Porcine Liver Anatomy Applied to Biomedicine.

Currently, there are at least 70 pure domestic pig breeds, but only certain breeds are used in biomedical research. The domestic pig liver is suitable for preclinical research because its size, physiology, and anatomy are similar to that of the human liver; in addition, there is a high degree of genetic similarity between the two species. For planning experiments and identifying improvements in both invasive and noninvasive methods of liver disease management, the morphological similarities and dissimilarities of the pig liver to its human counterpart must be taken into consideration along with sexual dimorphism and interindividual and interspecific variability. Recent histological evaluations based on stereological methods enable precise quantitative morphological estimates and guarantee their unbiased accuracy. The results thereof are crucial for revealing and assessing histological changes and can contribute to the optimization of study designs. New trends in computed tomography data processing have also been introduced. This review article summarizes the newest trends and findings in the field of porcine liver anatomy and histology as applicable to preclinical research.

Prognostic importance of some clinical and therapeutic factors for the effect of portal vein embolization in patients with primarily inoperable colorectal liver metastases.

INTRODUCTION: Portal vein embolization (PVE) may increase the resectability of liver metastases. However, the problem of PVE is insufficient growth of the liver or tumor progression in some patients. The aim of this study was to evaluate the significance of commonly available clinical factors for the result of PVE. MATERIAL AND METHODS: Portal vein embolization was performed in 38 patients with colorectal liver metastases. Effects of age, gender, time between PVE and liver resection, oncological therapy after PVE, indocyanine green retention rate test, synchronous, metachronous and extrahepatic metastases, liver volume before and after PVE, increase of liver volume after PVE and the quality of liver parenchyma before PVE on the result of PVE were evaluated. RESULTS: Liver resection was performed in 23 (62.2%) patients within 1.3 ±0.4 months after PVE. Tumor progression occurred in 9 (23.7%) patients and 6 (15.8%) patients had insufficient liver hypertrophy. Significant clinical factors of PVE failure were number of liver metastases (cut-off - 4; odds ratio - 4.7; p < 0.03), liver volume after PVE (cut-off 1000 cm(3); odds ratio - 5.1; p < 0.02), growth of liver volume after PVE (cut-off 150 cm(3); odds ratio - 18.7; p < 0.002), oncological therapy administered concomitantly with PVE (p < 0.003). CONCLUSIONS: Negative clinical factors of resectability of colorectal cancer liver metastases after PVE included more than four liver metastases, liver volume after PVE < 1000 cm(3), growth of the contralateral lobe by less than 150 cm(3) and concurrent oncological therapy.

New clinical scoring system for prognosis of early recurrence of colorectal liver metastases after surgical treatment.

BACKGROUND/AIMS: To determine the relationship between the mRNA expression of MMP-2, MMP-9, TIMP-1, TIMP-2 and CEA in tumour tissue and preoperative serum levels of these tumour markers in patients with colorectal liver metastases (CLM). Additionally, to establish a new scoring system based upon these results in combination with the volume of the metastatic process to identify patients with a high risk of early recurrence of CLM. METHODOLOGY: The correlation between the mRNA expression of CEA, TIMP-1, TIMP-2, MMP-2 and MMP-9 in tissue samples and preoperative serum levels of the named tumour markers was performed on 27 patients. The scoring system was proposed as a combination of all the independent parameters (mRNA expression of TIMP-1, MMP-9 and CEA in tumour tissue samples and preoperative serum levels of CEA and TIMP-1) in combination with the volume of the metastatic process. The evaluation was conducted in relation to the disease free interval (DFI). RESULTS: We observed a statistically significant relationship between the volume of liver metastases and DFI (p<0.0337). The scoring system divided the patients into groups with a tendency of early recurrence (p<0.0126). CONCLUSIONS: The high stages in our scoring systems augment the risk of recurrence. The proposed scoring system was shown to be an efficient instrument helpful in complex surgical and oncological access to patients after radical surgical treatment of CLM.

Portal and mesenteric vein thromboses in a patient with prothrombin G20210 mutation, elevated lipoprotein (a), and high factor VIII.

A 65-year-old man was examined for abdominal pain. Portal and mesenteric vein thromboses were described by ultrasound and computed tomography. No local cause was found. The patient had a positive history of venous thromboembolism. Thrombophilia workup revealed prothrombin G20210A mutation (heterozygous), C677T mutation of methylenetetrahydrofolate reductase gene (homozygous), elevated level of lipoprotein (a), and high level of coagulation factor VIII. Anticoagulation was started and planned for a long-term duration. The etiology of portal vein thrombosis is often multifactorial, with various combinations of systemic factors (inherited or acquired prothrombotic conditions) and local precipitating factors (inflammation, injury to the portal venous system, cancer of the abdominal organs, cirrhosis). The reported prevalence of hypercoagulable states in patients with portal vein thrombosis has been very heterogeneous so far. Some authors support a role of the prothrombin G20210A mutation. In the reported patient, this mutation was revealed in a combination with other hypercoagulable states.