No abstract available.
Human ; Liver/*blood supply/ultrasonography ; Liver Cirrhosis/*pathology ; Microcirculation/ultrasonography

Hepatocellular carcinoma (HCC) remains one of the major public health problems throughout the world. Although originally associated with tumorigenic processes, liver angiogenesis has also been observed in the context of different liver inflammatory, fibrotic, and ischemic conditions. Here we investigate the fractal dimension as a quantitator of non-Euclidean two-dimensional vascular geometry in a series of paired specimens of primary HCC and surrounding non-tumoral tissue, and discuss why this parameter might provide additional information regarding cancer behavior. The application of fractal geometry to the measurement of liver vascularity and the availability of a computer-aided quantitative method can eliminate errors in visual interpretation, and make it possible to obtain closer-to-reality numerals that are compulsory for any measurement process.
Animals ; Biomarkers ; Biomarkers, Tumor ; Biomechanical Phenomena ; Carcinoma, Hepatocellular ; blood supply ; pathology ; Humans ; Liver ; blood supply ; Liver Neoplasms ; blood supply ; pathology ; Neovascularization, Pathologic ; pathology

OBJECTIVEThe purpose of this study was to compare MRI findings of solitary hypovascular hepatic nodules, benign and malignant, to identify their MRI characteristics.

METHODSWe retrospectively assessed solitary hypovascular hepatic nodules ≤ 3 cm in 135 patients, among them there were 55 malignant nodules [29 peripheral nodules of cholangiocarcinoma, PCC, and 26 hepatic metastases, HM] and 80 benign nodules [48 inflammatory myofibroblastic tumors, IMT, and 32 hepatic hemangioma, HG], proved by surgery, biopsy or follow-up imaging. Unenhanced and dynamic enhanced MRI findings of the 135 patients were analyzed retrospectively. Statistical analysis included Chi-square test or Fisher's exact test, and receiver operating characteristic (ROC) curve.

RESULTSThere was significant difference (P < 0.05) between the malignant group and benign group in terms of location, margin, T2WI signal intensity, heterogeneity or homogeneity of the nodule, and type and degree of peritumoral and intratumoral enhancement. Area under the curve at the first film reading by three radiologists was 0.678 ± 0.047, 0.920 ± 0.022 at the second time, and there was a significant difference (Z = 5.22, P < 0.05) between them.

CONCLUSIONSOur data indicated that solitary hypovascular hepatic nodules show unenhanced and dynamic enhanced MRI features. Therefore, MR imaging combined with clinical and biochemical data does provide reliable information for a proper diagnosis of such hepatic lesions and differentiation of malignant from benign nodules.

Cholangiocarcinoma ; pathology ; Diagnosis, Differential ; Hemangioma ; pathology ; Humans ; Liver ; blood supply ; pathology ; Liver Neoplasms ; blood supply ; pathology ; Magnetic Resonance Imaging ; ROC Curve ; Retrospective Studies

Although reports of hypoplasia or absence of the liver of left lobe are not few, descriptions of the intrahepatic vessels are rare but valuable for discussion of the pathogenesis. The present report demonstrates a case of the left surgical lobe hypoplasia that is characterized by 1) the scar-like lobe with few parenchymal tissue and dilated bile ducts, 2) no Spiegel's lobe with the portal vein stuck to the inferior vena cava, 3) unusual configurations of the right hepatic vein and the 8th segmental portal vein branch, 4) the hepatic groove on S8, and 5) the trifurcation pattern of the portal vein primary division. According to the macroscopic and histological observations, we hypothesized that the secondary abnormal peritoneal fusion occurred in utero and/or during the postnatal growth, and that it involved the left portal vein and other adjacent structures, resulting in severe atrophy of the left surgical lobe.
Cadaver ; Female ; Human ; Korea ; Liver/*blood supply/*pathology ; Middle Aged ; Peritoneum/pathology ; Portal Vein/*pathology

In acute injury, liver recovers completely without any scarring change or complication. However, large portion of liver is changed into fibrotic state by excessive production of extracellular matrix (ECM) under chronic injury. Excessive production of ECM results in hepatic fibrosis and repeated process of hepatic fibrosis progress into liver cirrhosis. Liver cirrhosis is an irreversible and terminal state of chronic liver disease and one of the major causes of death in Korea. To block the progression to liver cirrhosis, various studies in the field of virology and immunology have been proceeded. Recently, studies on the hepatic fibrogenesis have progressed with the development of molecular biology. Hepatic stellate cells (HSC) play a key role in the pathogenesis of hepatic fibrosis by producing ECM. The degree of hepatic fibrosis depends on the proliferation and activation of HSC and increased net production of collagen. Therefore, inhibition of HSC activation is one of the main ways to block the progression of hepatic fibrosis. Many kinds of factors such as oxidative stress, acetaldehyde, ascorbic acid, transforming growth factor-beta (TGF-beta) and carbon tetrachloride (CCl4) have been reported to activate HSC and stimulate collagen gene expression. Although there are no definite and effective antifibrogenic agents, possible candidates are antioxidants, interferon, retinoids such as beta-carotene, flavonoids, renin-angiotensin system inhibitors and peroxisome proliferator activated receptor-gamma (PPAR-gamma) agonists. We tried to evaluate the charateristics of HSC in order to develop agents that inhibit hepatic fibrogenesis.
Extracellular Matrix/*metabolism ; Fibrosis ; Humans ; Liver/blood supply/metabolism/*pathology ; Liver Cirrhosis/etiology/genetics/*metabolism

No abstract available.
Animals ; Chronic Disease ; Endothelium, Vascular/*ultrasonography ; Human ; Liver/*blood supply ; Liver Diseases/*pathology ; Microcirculation/ultrasonography ; Rats

No abstract available.
Extracellular Matrix/*metabolism ; Fibrosis ; Humans ; Liver/blood supply/metabolism/*pathology ; Liver Cirrhosis/etiology/genetics/*metabolism

OBJECTIVETo investigate the anatomical variations of donor hepatic artery and explore the measures that can be taken to avoid accidental hepatic artery injury during graft procurement and reconstruction.

METHODSThe data of totally 843 consecutive patients undergoing orthotopic liver transplantation (OLT) during the period from April 2001 to July 2006 was reviewed in relation to anatomical variation of the donor hepatic arteries. The variations of the hepatic artery, the relationship between the anomalous hepatic artery and accidental injury of the hepatic artery were analyzed.

RESULTSIn the 843 cases of OLT, the total anatomical variation rate of the donor hepatic arteries was 20.4% (172/843). The common variations included replaced or accessory right hepatic arteries originated from superior mesenteric artery (6.67%, 57/843), replaced or accessory left hepatic arteries originated from the left gastric artery (6.41%, 54/843) or from the celiac trunk and gastro-duodenal artery (1.66%, 14/843), replaced or accessory right hepatic arteries originated from the celiac trunk, common hepatic artery and gastro-duodenal artery (1.54%,13/843), replaced or accessory right hepatic arteries and left hepatic arteries coexistence (0.83%, 7/843), variation of the common hepatic artery from the superior mesenteric artery (1.54%, 13/843) or from the abdominal aorta (0.95%, 8/843).

CONCLUSIONDuring graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can be a common clinical entity. Acquaintance with hepatic arterial variation and maintenance of the integrity of the superior mesenteric artery and celiac trunk are key to reducing potential hepatic artery injuries.

Arteries ; anatomy & histology ; pathology ; Humans ; Liver ; blood supply ; Liver Transplantation ; adverse effects ; Retrospective Studies

AIMTo investigate the protective effect of exogenous carbon monoxide (CO) on the liver injury induced by ischemia/reperfusion (I/R) of hind limbs in rats.

METHODS100 SD rats were divided randomly into sham operated group (S), S+ CO group (SC), I/R group (I/R), I/ R+ CO group (RC). A rat model of ischemia in hind limbs and the reperfusion liver injury was established with the occlusion of the femoral arteries for 4 h and re-opening for 6 - 72 h, 10 d. The rats in SC and RC groups were exposed to air containing CO (the volume traction of CO: 0.05%) for 2 h before and after reperfusion or the corresponding control time point, while the other two groups were exposed to the routine air. The pathologic changes of liver tissue were morphologically observed by HE stain. Serum GPT activity was tested by Automatic Biochemical Analyzer. The percentage of apoptosis, expression levels of bax and bcl-2 protein in liver tissue were detected by Flow Cytometry.

RESULTSThere was no difference between S and SC groups. Compared with SC group: (1) Pathological changes in liver tissue were significant in I/R and RC groups. (2) The serum GPT activity of I/R and RC groups was obviously increased. (3) In IR and RC groups, the percentage of apoptosis in liver tissue was all significantly increased. (4) The bax expression level was significantly increased. Compared RC group with I/R group: (1) Pathological change was slight. (2) The serum GPT activity was depressed. (3) The percentage of apoptosis and expression level of bax protein in liver tissue were depressed. (4) The expression level of bcl-2 protein in liver tissue was increased.

CONCLUSIONExogenous CO could attenuate liver tissue injury induced by limbs I/R in rats.

Animals ; Carbon Monoxide ; pharmacology ; Extremities ; blood supply ; Female ; Liver ; blood supply ; pathology ; Liver Diseases ; etiology ; pathology ; prevention & control ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; complications ; prevention & control

OBJECTIVETo analyze the origin of the feeding artery of the retroperitoneal invasion caused by massive hepatocellular carcinoma (HCC) and the characteristics of DSA. To explore the approaches to completely embolize the tumor blood supply and to assess the technical success rates, the safety and effectiveness with a purpose of improving the patients survival rates and living quality.

METHODSAfter complete ultraselective arterial embolization via hepatic artery for the 75 patients with retroperitoneal invasion led by massive HCC, those showing lipiodol deposition inconsistance compared with CT or MRI underwent the ultraselective catheterization to find potential tumor feeding arteries and then the subsequent chemoembolization. 3-6 months after operation CT or MRI was used to evaluate the efficacy. RETURNS: Retroperitoneal lesions were supplied by the posterior branch of right inferior phrenic artery (64%, 48/75), the right adrenal artery (33.3%, 25/75) and the right-side first lumbar artery (2.7%, 2/75), respectively. The success rates of ultraselective catheterization to tumor feed arteries was 100% (75/75). 3-6 months after embolization, the cases of complete and most-part iodine oil filling in the lesions were 72 (96%) and 3 (4%) respectively. The sizes of the lesions showed significant reduce (55, 73.3%), reduce (15, 20%) and no change (5,6.7%). Survival rates of 6, 12, 24 and 36 months after TACE were 90.7% (68/75), 81.3% (61/75), 49.3% (37/75) and 40% (30/75) respectively.

CONCLUSIONThe supply arteries of retroperitoneal invasion led by massive HCC come from the posterior branch of right phrenic artery, the right adrenal artery and the right first lumbar artery. Ultraselective TACE has high technical success rates, hight safety, and excellent effectiveness. The complete embolization of tumor feed artery can significantly increase the survival rates and living quality of these patients.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; blood supply ; pathology ; therapy ; Chemoembolization, Therapeutic ; Female ; Humans ; Liver Neoplasms ; blood supply ; pathology ; therapy ; Male ; Middle Aged ; Peritoneum ; pathology