scholarly journals Influence of portal hypertension on the state of the hemomicrocirculatory level of rat skin: morphological study

2021 ◽  
Vol 67 (3) ◽  
pp. 45-53
Author(s):  
N.R. Grytsevych ◽  
◽  
V.V. Vereschaka ◽  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Direct Action ◽  
Basal Layer ◽  
Average Diameter ◽  
Basal Membrane ◽  
Secondary Response ◽  
Elastic Fibers ◽  
Control Group ◽  
Small Areas

The effect of portal hypertension on the condition of the hemomicrocirculatory tract of the skin male white nonlinear rats was studied. Hypertension was simulated by applying a ligature to the portal vein according to the conventional method. After 30, 60 and 90 days, skin biopsies were taken from the anterior abdominal wall for optical microscopy examination, which was subjected to routine histological processing. In animals of the control group, which underwent sham surgery, the skin remained unchanged. In rats of the experimental group after 30 days in the basal layer of the epidermis there were cells with signs of degenerative changes. The basement membrane of the epidermis had small areas with thinning and thickening, which in both cases were accompanied by the formation of small and massive leukocyte infiltrates. Its edema was noted, which extended to the papillary and reticular layer of the dermis. Elastic fibers were unchanged. Only 50% of the microvessels looked intact, 20% microvessels were narrowed, and 30% had signs of stagnant hyperemia due to dilatation. After 60 days the epidermis was thinned, in the basal layer the cells with picnotized and displaced to the periphery nucleus were detected. In all studied layers of epidermis, besides reticular layer, expansion of arterioles, venules and capillary loops was observed. After 90 days the epidermis was represented by 3-6 layers of cells, its general refinement was observed due to the reduction of the thickness of the spinous and granular layers with simultaneous thickening of the horny layer. In the papillary layer of the dermis, the number of thin-walled blood vessels was increased. The average diameter of the arterioles of the hypodermis decreased relative to the values on the 60th day. The mean diameter of the arterioles of the subdermal network on the border of the papillary and reticular layers and capillary loops under the basal membrane was reduced what can be a sign of sclerotic changes in the microvessels. The venules diameter remained increased. In arterioles and venules, stasis of the microvessels, edema of their walls, microaneurysm, and venous sacculation were detected. Thus, we believe that the changes in the microvessels of the skin, which are observed in portal hypertension, are the result of hemodynamic disturbances in the tissue, which is a complex chain of hemomicrocirculatory flow to the direct action of hypertension in the portal vein and is a secondary response to systemic vascular damage.

scholarly journals Evaluation of portal pressure by doppler ultrasound in patients with cirrhosis before and after simvastatin administration – a randomized controlled trial

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 256 ◽  
Author(s):  
Nadia Elwan ◽  
Raafat Salah ◽  
Manal Hamisa ◽  
Ebtsam Shady ◽  
Nehad Hawash ◽  
...  
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Doppler Ultrasound ◽  
Resistance Index ◽  
Control Group ◽  
Randomized Controlled ◽  
Group I ◽  
Before And After

Background: Portal hypertension is one of the most frequent complications of cirrhosis. β-adrenergic blockers, with or without organic nitrates, are currently used as hypotensive agents. Statins such as simvastatin seem to be safe for patients with chronic liver diseases and exert multiple pleiotropic actions. This study aimed to assess PTH using Doppler ultrasound in patients with cirrhosis before and after simvastatin administration. Methods: This randomized controlled clinical trial was conducted on 40 patients with cirrhosis who were randomized into 2 groups: group I included 20 patients with cirrhosis who were administered 20 mg of simvastatin daily for 2 weeks and then 40 mg daily for another 2 weeks, and group II included 20 patients with cirrhosis who did not receive simvastatin as a control group. All patients underwent full clinical examination, laboratory investigations, and abdominal Doppler ultrasound at baseline and after 30 days to evaluate portal vein diameter, blood flow volume, direction and velocity of portal vein blood flow, hepatic artery resistance and pulsatility indices, splenic artery resistance index, portal hypertension index (PHI), liver vascular index, and modified liver vascular index (MLVI). Results: There was a highly significant decrease in the hepatic artery resistance index  in group I, from 0.785 ± 0.088 to 0.717 ± 0.086 (P < 0.001). There was a significant decrease in the PHI in group I , from 3.915 ± 0.973 m/sec to 3.605 ± 1.168 m/sec (P = 0.024). Additionally, there was a significant increase in the MLVI in group I from 11.540 ± 3.266 cm/sec to 13.305 ± 3.222 cm/sec, an increase of 15.3% from baseline (P = 0.009). No significant adverse effects were detected. Conclusions: Simvastatin is safe and effective in lowering portal hypertension. [ClinicalTrials.gov Identifier: NCT02994485]

scholarly journals Hyperdynamic circulation and serotonin levels in patients with liver cirrhosis

2004 ◽  
Vol 23 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Djordje Culafic ◽  
Vladimir Djukic ◽  
Dusko Mirkovic ◽  
Aleksandar Karamarkovic
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Solid Phase ◽  
Extraction Procedure ◽  
Average Diameter ◽  
Serotonin Release ◽  
Hyperdynamic State ◽  
Venous Circulation ◽  
Solid Phase Extraction Procedure

Patients with liver cirrhosis and portal hypertension develop hyperdynamic state of circulation. Recent studies indicate that nitric oxide, prostaglandin's, endothelin-1 and serotonin are of major importance in the pathogenesis of portal hypertension and other hemodynamic complications. In our study we estimated the levels of serotonin in sera and 24h urine in 20 patients with liver cirrhosis, using original solid phase extraction procedure. Concentration of serotonin in sera was ranged from 18 to 270 nmol/L and in 24h urine ranged from 97 to 238 nmol/L/24h. In comparison with reference values (determined in range from 280 ?1300 nmol/L in sera and determined in the range from 157.8?1035.4 nmol/ L/24h in urine), a significant fall of serotonin concentration in sera, and urine was noted. A statistically significant correlation between serotonin levels in sera and platelet count was found (p = 0.017). Colour Doppler ultrasonography and peroral fiberpanendoscopy was applied in the whole series to evaluate degree of portal hypertension. The average diameter of portal vein was 16 mm (SD=1.36) and mean blood flow velocity in portal vein was 12 cm/s (SD=1.12). Splenomegaly was approved in the whole group and the mean splenic craniocaudal distance was 17.75 mm (SD=1.65). Esophageal varices grade I?II were detected in 8 (40%) of our patients and reamaining 12 (60%) were grade III?IV. In cirrhotic liver, the spleen congestion, result from platelet degradation. Serotonin, release in to spleen sinusoidal spaces, induces strong vasoconstriction response in portal venous circulation, which contributes to maintain portal hypertension. However, we consider that the decrease of serotonin levels in sera lead to development of hyperdynamic state of circulation.

scholarly journals The role of ultrasonography in the evaluation of portal hemodynamics in healthy adults and pathologic conditions

2016 ◽  
Vol 22 (2) ◽  
pp. 128-134 ◽  
Author(s):  
C. Anda Achim ◽  
P. Bordei ◽  
E. Dumitru
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Healthy Subjects ◽  
Portal Blood Flow ◽  
Control Group ◽  
Portal Hemodynamics ◽  
Cirrhotic Patients

AbstractIntroduction: Portal hypertension results from increased resistance to the portal blood flow. The ultrasound represents a noninvasive tool for assessing the structural and hemodynamic abnormalities in this condition.Objectives: The assessment of the hemodynamic blood flow of the liver and spleen by using Doppler ultrasound in patients with portal hypertension compared with healthy subjects and to identify correlations with the severity of liver cirrhosis and esophageal varices.Materials and Method: This study included 50 patients with liver cirrhosis and 20 healthy subjects as controls. Different correlations were carried out between hemodynamic variables obtained from the Doppler examination and the severity of cirrhosis as assessed by the Child score and the degree of esophageal varices at endoscopy.Results: The portal vein diameter was larger in cirrhotic patients compared with the control group. The mean portal vein velocity and the blood flow were significantly lower in advanced forms of liver cirrhosis. The portal vein congestion index, the pulsatility and resistivity indexes of the hepatic artery were significantly increased in patients with CHILD B and C cirrhosis compared with the control group and patients in CHILD class A. There were no statistically significant differences between the pulsatility and resistivity indexes of the splenic artery in patients with cirrhosis. The liver vascular index was significantly lower in patients with advanced cirrhosis.Conclusions: The ultrasound is a valuable noninvasive tool for cirrhotic patients with portal hypertension. However, it is not sufficiently accurate in differentiating between different classes of cirrhosis or degrees of esophageal varices.

Reduced vascular sensitivity to norepinephrine in portal-hypertensive rats

1985 ◽  
Vol 248 (2) ◽  
pp. G192-G195 ◽  
Author(s):  
J. W. Kiel ◽  
V. Pitts ◽  
J. N. Benoit ◽  
D. N. Granger ◽  
A. P. Shepherd
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Vascular Tone ◽  
Control Group ◽  
Portal Vein Stenosis ◽  
Vascular Sensitivity ◽  
Proportional Increase ◽  
The Mean ◽  
Vein Stenosis

The development of portal hypertension following chronic portal vein stenosis is accompanied by a significant increase in intestinal blood flow. The present study was designed to determine whether intestinal vascular sensitivity to norepinephrine (NE) is also affected by chronic portal vein stenosis. Using a blood-perfused, in situ rat small intestine preparation, we found that, when compared with control animals, a significantly greater molar concentration of NE was required to achieve the same proportional increase in intestinal vascular resistance in portal-hypertensive animals. The mean ED50 value (+/-SE) for the portal-hypertensive group (704.3 +/- 186.1 nM) was significantly greater (P less than 0.05) than the mean ED50 value for the control group (271.4 + 48.1 nM). This finding implies that sympathetic maintenance of intestinal vascular tone may be impaired following chronic portal vein stenosis, possibly accounting for part of the intestinal hyperemia associated with portal hypertension.

scholarly journals Effect of Fluid Shear Stress on Portal Vein Remodeling in a Rat Model of Portal Hypertension

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Bin Wen ◽  
Jian Liang ◽  
Xin Deng ◽  
Ran Chen ◽  
Peichun Peng
Keyword(s):  
Electron Microscopy ◽  
Shear Stress ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Rat Model ◽  
Fluid Shear Stress ◽  
Membrane Integrity ◽  
Control Group ◽  
Fluid Shear ◽  
Cell Degeneration

Aims. To explore the effects and mechanisms of fluid shear stress on portal vein remodeling in a rat model of portal hypertension.Methods. Subcutaneous injections of CCl4 were given to establish a rat model of liver cirrhosis and portal hypertension. Biomechanical technology was adopted to determine the dynamic changes of haemodynamic indices and fluid shear stress. Nitric oxide (NO), synthase (NOS), and endothelin-1 (ET-1) of the portal vein blood were measured. Changes in geometric structure and ultrastructure of the portal vein were observed using optical and electron microscopy.Results. After the CC14 injections, rat haemodynamics were notably altered. From week 4 onwards, PVP, PVF, and PVR gradually and significantly increased (P<0.05versus baseline). The fluid shear stress declined from week 4 onwards (P<0.01versus control group). NO, NOS, and ET-1 increased after repeated CCI4 injections. Hematoxylin and eosin staining showed thickened portal vein walls, with increased inside and outside diameters. Electron microscopy revealed different degrees of endothelial cell degeneration, destruction of basement membrane integrity, proliferating, and hypertrophic smooth muscle cells.Conclusions. Fluid shear stress not only influenced the biomechanical environment of the portal vein but also participated in vascular remodeling.

scholarly journals A Novel Method of Determining Portal Systemic Shunting using Biodegradable 99TCm Labelled Albumin Microspheres

HPB Surgery ◽  
1995 ◽  
Vol 8 (4) ◽  
pp. 223-229 ◽  
Author(s):  
J. Yates ◽  
D. M. Nott ◽  
P. J. Maltby ◽  
D. Billington ◽  
J. N. Baxter ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Pressure ◽  
Repeated Measurements ◽  
Control Group ◽  
Portal Vein Ligation ◽  
Hypertensive Rats ◽  
Albumin Microspheres ◽  
Novel Method

Portal systemic shunting (PSS) and portal pressure were measured in control rats and in animals with portal hypertension induced by partial portal vein ligation (PPVL). The portal pressure in rats with partial portal vein ligation (13.4 ± 0.5 mm.Hg.) was significantly higher (p < 0.005) than in the control group (9.6 ± 0.6 mm.Hg.). Portal systemic shunting measured by consecutive injections of radiolabelled methylene diphosphonate (MDP), a non-diffusable marker and albumin microspheres directly into the splenic pulp was significantly increased (P < 0.005) in the portal hypertensive animals (30.8 ± 2.5%) compared to sham operated rats (2.6 ± 1.5%). Similarly, in portal hypertensive rats portal systemic shunting measured by intrasplenic injections of radiolabelled cobalt microspheres (37.1 ± 3.9%) was significantly greater (p < 0.005) than in control animals. There was a good correlation and agreement (r = 00.97) between the two methods of measuring portal systemic shunting. However because the 99Tcm-albumin microspheres are biodegradable the method allows portal systemic shunting to be measured in man. Furthermore since the computer adjusts the baseline to zero after each determination of portal systemic shunting the methodology allows repeated measurements to be made.

scholarly journals Correlation Of Portal Vein Pulsatility Pattern And Severity Of Liver Disease In Patients With Cirrhosis And Portal Hypertension

2013 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Anish Subedee ◽  
Benu Lohani ◽  
Shashi Sharma
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Portal Vein ◽  
Pulsatility Index ◽  
Study Groups ◽  
Control Group ◽  
Pulsatility Pattern ◽  
Cirrhotic Patients ◽  
The Difference ◽  
Cirrhotic Group

Objective: To correlate the portal vein pulsatility pattern with severity of liver disease in patients with cirrhosis of liver and portal hypertension. Subjects and methods: Doppler signals from the main portal vein of 36 healthy adults and 52 cirrhotic patients with portal hypertension were studied. Severity of liver disease was graded using modified Child-Pugh classification. Pulsatility of portal flow was quantified using portal venous pulsatility index and complete spectral widening was defined as absence of window below the wave base. The Doppler findings were correlated between the study groups. Results: The mean pulsatility index value in control group was 0.37+0.10 and in cirrhotic patients was 0.17+0.03 (Child A- 0.21+0.02, Child B- 0.18+0.02, Child C- 0.14+0.03). The difference between control and cirrhosis group, as well as the difference within different Child classes were statistically significant (P<0.05). None of the patients in control group had complete spectral widening while 76.92% of cirrhotic patients had complete spectral widening (28.5% of Child A, 66.6% of Child B and 100% of Child C). The difference in distribution of complete spectral widening between control and cirrhotic group as well as within the cirrhotic group was statistically significant (P<0.05). Conclusion: Portal vein pulsatility index and spectral widening can reflect the early hemodynamic changes in cirrhotic patients. These changes become more pronounced with increasing severity of liver disease. Journal of Nobel Medical College Vol. 2, No.1 Issue 3 Nov.-April 2013 Page 1-8 DOI: http://dx.doi.org/10.3126/jonmc.v2i1.7664

scholarly journals Relationship between hemodynamic parameters and portal venous pressure in cirrhosis patients with portal hypertension

2020 ◽  
Vol 15 (1) ◽  
pp. 981-987
Author(s):  
Hongjuan Yao ◽  
Yongliang Wang
Keyword(s):  
Portal Hypertension ◽  
Liver Function ◽  
Portal Vein ◽  
Doppler Ultrasound ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Portal Venous Pressure ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Vein Diameter

AbstractCirrhosis caused by viral and alcoholic hepatitis is an essential cause of portal hypertension (PHT). The incidence of PHT complication is directly proportional to portal venous pressure (PVP), and the clinical research of PVP and its hemodynamic indexes is of great significance for deciding the treatment strategy of PHT. Various techniques are currently being developed to decrease portal pressure but hemodynamic side effects may occur. In this article, the hemodynamic indexes of cirrhotic PHT patients were studied to explore the correlation between the index and PVP and to evaluate the clinical value of Doppler ultrasound in measuring PVP in patients with PHT. This was achieved by selecting 90 cirrhotic PHT patients who underwent transjugular intrahepatic portosystemic shunt in our hospital from June 2015 to September 2019. Fifty healthy people who had a physical examination in the hospital in the same period were selected as the control group. The liver hemodynamic parameters of two groups were measured by Doppler ultrasound, and the cirrhotic PHT patients were graded by the Child–Pugh grading method to evaluate the liver function and measure the PVP value. The results showed that both the central portal vein velocity (PVV) and splenic vein velocity (SVV) of the PHT group were lower than those of the control group. Also, the portal vein diameter (PVD), portal venous flow and splenic vein diameter (SVD) were higher than those of the control group (all Ps < 0.05). Among liver function graded PHT patients, the PVD, PVV, SVD and SVV were significantly different (all Ps < 0.05). Furthermore, the PVP of patients with liver function grades A, B and C was 38.9 ± 1.4, 40.6 ± 5.1 and 42.5 ± 4.8 cmH2O, respectively, with a significant difference. It can be concluded from this study that Doppler ultrasound can be used as a tool for clinical assessment of PHT in cirrhosis patients. Doppler ultrasound showed a good prospect in noninvasive detection of PHT in cirrhosis; however, this technique needs application on large sample population study to validate the results.

Stability of a rat model of prehepatic portal hypertension caused by partial ligation of the portal vein

2009 ◽  
Vol 15 (32) ◽  
pp. 3449
Author(s):  
Zhe Wen ◽  
Jin-Zhe Zhang ◽  
Hui-Min Xia ◽  
Chun-Xiao Yang ◽  
Ya-Jun Chen
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Rat Model

THE EFFECT OF OINTMENTS WITH ANTIOXIDANT ACTIVITY ON THE MORPHOLOGICAL STRUCTURES OF SKIN OF GUINEA PIGS EXPOSED TO LOCAL ULTRAVIOLET IRRADIATION

2019 ◽  
pp. 64-72
Author(s):  
T. V. Zvyagintseva ◽  
S. I. Myronchenko ◽  
N. I. Kytsyuk ◽  
O. V. Naumova
Keyword(s):  
Antioxidant Activity ◽  
Silver Nanoparticles ◽  
Ultraviolet Irradiation ◽  
Guinea Pigs ◽  
Main Group ◽  
The State ◽  
Elastic Fibers ◽  
Control Group ◽  
General Tendency ◽  
Skin Reactions

Considering the particular danger of remote skin reactions to ultraviolet irradiation (UVI), it is advisable to use ointments with antioxidant activity to reduce its negative effect on the skin. The rationale for the choice of ointments with antioxidant activity was the fact that they reduce the damaging effect of ultraviolet radiation in the erythemal and early post-erythemal period. The presence of a regular connection between the development of the early and late periods has given reason to assume the protective effect of ointments on the remote skin reactions. Objective: to study the effect of thiotriazoline ointment and thiotriazoline ointment with silver nanoparticles on the state of the morphological structures of the skin of guinea pigs after local UVI. Material and methods of research. The study involved 132 albino guinea pigs weighing 400-500 g, divided into 4 groups: 1 - intact, 2 - control (guinea pigs subjected to local UVI), 3 and 4 main ones. The third main group included guinea pigs that after UVI were administered thiotriazoline ointment in the treatment and prophylactic regime, the fourth main group included guinea pigs that after UVI were administered thiotriazoline ointment with silver nanoparticles in the same mode as Group 3. Ointments were applied 1 hour before irradiation and daily until erythema disappeared. Ultraviolet erythema was caused by irradiation in 1 minimum erythemal dose. After 2, 4 hours, on the 3rd, 8th, 15th, 21st, 28th day, the fragments of irradiated skin were investigated using histochemical and morphometric methods (fibroblast density and epidermis thickness). Results. Morphological changes in the skin after applying ointments with antioxidant activity were unidirectional. It was revealed that in the early periods after irradiation, thiotrazoline ointment and thiotrazoline ointment with silver nanoparticles do not affect changes in the thickness of the epidermis, but statistically significantly reduce the density of fibroblasts in the dermis on the 3rd day of the experiment compared to the control group. In the later periods, under the influence of thiotriazoline ointment, a gradual decrease in the thickness of the epidermis, which reached the norm by the end of the experiment, was observed. On the 8th day, the maximum density of fibroblasts was recorded, in the subsequent periods of the experiment, the index gradually decreased, which was accompanied by collagenization of the papillary layer in the loci of damage to collagen and elastic fibers detected in 50% of cases. In later times, under the influence of thiotriazoline ointment with silver nanoparticles, the processes of restoring the morphological structures of the skin occurred faster. In parallel with the decrease in the density of fibroblasts in the loci of the previous damage to the collagen and elastic fibers of the papillary layer, thickening of collagen fibers was observed, replacing them with segments of destruction of elastic fibers. In this group, at the end of the experiment, the collagenization locus was small, single, occurring in 16.7% of cases. Conclusions Ointments with antioxidant activity exert a positive effect on the state of morphological structures of the skin, damaged as a result of local UVI, in erythemal and post-erythemic periods. In the early periods after the local UVI, there was a general tendency for the effect of both ointments, as they reduced the density of fibroblasts on the 3rd day, but did not result in complete normalization. In the late period after local UVI , under the influence of thiotriazoline ointment and thiotriazoline ointment with silver nanoparticles, thickness of the epidermis (by 21st and 15th day, respectively) and density of fibroblasts (by the 28th day) decreased to normal while without treatment both indicators exceeded the norm by several times for 28 days of the experiment.

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