPA technique, a pulsatile pump was used to generate known perfusion rates in a range of 0.96-2.49 mL/min/g. All the known perfusion rates were determined using an ultrasonic flow probe and the known mass of the perfusion volume. FPA and maximum slope model (MSM) perfusion rates were measured using volume scans acquired from a 320-slice CT scanner, and then compared to the known perfusion rates. The measured perfusion using FPA (P(FPA)), with two volume scans, and the maximum slope model (P(MSM)) were related to known perfusion (P(K)) by P(FPA) = 0.91P(K) + 0.06 (r = 0.98) and P(MSM) = 0.25P(K) - 0.02 (r = 0.96), respectively. The standard error of estimate for the FPA technique, using two volume scans, and the MSM was 0.14 and 0.30 mL/min/g, respectively. The estimated radiation dose required for the FPA technique with two volume scans and the MSM was 2.6 and 11.7-17.5 mSv, respectively. Therefore, the FPA technique can yield accurate perfusion measurements using as few as two volume scans, corresponding to approximately a factor of four reductions in radiation dose as compared with the currently available MSM. In conclusion, the results of the study indicate that the FPA technique can make accurate dynamic CT perfusion measurements over a range of clinically relevant perfusion rates, while substantially reducing radiation dose, as compared to currently available dynamic CT perfusion techniques.

  19. Coronary events in patients undergoing orthotopic liver transplantation: perioperative evaluation and management.

    Science.gov (United States)

    Ali, Asghar; Bhardwaj, Hem L; Heuman, Douglas M; Jovin, Ion S

    2013-01-01

    Patients with advanced liver disease have a high prevalence of cardiac risk factors. The stress of liver transplant surgery predisposes these patients to major cardiac events, such as myocardial infarction or ventricular arrhythmias in addition to heart failure exacerbation. Liver transplant patients who experience coronary events in the perioperative period have a decreased five-yr survival rate. Cardiovascular risk stratification prior to liver transplant can be accomplished by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computed tomography, and coronary angiography. Pre-liver transplant management of cardiovascular pathology includes cardiovascular intervention like percutaneous coronary intervention, coronary bypass graft surgery, or medical management. Thorough screening and optimal management of underlying cardiovascular pathology and cardiovascular risk factors should decrease the incidence of new cardiac events in liver transplant recipients. © 2013 John Wiley & Sons A/S.

  20. [Value of perfusion scintigraphy of the testis].

    Science.gov (United States)

    Kotzerke, J; Erpenbach, K; Hengst, W

    1987-10-01

    Perfusion scintigraphy of the testicles has still its place, in addition to scrotal ultrasound imaging, in the investigation of the "acute scrotum". It reveals scintigraphic patterns typical for twisted testicle and acute or subacute epididymitis. Especially in the Bundeswehr, with its large number of young men, this method enhances the diagnostic spectrum and helps in making surgical decisions. However, in the examination of scrotal masses, ultrasound imaging or surgery is to be preferred.

  1. The evolution of perfusion education in America.

    Science.gov (United States)

    Toomasian, John M; Searles, Bruce; Kurusz, Mark

    2003-07-01

    Clinical cardiopulmonary perfusion has evolved significantly during its 50 years. The science, technology and educational processes related to cardiopulmonary bypass have undergone continual change and metamorphosis. Perfusionists were initially trained on the job or in the laboratory, but with the advent of myocardial revascularization and the explosion in cardiac surgery, the need for formal educational training programs became apparent. The American Society of Extracorporeal Technology began the arduous processes of credentialing and developing certification guidelines that have continued under the American Board of Cardiovascular Perfusion. Licensure has also been adopted in many states during the past 10 years where nearly 50% of all perfusionists are covered by some legislative act. One additonal challenge has been developing minimal standards in which perfusionists practice. The initial standards included the use of a checklist and have evolved to monitoring and recording the significant events and parameters of each clinical procedure. The education of perfusionists will continue to be a challenge related primarily to reduced fiscal resources, the applicant pool and the ever-changing demands for extracorporeal circulation services. According to demographic and census information, it is expected the overall number of cardiovascular interventions will increase dramatically towards the latter end of the current decade in the US. The question arises as to what role perfusionists will play, as treatment strategies continue to change. If the number of education programs and new graduates continue to decline, the total number of perfusionists will decline, especially as many senior perfusionists leave the field or retire. It may be difficult to predict the total number of cardiovascular interventions that will be required in the next several years. However, if the total number of cardiovascular interventions that require perfusion services increase as a function

  2. Myocardial perfusion studies in coronary diseases

    International Nuclear Information System (INIS)

    Mut, Fernando

    1994-01-01

    For detecting in precocious form a coronary disease is necessary to apply a diagnostic techniques. The main considerations to be indicated in the present work are: physiological considerations, myocardial perfusion studies with radiotracers such as Talio 201, 99mTc, MIBI, 99mTc-Teboroxima, 99mTc-Fosfinas, instrumentation for obtain good images,proceedings protocols, studies interpretation, standards, SPECT, anomalies standards, coronary diseases

  3. Regional cerebral perfusion in cardiovascular reflex syncope

    International Nuclear Information System (INIS)

    Toeyry, J.P.; Kuikka, J.T.; Laensimies, E.A.

    1997-01-01

    Little is known about the regional cerebral perfusion in subjects with presyncope or syncope, and the impact that autonomic nervous dysfunction has on it. Seven subjects with cardiovascular vasodepressor reflex syncope were studied. A baseline test was performed with the patients standing in the 70 upright position, while the passive head-up tilt table test with and without isoprenaline infusion was employed for provocation. Regional cerebral perfusion was assessed by means of single-photon emission tomography with technetium-99m labelled V-oxo-1,2-N,N 1 -ethylenedylbis-l-cysteine diethylester (baseline, and during blood pressure decline in the provocation test) and the autonomic nervous function by means of spectral analysis of heart rate variability (baseline, and before blood pressure decline in the provocation test). Every subject showed an abrupt decline in blood pressure in the provocation test (five with presyncope and two with syncope). The systolic and diastolic blood pressures decreased significantly (P<0.001) between the baseline and the provocation study time points (radiopharmaceutical injection and lowest systolic blood pressure). Mean cerebral perfusion as average count densities decreased upon provocation as compared with baseline (190±63 vs 307±90 counts/voxel, respectively, P=0.013). Hypoperfusion was most pronounced in the frontal lobe. These results suggest that cerebral perfusion decreases markedly during presyncope or syncope with systemic blood pressure decline in subjects with cardiovascular vasodepressor syncope. Furthermore, the autonomic nervous function remains unchanged before the systemic blood pressure decline. (orig.). With 3 figs., 2 tabs

  4. Alterações metabólicas induzidas por isquemia hepática normotérmica experimental e o efeito hepatoprotetor da ciclosporina Induced metabolic alterations due to experimental normothermic hepatic ischemia and the hepatoprotector effect of cyclosporin

    Directory of Open Access Journals (Sweden)

    José Huygens Parente Garcia

    2004-03-01

    hepatic ischemia and the probable hepatoprotective effect cyclosporin. METHOD: Normothermic hepatic ischemia during 60 minutes was induced in the rats. The time-course (0, 1, 6, 24 hours of changes in blood and in the hepatic concentrations of lactate, pyruvate, glucose, ketone bodies and in the ratio of acetoacetate/3-hydroxybutyrate, as well as the cytoplasmic and mitochondrial redox state of the liver cells were determined. A group of animals was daily pre-treated with cyclosporine (10 mg/kg during 4 days until the induction of hepatic ischemia, then they studied 1 hour after hepatic revascularization. Hepatic ischemia caused elevation in the concentrations of lactate in the liver, suggesting that a pronounced level of anaerobic metabolism occurred during the ischemia period. Liver ischemia promoted yet a fall in the concentration and in the ratio of ketone bodies (acetoacetate/3-hydroxybutyrate in the arterial blood in the studied period of one hour post-revascularization, perhaps reflecting impairment of ketogenesis as a result of the ischemic injury. CONCLUSION: The treatment with cyclosporine cause elevation in the concentration of ketone bodies and in the ratio of acetoacetate/3-hydroxybutyrate in the arterial blood 1 hour after reperfusion of the liver, suggesting that these drugs may accelerate the recovery of the ischemic hepatic lesion with reactivation of ketogenesis.

  5. Pediatric Liver Transplantation.

    Science.gov (United States)

    Rawal, Nidhi; Yazigi, Nada

    2017-06-01

    Excellent outcomes over the last 3 decades have made liver transplantation the treatment of choice for many advanced liver disorders. This success also opened liver transplantation to new indications such as liver tumors and metabolic disorders. The emergence of such new indications for liver transplantation is bringing a new stream of patients along with disease-specific challenges. The cumulative number of liver transplant recipients is peaking, requiring novel systems of health care delivery that meet the needs of this special patient population. This article reviews updates and new development in pediatric liver transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Liver disease in menopause.

    Science.gov (United States)

    Brady, Carla W

    2015-07-07

    There are numerous physiologic and biochemical changes in menopause that can affect the function of the liver and mediate the development of liver disease. Menopause represents a state of growing estrogen deficiency, and this loss of estrogen in the setting of physiologic aging increases the likelihood of mitochondrial dysfunction, cellular senescence, declining immune responses to injury, and disarray in the balance between antioxidant formation and oxidative stress. The sum effect of these changes can contribute to increased susceptibility to development of significant liver pathology, particularly nonalcoholic fatty liver disease and hepatocellular carcinoma, as well as accelerated progression of fibrosis in liver diseases, as has been particularly demonstrated in hepatitis C virus liver disease. Recognition of the unique nature of these mediating factors should raise suspicion for liver disease in perimenopausal and menopausal women and offer an opportunity for implementation of aggressive treatment measures so as to avoid progression of liver disease to cirrhosis, liver cancer and liver failure.

  7. Towards robust deconvolution of low-dose perfusion CT: Sparse perfusion deconvolution using online dictionary learning

    Science.gov (United States)

    Fang, Ruogu; Chen, Tsuhan; Sanelli, Pina C.

    2014-01-01

    Computed tomography perfusion (CTP) is an important functional imaging modality in the evaluation of cerebrovascular diseases, particularly in acute stroke and vasospasm. However, the post-processed parametric maps of blood flow tend to be noisy, especially in low-dose CTP, due to the noisy contrast enhancement profile and the oscillatory nature of the results generated by the current computational methods. In this paper, we propose a robust sparse perfusion deconvolution method (SPD) to estimate cerebral blood flow in CTP performed at low radiation dose. We first build a dictionary from high-dose perfusion maps using online dictionary learning and then perform deconvolution-based hemodynamic parameters estimation on the low-dose CTP data. Our method is validated on clinical data of patients with normal and pathological CBF maps. The results show that we achieve superior performance than existing methods, and potentially improve the differentiation between normal and ischemic tissue in the brain. PMID:23542422

  8. Transport of benzo[alpha]pyrene in the dually perfused human placenta perfusion model: effect of albumin in the perfusion medium

    DEFF Research Database (Denmark)

    Mathiesen, Line; Rytting, Erik; Mose, Tina

    2009-01-01

    Transport of benzo[alpha]pyrene (BaP) across the placenta was examined because it is a ubiquitous and highly carcinogenic substance found in tobacco smoke, polluted air and certain foods. Foetal exposure to this substance is highly relevant but is difficult to estimate. The human placenta is unique...... compared to other species; since it is available without major ethical obstacles, we have used the human placenta perfusion model to study transport from mother to foetus. Placentas were donated after births at Rigshospitalet in Copenhagen from pregnant mothers who signed an informed consent. Ba......P is lipophilic and studies using cell culture medium in 6-hr placenta perfusions showed minimal transport through the placenta. To increase the solubility of BaP in perfusion medium and to increase physiological relevance, perfusions were also performed with albumin added to the perfusion medium [2 and 30 mg...

  9. Hepatic failure in a rapidly involuting congenital hemangioma of the liver: failure of embolotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zenzen, Wendy; Alomari, Ahmad I. [Children' s Hospital Boston, Division of Vascular and Interventional Radiology, Department of Radiology, Boston, MA (United States); Perez-Atayde, Antonio R. [Children' s Hospital Boston and Harvard Medical School, Department of Pathology, Boston, MA (United States); Elisofon, Scott A. [Children' s Hospital Boston and Harvard Medical School, Division of Gastroenterology, Boston, MA (United States); Bae Kim, Heung [Children' s Hospital Boston and Harvard Medical School, Department of Surgery, Boston, MA (United States)

    2009-10-15

    We report the clinical course, imaging findings, and management of a rare case of rapidly involuting congenital hemangioma of the liver in a newborn girl. The baby presented with severe progressive hepatic dysfunction and cardiomegaly. Multimodality imaging demonstrated a large hypervascular solitary hepatic mass with marked transhepatic shunting, consistent with rapidly involuting congenital hemangioma. Because medical therapy failed, transarterial and transvenous embolization was performed with the main intention to improve the hepatic perfusion and function. Unfortunately, despite improvement in the cardiac overload, liver function continued to deteriorate. The baby eventually underwent successful liver transplantation. (orig.)

  10. Myocardial perfusion in type 2 diabetes with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Hesse, Birger; Meyer, Christian; Nielsen, Flemming S

    2004-01-01

    The purpose of this study was to assess whether acute angiotensin-converting enzyme (ACE) inhibition would improve myocardial perfusion and perfusion reserve in a subpopulation of normotensive patients with diabetes and left ventricular hypertrophy (LVH), both independent risk factors of coronary...... disease. Using positron emission tomography (PET), we investigated the response of regional myocardial perfusion to acute ACE inhibition with i.v. infusion of perindoprilat (vs saline infusion as control, minimum interval 3 days) in 12 diabetic patients with LVH. Myocardial perfusion was quantified...... with controls, maximal perfusion was reduced in patients (1.8+/-0.6 vs 2.5+/-1.0 ml min(-1) g(-1); P2.7+/-1.0 vs 3.6+/-1.3; P=0.059). During perindoprilat infusion, myocardial perfusion reserve in patients increased to 3.9+/-0.9 ( P

  11. Magnetic Resonance Imaging of Ventilation and Perfusion in the Lung

    Science.gov (United States)

    Prisk, Gordon Kim (Inventor); Hopkins, Susan Roberta (Inventor); Buxton, Richard Bruce (Inventor); Pereira De Sa, Rui Carlos (Inventor); Theilmann, Rebecca Jean (Inventor); Cronin, Matthew Vincent (Inventor)

    2017-01-01

    Methods, devices, and systems are disclosed for implementing a fully quantitative non-injectable contrast proton MRI technique to measure spatial ventilation-perfusion (VA/Q) matching and spatial distribution of ventilation and perfusion. In one aspect, a method using MRI to characterize ventilation and perfusion in a lung includes acquiring an MR image of the lung having MR data in a voxel and obtaining a breathing frequency parameter, determining a water density value, a specific ventilation value, and a perfusion value in at least one voxel of the MR image based on the MR data and using the water density value to determine an air content value, and determining a ventilation-perfusion ratio value that is the product of the specific ventilation value, the air content value, the inverse of the perfusion value, and the breathing frequency.

  12. Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

    International Nuclear Information System (INIS)

    Ward, H.E.; Jones, R.L.; King, E.G.; Sproule, B.J.; Fortune, R.L.

    1982-01-01

    An intraluminal carcinoid tumor obstructing the left mainstem bronchus produced hypoxemia through alteration in ventilation/perfusion matching. Studies of regional lung function using 133-xenon (/sup 133/Xe) and a multiprobe computerized instrumentation system documented a reduction of perfusion to 22 percent and ventilation to 6 percent of the total. There was negligible washout of intravenously injected /sup 133/Xe from the left lung consistent with air trapping. Four days after left mainstem bronchial sleeve resection, perfusion, ventilation and washout of injected xenon had significantly improved and by four months postresection, all measurements were virtually normal, although complete restoration of perfusion in relation to ventilation was delayed. Regional lung function studied with a multiprobe system in this patient provided a clinical model for the study of ventilation and perfusion inter-relationships in large airway obstruction and demonstrated that a prolonged time may be required for return of perfusion to normal

  13. Brain perfusion: computed tomography and magnetic resonance techniques.

    Science.gov (United States)

    Copen, William A; Lev, Michael H; Rapalino, Otto

    2016-01-01

    Cerebral perfusion imaging provides assessment of regional microvascular hemodynamics in the living brain, enabling in vivo measurement of a variety of different hemodynamic parameters. Perfusion imaging techniques that are used in the clinical setting usually rely upon X-ray computed tomography (CT) or magnetic resonance imaging (MRI). This chapter reviews CT- and MRI-based perfusion imaging techniques, with attention to image acquisition, clinically relevant aspects of image postprocessing, and fundamental differences between CT- and MRI-based techniques. Correlations with cerebrovascular physiology and potential clinical applications of perfusion imaging are reviewed, focusing upon the two major classes of neurologic disease in which perfusion imaging is most often performed: primary perfusion disorders (including ischemic stroke, transient ischemic attack, and reperfusion syndrome), and brain tumors. © 2016 Elsevier B.V. All rights reserved.

  14. Quantitative analysis of SPECT imaging parameters in patients with resting perfusion defects on myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Pruthi, Ankur; Asopa, Ramesh; Rajan, M.G.R.; Basu, Sandip

    2010-01-01

    Functional status/contractile behaviour of hibernating myocardium was analyzed objectively by analyzing the available quantitative parameters obtained on gated SPECT myocardial perfusion imaging (MPI) using Emory cardiac toolbox (ECTB) software. Materials and Methods: In this retrospective study, 70 patients with perfusion defects on 99 Tc-Sestamibi MPI (12 females, 58 males) who also underwent 18 F-FDG Cardiac PET study for assessment of hibernating myocardium were included for analysis. Patients were divided in three categories based on summed rest score (SRS) obtained from ECTB software, depicting the extent of perfusion defects. In a study population matched for extent of perfusion defects, quantitative parameters obtained from ECTB software such as left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (EDV), left ventricular end systolic volume (ESV) and left ventricular stroke volume (SV) were compared between patients showing evidence of hibernating myocardium and patients showing no evidence of hibernating myocardium. Student 't' test was applied on the given observations and a P-value <0.05 was considered as a significant difference between the means in two categories. Results: There was no significant difference in LVEF, EDV, ESV and SV measurements between those who demonstrate hibernating myocardium and those who show no evidence of hibernating myocardium across all the categories of patients. Few trends were evident in the present study in LVEF, EDV and ESV measurements i.e., fall in mean LVEF with increasing SRS and rise in mean EDV and ESV with increasing SRS. Conclusions: The findings were consistent with the nature of hibernating myocardium i.e., non-contractile and dysfunctional. The fall in the LVEF was suggestive of deteriorating myocardial function with increasing extent of perfusion defects. The increasing left ventricular EDV and ESV with increasing extent of perfusion defects was suggestive of rising incidence of

  15. Immune mediated liver failure

    OpenAIRE

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capac...

  16. Iodine concentration as a perfusion surrogate marker in oncology: Further elucidation of the underlying mechanisms using Volume Perfusion CT with 80 kVp.

    Science.gov (United States)

    Thaiss, Wolfgang M; Haberland, Ulrike; Kaufmann, Sascha; Spira, Daniel; Thomas, Christoph; Nikolaou, Konstantin; Horger, Marius; Sauter, Alexander W

    2016-09-01

    To assess the value of iodine concentration (IC) in computed tomography data acquired with 80 kVp, as a surrogate for perfusion imaging in hepatocellular carcinoma (HCC) and lymphoma by comparing iodine related attenuation (IRA) with quantitative Volume Perfusion CT (VPCT)-parameters. VPCT-parameters were compared with intra-tumoral IC at 5 time points after the aortic peak enhancement (APE) with a temporal resolution of 3.5 sec in untreated 30 HCC and 30 lymphoma patients. Intra-tumoral perfusion parameters for HCC showed a blood flow (BF) of 52.7 ± 17.0 mL/100 mL/min, blood volume (BV) 12.6 ± 4.3 mL/100 mL, arterial liver perfusion (ALP) 44.4 ± 12.8 mL/100 mL/min. Lesion IC 7 sec after APE was 133.4 ± 57.3 mg/100 mL. Lymphoma showed a BF of 36.8 ± 13.4 mL/100 mL/min, BV of 8.8 ± 2.8 mL/100 mL and IC of 118.2 ± 64.5 mg/100 mL 3.5 sec after APE. Strongest correlations exist for VPCT-derived BF and ALP with IC in HCC 7 sec after APE (r = 0.71 and r = 0.84) and 3.5 sec after APE in lymphoma lesions (r = 0.77). Significant correlations are also present for BV (r = 0.60 and r = 0.65 for HCC and lymphoma, respectively). We identified a good, time-dependent agreement between VPCT-derived flow values and IC in HCC and lymphoma. Thus, CT-derived ICs 7 sec after APE in HCC and 3.5 sec in lymphoma may be used as surrogate imaging biomarkers for tumor perfusion with 80 kVp. • Iodine concentration derived from low kVp CT is regarded as perfusion surrogate • Correlation with Perfusion CT was performed to elucidate timing and histology dependencies • Highest correlation was present 7 sec after aortic peak enhancement in hepatocellular carcinoma • In lymphoma, highest correlation was calculated 3.5 sec after aortic peak enhancement • With these results, further optimization of Dual energy CT protocols is possible.

  17. Whole-brain dynamic CT angiography and perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Orrison, W.W. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Department of Medical Education, University of Nevada School of Medicine, Reno, NV (United States); Snyder, K.V.; Hopkins, L.N. [Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Buffalo, NY (United States); Roach, C.J. [School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Ringdahl, E.N. [Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV (United States); Nazir, R. [Shifa International Hospital, Islamabad (Pakistan); Hanson, E.H., E-mail: eric.hanson@amigenics.co [College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States)

    2011-06-15

    The availability of whole brain computed tomography (CT) perfusion has expanded the opportunities for analysing the haemodynamic parameters associated with varied neurological conditions. Examples demonstrating the clinical utility of whole-brain CT perfusion imaging in selected acute and chronic ischaemic arterial neurovascular conditions are presented. Whole-brain CT perfusion enables the detection and focused haemodynamic analyses of acute and chronic arterial conditions in the central nervous system without the limitation of partial anatomical coverage of the brain.

  18. Three-dimensional fabrication of thick and densely populated soft constructs with complex and actively perfused channel network

    DEFF Research Database (Denmark)

    Pimentel, C Rodrigo; Ko, Suk Kyu; Caviglia, Claudia

    2017-01-01

    One of the fundamental steps needed to design functional tissues and, ultimately organs is the ability to fabricate thick and densely populated tissue constructs with controlled vasculature and microenvironment. To date, bioprinting methods have been employed to manufacture tissue constructs...... with open vasculature in a square-lattice geometry, where the majority lacks the ability to be directly perfused. Moreover, it appears to be difficult to fabricate vascular tissue constructs targeting the stiffness soft tissues such as the liver. Here we present a method for the fabrication of thick (e.g. 1...... cm) and densely populated (e.g. 10 million cells·mL-1) tissue constructs with a three-dimensional (3D) four arm branch network and stiffness in the range of soft tissues (1-10 kPa), which can be directly perfused on a fluidic platform for long time periods (> 14 days). Specifically, we co-print a 3D...

  19. Perfusion lung scanning: differentiation of primary from thromboembolic pulmonary hypertension

    International Nuclear Information System (INIS)

    Lisbona, R.; Kreisman, H.; Novales-Diaz, J.; Derbekyan, V.

    1985-01-01

    Of eight patients with pulmonary arterial hypertension, final diagnosis established by autopsy or angiography, four had primary hypertension and four hypertension from thromboembolism. The perfusion lung scan was distinctly different in the two groups. The lung scan in primary pulmonary hypertension was associated with nonsegmental, patchy defects of perfusion, while in thromboembolic hypertensives it was characterized by segmental and/or lobar defects of perfusion with or without subsegmental defects. The perfusion lung scan is a valuable, noninvasive study in the evaluation of the patient with pulmonary hypertension of undetermined cause and in the exclusion of occult large-vessel pulmonary thromboembolism

  20. Effect of Defocused CO2 Laser on Equine Tissue Perfusion

    Directory of Open Access Journals (Sweden)

    Bergh A

    2006-03-01

    Full Text Available Treatment with defocused CO2 laser can have a therapeutic effect on equine injuries, but the mechanisms involved are unclear. A recent study has shown that laser causes an increase in equine superficial tissue temperature, which may result in an increase in blood perfusion and a stimulating effect on tissue regeneration. However, no studies have described the effects on equine tissue perfusion. The aim of the present study was to investigate the effect of defocused CO2 laser on blood perfusion and to correlate it with temperature in skin and underlying muscle in anaesthetized horses. Differences between clipped and unclipped haircoat were also assessed. Eight horses and two controls received CO2 laser treatment (91 J/cm2 in a randomised order, on a clipped and unclipped area of the hamstring muscles, respectively. The significant increase in clipped skin perfusion and temperature was on average 146.3 ± 33.4 perfusion units (334% and 5.5 ± 1.5°C, respectively. The significant increase in perfusion and temperature in unclipped skin were 80.6 ± 20.4 perfusion units (264% and 4.8 ± 1.4°C. No significant changes were seen in muscle perfusion or temperature. In conclusion, treatment with defocused CO2 laser causes a significant increase in skin perfusion, which is correlated to an increase in skin temperature.

  1. Prior CT May Improve Diagnostic Confidence in Myocardial Perfusion Imaging.

    Science.gov (United States)

    Mehta, Pareen; Wassef, Heidi; Colletti, Patrick M

    2015-10-01

    Many patients with matching myocardial perfusion imaging defects may have prior CT examinations that include the myocardial region of interest, such as a CT chest or CT abdomen. We correlate these perfusion defects with available prior CT examinations to determine if this will improve diagnostic confidence. Myocardial perfusion scans were reviewed to identify cases with myocardial perfusion defects and prior CT imaging that included the myocardium. The CT was reviewed for evidence of myocardial injury that correlated with the perfusion defect. A retrospective review of 732 myocardial perfusion scans was performed, of which 69 cases with perfusion defects were identified that also had prior CT imaging available for review. Of this subset of patients, 19 patients had findings on the CT scan compatible with ischemia or infarction in the expected region of the perfusion defect, which allowed for a more confident diagnosis. Reviewing a prior CT scan, if available, during the interpretation of a myocardial perfusion scan, can help improve diagnostic confidence in over 25% of cases. This can lead to decreased indeterminate results and can be used to potentially avoid unhelpful further testing.

  2. Perfusion index as a possible predictor for postanesthetic shivering.

    Science.gov (United States)

    Kuroki, Chiharu; Godai, Kohei; Hasegawa-Moriyama, Maiko; Kuniyoshi, Tamotsu; Matsunaga, Akira; Kanmura, Yuichi; Kuwaki, Tomoyuki

    2014-02-01

    Postanesthetic shivering can be triggered by surgical stress and several aspects of anesthetic management and is frequently preceded by a decrease in peripheral blood flow due to thermoregulatory vasoconstriction. As perfusion index correlates with peripheral blood flow, we examined whether perioperative perfusion index, measured using pulse oximetry, might be correlated with postanesthetic shivering. Twenty-eight patients presenting for elective abdominal surgery were enrolled. Core (esophagus) and peripheral (finger) temperatures and perfusion index were recorded in the perioperative periods. Correlations between perfusion index and peripheral temperature and core-to-peripheral temperature gradient were then explored. Plasma levels of epinephrine and norepinephrine were also measured. The extent of shivering was graded after emergence from anesthesia. Perfusion index declined before emergence from anesthesia in patients who then developed postanesthetic shivering. This coincided with the time at which the difference between core and peripheral temperature became dissociated and peripheral temperature declined. Perioperative perfusion index was correlated with peripheral temperature and peripheral-core temperature gradient. Perfusion index at closure of the peritoneum predicted postanesthetic shivering and was significantly correlated with the extent of shivering. Plasma levels of both epinephrine and norepinephrine were significantly elevated after shivering events. Perfusion index was significantly lower in patients with postanesthetic shivering before emergence from anesthesia, indicating that measurement of perfusion index during and before the end of anesthesia might be a useful means of predicting postanesthetic shivering.

  3. Liver Transplants for Alcoholic Liver Disease

    Directory of Open Access Journals (Sweden)

    RJ Fingerote

    1991-01-01

    Full Text Available Alcohol related end-stage liver disease is a principal cause of liver failure. The scarcity of donor livers and the predominance of alcohol related end-stage liver disease has raised the issue of including alcoholics as candidates for liver transplantation. In rationalizing the arguments for and against the treatment of alcoholic end-stage liver disease with transplantation, factors such as recidivism, resource allocation and principles of medical practice must be considered. Public confidence in organ transplantation depends on the scientific validity and moral integrity of the policies adopted. Sound policies will prove defensible while policies based on perceptions or prejudices will, in the long run, harm the process.

  4. Intraductal Cooling via a Nasobiliary Tube During Radiofrequency Ablation of Central Liver Tumors Reduces Biliary Injuries.

    Science.gov (United States)

    Felker, Ely R; Lee-Felker, Stephanie A; Ajwichai, Khobkhoon; Tan, Nelly; Lu, David S; Durazo, Francisco A; Raman, Steven S

    2015-06-01

    The objective of our study was to determine the safety and efficacy of intraductal perfusion of chilled 5% dextrose in water (D5W) via an endoscopic nasobiliary tube (NBT) for the prevention of thermal bile duct injury in patients undergoing percutaneous radiofrequency ablation (RFA) of central liver tumors. We performed a retrospective study comparing outcomes of 32 consecutive patients who underwent percutaneous RFA of central liver tumors without intraductal perfusion of chilled D5W (control cohort) and 14 consecutive patients who underwent temporary intraductal perfusion of chilled D5W at 2 mL/s via endoscopic NBT placement before RFA (endoscopic NBT cohort). The primary and secondary outcomes were the rate of biliary complications and local tumor progression, respectively. All patients tolerated the procedures well. There was a significantly lower rate of biliary complications in the endoscopic NBT cohort (0/14 patients, 0%) than in the control cohort (10/32 patients, 31%) (p NBT cohort (12/14 patients, 86%) compared with the control cohort (20/32 patients, 62%) (p = 0.05). There was no difference in the rate of local tumor progression between the endoscopic NBT cohort (4/19 tumors, 21%) and the control cohort (9/39 tumors, 23%) (p = 1.0). Perfusion of chilled water through an endoscopic NBT helps prevent thermal biliary injury during RFA of central liver tumors without increasing rates of local tumor progression.

  5. Phthalate monoesters in perfusate from a dual placenta perfusion system, the placenta tissue and umbilical cord blood

    DEFF Research Database (Denmark)

    Mose, Tina; Mortensen, Gerda K; Hedegaard, Morten

    2006-01-01

    BP), and mono (2-ethyl-hexyl) phthalate (mEHP) were detected in both maternal and fetal perfusate, demonstrating a release of compounds from tissue or blood to perfusates. The distribution of compounds between perfusate, umbilical cord plasma, and tissue was in accordance with the physical-chemical properties...... of the compounds. Results from the present study of compounds residing in the tissue are essential before studying human transplacental transfer, storage, and metabolism of selected phthalate monoesters....

  6. Perfusion Intensity Correlates with Expression Levels of Psoriasis-Related Genes and Proteins

    NARCIS (Netherlands)

    Hendriks, Anke G M; Steenbergen, Wiendelt; Zeeuwen, Patrick L J M; Schalkwijk, Joost; Hondebrink, Erwin; Klitsie, Michiel A J; Schreurs, Ruud; Van De Kerkhof, Peter C M; Seyger, Marieke M B

    2015-01-01

    Background: Previous research revealed heterogeneity in the perfusion intensity within clinically homogenous-Appearing plaques, without differences in erythema. In addition, an increased perfusion was found within the perilesional skin. This raises the question whether the heterogeneity in perfusion

  7. Whole-organ tissue engineering: decellularization and recellularization of three-dimensional matrix liver scaffolds.

    Science.gov (United States)

    Sabetkish, Shabnam; Kajbafzadeh, Abdol-Mohammad; Sabetkish, Nastaran; Khorramirouz, Reza; Akbarzadeh, Aram; Seyedian, Sanam Ladi; Pasalar, Parvin; Orangian, Saghar; Beigi, Reza Seyyed Hossein; Aryan, Zahra; Akbari, Hesam; Tavangar, Seyyed Mohammad

    2015-04-01

    To report the results of whole liver decellularization by two different methods. To present the results of grafting rat and sheep decellularized liver matrix (DLM) into the normal rat liver and compare natural cell seeding process in homo/xenograft of DLM. To compare the results of in vitro whole liver recellularization with rats' neonatal green fluorescent protein (GFP)-positive hepatic cells with outcomes of in vivo recellularization process. Whole liver of 8 rats and 4 sheep were resected and cannulated via the hepatic vein and perfused with sodium dodecyl sulfate (SDS) or Triton + SDS. Several examinations were performed to compare the efficacy of these two decellularization procedures. In vivo recellularization of sheep and rat DLMs was performed following transplantation of multiple pieces of both scaffolds in the subhepatic area of four rats. To compare the efficacy of different scaffolds in autologous cell seeding, biopsies of homograft and xenograft were assessed 8 weeks postoperatively. Whole DLMs of 4 rats were also recellularized in vitro by perfusion of rat's fetal GFP-positive hepatic cells with pulsatile bioreactor. Histological evaluation and enzymatic assay were performed for both in vivo and in vitro recellularized samples. The results of this study demonstrated that the triton method was a promising decellularization approach for preserving the three-dimensional structure of liver. In vitro recellularized DLMs were more similar to natural ones compared with in vivo recellularized livers. However, homografts showed better characteristics with more organized structure compared with xenografts. In vitro recellularization of liver scaffolds with autologous cells represents an attractive prospective for regeneration of liver as one of the most compound organs. In vivo cell seeding on the scaffold of the same species may have more satisfactory outcomes when compared with the results of xenotransplantation. This study theoretically may pave the road for

  8. Metabolomic perfusate analysis during kidney machine perfusion: the pig provides an appropriate model for human studies.

    Directory of Open Access Journals (Sweden)

    Jay Nath

    Full Text Available Hypothermic machine perfusion offers great promise in kidney transplantation and experimental studies are needed to establish the optimal conditions for this to occur. Pig kidneys are considered to be a good model for this purpose and share many properties with human organs. However it is not established whether the metabolism of pig kidneys in such hypothermic hypoxic conditions is comparable to human organs.Standard criteria human (n = 12 and porcine (n = 10 kidneys underwent HMP using the LifePort Kidney Transporter 1.0 (Organ Recovery Systems using KPS-1 solution. Perfusate was sampled at 45 minutes and 4 hours of perfusion and metabolomic analysis performed using 1-D 1H-NMR spectroscopy.There was no inter-species difference in the number of metabolites identified. Of the 30 metabolites analysed, 16 (53.3% were present in comparable concentrations in the pig and human kidney perfusates. The rate of change of concentration for 3-Hydroxybutyrate was greater for human kidneys (p<0.001. For the other 29 metabolites (96.7%, there was no difference in the rate of change of concentration between pig and human samples.Whilst there are some differences between pig and human kidneys during HMP they appear to be metabolically similar and the pig seems to be a valid model for human studies.

  9. Xeno- and auto-perfusion of rabbit kidney. Machine perfusion with blood at 37 degrees C

    DEFF Research Database (Denmark)

    Jørgensen, K A; Kemp, E; Barfort, P

    1985-01-01

    Five rabbit kidneys were perfused with human blood and another five with their own blood in a re-circulating oxygenated system at 37 degrees C. The flow decreased to 2 ml/min. within 30 min. in all xenoperfusions, while none of the autoperfused had decreased to this level by 60 min. Endothelial...

  10. Pseudoketogenesis in the perfused rat heart

    Energy Technology Data Exchange (ETDEWEB)

    Fink, G.; Desrochers, S.; Des Rosiers, C.; Garneau, M.; David, F.; Daloze, T.; Landau, B.R.; Brunengraber, H.

    1988-12-05

    Ketogenesis is usually measured in vivo by dilution of tracers of (3R)-hydroxybutyrate or acetoacetate. We show that, in perfused working rat hearts, the specific activities of (3R)-hydroxybutyrate and acetoacetate are diluted by isotopic exchanges in the absence of net ketogenesis. We call this process pseudoketogenesis. When hearts are perfused with buffer containing 2.3 mM of (4-3H)- plus (3-14C)acetoacetate, the specific activities of (4-3H) and (3-14C)acetoacetate decrease while C-1 of acetoacetate becomes progressively labeled with 14C. This is explained by the reversibility of reactions catalyzed by mitochondrial 3-oxoacid-CoA transferase and acetoacetyl-CoA thiolase. After activation of labeled acetoacetate, the specific activity of acetoacetyl-CoA is diluted by unlabeled acetoacetyl-CoA derived from endogenous fatty acids or glucose. Acetoacetyl-CoA thiolase partially exchanges 14C between C-1 and C-3 of acetoacetyl-CoA. Finally, 3-oxoacid-CoA transferase liberates weakly labeled acetoacetate which dilutes the specific activity of extracellular acetoacetate. An isotopic exchange in the reverse direction is observed when hearts are perfused with unlabeled acetoacetate plus (1-14C)-, (13-14C)-, or (15-14C)palmitate; here also, acetoacetate becomes labeled on C-1 and C-3. Computations of specific activities of (3R)-hydroxybutyrate, acetoacetate, and acetyl-CoA yield minimal rates of pseudoketogenesis ranging from 19 to 32% of the net uptake of (3R)-hydroxybutyrate plus acetoacetate by the heart.

  11. Myocardial perfusion tomography with 7-pinhole collimator

    Energy Technology Data Exchange (ETDEWEB)

    Yonekura, Y.; Mukai, T.; Yamamoto, K. (Kyoto Univ. (Japan). Faculty of Medicine)

    1980-12-01

    The clinical efficacy of tomographic presentation of myocardial perfusion imaging with 7-pinhole collimator was evaluated. 35 cases including 5 normals, 4 patients with diffuse left ventricular hypertrophy, 21 with coronary artery disease (CAD) and 5 with hypertrophic cardiomyopathy (HCM) documented by coronary angiography and left ventriculography were selected for this study. Following the conventional /sup 201/Tl myocardial perfusion imaging (MPI), myocardial perfusion tomography (MPT) with 7-pinhole collimator was performed in both LAO and RAO projection. In addition, to examine wall motion abnormalities tomographically, /sup 201/Tl MPI as well as sup(99m)Tc-RBC blood pool imaging were gated to reconstruct multigated MPT (MGMPT) and multigated cardiac pool tomography (MGCPT). The detectability of the defect of the 7-pinhole tomography was compared with that of the conventional image using a cardiac phantom. The same degree of detectability was shown with both these two images. The MPT in LAO projection revealed superior sensitivity to the conventional MPI in the case of inferior wall infarction, and the MPT in RAO projection revealed superior sensitivity in the case of anterior wall infarction. A combination of the MGMPT and MGCPT succeeded in visualizing a subendocardial infarction as a focal gap between these two images. In the case of the small infarction undetectable in the conventional MPI, it can be seen as subtle wall motion abnormalities in the tomographic presentation in movie format. An asymmetrical hypertrophy in HCM can readily be localized in tomographic visualization. Tomographic reconstruction with 7-pinhole collimator from the optimal tomographic plane should be attempted, when the conventional display is equivocal.

  12. Biomarkers for liver fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, Jon M.; Burnum-Johnson, Kristin E.; Baker, Erin M.; Smith, Richard D.; Gritsenko, Marina A.; Orton, Daniel

    2017-05-16

    Methods and systems for diagnosing or prognosing liver fibrosis in a subject are provided. In some examples, such methods and systems can include detecting liver fibrosis-related molecules in a sample obtained from the subject, comparing expression of the molecules in the sample to controls representing expression values expected in a subject who does not have liver fibrosis or who has non-progressing fibrosis, and diagnosing or prognosing liver fibrosis in the subject when differential expression of the molecules between the sample and the controls is detected. Kits for the diagnosis or prognosis of liver fibrosis in a subject are also provided which include reagents for detecting liver fibrosis related molecules.

  13. Effects of hepatic ischemia-reperfusion injury on the P-glycoprotein activity at the liver canalicular membrane and blood-brain barrier determined by in vivo administration of rhodamine 123 in rats.

    Science.gov (United States)

    Miah, Mohammad K; Shaik, Imam H; Bickel, Ulrich; Mehvar, Reza

    2014-04-01

    To investigate the effects of normothermic hepatic ischemia-reperfusion (IR) injury on the activity of P-glycoprotein (P-gp) in the liver and at the blood-brain barrier (BBB) of rats using rhodamine 123 (RH-123) as an in vivo marker. Rats were subjected to 90 min of partial ischemia or sham surgery, followed by 12 or 24 h of reperfusion. Following intravenous injection, the concentrations of RH-123 in blood, bile, brain, and liver were used for pharmacokinetic calculations. The protein levels of P-gp and some other transporters in the liver and brain were also determined by Western blot analysis. P-gp protein levels at the liver canalicular membrane were increased by twofold after 24 h of reperfusion. However, the biliary excretion of RH-123 was reduced in these rats by 26%, presumably due to IR-induced reductions in the liver uptake of the marker and hepatic ATP concentrations. At the BBB, a 24% overexpression of P-gp in the 24-h IR animals was associated with a 30% decrease in the apparent brain uptake clearance of RH-123. The pharmacokinetics or brain distribution of RH-123 was not affected by the 12-h IR injury. Hepatic IR injury may alter the peripheral pharmacokinetics and brain distribution of drugs that are transported by P-gp and possibly other transporters.

  14. Fast Registration of Cardiac Perfusion MRI

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Larsson, Henrik B. W.

    2003-01-01

    This abstract presents a novel method for registration of cardiac perfusion MRI sequences. By performing complex analyses of variance and clustering in an annotated training set off-line, our method provides real-time segmentation in an on-line setting. This renders the method feasible for live...... motion-compensation in MR scanners. Changes in image intensity during the bolus passage are modelled by an Active Appearance Model augmented with a cluster analysis of the training set. Preliminary validation carried out using five subjects showed acceptable segmentation accuracy produced very rapidly...

  15. Stress-only myocardial perfusion scintigraphy

    DEFF Research Database (Denmark)

    Ejlersen, June A; May, Ole; Mortensen, Jesper

    2017-01-01

    and no previous coronary artery disease underwent a 2-day stress (exercise)/rest, gated, and attenuation-corrected (AC), 99m-technetium-sestamibi perfusion study, followed by invasive coronary angiography. The stress datasets were evaluated twice by four physicians with two different training levels (expert...... and novice): familiar and unfamiliar with AC. The two experts also made a consensus reading of the integrated stress-rest datasets. The consensus reading and quantitative data from the invasive coronary angiography were applied as reference methods. RESULTS: The sensitivity/specificity were 0...

  16. Obtaining liver tridimensional scaffold through the decellularization of rabbit whole liver in 24 hours

    Science.gov (United States)

    Federico, Schliamser; Ayelen, Rinaldi; Romina, Comin; Alba Nelly, Borchert; Adrian, Nari Gustavo; Alicia, Salvatierra Nancy; Mariana Paula, Cid

    2016-04-01

    In the present work, we development a new protocol for liver decellularization in which the hole decellularization was reached over 24 h. Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrixin which the time period involved didn't pass 24 h. Methods: The decellularization is obtained through the use of water and SDS (0,1-0,3 %), after freezing at -80 degrees, is the best alternative of different physical and/or chemical mechanisms to break down organ cells and leave only the extracellular matriz. After 24 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using microscopic observation corroborated the macroscopic results, with the hematoxylin-eosin and Masson staining showing no cells or nuclear material. In addition, the DNA quantification was less than 10% in the decellularized liver compared to control. Finally,the time taken to develop the decellularization protocol was less than 24 hours.

  17. Obtaining liver tridimensional scaffold through the decellularization of rabbit whole liver in 24 hours

    International Nuclear Information System (INIS)

    Federico, Schliamser; Ayelen, Rinaldi; Romina, Comin; Alicia, Salvatierra Nancy; Paula, Cid Mariana; Nelly, Borchert Alba; Adrian, Nari Gustavo

    2016-01-01

    In the present work, we development a new protocol for liver decellularization in which the hole decellularization was reached over 24 h. Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrixin which the time period involved didn't pass 24 h. Methods: The decellularization is obtained through the use of water and SDS (0,1-0,3 %), after freezing at -80 degrees, is the best alternative of different physical and/or chemical mechanisms to break down organ cells and leave only the extracellular matriz. After 24 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using microscopic observation corroborated the macroscopic results, with the hematoxylin-eosin and Masson staining showing no cells or nuclear material. In addition, the DNA quantification was less than 10% in the decellularized liver compared to control. Finally,the time taken to develop the decellularization protocol was less than 24 hours. (paper)

  18. Dynamic Contrast-Enhanced Ultrasound of Colorectal Liver Metastases as an Imaging Modality for Early Response Prediction to Chemotherapy

    Directory of Open Access Journals (Sweden)

    Marie Benzon Mogensen

    2017-06-01

    Full Text Available Our aim was to investigate whether dynamic contrast-enhanced ultrasound (DCE-US can detect early changes in perfusion of colorectal liver metastases after initiation of chemotherapy. Newly diagnosed patients with colorectal cancer with liver metastases were enrolled in this explorative prospective study. Patients were treated with capecitabine or 5-fluorouracil-based chemotherapy with or without bevacizumab. DCE-US was performed before therapy (baseline and again 10 days after initiation of treatment. Change in contrast-enhancement in one liver metastasis (indicator lesion was measured. Treatment response was evaluated with a computed tomography (CT scan after three cycles of treatment and the initially observed DCE-US change of the indicator lesion was related to the observed CT response. Eighteen patients were included. Six did not complete three series of chemotherapy and the evaluation CT scan, leaving twelve patients for analysis. Early changes in perfusion parameters using DCE-US did not correlate well with subsequent CT changes. A subgroup analysis of eight patients receiving bevacizumab, however, demonstrated a statistically significant correlation (p = 0.045 between early changes in perfusion measures of peak enhancement at DCE-US and tumor shrinkage at CT scan. The study indicates that early changes in DCE-US perfusion measures may predict subsequent treatment response of colorectal liver metastases in patients receiving bevacizumab.

  19. Brain hypoxanthine concentration correlates to lactate/pyruvate ratio but not intracranial pressure in patients with acute liver failure

    DEFF Research Database (Denmark)

    Bjerring, Peter Nissen; Hauerberg, John; Jørgensen, Linda

    2010-01-01

    of hypoxanthine, inosine, and lactate/pyruvate (LP) ratio are increased and correlated in patients with acute liver failure. Furthermore, we expect the purines and L/P ratio to correlate with intracranial pressure (ICP) (positively), and cerebral perfusion pressure (CPP) (negatively)....

  20. Isolated limb perfusion: what is the evidence for its use?

    NARCIS (Netherlands)

    Noorda, Eva M.; Vrouenraets, Bart C.; Nieweg, Omgo E.; van Coevorden, Frits; Kroon, Bin B. R.

    2004-01-01

    BACKGROUND: This study was conducted to assess the best available evidence for the use of isolated limb perfusion. METHODS: Following the principles of Evidence-Based Medicine, we reviewed the best available evidence for isolated limb perfusion (ILP) for melanoma and soft tissue sarcoma (STS) of the

  1. Tissue-specific sparse deconvolution for brain CT perfusion.

    Science.gov (United States)

    Fang, Ruogu; Jiang, Haodi; Huang, Junzhou

    2015-12-01

    Enhancing perfusion maps in low-dose computed tomography perfusion (CTP) for cerebrovascular disease diagnosis is a challenging task, especially for low-contrast tissue categories where infarct core and ischemic penumbra usually occur. Sparse perfusion deconvolution has been recently proposed to effectively improve the image quality and diagnostic accuracy of low-dose perfusion CT by extracting the complementary information from the high-dose perfusion maps to restore the low-dose using a joint spatio-temporal model. However the low-contrast tissue classes where infarct core and ischemic penumbra are likely to occur in cerebral perfusion CT tend to be over-smoothed, leading to loss of essential biomarkers. In this paper, we propose a tissue-specific sparse deconvolution approach to preserve the subtle perfusion information in the low-contrast tissue classes. We first build tissue-specific dictionaries from segmentations of high-dose perfusion maps using online dictionary learning, and then perform deconvolution-based hemodynamic parameters estimation for block-wise tissue segments on the low-dose CTP data. Extensive validation on clinical datasets of patients with cerebrovascular disease demonstrates the superior performance of our proposed method compared to state-of-art, and potentially improve diagnostic accuracy by increasing the differentiation between normal and ischemic tissues in the brain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Hypothermic Machine Perfusion of Kidney Grafts: Which Pressure is Preferred?

    NARCIS (Netherlands)

    Doorschodt, B. M.; Schreinemachers, M. C. J. M.; Behbahani, M.; Florquin, S.; Weis, J.; Staat, M.; Tolba, R. H.

    2011-01-01

    To assess the effect of the perfusion pressure (PP) during machine perfusion (MP) on the preservation quality of kidney grafts, we compared mean PPs of 25 and 30 mmHg using a porcine autotransplantation model. After assessment of the microcirculation, animals underwent left nephrectomy. Thereafter,

  3. Spatio-temporal analysis of blood perfusion by imaging photoplethysmography

    Science.gov (United States)

    Zaunseder, Sebastian; Trumpp, Alexander; Ernst, Hannes; Förster, Michael; Malberg, Hagen

    2018-02-01

    Imaging photoplethysmography (iPPG) has attracted much attention over the last years. The vast majority of works focuses on methods to reliably extract the heart rate from videos. Only a few works addressed iPPGs ability to exploit spatio-temporal perfusion pattern to derive further diagnostic statements. This work directs at the spatio-temporal analysis of blood perfusion from videos. We present a novel algorithm that bases on the two-dimensional representation of the blood pulsation (perfusion map). The basic idea behind the proposed algorithm consists of a pairwise estimation of time delays between photoplethysmographic signals of spatially separated regions. The probabilistic approach yields a parameter denoted as perfusion speed. We compare the perfusion speed versus two parameters, which assess the strength of blood pulsation (perfusion strength and signal to noise ratio). Preliminary results using video data with different physiological stimuli (cold pressure test, cold face test) show that all measures are influenced by those stimuli (some of them with statistical certainty). The perfusion speed turned out to be more sensitive than the other measures in some cases. However, our results also show that the intraindividual stability and interindividual comparability of all used measures remain critical points. This work proves the general feasibility of employing the perfusion speed as novel iPPG quantity. Future studies will address open points like the handling of ballistocardiographic effects and will try to deepen the understanding of the predominant physiological mechanisms and their relation to the algorithmic performance.

  4. American Liver Foundation

    Science.gov (United States)

    ... Progression of Liver Disease Reye Syndrome Type I Glycogen Storage Disease Wilson Disease Find Your Local Division ... about liver cancer HERE . Thanks to Hep B Free San Francisco, our campaign partner in Northern California, ...

  5. Antioxidants in liver health

    Science.gov (United States)

    Casas-Grajales, Sael; Muriel, Pablo

    2015-01-01

    Liver diseases are a worldwide medical problem because the liver is the principal detoxifying organ and maintains metabolic homeostasis. The liver metabolizes various compounds that produce free radicals (FR). However, antioxidants scavenge FR and maintain the oxidative/antioxidative balance in the liver. When the liver oxidative/antioxidative balance is disrupted, the state is termed oxidative stress. Oxidative stress leads to deleterious processes in the liver and produces liver diseases. Therefore, restoring antioxidants is essential to maintain homeostasis. One method of restoring antioxidants is to consume natural compounds with antioxidant capacity. The objective of this review is to provide information pertaining to various antioxidants found in food that have demonstrated utility in improving liver diseases. PMID:26261734

  6. Diet - liver disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002441.htm Diet - liver disease To use the sharing features on this page, please enable JavaScript. Some people with liver disease must eat a special diet. This diet ...

  7. 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 cholangitis (formerly called primary biliary cirrhosis). This group of tests ...

  8. Hepatic (Liver) Function Panel

    Science.gov (United States)

    ... or kidney disease, or nutritional problems. Liver enzymes: Alkaline phosphatase (ALP), alanine aminotransferase (ALT) , and aspartate aminotransferase (AST) . These enzymes help the liver convert food into energy. When their levels are high, it ...

  9. Liver Function Tests

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Diagnosing Liver Disease – Liver ...

  10. Concentration of Tumor Necrosis Factor-α and Interleukin-1β in Isolated Porcine Liver Depending on Type of Transgenesis.

    Science.gov (United States)

    Roman, P; Budziński, G; Suszka-Świtek, A; Caban, A; Oczkowicz, G; Wiaderkiewicz, R; Ryszka, F; Smorąg, Z; Cierpka, L

    2016-06-01

    Transgenic animals may serve as organ donors in human organ transplantation. However, the number of the studies addressing all doubts related to this issue is currently insufficient for the clinical application of this approach. The aim of this study was to analyze the hepatic tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) synthesis during a 24-hour cold preservation of the transgenic pig liver, depending on the type of transgenesis. The study was carried out on wild-type and transgenic pig livers with transferred human α1,2-fucosyltransferase (FUT) and/or α-galactosidase (GAL) gene (four groups; n = 6). Harvested livers were perfused for 30 minutes and stored for 24 hours in Biolasol (Biochefa) solution at 4°C with a subsequent 30-minute reperfusion (reflush). TNF-α and IL-1β concentrations were analyzed with an enzyme-linked immunosorbent assay. Perfusates were collected during the initial perfusion as well as after 24 hours of preservation and during the reperfusion. Tissue samples were harvested just after animal sacrifice, and after organ perfusion and reperfusion. A decrease in TNF-α concentration in homogenates was noted after both perfusion and reperfusion in all experimental groups. In contrast, there was a significant decrease in IL-1β concentration in the group with combined human FUT and GAL transgenes. Concurrently, increases in TNF-α and IL-1β concentrations were observed in the reperfusion perfusates in all groups. This study shows that IL-1β is synthesized in the ischemic livers of the transgenic animals with both human α1,2-fucosyltransferase and α-galactosidase transgenes. Further analysis is required to determine the importance of this observation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Brain perfusion imaging with iodinated amines

    International Nuclear Information System (INIS)

    Kung, H.F.

    1989-01-01

    Traditional nuclear medicine brain study using 99m Tc pertechnetate, glucoheptonate or diethlenetriaminepentacetic acid (DTPA) and planar imaging has experienced a significant decline in the past 10 years. This is mainly due to the introduction of X-ray CT and more recently the nuclear magnetic resonance (NMR) imaging, by which detailed morphology of the brain, including the detection of breakdown of the blood-brain barrier, can be obtained. The nuclear medicine brain imaging is only prescribed as a complementary test when X-ray CT is negative or equivocal and clinical suspicion remains. The attention of nuclear medicine brain imaging has been shifted from the detection of the breakdown of the blood-brain barrier to the study of brain function-perfusion, metabolism, and receptor binding, etc. The functional brain imaging provides diagnostic information usually unattainable by other radiological techniques. In this article, the iodinated amines as brain perfusion imaging agents are reviewed. Potential clinical application of these agents is discussed

  12. Chemosaturation with Percutaneous Hepatic Perfusion for Unresectable Isolated Hepatic Metastases from Sarcoma

    International Nuclear Information System (INIS)

    Deneve, Jeremiah L.; Choi, Junsung; Gonzalez, Ricardo J.; Conley, Anthony P.; Stewart, Steven; Han, Dale; Werner, Philip; Chaudhry, Tariq A.; Zager, Jonathan S.

    2012-01-01

    Purpose: Treatment of patients with unresectable liver metastases is challenging. Regional therapies to the liver have been developed that maximize treatment of the localized disease process without systemic toxic adverse effects. We discuss the procedural aspects of liver chemosaturation with percutaneous hepatic perfusion (CS-PHP). Methods: We present as an illustration of this technique a case report of the treatment of unresectable metastatic leiomyosarcoma of the liver. Results: A randomized phase III trial for unresectable liver metastases from melanoma was recently completed comparing CS-PHP with melphalan vs. best alternative care (BAC). When compared with BAC, CS-PHP was associated with a significant improvement in hepatic progression-free survival (8.0 months CS-PHP vs. 1.6 months BAC, p < 0.0001) and overall progression-free survival (6.7 months CS-PHP vs. 1.6 months BAC, p < 0.0001), respectively. On the basis of these results, and given our experience as one of the treating institutions for this phase III trial, we appealed for compassionate use of CS-PHP in a patient with isolated bilobar unresectable hepatic metastases from leiomyosarcoma. Four target lesions were identified and monitored to assess treatment response. A total of 4 CS-PHP procedures were performed, with a 25 % reduction in size of the largest lesion observed and 16 month hepatic progression-free survival. Toxicity was mild (neutropenia) and manageable on an outpatient basis. Conclusion: CS-PHP offers several advantages for unresectable hepatic sarcoma metastases. CS-PHP is minimally invasive and repeatable, and it has a predictable and manageable systemic toxicity profile. For appropriately selected patients, CS-PHP can delay tumor progression and could potentially improve survival.

  13. A model system for perfusion quantification using FAIR

    DEFF Research Database (Denmark)

    Andersen, Irene Klærke; Sidaros, Karam; Gesmar, Henrik

    2000-01-01

    Flow-sensitive experiments (FAIR) have been performed on a tube-flow phantom in order to validate quantitative perfusion measurements on humans. A straight-forward correspondence between perfusion and bulk-flow is found. It is shown that the flow phantom model only holds when the slice profiles...... of the involved RF pulses are taken into account. A small flow-independent off-set may be present in the data. The off-set is explained by the model. Based on the correspondence between the phantom and the in vivo models, it is shown that the lowest flow values that could be measured in the phantom correspond...... to perfusion values lower than the cortical perfusion in the brain. Thus, the experimental accuracy and the computational methods for quantitative perfusion measurements in vivo can be validated by a tube-flow phantom....

  14. A model system for perfusion quantification using FAIR

    DEFF Research Database (Denmark)

    Andersen, I.K.; Sidaros, Karam; Gesmar, H

    2000-01-01

    Flow-sensitive experiments (FAIR) have been performed on a tube-flow phantom in order to validate quantitative perfusion measurements on humans. A straight-forward correspondence between perfusion and bulk-flow is found. It is shown that the flow phantom model only holds when the slice profiles...... of the involved RF pulses are taken into account. A small flow-independent off-set may be present in the data. The off-set is explained by the model. Based on the correspondence between the phantom and the in vivo models, it is shown that the lowest flow values that could be measured in the phantom correspond...... to perfusion values lower than the cortical perfusion in the brain. Thus, the experimental accuracy and the computational methods for quantitative perfusion measurements in vivo can be validated by a tube-flow phantom...

  15. Lack of histological cerebellar changes in Wistar rats given pulegone for 28 days. Comparison of immersion and perfusion tissue fixation

    DEFF Research Database (Denmark)

    Mølck, Anne-Marie; Poulsen, Morten; Lauridsen, Søren Tindgard

    1998-01-01

    Pulegone was given orally by gavage to groups of 28 SPF Wistar rats at dosage levels of 0 or 160 mg/kg body weight per day for 28 days. Clinically treated animals showed slackness, depression, decreased food consumption, and body weight. The loss of body weight was accompanied by a marked decrease...... in plasma creatinine. In contrast to earlier results, this study did not reveal occurrence of cyst-like spaces in the white matter of cerebellum using either perfusion or immersion tissue fixation techniques. Pulegone increased plasma alkaline phosphatase and relative liver weight indicating an adverse...

  16. Immune mediated liver failure.

    Science.gov (United States)

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capacity. Direct damage and immune-mediated liver injury are two major factors involved in this process. Increasing evidence has suggested the essential role of immune-mediated liver injury in the pathogenesis of liver failure. Here, we review the evolved concepts concerning the mechanisms of immune-mediated liver injury in liver failure from human and animal studies. Both innate and adaptive immunity, especially the interaction of various immune cells and molecules as well as death receptor signaling system are discussed. In addition, we highlight the concept of "immune coagulation", which has been shown to be related to the disease progression and liver injury exacerbation in HBV related acute-on-chronic liver failure.

  17. Liver transplantation : an update

    NARCIS (Netherlands)

    Verdonk, R. C.; Van den Berg, A. P.; Slooff, M. J. H.; Porte, R. J.; Haagsma, E. B.

    2007-01-01

    Liver transplantation has been an accepted treatment for end-stage liver disease since the 1980s. Currently it is a highly successful treatment for this indication. The aim of this review is to give a general update on recent developments in the field of liver transplantation. In the last decades

  18. Liver Tumors (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Liver Tumors KidsHealth / For Parents / Liver Tumors What's in this article? Types of Tumors ... Cancerous) Tumors Symptoms Diagnosis Treatment Coping Print The liver is the body's largest solid organ. Lying next ...

  19. 492 Review Liver

    African Journals Online (AJOL)

    Marinda

    2009-11-26

    Nov 26, 2009 ... Severe bleeding still occurs in a minority of cases and efforts to define clinical and blood test predictors for major bleeding during liver surgery remain elusive. Excessive bleeding during liver surgery can be due to surgical factors, haemostatic problems due to liver disease or other causes and poor ...

  20. A Study on the Measurement of Intrapulmonary Shunt in Liver Diseases by the Nucleolide Method

    International Nuclear Information System (INIS)

    Yun, Sung Chul; Ahn, Jae Hee; Choi, Soo Bong

    1987-01-01

    The fact there are increase of intrapulmonary arteriovenous shunt amount in the liver cirrhosis patient has been known since 1950. And the method of shunt amount calculation by radionuclide method using 99m Tc-MAA was introduced in the middle of 1970. We measured intrapulmonary shunt amount by means of perfusion lung scan using 99m Tc-MAA in the various type of liver diseases especially in chronic liver diseases and acute liver disease. The results were as followed. 1) The amount of arteriovenous intrapulmonary shunt in the total case of liver disease was 9.3±3.9%, and that of in the control group was 4.6±2.1%. 2) The amount of arteriovenous intrapulmonary shunt in the chronic liver disease was 10.8±4.4%, and that of in the acute liver disease was 7.2±2.8%. We observed significant differences between normal control group and liver disease group, and between chronic liver disease group and acute liver disease group in the amount of shunt by the nucleolide method.

  1. Negative pressure ventilation enhances acinar perfusion in isolated rat lungs.

    Science.gov (United States)

    Watson, Kal E; Segal, Gilad S; Conhaim, Robert L

    2018-01-01

    We compared acinar perfusion in isolated rat lungs ventilated using positive or negative pressures. The lungs were ventilated with air at transpulmomary pressures of 15/5 cm H 2 O, at 25 breaths/min, and perfused with a hetastarch solution at P pulm art /P LA pressures of 10/0 cm H 2 O. We evaluated overall perfusability from perfusate flows, and from the venous concentrations of 4-µm diameter fluorescent latex particles infused into the pulmonary circulation during perfusion. We measured perfusion distribution from the trapping patterns of those particles within the lung. We infused approximately 9 million red fluorescent particles into each lung, followed 20 min later by an infusion of an equal number of green particles. In positive pressure lungs, 94.7 ± 2.4% of the infused particles remained trapped within the lungs, compared to 86.8 ± 5.6% in negative pressure lungs ( P ≤ 0.05). Perfusate flows averaged 2.5 ± 0.1 mL/min in lungs ventilated with positive pressures, compared to 5.6 ± 01 mL/min in lungs ventilated with negative pressures ( P ≤ 0.05). Particle infusions had little effect on perfusate flows. In confocal images of dried sections of each lung, red and green particles were co-localized in clusters in positive pressure lungs, suggesting that acinar vessels that lacked particles were collapsed by these pressures thereby preventing perfusion through them. Particles were more broadly and uniformly distributed in negative pressure lungs, suggesting that perfusion in these lungs was also more uniformly distributed. Our results suggest that the acinar circulation is organized as a web, and further suggest that portions of this web are collapsed by positive pressure ventilation.

  2. Value of chest X-ray combined with perfusion scan versus ventilation/perfusion scan in acute pulmonary embolism

    NARCIS (Netherlands)

    de Groot, M. R.; Turkstra, F.; van Marwijk Kooy, M.; Oostdijk, A. H.; van Beek, E. J.; Büller, H. R.

    2000-01-01

    The main purpose of ventilation scanning, as adjunct to perfusion lung scintigraphy, in acute pulmonary embolism is to allow for the classification of segmental perfusion defects as mismatched, which is generally accepted as proof for the presence of pulmonary embolism. We examined whether this

  3. A 3D printed microfluidic perfusion device for multicellular spheroid cultures.

    Science.gov (United States)

    Ong, Louis Jun Ye; Islam, Anik; DasGupta, Ramanuj; Iyer, Narayanan Gopalakkrishna; Leo, Hwa Liang; Toh, Yi-Chin

    2017-09-11

    The advent of 3D printing technologies promises to make microfluidic organ-on-chip technologies more accessible for the biological research community. To date, hydrogel-encapsulated cells have been successfully incorporated into 3D printed microfluidic devices. However, there is currently no 3D printed microfluidic device that can support multicellular spheroid culture, which facilitates extensive cell-cell contacts important for recapitulating many multicellular functional biological structures. Here, we report a first instance of fabricating a 3D printed microfluidic cell culture device capable of directly immobilizing and maintaining the viability and functionality of 3D multicellular spheroids. We evaluated the feasibility of two common 3D printing technologies i.e. stereolithography (SLA) and PolyJet printing, and found that SLA could prototype a device comprising of cell immobilizing micro-structures that were housed within a microfluidic network with higher fidelity. We have also implemented a pump-free perfusion system, relying on gravity-driven flow to perform medium perfusion in order to reduce the complexity and footprint of the device setup, thereby improving its adaptability into a standard biological laboratory. Finally, we demonstrated the biological performance of the 3D printed device by performing pump-free perfusion cultures of patient-derived parental and metastatic oral squamous cell carcinoma tumor and liver cell (HepG2) spheroids with good cell viability and functionality. This paper presents a proof-of-concept in simplifying and integrating the prototyping and operation of a microfluidic spheroid culture device, which will facilitate its applications in various drug efficacy, metabolism and toxicity studies.

  4. Hypervascular liver lesions in radiologically normal liver

    Energy Technology Data Exchange (ETDEWEB)

    Amico, Enio Campos; Alves, Jose Roberto; Souza, Dyego Leandro Bezerra de; Salviano, Fellipe Alexandre Macena; Joao, Samir Assi; Liguori, Adriano de Araujo Lima, E-mail: ecamic@uol.com.br [Hospital Universitario Onofre Lopes (HUOL/UFRN), Natal, RN (Brazil). Clinica Gastrocentro e Ambulatorios de Cirurgia do Aparelho Digestivo e de Cirurgia Hepatobiliopancreatica

    2017-09-01

    Background: The hypervascular liver lesions represent a diagnostic challenge. Aim: To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. Method: This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Results: Eighty eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p< 0.001), personal history of cancer (p=0.020), presence of >3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. Conclusion: It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine amino transaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients. (author)

  5. Hypervascular liver lesions in radiologically normal liver

    International Nuclear Information System (INIS)

    Amico, Enio Campos; Alves, Jose Roberto; Souza, Dyego Leandro Bezerra de; Salviano, Fellipe Alexandre Macena; Joao, Samir Assi; Liguori, Adriano de Araujo Lima

    2017-01-01

    Background: The hypervascular liver lesions represent a diagnostic challenge. Aim: To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. Method: This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Results: Eighty eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p< 0.001), personal history of cancer (p=0.020), presence of >3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. Conclusion: It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine amino transaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients. (author)

  6. Perfusion vector - a new method to quantify myocardial perfusion scintigraphy images: a simulation study with validation in patients

    DEFF Research Database (Denmark)

    Minarik, David; Senneby, Martin; Wollmer, Per

    2015-01-01

    Background The interpretation of myocardial perfusion scintigraphy (MPS) largely relies on visual assessment by the physician of the localization and extent of a perfusion defect. The aim of this study was to introduce the concept of the perfusion vector as a new objective quantitative method...... for further assisting the visual interpretation and to test the concept using simulated MPS images as well as patients. Methods The perfusion vector is based on calculating the difference between the anatomical centroid and the perfusion center of gravity of the left ventricle. Simulated MPS images were.......001) but not for patients with infarction. The correlation between the defect size and stress vector magnitude was also found to be significant (p assisting the visual interpretation in MPS studies. Further...

  7. Liver and gastrointestinal tract

    International Nuclear Information System (INIS)

    Shahid, M.A.

    1992-01-01

    Liver is often a site of a variety of diseases. A palpable liver during a routine clinical examination is an important finding and requires further investigations. The availability of non-invasive liver imaging procedures using nuclear, ultrasound, CT (and now MRI) techniques have immensely enhanced diagnostic accuracy in liver diseases. In this Chapter, a detailed description of routinely practised nuclear medicine procedures related to liver is given. Brief reference is also made to other imaging techniques, particularly ultrasonography, only for the purposes of comparison. Most of the information is based on our own clinical experience of past 30 years

  8. The Role of Mitochondrial Oxidation in Endotoxin-Induced Liver-Dependent Swine Pulmonary Edema

    Science.gov (United States)

    Siore, Amsel M.; Parker, Richard E.; Cuppels, Chris; Thorn, Natalie; Hansen, Jason M.; Stecenko, Arlene A.; Brigham, Kenneth L.

    2012-01-01

    We reported previously studies in an in situ perfused swine preparation demonstrating that endotoxemia induced lung injury required the presence of the liver and that the response was accompanied by oxidative stress. To determine whether lung and liver mitochondrial oxidative stress was important to the response, we compared the effects of equimolar amounts of two antioxidants, n-acetylcysteine, which does not replenish mitochondrial glutathione, and procysteine which does, on endotoxemia induced lung injury in the swine preparation. In a swine perfused liver-lung preparation, we measured physiologic, biochemical and cellular responses of liver and lung to endotoxemia with and without the drugs. Endotoxemia caused oxidation of the mitochondria-specific protein, thioredoxin-2, in both the lungs and the liver. Procysteine reduced thioredoxin-2 oxidation, attenuated hemodynamic, gas exchange, hepatocellular dysfunction, and cytokine responses and prevented lung edema. n-acetylcysteine had more modest effects and did not prevent lung edema. Conclusions: We conclude that mitochondrial oxidation may be critical to the pathogenesis of endotoxemia-induced liver-dependent lung injury and that choices of antioxidant therapy for such conditions must consider the desired subcellular target in order to be optimally effective. PMID:22925572

  9. Why do most human liver cytosol preparations lack xanthine oxidase activity?

    Science.gov (United States)

    Barr, John T; Choughule, Kanika V; Nepal, Sahadev; Wong, Timothy; Chaudhry, Amarjit S; Joswig-Jones, Carolyn A; Zientek, Michael; Strom, Stephen C; Schuetz, Erin G; Thummel, Kenneth E; Jones, Jeffrey P

    2014-04-01

    When investigating the potential for xanthine oxidase (XO)-mediated metabolism of a new chemical entity in vitro, selective chemical inhibition experiments are typically used. Most commonly, these inhibition experiments are performed using the inhibitor allopurinol (AP) and commercially prepared human liver cytosol (HLC) as the enzyme source. For reasons detailed herein, it is also a common practice to perfuse livers with solutions containing AP prior to liver harvest. The exposure to AP in HLC preparations could obviously pose a problem for measuring in vitro XO activity. To investigate this potential problem, an HPLC-MS/MS assay was developed to determine whether AP and its primary metabolite, oxypurinol, are retained within the cytosol for livers that were treated with AP during liver harvest. Differences in enzymatic activity for XO and aldehyde oxidase (AO) in human cytosol that can be ascribed to AP exposure were also evaluated. The results confirmed the presence of residual AP (some) and oxypurinol (all) human liver cytosol preparations that had been perfused with an AP-containing solution. In every case where oxypurinol was detected, XO activity was not observed. In contrast, the presence of AP and oxypurinol did not appear to have an impact on AO activity. Pooled HLC that was purchased from a commercial source also contained residual oxypurinol and did not show any XO activity. In the future, it is recommended that each HLC batch is screened for oxypurinol and/or XO activity prior to testing for XO-mediated metabolism of a new chemical entity.

  10. Intra-Arterial MR Perfusion Imaging of Meningiomas: Comparison to Digital Subtraction Angiography and Intravenous MR Perfusion Imaging.

    Directory of Open Access Journals (Sweden)

    Mark A Lum

    Full Text Available To evaluate the ability of IA MR perfusion to characterize meningioma blood supply.Studies were performed in a suite comprised of an x-ray angiography unit and 1.5T MR scanner that permitted intraprocedural patient movement between the imaging modalities. Patients underwent intra-arterial (IA and intravenous (IV T2* dynamic susceptibility MR perfusion immediately prior to meningioma embolization. Regional tumor arterial supply was characterized by digital subtraction angiography and classified as external carotid artery (ECA dural, internal carotid artery (ICA dural, or pial. MR perfusion data regions of interest (ROIs were analyzed in regions with different vascular supply to extract peak height, full-width at half-maximum (FWHM, relative cerebral blood flow (rCBF, relative cerebral blood volume (rCBV, and mean transit time (MTT. Linear mixed modeling was used to identify perfusion curve parameter differences for each ROI for IA and IV MR imaging techniques. IA vs. IV perfusion parameters were also directly compared for each ROI using linear mixed modeling.18 ROIs were analyzed in 12 patients. Arterial supply was identified as ECA dural (n = 11, ICA dural (n = 4, or pial (n = 3. FWHM, rCBV, and rCBF showed statistically significant differences between ROIs for IA MR perfusion. Peak Height and FWHM showed statistically significant differences between ROIs for IV MR perfusion. RCBV and MTT were significantly lower for IA perfusion in the Dural ECA compared to IV perfusion. Relative CBF in IA MR was found to be significantly higher in the Dural ICA region and MTT significantly lower compared to IV perfusion.

  11. Pulmonary artery perfusion versus no perfusion during cardiopulmonary bypass for open heart surgery in adults

    DEFF Research Database (Denmark)

    Buggeskov, Katrine B; Grønlykke, Lars; Risom, Emilie C

    2018-01-01

    handsearched retrieved study reports and scanned citations of included studies and relevant reviews to ensure that no relevant trials were missed. We searched for ongoing trials and unpublished trials in the World Health Organization International Clinical Trials Registry Platform (ICTRP) and at clinicaltrials...... of mortality, pulmonary events, serious adverse events (SAEs), and increased inflammatory markers for adult surgical patients. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Science Citation Index Expanded, and advanced Google for relevant studies. We......). We used GRADE principles to assess the quality of evidence. MAIN RESULTS: We included in this review four RCTs (210 participants) reporting relevant outcomes. Investigators randomly assigned participants to pulmonary artery perfusion with blood versus no perfusion during CPB. Only one trial included...

  12. Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

    Directory of Open Access Journals (Sweden)

    Sureyya Burcu Gorkem

    2016-01-01

    Full Text Available The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively. There was a significant decrease in ADC values of brain regions (p=0.018 and placenta (p=0.005 of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy. Our results would be a keystone for future studies which will compare larger group of monochorionic multiple pregnancies with singleton pregnancies.

  13. Zonation of gluconeogenesis, ketogenesis and intracellular pH in livers from normal and diabetic ketoacidotic rats: evidence for intralobular redistribution of metabolic events in ketoacidosis.

    Science.gov (United States)

    Burns, S P; Cohen, R D; Iles, R A; Bailey, R A; Desai, M; Germain, J P; Going, T C

    1999-10-01

    The intralobular distribution of metabolism was examined in the livers from rats with severe diabetic ketoacidosis (DKA), perfused at pH 6.8, and compared with that in livers from normal starved animals perfused at either pH 7.4 or 6.8. With lactate and palmitate as substrates, the perivenous uptake of periportally synthesized glucose seen in normal livers at pH 7.4 was abolished during DKA; indeed, gluconeogenesis was most active in the perivenous region. Whereas in normal livers perfused at pH 7.4 the periportal region showed a markedly elevated intracellular pH (pH(i)) compared with the perivenous zone, this distribution of pH(i) was reversed in DKA, with an intermediate distribution in normal livers perfused at pH 6. 8. 3-Hydroxybutyrate was generated throughout the lobule. Some acetoacetate generated periportally was converted to 3-hydroxybutyrate more perivenously. A steep gradient of oxygen uptake along the radius of the lobule was apparent in all three groups; oxygen uptake was greatly decreased perivenously despite adequate oxygen supply. These findings are consistent with our previous observations of the lobular co-location of high pH(i) and gluconeogenesis, and might offer an explanation of how high gluconeogenic rates can continue in spite of severe systemic acidosis in DKA. The findings provide direct evidence for a marked redistribution of intralobular metabolism in DKA.

  14. Myocardial CT perfusion imaging for ischemia detection

    Science.gov (United States)

    Capunay, Carlos

    2017-01-01

    Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions. Myocardial CT perfusion (CTP) can be performed with different approaches such as static and dynamic CTP. In addition, static CTP can be performed using single energy CT (SECT) or dual energy CT (DECT). In this review, we will discuss the technical parameters and the available clinical evidence of static CTP using both SECT and DECT. PMID:28540208

  15. Non-invasive MR perfusion study in patients with depression

    International Nuclear Information System (INIS)

    Lv Su; Huang Xiaoqi; Zou Ling; Li Dongming; Tang Hehan; Yang Hong; Zhang Tijiang; Li Xiuli; Gong Qiyong; Sun Xueli; Zou Ke

    2009-01-01

    Objective: To investigate the brain perfusion changes in patients with refractory depressive disorder (RDD) and non-refractory depressive disorder (NDD) using arterial spin labeling (ASL). Methods: Present study included 12 patients with RDD, 37 patients with NDD and 42 controls, and their age, sex and handedness were matched among the three groups. FAIR sequences were performed using a 3 T MR imaging system with an 8 channel phase array head coil. The labelled and controled images were subtracted and then averaged to obtain perfusion-weighted images. The first 2 images were excluded to avoid T 1 equilibrium effects and then voxel based analysis was performed using SPM2. One way ANOVA analysis using age as covariance (thresholded at P<0.01 uncorrected) was performed. Results: Patients with NDD showed regional alteration of the brain perfusion, mainly involved in two frontal- subcortical circuits, i.e. significantly decreased perfusion in the left frontal and thalamus (the limbic- thalamo-cortical circuit) whereas significantly increased perfusion in bilateral hippocampi, right lentiform and left anterior cingulated gyms (the limbic-striatal-pallidal-thalamic circuit). In contrast, patients with RDD presented significantly decreased perfusion involving bilateral frontal areas (the limbic-thalamo-cortical circuit) whereby no significantly increased perfusion areas were observed. Conclusion: In addition to the reported experimental evidences, our results suggest that the RDD is associated with inactivity of bilateral frontal areas, while the NDD is associated with inactivity of left frontal areas and overaetivity of bilateral limbic system. (authors)

  16. Radiological contrast media and pancreatic blood perfusion in anesthetized rats.

    Science.gov (United States)

    Linder, G; Carlsson, P O; Källskog, Ö; Hansell, P; Jansson, L; Riesenfeld Källskog, V

    2007-12-01

    Radiological contrast media (CM) have been suggested to be able to impair pancreatic microcirculation. To evaluate the effects of an iso-osmolar (iodixanol, 290 mOsm/kg H2O) and a low-osmolar (iopromide, 660 mOsm/kg H2O) CM on total pancreatic and islet blood perfusion. Thiobutabarbital-anesthetized rats were injected with iodine equivalent doses (600 mg I/kg body weight) of iodixanol or iopromide. Saline or low-osmolar mannitol (660 mOsm/kg H2O) solutions served as control substances. Blood perfusion measurements were then carried out with a microsphere technique. Iso-osmolar iodixanol had no effects on blood perfusion. Low-osmolar iopromide increased total pancreatic blood perfusion, whereas islet blood perfusion was unchanged. No differences were seen when mannitol solutions were given. Neither an iso-osmolar nor a low-osmolar CM affected pancreatic islet blood perfusion, whereas the low-osmolar CM increased total pancreatic blood perfusion. The absence of hemodynamic effect of low-osmolar mannitol suggests that the hyperosmolality per se of iopromide versus iodixanol does not induce the hemodynamic effect. The consequences of the effect of iopromide for pancreatic function remain to be established.

  17. Low dose CT perfusion using k-means clustering

    Science.gov (United States)

    Pisana, Francesco; Henzler, Thomas; Schönberg, Stefan; Klotz, Ernst; Schmidt, Bernhard; Kachelrieß, Marc

    2016-03-01

    We aim at improving low dose CT perfusion functional parameters maps and CT images quality, preserving quantitative information. In a dynamic CT perfusion dataset, each voxel is measured T times, where T is the number of acquired time points. In this sense, we can think about a voxel as a point in a T-dimensional space, where the coordinates of the voxels would be the values of its time attenuation curve (TAC). Starting from this idea, a k-means algorithm was designed to group voxels in K classes. A modified guided time-intensity profile similarity (gTIPS) filter was implemented and applied only for those voxels belonging to the same class. The approach was tested on a digital brain perfusion phantom as well as on clinical brain and body perfusion datasets, and compared to the original TIPS implementation. The TIPS filter showed the highest CNR improvement, but lowest spatial resolution. gTIPS proved to have the best combination of spatial resolution and CNR improvement for CT images, while k-gTIPS was superior to both gTIPS and TIPS in terms of perfusion maps image quality. We demonstrate k-means clustering analysis can be applied to denoise dynamic CT perfusion data and to improve functional maps. Beside the promising results, this approach has the major benefit of being independent from the perfusion model employed for functional parameters calculation. No similar approaches were found in literature.

  18. Ventilation and ventilation/perfusion ratios

    International Nuclear Information System (INIS)

    Valind, S.O.

    1989-01-01

    The thesis is based on five different papers. The labelling of specific tracer compounds with positron emitting radionuclides enables a range of structural, physiological and biochemical parameters in the lung to be measured non-invasively, using positron emission tomography. This concept affords a unique opportunity for in vivo studies of different expressions of pulmonary pathophysiology at the regional level. The present thesis describes the application of positron emission tomography to the measurements of ventilation and ventilation/perfusion ratios using inert gas tracers, neon-19 and nitrogen-13 respectively. The validity of the methods applied was investigated with respect to the transport of inert gas tracers in the human lung. Both ventilation and the ventilation/perfusion ratio may be obtained with errors less than 10 % in the normal lung. In disease, however, errors may increase in those instances where the regional ventilation is very low or the intra-regional gas flow distribution is markedly nonuniform. A 2-3 fold increase in ventilation was demonstrated in normal nonsmoking subjects going from ventral to dorsal regions in the supine posture. These large regional differences could be well explained by the intrinsic elastic properties of lung tissue, considering the gravitational gradient in transpulmonary pressure. In asymptomatic smokers substantial regional ventilatroy abnormalities were found whilst the regional gas volume was similar in smokers and nonsmokers. The uncoupling between ventilation and gas volume probably reflects inflammatory changes in the airways. The regional differences in dV/dt/dQ/dt were relatively small and blood flow was largely matched to ventilation in the supine posture. However, small regions of lung with very low ventilation, unmatched by blood flow commonly exists in the most dependent parts of the lung in both smokers and nonsmokers. (29 illustrations, 7 tables, 113 references)

  19. Brain perfusion SPECT in dementia syndromes

    International Nuclear Information System (INIS)

    Libus, P.; Stupalova, J.; Kuzelka, I.; Konrad, J.

    2002-01-01

    Aim: Brain perfusion SPECT is used in differential diagnostics of dementia syndromes. First of all the aim is to distinguish vascular dementia from degenerative dementia and to differentiate dementia from delirium, psychiatric syndromes, depression and secondary dementia, which is important in relation to therapy. The purpose of our study was to detect significance of BP SPECT and include it into the diagnostic process in dementia syndromes. Materials and methods: 51 women and 63 men aged 55 - 88 were evaluated in the study. The patients correspond to the general criteria of dementia diagnosis. They were sent to the examination by neurological, internal and psychiatric departments and out-patient departments. All patients were examined by 99mTc ECD SPECT using a double head camera PRISM 200 VP with LEHR collimator. The scintigraphic data were evaluated by the visual and semiquantitative analysis. Results: It was established that most patients in our group had vascular dementia, while Alzheimer's disease was second. In other groups we found out dementia at strategic infarct location, e.g. in gyrus angularis in the dominant hemisphere, frontal temporal lobe dementia and alcoholic dementia. Twenty-four patients had a normal diagnosis. Fifteen of them had a somatic reason of the delirious state and were re-classified into pseudodementia. Nine patients were not diagnostically included and the examination will repeated in four months time. Conclusion: We have found out a good applicability of brain perfusion SPECT in dementia syndromes diagnosis in our work. The best diagnosticable and most specific were the findings in multi-infarct dementia, Alzheimer's disease and frontal temporal lobe dementia. When vascular dementia is concerned we can even distinguish dementia at strategic infarction location, e.g. in thalamus, basal frontal telencefalon, in gyrus angularis of the dominant hemisphere, etc

  20. Dry Kit Development And Clinical Test Of 99mTc-L,L-ECD Radiopharmaceutical For Vrain Perfusion Imaging

    International Nuclear Information System (INIS)

    Kartini, Nani; Sofyan, Rohestri; Rukmini; Iswahyudi

    2000-01-01

    Technetium- 99m ethyl cysteinate dimer ( 99m Tc-L,L-ECD) has been synthesized and formulated based on ligand exchanged reaction with 99mTc-glucoheptonate. Considering the low stability of the dry kit produced, it was fairly necessary to develop the manufacture of L,L-ECD dry kit in order to obtain a more stable one that meet the requirements as brain perfusion imaging radiopharmaceutical. Experiment was done by modifying the packing of dry kit components of the previous formulation. Characteristics of 99m Tc-L,L-ECD produced from this formulation were studied by carrying out the sterility and toxicity test, then followed with clinical test to some volunteers. Evaluation of brain perfusion was done by tomography technique using gamma camera at Nuclear Medicine Installation, Hasan Sadikin Hospital. The modified formulation obtained consist of three components i.e. main ligand L,L-ECD; exchange ligand Ca-glucoheptonate and HaOH. Its stability could reach 8 months at-10 derajat C of storage. Effects of toxicity on mice did not appear. The result of clinical study shows that the radiopharmaceutical was distributed very rapidly in the blood brain circulations and retained in the brain for about one hour. The body scanning indicates that the substance was excreted in the brain for about one hour. The body scanning indicates that the substance was excreted though kidney, liver and spleen. Based on the results obtained the radiopharmaceutical could be promoted to be used for brain perfusion imaging

  1. Hepatic mitochondrial function analysis using needle liver biopsy samples.

    Directory of Open Access Journals (Sweden)

    Michael J J Chu

    Full Text Available BACKGROUNDS AND AIM: Current assessment of pre-operative liver function relies upon biochemical blood tests and histology but these only indirectly measure liver function. Mitochondrial function (MF analysis allows direct measurement of cellular metabolic function and may provide an additional index of hepatic health. Conventional MF analysis requires substantial tissue samples (>100 mg obtained at open surgery. Here we report a method to assess MF using <3 mg of tissue obtained by a Tru-cut® biopsy needle making it suitable for percutaneous application. METHODS: An 18G Bard® Max-core® biopsy instrument was used to collect samples. The optimal Tru-cut® sample weight, stability in ice-cold University of Wisconsin solution, reproducibility and protocol utility was initially evaluated in Wistar rat livers then confirmed in human samples. MF was measured in saponin-permeabilized samples using high-resolution respirometry. RESULTS: The average mass of a single rat and human liver Tru-cut® biopsy was 5.60±0.30 and 5.16±0.15 mg, respectively (mean; standard error of mean. Two milligram of sample was found the lowest feasible mass for the MF assay. Tissue MF declined after 1 hour of cold storage. Six replicate measurements within rats and humans (n = 6 each showed low coefficient of variation (<10% in measurements of State-III respiration, electron transport chain (ETC capacity and respiratory control ratio (RCR. Ischemic rat and human liver samples consistently showed lower State-III respiration, ETC capacity and RCR, compared to normal perfused liver samples. CONCLUSION: Consistent measurement of liver MF and detection of derangement in a disease state was successfully demonstrated using less than half the tissue from a single Tru-cut® biopsy. Using this technique outpatient assessment of liver MF is now feasible, providing a new assay for the evaluation of hepatic function.

  2. Integrated metabolic spatial-temporal model for the prediction of ammonia detoxification during liver damage and regeneration.

    Science.gov (United States)

    Schliess, Freimut; Hoehme, Stefan; Henkel, Sebastian G; Ghallab, Ahmed; Driesch, Dominik; Böttger, Jan; Guthke, Reinhard; Pfaff, Michael; Hengstler, Jan G; Gebhardt, Rolf; Häussinger, Dieter; Drasdo, Dirk; Zellmer, Sebastian

    2014-12-01

    The impairment of hepatic metabolism due to liver injury has high systemic relevance. However, it is difficult to calculate the impairment of metabolic capacity from a specific pattern of liver damage with conventional techniques. We established an integrated metabolic spatial-temporal model (IM) using hepatic ammonia detoxification as a paradigm. First, a metabolic model (MM) based on mass balancing and mouse liver perfusion data was established to describe ammonia detoxification and its zonation. Next, the MM was combined with a spatial-temporal model simulating liver tissue damage and regeneration after CCl4 intoxication. The resulting IM simulated and visualized whether, where, and to what extent liver damage compromised ammonia detoxification. It allowed us to enter the extent and spatial patterns of liver damage and then calculate the outflow concentrations of ammonia, glutamine, and urea in the hepatic vein. The model was validated through comparisons with (1) published data for isolated, perfused livers with and without CCl4 intoxication and (2) a set of in vivo experiments. Using the experimentally determined portal concentrations of ammonia, the model adequately predicted metabolite concentrations over time in the hepatic vein during toxin-induced liver damage and regeneration in rodents. Further simulations, especially in combination with a simplified model of blood circulation with three ammonia-detoxifying compartments, indicated a yet unidentified process of ammonia consumption during liver regeneration and revealed unexpected concomitant changes in amino acid metabolism in the liver and at extrahepatic sites. The IM of hepatic ammonia detoxification considerably improves our understanding of the metabolic impact of liver disease and highlights the importance of integrated modeling approaches on the way toward virtual organisms. © 2014 The Authors. Hepatology published by Wiley on behalf of the American Association for the Study of Liver Diseases.

  3. Development of an Ex Vivo, Beating Heart Model for CT Myocardial Perfusion

    NARCIS (Netherlands)

    Pelgrim, Gert Jan; Das, Marco; Haberland, Ulrike; Slump, Cees; Handayani, Astri; van Tuijl, Sjoerd; Stijnen, Marco; Klotz, Ernst; Oudkerk, Matthijs; Wildberger, Joachim E.; Vliegenthart, Rozemarijn

    2015-01-01

    Objective. To test the feasibility of a CT-compatible, ex vivo, perfused porcine heart model for myocardial perfusion CT imaging. Methods. One porcine heart was perfused according to Langendorff. Dynamic perfusion scanning was performed with a second-generation dual source CT scanner. Circulatory

  4. Imaging of ventilation/perfusion ratio by gated regional spirometry

    International Nuclear Information System (INIS)

    Touya, J.J.; Jones, J.P.; Price, R.R.; Patton, J.A.; Erickson, J.J.; Rollo, F.D.

    1981-01-01

    Gated 133 Xe images of patients rebreathing into a closed system can provide images of the distribution of lung volumes, ventilation and specific ventilation. These have been shown to be accurate, precise, and do not require unusually sophisticated equipment or skills. A mathematical transformation is used to correct the images for lung movement, which does not alter the total number of counts in the image. Perfusion images are gated to remove motion blurring but not transformed. Ventilation/perfusion images showing the distribution of V/Q ratio are then generated from the individual ventilation and perfusion images. (author)

  5. Lung perfusion and ventilation scintigraphy in pre- and postoperative diagnostics

    International Nuclear Information System (INIS)

    Sandrock, D.; Munz, D.L.

    1998-01-01

    Lung perfusion (Tc-99m labeled albumin particles) and ventilation (Xe-133 gas) are used prior to thoracic surgery in order to evaluate changes in perfusion and ventilation due to the underlying diseases. Furthermore, perfusion scintigraphy allows combined with spirometry the prediction of the postinterventional vital capacity and the forced expiratory volume in 1 s. The correlation coefficient for this procedure compared with values measured postoperatively are in the range of 0.8. The method allows the assessment of operability in terms of postinterventional function. (orig.) [de

  6. Pathologic evaluation of normal and perfused term placental tissue

    DEFF Research Database (Denmark)

    Maroun, Lisa Leth; Mathiesen, Line; Hedegaard, Morten

    2014-01-01

    with addition of antibiotics to the medium. In the "normal" tissue, certain lesions were very frequent and showed only fair or poor interobserver agreement. Revised minimum criteria for these lesions were defined and found reproducible. This study has emphasized the value of pathologic examination...... and selected findings were tested against success parameters from the perfusions. Finally, the criteria for frequent lesions with fair to poor interobserver variation in the nonperfused tissue were revised and reanalyzed. In the perfused tissue, the perfusion artefact "trophoblastic vacuolization," which...

  7. Prevalence of ECG changes during adenosine stress and its association with perfusion defect on myocardial perfusion scintigraphy.

    Science.gov (United States)

    Taywade, Sameer K; Ramaiah, Vijayaraghavan L; Basavaraja, Harish; Venkatasubramaniam, Parameswaran R; Selvakumar, Job

    2017-04-01

    Myocardial perfusion scintigraphy (MPS) is a valuable, noninvasive imaging modality in the evaluation of patients with coronary artery disease. Adenosine stress may occasionally be associated with ECG changes. This study evaluated the strength of association between adenosine stress-related ECG changes and perfusion defects on Tc-MPS. 117 (mean age: 61.25±9.27 years; sex: men 87, women 30) patients with known/suspected coronary artery disease underwent adenosine stress MPS. ECG was monitored continuously during adenosine stress for ST-depression. On the basis of the summed difference score, reversible perfusion defects were categorized as follows: normal: less than 4, mild: 4-8, moderate: 9-13, and severe: more than 13. ST-depression was observed in 27/117 (23.1%) and reversible perfusion defects were observed in 18/27 (66.66%) patients. 2/27, 6/27, and 10/27 patients had mild, moderate, and severe ischemia, respectively. 9/27 patients had normal perfusion. ECG changes and perfusion defects showed a moderate strength of association (correlation coefficient r=0.35, P=0.006). The sensitivity, specificity, positive predictive value, and negative predictive value of ECG findings for prediction of ischemia were 35.29, 86.36, 67.67, and 63.33%, respectively. ECG changes during adenosine stress are not uncommon. It shows a moderate strength of association with reversible perfusion defects. ECG changes during adenosine merit critical evaluation of MPS findings.

  8. Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

    International Nuclear Information System (INIS)

    Bair, H.J.; Platsch, G.; Wolf, F.; Guenter, E.; Becker, D.; Rupprecht, H.; Neumayer, H.H.

    1997-01-01

    Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [de

  9. In-vivo quantitative evaluation of perfusion zones and perfusion gradient in the deep inferior epigastric artery perforator flap

    Science.gov (United States)

    Saint-Cyr, Michel; Lakhiani, Chrisovalantis; Cheng, Angela; Mangum, Michael; Liang, Jinyang; Teotia, Sumeet; Livingston, Edward H.; Zuzak, Karel J.

    2013-03-01

    The selection of well-vascularized tissue during DIEP flap harvest remains controversial. While several studies have elucidated cross-midline perfusion, further characterization of perfusion to the ipsilateral hemiabdomen is necessary for minimizing rates of fat necrosis or partial fat necrosis in bilateral DIEP flaps. Eighteen patients (29 flaps) underwent DIEP flap harvest using a prospectively designed protocol. Perforators were marked and imaged with a novel system for quantitatively measuring tissue oxygenation, the Digital Light Hyperspectral Imager. Images were then analyzed to determine if perforator selection influenced ipsilateral flap perfusion. Flaps based on a single lateral row perforator (SLRP) were found to have a higher level of hemoglobin oxygenation in Zone I (mean %HbO2 = 76.1) compared to single medial row perforator (SMRP) flaps (%HbO2 = 71.6). Perfusion of Zone III relative to Zone I was similar between SLRP and SMRP flaps (97.4% vs. 97.9%, respectively). These differences were not statistically significant (p>0.05). Perfusion to the lateral edge of the flap was slightly greater for SLRP flaps compared SMRP flaps (92.1% vs. 89.5%, respectively). SMRP flaps had superior perfusion travelling inferiorly compared to SLRP flaps (88.8% vs. 83.9%, respectively). Overall, it was observed that flaps were better perfused in the lateral direction than inferiorly. Significant differences in perfusion gradients directed inferiorly or laterally were observed, and perforator selection influenced perfusion in the most distal or inferior aspects of the flap. This suggests broader clinical implications for flap design that merit further investigation.

  10. 25 Ways to Love Your Liver

    Science.gov (United States)

    ... Related Liver Disease Alpha 1 Antitrypsin Deficiency Autoimmune Hepatitis Benign Liver Tumors Biliary Atresia Cirrhosis of the Liver Galactosemia ... Related Liver Disease Alpha 1 Antitrypsin Deficiency Autoimmune Hepatitis Benign Liver Tumors Biliary Atresia Cirrhosis of the Liver Galactosemia ...

  11. In vitro culture of functionally active buffalo hepatocytes isolated by using a simplified manual perfusion method.

    Directory of Open Access Journals (Sweden)

    Santanu Panda

    Full Text Available In farm animals, there is no suitable cell line available to understand liver-specific functions. This has limited our understanding of liver function and metabolism in farm animals. Culturing and maintenance of functionally active hepatocytes is difficult, since they survive no more than few days. Establishing primary culture of hepatocytes can help in studying cellular metabolism, drug toxicity, hepatocyte specific gene function and regulation. Here we provide a simple in vitro method for isolation and short-term culture of functionally active buffalo hepatocytes.Buffalo hepatocytes were isolated from caudate lobes by using manual enzymatic perfusion and mechanical disruption of liver tissue. Hepatocyte yield was (5.3 ± 0.66×107 cells per gram of liver tissue with a viability of 82.3 ± 3.5%. Freshly isolated hepatocytes were spherical with well contrasted border. After 24 hours of seeding onto fibroblast feeder layer and different extracellular matrices like dry collagen, matrigel and sandwich collagen coated plates, hepatocytes formed confluent monolayer with frequent clusters. Cultured hepatocytes exhibited typical cuboidal and polygonal shape with restored cellular polarity. Cells expressed hepatocyte-specific marker genes or proteins like albumin, hepatocyte nuclear factor 4α, glucose-6-phosphatase, tyrosine aminotransferase, cytochromes, cytokeratin and α1-antitrypsin. Hepatocytes could be immunostained with anti-cytokeratins, anti-albumin and anti α1-antitrypsin antibodies. Abundant lipid droplets were detected in the cytosol of hepatocytes using oil red stain. In vitro cultured hepatocytes could be grown for five days and maintained for up to nine days on buffalo skin fibroblast feeder layer. Cultured hepatocytes were viable for functional studies.We developed a convenient and cost effective technique for hepatocytes isolation for short-term culture that exhibited morphological and functional characteristics of active hepatocytes

  12. Diagnosis of fatty liver

    International Nuclear Information System (INIS)

    Saitoh, Shuichi; Nagamine, Takeaki; Takagi, Hitoshi

    1988-01-01

    Diagnostic values of various ultrasonographic findings were evaluated from fatty infiltration ratio calculated by liver specimens in 42 patients. The ratio of the CT number of liver to those of spleen were also compared with fatty infiltration ratio in 11 patients. Fatty bandless sign one plus (perirenal bright echo between the liver and the right kidney is masked partially) or more and the fatty score 3 (it is calculated by several ultrasonographic findings) and the less than 0.90 of the ratio of CT number of liver to those of spleen were useful for diagnosis of fatty liver, the sensitivity was 100%, 87.5%, 85.7% and the accuracy was 78.1%, 81.8%, 81.8% respectively. It was considered that these criteria were suitable in screening study of fatty liver. (author)

  13. Liver disease in pregnancy

    Directory of Open Access Journals (Sweden)

    Shashank Shekhar

    2015-10-01

    Full Text Available Deranged liver function tests are encountered in 3% of pregnancies. The potential causes are classified as those unique to and those just incidental to pregnancy. Pregnancy-related diseases are the most frequent causes of liver dysfunction during pregnancy and exhibit a trimester-specific occurrence during pregnancy. Differentiation of liver dysfunction as that related to and just incidental to pregnancy is the key to management, especially when liver dysfunction is encountered after 28 weeks of pregnancy. It can be judged from the fact that delivery remains the cornerstone of management of pregnancy-related diseases except hyperemesis gravidarum. This is an overview of the causes of liver dysfunction during pregnancy; an update on the underlying mechanisms of their occurrence, especially liver diseases unique to pregnancy; and a methodological approach to their diagnosis and management.

  14. Robotic liver surgery

    Science.gov (United States)

    Leung, Universe

    2014-01-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  15. Investigation of Hepatic Blood Perfusion by Laser Speckle Imaging and Changes of Hepatic Vasoactive Substances in Mice after Electroacupuncture

    Directory of Open Access Journals (Sweden)

    Xiao-jing Song

    2014-01-01