Prophylactic application of laser light restores L-FABP expression in the livers of rats submitted to partial ischemia

OBJECTIVES: The objective of the present study was to evaluate the protective effect of pre-conditioning treatment with laser light on hepatic injury in rats submitted to partial ischemia using mitochondrial function and liver fatty acid binding protein as markers. METHODS: Rats were divided into four groups (n=5): 1) Control, 2) Control + Laser, 3) Partial Ischemia and 4) Partial Ischemia + Laser. Ischemia was induced by clamping the hepatic pedicle of the left and middle lobes of the liver for 60 minutes. Laser light at 660 nm was applied to the liver immediately prior to the induction of ischemia at 22.5 J/cm2, with 30 seconds of illumination at five individual points. The animals were sacrificed after 30 minutes of reperfusion. Blood and liver tissues were collected for analysis of mitochondrial function, determination of malondialdehyde and analysis of fatty acid binding protein expression by Western blot. RESULTS: Mitochondrial function decreased in the Partial Ischemia group, especially during adenosine diphosphate-activated respiration (state 3), and the expression of fatty acid binding protein was also reduced. The application of laser light prevented bioenergetic changes and restored the expression of fatty acid binding protein. CONCLUSION: Prophylactic application of laser light to the livers of rats submitted to partial ischemia was found to have a protective effect in the liver, with normalization of both mitochondrial function and fatty acid binding protein tissue expression.

Therapeutic effects of an ethanolic olive leaves extract or bone marrow mesenchymal stem cells against liver injury induced by gamma radiation

Background: Ionizing radiation absorption causes immediate biochemical, sub cellular and cellular damage, while its morphological expression and organ dysfunction are often considerably delayed. This study was aimed to investigate the possible therapeutic effects of ethanolic olive leaves extract or bone marrow derived-mesenchymal stem cells [BM-MSCs] transplanted in the liver of rats exposed to gamma radiation. For this purpose, hematological and biochemical parameters were determined

Materials and methods: 50 adult male albino rats [Sprague dawely strain] were used in this study. They were divided into 5 groups [C group: Untreated control rats; R group: rats exposed to a single dose of gamma-radiation [6 Gy], OLE group: rats treated with olive leaves extract [15 mg /kg body weight / day for 30 days], R+OLE group: animals of this group were irradiated with 6Gy then treated with OLE [15 mg /kg body weight/ day] after 3 hours post irradiation for 30 days. and R+MSCs group: Mesenchymal stem cells-irradiated animals [MSCs +R]: animals of this group were irradiated with 6Gy then injected after 6hours post irradiation with [BM-MSCs] 3x10[6] cells/ml suspension through caudal vein. All these groups were subjected to hematological and biochemical investigations

Results: Hematological and liver function changes were shown in gamma irradiated rats, these changes included a significant depression in hematological parameters of blood such as [RBCs, Hb, Hct and WBCs] and a significant increase in liver parameters [ALT,AST and ALP] at different intervals of the experiment in comparison with the control group. These changes manifested good amelioration in the exposed groups by using either olive leaves extract [OLE] or bone marrow mesenchymal stem cells [BM-MSCs]

Conclusion: Ethanolic olive leaves extracts and mesenchymal stem cells have ameliorated hematological and biochemical parameters changes in liver of the irradiated group. Their actions may be due to their anti-inflammatory and antioxidant properties

[Effect of cell phones microwaves on histologic structures of some visceral organs in rat]

Background and Objective: The electromagnetic field producer sets in daily life causes concerns about the adverse effects of such waves on human health. This study was done to evaluate the effect of cell phones microwaves on histologic structures of some visceral organs in rat

Methods: In this experimental study, 80 immature Wistar male rats with weight of 100-140 gram and 5 to 6 weeks age were randomly allocated into 3 experimental groups and one control group. The experimental rats were exposed to cell phones microwaves 5 hours a day for 1, 2 and 3 months. The control group received no radiation. After the experimental period rats were sacrificed and the appropriate tissues of the lung, heart, liver, brain and pancreas were prepared. Sections in 5 micro m thicknesses were stained by hematoxylin and eosin and studied microscopically

Results: Histological changes including edema, inflammatory cell infiltration and cell degeneration in the lung and mild degeneration and coagulation necrosis of the myocardial cells in the heart were observed. Histopthological examination of the liver revealed dilation of central veins and sinusoids, vacuolization of hepatocytes and mononuclear inflammatory cell infiltration. Limited changes were observed in pancreas and brain. Histological changes were increased in the groups that were exposed longer period of time to radiation

Conclusion: This study indicated that the harmful effect of cell phones radiation on rat tissues depending on the duration of exposure

Effect of irradiation with different laser wavelengths on oxidative stress of non-hepatectomized rats

PURPOSE: To assess the effect of two laser wavelengths, either separate or combined, on intact rat livers. METHOD: Nineteen male Wistar rats (200-300 g) were submitted to laser irradiation at 5 different sites on the liver surface.Wavelengths 660 and 780 nm were used, with a dose of irradiation of 60 J/cm2/site.The animals were divided into the groups:control (C) and animals irradiated with 660 nm laser (L1), with 780 nm laser (L2) or withboth wavelengths (L3).Mitochondrial function, mitochondrial swelling, and hepatocellular malondialdehyde (MDA) levels were determined.Data were analyzed by the Mann-Whitney test, with the level of significance set at 5%. RESULTS: There was a reduction of ADP-activated respiration (state 3) in group L1 compared to group C (p=0.0016), whereas the values of group L2 were similar to control.Group L3 also showed a reduction of state 3 (p=0.0159).There was a reduction of RCR in group L1 compared to control (p=0.0001) and to group L2 (p=0.0040).Mitochondrial swelling only differed between group L3 and control (p=0.0286).There was a increase in MDA levels in group L3 compared to control (p=0.0476) and to group L2 (p=0.0286) and in group L1 compared to group L2 (p=0.0132). CONCLUSION: Although laser irradiation reduced mitochondrial function,it did not interfere with the hepatocellular energy status.

Radiation Doses of Various CT Protocols: a Multicenter Longitudinal Observation Study

Emerging concerns regarding the hazard from medical radiation including CT examinations has been suggested. The purpose of this study was to observe the longitudinal changes of CT radiation doses of various CT protocols and to estimate the long-term efforts of supervising radiologists to reduce medical radiation. Radiation dose data from 11 representative CT protocols were collected from 12 hospitals. Attending radiologists had collected CT radiation dose data in two time points, 2007 and 2010. They collected the volume CT dose index (CTDIvol) of each phase, number of phases, dose length product (DLP) of each phase, and types of scanned CT machines. From the collected data, total DLP and effective dose (ED) were calculated. CTDIvol, total DLP, and ED of 2007 and 2010 were compared according to CT protocols, CT machine type, and hospital. During the three years, CTDIvol had significantly decreased, except for dynamic CT of the liver. Total DLP and ED were significantly decreased in all 11 protocols. The decrement was more evident in newer CT scanners. However, there was substantial variability of changes of ED during the three years according to hospitals. Although there was variability according to protocols, machines, and hospital, CT radiation doses were decreased during the 3 years. This study showed the effects of decreased CT radiation dose by efforts of radiologists and medical society.

Ameliorative effect of septilin, an ayurvedic preparation against γ-irradiation-induced oxidative stress and tissue injury in rats.

Ionizing radiation is known to induce multiple organ dysfunctions directly related to an increase of cellular oxidative stress, due to overproduction of reactive oxygen species (ROS). This study was aimed to investigate the effect of septilin (an ayurvedic poly-herbal formulation containing the principal herbs, namely Commiphora wightii, Trinospora cordifolia, Rubia cardifolia, Emblica officinalis, Saussurea lappa and Glycyrrhiza glabra) against whole body γ-irradiation-induced oxidative damage in hepatic and brain tissues in rats. Administration of septilin for 5 days (100 mg/kg) prior to radiation resulted in a significant increase in both superoxide dismutase (SOD) activity and total glutathione (GSH) level in hepatic and brain tissues, while serum high-density lipoprotein-cholesterol (HDL) was reduced by γ-irradiation. Also, septilin resulted in a significant decrease in NO(x), nitric oxide and malondialdehyde (MDA) levels in hepatic and brain tissues and a significant decrease in serum triglycerides, low-density lipoprotein-cholesterol (LDL) and total cholesterol levels and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels and alkaline phosphatase (ALP), γ-glutamyl transferase (GGT) activities, as well as serum tumor necrosis factor-alpha (TNF-α), compared to irradiated group. In conclusion, data obtained from this study indicated that septilin exhibited potential antioxidant activity and showed radioprotective effect against γ-radiation by preventing oxidative stress and scavenging free radicals.

Evaluation of radio-protective effect of melatonin on whole body irradiation induced liver tissue damage

Ionizing radiation interacts with biological systems to induce excessive fluxes of free radicals that attack various cellular components. Melatonin has been shown to be a direct free radical scavenger and indirect antioxidant via its stimulatory actions on the antioxidant system. The aim of this study was to evaluate the antioxidant role of melatonin against radiation-induced oxidative injury to the rat liver after whole body irradiation. In this experimental study, thirty-two rats were divided into four groups. Group 1 was the control group, group 2 only received melatonin [30 mg/kg on the first day and 30 mg/kg on the following days], group 3 only received whole body gamma irradiation of 10 Gy, and group 4 received 30 mg/kg melatonin 30 minutes prior to radiation plus whole body irradiation of 10 Gy plus 30 mg/kg melatonin daily through intraperitoneal [IP] injection for three days after irradiation. Three days after irradiation, all rats were sacrificed and their livers were excised to measure the biochemical parameters malondialdehyde [MDA] and glutathione [GSH]. Each data point represents mean ñ standard error on the mean [SEM] of at least eight animals per group. A one-way analysis of variance [ANOVA] was performed to compare different groups, followed by Tukey's multiple comparison tests [p<0.05]. The results demonstrated that whole body irradiation induced liver tissue damage by increasing MDA levels and decreasing GSH levels. Hepatic MDA levels in irradiated rats that were treated with melatonin [30 mg/kg] were significantly decreased, while GSH levels were significantly increased, when compared to either of the control groups or the melatonin only group. The data suggest that administration of melatonin before and after irradiation may reduce liver damage caused by gamma irradiation

Proteins and liver function changes in rats following cumulative total body irradiations / Proteínas y cambios de función hepática en ratas tras irradiación corporal total cumulativa

OBJECTIVE: Total body irradiation (TBI) is a choice therapy for the management of some malignancies; it is also a major cause of oxidative stress. The aim of this research is to sequentially document the effect of total body radiation on body function utilizing the sequential changes in liver function enzymes and proteins in rats. METHODS: Serum protein and liver enzymes were assessed using kits in rats exposed to total body radiations of 1.27 Gy/minute in cumulative doses to the fourth radiation at five-day intervals. RESULTS: Aspartate aminotransferase (AST), alanine transaminase (ALT) and serum protein were significantly (p < 0.05) elevated with increasing radiation. No significant differences between experimental and control groups for bilirubin concentrations were noted at any time. Serum levels of albumin were significantly (p < 0.05) increased with the first to third radiation exposures but reduced at the fourth cumulative dose exposure. CONCLUSION: Variations are associated with acute stress, inflammation which could be due to non-specific stress reaction, while fluctuations could arise as a result of tolerance and repair within the liver. These tests are significant for diagnosis of radiation-induced injury and can be important for evaluation of its severity and correct management.

OBJETIVO: La irradiación corporal total (ICT) es una terapia de elección para el tratamiento de algunos tumores malignos. También es una de las causas principales del estrés oxidativo. El objetivo de esta investigación es documentar el efecto de la radiación corporal total sobre las funciones corporales utilizando los cambios secuenciales en las enzimas de la función hepática y las proteínas en las ratas. MÉTODOS: Se evaluaron las proteínas séricas así como las enzimas hepáticas mediante el uso de kits en ratas expuestas a radiaciones corporales totales de 1.27 Gy/minuto en dosis cumulativas hasta la cuarta radiación con cinco días de intervalo. RESULTADOS: La aspartato transaminasa (AST), la alanina aminotransferasa (ALT) y la proteína sérica fueron elevadas significativamente (p < 0.05) con el aumento creciente de la radiación. No hubo diferencias significativas entre el grupo experimental y el grupo control, observándose concentraciones de bilirrubina todo el tiempo. Los niveles séricos de albúmina aumentaron significativamente (p < 0.05) con la primera de tres exposiciones a la radiación, pero experimentaron una reducción a partir de la cuarta exposición de dosis cumulativa. CONCLUSIÓN: Las variaciones están asociadas con estrés agudo e inflamación que podría deberse a una reacción a estrés no específico, mientras que las fluctuaciones podrían surgir como resultado de la tolerancia y la regeneración dentro del hígado. Estas pruebas son importantes para el diagnóstico de lesiones inducidas por radiación, así como para la evaluación de la severidad y el tratamiento correcto de las mismas.

Persistencia de los efectos del láser infrarrojo 6 J/cm² en hepatocitos de rata / Persistence of the effects of 6 J/cm2 infrared laser in rat hepatocytes

Hígados de ratas Sprague Dawley fueron irradiados con dosis diarias de 6 J/cm2 emitida por el láser AsGa equivalente a 904 nm durante 15 días De estos animales previamente anestesiados fueron sacrificados transcurridos 5, 10, 30, 45 y 60 días post irradiación para posteriormente obtener quirúrgicamente muestras de hígado y ser procesadas para microscopía electrónica de transmisión, aplicando técnicas morfométricas utilizando aumentos de 8.500 X con especial énfasis en cuantificar fracciones volumétricas de componentes celulares con el objetivo de precisar la duración de las estimulaciones infrarrojas. El análisis de los resultados entre hepatocitos controles e irradiados con dosis de 6 J/cm2 y tiempo de estimulación infrarroja revela que existen marcadas diferencias entre las fracciones volumétricas de componentes celulares determinantes de funcionalidad celular e involucrados en síntesis proteica, cuantificación que demuestra claramente que el efecto del láser infrarrojo persiste hasta los 30 días post estimulación, evidenciándose modificaciones de organelos que revelan alta funcionalidad, mientras que sobre este tiempo es observada una notable inhibición de dicha funcionalidad, concluyéndose entonces que los efectos de radiación infrarroja persisten en tiempos precisos provocando en los hepatocitos una drástica transformación en sus componentes y por ende en su funcionalidad. en estas células de elevado metabolismo.

Livers of Sprague Dawley rats were irradiated with daily doses of 6 J/cm2 emitted by a laser AsGa, equivalent to 904 nm during 15 days. Experiment animals were anaesthetised and killed after 5, 10, 30, 45 and 60 days post irradiation, in order to obtain samples of liver by surgery. These were processed for transmission electron microscopy, and morphometric techniques were applied using 8,500 X magnification with special emphasis on measuring the volumetric fractions of cell components in order to determine the duration of infrared stimulation. Analysis of the results between control hepatocytes and those irradiated with doses of 6 J/cm2 and by period after infra-red stimulation revealed the existence of marked differences between the volumetric fractions of cell components which determine cell function or are involved in protein synthesis. The measurements show clearly that the effect of the infrared laser persists up to 30 days post stimulation, with evidence of modifications of organelles revealing high functioning, while after 30 days a notable inhibition of this functioning is observed. It is therefore concluded that the effects of infrared radiation persist for precise times, provoking a drastic transformation in hepatocyte components, and thus the functioning of these high-metabolism cells.

Effect of laser on the remnant liver after the first 24 hours following 70 percent hepatectomy in rats / Efeito do laser no fígado remanescente nas primeiras 24 horas após hepatectomia a 70 por cento em ratos

PURPOSE: To evaluate the mitochondrial function of the remnant liver (RL) in the early phase of liver regeneration in rats after 70 percent partial hepatectomy (PH). METHODS: Sixty male Wistar rats (200-250g) submitted to 70 percent PH were divided into five groups according to the time of euthanasia and application or not of laser light: C = Control, time zero; 2 minutes, 4, 6 and 24 hours after PH. The dose of laser radiation was 22.5 J/cm², wavelength of 660 nm (visible/red), in the remnant liver. We studied the respiration activated by ADP (state 3), basal mitochondrial respiration (state 4), respiratory control ratio (RCR) and mitochondrial membrane potential (MMP). RESULTS: The mitochondrial function of RL changed at 4 and 6 hours after PH, with a significant increase in state 3 and a concomitant increase in state 4 and with maintenance of RCR. MMP differed significantly between the groups biostimulated with laser radiation and the control group 4 hours after HP, with a substantial reduction in the non-laser groups. CONCLUSION: The laser light at the dose used in this study did not induce additional damage to the RL and seems to have delayed the hepatocellular metabolic overload of the remnant liver.

OBJETIVO: Avaliar a função mitocondrial do fígado remanescente (FR) na fase precoce da regeneração hepática em ratos após hepatectomia parcial (HP) a 70 por cento. MÉTODOS: Sessenta ratos machos Wistar (200 - 250g) submetidos à HP a 70 por cento, foram distribuídos em cinco grupos de acordo com o tempo de eutanásia e com aplicação ou não de luz laser: C= Controle,tempo zero; 2 minutos, 4, 6 e 24 horas após HP. O laser foi utilizado na dose 22.5 J/cm², 660 nm, no FR.Estudou-se o estado 3 (respiração ativada por ADP), estado 4 (respiração mitocondrial basal), razão de controle respiratório,estado 3/estado 4 (RCR) e o potencial de membrana mitocondrial(PMM). RESULTADOS: A função mitocondrial do FR alterou-se no período de 4 e 6 horas após a HP com aumento significativo do estado 3 e aumento concomitante do estado 4, com manutenção da RCR. O PMM apresentou diferença significativa entre os grupos bioestimulados com laser e o controle a partir de 4 horas pós HP, com queda importante do grupo sem laser e tendência a equiparação dos valores após 24 horas. CONCLUSÃO: A luz laser, na dose utilizada no presente estudo, não induziu lesão adicional ao FR e parece ter retardado a sobrecarga hepatocelular do fígado remanescente.

Análisis morfométrico del efecto de estimulaciones de láser infrarrojo sobre núcleos de hepatocitos de rata / Morphometric analysis of the effect of infrared laser stimulation on hepatocyte nuclei in rats

De ratas Sprague Dawley tanto normales como irradiadas con dosis diarias de 1, 2, 4, 8, y 16 J/cm2 durante 15 días emitidas por el láser AsGa equivalente a 904 nm previamente anestesiadas, fueron quirúrgicamente obtenidas muestras de hígado, las que posteriormente fueron procesadas para microscopía óptica, siendo estudiadas y sometidas a técnicas morfométricas utilizando aumentos de 1000X, con especial énfasis en cuantificar áreas de núcleos y nucleolos. El análisis de los resultados entre hepatocitos normales e irradiados revela que existen marcadas diferencias entre sus áreas tanto nucleares como nucleolares, concluyéndose que los efectos de estas dosis de radiación infrarroja provoca en los hepatocitos una drástica transformación en sus componentes y por ende en su funcionalidad, principalmente en la relativa a la síntesis proteica, representando el efecto de estas estimulaciones sobre este tipo celular de elevado metabolismo.

Liver samples were taken from previously anaesthetised Sprague Dawley rats, both normal and irradiated with daily doses of 1, 2, 4, 8, and 16 J/cm2 applied over 15 days by AsGa laser equivalent to 904 nm. These samples were then processed for optical microscopy. They were studied and subjected to morphometric techniques using 1000X magnification, placing special emphasis on the quantification of the areas of nuclei and nucleoli. An analytic comparison of the results between normal and irradiated hepatocytes reveals the existence of significant differences between both the nuclear and nucleolar areas studied, from which it is concluded that the effect of these doses of infrared radiation is to provoke a drastic transformation in the components of the hepatocytes, and therefore in their functioning, principally with respect to protein synthesis, and that this would be the effect of stimulation of this nature on this type of high-metabolism cell.

Ameliorating effects of genestein: study on mice liver glutathione and lipid peroxidation after irradiation

Genistein is a soya isoflavone, which is found naturally in legumes, such as soybeans and chickpeas. Radiation-induced free radicals in turn impair the antioxidative defense mechanism, leading to an increased membrane lipid peroxidation that results in damage of the membrane bound enzyme and may lead to damage or death of cell. Hence, the lipid peroxidation is a good biomarker of damage occurs due to radiation and the inhibition of lipid peroxidation is suggestive of radioprotective action. Glutathione has been shown to protect cells against oxidative stress by reacting with peroxides and hydroperoxides and determines the inherent radiosensitivity of cells. For experimentation, healthy Swiss Albino male mice of 6 -8 weeks old were selected from inbred colony. Genistein was dissolved in dimethyl sulfoxide and then prepared different concentration solutions so that the volume administered intraperitoneally was 0.5 ml. Lipid peroxidation was estimated by the method of Ohkawa and GSH was estimated by the method of Moron. The intraperitoneal administration of optimum dose [200 mg/kg body weight] of Genistein before 24 hrs and 15 minutes of irradiation [8 Gy at a dose rate of 1.02 Gy/min] reverted the increase in lipid peroxidation [by 18.01% +/- 3.05] and decrease of Glutathione [by 62.05% +/- 21.58] caused by irradiation in liver of Swiss albino mice. Statistically analyzed survival data produced a dose reduction factor [DRF] = 1.24. The results indicate that Genistein against radiation effect may pave way to the formulation of medicine in radiotherapy for normal tissue and possible against radiomimetic drug induced toxicity

Modulation of radiation induced changes in nucleic acid content of liver of Swiss albino mouse by Tinospora cordifolia [Miers]

Radiotherapy is the main modality of cancer treatment. There are many chemical radioprotectors which unfortunately have lethal or toxic effect. Therefore the search is on to find out natural plant based radioprotectors. A well known medicinal plant, which is more acceptable to the body, Tinospora cordifolia, was tested in animal tissues against gamma radiations. Radioprotective effects of Tinospora cordifolia [Miers] extract against radiation induced biochemical changes in liver of Swiss albino mouse were investigated. For experimental study, healthy swiss albino mice were selected from an inbred colony and divided into six groups and exposed to 6Gy and 8Gygamma radiation [control] or 6Gy and 8Gy gamma radiation with 5mg/ kg body weight of TC extract [experimental], sham irradiated [Normal] and plant extract only. Mice were sacrificed at various post irradiation intervals and liver was removed for quantitative estimation of DNA and RNA. On the first day post irradiation in control group [6Gy and 8Gy both]. DNA content decreased significantly as compared to the sham irradiated controls. Then there was continuous increase uptill 28[th] day but it remained below the normal. Decrease in DNA content of liver in the experimental group [6Gy] was observed on 1[st] day but the values were higher than that of the controls. RNA content increased in the control animals treated with 6Gy and 8Gy which was maximum at day 3, followed by a decrease at the subsequent intervals. Increase in the amount of RNA was recorded in the experimental animals also. Then came down to the normal on 10[th] day in the experimental groups [P<0.01]. These results indicate that TC is able to protect nucleic acids the liver of Swiss albino mouse against gamma radiation

Hepatoprotective efficacy of Grewia asiatica fruit against oxidative stress in swiss albino mice

The radioprotective effect of Grewia asiatica fruit [GAE] which contains anthocyanin type cyanidin 3- glucoside, vitamin C, A, minerals, carotenes and dietary fibers etc was studied. For study Swiss albino mice were divided into five groups-1. Control [vehicle treated] 2. GAE treated [700 mg / Kg. b.wt / day for fifteen days], 3. Irradiated [5 Gy], 4. GAE + Irradiated and 5. Irradiated + GAE treated. The irradiation of animals resulted in a significant depletion in the DNA and RNA level at all intervals studied viz 1-30 days in comparison to control group. Treatment of mice with GAE before and after irradiation caused a significant elevation in liver DNA and RNA level in comparison to irradiated mice. Photomicrograph of liver histology also showed that pre and post supplementation of GAE provides protection against radiation. Similarly counting of different type hepatocytes also showed that GAE protect the liver against radiation. Thus biochemical and histopathological results proves that GAE has the potential against radiation

Challenge and Hope in Radiotherapy of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease. The tumor stage and underlying liver function are both major determinants of the treatment selection as well as prognosis in HCC patients, thus allowing no more than a 20% chance for potentially curative therapies. Radiotherapy technology has been evolved remarkably during the past decade, and radiation can be precisely delivered, thereby permitting higher doses to the tumour and reduced doses to surrounding normal tissues. There has been increasing interest in the merits of radiotherapy in HCC over the past few years, as indicated by a Pub Med search. Radiotherapy has been used as the definitive therapy with curative intent in early stage tumours. It has been used also in combination with TACE for intermediate stage tumours. In locally advanced tumours, radiotherapy has been combined with systemic agents. Despite its efficacy, radiotherapy has not yet been incorporated into the standard management guidelines of HCC. The lack of high evidence level data, especially randomized controlled trials, has posed an obstacle in including radiotherapy into the routine treatment schema of HCC. Therefore, well-designed prospective studies are strongly recommended using developing technology for radiotherapy alone or combination therapies. Also, many issues such as the optimal dose-fractionation, intra- or extrahepatic metastasis after radiotherapy, and radiation-induced hepatic dysfunction remain to be solved. In this review, current status of radiotherapy for HCC will be discussed with regard to technical consideration and combination strategy. The limitation and future perspectives will also be discussed.

Dissemination of bacteria labeled with technetium-99m after laparotomy and abdominal insufflation with different CO2 pressures on rats

PURPOSE: To asses the dissemination of bacteria labeled with technetium-99m (99mTc) from peritoneal cavity after different surgical procedures. METHODS: Bacteria of the Escherichia coli species labeled with 99mTc were used in a concentration of 10(8) units of colony-makers for ml (UFC/ml) and 1ml was inoculated through intra-peritoneal via. Forty-eight rats were divided into four groups: control, laparotomy, pneumoperitoneum with 10mmHg and pneumoperitoneum with 20mmHg of CO2. Procedures were performed 20 min after injection of the inoculum and lasted 30 min. Animals were sacrificed after six hours (Group 1) and 24 hours (Group 2). Samples of blood, liver and spleen were collected for radioactivity counting. RESULTS: After six hours, indirect detection of the bacteria in different organs was uniform in all groups. After 24 hours, a larger detection of technetium was observed in the livers of animals of the group insufflated with 20mmHg of CO2, when compared with those of control group (p<0.01). The other groups did not present statistically significant variations. CONCLUSIONS: The use of a higher intra-abdominal pressure was associated with a higher bacterial dissemination to the liver. The application of lower intra-abdominal pressures may be associated with a lower dissemination of the infectious status during laparoscopic approach of peritonitis status.

OBJETIVO: Avaliar a disseminação de bactérias marcadas com tecnécio-99m (99mTc) a partir da cavidade peritoneal após diferentes procedimentos cirúrgicos. MÉTODOS: Foram utilizadas bactérias da espécie Escherichia coli marcadas com 99mTc em uma concentração de10(8) unidades formadoras de colônia por ml (UFC/ml) sendo inoculado 1ml por via intra-peritoneal. Quarenta e oito ratos foram divididos em quatro grupos: controle, laparotomia, pneumoperitôneo com 10 mmHg e pneumoperitôneo com 20 mmHg de CO2. Os procedimentos foram realizados 20 minutos após a injeção do inóculo e duraram 30 minutos. Os animais foram sacrificados após seis horas (grupo 1) e 24 horas (grupo 2). Foram coletadas amostras de sangue, fígado e baço para contagem radioativa. RESULTADOS: Após seis horas, a detecção indireta das bactérias nos diferentes órgãos foi uniforme em todos os grupos. Após 24 horas, observou-se uma maior detecção de tecnécio nos fígados dos animais do grupo insuflado com 20 mmHg de CO2, quando comparados aos do grupo controle (p<0,01). Os outros grupos não apresentaram variações estatisticamente significativas. CONCLUSÕES: A utilização de pressões intra-abdominais mais elevadas associou-se a uma maior disseminação bacteriana para o fígado. A utilização de pressões intra-abdominais menos elevadas na abordagem da peritonite pode estar associada a uma menor disseminação do quadro infeccioso.

New photonic technologies for the treatment and diagnosis of hepatic diseases: an overview of the experimental work performed in collaboration, between Physics Institute of São Carlos and Ribeirão Preto Faculty of Medicine of the University of São Paulo / Novas tecnologias fotônicas no tratamento e diagnóstico de doenças hepáticas: uma revisão dos trabalhos experimentais realizados em colaboração, entre o Instituto de Física de São Carlos e a Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

Recent advances in optical techniques have created a great range of possibilities for diagnosis and therapeutics in liver related diseases. With the uses of efficient light sources like lasers and LEDs (Light Emitting Diodes) it is possible to employ the light-tissue interaction to promote hepatic tissue regeneration after partial hepatectomy, to detect hepatocarcinoma and steatosis by utilizing optical fluorescence, to evaluate the metabolism of the liver during hepatic transplantation as well as to treat liver tumors. We present here an overview of the technique presently in development at the Ribeirâo Preto Faculty of Medicine - USP in cooperation with the Physics Institute of São Carlos -USP. The results obtained so far have been the subject of a list of publications and are here presented as an overview. A new perspective for modern application of optical techniques in different medical practices related to the liver is presented.

Recentes avanços em técnicas ópticas têm propiciado vasto campo de possibilidades tanto para o diagnóstico quanto para a terapêutica de doenças hepáticas.Com o uso de eficientes fontes de luz como o laser e Light emitting diodes (LED) é possível utilizar a interação luz-tecido para promover a regeneração hepática após hepatectomias parciais,detectar hepatocarcinoma, esteatose e outras alterações do fígado pelo uso da fluorescência óptica,para avaliar o metabolismo hepático durante o transplante de fígado e na abordagem diagnóstica e terapêutica de alterações hepatocelulares. Os autores apresentam uma ampla revisão de técnicas atualmente em desenvolvimento na Divisão de Gastroenterologia Cirúrgica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo num trabalho cooperativo com o Instituto de Física de São Carlos da USP. Os resultados obtidos até agora têm sido motivo de lista de publicações que são aqui apresentados em forma de revisão. Uma nova perspectiva de moderna aplicação de técnicas ópticas em várias situações clínico-cirúrgicas relacionadas com o fígado é apresentada e amplamente discutida.

The effect of laser on remanescent liver tissue after 90 percent hepatectomy in rats / Efeito do laser no tecido hepático após hepatectomia a 90 por cento em ratos

PURPOSE: To evaluate the effect of laser beam on remanescent liver after partial hepatectomy 90 percent. METHODS: Wistar rats, (N= 42), were divided into six groups with seven specimens each. The partial hepatectomy (HP) was performed in all animals through exeresis of approximately 90 percent of the liver parenchyma. The animals from groups HP and Laser application, HPL24, HPL48 and HPL72 undertook laser irradiation carried out through application (dose of 22.5 J/cm²) in five different sites in the remanescent liver. The rats were then sacrificed 24, 48 and 72hours after HP procedure, for the liver regeneration analysis,using the Proliferating Cell Nuclear Antigen (PCNA),and for dosage of serum aminotransferases. RESULTS: Were demonstrated an increase of the serum levels of alanine aminotransferase for the group of 24 hours and a decrease for the group of 72 hours exposed to laser. The index of marked cells had a considerable more improvement for the group of 72 hours exposed in laser compared to other groups. CONCLUSION: Laser did not cause hepatic injuries additional to the partial hepatectomy and perhaps led to a benefit by stimulating the proliferative activity.

OBJETIVO: Avaliar o efeito da luz laser em remanescentes hepáticos após hepatectomia a 90 por cento. MÉTODOS: Aplicou-se luz laser com comprimento de onda de 660 nm e potência de 30 mw, por 30 segundos, na dose de 22,5 J/cm² em cada um deles, repetidos em cinco pontos do fígado remanescente, após realizada a hepatectomia a 90 por cento. Os animais foram sacrificados para análise do fígado, contagem de hepatócitos em proliferação (Proliferating Cell Nuclear Antigen -PCNA), e coleta de sangue para dosagem serica das aminotransferases, após 24, 48 e 72 horas. RESULTADO: O índice de células marcadas teve significativo aumento no grupo de 72 horas irradiados com laser. CONCLUSÃO: A análise dos resultados demonstrou que o laser não causou lesões hepáticas adicionais à hepatectomia parcial e estimulou a atividade proliferativa hepatocelular.

Scintigraphy of the hepatobiliar system in patients with pulmonary tuberculosis

The objective of this paper was to evaluate the hepatobiliary function of patients with pulmonary tuberculosis under triple treatment, using the technetium-99m-DISIDA (99mTc-DISIDA) hepatobiliary scintigraphy. Ten men and three women with pulmonary tuberculosis were subjected to hepatobiliary scintigraphy at the beginning of triple treatment (M1) and two months after it (M2). Patients were from the urban area, of low socioeconomic level, malnourished, and chronic alcohol and/or tobacco users. Ten normal individuals were evaluated as controls. Radiotracer images were acquired on a computerized gamma camera (Orbiter-Siemens) and T1/2 uptake and excretion values were calculated. Nutritional status and serum hepatic enzyme levels for each patient were evaluated at M1 and M2. None presented clinical or laboratory antecedent of hepatobiliary disease. At M1, there were no hepatic serum or kinetic alterations of the 99mTc-DISIDA. At M2, patients presented better nutritional conditions than at M1; there was increased serum aspartate aminotransferase (AST) and reduced excretion time for 99mTc-DISIDA, which was interpreted as a more adaptive than toxic phenomenon, yet not all alterations were significant and none manifested clinically. Apparently, triple treatment acted on the liver inducing the P450 cytochrome enzymatic system, accelerating radiotracer excretion, which follows the same path as the bilirubins