Effects of Organic Apricot on Liver Regeneration After Partial Hepatectomy in Rats

Background

The present study investigated the effects of (sun-dried organic apricot/SDOA) supplementation in chow on liver regeneration after partial hepatectomy/(PH) in rats.

Method

In this study, 28 female rats were randomized into four groups. On the 7th day of the study, group 1 underwent laparoscopic intervention while a PH was performed on the other three cohorts. On day 28, all rats were humanely killed. Blood and liver tissue samples were subjected to biochemical determinations, histological examinations, and measurement of tissue oxidative stress enzyme activity.

Results

Serum levels of alanine transaminase (ALT), alkaline phosphatase (ALP), and liver tissue glutathione (GSH) activities were affected by PH and/or SDOA consumption (P < .05). Moderately staining cell counts in group 4 were significantly different from the other three groups (P < .05). However, no significant differences were detected among all groups in regard to aspartate aminotransferase (AST) serum levels or liver tissue superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) or glutathione peroxidase (GSHpx) activities (P < .05).

Conclusion

The 5% SDOA supplementation over a 21-day feeding period showed a beneficial effect on liver regeneration in rats, as reflects by Ki-67 finding although there was no change in ALT or ALP or in liver tissue GSH activity.     

Effect of Ischemic Preconditioning and Postconditioning on Liver Regeneration in Prepubertal Rats

Background

Liver regeneration has great importance for transplantation, especially in children; however, it has not been studied sufficiently in development animals. Ischemia-reperfusion injury is a problem, and strategies such as ischemic preconditioning and postconditioning are not well defined regarding regeneration.

Objective

This study sought to evaluate liver regeneration with modulation by ischemic preconditioning and postconditioning in prepubertal rats subjected to total ischemia and reperfusion.

Methods

Thirty-five 5-week-old female Wistar rats were divided into groups of 7 animals each: control group (SHAM), 70% hepatectomy (HEP), total ischemia 30 minutes before hepatectomy (IR), ischemic preconditioning 10/10 minutes before ischemia (PRE), and two 30/30-second ischemic postconditioning cycles after ischemia and hepatectomy (POS). All animals were subjected to 24-hour reperfusion. Aspartate aminotransferase and alanine aminotransferase activity were measured to evaluate liver damage, and histological analysis, proliferating cell nuclear antigen (PCNA) and regenerated mass liver were used to evaluate liver regeneration. Statistical analyses were performed using ANOVA and Kruskal-Wallis test.

Results

Alanine aminotransferase and aspartate aminotransferase levels were significantly lower in conditioned groups than in the IR group. Regarding mitotic index, IR > control group and HEP (P < .05), PRE and POS were not significantly different from IR, and POS > HEP (P < .05). PCNA analysis showed that IR > HEP (P < .01), PRE < IR (P < .01), and no significant differences were observed between POS and IR groups. No significant differences in regenerated mass liver were observed between conditioned groups and HEP.

Conclusions

Ischemic postconditioning prevented ischemic injury, promoted greater liver regeneration, and should be further investigated as an alternative better than ischemic preconditioning.     

The Effect of Octreotide on Hepatic Ischemia-Reperfusion Injury in a Rabbit Model

Background

Hepatic ischemic-reperfusion injury (HIRI) is a major cause of morbidity and mortality following liver surgery. Octreotide (Oct) has been reported to improve hepatocellular energy metabolism in a rat HIRI model. This study was designed to evaluate whether Oct could protect the liver of rabbits against ischemic-reperfusion (I/R) injury.

Methods

Twenty-four adult New Zealand rabbits were randomly divided into a sham operated group (Control), an ischemia/reperfusion group (I/R), and an ischemia/reperfusion + Oct pretreatment group (I/R + Oct). The hemodynamic (mean arterial pressure [MAP] and heart rate [HR]) changes, liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and lactate dehydrogenase [LDH]) release, inflammatory cytokines (tumor necrosis factor [TNF]α and interleukin [IL]-1β) levels, and endotoxin (ETX) levels were measured during I/R.

Results

Compared with the Control group, the MAP decreased and HR increased in I/R and I/R + Oct groups at ischemia 15 minutes (P < .05) but were less in the I/R + Oct group relative to the I/R group (P < .05). ALT, AST, LDH, IL-1β, and ETX levels were increased in the I/R and I/R + Oct groups at ischemia 30 minutes (P < .05), however, the increase was lower in the I/R + Oct group relative to the I/R group (P < .05). Bcl-2 expression in the I/R + Oct group was higher compared with other groups (P < .05) and Bax expression in the I/R group was reduced compared with other groups (P < .05). Hepatocellular damage in the I/R + Oct group appeared to be less than in the I/R group by microscopy.

Conclusions

Oct pretreatment attenuated hemodynamic changes and decreased liver enzyme changes induced by HIRI in a rabbit model. The protection mechanisms of Oct may be related to reduced ETX levels, down-regulation of the inflammatory cytokines TNFα and IL-1β, and inhibition of hepatocellular apoptosis, as well as the modulation of the mitochondrion-mediated Bcl-2/Bax apoptosis pathway. Based on our study it appears that Oct may be useful in decreasing liver injury after liver surgery and/or transplantation and may serve as a promising agent against HIRI.     

Cytomegalovirus Infection Accelerates the Process of Chronic Rejection in Rat Liver Transplantation

Objective

Analysis of the pathogenesis of cytomegalovirus (CMV) infection for rat chronic liver rejection.

Methods

Based on animal models that we previously developed, we divided control and a CMV infection group to analyze survival, histopathology and rejection activity. The level and mRNA expression of transforming growth factor-β1, platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF) were measured in peripheral blood serum and liver tissue.

Results

Obliterative arteriopathy and fibrosis was significantly greater in the CMV infection versus the control group (P < .05). PDGF mRNA expression in rat liver and in peripheral blood were significantly higher in the CMV infection versus the control group (P < .05). bFGF mRNA expression in the CMV infection group was also significantly higher than among the controls (P < .05).

Conclusions

CMV infection aggravated foam cell obliterative arteriopathy and liver fibrosis in chronic liver rejection, processes that accelerate the immune response, which may correlate with early high PDGF and bFGF expression.     

Late Biliary Obstruction in Wistar Rats After Intermittent Hepatic Pedicle Clamping

Introduction

The temporary vascular occlusion of hepatic flow is one of the essential procedures in hepatic surgery.

Aim

Evaluate the late liver alterations after intermittent pedicle hepatic clamping (IHPC) in Wistar rats.

Methods

Male Wistar rats (n = 14) with average weight of 281.1 g, were anesthetized with intraperitoneal ketamine 5%. The IHPC group (n = 7) was submitted to U-shaped abdominal incision; the hepatic pedicle was isolated and submitted to IHPC ischemia 4 times, 5 minutes each, followed by reperfusion 4 times, 5 minutes each. The simulated operation group (n = 7) was subjected to anesthesia, laparotomy, and manipulation of the hepatic pedicle. On day 35, after fasting for 12 hours, liver biopsies were collected and blood was tested for liver aminotransferases (aspartate aminotransferase/alanine aminotransferase).

Results

All the IHPC group animals had a dilated common bile duct and increased liver enzymes (P < .05 by Mann-Whitney test). Ductular proliferation (100% of cases), porta-porta septa (42.8%), formation of lumps (42.8%), foci of necrosis (14.2%), and bile plugs (14, 2%) were observed only in the IHPC group.

Conclusion

In rats, IHPC caused morphologic features leading to biliary obstruction.     

Significance of Postoperative Changes in Hemodynamics and Biochemical Indices in Pediatric Recipients of Live-Donor Liver Transplants

Objective

The aim of this study was to evaluate the postoperative changes in hemodynamics and biochemical indices in pediatric recipients of live-donor liver transplants (LDLT).

Methods

Hemodynamics and biochemical indices (coagulation function, electrolytes, kidney function, liver function, and blood analysis) were monitored on the day before and the 1st, 3rd, 5th, and 7th days after the procedure in 20 children who underwent LDLT from June 2006 to January 2009.

Results

Compared with preoperative measurements, systolic and diastolic blood pressure and mean arterial pressure increased and prothrombin time was prolonged significantly during the first 7 days after LDLT (P < .05). Fibrinogen, platelet count, total protein, globulin, and blood magnesium decreased significantly (P < .05). Liver enzymes (aspartate transaminase [AST], alanine transaminase [ALT]) and blood sodium increased significantly; serum potassium and calcium declined on the first postoperative day (P < .05). On the 7th day, AST returned to nearly normal (P < .05) and ALT returned to the preoperative levels. Blood urea nitrogen fluctuated within the normal range (P < .05). Total and direct bilirubin decreased on the 1st day but returned to near normal levels on the 7th day (P <.001).

Conclusions

Our data demonstrated postoperative changes in hemodynamics, electrolytes, and biochemical indices in pediatric LDLT recipients. The changes in clotting factors and platelet count did not result in severe coagulation function disorder; kidney function was normal. Changes in liver enzymes and bilirubin compared with the preoperation indices were within the regulatory scope of liver and did not result in severe complications. These preliminary postoperative trends suggest that further prospective evaluation is needed.     

Th1/Th2 Cytokines and Soluble CD30 Levels in Kidney Allograft Patients With Donor Bone Marrow Cell Infusion

Objective

We investigated the relevance of donor bone marrow cell infusion (DBMI) and serum levels of interferon-γ (IFN-γ), interleukin-10 (IL-10), and soluble CD30 (sCD30) in kidney recipients.

Patients and Methods

We analyzed the allograft outcomes correlated with sCD30, IFN-γ, and IL-10 levels using pre- and posttransplantation sera from 40 live donor renal transplants (20 patients with DBMI [2.1 × 10⁹ ± 1.3 × 10⁹ mononuclear cells/body] and 20 controls).

Results

Patients with acute rejection episodes (ARE)—3/20 DBMI and 6/20 controls—showed increased sCD30 and IFN-γ as well as decreased IL-10 posttransplantation compared with nonrejectors. Significant differences were observed for sCD30 and IFN-γ levels: 59.54 vs 30.92 ng/mL (P = .02) and 11.91 vs 3.01 pg/mL (P = .01), respectively. Comparison of pre- and posttransplant levels of IFN-γ, IL-10, and sCD30 in ARE patients showed higher levels in posttransplant sera except for IFN-γ in controls (6.37 vs 11.93; P = .01). Increased IFN-γ and IL-10 were correlated with rejection (r = .93; P = .008). sCD30 correlated with serum creatinine among ARE patients in control and DBMI groups (r = .89; P = .019; and r = 1.00; P < .0001, respectively).

Conclusions

Higher levels of sCD30, IFN-γ, and IL-10 posttransplantation in rejecting patients provided evidence for coexistence of cellular and humoral responses in ARE. There appeared to be a down-regulatory effect of infusion on alloresponses.     

Difference in Outcomes Between Living Left Lobe Donors and Noncirrhotic Subjects Undergoing Left Lobe Resections

Objectives

The aim of this study was to compare short- and long-term outcomes between the living donors and patients without cirrhosis after left lobe resection.

Material and Methods

We retrospectively collected data from 40 left lobe donors (Group 1) and from 40 patients who had undergone left liver resection for various diseases (Group 2) from 2002 to 2010. In addition to preoperative parameters, we compared intraoperative variables as well as, short- and long-term outcomes, including postoperative complications and laboratory test results. The liver functions included total bilurubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio (INR), and albumin (ALB) compared as well as changes in white blood cell (WBC) count and platelet count.

Results

The preoperative parameters of the two groups were comparable. There was significantly more blood loss in Group 2 than Group 1 (422.5 mL vs 318.8 mL; P = .001), leading to more autologous blood transfusions in Group 2 (P = .008). The other intraoperative variables were similar between the two groups. The overall postoperative complication rate was similar: 4% in Group 1 and 8% in Group 2 (P = .213); however, there were longer hospital stays and overall costs in Group 1 (P < .05). The total bilirubin level, AST, and ALT of Group 2 were worse than those in Group 1 during the early postoperative period. Upon long-term follow-up the postoperative platelet count decreased in the two groups compared with the preoperative levels.

Conclusion

The type and rate of complications following left hepatectomy were similar between donors and noncirrhotic hepatic patients. Nevertheless, more serious liver dysfunction postoperatively was observed among the patient group.     

Outcomes of pancreatic debridement in acute pancreatitis: analysis of the nationwide inpatient sample from 1998 to 2010

Background

The objective of this study was to perform a national review of patients with acute pancreatitis (AP) who undergo pancreatic debridement (PD) to evaluate for risk factors of in-hospital mortality.

Methods

The Nationwide Inpatient Sample was used to identify patients with AP who underwent PD between 1998 and 2010. Risk factors for in-hospital mortality were assessed with multivariate logistic regression.

Results

From 1998 to 2010, there were 585,978 nonelective admissions with AP, of which 1,783 (.3%) underwent PD. From 1998 to 2010, the incidence of PD decreased from .44% to .25% (P < .01) and PD in-hospital mortality decreased from 29.0% to 15% (P < .05). Of patients undergoing PD, independent factors associated with increased odds of mortality were increased age (odds ratio [OR] 1.04, confidence interval [CI] 1.03 to 1.05; P < .01), sepsis with organ failure (OR 1.76, CI 1.24 to 2.51; P < .01), peptic ulcer disease (OR 1.83, CI 1.02 to 3.30; P < .05), liver disease (OR 2.27, CI 1.36 to 3.78; P < .01), and renal insufficiency (OR 1.78, CI 1.14 to 2.78; P < .05).

Conclusions

The incidence and operative mortality of PD have decreased significantly over the last decade in the United States with higher odds of dying in patients who are older, with chronic liver, renal, or ulcer disease, and higher rates of sepsis with organ failure.     

Preconditioning Donor Livers With Cromolyn or Compound 48/80 Prolongs Recipient Survival in a Rat Orthotopic Liver Transplantation Model

Background

Acute rejection (AR) remains a challenge in organ transplantation. Preconditioning donor organs can reduce AR and prolong survival. Whether preconditioning with cromolyn (CRM), a mast cell (MC) stabilizer, or compound 48/80 (CMP 48/80), a MC degranulator, can alleviate AR and prolong survival has not been studied.

Methods

We used the male-DA-to-female-Lewis-rat orthotopic liver transplantation (OLT) model. Donors were preconditioned with CRM in a MC stabilizing way (CRM group) or CMP 48/80 in a MC depleting way (CMP 48/80 group). Rats preconditioned with phosphate-buffered saline were used as controls (PBS group). After preconditioning, OLT surgeries were carried out. OLT male-Lewis-to-female-Lewis-rats were used as the syngeneic group (syngeneic group).

Results

Rats in the PBS group developed AR rapidly and died at 7.40 ± 1.14 days. Rats in the CRM and CMP 48/80 groups had significantly slower rejections and died at day 17.40 ± 1.67 or 14.20 ± 2.28, respectively (P < .05). Rats in the syngeneic group survived more than 60 days. Rejection activity indexes (RAIs) and liver functions were all alleviated through CRM or CMP 48/80 preconditioning. Interferon-γ messenger RNA (mRNA) expressions were reduced and interleukin-10 mRNA levels were higher in allografts in the CRM and CMP 48/80 groups, compared with the PBS group. These were confirmed by testing serum interferon-γ and interlerkin-10.

Conclusion

Preconditioning donor livers with CRM or CMP 48/80 can reduce AR and prolong survival of recipients after OLT.     

Evaluation of Oxidative Stress in the Late Postoperative Stage of Liver Transplantation

Introduction

Liver transplant recipients are at an increased oxidative stress risk due to pre-existing hepatic impairment, ischemia-reperfusion injury, immunosuppression, and functional graft rejection. This study compared the oxidative status of healthy control subjects, patients with liver cirrhosis on the list for transplantation, and subjects already transplanted for at least 12 months.

Patients and Methods

Sixty adult male patients, aged between 27 and 67 years, were subdivided into 3 groups: a control group (15 healthy volunteers), a cirrhosis group (15 volunteers), and a transplant group (30 volunteers). Oxidative stress was evaluated by activity of reduced glutathione, malondialdehyde, and vitamin E.

Results

There was a significant difference (P < .01) in the plasma concentration of reduced glutathione in the 3 groups, with the lowest values observed in the transplanted group. The malondialdehyde values differed significantly (P < .01) among the 3 groups, with the transplanted group again having the lowest concentrations. The lowest concentrations of vitamin E were observed in patients with cirrhosis compared with control subjects, and there was a significant correlation (P < .05) among the 3 groups. No correlations were found between reduced glutathione and vitamin E or between vitamin E and malondialdehyde. However, there were strong correlations between plasma malondialdehyde and reduced glutathione in the 3 groups: control group, r = 0.9972 and P < .0001; cirrhotic group, r = 0.9765 and P < .0001; and transplanted group, r = 0.8981 and P < .0001.

Conclusions

In the late postoperative stage of liver transplantation, oxidative stress persists but in attenuated form.     

Complete cervical spinal cord injury above C6 predicts the need for tracheostomy

Background

Failed extubation and delayed tracheostomy contribute to poor outcomes in patients with a traumatic spinal cord injury (SCI). We determined if the level and completeness of SCI predict the need for tracheostomy.

Methods

Data from 256 patients with SCI between C1 and T3 with or without tracheostomy were retrospectively analyzed. Logistic regression identified predictors for tracheostomy. Data are presented as raw percentage or odds ratio (OR) with 95% confidence interval. P < .05 indicates significance.

Results

Complete spinal cord injuries were common in patients requiring tracheostomy (55% vs 18%, P < .05), and predicted the need for tracheostomy (OR: 6.4 (3.1 to 13.5), P < .05). An injury above C6 predicted the need for tracheostomy in patients with complete injury (OR: 3.7 (1 to 11.9), P < .05), but not incomplete injury (OR: .7 (.3 to 1.9); P = .53).

Conclusion

Tracheostomy is unlikely in patients with incomplete SCI, regardless of the level of injury. Patients with complete SCI above C6 are likely to require tracheostomy.     

Superparamagnetic iron oxide magnetic nanomaterial-labeled bone marrow mesenchymal stem cells for rat liver repair after hepatectomy

Background

Superparamagnetic iron oxide magnetic nanomaterials (SPIO) are tracers used for treatment of central nervous and cardiovascular system complications in animal models. The present study investigated survival and proliferation of SPIO-labeled bone marrow mesenchymal stem cells (BMSCs) to determine their potential therapeutic value in liver repair.

Methods

Surface antigens of BMSCs were measured using flow cytometry. BMSCs viability, growth curve, and SPIO (0–100 μg/mL) labeling rate were evaluated using trypan blue staining, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and Prussian blue staining, respectively. SPIO-labeled BMSCs were transplanted via liver or spleen injection in rats undergoing 70% hepatectomy. Distribution of SPIO-labeled BMSCs in liver and spleen, and liver repair were evaluated by magnetic resonance imaging (MRI), and serum alanine aminotransferase, aspartate aminotransferase, albumin, and total bilirubin levels.

Results

CD29⁺/CD90⁺/CD45⁻ BMSCs were successfully isolated from rats. Labeling rate of SPIO in 25 μg/mLwas 94.9%. SPIO labeling did not affect BMSCs survival and proliferation. MRI showed that BMSCs colonized in the liver, whether via spleen or liver injection. Serum levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin in the transplanted rats were significantly lower than in the hepatectomy group at days 1, 3, and 7 after hepatectomy (all P < 0.05), whereas serum albumin levels were significantly higher in the transplanted rats on posthepatectomy day 3 (both P < 0.05). These indicators were not significantly different between the spleen and liver injection approaches.

Conclusions

BMSCs transplantation via liver or spleen injection could significantly accelerate liver healing. In vivo MRI of SPIO-labeled BMSCs can be used to trace real-time liver healing during clinical treatment after hepatectomy.     

Psychological Predictors (Personal Recourses) of Quality of Life for Heart Transplant Recipients

Background

Heart transplantation (HTx) has a significant impact on all areas of the operation, adjustment, and quality of life (QOL) in patients after heart transplantation. In the process of healing and coping with the new situation, it is important to have personal resources.

Aim

The main objectives of this study were to assess subjective QOL of patients after HTx and to determine the relationship between personal resources and QOL in this group of patients.

Material and Methods

The study included 121 patients who received a heart transplant. A standardized instrument used to measure the quality of life was the World Health Organization (WHO) QOL Brief Questionnaire. The personal resources and deficits were determined using the following research techniques: Antonovsky's Sense of Coherence (SOC), coping strategies for stress (Brief-COPE), Generalized Self Efficacy Scale (GSES), and Life Orientation Test (LOT-R). The data were analyzed statistically.

Results

The patients gained an average level of QOL (13.75). The results indicate a positive relationship between the QOL in all its domains and personal resources: a sense of coherence (r = 0.65; P < .05), optimism (r = 0.55; P < .05), self-efficacy (r = 0.58; P < .05), and strategies for coping (active coping [r = 0.41; P < .05], planning [r = 0.42; P < .05; P < .05], and positive revaluing [r = 0.40; P < .05]). The regression model explained 56% of the predictors of QOL in patients after HTx.

Applications

It is necessary to strengthen personal resources in this group of patients as well as to detect early and treat symptoms of depression and to cope with stress.     

Ambroxol Alleviates Hepatic Ischemia Reperfusion Injury by Antioxidant and Antiapoptotic Pathways

Background

Hepatic ischemia/reperfusion (HI/R) injury is a common pathologic process caused by many clinical settings, such as liver resection, liver transplantation, hypovolemic shock, and trauma. The use of ambroxol, which acts as a mucolytic agent, provides antioxidant and anti-inflammatory effects.

Methods

A rat model of HI/R was induced by clamping the hepatic artery, the hepatoportal vein, and the bile duct with a vascular clamp for 30 minutes followed by reperfusion for 6 hours under anesthesia. The sham group underwent laparotomy without hepatic ischemia. The ambroxol group was injected into the tail vein in the ambroxol group 5 minutes before HI/R at one dose of 20 mg/kg, 80 mg/kg, or 140 mg/kg. The control group underwent the same procedure as the ambroxol group but with administration of physiological saline. Liver injury was evaluated by biochemical and histopathological examinations. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were assayed in serum samples. Superoxide dismutase (SOD), catalase (CAT), malondiadehyde (MDA), and glutathione (GSH) were spectrophotometrically measured. Furthermore, caspase-3, Bcl-2 and Bax expression as well as the level of c-Jun N-terminal kinases (JNK) we estimated activation.

Results

Wistar rats that received 20, 80 mg or 140 mg of ambroxol displayed reduced HI/R injury compared with controls. Use of ambroxol reduced the histologic injury and significantly decreased serum ALT and AST levels. In addition, ambroxol enhanced the activity of hepatic tissue SOD and CAT, increasing GSH but decreasing MDA tissue contents. In the ambroxol group, Bcl-2 expression was increased and Bax and caspase-3 decreased compared with the controls. Furthermore, ambroxol reduced levels of phosphorylated JNK (P < .05).

Conclusion

These results indicated that ambroxol attenuated rat HI/R through upregulation of intracellular antioxidant and anti-apoptotic signaling pathways.     

Glycogen synthase kinase 3 inhibitor attenuates endotoxin-induced liver injury

Background/Aims

Endotoxin (lipopolysaccharide, LPS)-induced acute liver injury was attenuated by endotoxin tolerance (ET), which is characterized by phosphatidylinositol 3-kinase pathway/Akt signaling. Glycogen synthase kinase 3 (GSK-3) acts downstream of phosphatidylinositol 3-kinase pathway/Akt and GSK-3 inhibitor protects against organic injury. This study evaluates the hypothesis that ET attenuated LPS-induced liver injury through inhibiting GSK-3 functional activity and downstream signaling.

Methods

Sprague-Dawley rats with or without low-dose LPS pretreatment were challenged with or without large dose of LPS and subsequently received studies. Serum tumor necrosis factor-alpha, interleukin-10, alanine aminotransferase, lactate dehydrogenase, and total bilirubin levels were analyzed, morphology of liver tissue was performed, glycogen content, myeloperoxidase content, phagocytosis activity of Kupffer cells, and the expression and inhibitory phosphorylation as well as kinase activity of GSK-3 were examined. Survival after LPS administration was also determined.

Results

LPS induced significant increases of serum TNF-α, alanine aminotransferase, lactate dehydrogenase, and total bilirubin (P < 0.05), which were companied by obvious alterations in liver: the injury of liver tissue, the decrease of glycogen, the infiltration of neutrophils, and the enhancement of phagocytosis of Kupffer cells (P < 0.05). LPS pretreatment significantly attenuated these alterations, promoted the inhibitory phosphorylation of GSK-3 and inhibited its kinase activity, and improved the survival rate (P < 0.05).

Conclusions

ET attenuated LPS-induced acute liver injury through inhibiting GSK-3 functional activity and its downstream signaling.     

Pre-resection gastric bypass reduces post-resection body mass index but not liver disease in short bowel syndrome

Background

Obese patients developing short bowel syndrome (SBS) maintain a higher body mass index (BMI) and have increased risk of hepatobiliary complications. Our aim was to determine the effect of pre-resection gastric bypass (GBP) on SBS outcome.

Methods

We reviewed 136 adults with SBS: 69 patients with initial BMI < 35 were controls; 43 patients with BMI > 35 were the obese group; and 24 patients had undergone GBP before SBS.

Results

BMI at 1, 2, and 5 years was similar in control and GBP groups, whereas obese patients had a persistently increased BMI. Eight (33%) of the GBP patients had a pre-resection BMI > 35, but post-SBS BMI was similar to those <35. Obese patients were more likely to wean off PN (47% vs 20% control and 12% GBP, P < .05). Radiographic fatty liver tended to be higher in the GBP group (54% vs 19% control and 35% obese). End-stage liver disease occurred more frequently in obese and GBP patients (30% and 33% vs 13%, P < .05).

Conclusions

Pre-resection GBP prevents the nutritional benefits of obesity but does not eliminate the increased risk of hepatobiliary disease in obese SBS patients. This occurs independent of pre-SBS BMI suggesting the importance of GBP itself or history of obesity rather than weight loss.