Liver venous deprivation: an interesting approach for regenerative liver surgery

Maternal infection-induced early pregnancy complications arise from perturbation of the immune environment at the uterine early blastocyst implantation site (EBIS), yet the underlying mechanisms remain unclear. Here, we demonstrated in a mouse model that the progression of normal pregnancy from days 4 to 6 induced steady migration of leukocytes away from the uterine decidual stromal zone (DSZ) that surrounds the implanted blastocyst. Uterine macrophages were found to be CD206+ M2-polarized. While monocytes were nearly absent in the DSZ, DSZ cells were found to express monocyte marker protein Ly6C. Systemic endotoxic lipopolysaccharide (LPS) exposure on day 5 of pregnancy led to: (1) rapid (at 2 h) induction of neutrophil chemoattractants that promoted huge neutrophil infiltrations at the EBISs by 24 h; (2) rapid (at 2 h) elevation of mRNA levels of MyD88, but not Trif, modulated cytokines at the EBISs; and (3) dose-dependent EBIS defects by day 7 of pregnancy. Yet, elimination of maternal neutrophils using anti-Ly6G antibody prior to LPS exposure failed to avert LPS-induced EBIS defects allowing us to suggest that activation of Tlr4-MyD88 dependent inflammatory pathway is involved in LPS-induced defects at EBISs. Thus, blocking the activation of the Tlr4-MyD88 signaling pathway may be an interesting approach to prevent infection-induced pathology at EBISs.

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Biological impact of an enhanced recovery after surgery programme in liver surgery

BJS Open ◽

10.1093/bjsopen/zraa015 ◽

2020 ◽

Vol 5 (2) ◽

Author(s):

S Gonvers ◽

J Jurt ◽

G -R Joliat ◽

N Halkic ◽

E Melloul ◽

...

Keyword(s):

Liver Surgery ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Surgical Stress ◽

Multivariable Analysis ◽

Albumin Concentration ◽

Biological Impact ◽

Reactive Protein ◽

Before And After ◽

Major Resection

Abstract Background The clinical and economic impacts of enhanced recovery after surgery (ERAS) programmes have been demonstrated extensively. Whether ERAS protocols also have a biological effect remains unclear. This study aimed to investigate the biological impact of an ERAS programme in patients undergoing liver surgery. Methods A retrospective analysis of patients undergoing liver surgery (2010–2018) was undertaken. Patients operated before and after ERAS implementation in 2013 were compared. Surrogate markers of surgical stress were monitored: white blood cell count (WBC), C-reactive protein (CRP) level, albumin concentration, and haematocrit. Their perioperative fluctuations were defined as Δvalues, calculated on postoperative day (POD) 0 for Δalbumin and Δhaematocrit and POD 2 for ΔWBC and ΔCRP. Results A total of 541 patients were included, with 223 and 318 patients in non-ERAS and ERAS groups respectively. Groups were comparable, except for higher rates of laparoscopy (24.8 versus 11.2 per cent; P < 0.001) and major resection (47.5 versus 38.1 per cent; P = 0.035) in the ERAS group. Patients in the ERAS group showed attenuated ΔWBC (2.00 versus 2.75 g/l; P = 0.013), ΔCRP (60 versus 101 mg/l; P <0.001) and Δalbumin (12 versus 16 g/l; P < 0.001) compared with those in the no-ERAS group. Subgroup analysis of open resection showed similar results. Multivariable analysis identified ERAS as the only independent factor associated with high ΔWBC (odds ratio (OR) 0.65, 95 per cent c.i. 0.43 to 0.98; P = 0.038), ΔCRP (OR 0.41, 0.23 to 0.73; P = 0.003) and Δalbumin (OR 0.40, 95 per cent c.i. 0.22 to 0.72; P = 0.002). Conclusion Compared with conventional management, implementation of ERAS was associated with an attenuated stress response in patients undergoing liver surgery.

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Luteogenesis and Embryo Implantation Are Enhanced by Exogenous hCG in Goats Subjected to an Out-of-Season Fixed-Time Artificial Insemination Protocol

Biology ◽

10.3390/biology10050429 ◽

2021 ◽

Vol 10 (5) ◽

pp. 429

Author(s):

Jorge A. Bustamante-Andrade ◽

César A. Meza-Herrera ◽

Rafael Rodríguez-Martínez ◽

Zurisaday Santos-Jimenez ◽

Oscar Ángel-García ◽

...

Keyword(s):

Corpus Luteum ◽

Artificial Insemination ◽

Body Condition Score ◽

Embryo Implantation ◽

Implantation Rate ◽

Fixed Time ◽

Efficiency Index ◽

Control Group ◽

Condition Score ◽

Interesting Approach

The aim of this study was to evaluate the possible effect of two doses of hCG (100 and 300 IU) applied at two different times (7 and 14 d) after a fixed-time artificial insemination protocol (FTAI) upon some variables involved in the embryonic implantation rate in goats during the natural deep anestrous season (April, 25° north). The experimental units considered crossbred, multiparous, anovulatory goats (n = 69, Alpine, Saanen, Nubian x Criollo), with average body weight (43.6 ± 5.7 kg) and body condition score (1.86 ± 0.28 units) located in northern–semiarid Mexico (25° N, 103° W). Once the goat’s anestrus status was confirmed, goats were subjected to an estrus induction protocol. Upon estrus induction confirmation, goats (n = 61) were subjected to a FTAI procedure. Immediately after the FTAI, the goats were randomly distributed to five experimental groups: (1). G100-7 (n = 13) 100 IU, hCG 7 d post-FTAI, (2). G100-14 (n = 12) 100 IU hCG, 14 d post-FTAI, (3). G300-7 (n = 12) 300 IU, hCG, 7 d post-FTAI, (4). G300-14 (n = 12) 300 IU hCG 14 d post-FTAI, and (5). Control group, CONT (n = 12) 0.5 mL saline, 7 and 14 d post-FTAI. The response variables conception rate (39.36 ± 0.23), fertility rate (27.96%), prolificacy rate (1.1 ± 0.29 kids), ovulation rate (0.74 ± 0.20 corpus luteum) corpus luteum diameter (10.15 ± 0.59 mm), embryo number (1.58 ± 0.20), and embryo implantation rate (48.96%), did not differ between treatments. However, while the variables fecundity rate (67%), embryo efficiency index-1 (33.99 ± 0.20%), and embryo efficiency index-2 (27.94 ± 0.30%) were favored by the G300-14 treatment, the corpus luteum area was favored (p < 0.05) by both G300-7 (113.30 ± 0.19 mm2) and G300-14 (103.04 ± 0.17 mm2). Such reproductive strategy emerges as an interesting approach, not only to enhance the out-of-season reproductive outcomes, but also to boost one of the main rulers defining the global reproductive efficiency of a heard, namely, the embryo implantation efficiency.

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New Insight on Liquid Steel Microalloying by Pulse-Step Method in Two-Strand Slab Tundish by Numerical Simulations

Crystals ◽

10.3390/cryst11040448 ◽

2021 ◽

Vol 11 (4) ◽

pp. 448

Author(s):

Adam Cwudziński

Keyword(s):

Liquid Steel ◽

Mixing Time ◽

Casting Process ◽

Step Method ◽

Flow Control Devices ◽

Alloy Addition ◽

Interesting Approach ◽

Control Devices ◽

Steel Flow ◽

Alloy Concentration

Developing a technology for introducing alloy addition to liquid steel during the course of continuous casting process seems to be an interesting approach to enhancing the steelmaking process, especially as the effective introduction of micro-additives or non-metallic inclusion modifiers to the liquid steel is the key to the production of the highest-quality steel. This paper presents the results of investigation describing the process of liquid steel chemical homogenisation in the two-strand slab tundish. The alloy was fed to liquid steel by pulse-step method. Five tundish equipment variants with different flow control devices and alloy addition feeding positions were considered. The paper includes fields of liquid steel flow, alloy concentration vs. time curves, dimensionless mixing time, minimum time values and alloy concentration deviations at tundish outlets. The results pointed much more effectively with liquid steel mixing nickel than aluminium. For aluminium obtaining a 95% chemical homogenisation level requires three-fold more time. Moreover, it is definitely beneficial for chemical homogenisation to initiate the alloying process simultaneously in two sites. This procedure generates, among others, the least alloy deviation of concentration at tundish outlets.

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The changing scene of liver surgery

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1990.tb125518.x ◽

1990 ◽

Vol 153 (7) ◽

pp. 433-433

Author(s):

Kenneth J Hardy

Keyword(s):

Liver Surgery

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The Mediterranean Diet, a Rich Source of Angiopreventive Compounds in Cancer

Nutrients ◽

10.3390/nu11092036 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2036 ◽

Cited By ~ 5

Author(s):

Beatriz Martínez-Poveda ◽

José Antonio Torres-Vargas ◽

María del Carmen Ocaña ◽

Melissa García-Caballero ◽

Miguel Ángel Medina ◽

...

Keyword(s):

Mediterranean Diet ◽

Essential Role ◽

Chemopreventive Agents ◽

Angiogenic Potential ◽

Slowing Down ◽

Interesting Approach ◽

The Mediterranean ◽

Tumor Growth And Metastasis ◽

Early Phases

Diet-based chemoprevention of cancer has emerged as an interesting approach to evade the disease or even target its early phases, reducing its incidence or slowing down tumor progression. In its basis in the essential role of angiogenesis for tumor growth and metastasis, angioprevention proposes the use of inhibitors of angiogenesis in cancer prevention. The anti-angiogenic potential exhibited by many natural compounds contained in many Mediterranean diet constituents makes this dietary pattern especially interesting as a source of chemopreventive agents, defined within the angioprevention strategy. In this review, we focus on natural bioactive compounds derived from the main foods included in the Mediterranean diet that display anti-angiogenic activity, as well as their possible use as angiopreventive agents.

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Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02113-1 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Mirhasan Rahimli ◽

Aristotelis Perrakis ◽

Vera Schellerer ◽

Andrew Gumbs ◽

Eric Lorenz ◽

...

Keyword(s):

Abdominal Surgery ◽

Minimally Invasive ◽

Liver Surgery ◽

Colorectal Liver Metastases ◽

Survival Rates ◽

Long Term Outcomes ◽

Short Term ◽

Minimally Invasive Liver Surgery ◽

Previous Abdominal Surgery

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

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