ABSTRACT— In a longitudinal study liver volume and liver function were measured in a series of 12 patients undergoing partial liver resection for focal hepatic lesions. Ultrasonography revealed that liver volume, reduced by about 50% by the resection, progressively increased, and 6 months after surgery it returned to nearly normal values. A variable reduction in routine liver function tests was observed, possibly reflecting the influence of the different reserve synthetic capacity of the liver and, in the early postoperative phase, plasma half‐life of liver products and blood loss or changes in plasma volume. The galactose elimination capacity was only marginally reduced in the early period (from a pre‐surgery value of 2.49 ± SE 0.21 mmol/min to 2.31 ± 0.14 after 7 days; p = ns) and reached a nadir at 14 days (1.97 ± 0.16; p<0.001). When expressed per unit of liver volume, the galactose elimination (22 ± 2 μmol/min per unit before resection) progressively decreased during the regeneration phase from 36 ± 4 at 14 days to 26 ± 3 at 6 months (P vs 14‐day: <0.01). At 6 months both galactose elimination and galactose elimination per unit of liver volume were no longer different from baseline values. Our data show that, following hepatic resection, both liver volume and liver function increase and progressively return to nearly normal values. In agreement with data obtained in animal studies, it appears that the metabolic activity of the remaining parenchyma is increased in the early postoperative phase, and it slows down in the course of regeneration.
ring cells in advanced gastric cancer. A clinical, pathological and histochemical study. Acta path. microbiol. immunol. scand. Sect. A, 95: [225][226][227][228][229][230][231] 1987.A pathological and histochemical study on the presence of signet-ring cells (SRC) in 108 advanced gastric cancer (AGC) has been evaluated. According to Lauren's classification, 59 were of intestinal (I) and 49 of diffuse (D) type. The amount of SRC seems to be a prognostic parameter in D-carcinoma: the 5-year survival rate was 49% and 22% in cases with 1-24% and 75-100% SRC, respectively. Histochemically, in our series of SRC D-carcinoma the quality of much secretion of SRC closely resembled the goblet cells of intestinal metaplasia. The histogenetic origin of D-gastric carcinoma was discussed.
Chronic atrophic gastritis is considered a precancerous condition for carcinoma of the stomach. To evaluate the correlation between progressive alterations in the mucosa and gastric juice microenvironmental factors, retained involved on N-nitroso compounds carcinogenesis, detailed analyses of biochemical and microbiological parameters such as pH, total viable counts (TVC), nitrate reductase positive bacterial counts (NRPBC), nitrite (NO2-) and thiocyanate (SNC-) levels, were carried out on 56 fasting gastric juices samples obtained at endoscopy from 28 patients with chronic atrophic gastritis (CAG), 14 with gastric cancers (GC), and 14 normal controls (NC). The mean values of pH, nitrite, TVC, and NRPBC were significantly lower in the juices of NC than in those of CAG and GC patients. Furthermore, the mean levels of the same parameters were higher in GC than in CAG juices. No significant difference was found in the three groups for SCN- level which principally resulted influenced by smoke habit. The 28 patients with CAG were subdivided into two groups (Group A = Diffuse chronic atrophic gastritis--DCAG; Group B = Multifocal chronic atrophic gastritis--MCAG) according to the involvement of gastric corpus and fundus besides antrum by a process of mucosal atrophy. The mean levels of pH, nitrite, TVC, and NRPBC were significantly higher in MCAG than in normal controls but statistically lower in reference to DCAG and cancers. In these two groups no difference was found for the same variables. The percentage of contaminated juices was higher for DCAG and cancers in respect to MCAG but no difference was found between DCAG and neoplastic stomachs. The results of this study suggest that the DCAG could be considered as the chronic atrophic gastritis type more exposed to the risk of N-nitroso compounds carcinogenesis.
The liver and spleen size and the splanchnic vessel caliber were evaluated by means of real‐time ultrasonography in 12 consecutive patients who underwent a partial hepatic resection for benign or malignant lesions. All parameters were evaluated before surgery and 14 days, 28 days, two months, and six months after the partial hepatic resection. The liver size, which was halved after the resection, progressively increased during the follow‐up. The splanchnic veins showed, at 14 and 28 days, a significant increase in caliber and a reduced compliance to breathing, which progressively returned to normal levels. The spleen size increased after partial hepatectomy and remained enlarged throughout the study. Ultrasonography was able to detect that partial hepatic resection is followed by a progressive regeneration of the residual parenchyma and by a transient increase in portal pressure, which returns to normal levels when the liver regenerates.
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