Assessment of remnant liver function and volume after selective ligation of portal vein and hepatic artery in a rat model

Abstract Purpose: To evaluate liver regeneration after selective ligation of portal vein and hepatic artery by 3D Computed Tomography in an experimental model. Methods: Sixteen Wistar rats were randomized into four equal groups: Group I- control (sham), Group II- isolated selective ligation of the hepatic artery, Group III- isolated selective ligation of the portal vein and Group IV- combined ligation of portal vein and hepatic artery. Before procedure and five days after a 3D CT Scan was performed to analyze the hypertrophy, weight and function of the remnant liver. Results: The largest regeneration rate and increase of weight in the hypertrophied lobe was detected in group IV, the first with an average of 3.99 (p=0.006) and the last varying from 6.10g to 9.64g (p=0.01). However, total liver weight and the R1 ratio (Hypertrophied Lobe Weight/Total Liver Weight) was higher in group III (P<0.001) when compared with groups I, II and IV and showed no difference between them. The immunohistochemical examination with PCNA also found higher percentages with statistical significance differences in rats of groups III and IV. It was possible to confirm a strong correlation between hypertrophied lobe weight and its imaging volumetric study. Liver function tests only showed a significant difference in serum gamma-glutamyltransferase and phosphorous. Conclusion: There is a largest liver regeneration after combined ligation of portal vein and hepatic artery and this evidence may improve the knowledge of surgical treatment of liver injuries, with a translational impact in anima nobile.

Value of clinical features in the diagnosis of enteric fever.

There is no objective data on the value of individual clinical symptoms or signs in the diagnosis of enteric fever in a febrile patient. The purpose of the study was to assess the value of some clinical and simple laboratory features in the diagnosis of enteric fever. One hundred & six patients with microbiologically confirmed enteric fever and 170 patients with other established febrile illnesses were included in the evaluation. History of stepladder pattern of rise of temperature, loose motions, relative bradycardia and coated tongue proved to be powerful markers of enteric fever with high specificity (100%, 94.71%, 94.71%, 94.12% respectively), positive and negative predictive values. Headache, hepatomegaly and splenomegaly were moderately powerful. ESR and WBC count appeared to have little value in the diagnosis of enteric fever. Pattern of onset and loose motions did not discriminate between typhoid and paratyphoid fever. Most of these patients had illness persisting beyond one week by which viral infections and infectious enterocolitides were largely excluded. Elucidation of power of these markers in distinguishing enteric fever from other febrile illnesses with the help of better designed prospective studies would lessen our dependence on expensive and time consuming laboratory investigations.

Epidemiologia del alcoholismo en el hospital de clinicas. Servicio de medicina varones II en los periodos de 1978-1987 / Epidemiology of alcoholism in the male patients of Hsopital de Clionicas

Histologicamente segun estudios hechos por Goncalvez y col. la necrosis e infiltrado inflamatorio se presento en todos los casos, mientras que la esteatosis en un 98 //. En los pacientes fallecidos se encontro con mas frecuencia la ictericia, hemorragia digestiva alta y la encefalopatia. La tasa de mortalidad especifica segun Dieter Gorenc y col., fue de 45,8/100.000. El estudio realizado en el Hospital de Clinicas permite demostrar tasas especificas de morbimortalidad en nuestro medio no estudiadas con anterioridad en este centro hospitalario, para hacer de este modo un estudio comparativo con el resto de paises latinos.

Platelet antibodies in bilharzial Hepatosplenomegaly

This study was conducted on forty subjects, thirty male patients with bilharzial hepatosplenomegaly and ten healthy control subjects matched for age and sex. Platelets were studied quantitatively and platelet functions were assessed by bleeding time, clot retraction, platelet adhesion and aggregation. Immunological investigations including determination of serum immunoglobulins [IgG, IgM, and IgA], serum complement [C3c and C4], circulating immune complexes [CICs], as well as clot retraction test for detection of platelet antibodies. There was a significant reduction of platelet count and a negative correlation between the platelet count and the platelet antibodies in patients group. Diminished platelet functions were demonstrated by decreased platelet adhesion, decreased clot retraction, and impaired adenosine diphosphate [ADP] aggregation. No statistical correlation was found between the impairment of aggregation and the degree of inhibition of clot retraction. On the contrary, and inverse correlation was demonstrated between clot retraction and platelet antibodies. Significant higher levels of IgG and IgM in patients' group were detected whereas serum IgA levels showed no statistical difference. Significantly increased levels of serum C3c were demonstrated and there was an inverse correlation between C3c levels and platelet count, however, there was no correlation between serum C3c and platelet antibodies. Serum levels of C4 were not significantly deviated from normal levels. Serum levels of CICs were higher in patients' group and a significant positive correlation was found between these complexes and serum IgG levels. In conclusion, the present study proved the presence of platelet antibodies in patients with bilharzial hepatosplenomegaly. The observed quantitative and qualitative platelet defects in those patients had been correlated to the presence of platelet antibodies and the concomitant immunological disturbances