[Effects of FRNK on activation and migration of hepatic stellate cells].

Objective: To investigate the effect of focal adhesion kinase related non kinase (FRNK) on the activation and migration of hepatic stellate cells (HSCs). Methods: Human liver tissue was divided into healthy control group and fibrosis group from March 2019 to September 2019 in Affiliated Hospital of Guizhou Medical University. C57BL/6 mice were divided into wild type (WT) and FRNK gene knockout type (FRNK-/-) groups. The liver fibrosis model was established with carbon tetrachloride (CCl4). After that, FRNK gene overexpression (Ad-FRNK) was constructed with adenovirus vector. HE and Masson staining were used to evaluate the pathological changes and fiber deposition of liver tissue. Western blot was used to detect the expression of PY397-FAK and α-SMA protein. Mouse primary HSCs were extracted, and the effect of FRNK on HSCs migration was detected by wound healing, activation of Rac and Rho was detected by Western blot. Results: The expression of PY397-FAK protein in human liver tissue with hepatic fibrosis was significantly higher than that in healthy control group (0.88±0.09 vs. 0.73±0.09). FRNK was significantly lower than that in control group(0.68±0.09 vs. 0.79±0.11). After animal model was set up, the degree of liver fibrosis in FRNK-/-mice (153±13)% was more serious than that in WT (100%) group. The expression of PY397-FAK and α-SMA protein was significantly elevated (2.50±0.23 vs. 0.75±0.09, 1.46±0.20 vs. 0.92±0.10). After FRNK gene was re-expressed (100%), the degree of liver fibrosis was mainly reversed [(74±6)%], and the expression of PY397-FAK and α-SMA was accordingly decreased(0.68±0.11 vs. 1.12±0.19,0.68±0.10 vs. 0.85±0.06). In vitro, FRNK inhibited the migration of HSCs [WT∶FRNK-/-∶Ad-FRNK,(339±49)%∶(580±53)%∶(259±33)%] and the activation of Rac and Rho proteins (Rac: 0.54±0.07 vs. 0.91±0.10 vs. 0.77±0.12,Rho:0.45±0.05 vs. 0.64±0.06 vs. 0.53±0.07), all P<0.01. Conclusions: FRNK can inhibit the activation and migration of HSCs which contributed to liver fibrosis. The potential mechanism is related to down regulation of PY397-FAK and inhibition of Rac and Rho activation.

[Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province].

Objective: To study the effect of COVID-19 on pregnancy outcomes and neonatal prognosis in Hubei Province. Method: s A retrospective comparison of the pregnancy outcomes was done between 16 women with COVID-19 and 45 women without COVID-19. Also, the results of laboratory tests, imaging examinations, and the 2019 novel coronavirus (2019-nCoV) nucleic acid test were performed in 10 cases of neonatal delivered from women with COVID-19. Result: s (1) Of the 16 pregnant women with COVID-19, 15 cases were ordinary type and 1 case was severe type. No one has progressed to critical pneumonia.The delivery method of the two groups was cesarean section, and the gestational age were (38.7±1.4) and (37.9±1.6) weeks,there was no significant difference between the two groups (P>0.05). Also, there wee no significant differences in the intraoperative blood loss and birth weight of the newborn between the two groups (all P>0.05). (2) Ten cases of neonates delivered from pregnant women with COVID-19 were collected. The 2019-nCoV nucleic acid test were all negative.There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups (all P>0.05).(3) In the treatment of uterine contraction fatigue, carbetocin or carboprost tromethamine was used more in cesarean section for pregnant women with COVID-19 (1.3±0.6), compared with Non-COVID-19 group (0.5±0.7),the difference was statistically significant (P=0.001). Conclusions: If there is an indication for obstetric surgery or critical illness of COVID-19 in pregnant women, timely termination of pregnancy will not increase the risk of premature birth and asphyxia of the newborn, but it is beneficial to the treatment and rehabilitation of maternal pneumonia. Preventive use of long-acting uterotonic agents could reduce the incidence of postpartum hemorrhage during surgery. 2019-nCoV infection has not been found in neonates delivered from pregnant women with COVID-19.

Creation of Electron-Positron Pairs in Photon-Photon Collisions Driven by 10-PW Laser Pulses.

A novel approach is proposed to demonstrate the two-photon Breit-Wheeler process by using collimated and wide-bandwidth γ-ray pulses driven by 10-PW lasers. Theoretical calculations suggest that more than 3.2×10^{8} electron-positron pairs with a divergence angle of 7° can be created per shot, and the signal-to-noise ratio is higher than 10^{3}. The positron signal, which is roughly 100 times higher than the detection limit, can be measured by using the existing spectrometers. This approach, which could demonstrate the e^{-}e^{+} pair creation process from two photons, would provide important tests for two-photon physics and other fundamental physical theories.

Detection and analysis of laser driven proton beams by calibrated Gafchromic HD-V2 and MD-V3 radiochromic films.

The radiochromic film (RCF) is a high-dose, high-dynamic range dosimetry detection medium. A stack of RCFs can be used to detect both spatial and energetic distribution of laser driven ion beams with a large divergence angle and continuous energy spectrum. Two types of RCFs (HD-V2 and MD-V3, from Radiation Products Design, Inc.) have been calibrated using MeV energy protons and carbon ions produced by using a 2 × 6 MV tandem electrostatic accelerator. The proportional relationship is obtained between the optical density and the irradiation dose. For protons, the responses are consistent at all energies with a variation of about 15%. For carbon ions, the responses are energy related, which should be noted for heavy ion detection. Based on the calibration, the broad energy spectrum and charge distribution of laser accelerated proton beam with energy from 3 to 8 MeV and pC charge were detected and reconstructed at the Compact LAser Plasma Accelerator at Peking University.

High-efficiency γ-ray flash generation via multiple-laser scattering in ponderomotive potential well.

γ-ray flash generation in near-critical-density target irradiated by four symmetrical colliding laser pulses is numerically investigated. With peak intensities about 10^{23} W/cm^{2}, the laser pulses boost electron energy through direct laser acceleration, while pushing them inward with the ponderomotive force. After backscattering with counterpropagating laser, the accelerated electron is trapped in the electromagnetic standing waves or the ponderomotive potential well created by the coherent overlapping of the laser pulses, and emits γ-ray photons in a multiple-laser-scattering regime, where electrons act as a medium transferring energy from the laser to γ rays in the ponderomotive potential valley.

Regulation of ornithine decarboxylase in a transformed cell line that overexpresses translation initiation factor eIF-4E.

pMV7-4E cells (4E-P2), derived from NIH-3T3 cells, overexpress eIF-4E and exhibit characteristics of transformation, possibly due to translational relief of mRNAs encoding proteins that regulate cell growth. Ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine biosynthesis, is induced in 4E-P2 cells, and this induction appears to be related to the transformed phenotype of these cells. ODC mRNA contains extensive secondary structure in its 5' untranslated region (5'UTR) and may be regulated by eIF-4E, which melts mRNA secondary structure. To better understand this regulation, cDNA constructs containing the wild-type 5'UTR of ODC or deletion mutants inserted ahead of the luciferase gene were transfected into 4E-P2 and 3T3 cells. Expression of luciferase was higher in 4E-P2 cells in all cases, suggesting that the secondary structure of the ODC 5'UTR inhibits expression in 3T3 cells, and this inhibition is overcome by the high eIF-4E levels in 4E-P2 cells. When a small open reading frame present in the 5'UTR of ODC was destroyed by a point mutation, this luciferase construct was expressed about 6-fold over that containing the wild-type 5'UTR in both cell lines, although both of these 5'UTRs contain the same predicted secondary structure. Thus, factors in addition to eIF-4E may be involved in the regulation of ODC. To examine the differences in ODC regulation by polyamines in normal and transformed cells, the effect of N1,N12-bis(ethyl)spermine (BE-3-4-3) on the synthesis and degradation of ODC was examined. ODC activity in 4E-P2 cells was 10 times less sensitive to reduction by BE-3-4-3 compared to 3T3 cells, suggesting that high ODC levels in eIF-4E-overexpressing cells are the result of decreased regulation by polyamines as well as relief of translational regulation by eIF-4E.

Effect of polyamine analogues and inhibition of polyamine oxidase on spermidine/spermine N1-acetyltransferase activity and cell proliferation.

Several bis(ethyl)polyamine analogues are currently undergoing trials as antitumor agents. The ability of some of these analogues to induce spermidine/spermine N1-acetyltransferase and to inhibit cell proliferation was examined in a number of different cell lines. Although N1,N11 bis(ethyl)norspermine was a potent inducer of the acetylase in all cell lines tested, there was a striking difference in the acetylase induction in response to N,N'-bis(ethylamino)propyl]-1,7-heptanediamine. This was a very strong inducer in CHO cells but had no effect in HT29 cells and very little effect in COS-7 or L1210 cells. There was no correlation between the induction of the acetylase and the ability of these analogues to inhibit cell proliferation since N1,N11-bis(ethylamino)-propyl]-1,7-heptanediamine was as at least as strongly antiproliferative as N1,N11-bis(ethyl)-norspermine or N1,N12-bis(ethyl)spermine. Acetylase induction and the intracellular level of the analogues were increased in CHO cells by treatment with a polyamine oxidase inhibitor suggesting that they are degraded by polyamine oxidase. The absence of polyamine oxidase in some tumors may therefore contribute to their sensitivity to these analogues.

Surgical resection for recurrent hepatocellular carcinoma: prognosis and analysis of risk factors.

BACKGROUND: Hepatocellular carcinoma (HCC) is common in Asian countries, and tumor recurrence is the most common cause of treatment failure after curative resection. Repeated hepatectomy is performed only for selected patients because most patients with HCC also have liver cirrhosis and poor liver function reserve. The purposes of this study were to clarify the outcome of the patients after second hepatectomy for recurrent HCC and to evaluate the prognostic factors after second hepatectomy. METHODS: We used retrospective cohort study to examine the disease-free survival, cumulative survival, and possible prognostic factors for recurrence and death in 59 patients who underwent surgical resection for recurrent HCC at the National Taiwan University Hospital from August 1986 to December 1993. Another 64 patients with unresectable recurrent HCC were used as a historical control group. The survival curves between those patients with resectable HCC and those with unresectable HCC were compared. RESULTS: After resection for recurrent HCC, gender and multiplicity (n > 3) of tumor affect recurrence rate (p = 0.046 and 0.021, respectively), whereas gender, age, and tumor invasiveness affect survival rate significantly (p = 0.024, 0.021, and 0.046, respectively). The survival rate of patients with resectable HCC was significantly better than that of those with unresectable HCC. CONCLUSIONS: For recurrent HCC surgical resection is an effective mode of treatment in selected patients. Whether surgery is better than other modes of treatment in the treatment of resectable recurrent HCC demands further investigation.

Evaluation of cyclosporine C2 levels in long-term stable renal allograft recipients.

BACKGROUND: The use of cyclosporine was traditionally monitored by the trough level (C(0)). However, the immunosuppressive effects of cyclosporine correlate with its drug exposure, represented by the area under curve (AUC). It was also noted that cyclosporine C(0) level correlated with AUC poorly, while C(2) level (concentration at 2 hours after drug administration) satisfactorily correlated with AUC. Most recent studies concern the use of C(2) levels in de novo renal transplant patients; target levels of C(2) have been suggested. There is rare discussion about the C(2) target level for long-term cyclosporine-maintenance patients. Our objectives were to analyze the cyclosporine C(2) levels of patients more than 12 months after transplantation as well as changes in C(2) with time and the correlation between C(2) level and renal function. METHODS AND PATIENTS: This was a cross-sectional case-controlled study of 101 kidney recipients immunosuppressed with a cyclosporine-based regimen for at least 12 months. Both C(0) and C(2) levels were examined at various time points during outpatient clinic follow-up. The patients were stratified according to the time after transplant surgery, or to their renal function. RESULTS: The 101 patients were divided into three groups based on the time after renal transplant surgery. Groups 1, 2, and 3 represented patients transplanted for 1 to 3 years (n = 16), 4 to 6 years (n = 35), and more than 6 years (n = 50), respectively. The C(2) levels for each group were 657 +/- 232, 561 +/- 186, and 580 +/- 243 ng/mL, respectively, (P = NS). When stratified into low versus high C(2) groups, there were no significant differences in renal function both at the beginning and at the end of 1 year follow-up. Seven of 67 patients shifted to stronger immunosuppression in the low C(2) group, but only 2/34 in the high C(2) group, a difference that was not significant (P = .234 by Fisher Exact Test). Patients with creatinine levels greater than 1.5 mg/dL or lower than 1.5 mg/dL showed no difference in C(2) on C(0) levels. Patients with deterioration of renal function during this period had no different C(2) levels as those with no deterioration of renal function. CONCLUSION: The average C(2) levels among long-term cyclosporine-maintained patients were significantly lower than those previously suggested. C(2) levels did not correlate with the long-term outcome of renal function in patients at least 1 year after renal transplantation.

Effects of and predictors for tacrolimus rescue therapy among renal transplant patients under cyclosporine-based immunosuppression.

BACKGROUND: Though cyclosporine has dramatically decreased rejection rates and improved graft survival rates of renal allografts, there is still a remarkable rate of acute rejection and progressive deterioration of renal function after transplantation. Rescue therapy with tacrolimus has been used for allografts failing under cyclosporine-based treatment in order to get some renal functional recovery or stabilization. The aim was to evaluate tacrolimus rescue therapy for failing allografts under cyclosporine-based immunosuppression for possible prediction factors for success. PATIENTS AND METHODS: Thirty-five renal allograft recipients with failing transplants under cyclosporine-based immunosuppression were enrolled into this study. Renal function was evaluated by reciprocal serum creatinine level (1/Cr) and calculated CCr. The slope of changes in 1/Cr and CCr were calculated before and after tacrolimus therapy. The possible risk factors that affect the outcome of tacrolimus rescue therapy were analyzed. RESULTS: Nineteen patients showed improved renal function (group 1) and 16 patients, persistent deterioration (group 2) after rescue therapy. Group 1 showed positive slopes of changes of 1/Cr and CCr after rescue therapy. Group 2 patients showed persistent negative slopes although less negative than before rescue therapy. Only the posttransplant time was the significant predictive factor for successful tacrolimus therapy (P = .018). CONCLUSION: Tacrolimus rescue therapy improved or stabilized renal function in some patients with failing grafts under cyclosporine-based immunosuppression. To assure a successful rescue effect, it should be given early after transplantation, if there is a tendency toward deterioration of renal function.

Liver transplantation for acute hepatic failure.

INTRODUCTION: The mortality rate of acute hepatic failure (AHF) with conservative treatment is 40% to 90%, depending on the etiology. Hepatitis B infection is the major cause of AHF in Asia. In this study, we examined the role of liver transplantation for adult patients with AHF. METHODS: Sixteen patients with AHF received liver transplants in the past 6 years. Eight patients received cadaveric donor and another 8 living-related donor grafts. Fifteen patients suffered from hepatitis B-related disease and 1 had drug-induced AHF. Extracorporeal charcoal hemoperfusion was used as a bridge to liver transplantation in the first 2 patients and plasma exchange was used in the following patients. RESULTS: One patient died 1 month after the operation due to primary nonfunction. The other 15 patients are alive with good graft function at 2 months to 6 years follow-up. The success rate is 94%. Postoperative complications included infection in 10 patients (62.5%), acute rejection in 4 patients (25%), and biliary complication in 2 patients (12.5%). No neurological complications were noted. CONCLUSION: Liver transplantation is the most effective treatment for patients with AHF. Living donors may be considered due to the organ shortage and the critical patient disease.

Use of simulect can reduce the incidence of acute rejection and demonstrates with superior 3-year patient and graft survival rates in renal transplantation.

BACKGROUND: Acute rejection is a major cause of graft loss in renal transplantation. Because the highest risk for acute rejection is in the first month posttransplantation, improved prophylaxis could be most beneficial in this period. Simulect administration provides 30 to 45 days of immunoprophylaxis against acute rejection during the critical period after transplantation. OBJECTIVES: We sought to assess the incidence of acute rejection episodes and the safety and tolerability of Simulect plus Neoral immunosuppression. Patient and graft survival rates up to 3 years posttransplantation were evaluated. METHOD: Forty-one transplant recipients received Simulect by intravenous infusion of an initial 20-mg dose on the day of renal transplantation and a second 20-mg dose on day 4 posttransplant. All renal recipients received immunosuppression with Neoral and steroid. RESULTS: There were eight cases (19.5%) of acute rejection within 1 year. The rejection episodes were easily reversed with steroid pulse therapy in seven patients except for graft loss. The 1-, 2-, and 3-year graft survival rates were 95%, 93%, and 88%, respectively. Overall, the 3-year patient survival rate was 100%. CONCLUSIONS: Simulect in combination with Neoral and steroid-reduced the incidence of acute rejection without an increase in adverse events. The low incidence and severity of acute rejection may have led to the superior 3-year patient and graft survival rates in renal transplantation.

Do patients with acute liver failure have a better chance to receive liver grafting?

OBJECTIVE: Patients with acute hepatic failure (AHF) were always given first priority on the transplant waiting list. We investigated whether AHF patients will deprive other patients on the waiting list of the chance of liver transplantation (LTx). METHODS AND RESULTS: From January 1999 to March 2003, a total of 423 patients were on the transplant waiting list at the National Taiwan University Hospital. Sixty-five of the patients had AHF caused by hepatitis-B-related disease (HBV, n = 52, 80%), Wilson disease (n = 3, 4.6%), drug-induced AHF (n = 3, 4.6%), and other causes (n = 7, 10.8%).Thirty-three patients died and 16 survived by medical treatment. Two received LTx abroad and 14 underwent LTx at our hospital (7 living-related; 7 cadaver). A total of 140 patients died while waiting for a transplant during the period studied. Of them, 107 were among 358 non-AHF patients (30%), and time-to-death interval was 133 +/- 175 days (median: 62); 33 were among 65 AHF patients (51%); time to death was 19 +/- 28 days (median: 8). There were 35 cadaver donor livers available during the period; 28 of 358 non-AHF patients (7.8%), and 7 of 65 AHF patients (10.7%) received cadaveric LTx. Their waiting time totaled 342 +/- 316 and 12 +/- 9 days, respectively (P < .0001). CONCLUSION: Most AHF patients died unless they received liver grafts. Even with a higher priority assigned to them, AHF patients still have little chance to get a cadaver donor liver in Taiwan, and non-AHF patients have an even slimmer chance. Therefore, we need to encourage liver donation from living-related donors.

Liver transplantation for patients with hepatocellular carcinoma.

BACKGROUND: Liver transplantation (LT) has been advocated as a salvage treatment for unresectable hepatocellular carcinoma (HCC). Selection criteria still need to be developed in Taiwan. OBJECTIVES: The purpose of our study was to assess the clinical findings and outcome of cirrhotic patients with HCC undergoing liver transplantation. METHODS: Our study consisted of 13 HCC patients who underwent liver transplantation during October 1996 to March 2003. The medical records and pathologic reports were analyzed retrospectively. RESULTS: Overall survival rates at 1 and 3 years were 86% and 61%, respectively. HCC recurrences occurred in three patients, one of whom is still alive with HCC recurrence 2 years after LT. The other two patients died of HCC recurrence 1 and 2 years after LT, respectively. Pretransplant alpha-fetoprotein (AFP) levels of >200 ng/mL were noted in all three patients with HCC recurrence. In contrast, only one of the ten patients without HCC recurrence had pretransplant AFP >200 ng/mL (P = .003). Four patients did not meet Milan criteria, two of whom had HCC recurrence. However, the other two patients with microscopic vascular invasion survived and were free of HCC. The only one patient, who had histologic grade 4 HCC, died of recurrence, although his tumor was AJCC stage 1. CONCLUSIONS: High AFP level is a risk factor for HCC recurrence after LT. In addition to Milan criteria, histologic tumor grading should be considered in patient selection. Microscopic vascular invasion may not affect the outcome of the patients with early HCC.

Surgical complications and outcome of living related liver transplantation.

INTRODUCTION: Living donor liver transplantation (LDLT) is now widely performed for patients to resolve the critical shortage of organs from cadavers. Despite rapid implementation and expansion of the procedure, both outcome and complication analyses of LDLT are still incomplete. OBJECTIVES: To analyze the outcome of LDLT, with particular reference to complications of those in need of surgical or radiological intervention. METHODS: Forty-eight LDLTs performed at National Taiwan University Hospital between December 1997 and April 2003 were reviewed retrospectively. RESULTS: Forty-two (87.5%) patients survived the operation. The 1-year graft and patient survival rate was 81.5%. Seventeen of the 48 LDLT patients had at least one postoperative complication, which needed surgical or radiological intervention. The complications included bile leakage (n = 3), biliary stricture (n = 4), internal bleeding (n = 7), intra-abdominal abscess (n = 2), liver abscess (n = 1), hepatic artery thrombosis (n = 2), duodenal ulcer bleeding (n = 1), jejunal perforation (n = 1), adhesion ileus (n = 1), and intracranial hemorrhage (n = 1). Nine of the 17 patients with complications died. In contrast, only 2 of the other 31 patients died. Seven of the mortalities were related to the complications. All survivors received only one definite intervention early after the complications were diagnosed. However, the others received an average of 1.71 +/- 0.95 (0 to 3) interventions. CONCLUSIONS: Complications requiring surgical or radiological treatment caused major mortality of LDLT. Early and definite treatment of these complications is important to improve the patient's outcome.

Salvaging procedures for dysfunctional peritoneovenous shunt.

BACKGROUND/AIMS: Peritoneovenous shunt is one of the treatments for refractory ascites. However, the dysfunction of the shunt is frequently seen and needs further management. We in this manuscript reported our experience in the salvaging procedures of dysfunctional peritoneovenous shunt. METHODOLOGY: A total of 29 Denver shunts were constructed for the management of refractory ascites at the Department of Surgery, National Taiwan University Hospital since January 1992 to February 1999. A cross-sectional case study was performed. RESULTS: There was a total of 20 cases of mechanical dysfunction for these 29 patients. In the management of 6 peritoneal catheter occlusions which occurred in the early phase of this series, revision was performed by lengthening of the peritoneal catheter with a peritoneal dialysis catheter so that the catheter tip could rest in the Douglas pouch. The same procedure was adopted in the last 14 consecutive Denver shunts and this significantly decreased the incidence of peritoneal catheter occlusion (6/15 vs. 0/14, P = 0.011 by Fisher's exact test). In the 6 episodes of valve occlusion, the reservoir of the Denver shunt was replaced with a new one but the peritoneal and venous catheters were not changed. In the 8 episodes of venous catheter dysfunction, two venous catheters slipping out were managed by lengthening the catheter with a large-bore Hickmann catheter. In the other 6 episodes, a new venous catheter was inserted to the other side of the internal jugular vein or saphenous vein through a subcutaneous tunnel and the catheter was connected to the reservoir with a connector. CONCLUSIONS: Although peritoneovenous shunt did not prolong the life expectancy of the patients with decompensated liver cirrhosis, it did relieve tense ascites rapidly and improve the quality of life remarkably. The modifications and salvaging procedures we used in our series could restore a dysfunctional Denver shunt easier, safer and with a higher cost-saving than a total revision of the shunt.

Serum hepatocyte growth factor before and after resection for hepatocellular carcinoma.

BACKGROUND/AIMS: Hepatocyte growth factor (HGF) is the most potent hepatocyte proliferation stimulator. Serum HGF levels are high in various liver disease states such as cirrhosis, hepatocellular carcinoma (HCC) and hepatitis. But the role HGF plays in HCC is not clear at present. The purposes of this study are: 1) to reveal the HGF profile pre- and post-HCC resection, which has not been well-described before; and, 2) to analyze the relationships between the pre- and post-operative HGF levels and various clinical parameters. METHODOLOGY: We performed a retrospective cohort study to check the HGF profiles before and after curative resections for HCC and to analyze the relationships between them by using clinical parameters from 35 consecutive patients at the Department of Surgery, National Taiwan University Hospital. Blood samples collected from another 23 healthy individuals admitted for health check-ups were used as normal controls. Serum HGF was determined with an ELISA kit. RESULTS: The baseline HGF concentration in HCC patients was significantly higher than that in normal controls (1743+/-73 vs. 948+/-54 pg/ml, p<0.0001). The HGF concentrations on post-operative days (POD) 1, 3, 5, 7, and 14 were all significantly higher than those seen in normal controls (all p less than 0.0001). The first and third POD HGF values were significantly higher than the pre-operative level (p=0.00135 and 0.00187 respectively). The HGF concentrations would return to the pre-operative level on the fifth POD, but they never returned to normal level at the end of the two-week study. The pre-operative HGF level was affected by patient age (p=0.0236), and the post-operative peak HGF level was positively correlated with the pre-operative indocyanin green retention rate (ICGR15) and GOT level (p=0.0320 and 0.0234 respectively). CONCLUSIONS: In this study, we proved, indirectly, that HGF was not secreted by the HCC tumor cells per se. The peak post-operative HGF level reflected the relative stress of the operation on the diseased liver, but did not reflect the absolute physical extent of liver resection. The relationships between HGF and the prognosis of the patients after HCC resection demands further investigation.

Hepatic portal vein gas following blunt colon injury: report of a case.

Blunt colon injuries sometimes result in signs of peritoneal irritation requiring exploratory laparotomy. More frequently there are no specific symptoms, and this leads to a delay in diagnosis and management. Some imaging studies point to blunt colon injury, but gas in both the hepatic portal and mesenteric veins has rarely been reported. Hepatic portal venous gas (HPVG) is a rare roentgenographic picture, and its presence usually represents a serious intra-abdominal catastrophe. Computed tomography and plain abdominal X ray in a 52-year-old man with blunt abdominal injury showed significant gas in the portal venous system and pneumatosis intestinales of the ascending colon. Exploratory laparotomy revealed segmental necrosis of the transverse colon in front of the vertebrae. The presence of HPVG may have been due to mucosal disruption, vascular compromise or prolonged increased intra-abdominal pressure. Its presence in patients with blunt abdominal trauma suggests the possibility of bowel injury. Surgical exploration should be considered when HPVG is noted on roentgenographic studies.