入肝血流阻断对正常大鼠部分肝切除术后肝再生的影响

目的 探讨人肝血流阻断对部分肝切除术后正常大鼠肝再生的影响。方法 健康雄性Ｗｉｓｔａｒ大鼠随机分为３组：ＰＴＣ组,肝门阻断１５ｍｉｎ切肝组;ＰＨ组,部分肝切除组;ＳＯ组,假手术组,测定术后肝脏重量的变化;用免疫组化法检测术后２４、４８、７２ｈ和７ｄ各时相点ＰＣＮＡ标记指数;观察各组术后血清前白蛋白（ＰＡ）的变化。结果 ＰＴＣ组较ＰＨ组术后肝再生率下降;ＰＣＮＡ标记指数降低,高峰延迟;ＰＡ水平恢复缓     

Changes of nitric oxide synthase activity and free methylarginines contents in regenerating rat liver after partial hepatectomy

In the present study, liver regeneration rate (%) was increased up to 70% 3 days after partial hepatectomy (PH). Nitric oxide synthase (NOS) activity in liver tissue as well as serum nitrite/nitrate content had no timed response, revealing no significant difference between shamoperated and partially hepatectomized rat liver. Contents of free methylarginines in liver tissue were increased biphasically in a time-dependent manner after PH. However, those in serum did not exhibit the same patterns as in liver. Taken together, the results suggest that N^G-monomethyl-L-arginine (MMA) and N^G, N^G-dimethylarginine (DMA) play a role in inhibiting nitric oxide (NO) synthesis in regenerating rat liver because the increase of their contents was synchronized with NOS expression.     

Pathophysiology of dogs after 84% hepatectomy with emphasis on prostaglandin metabolites and the effect of a thromboxane A2 synthesis inhibitor and a prostaglandin I2 analog

The pathophysiological conditions following 84% hepatectomy were examined in terms of the changes in thromboxane A₂ (TxA₂) and prostaglandin I₂ (PGI₂) in canine model. OKY-046, TxA₂ inhibitor, and OP-2507, a PGI₂ analog, were administered to evaluate the possibility of extending hepatic resection. The 2-week survival rate following 84% hepatectomy significantly improved after the administration of OKY-046 and OP-2507, from 12.5% to 58.3% and 75.0%, respectively. Furthermore, OP-2507 significantly improved impaired hepatocyte and sinusoidal endothelial cell function after 84% hepatectomy, resulting in a satisfactory recovery to the preoperative levels. Within 24 h after 84% hepatectomy, the plasma levels of thromboxane B₂ (TxB₂) increased significantly, and the 6-keto-prostaglandin F_l (6-KF) levels became slightly elevated. OKY-046 and OP-2507 decreased TxB₂ and increased 6-KF in the plasma, resulting in the maintenance of sufficient blood flow in the portal vein and hepatic tissue and the mitigation of microcirculatory disorders. Moreover, the cytoprotective effects of the two drugs inhibited functional impairment of the residual liver. In conclusion, abnormal prostaglandin metabolites were produced after 84% hepatectomy, being involved in residual liver disorders. However, the administration of either an inhibitor of TxA₂ synthesis or PGI₂ analog ameliorated the functional impairment of the residual liver, which suggests their potential value for extending the resectability of the liver from what is presently feasible.An abstract of this study was presented at the 92nd Annual Meeting of the Japan Surgical Society held in 1992.     

A morphological,biochemical, and radioautographic study in rats

Splenectomy has long been an establishmd surgical procedure in various conditions, including trauma. Because total splenectomy has often been correlated with sepsis, every surgeon tries to preserve as much of the injured spleen as possible. Contradictory reports have been published as to whether regeneration of the remaining splenic tissue is possible. In the present study, 28 Sprague-Dawley rats ( 100 g) were divided into four groups. They underwent two-thirds partial splenectomy; the remaining splenic tissue was examined after 1 day, 1 week, 1 month and 3 months postoperatively. The following parameters were determined: weight, length, and protein and deoxyribonucleic acid (DNA) content of the remaining spleen. The incorporation of ³H-thymidine into the remaining spleen tissue was also measured. Histology and radioautography were studied in parallel. Results were compared with control animals that were operated upon but with no partial splenectomy. One day, 1 week, and 1 month following partial splenectomy, a slight increase in weight, length, protein, and DNA content as well as incorporation of the radioisotope into cellular DNA was found. By 3 months after the operation, there was no difference in the above parameters between the experimental animals and controls.Radioautographs indicated that most of the cells containing the isotope were situated in the perinodular areas in the red pulp, accompanied by an increased number of inflammatory cells. We found this cell proliferation mainly along the cut surface of the spleen. The slight increase that was found in all the parameters examined up to 1 month after partial splenectomy is an inflammatory response and not regeneration of the spleen.     

胃选择性迷走神经切断对大鼠肝再生的影响——肝细胞体积、数量和DNA含量的研究

探讨胃选择性迷走神经切断对大鼠再生肝细胞体积、数量和ＤＮＡ含量的影响。分别测定大鼠胃选择性迷走神经切断加肝叶大部分切除及肝叶大部分切除术后７ ｄ 再生肝ＤＮＡ含量、肝细胞数和体积。用多功能显微图像测量仪测定切片中肝细胞和肝细胞核面积及肝细胞核直径。按体视学方法测算整个肝脏的肝细胞数。用细胞分光光度技术测定切片中单个肝细胞ＤＮＡ 含量。结果表明, 胃选择性迷走神经切断加肝叶大部分切除组大鼠肝细胞ＤＮＡ含量、数量及体积均较单纯肝叶切除组增加 （Ｐ＜ ０．０５）。提示胃选择性迷走神经切断对大鼠肝再生过程有一定的促进作用。     

应用CD3AK细胞预防肝癌术后复发的初步观察

目的 观察ＣＤ３ＡＫ细胞治疗对肝癌术后复发的影响。方法 ６２例肝癌切除术按序列单双数的原则分为两组,研究组３２例术后１周开始应用ＣＤ３ＡＫ细胞治疗,每隔２～３个月施行一疗程,共２～６个疗程;对照组３０例术后不用ＣＤ３ＡＫ细胞治疗,仅作一般护治疗。结果 ①研究组术后１年复发率６．３％（２／３２）明显低于对照组２６．７％（８／３０）（Ｐ〈０．０５）;②研究组和对照组术后４周免疫功能有明显差异（Ｐ〈０．     

脾部分切除术的技巧与体会

目的：最大限度地保留脾组织及脾功能可使机体避免或减少因无脾而导致不良后果。方法 主要操作技巧,充分游离脾脏,解剖脾门时勿伤及脾极动脉,结扎并切断受损之脾叶,段血管,垂直褥区缝合残面,结下衬以明胶海绵,打结力度适宜;缝合完毕后观察１５分钟方脾还纳腹腔,结果 ２０例患者行脾部分切除术。１例出现脾窝积液,并经穿刺油液后治愈,余者均痊愈出院,１７例患者随访１－９年,免疫功能正常,远期疗效优良,结论,对脾     

用MTTp和F-V曲线形状对吸烟者肺通气功能的对比研究

为评价部分平均通过时间（ＭＴＴｐ）和Ｆ－Ｖ曲线形状对检查吸烟者小气道功能的临床意义,作者对１１６例被动和轻、重度主动吸烟者进行了常规肺通气功能、ＭＴＴｐ和Ｆ－Ｖ曲线形状的探讨。常规肺通气功能和Ｆ－Ｖ曲线形状用常规法测定。ＭＴＴｐ用“简易计算法”公式计算。结果显示凸型Ｆ－Ｖ曲线的分布随吸烟程度而上升。·Ｖ５０、·Ｖ２５下降及ＭＴＴ４５％～５５％、ＭＴＴ７０％～８０％延长在凸型与重度吸烟组一致。ＭＴＴ４５％～５５％与ＭＴＴ７０％～８０％延长的范围在两者都是预计值的１１０％～１２０％,表明小气道功能已有轻度障碍。因而凸型Ｆ－Ｖ曲线、ＭＴＴ４５％～５５％及ＭＴＴ７０％～８０％延长、·Ｖ５０、·Ｖ２５下降都是检查小气道功能的敏感指标。用“简易计算法”计算ＭＴＴｐ简便准确,宜于临床推广应用     

Laparoscopic partial adrenalectomy

Background: Most laparoscopic adrenalectomies involve total removal of the whole adrenal gland, and reports of laparoscopic partial adrenalectomies have been very few. The criteria for performing a laparoscopic partial adrenalectomy have not been described. Methods: (a) Patients with functioning adrenal tumors smaller than 3 cm in diameter were selected. (b) The solitary adrenal tumors were evaluated by preoperative thin-slice computed tomography (CT) scan. (c) Solitary lesions were reconfirmed with intraoperative ultrasonography. (d) Partial adrenalectomy was performed with at least a 5-mm margin using a vascular stapler. Results: Laparoscopic partial adrenalectomy was performed in five patients using the vascular stapler. Hemostasis was perfect in all five patients. The tumor was located in the inferior part of the right adrenal gland in three cases and in the upper pole of the left adrenal gland in two cases. The postoperation pathologic diagnosis was adrenocortical adenoma in all five patients, and excessive hormonal levels or symptoms all disappeared. Conclusions: Laparoscopic partial adrenalectomy can be performed safely using a vascular stapler. Received: 26 May 1998/Accepted: 30 June 1998     

Videolaparoscopic treatment of liver hydatid cysts with partial cystectomy and omentoplasty

Hydatid disease is one of the world's most important health problems. Although several conservative approaches have been used for the management of this condition, surgery remains the ideal choice in most of the cases. Videolaparoscopic approach can safely be applied for the management of liver hydatid cysts if several precautions are undertaken. In this study, we present two liver hydatid cyst cases successfully treated with partial cystectomy and omentoplasty using videolaparoscopic approach.