ABSTRACT
La prevalencia de enfermedades hepáticas a nivel mundial registra cifras alarmantes. Solo la infección por malaria afecta a 500 millones de personas por año a nivel mundial. Enfermedades de etiología viral como hepatitis B y C, contribuyen al aumento de la casuística y por su caracter de patologías de tipo crónico evolucionan a formas severas como la fibrosis o los procesos neoplásicos. La relevancia del hígado como órgano central en la maquinaria metabólica del organismo y como clave partícipe de la respuesta inflamatoria sistémica, indican la necesidad de preservar sus capacidades funcionales.
Subject(s)
Humans , Male , Female , Candida albicans , Hepatocytes/immunology , Liver/immunology , Lymphocytes/immunology , Kupffer Cells/pathologyABSTRACT
OBJETIVO: Avaliação morfológica do fígado e baço de ratos submetidos à oxigenoterapia hiperbárica após a ligadura das veias hepáticas. MÉTODO: Foram utilizados 30 animais machos adultos da espécie Holtzman, distribuídos aleatoriamente em dois grupos de 15 animais cada, assim designados: grupo 1 - ligadura das veias hepáticas; grupo 2 - ligadura das veias hepáticas associada à oxigenoterapia hiperbárica. Todos os animais foram submetidos à anestesia geral por meio de solução contendo cloridrato de cetamina (40 mg/ml) e cloridrato de meperidina (10 mg/ml) na dose de 50 mg/kg/peso, laparotomia mediana e ligadura das veias hepáticas. A oxigenoterapia hiperbárica foi aplicada nos animais do grupo 2, a partir da oitava hora do pós-operatório, por 120 minutos, sendo 90 minutos sob pressão de 2,5 atmosferas e 15 minutos no início e final da terapêutica, para promover a compressão e descompressão gradativa no período de 20 dias consecutivos. No 21° dia de pós-operatório, os animais foram mortos por inalação de éter e submetidos à laparotomia e extirpação dos fígados e baços para exame histológico. Foram comparados os resultados da histologia hepática e esplênica aplicando-se o teste exato de Fisher, considerando-se a diferença significante de P < 0,05. RESULTADOS: Os exames histológicos dos fígados e baços dos animais dos grupos 1 e 2 mostraram as seguintes alterações: presença de trombose nas veias hepática, porta e centro-lobular em cinco (33,3 por cento) animais do grupo 1 e ausência no grupo 2; presença de necrose dos hepatócitos caracterizada como acentuada em sete animais (46,7 por cento) e leve em oito (53,3 por cento) animais do grupo 1, enquanto que, em todos os animais do grupo 2, esta alteração foi caracterizada como leve; presença de células de Kupffer muito proeminentes e hipertrofiadas em 14 (93,3 por cento) animais do grupo 1 e pouco proeminentes e hipertrofiadas em todos os animais do grupo 2; congestão da polpa vermelha considerada acentuada em seis (40 por cento) e moderada em nove (60 por cento) animais do grupo 1 e em todos os animais do grupo 2; hemossiderose moderada ou acentuada em 14 (93,3 por cento) animais do grupo 1 e leve em todos os animais do grupo 2. As análises estatísticas realizadas entre os dois grupos mostraram diferenças significativas em todas a variáveis estudadas (P < 0,05)...
Subject(s)
Animals , Male , Rats , Spleen/anatomy & histology , Hyperbaric Oxygenation , Liver/anatomy & histology , Thrombosis , Rats, Sprague-Dawley , Hepatocytes/pathology , Hemosiderosis , Hepatic Veins , Kupffer Cells/pathology , LigationABSTRACT
Morphological and morphometric studies were conducted under light microscope on paraffin sections (H&E) of liver from controls and experimental rats subjected to repeated heat stress for 4 h/day, at 38 degrees +/- 0.5 degree C (relative humidity 65-82%) for 2-8 consecutive days. The morphometric variables were derived by intersection-point counting method, using simple square lattice test system A100. Twinning of liver cell plates and anisocytosis characterised morphological changes in rats exposed to heat twice. Following five heat exposures, rat liver showed ballooning degeneration of hepatocytes, associated with sinusoidal compression and loss of normal liver cell plate pattern. The degenerative changes in liver parenchyma were more pronounced in rats that underwent eight heat exposures. Despite hepatocytic degeneration, the numerical density of hepatocytes (Nvh) and the volume density of hepatocytes (Vvh) increased with the increase in number of heat exposures, indicating associated heat induced acceleration in hepatocytic proliferation. A successive fall, with increase in the number of heat exposures, in the sinusoidal length density (Jvs) and in the numerical density of Kupffer cells on area (Nak) revealed progressive damage to hepatic-vascular endothelium, which suggest an adverse effect on the immune status of the animals.
Subject(s)
Algorithms , Animals , Body Temperature , Heat Stress Disorders/pathology , Kupffer Cells/pathology , Liver/cytology , Male , RatsABSTRACT
INTRODUCTION: Falciparum malaria occasionally presents with encephalopathy, jaundice and fever mimicking fulminant hepatic failure. PATIENTS: We recently managed seven cases (mean age 34 years, range 20-45; all men) of acute falciparum malaria presenting with a short history [mean duration 8.1 (4-15) days] of fever, jaundice, altered sensorium and oliguria. Only one patient had splenomegaly. Investigations revealed jaundice (bilirubin 1.9-30.7 mg/dl), moderate to severe anaemia (Hb 4-8 gm/dl), increased liver enzymes (2-4 times normal) and azotaemia (serum creatinine 1.6-7.4 mg/dl). Coagulation parameters were deranged in 3 with clinical bleeding in two cases. One patient without a past history of diabetes had increased blood glucose values with ketonuria. HBsAg was negative in all cases. Patients received supportive therapy along with intravenous quinine. Peritoneal dialysis was done in one patient. Three patients showed rapid recovery and four succumbed to the disease. Post-mortem liver biopsy showed Kupffer cell hyperplasia, pigment deposition, foci of steatosis and necrosis along with submassive necrosis in one case. CONCLUSIONS: In areas endemic for malaria, awareness of this entity is a must. In a patient with jaundice and altered sensorium, disproportionate anaemia, azotaemia and only mild elevation of liver enzymes should help differentiate these patients from cases of fulminant hepatic failure. The diagnosis can be confirmed by peripheral blood examination. Early institution of specific therapy may be the only life saving measure in these patients.
Subject(s)
Adult , Antimalarials/therapeutic use , Humans , India/epidemiology , Kupffer Cells/pathology , Liver/pathology , Liver Failure, Acute/etiology , Malaria, Falciparum/complications , MaleABSTRACT
Liver tissues from 17 patients with advanced stages of beta-thal/Hb E disease were examined by light and electron microscopy, with emphasis on cellular damage due to excess iron overload. Various histochemical stains were performed to grade degrees of iron deposition and fibrosis, and to demonstrate hepatitis B surface antigen, in Kupffer cells as well as macrophages. The results of light and electron microscopic studies were correlated. There was a variation in the distribution of hepatic iron and the severity of fibrosis. In most of the cases ballooning degeneration of the hepatocytes, increase in number of lysosomes, hemosiderin and ferritin in hepatocytes as well as in the sinusoidal lining cells were found. The ferro-acidophilic body, representing another important form of hepatocellular necrosis also occurred. So far no precise mechanisms can be concluded.