Studies on pathophysiology following resection of cirrhotic liver in dogs, with the view points of functional and morphological changes of hipatic sinusoidal lining cells.

近年来，外毒素(ET)和细菌易位(Bt)被认为是器官损伤的重要因素。本研究旨在探讨肝窦衬里细胞产生各种化学介质与肝细胞之间的相互作用。本研究采用成年杂种犬肝硬变模型。实验犬分为4组：40%和70%肝硬变切除组和70%和84%正常肝切除加用二甲基亚硝胺组。这四组被分成两个亚组：一个用灌肠和抗生素作为结肠准备的治疗组和另一个未治疗组。根据肠系膜淋巴结(MLC)细菌培养的阳性情况对BT进行研究。存活率和术前结肠准备：肝硬化组40%和正常肝组70%的患者TE-…显著降低MLC术前结肠准备阳性率和血ET水平的RMS越高。结果：1.正常肝组织病理形态相似，存活率明显提高。肝窦衬里细胞的功能和形态变化。术前结肠准备显示，即使是过度肝切除，从血液中透明质酸和β-NaH的功能和电子显微镜的形态观察来看，肝窦衬里细胞包括内皮细胞和Kupffer细胞都被良好地保留了下来。而在非结肠制剂组，功能和形态明显异常。肝细胞与Kupffer细胞共培养的相互作用：肝硬变40%和70%肝切除后24 h分别培养肝细胞和肝窦衬里细胞时，肝切除40%后肝细胞和肝窦衬里细胞的功能和形态均较好。然而，肝细胞和Kupffer细胞共培养的结果显示，在40%的肝切除中，两种细胞的功能和形态都更好。在70%肝切除后的共培养中，肝细胞明显紊乱。结肠制剂组肝细胞和Kupffer细胞均出现不可逆性改变，提示肝硬变切除后残肝功能障碍的加重与BT有关，ET水平升高可诱导Kupffer细胞的启动，肝窦衬里细胞产生的化学介质对肝细胞可能产生强烈的干扰作用。因此，术前结肠准备改善了扩张性肝切除术后的预后。较少

Exdotoxin (ET) and bacterial translocation (BT) have been recently documented as important factors in organ injury. The purpose of this study was to elucidate, the interaction between the hepatic sinusoidal lining cells producing various chemical mediators and the hepatocytes, using liver cirrhotic models of adult mongrel dogs well-reflecting upon this pathophysiology which under-went hepatectomy. Experimental dogs were divided into 4 groups : 40% and 70% hepatectomy of cirrhotic liver and 70% and 84% hepatectomy of normal liver along with the administration of Dimethylnitrosamin. These four groups were divided into two subgroups : a treated group with enema and antibiotics as colon preparation and another non-treated group. The BT was studied with respect to positivity for bacterium culture in mesenteric lymph nodes (MLC).1. Survival rate and preoperative colon preparation : In 40% hepatectomy of cirrhotic liver and 70% hepatectomy of normal liver, significant reduction was seen in te … More rms of the MLC positive rate of preoperative colon preparation and blood ET level. Similar pathologic conditions were shown in normal liver and the survival rate significantly improved.2. The functional and morphological changes of hepatic sinusoidal lining cells.The preoperative colon preparation revealed that in even excessive hepatectomy, the hepatic sinusoidal lining cells including the endothelial cells and Kupffer cells were favorably maintained, judging from the functions of hyaluronic acid and beta-NAH in the blood and electron microscopic morphological findings. On the other hand, in non-colon preparation group, the function and morphology were notably abnormal.3. The interaction between the hepatocytes and the Kupffer cells in co-culture : When the hepatocytes and the sinusoidal lining cells were cultured separately at 24 hours after 40% and 70% hepatectomy of the cirrhotic liver, both cells after 40% hepatectomy were better with respect to their function and morphology. However, the results from the co-culture of the hepatocytes and the Kupffer cells demonstrated better functions and morphology of both cells in 40% hepatectomy. In the co-cultrue after 70% hepatectomy, the hepatocytes were significantly disturbed. The colon preparation group showed irreversible findings in both the hepatocytes and Kupffer cells.The results indicated that the exacerbation of the functional disturbance of the remnant liver after hepatectomy of cirrhosis depended on BT,and increase of ET level induced the priming of the Kupffer cells, and the chemical mediators to the hepatocytes which were yielded from the hepatic sinusoidal lining cells might cause strong disturbances. Therefore, preoperative colon preparations improved the prognosis after expansive hepatectomy. Less