Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HEPATECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources

Hepatic inflammation following 70% hepatectomy may be related to up-regulation of epithelial neutrophil activating protein-78.

Tumor necrosis factor-alpha (TNF) is known to be released after partial hepatectomy. Furthermore, TNF triggers the release of chemotactic cytokines, such as epithelial neutrophil activating protein (ENA-78), which are important for neutrophil chemotaxis, activation, and propagation of the inflammatory response. We now postulate that ENA-78 may play a role the hepatic inflammatory response that occurs following partial hepatectomy. Rats were subjected to 70% hepatectomy or sham laparotomy and were killed in a time-dependent manner. Hepatic neutrophil influx, as assessed by myeloperoxidase (MPO) levels, serum alanine aminotransferase (ALT), and hepatic TNF and ENA-78 levels, as measured by ELISA, were evaluated at 1, 6, and 12 h following operation. MPO levels became significantly elevated within 6 h of hepatectomy and remained elevated at 12 h. Serum ALT became significantly elevated within 1 h of hepatectomy and continued to rise at 12 h. Hepatic TNF and ENA-78 were also increased significantly after hepatectomy. Next, rats undergoing 70% hepatectomy were treated with neutralizing anti-ENA-78 serum; this resulted in a significant decrease in hepatic MPO and serum ALT, suggesting less hepatic injury. To determine whether ENA-78 release was induced by TNF is this model, rats were treated with neutralizing anti-TNF serum and hepatic ENA-78 levels measured 6 h posthepatectomy. ENA-78 levels were significantly decreased in the animals receiving the anti-TNF serum, suggesting that ENA-78 is released in response to TNF in this model. These data suggest that TNF triggers the release of ENA-78 following 70% hepatectomy and that ENA-78 contributes to the hepatic neutrophil influx and liver injury following 70% hepatectomy.

Alanine Transaminase↗

Extent of hepatectomy in the rat. Evaluation of basal conditions and effect of therapy.

In the present study, subtotal hepatectomy was evaluated as a model of acute liver failure in the rat. Sprague-Dawley rats, weighing 250-300 g, underwent hepatectomy under varying basal conditions of temperature and glucose administration. Rats operated and maintained postoperatively at ambient temperature (25 degrees C external environment) developed hypothermia with a rate of return to normal temperature which was related to the extent of hepatectomy and the availability of glucose postoperatively. However, no significant difference in survival was observed between groups maintained at ambient temperature and those whose core temperature was maintained at 37 degrees C by passive external warming. Severe hypoglycemia was observed in rats undergoing 90 and 95% hepatectomy without glucose postoperatively. With 20% glucose available in drinking water the mortality of 90% hepatectomy was reduced from 95 to 40% (p less than 0.0001). With increase of the hepatectomy to 95%, 90% mortality was observed despite glucose support. Transplantation of 4 x 10(7) isolated syngeneic hepatocytes intraperitoneally at the time of hepatectomy did not increase survival after 90 or 95% hepatectomy; addition of testosterone therapy did not improve survival either alone or with hepatocyte transplantation. In this study, hepatectomy exceeding 90% was lethal and did not respond to the supportive measures provided. Hepatocyte transplantation and testosterone pretreatment, both therapies which are thought to increase regeneration, were ineffective in improving survival in this resection model.

Animals↗

Experimental study of vagotomy for prevention of stress ulcer after hepatectomy of cirrhotic livers. Its influence on hepatic regeneration.

We experimentally studied the influence of vagotomy on hepatic regeneration in rats after hepatectomy of cirrhotic livers. In animals that underwent hepatectomy plus vagotomy the reduction in gastric pH was suppressed, but gastric mucosal blood flow was less than that in control animals that received hepatectomy alone. The suppression of 3H-thymidine uptake percentage and thymidine kinase activity after hepatectomy was more marked in animals treated with hepatectomy plus vagotomy than in controls treated with hepatectomy alone. Hepatic DNA level tended to be lower in animals treated with hepatectomy plus vagotomy than in controls. In animals treated with hepatectomy plus vagotomy, the peak level of the mitotic index was lower and the hepatic regeneration rate was evidently suppressed. These results suggest that it is not appropriate to apply vagotomy, during hepatectomy of cirrhotic livers, for the prevention of postoperative stress ulcer because it causes a marked reduction in gastric mucosal blood flow and suppresses hepatic regeneration.

Animals↗

Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm.

AIM: To determine which treatment modality--hepatectomy or percutaneous ablation--is more beneficial for patients with small hepatocellular carcinoma (HCC) (< or =4 cm) in terms of long-term outcomes. METHODS: A retrospective analysis of 149 patients with HCC < or =4 cm was conducted. Eighty-five patients underwent partial hepatectomy (anatomic in 47 and non-anatomic in 38) and 64 underwent percutaneous ablation (percutaneous ethanol injection in 37, radiofrequency ablation in 21, and microwave coagulation in 6). The median follow-up period was 69 mo. RESULTS: Hepatectomy was associated with larger tumor size (P<0.001), whereas percutaneous ablation was significantly associated with impaired hepatic functional reserve. Local recurrence was less frequent following hepatectomy (P<0.0001). Survival was better following hepatectomy (median survival time: 122 mo) than following percutaneous ablation (median survival time: 66 mo; P=0.0123). When tumor size was divided into < or =2 cm vs >2 cm, the favorable effects of hepatectomy on long-term survival was seen only in patients with tumors>2 cm (P=0.0001). The Cox proportional hazards regression model revealed that hepatectomy (P=0.006) and tumors < or =2 cm (P=0.017) were independently associated with better survival. CONCLUSION: Hepatectomy provides both better local control and better long-term survival for patients with HCC < or =4 cm compared with percutaneous ablation. Of the patients with HCC < or =4 cm, those with tumors >2 cm are good candidates for hepatectomy, provided that the hepatic functional reserve of the patient permits resection.

Adult↗

A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease.

BACKGROUND: Although hepatic resection is the most reliable treatment for hepatocellular carcinoma, impaired liver function because of cirrhosis or chronic hepatitis contributes to relatively high rates of postoperative complications. We have reviewed a series of hepatectomies at our institution and investigated risk factors for complications after hepatectomy in patients with impaired liver compared with patients with normal liver. METHODS: From October 1994 to March 1998, 277 hepatectomies for hepatocellular carcinoma, cholangiocellular carcinoma, metastatic liver tumors, and other hepatic diseases were performed. In an attempt to clarify the safety of hepatectomy for the impaired liver at our institution, we did a comparative study of postoperative complications after hepatectomy in 2 groups: patients with impaired livers (187 hepatectomies) and patients with normal livers (90 hepatectomies). RESULTS: Of the 277 hepatectomies, bile leakage occurred in 25 patients (16 in impaired livers vs 9 in normal livers), abdominal infection in 45 patients (30 vs 15 patients), wound infection in 13 patients (9 vs 4 patients), pleural effusion in 52 patients (35 vs 17 patients), atelectasis in 26 patients (17 vs 9 patients), pneumonia in 4 patients (3 vs 1 patients), ileus in 6 patients (3 vs 3 patients), intra-abdominal hemorrhage in 3 patients (0 vs 3 patients), and hyperbilirubinemia in 5 patients (4 vs 1 patients). Hepatic insufficiency and hospital death were not experienced in this series. The mean postoperative hospital stay was 22.9 days (23.5 vs 23.1 days), and except for intra-abdominal hemorrhage there was no statistically significant difference between the 2 groups. CONCLUSIONS: Hepatectomy for the impaired liver is now as safe a procedure as for the normal liver, provided the overall guidelines outlined in our algorithm are followed.

Adolescent↗

Influence of the extent of hepatectomy on the portal hypertensive state in patients with hepatoma.

BACKGROUND/AIMS: Portal hypertensive symptoms, such as esophageal varices and hypersplenism, are frequently observed in patients with hepatocellular carcinoma (HCC). We investigated whether or not the extent of hepatectomy for HCC has an influence on the deterioration of the portal hypertensive state. METHODOLOGY: Fifty-four patients who underwent curative hepatectomy for HCC at our institute were retrospectively studied. The 54 patients were classified in two groups according to the extent of hepatectomy: Group A patients (n = 38) underwent minor hepatectomy (subsegmentectomy or less) and Group B patients (n = 16) underwent major hepatectomy (segmentectomy or more). On the basis of the endoscopic findings for the esophageal varices and the blood platelet counts, the alterations of portal hypertensive state were evaluated before and after hepatectomy. RESULTS: The number of patients whose esophageal varices deteriorated post-operatively, amounted to 9 (23.7%) in Group A and 1 (6.3%) in Group B (not significant). No significant differences were found in the platelet counts between pre- and post-operative states in each Group (A and B). In all of the 6 patients whose esophageal varices first came about after hepatectomy, the advent of the varices occurred more than 1 year after surgery. CONCLUSIONS: These results suggest that in the patients undergoing hepatectomy for HCC, the clinical deterioration of the portal hypertensive state in not caused by the extent of hepatectomy, but by the advance of the coexisting chronic hepatic diseases or tumor recurrence.

Carcinoma, Hepatocellular↗

The subcutaneous splenic transposition prevents liver injury induced by excessive portal pressure after massive hepatectomy.

BACKGROUND/AIMS: We have proposed that acute portal hypertension, reflecting sinusoidal shear stress, becomes a trigger of liver regeneration after partial hepatectomy. Moreover, excessive shear stress induces liver injury. We investigated whether the use of a portosystemic shunt can reduce surplus damage of the remnant liver by means of excessive shear stress after massive hepatectomy. METHODOLOGY: In this study, to determine whether and by what mechanism excessive shear stress induces liver injury, we used the rat model to investigate whether a subcutaneous splenic transposition, which consists of a portosystemic shunt up to 4 weeks post-surgery, can prevent liver injury. RESULTS: Subcutaneous splenic transposition decreased the portal pressure immediately after 90% massive hepatectomy and relieved the elevation of transaminase and serum hyaluronic acid compared with findings of the no shunt group. In addition, the degree of leukocytopenia and thrombocytopenia in 90% massive hepatectomy with subcutaneous splenic transposition were better than those in 90% massive hepatectomy without subcutaneous splenic transposition. Serum tumor necrosis factor-alpha levels of the shunt group were lower than those of massive hepatectomy without subcutaneous splenic transposition. The rats that underwent 95% massive hepatectomy died within 48 hrs. The extent to which subcutaneous splenic transposition prolonged survival after 95% massive hepatectomy was statistically significant (mean survival of shunt group 60.9 +/- 13.4 hours vs. no shunt group 25.4 +/- 2.3 hours P = 0.001). CONCLUSIONS: These findings suggest that excessive shear stress after massive hepatectomy induces the liver injury against the hepatocytes and the sinusodial endothelial cells via intrahepatic microcirculation failure accompanied by overimmunoreaction.

Animals↗

Intestinal ischemia-reperfusion impairs liver regeneration after partial hepatectomy in rats.

BACKGROUND/AIMS: The deleterious effects of intestinal ischemia-reperfusion on liver are realized, but its effect on the regenerative capacity of the liver has not been studied. Our aim in this study was to determine the effect of intestinal ischemia-reperfusion on liver regeneration. METHODOLOGY: Sprague-Dawley rats were randomly divided into six groups; two sham-operated, two hepatectomy, and two hepatectomy with intestinal ischemia-reperfusion groups. To create intestinal ischemia-reperfusion, the superior mesenteric artery and collateral arteries supplying the small intestine were occluded for 20 minutes. Partial hepatectomy was performed during the period of ischemia. Ischemia-reperfusion injury in the mucosal layer of the small intestine was scored in light microscopy. Liver regeneration parameters (proliferating cell nuclear antigen labeling index for hepatocytes and liver regeneration rate), and serum levels of aspartate aminotransferase and alanine aminotransferase were studied on day 1 or 4 after operation. RESULTS: Mucosal injury score was high in the hepatectomy with intestinal ischemia-reperfusion groups. Liver regeneration rate and proliferating cell nuclear antigen labeling index were less in these groups than the hepatectomy groups on day 1 and 4. There were no differences in the serum levels of aspartate aminotransferase and alanine aminotransferase between hepatectomy and hepatectomy with intestinal ischemia-reperfusion groups. The mortality rate was higher in the hepatectomy with intestinal ischemia-reperfusion groups than the other groups. CONCLUSIONS: Ischemia and reperfusion of the small intestine impaired liver regeneration with high mortality after partial hepatectomy in the rats.

Alanine Transaminase↗

[Evaluation of hepatectomy in small hepatocellular carcinoma--comparison with transcatheter arterial embolization therapy].

Therapeutic effect on 81 hepatectomized patients with hepatocellular carcinoma (HCC) less than 5cm in diameter was compared to that achieved by transcatheter arterial embolization therapy (TAE) in 61. The 5-year cumulative survival rate after hepatectomy was 38%, which was better than that of TAE (8%). Outcome after hepatectomy was better than that after TAE, according to tumor size in less than 2cm in diameter and single nodule. The 3-, and 5-year survival rates for curative hepatectomy were significantly better than those for TAE. But there was no significant difference in survival curves between relative noncurative hepatectomy and TAE. In terms of hepatic reserve with reference to Child's classification, the survival curve for TAE was better than that for relative noncurative hepatectomy in patients with Child-A, but there was no significantly difference between these two methods. Survivors more than 3 years after hepatectomy and TAE were 24 (48.0%) and 11 (23.4%) patients, respectively. Nineteen of 24 patients with hepatectomy had recurrent HCCs, of which reresection was done in 6, TAE in 11 and other treatments in 2. The advantage of hepatectomy in comparison with TAE is a possibility of long-term survival, if curative hepatectomy is performed.

Adolescent↗

Study of hemorheological parameters following partial hepatectomy in rats with chronic aluminium intoxication.

The aim of our work was to analyze the hemorheological parameters following partial hepatectomy in rats with chronic Al-intoxication (Al). Male Wistar rats were randomly assigned into four experimental groups (n=6 each one): Sham (rats subjected to simulated surgery); Al+Sham; Partial Hepatectomy (animals subjected to 65% liver resection) and Al+Partial Hepatectomy. Our results show that both Partial Hepatectomy and Al treatment produce a decrease of plasma cholesterol level, which showed a negative association with Rigidity Index increase (r(s)=-0.6475, p<0.05). The increase of Rigidity Index observed in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy could be related to the increase of the proportion of non-discocytic erythrocytes, particularly stomatocytes, which determines a diminution of the Morphological Index. In the Altreated groups, greater changes in Rigidity Index and Morphological Index were observed. The relative viscosity of blood at a standard haematocrit of 40% was increased in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy as compared to Sham, due to erythrocyte rigidity. On the other hand, we observed that the increase of plasma fibrinogen concentration correlates with augmentation of plasma viscosity (r(s)=0.689, p=0.004) for all the experimental groups studied. The results indicate that both administration of Al and Partial Hepatectomy induce microcytic hypocromic anaemia in the rats reflected by a significant decrease of haematocrit, mean corpuscular volume and mean corpuscular haemoglobin concentration. From these results, we conclude that in partially hepatectomized, Al-overloaded rats the decrease in erythrocyte deformability may be an important factor leading to the installation of anaemia.

Aluminum↗

Non-parallel secretion of pancreatic amylase and trypsinogen following hepatectomy in rats.

To explore the changes in exocrine pancreatic function in the stages of active regeneration and recovery after hepatectomy, we measured the caerulein-stimulated amylase and trypsinogen output in anesthetized rats 4 days and 8 days after about 70% hepatectomy. Both 4 days and 8 days after hepatectomy, the amylase output was significantly greater than in the control groups. On the other hand, 4 days after hepatectomy, the trypsinogen output was almost the same as in the control groups, and 8 days after hepatectomy, it was significantly lower than in the control groups. Thus, the secretion of amylase and trypsinogen 8 days after hepatectomy was not parallel. The amylase content of the pancreas was significantly larger after hepatectomy than in the control groups, but the trypsinogen content was significantly smaller. These results indicate a non-parallel secretion of pancreatic digestive enzymes, as well as differences in the functions of the acinar cells after partial hepatectomy, and the important role of amylase in glucose metabolism after hepatectomy.

Amylases↗

[Experimental studies on extension of resectability of the liver in dogs with special reference to an extended hepatectomy in two stages after ligation of the portal vein branch].

The purpose of this study is to clarify the limit of extended hepatectomy, such as 84% hepatectomy for normal liver and 70% hepatectomy for Dimethylnitrosamine-induced cirrhotic liver in dogs, using ligation of the portal vein branch (PBL) in advance. Portal vein branch could be ligated up to 84% area in normal liver and 70% area in cirrhotic liver, for survival. Four weeks after PBL the non-ligated area of the liver was obviously enlarged, and the hepatic function was almost equal to that before PBL. Four weeks after PBL of 84% area in normal liver and 70% area in cirrhotic liver, the ligated area was resected by two staged procedure. Although the four-week survival rates after one staged 84% hepatectomy in normal liver and 70% hepatectomy in cirrhotic liver were 22.2% and 0% respectively, they markedly improved such as 66.7% and 50.0% after two staged hepatectomy respectively, and they were 42.1% and 30.0% respectively even if the death of PBL was count in. ICG Rmax prior to hepatectomy after PBL indicated clearly the functional resectability of the liver. The remnant liver function after two staged hepatectomy was significantly better than that after one staged hepatectomy, due to sufficient hepatic blood flow.

Animals↗

[Evaluation of irregular hepatectomy for primary liver carcinoma].

From 1964 to 1985, 120 patients with primary liver carcinoma were treated by operation in our hospital. Regular hepatectomy was done in 7 patients, palliative irregular hepatectomy in 28 and radical irregular in 85. The operation mortality was 4.2% in irregular hepatectomy group (113 cases) but 14.3% in regular hepatectomy group (7 cases) (P greater than 0.05). The 1, 3 and 5 year survival rates were 68.8%, 48.1% and 20.0% in radical irregular hepatectomy group but 83.3%, 33.3% and 16.7% in regular hepatectomy group. 10 of 28 patients treated by palliative hepatectomy were added with radiation. Majority of these patients died in 1 year after operation but 2 patients survived for more than 2 years and 1 for more than 7 years. The data show that in Asia, the incidence of primary liver carcinoma concurrent with liver cirrhosis is high and irregular hepatectomy is a suitable treatment. There is no difference between irregular and regular hepatectomy groups in the prognosis. But the former could reduce the operative time, mortality and the possibility of bleeding and complications.

Adolescent↗

The effects of transplantation of hepatocytes cultured with insulin on acute liver failure induced by 90% hepatectomy in the rat.

OBJECTIVE: To evaluate the influence of transplantation of hepatocytes either not cultured or cultured with or without insulin on survival in rats with acute liver failure induced by 90% hepatectomy. DESIGN: Randomized laboratory experiment. SETTING: University department, Sweden. MATERIAL: 60 Adult male Sprague-Dawley rats, not including donors. INTERVENTIONS: 90% hepatectomy without hepatocyte transplantation, or with intrasplenic transplantation of: uncultured hepatocytes immediately after resection, or uncultured hepatocytes one or three days before resection, or hepatocytes cultured with or without insulin immediately after resection (n = 10 in each group). MAIN OUTCOME MEASURES: Cell viability, attachment ability, survival, liver function, and body weight. RESULTS: Transplantation of hepatocytes cultured for 3 days without insulin or of uncultured hepatocytes one day prior to hepatectomy did not significantly improve 30-day survival compared with uncultured hepatocyte transplantation immediately after hepatectomy. Hepatocytes cultured with insulin for 3 days and transplanted immediately after hepatectomy significantly improved survival compared with animals in which hepatocytes were transplanted either uncultured or cultured for 3 days without insulin immediately after hepatectomy. Hepatocyte transplantation 3 days before hepatectomy further increased survival compared with the other groups in which transplantation was done immediately after hepatectomy. Acute failure, acute compensatory, and late 'enhanced' phases were defined within 30 days of hepatectomy. CONCLUSION: Transplantation of hepatocytes that are cultured with hepatocellular trophic factors (for example insulin) before transplantation may have the potential to increase the effectiveness of transplanted hepatocytes in the treatment of acute liver failure.

Analysis of Variance↗

Comparison of hepatectomy and transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma: necessity for prospective randomized trial.

Transcatheter arterial chemoembolization is now widely used in cases of surgically unresectable hepatocellular carcinoma. However, it is unclear whether patients with surgically resectable hepatocellular carcinoma should always be treated with hepatectomy as opposed to transcatheter arterial chemoembolization. Sixty-six patients with hepatocellular carcinoma underwent hepatectomy, whereas 29 patients with more advanced hepatocellular carcinoma were treated with transcatheter arterial chemoembolization at our hospital from 1984 to 1990. All cases were associated with cirrhosis of Child class A or B. All of them underwent hepatectomy or transcatheter arterial chemoembolization for the first time. Their outcomes were determined on March 31, 1991. The backgrounds and survival curves for hepatectomy and transcatheter arterial chemoembolization were compared in both Child A and Child B patients. For both Child A and B patients, no significant difference was found between hepatectomy and transcatheter arterial chemoembolization with respect to age, sex, cause of underlying cirrhosis, liver function assessed by indocyanine green test and maximum diameter of the main tumor. The incidence of multiple hepatocellular carcinoma, more advanced hepatocellular carcinoma (TNM stage III or IV) or both was significantly higher in the transcatheter arterial chemoembolization group than in the hepatectomy group for both Child A and Child B patients. The survival curves of both the hepatectomy and the transcatheter arterial chemoembolization groups showed no significant difference for both Child A and Child B patients. A prospective study is therefore warranted to elucidate whether hepatectomy or transcatheter arterial chemoembolization is more effective for treating resectable hepatocellular carcinoma associated with cirrhosis.

Adult↗

Multiple repeat resections of intra- and extrahepatic recurrences in patients undergoing initial hepatectomy for colorectal carcinoma metastases.

Recent evidence suggests that single repeat metastasectomy may provide survival benefits for selected patients experiencing hepatic or pulmonary recurrences following initial hepatectomy for colorectal carcinoma metastases. The aim of this retrospective study was to clarify the efficacy of multiple repeat resections of intra- and extrahepatic recurrences following initial hepatectomy. A total of 100 patients underwent curative partial hepatectomy as the initial procedure for colorectal carcinoma metastases. Tumor relapse after initial hepatectomy was seen in 72 patients, of whom 28 underwent 45 repeat metastasectomies of various sites: 18 patients underwent a single repeat metastasectomy, and 10 underwent multiple repeat metastasectomies. The overall survival rate at 5 years after initial hepatectomy was 36.6%, while the 5-year survival rate after repeat metastasectomy in the 28 patients was 43.6%. The outcome of initial hepatectomy was comparable with that of repeat metastasectomy (p = 0.6924). Among the 28 patients undergoing repeat metastasectomy, the outcome of resection of intrahepatic recurrences in 11 patients was comparable with the outcome of resection of extrahepatic recurrences in 17 patients(p = 0.3926). The outcome of multiple repeat metastasectomies compared favorably with single repeat metastasectomy(p = 0.1803). Multivariate analysis(p < 0.0001) showed that repeat metastasectomy was the strongest prognostic factor. In conclusion, both single and multiple repeat resections of intra- and extrahepatic recurrences after initial hepatectomy are efficacious in colorectal carcinoma patients. Repeat resection should be considered for any resectable recurrences after hepatectomy.

Adenocarcinoma↗

Changes in serum hyaluronic acid levels and expression of CD44 and CD44 mRNA in hepatic sinusoidal endothelial cells after major hepatectomy in cirrhotic rats.

Serum hyaluronic acid (HA) is widely distributed in connective tissues, and the majority of circulating HA is degraded by hepatic sinusoidal endothelial cells (SECs) via a receptor recycling pathway. Our previous clinical study revealed that monitoring serum HA levels after hepatectomy is useful in predicting the development of liver failure. In the present study, to determine the mechanism of the high HA levels after hepatectomy, especially in patients with liver cirrhosis, expression of the major HA receptor, CD44, and its mRNA was investigated in SECs isolated from rats with thioacetamide-induced liver cirrhosis subjected to 70% hepatectomy (group I) and from rats with a normal liver that were subjected to 70% hepatectomy (group II). The 48-hour postoperative survival rate in group I (13.3%) was significantly lower than in group II (100%). In group II, the expression of CD44 mRNA had increased significantly at 6 hours after hepatectomy, and this was followed by progressive increases in expression of CD44, indicating activation of SEC function. The increased serum HA levels after hepatectomy in group II became normal as CD44 expression increased. By contrast, the expression of CD44 and CD44 mRNA in group I was markedly attenuated after hepatectomy. The very low CD44 expression was followed by a significant and sustained increase in serum HA levels, indicating functional failure of the SECs. These results suggest that the significantly impaired functional reserve of SECs in liver cirrhosis is associated with increased mortality after 70% hepatectomy.

Alanine Transaminase↗

Adaptive sex-dependent changes in the zonation of carbohydrate and lipid metabolism in rat liver lobules after partial hepatectomy.

To evaluate changes in metabolic heterogeneity in rat liver lobules after partial hepatectomy, we measured parameters of carbohydrate and lipid metabolism cytophotometrically in periportal and pericentral zones of livers of mature female and male rats. Glycogen content was shown to be always higher in pericentral zones than in periportal zones. After a rapid depletion of glycogen stores during the first 8 hr after partial hepatectomy, the levels were restored to normal after 24 hr, but a significant depletion was found again at 48 hr after operation. These fluctuations were similar in female and male rat livers. The lipid content in control rat livers was low and was mainly localized in periportal zones. Partial hepatectomy caused a significant increase in lipid content after 24 to 48 hr in periportal zones only, which was distinctly higher in female than in male rat livers. Activity of NADPH-producing glucose-6-phosphate dehydrogenase was heterogeneously distributed in lobules of female control rats with highest activity in pericentral zones, whereas a lower but evenly distributed activity was found in lobules of control male rats. The activity was not affected by partial hepatectomy in male rats, whereas the activity in female rat livers decreased to levels found in male rats at 24 to 48 hr after operation. Another NADPH-producing enzyme, malate dehydrogenase, showed the highest activity pericentrally in female rats, and a low activity was evenly distributed in male rats. The activity did not change significantly after partial hepatectomy. The ketogenic enzyme beta-hydroxybutyrate dehydrogenase showed the highest activity in pericentral zones of control livers. The activity in male rat livers was almost twice as high as in female rat livers in both zones. Partial hepatectomy caused a distinct reduction in activity in both zones and both sexes, but the strongest reduction was found periportally. Alkaline phosphatase activity, which is linked with bile acid secretion by hepatocytes, was low in control male and female rats and was mainly found periportally. The activity was increased dramatically at 24 to 48 hr after partial hepatectomy in both zones and particularly in male rat livers. The index for the Krebs cycle, succinate dehydrogenase activity, was highest in periportal zones. At 24 to 48 hr after partial hepatectomy, this preferential zonation was lost, and the activity was slightly higher in pericentral zones. This reversal of zonation was found in all livers of female and male rats investigated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗