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Qihong Ni, Haolu Wang, Yunhe Zhang, Lijun Qian, Jiachang Chi, Xiaowen Liang, Tao Chen, Jian Wang
PURPOSE: The purpose of this study is to investigate the value of multidetector computed tomography (MDCT) assessment of resectability in hilar cholangiocarcinoma, and to identify the factors associated with unresectability and accurate evaluation of resectability. METHODS: From January 2007 to June 2015, a total of 77 consecutive patients were included. All patients had preoperative MDCT (with MPR and MinIP) and surgical treatment, and were pathologically proven with hilar cholangiocarcinoma...
October 21, 2016: Abdominal Radiology
Kenneth Eng Ling Kwan, Vishalkumar G Shelat, Cher Heng Tan
Recurrent pyogenic cholangitis (RPC) is an infective process involving the biliary tree typified by pigmented intraductal calculi with dilatation of the intra- and extrahepatic biliary tree. Previously endemic to South-east Asia, RPC can now be seen in Western countries with the increasing access to international travel and immigration. Affected patients are often plagued by recurrent bouts of cholangitis, and commonly suffer from complications such as abscess formation and biliary strictures. In severe cases, cirrhosis with portal hypertension may develop...
October 21, 2016: Abdominal Radiology
Manuel Guerrero-Hernandez, Carlos A Hinojosa, Javier E Anaya-Ayala, Erika Elenes, Aldo Torre
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV...
October 20, 2016: Vascular and Endovascular Surgery
Pim B Olthof, Michal Heger, Krijn P van Lienden, Kora de Bruin, Roelof J Bennink, Thomas M van Gulik
BACKGROUND: Portal vein embolization is the gold standard approach to preoperatively enhance the future liver remnant before liver resection. Portal vein embolization is studied in several experimental animal models; however, clinical translation of results is often difficult. We aimed to examine the translational value of the portal vein embolization response in a standardized rabbit model by comparing the volume and function increase with the response seen in patients. METHODS: Six rabbits were subjected to embolization of the cranial liver lobes, and the hypertrophy response of the caudal liver lobe was studied using computed tomography volumetry and Technetium-99m-labeled-mebrofenin hepatobiliary scintigraphy...
October 18, 2016: Surgery
Jolanda van Hengel, Celine Van den Broeke, Tim Pieters, Louis Libbrecht, Ilse Hofmann, Frans van Roy
p120 catenin (p120ctn) is required for the stability of classic cadherins at the cell surface and is thought to play a central role in modulating cell-cell adhesion. Cytoplasmic p120ctn promotes cell motility, and probably other activities, by modulating the activities of RhoA, Rac and Cdc42. E-cadherin is expressed in periportal but not in perivenous hepatocytes. In contrast, all hepatocytes of normal mouse liver express N-cadherin. Cholangiocytes express exclusively E-cadherin. Mice with p120ctn ablation in hepatocytes and cholangiocytes (p120LiKO mice) were generated by Cre-loxP technology...
October 15, 2016: European Journal of Cell Biology
Yongxia Zhao, Yanmin Wu, Ziwei Zuo, Hongna Suo, Sisi Zhao, Jun Han, Xian Chang, Shujie Cheng
OBJECTIVE: To investigate the effect of low-concentration contrast medium on spectral computed tomography (CT) image quality for portal venography CT. METHODS: 150 patients with suspected portal diseases were divided into three groups and had spectral CT examination using a GE Discovery CT 750 HD scanner. The patients in three groups were injected with different concentrations of iodine (350 mgI/mL, 315 mgI/mL and 280 mgI/mL) at an injection rate of 4.0-5...
October 21, 2016: Journal of X-ray Science and Technology
N Platz Batista da Silva, M Schauer, M Hornung, S Lang, L P Beyer, I Wiesinger, C Stroszczynski, E M Jung
OBJECTIVE: To evaluate the efficacy of strain elastography (SE) using semi-quantitative measurement methods compared to constrast enhanced ultrasound during liver tumor surgery (Io-CEUS) for dignity assessment of focal liver lesions(FLL). MATERIAL AND METHODS: Prospective data acquisition and retrospective analysis of US data of 100 patients (116 lesions) who underwent liver tumor surgery between 10/2010 and 03/2016. Retrospective reading of SE color patterns was performed establishing groups depending on dominant color (>50% blue = stiff, inhomogenous, >50% yellow/red/green = soft tissue)...
October 20, 2016: Clinical Hemorheology and Microcirculation
Satoshi Ogiso, Kentaro Yasuchika, Ken Fukumitsu, Takamichi Ishii, Hidenobu Kojima, Yuya Miyauchi, Ryoya Yamaoka, Junji Komori, Hokahiro Katayama, Takayuki Kawai, Elena Yukie Yoshitoshi, Sadahiko Kita, Katsutaro Yasuda, Shinji Uemoto
A whole-organ regeneration approach, using a decellularised xenogeneic liver as a scaffold for the construction of a transplantable liver was recently reported. Deriving suitable scaffolds was the first step towards clinical application; however, effective recellularisation remains to be achieved. This report presents a strategy for the improvement of the recellularisation process, using novel cell-seeding technique and cell source. We evaluated recellularised liver grafts repopulated through the portal vein or the biliary duct with mice adult hepatocytes or E14...
October 21, 2016: Scientific Reports
Ameya S Joshi, Ashok R Mohite, Premlata K Varthakavi, Pravin M Rathi
Alstrom syndrome is an autosomal recessive multisystem disorder caused by mutation in ALMS1 (2p13). Very few cases of same are reported so far of same. We report a case of Alstrom syndrome (AS) who presented with type II diabetes mellitus and portal hypertension. Unilateral anorchia with hypergonadotropic hypogonadism is another unique feature of our case.
October 2016: Journal of the Association of Physicians of India
Martin de Santibañes, Luis Boccalatte, Eduardo de Santibañes
Recently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) emerged as a novel surgical strategy to induce a rapid and large hypertrophy of the future liver remnant (FLR). We conducted a computerized search using PubMed and Google Scholar for reports published between March 2012 and July 2016 using mesh headings and key words relating to the ALPPS surgical procedure. The promising results obtained up to date are difficult to interpret due to the heterogeneous group of patients with different underlying pathologies and different chemotherapy schemes...
October 20, 2016: Updates in Surgery
Stefano Fiorucci, Angela Zampella, Giuseppe Cirino, Mariarosaria Bucci, Eleonora Distrutti
Bile acids are end product of cholesterol metabolism generated in the liver and released in the intestine. In addition to their role in nutrient absorption, bile acids are increasingly recognized as regulatory signals which exert their function beyond the intestine by activating a network of membrane and nuclear receptors. The best characterized of these bile acid activated receptors, GPBAR1 (also known as TGR5) and the Farnesosid-x-receptor (FXR) have also been detected in the vascular system and their activation mediate the vasodilatory effects of bile acids in the systemic and splanchnic circulation...
October 7, 2016: American Journal of Physiology. Heart and Circulatory Physiology
B Franko, P Fournier, T Jouve, P Malvezzi, I Pelloux, J P Brion, P Pavese
OBJECTIVE: Lactobacillus bacteremia is a rare event and its epidemiology is poorly known. Whether Lactobacillus bacteremia is a contaminant, a risk factor, or a risk marker of death remains an open question. PATIENTS AND METHODS: We conducted a retrospective study of patients presenting with Lactobacillus bacteremia (LB), between January 2005 and December 2014, at the Grenoble University Hospital. RESULTS: LB was observed in 38 patients (0...
October 17, 2016: Médecine et Maladies Infectieuses
Wubing He, Lihong Chen, Lin Zheng, Liuping Luo, Lingyun Gao
BACKGROUND: Dendritic cells (DCs) and regulatory T (Treg) cells are crucial for inducing immune tolerance. However, the suppressive function of infused Treg cells and immature DCs (imDCs) following solid organ transplantation remains unclear. METHODS: ImDCs derived from DA-donor rats and Treg cells isolated from spleens of Lewis rats were prepared. A heterotopic liver transplantation model was established to examine the immune tolerance effects of infusion of Treg-imDCs, imDCs and Treg cells individually...
October 17, 2016: Molecular Immunology
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
James A St John
No abstract text is available yet for this article.
October 20, 2016: Virulence
Lee M Bass, Stanley Kim, Riccardo Superina, Saeed Mohammad
Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2...
October 20, 2016: Pediatric Transplantation
Ernesto Sparrelid, Stefan Gilg, Torkel B Brismar, Lars Lundell, Bengt Isaksson
PURPOSE: The aim of this study was to investigate whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can be used as an effective and safe rescue procedure in patients with colorectal liver metastases (CRLM) and insufficient effect on the future liver remnant (FLR) after previous portal vein occlusion (PVO). METHODS: Eleven patients with bilobar CRLM treated with neoadjuvant chemotherapy and previous PVO with insufficient effect on the FLR were analyzed retrospectively from a prospective database...
October 19, 2016: Langenbeck's Archives of Surgery
Jian-Hong Zhong, Guido Torzilli, Hao Xing, Chao Li, Jun Han, Lei Liang, Han Zhang, Shu-Yang Dai, Le-Qun Li, Feng Shen, Tian Yang
Symptoms of early hepatocellular carcinoma (HCC) often go unnoticed, so more than half of patients with primary HCC are diagnosed after their disease has already reached an intermediate or advanced stage, or after portal hypertension has appeared. While hepatic resection is widely recognized as a first-line therapy to treat very early or early HCC, its use in treating intermediate or advanced HCC or HCC involving portal hypertension remains controversial. Here we review PubMed-indexed literature covering the use of hepatic resection for such patients...
December 2016: BBA Clinical
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
Jeffrey Gnerre, Yankai Sun, Andrzej Jedynak, Anthony Gilet
Gallbladder varices are a rare form of collateralization that develop in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen and confirmed by Color Doppler Sonography. A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis due to tumor extension during the course of treatment and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy...
May 2016: Journal of Radiology Case Reports
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