• Title/Summary/Keyword: hepatectomy

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Morphological Study on Differentiation of Hepatocytic Stem Cell by Intrasplenic Transplantation after Partial Hepatectomy (간부분 절제술 후 비장내 이식한 간세포화 줄기세포의 분화에 관한 형태학적 연구)

  • 양영철;박재홍;박중규;배기원
    • Journal of Life Science
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    • v.12 no.3
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    • pp.294-305
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    • 2002
  • This study was performed to evaluate regenerative effects of intrasplenic stem cell transplantation after partial hepatectomy. To evaluate the regenerative effects, Sprague Dawley rats were used. In vivo the embryonic stem cells of blastocysts were collected from superovulated rats on day 3.5 after the vaginal plug checked. The embryonic stem cells were cocultured with hepatocytes for 8 days, they were transplanted into the spleen. After the intrasplenic transplantation of cultured stem cells, they were initially distributed near the periarterial lymphatic sheath after transplantation in the hematoxylin-eosin staining. Their number were formely increased and their size enlarged at forming small lobules. The embryonic stem cells in the culture proliferated and initially proliferated around the periarterial lymphatic sheath and later they around the trabecula with blood vessels. After the transplantation of stem cells, their cell organelles were well developed rough endoplasmic reticulum at the 20th with prominent epidermal growth factor reaction, developed smooth endoplasmic reticulum at the 30th day, well differentiated bile canaliculi with increased transforming growth factor-$\beta$ and apoptosis reactions.

Measurements of the Hepatectomy Rate and Regeneration Rate Using Deep Learning in CT Scan of Living Donors (딥러닝을 이용한 CT 영상에서 생체 공여자의 간 절제율 및 재생률 측정)

  • Sae Byeol, Mun;Young Jae, Kim;Won-Suk, Lee;Kwang Gi, Kim
    • Journal of Biomedical Engineering Research
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    • v.43 no.6
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    • pp.434-440
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    • 2022
  • Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

Evaluation and Prediction of Post-Hepatectomy Liver Failure Using Imaging Techniques: Value of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

  • Keitaro Sofue;Ryuji Shimada;Eisuke Ueshima;Shohei Komatsu;Takeru Yamaguchi;Shinji Yabe;Yoshiko Ueno;Masatoshi Hori;Takamichi Murakami
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.24-32
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    • 2024
  • Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

The Role of Sympathetic Activity in the Early Phase of Liver Regeneration after Partial Hepatectomy (간-부분절제(肝-部分切除) 후 나타나는 재생과정(再生過程)에서 교감신경계(交感神經系)의 역할(役割)에 관(關)한 연구(硏究))

  • Choi, Sang-Hyun;Lee, Joong-Geun;Park, Chung-San;Chun, Boe-Gwun;Chun, Yeon-Sook
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.177-183
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    • 1990
  • This study was undertaken to confirm whether or not the sympathetic nervous system takes part in the liver regeneration after partial hepatectomy. The male Sprague-Dawley rats were pretreated with I.P. injection of guanethidine 25 mg/kg: single dose (G-1); multiple doses once a day for 3 days (G-3), for 5 days (G-5), or for 6 days (G-6). The rats were subjected to partial hepatectomy $(70.4{\pm}1.99%)$ under light anesthesia of diethyl ether. 1) The systolic blood pressure of control rat was $98.0{\pm}3.9\;mmHg$ and was not affected by G-1. But after the pretreatment with G-3, G-5 or G-6, the pressure was markedly decreased by over 25 %. 2) Both of plasma norepinephrine and epinephrine levels showed the marked increases 3 hrs after the hepatectomy. However, the increases are entirely inhibited by G-1 or G-6. 3) All the liver contents of putrescine, spermidine and spermine showed the significant increases 6 hrs after the hepatectomy and were not affected by G-1 or G-6 with the exception of the inhibition of putrescine increase by only G-6. The present results suggest that the sympathetic activation appeared after partial hepatectomy seems not to play an important role in rat liver regeneration.

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Vitamin C Promoted Liver Regeneration Following Partial Hepatectomy-induced Hepatic Injury in Senescence Marker Protein-30-deficient Mice (비타민 C 투여는 간 부분절제술에 의한 간 재생을 촉진 시킴)

  • Han, Seon Young;Hwang, Meeyul;Kim, Ah-Young;Lee, Eun-Mi;Lee, Eun-Joo;Lee, Myeong-Mi;Sung, Soo-Eun;Kim, Sang-Hyeob;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.25 no.3
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    • pp.336-344
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    • 2015
  • The capacity for liver regeneration involves a variety of nutritional factors. Vitamin C has multiple metabolic and antioxidant functions. In this study, we investigated the role of vitamin C in liver regeneration following hepatectomy in senescence marker protein (SMP)-30 knockout (KO) mice. Partial hepatectomy was performed by resecting the median and left lateral lobes of mice. Vitamin C accelerated liver recovery in SMP30 KO mice treated with vitamin C (KV). The livers of the KV mice exhibited lower levels of aspartate aminotransferase and lower injury than those of the KO mice. Increased type II transforming growth factor-β receptor (TGF-βRII)-mediated regeneration signaling was accompanied by HGF and cMet in the KV but not the KO mice. Consistent with this, the expression of cell cycle regulatory proteins, including cyclin D1 and proliferating cell nuclear antigen (PCNA), increased rapidly in the KV mice. Enhanced activation of ERK and GSK-3β proteins and a significantly increased number of binuclear hepatocytes were also detected in the livers of the KV mice. Moreover, the KV mice synthesized the highest levels of albumin. These data suggest that treating SMP30 knockout mice with vitamin C resulted in earlier recovery and liver regeneration by activation of the regeneration system.

Transcriptional Control of Lactate Dehydrogenase A-Gene Expression during the Pre-replicative Phase of Regenerating Rat Liver (백서 재생간조직의 낙산탈수소효소 A-유전자 발현의 전사활성)

  • Kim, Hae-Young;Lee, Seung-Ki
    • YAKHAK HOEJI
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    • v.32 no.4
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    • pp.239-244
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    • 1988
  • Transcriptional rate of lactate dehydrogenase A-gene(LDH-A) during the prereplicative phase of regenerating rat liver was determined by in vitro run-off transcription assay. The results show that the transcription rate of LDH A-gene increases between 12 hours and 15 hours peaking at 13 hours after partial hepatectomy of rat liver. The increased rate of LDH A-gene transcription was interfered after DL-propranolol treatment intraperitoneally injected twice at 1 hour and 8 hours after partial hepatectomy indicating that the transcriptional control of LDH A-gene expression may be mediated by beta adrenergic receptor and cAMP as a second messenger. And also was it shown that the temporally increased rate of LDH A-gene transcription was maximum one hour after the second cAMP-surge which is known to play an important role for the initiation of DNA replication during regeneration of rat liver. And the transcriptional rate of LDH A-gene was decreased to the basal level at the time period when the hepatocytes proliferate rapidly suggesting that the induced LDH Aisozyme may be required for the initiation of DNA replication during regeneration of rat liver. These data may be supporting for the hypothesis suggesting that the induced LDH A-isozyme during the pre-replicative phase of regenerating rat liver may play bifunctional roles as a glycolytic enzyme and a helix destablizing protein as well.

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Chronic Gastric Volvulus as a Late Complication of Hepatectomy for Hepatoblastoma in a Child: A Case Report

  • Lee, Han Shin;Jung, Eun Jung;Park, Ji Sook;Park, Taejin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.608-612
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    • 2019
  • Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.

Use of a Postoperative Hepatic Arterial Embolization in Patients with Postoperative Bleeding due to Severe Hepatic Injuries (외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성)

  • Cha, Soo Hyun;Jung, Yong Sik;Won, Jae Hwan;Kim, Wook Whan;Wang, Hee Jung;Kim, Myung Wook;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.59-66
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    • 2006
  • Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

Prognostic Significance of Preoperative Serum Alpha-fetoprotein in Hepatocellular Carcinoma and Correlation with Clinicopathological Factors: a Single-center Experience from China

  • An, Song-Lin;Xiao, Ting;Wang, Li-Ming;Rong, Wei-Qi;Wu, Fan;Feng, Li;Liu, Fa-Qiang;Tian, Fei;Wu, Jian-Xiong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4421-4427
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    • 2015
  • Objectives: To investigate the prognosis significance of preoperative serum alpha-fetoprotein (AFP) and the correlation with clinicopathological factors of hepatocellular carcinoma (HCC) patients who underwent hepatectomy. Materials and Methods: Clinicopathological data of retrospective analysis were collected for 251 HCC patients undergoing hepatectomy in this study. According to preoperative AFP level, patients were categorized into AFP-negative (0-20ng/mL) and AFP-positive (>20 ng/mL) groups for Kaplan-Meier analysis and Cox proportional hazard regression modeling. Results: The results demonstrated that increased AFP was associated with longer prothrombin time (PTs), liver capsule invasion, low grade differentiation, and late Barcelona Clinic Liver Center (BCLC) stage. Moreover, the female patients had a greater prevalence of increased preoperative AFP than male patients [284.8 (3.975-3167.5) vs (3.653-140.65); Z-2.895, p=0.004]. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 78.1, 57.5, and 40.6 % in the AFP-negative group and 61.8, 37.7, and 31.4 %, respectively, in the AFP-positive group (log-rank test 8.312, p=0.004). The 1-, 3-, and 5-year overall survival (OS) rates were 94.4, 83.8, and 62.3% in the AFP-negative group and 87.2, 60.0, and 36.7%, respectively, in the AFP-positive group. The difference was statistically significant (log-rank test, 16.884, p=0.000). Cox proportional-hazards model identified preoperative AFP to be an independent prognostic predictor of overall survival. Conclusions: Preoperative serum AFP is an independent predictor of prognosis among HCC patients following surgical resection. Female patients have a higher preoperative AFP than their male counterparts.

Effects of Branched Chain Amino Acids Added to a Diet on the Liver Regeneration in the Partial Hepatectomized Rat (분지쇄(分枝?)아미노산(酸)이 재생간(再生肝) 흰쥐에 미치는 영양학적(營養擧的) 효과(?果))

  • Kim, Eul-Sang;Fukushima, Hideo;Oda, Toshitsugu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.13 no.4
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    • pp.451-458
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    • 1984
  • The effects of branched chain amino acids added to a diet on changes in the body weight with or without liver, moist and dry liver weight, protein, DNA, $^3H-thymidine$ incorporation into DNA, ana mitotic index of regenerating liver were studied in partial hepatectomized rat. Experimental diet was a 14.63% casein diet supplemented with 1.49% L-leucine, 0.90% L-isoleucine and 0.98% L-Valine, and control diet was an 18.0% casein. In both diets, 2.54% nitrogen were included. Rats fed experimental diet were significantly increased body weight with or without liver 7 days, and regenerated weight of dry liver and an index of liver regeneration 5 days after partial hepatectomy. Mitotic index, contents of protein and DNA increased in regenerating liver after partial hepatectomy was higher in experimental diet group. This results suggest that branched chain amino acids have an benefitial effect on whole body as well as liver regeneration after partial hepatectomy in rat.

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