Biomedical subjects

S Bengmark

Publications and source records attributed to S Bengmark.

At least 55 records · Page 3Linked to original sources

PubMed1994

Obstructive jaundice impairs reticuloendothelial function and promotes bacterial translocation in the rat.

Septic complications and renal insufficiency following biliary tract surgery are frequently seen in patients with obstructive jaundice. The precise mechanisms for understanding the susceptibility of the jaundiced patients to sepsis are, however, not clear. The present study aimed at investigating the influence of biliary obstruction on the reticuloendothelial function and bacterial translocation at various time intervals in the rat. Reticuloendothelial system (RES) function, as evaluated by measuring blood clearance of intravenously injected 125I-labeled Escherichia coli, and bacterial translocation were studied 3 days and 1, 2, and 3 weeks following either sham operation or common bile duct ligation (CBDL) and transection in the rat. RES function was significantly impaired and renal uptake of radiolabeled E. coli was significantly higher in jaundiced animals from Day 3 and on after CBDL (P < 0.01) concomitant with elevation of plasma levels of bilirubin and liver enzymes (P < 0.001) compared with their corresponding controls. The incidence of bacterial translocation 3 days and 1 and 2 weeks after biliary obstruction significantly increased (P < 0.05). We conclude that RES phagocytic function is impaired and the incidence of bacterial translocation is increased in jaundiced rats. These findings might contribute to explain the high susceptibility of postoperative septic complications and renal dysfunction in patients with obstructive jaundice.

Acute Kidney Injury↗

PubMed1994

Bacterial translocation after intraperitoneal implantation of rubber fragments in the splenectomized rat.

The aim of the present study was to determine the influence of splenectomy on the incidence of enteric bacterial translocation in rats with intraperitoneal rubber drain implantation. Male Sprague-Dawley rats (250-300 g) underwent splenectomy or sham operation 7 days prior to the intraperitoneal implantation of rubber drain fragments (7 cm2). Bacterial translocation was measured 2 days after rubber drain implantation. The incidence of bacterial translocation was significantly higher in the group with intraperitoneal rubber drain implantation plus sham splenectomy than in the groups with sham splenectomy plus sham implantation, splenectomy plus sham implantation or splenectomy plus rubber drain implantation. An increase in ileal permeability of 125I-human serum albumin was induced by intraperitoneal rubber drain implantation and ameliorated by splenectomy. Splenectomy also improved the impaired intestinal motility induced by intraperitoneal rubber drain implantation. Histological examination revealed a preserved normal mucosal architecture in splenectomized rats. Thus, splenectomy reduced the rate of enteric bacterial translocation induced by intraperitoneal biomaterial implantation.

Animals↗

PubMed1994

Rearterialization of liver tumors after various dearterialization procedures.

Repeat dearterializations seem to be a means to prevent collateral formation, which is partly responsible for the failure of hepatic artery ligation (HAL) or permanent dearterialization when used to treat liver tumors. In this study restoration of tumor blood flow was evaluated after various procedures: HAL (n = 12), permanent dearterialization (n = 18), repeated dearterializations for 2 hr/day (n = 12), and sham dearterialization (n = 12). Tumor blood flow was measured 10 days after sham dearterialization, permanent dearterialization, and repeated dearterializations for 2 hr in order to further illustrate the effect of prolonged dearterialization on tumor rearterialization. Hepatic and tumor arterial blood flow was measured using the reference organ method (NEN, 141Ce microspheres with diameter 15 microns). Our results showed that during a transient dearterialization blood flow decreased to 1% (0.01 +/- 0.01 ml/min/g) of the flow in the controls (0.82 +/- 0.10 ml/min/g) (P < 0.01). After HAL tumor blood flow recovered to initial levels after 48 hr (0.73 +/- 0.17 ml/min/g). Even in rats subjected to a permanent dearterialization blood flow was reestablished at Day 6 (0.59 +/- 0.21 ml/min/g). In contrast, after repeat daily 2-hr dearteralizations blood flow remained significantly very low during the 6th transient dearterialization (0.11 +/- 0.03 ml/min/g) compared with both sham-operation and HAL as well as permanent dearterialization (P < 0.01). During the 10th daily dearterialization tumor blood flow was still significantly low compared with both controls (P < 0.001) and permanent dearterialization (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Inhibition of bacterial translocation in obstructive jaundice by muramyl tripeptide phosphatidylethanolamine in the rat.

Obstructive jaundice is frequently associated with septic complications and enteric bacteria have been isolated from both the infectious focus and bile in jaundiced patients. The present study aimed to evaluate bacterial translocation and the influence of a macrophage-stimulant (muramyl tripeptide phosphatidylethanolamine) on bacterial translocation in obstructive jaundice. Male Sprague-Dawley rats were subjected to sham operation (n = 10) or common bile-duct ligation and transection (n = 35). Two weeks later, jaundiced animals received either physiological saline (n = 15), muramyl tripeptide phosphatidylethanolamine liposomes (n = 10) or placebo (empty) liposomes (n = 10) orally, while sham-operated rats received physiological saline, 48 h prior to evaluation of enteric bacterial translocation. Blood, bile and caecal contents were collected and cultured aerobically and anaerobically, as were tissue samples from the liver, spleen and mesenteric lymph nodes. Positive mesenteric lymph node cultures in animals with jaundice + saline (7/15; 47%) and jaundice + placebo liposomes (4/10; 40%) significantly differed (p < 0.05) from sham-operated animals (1/10; 10%) and muramyl tripeptide phosphatidylethanolamine treated animals (0/10). Caecal counts (CFU/g) of Escherichia coli, Lactobacilli and aerobic and microaerobic bacteria did not differ statistically among the groups, although the number of E. coli tended to be higher in jaundiced animals. Thus, liposomal muramyl tripeptide phosphatidylethanolamine inhibits bacterial translocation, probably by activating mucosal macrophages and enhancing reticuloendothelial system function in rats with biliary obstruction.

Acetylmuramyl-Alanyl-Isoglutamine↗

PubMed1994

Promotion of Escherichia coli adherence to rubber slices by adsorbed fibronectin.

Biomaterial-associated infections are a problem in the use of endoprosthetic materials in the palliative treatment of malignant obstructive jaundice. Fibronectin has been reported to mediate adherence of bacteria to host tissue and biomaterials. Adsorption of fibronectin to rubber--representing material used for biliary drainage--and subsequent adherence of Escherichia coli strain PSS1 and E. coli strain NG7C (which binds to immobilised fibronectin) were investigated. Quantitative adsorption of fibronectin to rubber slices was studied with 125I-labelled, purified human plasma fibronectin. In buffer solutions, fibronectin showed a high affinity for rubber slices. Adherence of the E. coli strains to uncoated rubber slices was similar and was significantly inhibited by the presence of plasma components and bile. Adherence of E. coli PSS1 to fibronectin-coated slices was poor. In contrast, E. coli NG7C adhered efficiently to coated slices in proportion to the amount of adsorbed fibronectin; adherence was not reduced by the presence of albumin or bile, or the fibronectin-binding ligands gelatin, heparin and fibrinogen. However, pre-digestion of coated slices with trypsin significantly reduced adherence.

Adsorption↗

PubMed1994

Abdominal rubber drain piece aggravates intra-abdominal sepsis in the rat.

Biomaterials in the peritoneal cavity disrupt the physiology of the host and may cause bacterial translocation. The current study was performed to determine whether biomaterials exacerbate intra-abdominal infections. Adult male rats were divided into four groups: group 1, celiotomy+intraperitoneal (i.p.) saline; group 2, celiotomy+i.p. Escherichia coli (3 x 10(8) cfu); group 3, i.p. rubber+i.p. saline; and group 4, i.p. rubber+i.p. E. coli (3 x 10(8) cfu). Twelve h after the challenge, enteric bacterial translocation, bacterial population levels in the cecum and serum levels of IL-6 and TNF were measured. Bacterial translocation to mesenteric lymph nodes and the liver was observed in animals from groups 2 and 3, but significantly increased in group 4 with a concomitant elevation of serum levels of TNF and IL-6, as compared with group 1. Histological examination revealed a more pronounced inflammatory reaction in the peritoneum and distal ileum in group 4 than in groups 2 and 3. These results suggest that the presence of rubbers in the peritoneal cavity aggravates intra-abdominal sepsis.

Abdomen↗

PubMed1994

The influence of portal deviation on the effect of repeat dearterializations of a transplantable adenocarcinoma to the rat liver.

As liver tumours receive some of their blood supply from the portal vein, we wanted to illustrate the influence of portal blood flow in combination with dearterialization in the treatment of liver tumours. Forty male, inbred Wistar/Furth rats with an adenocarcinoma transplanted to the liver were treated with various inflow occlusions repeated daily for 5 days. Deviation of the portal blood flow alone with an end-side porto-caval shunt did not alter the tumour growth (p = 0.089). Thirty min of repeat dearterializations was potentiated by portal deviation so that tumour growth was delayed (p = 0.004). However, repeat dearterializations for 60 min in portal deviated rats induced irreversible liver damage and all rats died in a few days. Repeated dearterializations for 60 minutes alone retarded the tumour growth as efficiently (p = 0.007). Simultaneous occlusion of the hepatic artery and the portal vein for 30 minutes with a side-side porto-caval shunted (total devascularization) did not affect tumour growth (p = 0.154). Liver aminotransferases (ASAT and ALAT) were substantially increased following dearterialization for 30 min in rats with either an end-side or a side-side porto-caval shunt. Dearterialization for 60 min in rats with end-side porto-caval shunts gave a further release of ASAT and ALAT. In conclusion, portal deviation did not augment the therapeutic benefit of repeat dearterializations for the treatment of this experimental liver tumour. Repeat dearterializations alone seemed to be a feasible and efficient therapy for liver tumours.

Adenocarcinoma↗

PubMed1994

Orally administered phospholipids inhibit abdominal rubber-drain-induced bacterial translocation in the rat.

In order to determine the influence of phospholipid on abdominal biomaterial-induced bacterial translocation (BT), phsophatidylcholine (PC) or phosphatidylinositol (PI) was administered orally or intraperitoneally in rats with intraperitoneal implantation of 7-cm2 rubber drain pieces. Two days after surgery, the incidence of translocation to mesenteric lymph nodes and liver significantly decreased, the adherence of 3H-labeled Escherichia coli to the ileal mucosa was significantly inhibited and the phagocytic and bactericidal capacity of peritoneal macrophages increased in animals with PC or PI administered orally, but not intraperitoneally, as compared with rats without phospholipid administration. Scanning electron microscopy revealed a coating layer on the surface of the intestinal mucosa in phospholipid-gavaged rats. Thus, the results in the present study imply that oral, but not intraperitoneal, PC of PI administration reduces enteric BT induced by intraperitoneal drain implantation.

Administration, Oral↗

PubMed1994

Phospholipids prevent enteric bacterial translocation in the early stage of experimental acute liver failure in the rat.

BACKGROUND: Bacterial infections and bacteremia in acute liver failure may at least partly be attributed to translocation of enteric bacteria. Attempts to prevent or treat such infections by the use of antibiotics may instead result in overgrowth of surviving microbes. METHODS: In the present study, normal saline (1.5 ml/100 g body weight), phosphatidylcholine (1.5 ml/100 g body weight), and phosphatidylinositol (1.5 ml/100 g body weight) were orally administered by means of a gastric tube both 12 h and 30 min before operation. Effects of enteric administration of phospholipids on the prevention of enteric bacterial translocation, intestinal and mucosal mass, and enterocyte protein contents in acute liver failure induced by subtotal liver resection in the rat were evaluated. RESULTS: The incidence of bacterial translocation increased significantly 2 and 4 h after 90% hepatectomy as compared with sham-operated animals. Enteric administration of phospholipids, however, significantly reduced the incidence of bacterial translocation after 90% hepatectomy. Phospholipid treatment prevented the postoperative decrease in intestinal mucosal mass and enterocyte protein content. CONCLUSIONS: Enteral administration of phospholipids thus seems to protect against translocation of enteric bacteria and prevent against a decrease in intestinal mucosal mass and enterocyte protein content after subtotal hepatectomy in the rat.

Animals↗

PubMed1994

The association between enteric bacterial overgrowth and gastrointestinal motility after subtotal liver resection or portal vein obstruction in rats.

OBJECTIVE: To test the hypothesis that intestinal motility is delayed after hepatectomy, which alters the ecology of the enteric microflora and contributes to the development of bacterial translocation from the gut. DESIGN: Open experimental study. SETTING: University department of surgery. MATERIAL: Adult male Sprague-Dawley rats (n = 6 in each group at each time point). INTERVENTIONS: Sham operation, 90% hepatectomy, and portal venous obstruction. MAIN OUTCOME MEASURES: Intestinal morphology, immunocytochemistry of the enteric nervous system, enteric bacterial growth in the small intestine and colon, and intestinal transit time. RESULTS: Intestinal transit was already delayed one hour after 90% hepatectomy, and histopathological alterations and overgrowth by Escherichia Coli had developed after two hours. There were significant differences in intestinal transit time between sham operated rats and those subjected to portal venous obstruction on the one hand, and those that underwent 90% hepatectomy on the other. There was no difference in intestinal transit time between rats with portal venous obstruction and the sham operated animals. CONCLUSION: Delayed intestinal transit after 90% hepatectomy may contribute to enteric bacterial overgrowth and thereby contribute to the development of bacterial translocation from the gut.

Animals↗

PubMed1994

Macrophage phagocytic dysfunction and reduced metabolic response in experimental obstructive jaundice.

OBJECTIVE: To investigate the metabolic response as measured by microcalorimetry and the phagocytic activity or peritoneal macrophages that had been harvested from jaundiced and normal rats and incubated with Escherichia coli in vitro. DESIGN: Open laboratory study. SETTING: University departments of surgery and immunology. MATERIAL: 12 Male Sprague-Dawley rats. INTERVENTIONS: Ligation and transsection of the common bile duct (n = 6) or sham operation (n = 6). MAIN OUTCOME MEASURES: Metabolic response (pW/cell) measured by microcalorimetry and phagocytic function assessed by light microscopy after Giemsa stain two weeks after operation. RESULTS: The mean (SEM) maximal metabolic response of macrophages and the metabolic rate one hour after inoculation with E coli were significantly reduced in jaundiced rats compared with controls (6.95 (1.95) compared with 27.39 (7.24), p = 0.005, and 5.50 (1.05) compared with 20.10 (3.35) p = 0.016, respectively) as were the number of E coli phagocytosed by macrophages harvested from jaundiced animals (p = 0.0002). CONCLUSION: The reduced metabolic response and phagocytosis of E coli by peritoneal macrophages in rats by biliary obstruction is a sign of depressed reticuloendothelial function. This mechanism may explain the high incidence of infective complications inpatients with obstructive jaundice.

Animals↗

PubMed1993

Bacterial translocation in acute liver failure induced by 90 per cent hepatectomy in the rat.

Bacterial infection and bacteraemia have been observed in patients with acute liver failure. The exact source of bacteria and nature of pathophysiological mechanisms explaining the development of infection remain unclear. In the present study, acute liver failure was induced by 90 per cent hepatectomy in the rat. The mesenteric lymph nodes and organs were harvested aseptically for bacteriological culture after sham operation or 90 per cent hepatectomy. Function of the liver and reticuloendothelial system (RES) was assayed; gut oxygen extraction was also measured. Translocation of enteric bacteria occurred 2 h after operation and increased with time following hepatectomy. Overgrowth of Escherichia coli in the distal small intestine started 2 h after operation. RES function decreased immediately after 90 per cent hepatectomy; uptake rates per gram tissue in other organs increased significantly. These results indicate that bacterial translocation occurred early after 90 per cent hepatectomy, associated with a decrease in RES function and gut oxygen extraction, and overgrowth of intestinal bacteria.

Animals↗

PubMed1993

Effect of putative phospholipase A2 inhibitors on acetic acid-induced acute colitis in the rat.

Phospholipase activation may play an important role in ulcerative colitis. This hypothesis was tested by evaluating the effect of two non-selective phospholipase (PL) A2 inhibitors, quinacrine and p-bromophenacyl-bromide (pBPB), on acetic acid-induced colitis in the rat. The calcium antagonist verapamil, which may also act as a PLA2 inhibitor, was also tested. Acute colitis was induced in an isolated colonic segment by instillation of 4 per cent acetic acid for 15 s; this induces a uniform colitis after 4 days. The severity of colitis was evaluated histologically, by measuring myeloperoxidase (MPO) activity and by determining plasma exudation into the lumen of the colon (permeability) with 125I-labelled albumin given intravenously. All three putative PLA2 inhibitors tested were found to prevent the development of colitis. Intravenous administration of quinacrine 10 mg kg-1 at 30 min before instillation of acetic acid resulted in a normal mucosal appearance, normal MPO activity and a significantly reduced increase in plasma exudation into the colon. A similar effect was achieved using verapamil. Intracolonic administration of either quinacrine or pBPB also prevented acetic acid-induced colitis. However, three doses, starting immediately after acetic acid administration and repeated on the first and second days, were needed to achieve this, whereas one dose produced only a partial effect. PLA2 may play an important role in acetic acid-induced colitis and inhibition of its activity may offer an alternative mode of treatment in ulcerative colitis.

Acetates↗

PubMed1993

Effect of intraperitoneal prosthetic materials on reticuloendothelial function in the rat.

The effect of different intraperitoneal prosthetic biomaterials on reticuloendothelial system (RES) function and bacterial translocation were studied in the rat. Rubber drains, knitted dacron (KD), or silicone elastomer (SE) with surface areas of either 3 or 10 cm2 were implanted into the lower right part of the abdominal cavity under aseptic conditions. RES function, expressed as the phagocytic index and the uptake of 125I-labeled Escherichia coli (cpm/g tissue) in systemic organs (liver, spleen, lungs, and kidneys) and in gut-associated lymphoid tissues [GALT; i.e., mesenteric lymph nodes (MLN), jejunum, ileum, and colon], was measured 1 day after implantation/sham operation. A significant elevation of the phagocytic index was noted in all implanted groups, except the group with 3 cm2 of SE, as compared with controls. The uptake of 125I-labeled E. coli significantly increased in the liver (rubber, 10 cm2), spleen (rubber, 10 cm2), lungs (rubber, 10 cm2; KD, 3 and 10 cm2; SE, 3 and 10 cm2) and kidneys (rubber, 10 cm2), but significantly decreased in the MLN and jejunum in all implanted groups, in ileum (KD, 10 cm2; SE, 3 cm2), and colon (rubber, 10 cm2; KD, 3 and 10 cm2; SE, 3 cm2). The percentage uptake significantly increased in the systemic organs and decreased in the GALT in most of the implanted groups. Indigenous bacterial translocation to the MLN, liver, spleen, lungs, and kidneys occurred simultaneously. A size-dependent fashion in influence on RES function and incidence of bacterial translocation was observed. The results suggest that intraperitoneal prosthetic biomaterials alter host RES function with concomitant bacterial translocation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

Phospholipase-resistant phosphatidylcholine reduces intra-abdominal adhesions induced by bacterial peritonitis.

The majority of intra-abdominal adhesions develop postoperatively or following peritonitis. We have previously shown that L-phosphatidylcholine reduces postoperative peritoneal adhesions in rats. In the present study, we examined whether adhesion formation after bacterial peritonitis is also reduced by L-phosphatidylcholine or by DL-alpha-phosphatidylcholine, which is degraded only 50% by phospholipase A2. Peritonitis was induced in the rat by caecal ligation and double puncture; cecotomy was performed 12, 15, or 18 h later. Adhesions were assessed blindly by a scoring system 7 days after cecotomy. When cecotomy was scheduled for 18 h after caecal ligation and puncture, the 7-day mortality was 90% (n = 20). When cecotomy was performed at 12 h, no mortality was seen; however, the adhesion score was low (2.3 +/- 0.7). When cecotomy was performed 15 h after caecal ligation and puncture, the mortality was 25% and the adhesion score was 4.3 +/- 0.9. This figure was reduced significantly by intraperitoneal instillation of L-phosphatidylcholine or DL-alpha-phosphatidylcholine for 3 subsequent days. However, the mortality increased by L-phosphatidylcholine (P < 0.01), whereas mortality after DL-alpha-phosphatidylcholine remained at 30%. We conclude that administration of both L-phosphatidylcholine and DL-alpha-phosphatidylcholine decrease adhesion formation after bacterial peritonitis.

Animals↗

PubMed1993

Phospholipid impregnation of abdominal rubber drains: resistance to bacterial adherence but no effect on drain-induced bacterial translocation.

In order to evaluate the effect of surface modification of biomaterials on bacterial adherence and bacterial translocation after intraperitoneal biomaterial implantation, phosphatidylcholine- or phosphatidylinositol-impregnated rubber drain pieces, which had been intraperitoneally implanted in the rat for 2 and 7 days, or unimplanted, were incubated in vitro with 3H-labelled Escherichia coli and Enterobacter cloacae. As compared with unimpregnated pieces, the adherence of bacteria significantly decreased to phosphatidylcholine- and phosphatidylinositol-impregnated rubber drain pieces that were either unimplanted or implanted for 2 days, but not for 7 days. The supplementation of albumin in the medium reduced the adherence of bacteria to the unimplanted, unimpregnated drain pieces, but did not further decrease adherence of bacteria to the unimplanted, phospholipid-impregnated brain pieces. Bacterial growth was inhibited after incubation in nutrient broth supplemented with phospholipids. The incidence of enteric bacterial translocation induced by intraperitoneal drain implantation did not differ between phospholipid-impregnated and unimpregnated drain pieces. Scanning electron microscopy revealed a large amount of biofilm and fibrous deposition on the surface of the implanted, phospholipid-impregnated rubber drain pieces. Thus, phospholipid impregnation of rubber drains reduces bacterial adherence and inhibits bacterial growth, without influencing the incidence of bacterial translocation.

Abdomen↗

PubMed1993

Binding of Escherichia coli to Penrose rubber drains--an in vitro study.

Ten different isolates of Escherichia coli were used to compare bacterial attachment to Penrose rubber drains at different temperatures and to investigate a possible relation with cell surface hydrophobicity and charges, as well as the capacity of autoaggregation. Penrose rubber drain pieces of 1 cm2 were incubated with 4.8 x 10(6) E. coli cells for 1 h at 22, 37 and 42 degrees C, respectively. After rinsing with phosphate buffered saline (PBS), the number of adhering bacteria on the drain pieces was calculated by measuring cellular ATP (adenosine triphosphate) bioluminescence. Bacterial cell surface properties at different temperatures were determined by two-phase partitioning and autoaggregation was determined by arbitrary scoring under the dissecting microscope. For most strains of E. coli, the number of adherence to Penrose rubber drain was higher at 22 degrees C than at 37 degrees C and 42 degrees C. Bacterial cell-surface properties and autoaggregation capacity were influenced by the growth temperature, but without correlation to bacterial ability to attach to rubber drains. Thus, the present study demonstrates that attachment of E. coli to Penrose rubber drains was significantly influenced by temperature, but bacterial cell-surface hydrophobicity and charge as well as autoaggregation capacity had no influence on bacterial attachment ability.

Bacterial Adhesion↗

PubMed1993

Water-soluble ethylhydroxyethyl cellulose prevents bacterial translocation induced by major liver resection in the rat.

Enteric bacteria might act as pathogens, translocating across the intestinal barrier to extraintestinal sites after major liver resection. In the current study, water-soluble ethylhydroxyethyl cellulose (EHEC) was administered before hepatectomy to evaluate the influence on bacterial translocation induced by major liver resection, phagocytic capacity by visceral and circulating macrophages, enteric bacterial population, and bacterial adherence on the intestinal surface in rats subjected to sham operation or to 70% or 90% hepatectomy. Oral or intravenous (IV) administration of EHEC reduced the incidence of bacterial translocation to mesenteric lymph nodes (MLN) and blood after major liver resection. Oral EHEC appeared more effective than IV administration in protecting against bacterial translocation to MLN in animals with 90% hepatectomy. Ethylhydroxyethyl cellulose (oral and IV) significantly diminished intestinal macrophage uptake capacity of 125I-labeled, heat-killed Escherichia coli as compared with animals without EHEC administration. Overgrowth or colonization of enteric bacteria after major liver resection could be prevented by oral or IV EHEC. Adherence of 14C-labeled, alive E. coli on the intestinal mucosa decreased after EHEC treatment in animals subjected to major liver resection. Systemic arterial pressure and intestinal blood flow markedly decreased from 1 hour and on after 90% hepatectomy. Intravenous administration of EHEC did not improve these alterations. Bacterial hydrophobicity and surface negative charge were significantly reduced 1 hour after bacterial culture with EHEC. Thus, EHEC appears to be a potent agent preventing translocation of enteric bacteria from the gut after major liver resection, by altering the surface characters of enteric bacteria, balancing the enteric microflora, inhibiting bacterial attachment onto the intestinal surface, and blocking phagocytosis by intestinal macrophages.

Animals↗