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[PMID]:29376604
[Au] Autor:Guliev BG; Yagubov KK
[Ad] Endereço:Department of Urology, I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.
[Ti] Título:[Laparoscopic transperitoneal partial nephrectomy for a tumor of the upper segment].
[So] Source:Urologiia;(6):96-100, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:INTRODUCTION: Laparoscopic resection of upper pole kidney tumors is a technically challenging procedure. When tumors are located on the dorsal side of the kidney, the renal-rotation technique may facilitate laparoscopic partial nephrectomy. AIM: To present the technique and results of laparoscopic partial nephrectomy (LPN) for tumors of the upper pole of the kidney with its rotation around the renal hilum. MATERIAL AND METHODS: The study presents a retrospective analysis of the results of 12 patients who underwent LPN for upper pole kidney tumors using the renal-rotation technique. The kidney with the renal hilar vessels and the upper third of the ureter were mobilized using a transperitoneal access. Then the kidney was rotated over its pedicular axis so that the upper pole was located inferiorly. As a result, the posterior upper pole tumor was located anteriorly, thereby facilitating its resection. After removing the tumor and confirming homeostasis, the kidney was returned to its original position. RESULTS: The results of LPN using this technique were successful in all 12 patients. The mean operative time was 120+/-35.0 (90-210) min, the warm ischemia time was 14.5+/-7.8 (10-26) min, and the blood loss was 120.0+/-65.5 (60-300) ml. The intraoperative complication occurred in 1 (8.3%) patients, postoperative complications were observed in 3 patients. Histopathology showed that 11 (91.7%) patients had renal cell carcinoma and one (8.3%) had angiomyolipoma. Analysis of early (18.6+/-5.0 months) oncological outcomes showed no local recurrence and distant metastases. CONCLUSION: With dorsally located upper pole kidney tumors, the renal-rotation technique facilitates the performance of LPN and minimizes the risk of intra- and postoperative complications. This method requires the maximum mobilization of the kidney along with the renal hilar vessels and the upper third of the ureter to rotate it for optimal resection conditions.
[Mh] Termos MeSH primário: Neoplasias Renais/cirurgia
Laparoscopia/métodos
Nefrectomia/métodos
Isquemia Quente/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Neoplasias Renais/diagnóstico por imagem
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


  2 / 905 MEDLINE  
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[PMID]:29376590
[Au] Autor:Guseinov RG; Popov SV; Gorshkov AN; Sivak KV; Martov AG
[Ad] Endereço:St. Lukes Clinical Hospital, St. Petersburg, Russia.
[Ti] Título:[Effects of the of renal warm ischemia time on the recovery of filtration function in the experiment].
[So] Source:Urologiia;(6):20-29, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To investigate experimentally ultrastructural and biochemical signs of acute injury to the renal parenchyma after warm renal ischemia of various duration and subsequent reperfusion. MATERIALS AND METHODS: The experiments were performed on 44 healthy conventional female rabbits of the "Chinchilla" breed weighted 2.6-2.7 kg, which were divided into four groups. In the first, control, group included pseudo-operated animals. In the remaining three groups, an experimental model of warm ischemia of renal tissue was created, followed by a 60-minute reperfusion. The renal warm ischemia time was 30, 60 and 90 minutes in the 2nd, 3rd and 4th groups, respectively. Electron microscopy was used to study ultrastructural disturbances of the renal parenchyma. Biochemical signs of acute kidney damage were detected by measuring the following blood serum and/or urine analytes: NGAL, cystatin C, KIM-1, L-FABP, interleukin-18. The glomerular filtration was evaluated by creatinine clearance, which was determined on days 1, 5, 7, 14, 21 and 35 of follow-up. RESULTS: A 30-minute renal warm ischemia followed by a 60-minute reperfusion induced swelling and edema of the brush membrane, vacuolation of the cytoplasm of the endothelial cells of the proximal tubules, and microvilli restructuring. The observed disorders were reversible, and the epithelial cells retained their viability. After 60 minutes of ischemia and 60 minutes of reperfusion, the observed changes in the ultrastructure of the epithelial cells were much more pronounced, some of the epithelial cells were in a state of apoptosis. 90 min of ischemia and 60 min of reperfusion resulted in electron-microscopic signs of the mass cellular death of the tubular epithelium. Concentration in serum and/or biochemical urine markers of acute renal damage increased sharply after ischemic-reperfusion injury. Restoration of indicators was observed only in cases when the renal warm ischemia time did not exceed 60 minutes. The decrease in creatinine clearance occurred in the first 24 hours after the intervention, lasting not less than two weeks after a 30-minute warm ischemia, at least 3 weeks after a 60-minute warm ischemia and continued more than a month after a 90-minute renal artery occlusion. CONCLUSION: Intraoperative warm ischemia and subsequent reperfusion are the actual reasons for the alteration of the ultrastructure of the renal tissue and the impairment of the filtration function. The severity of the disorders depends on the duration of the damaging factors. After a 30-60-minute ischemia, the structural and functional changes in the renal tissue are reversible. The mass death of nephrocytes-effectors is possible only after warm renal ischemia longer than 60 min.
[Mh] Termos MeSH primário: Lesão Renal Aguda
Taxa de Filtração Glomerular
Rim
Isquemia Quente/métodos
[Mh] Termos MeSH secundário: Lesão Renal Aguda/metabolismo
Lesão Renal Aguda/patologia
Lesão Renal Aguda/fisiopatologia
Animais
Feminino
Rim/metabolismo
Rim/patologia
Rim/fisiopatologia
Rim/ultraestrutura
Coelhos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


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[PMID]:28464554
[Au] Autor:Khene ZE; Peyronnet B; Bosquet E; Pradère B; Robert C; Fardoun T; Kammerer-Jacquet SF; Verhoest G; Rioux-Leclercq N; Mathieu R; Bensalah K
[Ad] Endereço:Department of Urology, Rennes University Hospital, Rennes, France.
[Ti] Título:Does training of fellows affect peri-operative outcomes of robot-assisted partial nephrectomy?
[So] Source:BJU Int;120(4):591-599, 2017 10.
[Is] ISSN:1464-410X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group). Peri-operative data were compared between the two groups. Linear and logistic regression analyses were performed to assess the impact of fellows' involvement on peri-operative and postoperative outcomes. Trifecta and margins ischaemia complications (MIC) score achievement rates were used to assess the quality of surgery in both the expert and fellow groups. Trifecta was defined as a combination of warm ischaemia time <25 min, negative surgical margins and no peri-operative complications. MIC score was defined as negative surgical margins, ischaemia time <20 min, and absence of complications grade ≥3. RESULTS: Fellows were involved in a total of 89 procedures (41%). Patients' characteristics were similar in the two groups. Operating time and warm ischaemia time (WIT) were longer in the fellow group (180 vs 120 min, P < 0.001, and 18 vs 14 min, P = 0.002, respectively). Length of hospital stay (LOS) was longer in the fellow group (5 vs 4.3 days; P = 0.05) and patients in this group had higher estimated blood loss (EBL; 400 vs 300 mL; P = 0.01), but this had no impact on transfusion rate (14% vs 11%; P = 0.43). Positive surgical margin rates were similar in the fellow and expert groups (2.2% vs 3.1%; P = 0.70). Major complications were more frequent in the fellow group (12.3% vs 6.3%), but the difference was not significant (P = 0.10). In multivariable analysis, fellow involvement was predictive of longer WIT (ß = 0.22; P = 0.003) and operating time (ß = 0.49; P < 0.001), but was not associated with EBL (ß = 0.12, P = 0.09) or LOS (ß = 0.12, P = 0.11). Finally, fellow involvement was associated with a lower rate of trifecta and MIC score accomplishment (odds ratio [OR] 0.53, P = 0.05 and OR 0.46, P = 0.01, respectively). CONCLUSION: Training fellows to perform RAPN is associated with longer operating time and WIT but does not appear to compromise other peri-operative outcomes.
[Mh] Termos MeSH primário: Competência Clínica
Educação de Pós-Graduação em Medicina/métodos
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Procedimentos Cirúrgicos Robóticos/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Bases de Dados Factuais
Feminino
Seguimentos
França
Hospitais Universitários
Seres Humanos
Neoplasias Renais/patologia
Masculino
Meia-Idade
Nefrectomia/efeitos adversos
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/fisiopatologia
Estudos Retrospectivos
Medição de Risco
Procedimentos Cirúrgicos Robóticos/métodos
Resultado do Tratamento
Isquemia Quente
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/bju.13901


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[PMID]:28457413
[Au] Autor:Puliti Reigada CH; de Ataide EC; de Almeida Prado Mattosinho T; Boin IFSF
[Ad] Endereço:Unit of Liver Transplantation Unit, State University of Campinas, Campinas, Brazil.
[Ti] Título:Hepatic Artery Thrombosis After Liver Transplantation: Five-Year Experience at the State University of Campinas.
[So] Source:Transplant Proc;49(4):867-870, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival. RESULTS: The incidence of HAT was 21/263, or 7.9%. Pure average MELD score was 22 ± 7.4. There was vascular anatomic variation in the graft in 14.2% of cases, in the majority (66.6%) a right hepatic artery from the superior mesenteric artery, and 4.76% of patients had CMV infection and acute cellular rejection (1 case each). There were biliary complications in 38% of patients, 13.3% of cases in patients with early HAT, and 100% of patients with late HAT (P = .002). Body mass index in late HAT was higher (P = .01). CONCLUSIONS: Late HAT was related to a significant increase in biliary complications (stenosis), and the survival rate was similar at 5 years.
[Mh] Termos MeSH primário: Artéria Hepática
Transplante de Fígado/efeitos adversos
Fígado/irrigação sanguínea
Trombose/epidemiologia
Transplantes/irrigação sanguínea
[Mh] Termos MeSH secundário: Carcinoma Hepatocelular/cirurgia
Isquemia Fria/efeitos adversos
Infecções por Citomegalovirus/complicações
Feminino
Rejeição de Enxerto/virologia
Seres Humanos
Incidência
Fígado/virologia
Neoplasias Hepáticas/cirurgia
Masculino
Artéria Mesentérica Superior
Meia-Idade
Reoperação/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Taxa de Sobrevida
Trombose/etiologia
Isquemia Quente/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457409
[Au] Autor:Chedid MF; Bosi HR; Chedid AD; Alvares-da-Silva MR; Leipnitz I; Grezzana-Filho TJM; Reis MJ; Filho GM; Ghissi AJ; Neto PR; de Araujo A; Arruda S; Lopes AB; Michalczuk MT; Backes AN; Kruel CDP; Kruel CRP
[Ad] Endereço:Liver Transplant Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Electronic address: marciochedid@hotmail.com.
[Ti] Título:One Hundred Consecutive Liver Transplants Using Institutes Georges Lopez-1 Preservation Solution: Outcomes and Prognostic Factors.
[So] Source:Transplant Proc;49(4):848-851, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are only 4 prior studies reporting on outcomes of liver transplantation (LT) using Institutes Georges Lopez-1 (IGL-1) preservation solution. Detection of negative predictors of LT using IGL-1 may help finding strategies to protect selected recipients at higher risk of graft failure and death. METHODS: Review of all consecutive adult patients who underwent a first whole-graft LT using IGL-1 at authors' institution from 2013 to 2016. Primary end point was graft failure within the first 90 postoperative days (PODs). Graft losses due to any cause (including all deaths with a functioning graft) were recorded as graft failures. RESULTS: Of all 100 patients included in this study, 37 were women; median age was 58 years (range 18-71). There were 12 graft losses during the first 90 PODs (including 3 cases of primary nonfunction of the liver allograft), and 10 of the 12 graft losses occurred on first 30 PODs. All 12 patients who experienced graft loss (including 1 patient who underwent liver retransplantation) died within the first 90 PODs. Of the total 100 patients, 14 experienced biliary complications. Univariate analysis revealed prolonged warm ischemic time (WIT) as the only predictor of 90-day graft failure (odds ratio = 23.5, confidence interval = 1.29-430.18, P = .03). The cutoff by receiver operating characteristic curve for WIT was 38 minutes (area under the curve = 0.70). Positive predictive value for WIT >38 minutes was 94.3%. CONCLUSIONS: LT using IGL-1 can be performed safely. Similar to prior reports on LT using other preservation solutions, prolonged WIT was associated with adverse outcomes.
[Mh] Termos MeSH primário: Transplante de Fígado/métodos
Soluções para Preservação de Órgãos
Preservação de Órgãos/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Doença Hepática Terminal/cirurgia
Feminino
Sobrevivência de Enxerto
Seres Humanos
Masculino
Meia-Idade
Período Pós-Operatório
Prognóstico
Reoperação
Estudos Retrospectivos
Fatores de Tempo
Isquemia Quente
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Organ Preservation Solutions)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457385
[Au] Autor:Baroncelli F; Alberione MC; Cacciotti V; Artusio D; Vergano M; Livigni S
[Ad] Endereço:Scuola di Specializzazione in Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Torino, Torino, Italy.
[Ti] Título:Blood Lactate Concentrations Before and After Withdrawal of Life-Sustaining Treatments in Controlled Donation After Circulatory Death: A Case Report From Italy.
[So] Source:Transplant Proc;49(4):740-742, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 20-minute hands-off period with isoelectric electrocardiography (ECG) monitoring is currently required for the declaration of cardiac death in Italy, thus prolonging the warm ischemia time (WIT) during donation after circulatory death (DCD). Normothermic regional perfusion (NRP) can be a valid tool to optimize organ perfusion as a bridge to donation. A 62-year-old woman with catastrophic brain injury due to massive intracranial hemorrage, not fulfilling brain death criteria, underwent controlled DCD after withdrawal of life-sustaining therapies (WLST). NRP was established after a functional WIT of 43 minutes. Despite concerns regarding a prolonged WIT imposed by the national legislation on declaration of cardiac death, NRP was successful in restoring an adequate perfusion to liver and kidneys, as evidenced by a sustained reduction in blood lactate concentration. Liver and kidneys were successfully transplanted after ex vivo machine perfusion.
[Mh] Termos MeSH primário: Morte Encefálica/diagnóstico
Ácido Láctico/sangue
Preservação de Órgãos/métodos
Coleta de Tecidos e Órgãos/métodos
Isquemia Quente
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Itália
Meia-Idade
Perfusão
Doadores de Tecidos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
33X04XA5AT (Lactic Acid)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29023512
[Au] Autor:Bochimoto H; Matsuno N; Ishihara Y; Shonaka T; Koga D; Hira Y; Nishikawa Y; Furukawa H; Watanabe T
[Ad] Endereço:Health Care Administration Center, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan.
[Ti] Título:The ultrastructural characteristics of porcine hepatocytes donated after cardiac death and preserved with warm machine perfusion preservation.
[So] Source:PLoS One;12(10):e0186352, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The effects of warm machine perfusion preservation of liver grafts donated after cardiac death on the intracellular three-dimensional ultrastructure of the organelles in hepatocytes remain unclear. Here we analyzed comparatively the ultrastructure of the endomembrane systems in porcine hepatocytes under warm ischemia and successive hypothermic and midthermic machine perfusion preservation, a type of the warm machine perfusion. Porcine liver grafts which had a warm ischemia time of 60 minutes were perfused for 4 hours with modified University of Wisconsin gluconate solution. Group A grafts were preserved with hypothermic machine perfusion preservation at 8°C constantly for 4 hours. Group B grafts were preserved with rewarming up to 22°C by warm machine perfusion preservation for 4 hours. An analysis of hepatocytes after 60 minutes of warm ischemia by scanning electron microscope revealed the appearance of abnormal vacuoles and invagination of mitochondria. In the hepatocytes preserved by subsequent hypothermic machine perfusion preservation, strongly swollen mitochondria were observed. In contrast, the warm machine perfusion preservation could preserve the functional appearance of mitochondria in hepatocytes. Furthermore, abundant vacuoles and membranous structures sequestrating cellular organelles like autophagic vacuoles were frequently observed in hepatocytes after warm machine perfusion preservation. In conclusion, the ultrastructure of the endomembrane systems in the hepatocytes of liver grafts changed in accordance with the temperature conditions of machine perfusion preservation. In addition, temperature condition of the machine perfusion preservation may also affect the condition of the hepatic graft attributed to autophagy systems, and consequently alleviate the damage of the hepatocytes.
[Mh] Termos MeSH primário: Hepatócitos/ultraestrutura
Fígado/ultraestrutura
Preservação de Órgãos/normas
[Mh] Termos MeSH secundário: Adenosina/farmacologia
Alopurinol/farmacologia
Animais
Membrana Celular/ultraestrutura
Citocromos c/metabolismo
Morte
Feminino
Glutationa/farmacologia
Insulina/farmacologia
Fígado/efeitos dos fármacos
Fígado/metabolismo
Microscopia Eletrônica de Varredura
Microscopia Eletrônica de Transmissão
Microscopia de Fluorescência
Proteínas Associadas aos Microtúbulos/metabolismo
Mitocôndrias/ultraestrutura
Soluções para Preservação de Órgãos/farmacologia
Rafinose/farmacologia
Suínos
Isquemia Quente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Insulin); 0 (Microtubule-Associated Proteins); 0 (Organ Preservation Solutions); 0 (University of Wisconsin-lactobionate solution); 63CZ7GJN5I (Allopurinol); 9007-43-6 (Cytochromes c); GAN16C9B8O (Glutathione); K72T3FS567 (Adenosine); N5O3QU595M (Raffinose)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171013
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186352


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[PMID]:28952698
[Au] Autor:Popov SV; Guseinov RG; Martov AG; Muratov TM; Tabynbaev NB
[Ad] Endereço:St. Lukes Clinical Hospital, St. Petersburg, Russia.
[Ti] Título:[Molecular and cellular mechanisms of damage to renal parenchyma in renal warm ischemia].
[So] Source:Urologiia;(4):79-84, 2017 Sep.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Warm ischemia of the renal parenchyma is a forced feature of laparoscopic partial nephrectomy. It is accompanied by oxygen deprivation of the organ and followed by re-oxygenation, which can cause additional damage to the renal tissue. This damage can result in acute functional and structural disorders of individual parts of the nephron, increasing the risk for a renal dysfunction. Timely diagnosis of the dysfunction is vital for the success of the treatment. The article provides an overview of current scientific data on the mechanisms of ischemic and reperfusion injuries at the molecular-cellular level and describes the current methods of their detection. Experimental and clinical study of the molecular-cellular mechanisms of ischemic-reperfusion injury of the renal tissue made it possible, first, to determine the main targets of alteration (cytolemma, mitochondria, lysosomes), and second, to establish its consequences, among which the most important are hypoergosis, DNA damage, simultaneous activation of intracellular systems of the suicidal program and induction of electrical breakdown of membranes of target nephrocytes; thirdly, to reveal the range of possibilities for limiting the consequences of hypoxia and/or re-oxygenation, among which interference in the metabolism of purines, measures ensuring the preservation of colloid osmotic pressure inside and outside the cell and membrane stabilization, antioxidant defense and inhibition of cysteine proteinases, etc. However, despite the advances in understanding the pathogenesis of cell damage, including ischemic-hypoxic injury, the problem of intraoperative ischemia-reperfusion safety remains relevant.
[Mh] Termos MeSH primário: Rim/patologia
Tecido Parenquimatoso/patologia
Traumatismo por Reperfusão/patologia
Isquemia Quente/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Apoptose
Cálcio/metabolismo
Calpaína/metabolismo
Hipóxia Celular
Radicais Livres/metabolismo
Seres Humanos
Espaço Intracelular/metabolismo
Rim/irrigação sanguínea
Rim/metabolismo
Tecido Parenquimatoso/metabolismo
Proteólise
Traumatismo por Reperfusão/etiologia
Traumatismo por Reperfusão/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Free Radicals); EC 3.4.22.- (Calpain); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE


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[PMID]:28704337
[Au] Autor:Weng J; Li W; Jia X; An W
[Ad] Endereço:1 Department of Cell Biology and Municipal Laboratory of Liver Protection and Regulation of Regeneration, Capital Medical University, Beijing, China.
[Ti] Título:Alleviation of Ischemia-Reperfusion Injury in Liver Steatosis by Augmenter of Liver Regeneration Is Attributed to Antioxidation and Preservation of Mitochondria.
[So] Source:Transplantation;101(10):2340-2348, 2017 Oct.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fatty liver is one of the major impediments to liver surgery and liver transplantation because steatotic hepatocytes are more susceptible to ischemia-reperfusion injury (IRI). In this study, the effects of augmenter of liver regeneration (ALR) on hepatic IRI in steatotic mice were investigated. METHODS: In vivo, liver steatosis of mice was induced by feeding a methionine-choline-deficient diet for 2 weeks. Three days before hepatic partial warm IRI, mice were transfected with the ALR-containing adenovirus. In an in vitro study, the protective effect of ALR on steatotic HepG2 cells was analyzed after hypoxia/reoxygenation (HR) treatment. RESULTS: The transfection of the ALR gene into steatotic mice attenuated liver injury, inhibiting hepatic oxidative stress, increasing antioxidation capacities, promoting liver regeneration, and consequently suppressing cell apoptosis/death. Furthermore, resistance to HR injury was notably increased in ALR-transfected cells compared with the vector-transfected cells. The HR-induced rise in the mitochondrial reactive oxygen species was reduced, and cellular antioxidant activities were enhanced. The ALR transfection prevented cells from apoptosis, which can be attributed to the preservation of the mitochondrial membrane potential, enhancement of oxygen consumption rate and production of adenosine triphosphate. CONCLUSIONS: ALR protects steatotic hepatocytes from IRI by attenuating oxidative stress and mitochondrial dysfunction, as well as improving antioxidant effect. ALR may be used as a potential therapeutic agent when performing surgery and transplantation of steatotic liver.
[Mh] Termos MeSH primário: Proteínas de Ligação a DNA/biossíntese
Fígado Gorduroso/cirurgia
Terapia Genética/métodos
Fígado/cirurgia
Mitocôndrias Hepáticas/metabolismo
Proteínas de Neoplasias/biossíntese
Estresse Oxidativo
Traumatismo por Reperfusão/prevenção & controle
Isquemia Quente/efeitos adversos
[Mh] Termos MeSH secundário: Trifosfato de Adenosina/metabolismo
Adenoviridae/genética
Animais
Apoptose
Proteínas de Ligação a DNA/genética
Modelos Animais de Doenças
Fígado Gorduroso/complicações
Fígado Gorduroso/metabolismo
Fígado Gorduroso/patologia
Vetores Genéticos
Células Hep G2
Seres Humanos
Fígado/metabolismo
Fígado/patologia
Regeneração Hepática
Masculino
Potencial da Membrana Mitocondrial
Camundongos Endogâmicos C57BL
Mitocôndrias Hepáticas/patologia
Proteínas de Neoplasias/genética
Consumo de Oxigênio
Traumatismo por Reperfusão/genética
Traumatismo por Reperfusão/metabolismo
Traumatismo por Reperfusão/patologia
Transdução de Sinais
Fatores de Tempo
Transfecção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA-Binding Proteins); 0 (MLL2 protein, human); 0 (Neoplasm Proteins); 8L70Q75FXE (Adenosine Triphosphate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001874


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[PMID]:28675368
[Au] Autor:Brasoveanu V; Pautov M; Ionescu MI; Anghel C; Dudus DI; Moothoor M; Ichim F; Gangone E; Barbu I
[Ti] Título:Ante-situm Liver Resection for Giant Hepatic Tumour - Case Report and Review of Literature.
[So] Source:Chirurgia (Bucur);112(3):326-331, 2017 May-Jun.
[Is] ISSN:1221-9118
[Cp] País de publicação:Romania
[La] Idioma:eng
[Ab] Resumo:Ex-situ liver surgery refers to complex liver resections involving hepatic vascular exclusion and a warm ischemia time (WIT) of more than 90 minutes that allows liver resection and vascular reconstruction in patients with giant liver tumours with a difficult approach . Ante-situm liver resections, otherwise called "œex-situ in-vivo" resections is achieved through externalization of the liver outside of the abdominal cavity by clamping and sectioning of the efferent pedicles (suprahepatic veins) ("ex situ") without cutting the afferent vascular pedicle ("in vivo"), thus leaving the hepatic pedicle intact. We present a case report of a 36 yo male patient diagnosed by MRI scan with giant liver tumor in the left hemiliver. A left "ex-situ in-vivo" hepatectomy was performed by dissecting and ligating the left and middle hepatic veins, clamping and sectioning the right hepatic vein, Pringle maneuver, externalization of the liver followed by the tumor resection and right hepatic vein reimplantation. The short warm ischemia time (hepatic resection + liver reimplantation - 30 minutes) allowed us to perform the procedure without installing a veno-venous or porto-caval shunt otherwise used in all of ex-situ procedures described in the literature reviewed in this presentation. Ex-situ liver resection is a viable procedure for giant liver tumours in highly selected cases. It facilitates resection of large liver tumours that would be otherwise unresectable, extending the indications of surgical treatment.
[Mh] Termos MeSH primário: Hepatectomia/métodos
Neoplasias Hepáticas/diagnóstico por imagem
Neoplasias Hepáticas/cirurgia
Imagem por Ressonância Magnética
Isquemia Quente
[Mh] Termos MeSH secundário: Adulto
Veias Hepáticas/cirurgia
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE



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