ABSTRACT
Aims: Currently there is not a single conventional marker to reliably assess liver function recovery after hepatectomy. Our aim was to investigate the potential role of circulating lipid levels as markers of liver function recovery. The study was conducted in the experimental laboratory of the Aretaieion Hospital. Methodology: 48 male Wistar rats (240-350g) were assigned in 2 groups; the sham operated group (A=21) and the 70% hepatectomy group (B=27). There were 3 subgroups according to the day the animals were killed (1st, 3rd and 7th postoperative day [PO]). We measured the levels of AST, ALT, albumin, total protein, triglycerides, HDL and cholesterol in plasma and correlated them with the steps of liver regeneration Results: Significant differences between the groups were observed in the levels of HDL (P=0.001) and cholesterol (P=0.001) on the 1st PO day, and in triglycerides (P=0.045) on the 7th PO day. Conclusion: Cholesterol, and in a lesser degree HDL levels seem to reflect well liver function recovery after hepatectomy. In this experiment they were more sensitive than albumin in assessing the deterioration of liver function as well as the subsequent recovery during regeneration hence they may represent a more accurate marker of liver function. Rise in plasma triglyceride levels reflect the completion of the regenerative process.
ABSTRACT
The gonadal arteries (testicular or ovarian arteries) emerge normally from the lateral aspect of the abdominal aorta, a little inferior to the renal arteries. Several other sites of origin of these arteries have been recorded with the renal and accessory renal arteries being the most common. In the present case report, the testicular arteries originated from the lower polar accessory renal arteries in both sides. The testicular veins followed had the usual origin and course, while an accessory renal vein was observed only in the right side. These anomalies were combined with an abnormal left ureter exiting from the lower pole of the kidney. Only one male cadaver among 77 adult human cadavers of Caucasian origin presented this set of variations (frequency: 1.3%). Variations of renal and gonadal vessels are important, as their presence could result in vascular injury of any accessory or aberrant vessel if the surgeon does not identify them.
Las arterias gonadales (testiculares o ováricas) se originan normalmente de la parte lateral de la parte abdominal de la aorta, distal a las arterias renales. Se han registrado otros lugares de origen de estas arterias, entre ellos, los más comunes en las arterias renales y renales accesorias. En el presente caso, las arterias testiculares se originaron bilateralmente desde las arterias renales polares inferiores accesorias. Las venas testiculares siguieron el origen y curso habitual, mientras que una vena renal accesoria sólo se observó en el lado derecho. Estas anomalías se combinaron con un uréter izquierdo anormal que salía desde el polo inferior del riñón. Sólo un cadáver de sexo masculino, de origen caucásico, entre los 77 cadáveres humanos adultos, presentaba este conjunto de variaciones (frecuencia: 1,3%). Las variaciones de los vasos renales y gonadales son importantes. Su presencia, si el cirujano no los identifica, puede resultar en lesiones vasculares de algún vaso accesorio o aberrante.
Subject(s)
Humans , Adult , Renal Artery/anatomy & histology , Testis/blood supply , Kidney/blood supply , Aorta, Abdominal/anatomy & histology , Arteries/anatomy & histology , Ureter/blood supply , Cadaver , Anatomic VariationABSTRACT
Background & objectives: Ischaemia/reperfusion (I/R) associated with major liver surgery compromises liver function. Ischaemic preconditioning (IPC) may be effective in minimizing hepatic I/R injury. This study aimed to investigate the impact of liver ischaemic manipulations on lipid metabolism in rat during the process of liver recovery after liver surgery. Methods: Sixty three male Wistar rats were assigned to three groups: the sham group, the I/R group which underwent warm ischaemia and reperfusion (I/R), and the IPC group. The animals were subdivided in 3 groups [1st, 3rdand 7th postoperative day (PO)]. Hepatic lipase (HL) and total lipase (TL) activity and the levels of aspartate and alanine transaminases (AST, ALT), triglycerides, HDL and cholesterol were measured in plasma. Results: There was no significant difference in the activity of HL and TL between the groups. Significant higher levels of HDL (P<0.0001) were observed in the IPC group when compared to the other groups on the 3rd PO day. Triglycerides (P<0.0001) and HDL (P=0.003) in the IPC group were higher than the sham group on the 7th PO day while HDL was also higher in the I/R group. Significantly higher cholesterol levels were found in the I/R and IPC groups on the 7th PO day, which were not observed in the sham group. There was a similar curve for triglycerides in the sham and IPC groups while there were significantly higher levels of triglycerides on day 7 for the I/R group. The levels of HDL in the IPC group were higher on the 3rd and 7th PO day, compared to day 1. Interpretation & conclusion: Warm ischaemia and I/R injury do not seem to affect lipolytic enzyme activity after the 1st PO day despite the effects on plasma lipids. IPC seems to prevent accumulation of triglycerides and cholesterol in plasma.