[Changes in the fat composition and histomorphology of the liver in TPN, with and without ultra-short bowel]. / Cambios en la composición de la grasa y en la histomorfología hepáticas tras NPT, con y sin intestino ultra-corto.

BACKGROUND & AIMS: Short Bowel syndrome is a serious intestinal insufficiency. The most common etiology in adults nowadays is intestinal ischemia and inflammatory disease, while in children the most common are congenital anomalies, volvolus and necrotizing enterocolaitis, which makes the TPN obligatory. However the intestine is intimately related to the liver through the entero-hepatic circulation and different endocrinological entero-hepatic systems. Massive intestinal resections and TPN would alter this relationship, and could change the hepatic tissue composition and its histomorphology. The aim of this work is to know these changes in more detail. MATERIALS AND METHODS: We used 3 experimental groups: Group A (10 guinea pigs), which was given anesthetic and a simple laparotomy and fed for 10 days with NPT. Group B (10 guinea pigs), underwent total thin intestine resection and were fed for 10 days with NTP. The control group (6 guinea pigs) underwent anesthetic and a simple sham laparotomy and were fed orally. After this period blood and hepatic tissue samples were taken in order to study the liver fat (total fat, proportion of neutral and polar lipids, proportion of phospholipids and fatty acids). Liver biopsies were taken and studied under an optical microscope. RESULTS: The animals from group A and B, underwent NPT, showed a significant increase in glycemie and serum triglycerides, decreasing the cholesterol in GB. There was a significant decrease in weight and in the proportion of fat per g of the liver tissue, at a maximum level in GB, and an even higher decrease in the LP/LN ratio in GA and GB. There was also a change in the proportion of phospholipids, decreasing the Phosphatidilinositol and increasing the Phosphatidiletanolamine. There was also a decrease in the AG w6/w3 ratio. Histologically appear a steatohepatitys, with a striking decrease in the mitochondrial density, being more intensive in GB. CONCLUSIONS: NPT alters the composition of the hepatic fat and the hystomorphology of the liver. The short bowel syndrome have more lesional mechanisms, favouring the hepatic damage caused by NPT.

Cambios en la composición de la grasa y en la histomorfología hepáticas tras NPT, con y sin intestino ultracorto / Changes in the fat composition and histomorphology of the liver in TPN, with and without ultra-short bowel

Introducción: El síndrome de intestino corto es una insuficiencia grave intestinal cuya etiología más frecuente en adultos son la isquemia intestinal y la enfermedad inflamatoria y en niños las malformaciones congénitas, el vólvulo y la enterocolitis necrotizante, obligando al uso de la NPT. Pero el intestino está íntimamente relacionado con el hígado a través de la circulación entero-hepática y de diferentes sistemas endocrinos entero-hepáticos. La resección intestinal y la Nutrición Parenteral alterarán esta relación, pudiendo variar la composición del tejido hepático y su histomorfología. El objetivo de este trabajo es conocer más concretamente estos posibles cambios. Materiales y métodos: Utilizamos 3 grupos experimentales: Grupo A (10cobayos), sometidos a una anestesia y laparotomía simple y nutridos durante 10 días con NPT. Grupo B (10cobayos), con resección intestinal yeyunoileal total y nutridos durante 10 días con NPT. Grupo Ctr (6 cobayos), sometidos a anestesia y laparotomía simple y nutridos oralmente. Tras este período se estudiaron muestras de sangre y de tejido hepático, tanto para el estudio de la grasa hepática (grasa total, proporciones de lípidos neutros y polares, proporciones de fosfolípidos y de ácidos grasos) como para estudio histológico. Resultados: Los animales de los grupos A y B, sometidos a NPT, presentan incrementos significativos en la glucemia y en los triglicéridos séricos, y descensos en el colesterol. Disminuyen el peso y la proporción de grasa por g de hígado, máxime en el GB, así como el cociente LP/LN en los GA y GB. Se modifican las proporciones de fosfolípidos, disminuyendo el fosfatidilinositol y aumentando la fosfatidiletanolamina; disminuyendo también el cociente de los AG w6/w3. Histológicamente, aparece una esteatohepatitis, con disminución marcada de la densidad mitocondrial, siendo mas intensos en el GB. Conclusión: la NPT altera la composición de la grasa hepática y la histomorfológica del hígado. El SIUC tiene más mecanismos lesionales, potenciándose el daño hepático causado por la NPT (AU)

Background & Aims: Short Bowel syndrome is a serious intestinal insufficiency. The most common etiology in adults nowadays is intestinal ischemia and inflammatory disease, while in children the most common are congenital anomalies, volvolus and necrotizing enterocolaitis, which makes the TPN obligatory. However the intestine is intimately related to the liver through the enterohepatic circulation and different endocrinological entero-hepatic systems. Massive intestinal resections and TPN would alter this relationship, and could change the hepatic tissue composition and its histomorphology. The aim of this work is to know these changes in more detail. Materials and methods: We used 3 experimental groups: Group A (10 guinea pigs), which was given anesthetic and a simple laparotomy and fed for 10 days with NPT. Group B (10 guinea pigs), underwent total thin intestine resection and were fed for 10 days with NTP. The control group (6 guinea pigs) underwent anesthetic and a simple sham laparotomy and were fed orally. After this period blood and hepatic tissue samples were taken in order to study the liver fat (total fat, proportion of neutral and polar lipids, proportion of phospholipids and fatty acids). Liver biopsies were taken and studied under an optical microscope. Results: The animals from group A and B, underwent NPT, showed a significant increase in glycemie and serum triglycerides, decreasing the cholesterol in GB. There was a significant decrease in weight and in the proportion of fat per g of the liver tissue, at a maximum level in GB, and an even higher decrease in the LP/LN ratio in GA and GB. There was also a change in the proportion of phospholipids, decreasing the Phosphatidili-nositol and increasing the Phosphatidiletanolamine. There was also a decrease in the AG w6/w3 ratio. Histologically appear a steatohepatitys, with a striking decrease in the mitochondrial density, being more intensive in GB. Conclusions: NPT alters the composition of the hepatic fat and the hystomorphology of the liver. The short bowel syndrome have more lesional mechanisms, favouring the hepatic damage caused by NPT (AU)

Cambios en la composición de la grasa y en la histomorfología del hígado tras resecciones intestinales parciales / Changes in the fat composition and histomorphology of the liver after partial intestinal resections

Introducción y objetivos: Teóricamente, las resecciones intestinales parciales podrían afectar al hígado a través de la absorción de nutrientes y de la circulación enterohepática de los ácidos biliares, por las posibles alteraciones sobre el complejo hormonal duodeno-bilo-hepato-pancreático y por los efectos secundarios de la translocación bacteriana intestinal. Estos mecanismos fisiopatológicos pueden sumarse modificando la composición y la histomorfología hepática, específicamente la composición de la grasa hepática. El objetivo de este trabajo experimental es conocer mas profunda y concretamente las alteraciones secundarias a las resecciones intestinales parciales. M & M: Utilizamos 26 cobayos divididos en 3 grupos: Grupo A (n=10), con resección yeyunal; Grupo B (n=10) con resección ileal y Grupo control (GCtr, n=6). Los animales fueron nutridos oralmente durante 21 días. Al final se obtuvieron muestras para analizar la bioquímica sérica y se homogeneizó el tejido hepático para estudio de la grasa hepática (grasa total, proporciones de lípidos neutros y polares y proporciones de fosfolípidos y de ácidos grasos). Se tomaron muestras para estudio histomorfológico. Resultados: Los animales con resección yeyunal e ileal presentaron disminución del colesterol sérico, del peso de la gota grasa/g tejido y del cociente w6/w3 y del C18-2/C18-3, sin alteraciones en la distribución de fosfolípidos. Se halló macroesteatosis y disminución de la densidad mitocondrial en los animales del G-B. Conclusiones: las resecciones intestinales parciales, especialmente las ileales sí parecen influir a corto plazo en la composición de la grasa estructural del hígado. Estos cambios en los lípidos estructurales y en la histomorfología pudieran ser compensados a medio plazo. Estos hallazgos pueden ayudarnos a entender mejor la relación hepato-intestinal (AU)

Background & Aims: The partial resection of the intestine could affect the liver through alteration in nutrient absorption, loss of the bile acids via the enterohepatic circulation, alterations in the hepato-duodenobilio-pancreatic hormonal complex as well as a bacterial translocation. All these factors could sum up and induce changes in the tissue composition and in hepatic histomorphology. The aim of this experimental study is to acquire a profound knowledge of these hepatic alterations after the partial intestinal resection. M & M: 26 Dunkin Hartley guinea pigs were used: Group A with only jejunum resection, Group B with only ileum resection, and Group CtrG, the control group. They were monitored for 21 days. At the end, blood samples were taken for serum biochemical analysis. Samples of hepatic tissue were taken for histomorphological optical study. All the rest liver was homogenize and the fat liver composition was analysed (total fat, lipid fractions, phospholipids fractions and fatty acids of the liver). Results: There was a significant decrease in serum cholesterol in both GA & GB. There was also a decrease of the total fat/g liver tissue, without changes in the phospholipids fraction and decreases in the C18-2/C18-3 and w6/w3 ratios. There was a minimal macrosteatosis and reduction of the number of mitochondries in GB. Conclusions: the partial intestinal resection, specially ileum resections, looks like influence the structural fat liver composition. However, these changes could be compensated for by the liver and oral nutrition. These findings help us to improve the liver-intestinal relationships (AU)

[Changes in the fat composition and histomorphology of the liver after partial intestinal resections]. / Cambios en la composición de la grasa y en la histomorfología del hígado tras resecciones intestinales parciales.

BACKGROUND & AIMS: The partial resection of the intestine could affect the liver through alteration in nutrient absorption, loss of the bile acids via the enterohepatic circulation, alterations in the hepato-duodenobilio-pancreatic hormonal complex as well as a bacterial translocation. All these factors could sum up and induce changes in the tissue composition and in hepatic histomorphology. The aim of this experimental study is to acquire a profound knowledge of these hepatic alterations after the partial intestinal resection. M & M: 26 Dunkin Hartley guinea pigs were used: Group A with only jejunum resection, Group B with only ileum resection, and Group CtrG, the control group. They were monitored for 21 days. At the end, blood samples were taken for serum biochemical analysis. Samples of hepatic tissue were taken for histomorphological optical study. All the rest liver was homogenize and the fat liver composition was analysed (total fat, lipid fractions, phospholipids fractions and fatty acids of the liver). RESULTS: There was a significant decrease in serum cholesterol in both GA & GB. There was also a decrease of the total fat/g liver tissue, without changes in the phospholipids fraction and decreases in the C18-2/C18-3 and w6/w3 ratios. There was a minimal macrosteatosis and reduction of the number of mitochondries in GB. CONCLUSIONS: the partial intestinal resection, specially ileum resections, looks like influence the structural fat liver composition. However, these changes could be compensated for by the liver and oral nutrition. These findings help us to improve the liver-intestinal relationships.

Role of fine-needle biopsy in the diagnosis of hydatid cyst.

The cytopathologic findings in 17 patients with hydatid cyst are reported. All patients but one were referred for evaluation of a tumor mass. In 13 patients the aspirated material was diagnostic of hydatid cyst. In four patients only acellular laminated membranes were present in the aspirate and a presumptive cytopathologic diagnosis of hydatid cyst was made. Subsequent histologic studies confirmed the diagnosis of hydatidosis in all patients. No complications were encountered. Fine-needle biopsy appears a safe diagnostic approach in the evaluation of suspected hydatid disease. The presence of acellular laminated membranes confirm the diagnosis of hydatid cyst.