Sonographic and Anatomical Evaluation of the Liver and Portal Vein Reference Values / Evaluación Ecográfica y Anatómica de los Valores de Referencia del Hígado y la Vena Porta

SUMMARY: This paper's aim is a morphometric evaluation of liver and portal vein morphometry using ultrasonography in healthy Turkish population. This study was carried out with 189 subjects (107 females, 82 males). The demographic data and the body surface area were calculated. The longitudinal axis of the liver for two lobes, diagonal axis or liver span, anteroposterior diameter of the liver and portal vein, portal vein transverse diameter, caudate lobe anteroposterior diameter, and portal vein internal diameters as well as longitudinal liver scans in an aortic plane, sagittal plane, transverse plane, and kidney axis were measured. All measurements were analyzed according to age, sex, body mass index, obesity and alcohol consumption. The mean values of the age, height, weight and body mass index were calculated as 44.39 years, 167.05 cm, 74.23 kg, and 27.06kg/m2 in females, respectively. The same values were 44.13 years, 167.70 cm, 75.93 kg and 26.71 kg/m2 in males, respectively. There was significant difference between demographic characteristics, gender, and alcohol consumption in terms of anteroposterior diameter of the liver, portal vein transverse diameter of the right side and liver transverse scan. Also, some measurements including portal vein transverse diameter, liver transverse scan and at kidney axis longitudinal scan of liver showed significant difference between the age groups. There was significant difference in diagonal axis and anteroposterior diameter of liver, portal vein internal diameter, and longitudinal liver scans of the aortic plane parameters between obesity situation. The findings obtained will provide important and useful reference values as it may determine some abnormalities related liver diseases. Also, age, sex, obesity and body mass index values can be effective in the liver and portal vein morphometry related parameters.

El objetivo de este artículo fue realizar una evaluación de la morfometría del hígado y la vena porta mediante ecografía en una población turca sana. Este estudio se llevó a cabo en 189 sujetos (107 mujeres, 82 hombres). Se calcularon los datos demográficos y la superficie corporal. Se midió eleje longitudinal del de dos lóbulos del hígado, el eje diagonal o la extensión del hígado, los diámetros anteroposterior del hígado y de la vena porta, el diámetro transversal de la vena porta, anteroposterior del lóbulo caudado y los diámetros internos de la vena porta, así como las exploraciones longitudinales del hígado en un plano aórtico. Se midieron el plano sagital, el plano transversal y el eje del riñón. Todas las mediciones se analizaron según edad, sexo, índice de masa corporal, obesidad y consumo de alcohol. Los valores medios de edad, talla, peso e índice de masa corporal se calcularon como 44,39 años, 167,05 cm, 74,23 kg y 27,06 kg/m2 en las mujeres, respectivamente. Las mismas variable fueron 44,13 años, 167,70 cm, 75,93 kg y 26,71 kg/m2. Hubo diferencias significativas entre las características demográficas, el sexo y el consumo de alcohol en términos de diámetro anteroposterior del hígado, diámetro transversal de la vena porta del lado derecho y exploración transversal del hígado. Además, algunas mediciones, incluido el diámetro transversal de la vena porta, la exploración transversal del hígado y la exploración longitudinal del hígado en el eje del riñón, mostraron diferencias significativas entre los grupos de edad. Hubo diferencias significativas en el eje diagonal y el diámetro anteroposterior del hígado, el diámetro interno de la vena porta y los parámetros de las exploraciones hepáticas longitudinales del plano aórtico entre situaciones de obesidad. Los hallazgos obtenidos proporcionarán valores de referencia importantes y útiles ya que pueden determinar algunas anomalías relacionadas con enfermedades hepáticas. Además, los valores de edad, sexo, obesidad e índice de masa corporal pueden ser eficaces en los parámetros relacionados con la morfometría del hígado y la vena porta.

Alterations of serum biochemical parameters and tyrosine phosphorylation in kidney and liver of chronic stress-induced rats / Alterações dos parâmetros bioquímicos séricos e fosforilação da tirosina em rim e fígado de ratos induzidos por estresse crônico

Chronic stress (CS) can contribute to dysfunction in several organs including liver and kidney. This study was performed to investigate the changes in serum biochemistry, histological structure, as well as in localization of tyrosine phosphorylated proteins (TyrPho) and Heat shock protein 70 (Hsp-70) in liver and kidney tissues of CS rats induced by two stressors (restrained and force swimming) for 60 consecutive days. Samples of blood, liver, and kidney were collected from adult male Sprague-Dawley rats in each group. Our results showed that serum biochemical parameters including corticosterone, blood sugar, urea nitrogen, creatinine, cholesterol, triglyceride, HDL-C, LDL-C, ALT, AST, alkaline phosphatase in CS group were significantly different from that in normal group in both liver and kidney tissues. Although histological structure was not changed. TyrPho expression was significantly increased in liver lysate but significantly decreased in kidney. Hsp-70 expression in liver increased whereas in kidney decreased. In conclusion, CS can induce changes in liver and kidney functions.

O estresse crônico (SC) pode contribuir para a disfunção em vários órgãos, incluindo fígado e rim. Este estudo foi realizado para investigar as alterações na bioquímica sérica, estrutura histológica, bem como na localização de proteínas tirosina fosforiladas (TyrPho) e proteína de choque térmico 70 (Hsp-70) em tecidos hepáticos e renais de ratos CS induzidas por dois estressores (restrito e natação forçada) por 60 dias consecutivos. Amostras de sangue, fígado e rim foram coletadas de ratos Sprague-Dawley machos adultos em cada grupo. Nossos resultados mostraram que os parâmetros bioquímicos séricos, incluindo corticosterona, glicemia, nitrogênio ureico, creatinina, colesterol, triglicerídeos, HDL-C, LDL-C, ALT, AST, fosfatase alcalina no grupo CS foram significativamente diferentes do grupo normal em ambos os fígados e tecidos renais. Embora a estrutura histológica não tenha sido alterada, a expressão de TyrPho aumentou significativamente no lisado hepático, mas diminuiu significativamente no rim. A expressão de Hsp-70 no fígado aumentou, enquanto que no rim diminuiu. Em conclusão, a CS pode induzir alterações nas funções hepáticas e renais.

Liver Size and its Correlation with Anthropometric Parameters and Age / El Tamaño del Hígado y su Correlación con los Parámetros Antropométricos y la Edad

SUMMARY: The liver has over 500 physiological and biochemical roles in our organism so checking of liver size and function is a part of every clinical examination. Aim of our research was to estimate liver size on computed tomography (CT) of the abdomen images and to determinate relations between liver dimensions and anthropometric parameters. The research included 99 patients, 49 men and 50 women, who were referred for CT of abdomen. We measured body height (BH) and body mass (BM), and calculated body mass index (BMI) and body surface area (BSA). Also, on CT images we measured anteroposterior (AP), laterolateral (LL) and two craniocaudal liver diameters (one at the level of midclavicular line - CCmcl, and the other was maximal - CCmax). Liver volume (LV) was calculated with formula. Our results showed that AP diameter positively correlated with BSA (r=0.30) in women. LL diameter positively correlated with BH (r=0.43), and BSA (0.31) in men. CCmcl diameter positively correlated with BH (r=0.33), BM (r=0.31), and BSA (r=0.34) in men, while in women it correlated only with BH (r=0.38). CCmax diameter positively correlated with BH (r=0.33) and BSA (r=0.33) in men. LV positively correlated with BH and BSA in both men (r=0.36, r=0.33, respectively) and women (r=0.42, r=0.31, respectively), and in men also with BM (r=0.34). LL, CCmcl, CCmax, and LV negatively correlated with aging in both sexes After the age of 60, there was a decrease in size of LL, CC diameters, as well as in LV. We concluded that liver dimensions decrease with aging, regardless of sex at the expanse of LL and CC diameters which are related to the size of body parameters, so that for a precise evaluation of liver size all three diameters should be measured, LV as well as BH, BM, and BSA.

El hígado desempeña más de 500 funciones fisiológicas y bioquímicas en nuestro organismo, por lo que comprobar el tamaño y la función de este órgano es parte de cada examen clínico. El objetivo de nuestra investigación fue estimar el tamaño del hígado mediante tomografía computarizada (TC) de imágenes del abdomen y determinar las relaciones entre las dimensiones del hígado y los parámetros antropométricos. La investigación incluyó a 99 pacientes, 49 hombres y 50 mujeres, que fueron remitidos para TC de abdomen. Medimos la altura corporal (BH) y la masa corporal (BM), y calculamos el índice de masa corporal (IMC) y el área de superficie corporal (BSA). Además, en las imágenes de TC medimos los diámetros hepáticos anteroposterior (AP), laterolateral (LL) y dos craneocaudales (uno a nivel de la línea medioclavicular - CCmcl, y el diámetro máximo - CCmax). El volumen del hígado (VI) se calculó con una fórmula. Nuestros resultados mostraron que el diámetro AP se correlacionó positivamente con BSA (r = 0,30) en mujeres. El diámetro de LL se correlacionó positivamente con BH (r=0,43) y BSA (0,31) en hombres. El diámetro CCmcl se correlacionó positivamente con BH (r=0,33), BM (r=0,31) y BSA (r=0,34) en hombres, mientras que en mujeres se correlacionó solo con BH (r=0,38). El diámetro CCmax se correlacionó positivamente con BH (r=0,33) y BSA (r=0,33) en hombres. El VI se correlacionó positivamente con BH y BSA tanto en hombres (r=0,36, r=0,33, respectivamente) como en mujeres (r=0,42, r=0,31, respectivamente), y en hombres también con BM (r=0,34). LL, CCmcl, CCmax y LV se correlacionaron negativamente con el envejecimiento en ambos sexos. Después de los 60 años, hubo una disminución en el tamaño de los diámetros LL, CC y LV. Concluimos que las dimensiones del hígado disminuyen con la edad, independientemente del sexo, en la extensión de los diámetros LL y CC que están relacionados con el tamaño de los parámetros corporales, por lo que para una evaluación precisa del tamaño del hígado se debe medir LV como BH, BM y BSA.

Histomorphological, Histochemical and Ultrastructural Studies on the Healthy Liver of Yemen Veiled Chameleon (Chamaeleo calyptratus) in Southern Saudi Arabia / Estudios Histomorfológicos, Histoquímicos y Ultraestructurales en el Hígado Sano del Camaleón Velado de Yemen (Chamaeleo calyptratus) en el Sur de Arabia Saudita

SUMMARY: The livers of reptiles are being studied as a model for the link between the environment and hepatic tissue. There have been few investigations on the histology of reptile livers, and very few or no studies have examined the histology of liver of veiled chameleon (Chamaeleo calyptratus). This paper describes the histomorphological, histochemical and ultrastructural characterization of the liver of veiled chameleons in southern Saudi Arabia. Seven Chamaeleo calyptratus were captured in the summer season in Abha City, Aseer region, southern Saudi Arabia. Chamaeleon liver samples were processed for histomorphology, histochemistry and ultrastructure analyses. Morphologically liver of Chamaeleo calyptratus was observed as a large dark brown organ with lighter speckles, which represent melanin deposits. It located at the ventral part of abdominal cavity forward of the stomach. Its dimensions approximately were 3.7 x 2 cm. The liver was a bilobed organ divided into two lobes, right and left lobes. The right one was bigger than the others. The gallbladder was well developed and had an elongated shape, situated between the two lobes and contained the bile for the digestion. Microscopically, the liver was found to be covered by a thick layer of connective tissue, which formed the hepatic capsule. Hepatic parenchyma probably appeared in cross sections as hepatic glandular-like alveoli "acini" or follicular structures with various diameters, each acinus contains approximately four to six hepatocytes, surrounded by sinusoidal capillaries filled with abundant melanomacrophages, which are absent in birds and mammals. Melanomacrophages are common in the hepatic parenchyma's perisinusoidal areas, particularly near portal spaces. Hepatocytes are polyhedral or pyramidal with and mostly contained large, rounded nuclei mostly peripherally located, with prominent dark oval nucleoli. Some of nuclei are eccentric or central position. The cytoplasm appeared spongy or vacuolated and more eosinophilic when stained by hematoxylin-eosin and strongly reactive to PAS staining technique, indicating abundant glycogen content. The reticular fibers that surround hepatocytes, blood arteries, and sinusoids supported the hepatic parenchyma. The blood sinusoids are seen interspersed among hepatocytes of varying sizes. The sinusoidal lumen was bordered by flattened endothelial cells and includes elliptical nucleated erythrocytes and liver macrophages as phagocytes, which are also known as Kupffer cells. Branches of the portal vein, hepatic artery, small bile duct, and lymph vessels were detected in the hepatic portal area "tract" or triad which made up of connective. Hematopoietic tissue was observed in subcapsular region and portal triads. Ultrastructurally, the hepatocyte appeared polyhedric containing a single large rounded basal or eccentric vesicular nucleus with prominent nucleolus. Extensive network of rough endoplasmic reticulum (RER) often arranged in an array parallel to the nuclear membrane with many mitochondria, and Golgi apparatus were described. The cytoplasm contained glycogen granules, vesicles or vacuoles scattered throughout the cytoplasm especially at the apical region were reported. The bile canaliculi and the hepatic "Kupffer" cells were also discussed. This is the first study on the histological characterization of the healthy liver of Yemen veiled chameleon in southern Saudi Arabia. The findings reported here should be used as a reference to compare with the pathological abnormalities of the liver in this animal.

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Anatomical and histological traits of Brycon amazonicus liver cultivated in a semi-intensive system / Características anatômicas e histológicas do fígado de Brycon amazonicus cultivado em sistema semi-intensivo

The work aimed to evaluate the weight-length relationship and the condition factor, characterizing the biometry, anatomy, histology and volumetric density of the liver of Brycon amazonicus, in different stages of body growth. The experiment used twenty specimens in four stages of body growth (PI, PII, PIII and PIV) harvested every 90 days, containing five specimens, each group. The livers were dissected, weighed (g) and processed routinely using the hematoxylin and eosin technique. The data were submitted to analysis of variance, Pearson's correlation test and linear regression. The equation that represented the weight-length relation was W = 0.05902 x L2.63, with negative allometric growth, but with a relative condition factor equal to 1.0. The liver was divided into three lobes with the gallbladder close to the right lobe and its color varied from light red to dark red, not varying in relation to other fish species. The hepatosomatic relationship followed body growth until the PII group stage and then declined, demonstrating the behavior of its development in Brycon amazonicus. The organ consists predominantly of hepatocytes, followed by sinusoidal vessels and capillaries, with histological morphology similar to that of many species of fish. Melanomacrophage centers were found only in the most developed animals, but in small quantities, prompting the development of new research on this cell, in this species. In this way, research of this nature allows the characterization of fish species, helping to improve breeding methods, understanding pathological processes caused by diseases, and obtaining better productive capacity, serving an increasingly demanding and prosperous market.

O trabalho objetivou avaliar a relação peso-comprimento e o fator de condição, caracterizando a biometria, anatomia, histologia e densidade volumétrica do fígado de Brycon amazonicus, em diferentes estágios de crescimento corporal. O experimento utilizou vinte espécimes em quatro fases de crescimento corporal (PI, PII, PIII e PIV) colhidos a cada 90 dias, contendo cinco espécimes, cada grupo. Os fígados foram dissecados, pesados (g) e processados rotineiramente pela técnica da hematoxilina e eosina. Os dados foram submetidos à análise de variância, teste de correlação de Pearson e regressão linear. A equação que representou a relação peso-comprimento foi W = 0,05902 x L2,63, com crescimento alométrico negativo, mas com fator de condição relativo igual a 1,0. O fígado apresentou-se dividido em três lobos com a vesícula biliar próxima ao lobo direito e sua cor variou de vermelho claro a vermelho escuro, não variando em relação a outras espécies de peixes. A relação hepatossomática acompanhou o crescimento corporal até a fase do grupo PII e então declinou, demonstrando o comportamento de seu desenvolvimento em Brycon amazonicus. O órgão constitui-se predominantemente por hepatócitos, seguido de vasos e capilares sinusoidais, com a morfologia histológica semelhante ao de muitas espécies de peixes. Centros melanomacrófagos foram encontrados apenas nos animais mais desenvolvidos, mas em pequena quantidade, instigando o desenvolvimento de novas pesquisas sobre esta célula, nesta espécie. Desta forma, pesquisas desta natureza permitem a caracterização de espécies de peixes, auxiliando no aperfeiçoamento de métodos de criação, compreensão de processos patológicos provocados por enfermidades, e obtenção de melhor capacidade produtiva, atendendo um mercado cada vez mais exigente e próspero.

Down-regulation of complement genes in lipopolysaccharidechallenged zebrafish (Danio rerio) larvae exposed to Indonesian propolis / Regulação negativa dos genes do complemento em larvas de peixe-zebra (Danio rerio) desafiadas com lipopolissacarídeo expostas à própolis indonésia

Although propolis has been reported for having anti-inflammatory activities, its effects on complement system has not been much studied. This research was conducted to find out the effects of Indonesian propolis on the expression levels of C3, C1r/s, Bf, MBL, and C6 in zebrafish larvae which were induced by lipopolysaccharide (LPS). Counting of macrophages migrating to yolk sac and liver histology were carried out. Larvae were divided into four groups: CON (cultured in E3 medium only), LPS (cultured in a medium containing 0.5 μg/L LPS), LPSIBU (cultured in a medium containing LPS, and then treated with 100 μg/L ibuprofen for 24 hours), and LPSPRO (cultured in a medium containing LPS, and then immersed in 14,000 μg/L propolis for 24 hours) groups. The results showed that complement gene expression in larvae from the LPSIBU and LPSPRO groups were generally lower than in larvae from the LPS group. The number of macrophage migrations to the yolk in the LPSPRO group was also lower than in the LPS group. Histological structure of liver in all groups were considered normal. This study shows that Indonesian propolis has the potential to be used as an alternative to the substitution of NSAIDs.

Embora a própolis tenha sido relatada por ter atividade anti-inflamatória, seus efeitos no sistema complemento, uma parte do sistema imunológico inato, não foram muito estudados. Esta pesquisa foi conduzida para descobrir os efeitos da própolis da Indonésia nos níveis de expressão de C3, C1r/s, Bf, MBL e C6 em larvas de peixe-zebra induzidas por lipopolissacarídeo (LPS). Foram realizadas contagens de macrófagos que migram para o saco vitelino e histologia do fígado. As larvas foram divididas em quatro grupos: CON (cultivadas apenas em meio E3), LPS (cultivadas em meio contendo 0,5 μg/L de LPS), LPSIBU (cultivadas em meio contendo LPS e, em seguida, tratadas com 100 μg/L de ibuprofeno por 24 horas) e LPSPRO (cultivado em meio contendo LPS, e então imerso em própolis 14,000 μg/L por 24 horas). Os resultados mostraram que a expressão do gene do complemento em larvas dos grupos LPSIBU e LPSPRO foi geralmente menor que em larvas do grupo LPS. O número de migrações de macrófagos para a gema no grupo LPSPRO também foi menor que no grupo LPS. A estrutura histológica do fígado em todos os grupos foi considerada normal. Este estudo mostra que a própolis indonésia tem potencial para ser utilizada como alternativa na substituição dos AINEs (anti-inflamatórios não esteroides).

Abdominal ultrasound in amazonian manatee (Trichechus inunguis) (Natterer, 1883) / Ultrassonografia abdominal em peixe boi amazônico (Trichechus inunguis (Natterer, 1883)

Morphophysiological species researches are fundamental, and diagnostic imaging is an excellent technique, already used in wild animals, with great application, not invasive and provide real-time information of each body. Amazonian manatees are on the list of endangered animals classified in the vulnerable category and knowledge of the normal pattern of ultrasound anatomy of organs and tissues is important for the maintenance and well-being of captive specimens contributing to reintroduction actions. The objective of the study was to standardize the examination technique and describe the ultrasound findings of the liver, gallbladder, stomach, urinary bladder and the subcutaneous tissue of the abdominal region in Trichechus inunguis, in order to contribute with the anatomical and sonographic knowledge and assist in the diagnosis and prognosis diseases. The study used 18 animals to describe the normal sonographic anatomy in the abdominal cavity of the Amazonian manatee. During abdominal scan, it was possible to visualize the features of the liver, gallbladder, stomach, urinary bladder obtained satisfactory results in this study. Therefore, other structures were not primarily identified by the reduced time, lots of fat and gases in intestines of animals.

Pesquisas morfofisiológicas em espécies selvagens são fundamentais, e o diagnóstico por imagem é uma excelente técnica, já usada e com grande aplicação, não invasiva e que fornece informações em tempo real de cada órgão. Peixes-boi-amazônico encontram-se na lista de animais ameaçados de extinção classificados na categoria vulnerável e o conhecimento do padrão normal da anatomia ultrassonográfica de órgãos e tecidos é importante para a manutenção e bem-estar de espécimes em cativeiro contribuindo para ações de reintrodução. O objetivo deste estudo foi padronizar a técnica de exame e descrever os achados ultrassonográficos do fígado, vesícula biliar, estômago, vesícula urinária e o tecido subcutâneo da região abdominal em Trichechus inunguis, de modo a contribuir com o conhecimento anátomo-sonográfico e auxiliar no diagnóstico e prognóstico de doenças. O estudo utilizou 18 animais para descrever a anatomia ultrassonográfica normal na cavidade abdominal de peixe-boi amazônico. Durante a varredura abdominal foi possível visualizar as características dos órgãos obtendo resultados satisfatórios neste estudo, concluindo ser uma técnica eficiente para avaliação de determinados órgãos abdominais em peixe-boi amazônico. Entretanto, outras estruturas não foram identificadas principalmente pelo tempo reduzido, muita gordura e gases nos intestinos dos animais.

Revisión Anatómica de Sistema Venoso Intrahepático. Hematoma Intrahepático Subcapsular en Colecistectomia Laparoscópica / Anatomical Review of Intrahepatic Venous System. Subcapsular Intrahepatic Hematoma In Laparoscopic Cholecystectomy

La aparición del hematoma intrahepático subcapsular (SHI) después de la colecistectomía laparoscópica es una complicación poco frecuente. El estudio anatómico de las venas suprahepáticas nos permitió observar que existen numerosos patrones de ramificación de estos. Presentamos el caso de una mujer de 37 años que, durante la intervención de colecistectomía laparoscópica, se observa en el acto quirúrgico, la formación espontánea de hematomas subcapsulares, secundario a la tracción forzada del fondo del órgano

The appearance of subcapsular intrahepatic hematoma (SHI) after laparoscopic cholecystectomy is an infrequent complication.The anatomical study of the suprahepatic veins allowed us to observe that there are numerous branching patterns of these. We present the case of a 37-year-old female who, during the laparoscopic cholecystectomy intervention, is observed in the surgical act, the spontaneous formation of subcapsular hematomas, secondary to forced traction of the fundus of the organ

Bases anatómicas y aplicación clínica inicial del abordaje glissoniano intrahepático en las hepatectomías / Anatomical bases and initial clinical application of the intrahepatic Glissonian approach in hepatectomies / Bases anatômicas e aplicação clínica inicial da abordagem glissoniana intra-hepática em hepatectomias

Introducción: El control pedicular durante las resecciones hepáticas puede hacerse mediante disección hiliar extrahepática (DHE) o abordaje glissoniano (AG). El AG intrahepático (AGI) según técnica de Machado puede brindar ciertas ventajas, especialmente en disecciones difíciles. Sin embargo, es menos empleado que la DHE. Objetivo: Analizar las bases anatómicas del AGI y comunicar nuestra experiencia clínica inicial. Material y métodos : El AGI según técnica de Machado se practicó en seis (6) hígados cadavéricos. Luego se hizo la disección hepática para valorar la efectividad del cargado pedicular y medir la profundidad de los diferentes pedículos glissonianos. La aplicación clínica de la técnica fue gradual y selectiva, aplicándola cuando nos parecía factible y que aportaba alguna ventaja sobre la DHE. Resultados: en los 6 hígados cadavéricos fue posible realizar el cargado de todos los pedículos glissonianos (lobares y sectoriales bilateralmente, así como los segmentarios izquierdos). Estos se encuentran a una profundidad menor a 2 cm de la capsula hepática, siendo accesibles para su control mediante AGI. La principal excepción es el pedículo anterior derecho, cuyo nacimiento es más profundo, lo que asociado a su origen en sentido cefálico y a veces ramificado, puede hacer más difícil su cargado. La aplicación del AGI se llevo a cabo en 5 pacientes, en todos fue efectiva, insumió poco tiempo y no tuvo complicaciones intraoperatorias. Conclusiones: el AGI según técnica de Machado es un procedimiento sistematizado, reproducible, factible y seguro, aún en su aplicación clínica inicial. El conocimiento anatómico de los pedículos glissonianos es fundamental para llevarlo a cabo con éxito.

Introduction: Pedicle control during liver resections can be done by extrahepatic hilar dissection (EHD) or the Glissonian approach (GA). Intrahepatic GA (IGA) according to the Machado technique can offer certain advantages, especially in difficult dissections. However, it is used less than the DHE. Objective : to analyze the anatomical bases of the IGA and to communicate our initial clinical experience. Material and methods : IGA according to the Machado technique was performed on six (6) cadaveric livers. Liver dissection was then performed to assess the effectiveness of pedicle loading and measure the depth of the different Glissonian pedicles. The clinical application of the technique was gradual and selective, applying it when it seemed feasible and that it provided some advantage over DUS. Results : in the 6 cadaveric livers it was possible to load all the Glissonian pedicles (lobar and sectoral bilaterally, as well as the left segmental ones). These are found at a depth of less than 2 cm from the hepatic capsule, being accessible for control by IGA. The main exception is the right anterior pedicle, whose origin is deeper, which, associated with its cephalad and sometimes branched origin, can make it more difficult to load. The application of the IGA was carried out in 5 patients, in all of them it was effective, it took little time and there were no intraoperative complications. Conclusions: the IGA according to the Machado technique is a systematic, reproducible, feasible and safe procedure, even in its initial clinical application. The anatomical knowledge of the Glissonian pedicles is essential to carry it out successfully.

Introdução: o controle pedicular durante as ressecções hepáticas pode ser feito por dissecção hilar extra-hepática (DHE) ou abordagem Glissoniana (AG). A AG intra-hepática (AGI) segundo a técnica de Machado pode oferecer algumas vantagens, principalmente em dissecções difíceis. No entanto, é usado menos do que o DHE. Objetivo: Analisar as bases anatômicas da AGI e comunicar nossa experiência clínica inicial. Material e métodos : A AGI segundo a técnica de Machado foi realizada em seis (6) fígados cadavéricos. A dissecção do fígado foi então realizada para avaliar a eficácia da carga pedicular e medir a profundidade dos diferentes pedículos Glissonianos. A aplicação clínica da técnica foi gradativa e seletiva, aplicando-a quando parecia viável e que proporcionava alguma vantagem sobre o USD. Resultados: nos 6 fígados cadavéricos foi possível carregar todos os pedículos Glissonianos (lobares e setoriais bilateralmente, assim como os segmentares esquerdos). Estes são encontrados a menos de 2 cm da cápsula hepática, sendo acessíveis para controle por AGI. A principal exceção é o pedículo anterior direito, cuja origem é mais profunda, o que, associado à sua origem cefálica e por vezes ramificada, pode dificultar o carregamento. A aplicação da AGI foi realizada em 5 pacientes, em todos foi eficaz, em pouco tempo e sem complicações intraoperatórias. Conclusões : AGI segundo a técnica de Machado é um procedimento sistemático, reprodutível, factível e seguro, mesmo em sua aplicação clínica inicial. O conhecimento anatômico dos pedículos Glissonianos é essencial para realizá-lo com sucesso.

Application of stereology in liver volume measurements using computed tomography scan / Aplicación de la estereología en mediciones de volumen hepático mediante tomografía computarizada

SUMMARY: The application of stereology in hepatobiliary conditions is essential in liver volume estimation. Computerized topographic scan with contrast is a reliable method in liver scanning for precise boundaries demarcation. Liver volumetry varies in relation to different factors. Reports showed a correlation of liver volume with sex and body mass index. Steady relation between age and ethnicity is not established. This study aimed to design a protocol for liver volume measurement and apply it in the estimation of volume among the Sudanese population use stereology. Recruitment of the study population was obtained in the royal scan clinic in Khartoum by making an announcement for participation in the study. Patients with a history of hepatobiliary diseases were excluded. CT abdomen with contrast was obtained in DICOM format and transferred to computer-based software for image analysis. A protocol was designed and validated and then applied in volume estimation using software MRIcro for image display, ImageJ for volume estimation, and Onis 2.6 as image viewer. 300 apparently healthy volunteers were recruited. The protocol reliability result was 0.805. Absolute mean liver volume was 3261.32 ± 1365.313 cm3. High liver volume among females was detected than among males. A positive correlation was detected between volume and body mass index (p-value 0.001) regardless of sex. Relation with age showed a rough steady rise till the age of 50 years then it started to decline steadily. The relationship was detected in liver volume with sex and body mass index. More studies are needed to investigate the relationship between ethnicity and age groups.

RESUMEN: La aplicación de la estereología en condiciones hepatobiliares es fundamental en la estimación del volumen hepático. El escaneo topográfico computarizado con contraste es un método confiable en el escaneo del hígado para la demarcación precisa de sus límites. La volumetría hepática varía en función de diferentes factores. Los informes mostraron una correlación del volumen del hígado con el sexo y el índice de masa corporal. No se establece una relación estable entre la edad y la etnia. Este estudio tuvo como objetivo diseñar un protocolo para la medición del volumen hepático de la población sudanesa usando la estereología. El reclutamiento de la población de estudio fue realizado en la clínica de exploración real en Jartum mediante un anuncio de participación. Se excluyeron los pacientes con antecedentes de enfermedades hepatobiliares. Se obtuvo TC de abdomen con contraste en formato DICOM y se transfirió a un software informático para el análisis de imágenes. Se diseñó y validó un protocolo y luego se aplicó en la estimación de volumen utilizando el software MRIcro para la visualización de imágenes, ImageJ para la estimación de volumen y Onis 2.6 como visor de imágenes. Se reclutaron 300 voluntarios sanos. El resultado de la fiabilidad del protocolo fue 0,805. El volumen hepático medio absoluto fue 3261,32 ± 1365,313 cm3. Se detectó un volumen más elevado de hígado en las mujeres que en los hombres. Se detectó una correlación positiva entre el volumen y el índice de masa corporal (valor de p 0,001) independientemente del sexo. La relación con la edad mostró un aumento continuo y brusco hasta los 50 años, luego comenzó a disminuir de manera constante. Se detectó la relación del volumen hepático con el sexo y el índice de masa corporal. Se necesitan más estudios para investigar la relación entre la etnia y los grupos etarios.

Histological architectures and biometric characteristics of indigenously plastinated organs of goat / Arquitectura histológica y características biométricas de órganos de cabra plastinados localmente

SUMMARY: The histo-morphology and biometry of liver, lung and kidney of goat were studied. The obtained samples were divided into two groups. One set of tissue was processed for paraffin embedding after formalin fixation. The other set was indigenously plastinated. The plastinates were embedded with paraffin without deplastination. Both the non plastinated and plastinated tissues were sectioned and processed for routine staining. The tissues were examined under light microscope for histological architectures and quantitatively assessed the biometric parameters. The non plastinated and plastinated samples yielded mostly similar histological architectures. But plastinated liver showed alterations and artifacts with enlargement of the central vein and hepatic sinusoidal space. Plastinated lung revealed enlarged alveolar sac. Lack of nuclear clarity was observed for all the plastinated samples. The plastinated kidney revealed compactness of the cellular structures and shrinkage induced artifacts with clear renal corpuscles structure and obvious glomerular capsule (Bowman's capsule). The biometric measurements of central vein of liver, alveolar sac of lung, glomerulus and glomerular space of kidney of both plastinated and non plastinated tissue were also performed using calibrated stage micrometer. Comparison was done between the biometric data for both plastinated and non plastinated tissue. No significant difference was found in the obtained biometric data of liver and lung. Only a significant difference was observed between the width of glomerulus of non plastinated kidney and width of glomerulus of plastinated kidney. The morphological and biometric study of non plastinated and plastinated organs of goat can conclude that histological slides can be made from indigenously plastinated organs with well preserved histological architectures of the tissues with some rare exceptions. Plastination does not affect the biometric characteristics of the organs. In addition, the comparative morphologic and biometric study of plastinated and non plastinated organs of goat will be useful in education and research.

RESUMEN: En este estudio se analizó la histomorfología y biometría de hígado, pulmón y riñón de cabra. Las muestras obtenidas se dividieron en dos grupos: una cohorte de tejido fue procesada para su inclusión en parafina después de la fijación con formalina. La siguiente cohorte fue plastinada localmente. Tanto los tejidos no plastinados como los plastinados fueron seccionados y procesados para tinción de rutina. Los tejidos se examinaron con un microscopio óptico en busca de arquitecturas histológicas y se evaluaron cuantitativamente los parámetros biométricos. Las muestras no plastinadas y plastinadas produjeron arquitecturas histológicas en su mayoría similares. El hígado plastinado mostró alteraciones y artefactos con un aumento de la vena central y del espacio sinusoidal hepático. El pulmón plastinado reveló aumento del saco alveolar. Se observó falta de claridad nuclear en todas las muestras plastinadas. El riñón plastinado reveló compacidad de las estructuras celulares y artefactos inducidos por contracción con estructura clara de corpúsculos renales y obvia cápsula glomerular (cápsula de Bowman). Las mediciones biométricas de la vena central del hígado, el saco alveolar del pulmón, el glomérulo y el espacio glomerular del riñón de tejido plastinado y no plastinado también se realizaron utilizando un micrómetro de platina calibrado. Se realizó una comparación entre los datos biométricos del tejido plastinado y no plastinado. No se encontraron diferencias significativas en los datos biométricos obtenidos de hígado y pulmón. Se observó una diferencia significativa entre el ancho del glomérulo del riñón no plastinado y el ancho del glomérulo del riñón plastinado. En el estudio morfológico y biométrico de órganos de cabra no plastinados y plastinados se puede concluir que es posible hacer portaobjetos histológicos a partir de órganos plastinados naturales con arquitecturas histológicas de los tejidos bien conservadas, con algunas excepciones. La plastinación no afecta las características biométricas de los órganos. Además, el estudio comparativo morfológico y biométrico de órganos plastinados y no plastinados de cabra será de utilidad en la educación y la investigación.

Biomarcadores histológicos em Sciades herzbergii (Pisces, Ariidae) para avaliação de impactos em ambientes estuarinos da Baía de São Marcos, Maranhão / [Biomarkers histological in Sciades herzbergii (Pisces, Ariidae) for impact assessment in estuarine environments of São Marcos Bay, Maranhão]

Neste estudo, objetivou-se avaliar o impacto ambiental em áreas estuarinas da Baía de São Marcos, Maranhão, utilizando-se alterações histológicas nas brânquias e no fígado de Sciades herzbergii como biomarcadores de contaminação aquática. Foram realizadas coletas no período chuvoso (março de 2018) e de estiagem (julho de 2018), em que foram capturados 40 exemplares de S. herzbergii em duas regiões distintas da Baía de São Marcos: A1) Ilha dos Caranguejos (área referência); A2) Terminal de Pesca Industrial de Porto Grande (área potencialmente contaminada). As estações foram georreferenciadas por GPS e, em cada local de captura dos peixes, registraram-se as seguintes variáveis abióticas: temperatura, salinidade, pH e oxigênio dissolvido. Em campo, os organismos foram pesados e medidos, as brânquias e os fígados foram retirados e fixados. Posteriormente, foram mantidos em álcool a 70% até o procedimento histológico padrão. Resultados indicam que as duas áreas são semelhantes em termos de características físico-químicas da água e do sedimento. Todavia, a análise semiquantitativa das alterações histológicas observadas revelou que as brânquias foram o órgão mais afetado nos peixes de A2, indicando que os peixes desse local apresentam danos teciduais maiores resultantes de estresse acentuado por impactos antrópicos.(AU)

This study aimed to evaluate the environmental impact in estuarine areas of São Marcos Bay, Maranhão, using histological changes in the gills and liver of Sciades herzbergii as biomarkers of aquatic contamination. Samples were collected during the rainy (March 2018) and dry (July 2018) seasons, in which 40 specimens of S. herzbergii were captured in two distinct regions of São Marcos Bay: A1) Crab Island (reference area); A2) Porto Grande Industrial Fishing Terminal (potentially contaminated area). The stations were georeferenced by GPS and at each fish capture site the following abiotic variables were recorded: temperature, salinity, pH and dissolved oxygen. In the field, the organisms were weighed and measured and the gills and livers removed and fixed. Afterwards, they were kept in 70% alcohol until the standard histological procedure. Results indicate that the two areas are similar in terms of physicochemical characteristics of water and sediment. However, the semi-quantitative analysis of the observed histological alterations revealed that the gills were the most affected organ in A2 fish, indicating that the fish in this site have greater tissue damage resulting from stress accentuated by anthropic impacts.(AU)

Descripción morfológica e histológica del tejido hepático de Gambusia holbrooki (Pisce: Poeciliidae) que habita en la Provincia de Arica - Chile / Morphological and histological description of the liver tissue of Gambusia holbrooki (Pisce: Poeciliidae) inhabiting the Province of Arica - Chile

Gambusia holbrooki es el pez de agua dulce con mayor distribución en Chile y el mundo, pero los estudios que abordan la morfología e histología hepática del pez son escasos. El hígado es utilizado para evidenciar efectos subletales de contaminantes ambientales y es preciso contar con una descripción histomorfológica del hígado para futuros estudios comparativos. El presente estudio tiene como objetivo describir patrones histomorfológicos del hígado de Gambusia holbrooki, para ello se colectaron 97 individuos adultos de los sistemas límnicos de los valles de Lluta y Azapa (Extremo norte de Chile), para observar patrones morfológicos comunes en ambas poblaciones, se utilizó técnicas histológicas de rutina e histoquímica. Las evidencias demostraron que el hígado contiene tejido pancreático y su arquitectura tisular es trabecular con mayor presencia de capilares sinusoides.

Gambusia holbrooki is the freshwater fish with the greatest distribution in Chile and the world. However, studies dealing with morphology and liver histology of fish are scarce. The liver commonly shows the sublethal effects of environmental pollutants and there should be a histomorphological description of the liver for further comparative studies. The present study aims to describe histomorphological patterns of the liver of Gambusia holbrooki. A total of 97 adult individual specimens were collected from the ecosystems in the valleys of Lluta and Azapa (Region of Arica and Parinacota), to observe patterns morphologically common in both populations. Routine histological and histochemical techniques were used for analysis. The evidence showed that the liver contains pancreatic tissue, and that tissue architecture is trabecular with greater presence of capillary sinusoids.

Anatomy of the liver (a05.8. 01. 001): worldwide review, 2019: new findings, concepts and definitions support a division of the liver into seven portal segments / Anatomía del hígado (a05. 8.01. 001): revisión mundial, 2019: nuevos hallazgos, conceptos y definiciones respaldan una división del hígado en siete segmentos portales

Due to a lack of consensus on the description of the human liver anatomy, we decided to explore different researches worldwide. Studies are focused on the hepatic vascularization. The results obtained through serial dissections in embryos, fetuses and adults have contributed to new definitions. Researchers around the world have agreed on finding the bases to propose a liver segmentation with seven portal segments.

La confusión existente en la descripción de la anatomía del hígado humano nos llevó a realizar esta revisión a nivel mundial. Las investigaciones se centran en la vascularización del hígado, el conocimiento obtenido mediante disecciones seriadas en embriones, fetos y adultos han aportado nuevos conocimientos que fundamentan nuevas definiciones. Investigadores de países distantes han coincidido en encontrar las bases para proponer una segmentación del hígado con siete segmentos portales.

Aspectos morfológicos do rúmen, omaso e fígado de tourinhos alimentados com diferentes níveis de glicerina bruta / Morphological aspects of rumen, omasum and liver of bulls fed different levels of crude glycerin

The morphology of the ruminal and omasal mucosa and hepatic parenchyma of 44 young bulls submitted to four types of concentrates were evaluated by varying the inclusion level of crude Glycerin - CG (0, 6, 12 and 18%). The variables evaluated were number of ruminal papillae per cm² of wall; area of the papillae and total absorption surface per cm² of wall; Mitotic index - MI, height and area of ruminal and omasal papillae; and hepatic morphology. The samples processed for inclusion in paraffin and stained with Hematoxylin-Eosin. The different levels of inclusion of CG in the diet did not interfere either in the number of papillae per cm2 of rumen wall (P= 0,70) or in the ruminal absorptive surface area (P= 0,89). Animals that received diets with levels 12 and 18% had higher MI of the ruminal epithelium (P< 0.01), but higher cell proliferation wasn't reflected in height gain and papillary area (P= 0,82). The omasal mucosa wasn't influenced by the inclusion of CG (MI e height gain and papillary area, P= 0,43, P= 0,56 e P= 0,9, respectively). The inclusion of GB in up to 18% of diet dry matter didn't alter the morphology of the rumen and omaso mucosa; and the integrity hepatic parenchyma.(AU)

Histopathological analysis of liver of the catfish Pimelodus maculatus in a tropical eutrophic reservoir from Southeastern Brazil

We described liver tissues of the long-whiskered catfish Pimelodus maculatus using histological techniques through structures stained with hematoxylin and eosin. A total of 21 adult individuals were collected using gill nets during the winter of 2012, in a eutrophic reservoir in Southeastern Brazil. The main aim was to characterize the tissues and eventual changes, since this organ has a notable sensitivity to changes in altered aquatic systems. The liver contains the exocrine pancreas (hepatopancreas) that have pancreatic cells arranged around a branch of the portal vein. The hepatocytes are diffuse and arranged in cords. Normal liver of P. maculatus have a continuous compact field of weakly eosinophilic, rounded hepatocytes with scattered islands of connective tissue that enclose the bile ducts and blood vessels. The organization of exocrine pancreatic tissues is similar to the acinar morphology of many teleosts. Histopathological alterations in liver were evaluated semi-quantitatively and based on the severity of the lesions. The alterations in each organ were classified in progressive stages of damage to the tissue. Six types of liver alterations were found: 1) cytoplasmic vacuolization; 2) congestion; 3) inflammatory infiltrated; 4) infiltration of adipocytes; 5) steatosis; 6) granuloma. Incidence of melanomacrophage centers were observed in the liver. However, we cannot directly associate such changes with the eutrophic conditions of the reservoir, because we have no available reference area to compare. These findings are a baseline contribution, which enables comparisons with similar fish species in other tropical aquatic systems in further studies.

Biliary tract in trident, an anatomical variation between the cystic duct and its union to the common hepatic duct: a rare case report / Tracto biliar en tridente, una variación anatómica entre el conducto cístico y su unión al conducto hepático común: un caso raro

SUMMARY: Given that the gallbladder and the biliary tract are subject to multiple anatomical variants, detailed knowledge of embryology and its anatomical variants is essential for the recognition of the surgical field when the gallbladder is removed laparoscopically or by laparotomy, even when radiology procedures are performed. During a necropsy procedure, when performing the dissection of the bile duct is a rare anatomical variant of the bile duct, in this case the cystic duct joins at the confluence of the right and left hepatic ducts giving an appearance of trident. This rare anatomical variant in the formation of common bile duct is found during the exploration of the bile duct during a necropsy procedure, it is clear that the wrong ligation of a common hepatic duct can cause a great morbi-mortality in the postsurgical of biliary surgery. This rare anatomical variant not previously described is put in consideration to the scientific community. Anatomical variants of the biliary tract are associated with high rates of morbidity and mortality, causing serious bile duct injuries. Only the surgical skill of the surgeon and his open mind to the possibilities of abnormalities make the performance of cholecystectomy a safe procedure.

RESUMEN: Dado que la vesícula biliar y el tracto biliar están sujetos a múltiples variantes anatómicas, el conocimiento detallado de la embriología y sus variantes anatómicas es esencial para el reconocimiento del campo quirúrgico cuando la vesícula biliar se extirpa laparoscópicamente o por laparotomía, incluso cuando se realizan procedimientos de radiología. Durante un procedimiento de necropsia, se realiza la disección del conducto biliar y se observa una variante anatómica inusual del conducto biliar; en este caso, el conducto cístico se une a la confluencia de los conductos hepáticos derecho e izquierdo dando una apariencia de tridente. Esta rara variante anatómica en la formación del conducto biliar común puede causar una gran morbimortalidad en la cirugía biliar asociado a una ligadura incorrecta. Esta extraña variante anatómica no descrita anteriormente se reporta a la comunidad científica, debido a que las variantes anatómicas del tracto biliar se asocian con altas tasas de morbilidad y mortalidad, al causar lesiones graves en el conducto biliar. Solo la habilidad quirúrgica del cirujano y su mente abierta a las posibilidades de variaciones anatómicas hacen que la realización de la colecistectomía sea un procedimiento seguro.

Intermittent training followed by detraining provides the preservation of hepatic tissue and body composition of eutrophic rats in relation to obese rats after the detraining period / El entrenamiento intermitente seguido de desacondicionamiento facilita la preservación del tejido hepático y la composición corporal de las ratas eutróficas en relación a las ratas obesas después del período de desacondicionamiento

The aim of the study was to evaluate the effects of intermittent training followed by detraining on liver tissue and body composition of rats subjected to a normolipidic or hyperlipidic diet. Sixty Wistar rats were divided into the groups Sedentary Control (SC), Exercised Control (EC), Sedentary Control euthanized at six months of age (SC(6)), Detrained Control (DC), Sedentary Obese (SO), Exercised Obese (EO), Sedentary Obese euthanized at six months of age (SO(6)) and Detrained Obese (DO), which performed intermittent training for eight weeks. After, the groups SC(6), DC, SO(6) and DO performed a detraining protocol for eight weeks. The animals were euthanized, with measurements of body mass and length taken, and retrieval of Epididymal Adipose Tissue (EAT) for body composition variables and the liver for karyometric and stereological analysis. Significant differences were found in the liver mass values of the EC relative to the DO and in the SO(6) liver in relation to all groups, with a greater gain in body mass of the SO(6) in comparison to the EC; in the EAT total, EAT percentage and BM of SO(6) and DO in relation to the EC and the DC and in the karyometric variables of the EC and the DC in relation to EO and DO, with no differences in the stereology and on the Lee index between all groups. Intermittent training showed better effects on the DC liver tissue compared to EO and DO, and on the EC and DC body composition compared to SO(6) and DO.

El objetivo del estudio fue evaluar los efectos del entrenamiento intermitente seguido de desentrenamiento en el tejido hepático y la composición corporal de ratas sometidas a una dieta normolipídica e hiperlipídica. Sesenta ratas Wistar se dividieron en los siguientes grupos: Control Sedentario (CS), Control Entrenado (CE), Control Sedentario sacrificado a los seis meses de edad (SC (6)), Control Desentrenado (CD), Obeso Sedentario (OS), Obeso Entrenado (OE), Obesidad Sedentaria sacrificados a los seis meses de edad (OS) (6)) y Obesidad Desentrenada (DOD), que realizó un entrenamiento intermitente durante ocho semanas. Posteriormente, los grupos CS (6), CD, OS (6) y DO realizaron un protocolo de desentrenamiento durante ocho semanas. Los animales fueron sacrificados, con mediciones de masa corporal y longitud, y la recuperación de tejido adiposo epididimal (EAT) para las variables de composición corporal y el hígado para el análisis estereológico y cariométrico. Se encontraron diferencias significativas en los valores de la masa hepática de CE en relación con DO y en el hígado SO (6) en relación con todos los grupos, con un mayor aumento en la masa corporal del SO (6) en comparación con la CE; en el total de EAT, porcentaje de EAT y BM de SO (6) y OD en relación con CE y CD y en las variables cariométricas de CE y CD en relación con OE y OD, sin diferencias en la estereología y en el índice de Lee entre todos los grupos. En el entrenamiento intermitente se observaron mejores efectos en el tejido hepático de CD en comparación con OE y OD, y en la composición corporal de CE y CD en comparación con OS (6) y OD.