- Variceal bleeding in cirrhotic patients: What is the best prognostic score? [Journal Article]
- TJTurk J Gastroenterol 2016; 27(5):464-469
- CONCLUSIONS: AIMS65 score is the best simple and applicable scoring system for independently predicting mortality in cirrhotic patients with acute variceal bleeding.
- Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center's experience in Turkey. [Journal Article]
- TJTurk J Gastroenterol 2016; 27(5):450-457
- CONCLUSIONS: Infectious and indeterminate cases constituted the most common etiology of PALF, and the etiology was related to the prognosis in our series. Although high PELD and PRISM scores were related to poor prognoses, no sharp thresholds for individual laboratory tests could be elucidated. Liver transplantation was the only curative treatment for patients with poor prognoses and resulted in high survival rates (1-, 5-, and 10-year survival rates of 81.3%, 81.3%, and 75%, respectively) in our study.
- Nitrergic and opioidergic systems affect radiographic density and histomorphometric indices in bile-duct-ligated cirrhotic rats. [Journal Article]
- HHHistol Histopathol 2016 Oct 26; :11836
- Metabolic bone disease is a major issue in chronic liver disease. Increased production of nitric oxide (NO) and elevation of endogenous opioids have been suggested to occur during cholestasis/cirrhos...
Metabolic bone disease is a major issue in chronic liver disease. Increased production of nitric oxide (NO) and elevation of endogenous opioids have been suggested to occur during cholestasis/cirrhosis. We aimed to investigate the involvement of nitrergic and opioidergic systems in bone loss after bile-duct-ligation (BDL) in rats using optical density (OD) evaluation and histomorphometric analysis. BDL- and sham-operated (SO) rats received injections of 3mg/kg Nω-Nitro-L-arginine methyl-ester-hydrochloride (L-NAME) as an NO-synthase inhibitor, 10mg/kg naltrexone (NTX) as an opioid-receptors antagonist or saline once daily for 28 days. Lateral cephalometric radiographs were taken on days 0 and 28 and histomorphometric and biochemical indices were measured. Plasma levels of total bilirubin and alkaline-phosphate were markedly increased in BDL compared with SO rats (p≤0.05). Among the studied variables, osteoclast number/mm trabecular surface showed significant increase in BDL animals compared to controls, which was significantly reduced following NO-synthase inhibition (p≤0.05). Similarly, cortical area slightly decreased in BDL animals in comparison to controls, whereas both L-NAME and NTX significantly increased this variable. Following BDL, optical density increased in the skulls of cirrhotic animals and showed a significant decrease after blocking opioid-receptors (p≤0.05). Inhibition of NO-synthase and/or opioid receptors caused significant changes in OD and histomorphometric parameters in BDL rats, both in favor of reducing bone loss. If confirmed by further studies, it seems that manipulation of these systems might be able to improve bone problems in subjects with cholestasis/cirrhosis.
- Improving O2 reduction at an enzymatic biocathode: mimicking the lungs. [Journal Article]
- CCChem Commun (Camb) 2016 Oct 26
- Here, we demonstrate the use of phospholipid micelles to enhance O2 concentrations by two-fold at the surface of a bilirubin oxidase biocathode. Specifically, 1,2-diarachidoyl-sn-glycero-3-phosphocho...
Here, we demonstrate the use of phospholipid micelles to enhance O2 concentrations by two-fold at the surface of a bilirubin oxidase biocathode. Specifically, 1,2-diarachidoyl-sn-glycero-3-phosphocholine was used in a glucose enzymatic fuel cell to limit power losses due to O2 transport, even in a quiescent solution.
- Stable overexpression of the constitutive androstane receptor reduces the requirement for culture with dimethyl sulfoxide for high drug metabolism in HepaRG cells. [Journal Article]
- DMDrug Metab Dispos 2016 Oct 25
- Dimethyl sulfoxide (DMSO) induces cellular differentiation and expression of drug metabolic enzymes in the human liver cell line HepaRG. However, DMSO also induces cell death and interferes with cell...
Dimethyl sulfoxide (DMSO) induces cellular differentiation and expression of drug metabolic enzymes in the human liver cell line HepaRG. However, DMSO also induces cell death and interferes with cellular activities. The aim of this study was to examine if overexpression of the constitutive androstane receptor (CAR, NR1I3), the nuclear receptor controlling various drug metabolism genes, would sufficiently promote differentiation and drug metabolism in HepaRG cells, optionally without using DMSO. By stable lentiviral overexpression of CAR, HepaRG cultures were less affected by DMSO in total protein content and obtained increased resistance to acetaminophen- and amiodarone-induced cell death. Transcript levels of CAR target genes were significantly increased in HepaRG-CAR cultures without DMSO, resulting in increased activities of cytochrome P450 (CYP) enzymes and bilirubin conjugation to levels equal or surpassing those of HepaRG cells cultured with DMSO. Unexpectedly, CAR overexpression also increased the activities of non-CAR target CYPs, as well as albumin production. In combination with DMSO treatment, CAR overexpression further increased transcript levels and activities of CAR targets. Induction of CYP1A2 and CYP2B6 remained unchanged, while CYP3A4 was reduced. Moreover, the metabolism of low clearance compounds warfarin and prednisolone was increased. In conclusion, CAR-overexpression creates a more physiologically relevant environment for studies on hepatic (drug) metabolism and differentiation in HepaRG cells without the utilization of DMSO. DMSO may still be applied to accomplish higher drug metabolism, required for sensitive assays, such as low-clearance studies and identification of (rare) metabolites, while reduced total protein content after DMSO culture is diminished by CAR overexpression.
- Bile Cast Nephropathy Caused by Obstructive Cholestasis. [Journal Article]
- AJAm J Kidney Dis 2016 Oct 22
- Acute kidney injury (AKI) is a major complication in patients with liver disease. Although hepatorenal syndrome is frequently involved, bile cast nephropathy, characterized by tubular bile cast forma...
Acute kidney injury (AKI) is a major complication in patients with liver disease. Although hepatorenal syndrome is frequently involved, bile cast nephropathy, characterized by tubular bile cast formation, has been scarcely described in the setting of severe liver failure. Few renal histology studies are available in these patients. We describe a case of bile cast nephropathy in a patient with obstructive cholestasis caused by stones in the common bile duct. The kidney biopsy confirmed this diagnosis, with several green casts in tubular lumens, tubular injury, and bilirubin composition of the tubular casts with Hall stain. The patient had no confounding cause of kidney failure, and complete kidney recovery followed removal of the bile duct obstruction. This case shows that severe cholestasis is sufficient to cause AKI, and that AKI can be reversible after treatment of the biliary obstruction.
- Routine intraoperative cholangiography is unnecessary in patients with mild gallstone pancreatitis and normalizing bilirubin levels. [Journal Article]
- AJAm J Surg 2016 Sep 28
- CONCLUSIONS: Routine IOC is not necessary in the setting of mild gallstone pancreatitis with normalizing bilirubin values.
- Anti-inflammatory Signaling During Ex Vivo Liver Perfusion Improves the Preservation of Pig Liver Grafts Before Transplantation. [Journal Article]
- LTLiver Transpl 2016 Aug 24
- CONCLUSIONS: Addition of anti-inflammatory strategies further improves warm perfused preservation. This article is protected by copyright. All rights reserved.
- Total internal biliary diversion during liver transplantation for type 1 progressive familial intrahepatic cholestasis: a novel approach. [Case Reports]
- PTPediatr Transplant 2016; 20(7):981-986
- LT for PFIC type 1 is often complicated by postoperative diarrhea and recurrent graft steatosis. A 26-month-old female child with cholestatic jaundice, pruritus, diarrhea, and growth retardation reve...
LT for PFIC type 1 is often complicated by postoperative diarrhea and recurrent graft steatosis. A 26-month-old female child with cholestatic jaundice, pruritus, diarrhea, and growth retardation revealed total bilirubin 9.1 mg/dL, gamma-glutamyl transpeptidase 64 IU/L, and TBA 295.8 μmol/L. Genetic analysis confirmed ATP8B1 defects. A LT (segment 2, 3 graft) from the heterozygous father was performed. Biliary diversion was performed by a 35-cm jejunum conduit between the graft hepatic duct and the mid-transverse colon. Stools became pigmented immediately. Follow-up at 138 days revealed resolution of jaundice and pruritus and soft-to-hard stools (6-8 daily). Radioisotope hepato-biliary scintigraphy (days 26, 68, and 139) confirmed unobstructed bile drainage into the colon (t1/2 34, 27, and 19 minutes, respectively). Contrast meal follow-through at day 62 confirmed the absence of any colo-jejuno-hepatic reflux. At 140 days, contrast follow-through via the biliary stent revealed patent jejuno-colonic anastomosis and satisfactory transit. Graft biopsy at LT, 138 days, and 9 months follow-up revealed comparable grades of macrovesicular steatosis (<20%). TIBD during LT may be a clinically effective stoma-free biliary diversion and may prevent recurrent graft steatosis following LT for PFIC type 1.
New Search Next
- Normothermic Ex Vivo Liver Perfusion Using Steen Solution as Perfusate for Human Liver Transplantation-First North American Results. [Journal Article]
- LTLiver Transpl 2016 Jun 24
- CONCLUSIONS: Liver preservation with normothermic ex vivo perfusion with the Metra(TM) device using Steen solution is safe and results in comparable outcomes to CS after LT. Using FDA approved Steen solution will avoid a potential regulatory barrier in North America. This article is protected by copyright. All rights reserved.