• The Korean Journal of Pharmacology
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• v.23 no.1
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• pp.15-23
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• 1987

To elucidate the mechanism of splanchnic hyperemia associated with chronic portal hypertension, we have investigated the alteration in visceral reflexes in conjuction with circulatory hemodynamics in portal ligated portal hypertension in cats. When capsaicin, bradykinin and vasopressin were injected via splenic artery of sham cat, respectively, they caused not only reflex excitation of systemic arterial pressure, but also elevation of splenic venous pressure with unchanged heart rates. Simultaneously, they evoked the sympathetic efferent excitation of liver (spleno-hepatic reflex) as well as of spleen (spleno-splenic reflex). Similarly, capsaicin upon pledging on the liver surface evoked a significant increase in the pressor reflex with hepatic nerve excitation (hepato-hepatic reflex). After portal ligation, the splenic venous pressure was gradually elevated in association with decrease in systemic arterial pressure. However, the excitation of pressor reflex was enhanced on the and day, thereafter, being returned to the control, and the reflexly induced spleno-splenic, spleno-hepatic and hepato-hepatic sympathetic excitations were significantly diminished on the 8th day following portal vein ligation. In conclusion, it is suggested that sympathetic reflexes to spleen and liver are specifically intervened by the same central pathways and furthermore, the diminution of these viscero-visceral reflex excitations after portal ligation may be related to the intestinal hyperemia.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.677-681
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• 2012

The aim of the present research was to investigate clinicopathologic correlations of immunohistochemically-demonstrated axin (axis inhibition) and ${\beta}$-catenin expression in primary hepatocellular carcinomas (HCCs), in comparison with paraneoplastic, cirrhotic and normal liver tissues. Variation in Axin expression across groups were significant (P < 0.01), correlating with alpha fetoprotein (AFP), HBsAg, cancer plugs in the portal vein, and clinical stage of HCCs(P < 0.05); however, there were no links with sex, age, and tumour size (P > 0.05). Differences in cell membrane ${\beta}$-catenin expression were also statistically significant (P < 0.01), again correlated with AFP, HBsAg, cancer plugs in the portal vein, and clinical stage in HCCs (P < 0.05) but not with sex, age, and tumour size (P > 0.05). Axin expression levels in tissues with reduced membrane ${\beta}$-catenin were low (P < 0.05), also being low with nuclear ${\beta}$-catenin expression (P < 0.05). Axin and ${\beta}$-catenin may play an important role in the genesis and progression of HCC via the Wnt signal transmission pathway. Simultaneous determination of axin, ${\beta}$-catenin, AFP, and HBsAg may be useful for early diagnosis, and metastatic and clinical staging of HCCs.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3509-3514
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• 2013

The prognostic value of the fibroblast growth factor-inducible 14 (Fn14) expression in hepatocellular carcinoma (HCC) is unknown. Real-time PCR (RT-PCR), western blot assays and immunohistochemistry analysis were here performed in order to compare Fn14 expressios in paired liver samples of HCC and normal liver tissue. Most of the tumor tissues expressed significantly higher levels of Fn14 compared to adjacent non-tumor tissues, with Fn14High accounting for 54.6% (142/260) of all patients. The Pearson ${\chi}^2$ test indicated that Fn14 expression was closely associated with serum alpha fetal protein (AFP) (P=0.002) and tumor number (p=0.019). Univariate and multivariate analyses revealed that along with tumor diameter and portal vein tumor thrombosis (PVTT ) type, Fn14 was an independent prognostic factor for both overall survival (OS) (HR=1.398, p=0.008) and recurrence (HR=1.541, p=0.001) rates. Fn14 overexpression HCC correlated with poor surgical outcome, and this molecule may be a candidate biomarker for prognosis as well as a target for therapy.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.27-33
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• 1989

The relationship between angiographic findings and those of $^{67}Ga$ scan was evaluated in 30 patients with primary hepatocellular carcinoma diagnosed by either pathological examination or laboratory, radiologic findings. Twenty-three cases revealed hot activities on $^{67}Ga$ scan and definite tumor stains on angiography. Main findings of $^{67}Ga$ scans of 7 cases were isoactivity in 5 and cold area in 2, 5 of which revealed faint or no tumor stain on angiography. Cold areas within the primary hepatocellular carcinoma were noted in 9 cases by $^{67}Ga$ scan. In 6 cases these were due to tumor necrosis. Remaining 3 cases had arterioportal shunt, portal vein thrombosis and one had necrosis as well. These results indicate that gallium uptake of primary hepatocellular carcinoma seems to be relatively correlated with tumor stains on angiography. It is well known that the necrotic portion of primary hepatocellular carcinoma does not uptake gallium and it's the main cause of cold areas on $^{67}Ga$ scan. And we suspect that the hemodynamic changes of primary hepatocellular carcinoma such as large arterioportal shunt, portal vein thromosis may cause the decreased activity on $^{67}Ga$ scan.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.703-706
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• 2014

Objective: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC). Methods: In this retrospective case-control study, data were collected from patients who underwent sequential TACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomography volumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and to check whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry after TACE, prior to and after major hepatectomy. Results: Mean average FRL volume increased 32.3-71.4% (mean 55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned to normal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis. Conclusion: Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgical resection, and greatly reduce postoperative intra- and extrahepatic metastasis.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.271-272
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• 1998

Contrast-enhanced CT has an important role in the assessment of liver lesions. However, the optimal protocol to get most effective result is not clear. The main principle for deciding injection protocol is to optimize lesion detectability by rapid scanning when lesion-to-liver contrast is maximum. For this purpose, we developed a physiological model of contrast medium enhancement based on the compartment modeling and pharmacokinetics. Blood supply to liver was modeled in two paths. This dual supply character distinguishes the CT enhancement of liver from that of the other organs. The first path is by hepatic artery and the second is by portal vein. It is assumed that only hepatic artery can supply blood to hepatocellular carcinoma (HCC) compartment. It is known that this causes the difference of contrast enhancement between normal liver tissue and hepatic tumor. By solving differential equations for each compartment simultaneously using computer program Matlab, CT contrast-enhancement curves were simulated. Simulated enhancement curves for aortic, hepatic, portal vein, and HCC compartments were compared with mean enhancement curves from 24 patients exposed to the same protocols as simulation. These enhancement curves were in a good agreement. Furthermore, we simulated lesion-to-liver curves for various injection protocols, and analyzed the effects. These may help to optimize the scanning protocols for good diagnosis.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.248-251
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• 2013

Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.274-278
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• 1990

Metastases to the liver presents a common clinical problem in the management of patients with cole-rectal cancer, and are responsible for a high degree of morbidity and mortality associated with this malignancy. Unfortunately, attempts at preventing the development of liver metastases in "high risk" patients has so far been unsuccessful. Ongoing studies of adjuvant chemotherapy have not yet illustrated a significant increase in survival in patients receiving such therapy. The purpose of the study is to investigate the value of adjuvant radiotherapy given in the form of colloidal chromic phosphate P-32 suspension administered via portal vein after radical resection of the primary cancer, in preventing the growth of occult metastases in the liver. Twenty one patients (10 patients of treated group with 11 controls) were followed 18 months after operation. There was no significant change in the CBC and liver functions after administration of P-32 labeled colloidal chromic phosphate. The number of patients who showed local metastases at 18 months were 2 in the treated group and 3 in the control group. While liver metastases occurred in one patient at 6 months and in three at 12 months in the control group, there was no development of liver metastases by 12 months in the treated group. At 18 month follow-up CT scan one patient in the treated group showed a single nodule in the liver. In conclusion liver metastasis rate was lower in the patients who received colloidal P-32 chromic phosphate via portal vein after radical resection of the primary cole-rectal cancer.

• The Korean Journal of Physiology and Pharmacology
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• v.12 no.1
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• pp.31-35
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• 2008

Lysophosphatidylcholine (LPC), a metabolite of membrane phospholipids by phospholipase $A_2$, has been considered responsible for the development of abnormal vascular reactivity during atherosclerosis. $Ca^{2+}$ influx was shown to be augmented in atherosclerotic artery which might be responsible for abnormal vascular reactivity. However, the mechanism underlying $Ca^{2+}$ influx change in atherosclerotic artery remains undetermined. The purpose of the present study was to examine the effects of LPC on L-type $Ca^{2+}$ current $(I_{Ca(L)})$ activity and to elucidate the mechanism of LPC-induced change of $I_{Ca(L)}$ in rabbit portal vein smooth muscle cells using whole cell patch clamp. Extracellular application of LPC increased $I_{Ca(L)}$ through whole test potentials, and this effect was readily reversed by washout. Steady state voltage dependency of activation or inactivation properties of $I_{Ca(L)}$ was not significantly changed by LPC. Staurosporine (100 nM) or chelerythrine $(3{\mu}M)$, which is a potent inhibitor of PKC, significantly decreased basal $I_{Ca(L)}$, and LPC-induced increase of $I_{Ca(L)}$ was significantly suppressed in the presence of PKC inhibitors. On the other hand, application of PMA, an activator of PKC, increased basal $I_{Ca(L)}$ significantly, and LPC-induced enhancement of $I_{Ca(L)}$ was abolished by pretreatment of the cells with PMA. These findings suggest that LPC increased $I_{Ca(L)}$ in vascular smooth muscle cells by a pathway that involves PKC, and that LPC-induced increase of $I_{Ca(L)}$ might be, at least in part, responsible for increased $Ca^{2+}$ influx in atherosclerotic artery.

• Vascular Specialist International
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• v.34 no.4
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• pp.83-87
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• 2018

Purpose: Thrombosis of the portal vein, known as pylephlebitis, is a rare and fatal complication caused by intraperitoneal infections. The disease progression of superior mesenteric venous thrombosis (SMVT) is not severe. This study aimed to determine the clinical features, etiology, and prognosis of SMVT. Materials and Methods: We retrospectively reviewed the medical records of 41 patients with SMVT from March 2000 to February 2017. We obtained a list of 305 patients through the International Classification of Disease-9 code system and selected 41 patients with SMVT with computed tomography. Data from the medical records included patient demographics, comorbidities, review of system, laboratory results, clinical courses, and treatment modalities. Results: The causes of SMVT were found to be intraperitoneal inflammation in 27 patients (65.9%), malignancy in 7 patients (17.1%), and unknown in 7 patients (17.1%). Among the patients with intraperitoneal inflammation, 14 presented with appendicitis (51.9%), 7 with diverticulitis (25.9%), and 2 with ileus (7.4%). When comparing patients with and without small bowel resection, the differences in symptom duration, bowel enhancement and blood culture were significant (P=0.010, P=0.039, and P=0.028, respectively). Conclusion: SMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis. In addition, rapid symptom progression and positive blood culture can be the prognostic factors related to extensive bowel resection. Use of appropriate antibiotics and understanding of disease progression can help improve the outcomes of patients with SMVT.