• Title/Summary/Keyword: portal vein

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Usefulness of Liver Fibrosis According to Classification of Image Score System In Abdominal Ultrasonography (복부 초음파검사에서 영상 점수 시스템 분류에 따른 간 섬유화 평가의 유용성)

  • An, Hyun;Ji, Tae-jeong;Lee, Hyo-young;Im, In-chul
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.187-194
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    • 2019
  • The purpose of this study was to evaluate the pathologic results of hepatic parenchyma parameters such as liver parenchyma, liver surface, liver margin and liver, portal vein, spleen size, And to evaluate the usefulness of fibrosis progression and hepatic ultrasonography. The sensitivity, specificity, positive predictive value, and prognostic value according to the stage of fibrosis and grade of inflammation were divided into two groups according to the morphologic variable "A" through ultrasound and "B" We evaluated the predictive value and predicted the variables to evaluate fibrosis in clinical diagnosis and treatment of patients with chronic liver disease. The sensitivity and specificity of hepatic fibrosis in hepatic morphologic variables and other size variables were highest in liver surface and edge. The morphologic parameters used in the evaluation of fibrosis were clinically relevant in distinguishing the fibrosis stage from the results of liver biopsy.

Suitability of denervated muscle flaps as recipient sites for pancreatic islet cell transplantation

  • Park, Jong-Lim;Kim, Taewoon;Kim, Baek-Kyu
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.133-143
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    • 2021
  • Background Extensive research has been conducted on islet transplantation as a possible cure for diabetes. Islet transplantation in the liver via the portal vein has shown remarkable results, but numerous other recipient sites are currently being investigated. We aimed to show the effectiveness of using a muscle flap as a recipient site for islet transplantation. Methods Islet cells were harvested from 12 isogenic Lewis rats, and then diabetes was induced in another 12 isogenic Lewis rats by streptozotocin injection. In six rats, 3,000 islets were transplanted into gastrocnemius muscle flaps, and in the other six rats, the same number of islets were transplanted into the gastrocnemius muscle. The transplanted islet cell function between the two groups was compared by means of blood glucose tests, glucose tolerance tests, immunohistochemistry, and real-time reverse transcription polymerase chain reaction. Results In the muscle flap group, blood glucose levels significantly decreased after islet transplantation. Blood glucose levels were significantly different between the two groups at 3 weeks after transplantation. The muscle flap group showed nearly normoglycemic results upon the glucose tolerance test, whereas the muscle group was hyperglycemic. Immunohistochemical evaluation showed positive results against insulin and glucagon in biopsies of both groups, and the islet cell density was higher in the muscle flap group. There were no statistically significant differences between the two groups in real-time reverse transcription polymerase chain reaction results. Conclusions Our results suggest that muscle flaps are promising candidates for islet cell transplantation.

Computed Tomographic Features of Gallbladder Agenesis in a Golden Retriever

  • Yujung Lee;Dongjun Kim;Jeongin Choi;Youngwon Lee;Hojung Choi
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.43-48
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    • 2024
  • A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.

Hepatic artery anastomosis in liver transplantation (간이식에서 간동맥 문합술)

  • Park, Myong Chul;Kim, Chee Sun;Park, Dong Ha;Pae, Nam Suk;Wang, Hee Jung;Kim, Bong Wan
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.33-37
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    • 2009
  • Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed between February 2005 and May 2008. Male to female ratio of the liver transplantation recipients was 3.4 : 1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92 mm and mean artery length was 24.25 mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re - anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

Gastrointestinal and Hepatic First-pass Effects of Triflusal in Rats (흰쥐에서 트리플루살의 위장관 및 간 초회통과효과)

  • Cho, Hea-Young;Jeong, Tae-Jin;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.31 no.4
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    • pp.265-271
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    • 2001
  • In order to elucidate the influence of intestinal and hepatic first-pass effect on the pharmacokinetics of triflusal, the biotransformation of triflusal in the gastrointestinal tract and liver was designed. Moreover, we tried to establish an HPLC method applicable for bioassay and available to pharmacokinetics, not only with the simultaneous determination of triflusal and its active metabolite, 2-hydroxy-4-trifluoromethyl benzoic acid (HTB), but also with improving sensitivity. After the administration of triflusal (10 mg/kg) and HTB (10 mg/kg) into femoral vein, portal vein (only triflusal) and oral route (only triflusal), pharmacokinetic parameters were investigated from the plasma concentration-time profiles of triflusal and HTB in rats. An HPLC method was developed for the simultaneous determination of triflusal and HTB in rat plasma, urine and bile. The HPLC analysis was carried out using a C18 column and acetonitrile-methanol-water (25:10:65, v/v/v) as the mobile phase and UV detection at 234 nm. Furosemide was used as the internal standard. The calibration curves were linear over the concentration range $0.05-5.0\;{\mu}g/ml$ for triflusal and $0.2-200.0\;{\mu}g/ml$ for HTB with correlation coefficients greater than 0.999 and with intra-day or inter-day coefficients of variation not exceeding 10.0%. This assay procedure was applied to the study of metabolite pharmacokinetics of triflusal and HTB in rats. It was supposed that triflusal was almost metabolized in vivo because urinary and biliary excreted amounts of triflusal could be ignored as it was lower than 1.2% of the administered dose. According to the gastrointestinal and hepatic biotransformation pathways of triflusal, it was found that triflusal was hydrolyzed by about 5% in intestine and metabolized by about 53% in liver, and that the bioavailability of triflusal after oral administration of triflusal was 0.44, and also that the fraction of total elimination rate of triflusal which formed HTB in liver $(F_{mi},\;%)$ was about 98%. These results showed that triflusal was almost metabolized in liver, and the total elimination of triflusal in the body was dependent to the formation rate of HTB from triflusal in liver.

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Diagnostic Accuracy of CT for Evaluating Circumferential Resection Margin Status in Resectable or Borderline Resectable Pancreatic Head Cancer: A Prospective Study Using Axially Sliced Surgical Pathologic Correlation

  • Ji Hoon Park;Yoo-Seok Yoon;Seungjae Lee;Hae Young Kim;Ho-Seong Han;Jun Suh Lee;Won Chang;Haeryoung Kim;Hee Young Na;Seungyeob Han;Kyoung Ho Lee
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.322-332
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    • 2022
  • Objective: CT plays a central role in determining the resectability of pancreatic cancer, which directs the use of neoadjuvant therapy. This study aimed to assess the diagnostic accuracy of CT in predicting circumferential resection margin (CRM) involvement in patients with resectable or borderline resectable pancreatic head cancer. Materials and Methods: Seventy-seven patients who were scheduled for upfront surgery for resectable or borderline resectable pancreatic head cancer were prospectively enrolled, and 75 patients (38 male and 37 female; mean age ± standard deviation, 68 ± 11 years) were finally analyzed. The CRM status was evaluated separately for the superior mesenteric artery (SMA) and posterior and superior mesenteric vein/portal vein (SMV/PV) margins. Three independent radiologists reviewed the preoperative CT images and evaluated the resection margin status. The reference standard for CRM status was pathologic examination of pancreaticoduodenectomy specimens in an axial plane perpendicular to the axis of the second portion of the duodenum. The diagnostic accuracy of CT was assessed for overall CRM involvement, defined as involvement of the SMA or posterior margins (per-patient analysis), and involvement of each of the three resection margins (per-margin analysis). The data were pooled using a crossed random effects model. Results: Forty patients had pathologically confirmed overall CRM involvement in pancreatic cancer, while CRM involvement was not seen in 35 patients. For overall CRM involvement, the pooled sensitivity and specificity were 15% (95% confidence interval: 7%-49%) and 99% (96%-100%), respectively. For each of the resection margins, the pooled sensitivity and specificity were 14% (9%-54%) and 99% (38%-100%) for the SMA margin, 12% (8%-46%) and 99% (97%-100%) for the posterior margin; and 37% (29%-53%) and 96% (31%-100%) for the SMV/PV margin, respectively. Conclusion: CT showed very high specificity but low sensitivity in predicting pathological CRM involvement in pancreatic cancer.

Characterization of Fatty Acid Digestion of Beijing Fatty and Arbor Acres Chickens

  • Yuan, J.M.;Guo, Y.M.;Yang, Y.;Wang, Z.H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.8
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    • pp.1222-1228
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    • 2007
  • The aim of this experiment was to compare the characterization of fatty acid digestion of Beijing Fatty (BF) and Arbor Acres (AA) chickens. One-day-old male AA and BF chickens were raised in the same house, and fed with the same diet. We first evaluated utilization of dietary fatty acids in chickens by the total collection procedure, and chickens were then killed to compare the abundance of intestinal mRNA expression of liver-fatty acid binding protein (L-FABP) and intestinal-fatty acid binding protein (I-FABP) by Real-time PCR, and also the pH of intestinal mucosa at 3 and 6 weeks of age. Another group of chickens were sampled at 6 weeks of age to compare the total bile acid concentration in serum, and lipase activity in contents of the small intestine. Results showed that compared to AA chickens, BF chickens had higher lipase activity in the content of the small intestine (p<0.05), greater total bile acid content in portal vein blood (p<0.05) at 6 weeks of age, lower intestinal mucosal pH at both 3 weeks (p<0.05) and 6 weeks (p<0.05) of age, and higher abundance of liver-fatty acid binding protein (L-FABP) mRNA expression in intestine tissues at 6 weeks of age (p<0.05), and higher digestibility of fatty acids at both 3 and 6 weeks (p<0.05) of age. There was no difference in I-FABP mRNA expression between AA and BF chickens at either age. Thus, BF chickens had greater fatty acids utilization than AA chickens that was associated with L-FABP, lipase activity, bile acid content and intestinal mucosal pH.

Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma

  • Jo, Soo Yeon;Ryu, Soo Hyung;Kim, Mi Young;Moon, Jeong Seop;Yoon, Won Jae;Kim, Jin Nam
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.155-158
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    • 2016
  • Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

Effect of Thiol-reducing Agents and Antioxidants on Sulfasalazine-induced Hepatic Injury in Normotermic Recirculating Isolated Perfused Rat Liver

  • Heidari, Reza;Esmailie, Neda;Azarpira, Negar;Najibi, Asma;Niknahad, Hossein
    • Toxicological Research
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    • v.32 no.2
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    • pp.133-140
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    • 2016
  • Sulfasalzine is a widely administered drug against inflammatory-based disorders in human. However several cases of liver injury are associated with its administration. There is no stabilized safe protective agent against sulfasalazine-induced liver injury. Current investigation was designed to evaluate if N-acetylcysteine (NAC) and dithioteritol (DTT) as thiol reducing agents and/or vitamins C and E as antioxidants have any protective effects against sulfasalazine-induced hepatic injury in an ex vivo model of isolated rat liver. Rat liver was canulated and perfused via portal vein in a closed recirculating system. Different concentrations of sulfasalazine and/or thiol reductants and antioxidants were administered and markers of organ injury were monitored at different time intervals. It was found that 5 mM of sulfasalazine caused marked liver injury as judged by rise in liver perfusate level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (p < 0.05). A significant amount of lipid peroxidation and hepatic glutathione depletion were detected in drug-treated livers, accompanied with significant histopathological changes of the organ. Administration of NAC ($500{\mu}M$), DTT (${400\mu}M$), Vitamin C ($200{\mu}M$), or vitamin E ($200{\mu}M$) significantly alleviated sulfasalazine-induced hepatic injury in isolated perfused rat liver. The data obtained from current investigation indicate potential therapeutic properties of thiol reductants and antioxidants against sulfasalazine-induced liver injury.

Effect of Phenobarbital on the Metabolite Kinetics of Diltiazem in Rats (랫트에 있어서 딜티아젬의 대사동태에 미치는 페노바르비탈의 효과)

  • Lee, Yong-Bok;Koh, Ik-Bae;Shim, Chang-Koo;Kim, Shin-Keun;Lee, Min-Hwa
    • Journal of Pharmaceutical Investigation
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    • v.22 no.4
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    • pp.301-306
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    • 1992
  • The influence of phenobarbital (PB) pretreatment (75 mg/kg/day, i.p. for 4 days) on the metabolite kinetics of diltiazem (DTZ) was studied in rats in order to elucidate the effect of esterase induced by PB on the formation of DTZ to desacetyldiltiazem (DAD), DAD was injected via portal vein (3 mg/kg) to the control and PB-pretreated rats, The intrinsic hepatic clearance of DAD was significantly increased by PB pretreatment and the absolute bioavailability of DAD was significantly decreased in the PB-pretreated rats. According to the hepatic biotransformation model of DTZ, the fraction of systemic clearance of DTZ which forms DAD $(G_{mi})$ was different from that of DTZ which furnishes the available DAD to the systemic circulation $(F_{mi})$ in control rats. This result shows that DTZ was suspected of the sequential hepatic first-pass metabolism. On the other hand, PB pretreatment enhanced the $G_{mi}$ value of DTZ by 44%. It may be concluded that the deacetylation of DTZ to DAD in rats is increased by the esterase induced by PB but the transfer rate of DAD immediately formed from DTZ into systemic circulation is not affected by PB due to the 27% decreased absolute bioavailability of DAD resulting from PB pretreatment.

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