Digestive diseases and sciences
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Comparative Study
Pathogenic role of endothelial nitric oxide synthase (eNOS/NOS-III) in cerulein-induced rat acute pancreatitis.
Nitric oxide (NO) is a potent pancreatic vasodilator, yet the pathogenic role of NO in acute pancreatitis remains controversial. NO is generated from L-arginine by NO synthase (NOS), classified into three isozymes: neuronal (nNOS), inducible (iNOS), and endothelial NOS (eNOS). The purpose of the present study was to investigate the role of NO/NOS isozymes in the pathogenesis of cerulein-induced acute pancreatitis in rats. ⋯ The increases in the serum amylase level and pancreas weight, as well as the lipid peroxidation induced by cerulein, were significantly attenuated by the administration of BH4. L-NAME had no effect on pancreatic secretion induced by cerulein. These results suggest that the uncoupled eNOS, probably caused by the decrease in endogenous BH4 availability, plays a deleterious role in the pathogenesis of cerulein-induced acute pancreatitis.
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To clarify the relationship between morphological measurements of hepatic volume by computed tomography (CT-vol) and functional volume (RI-vol) by technetium-99m galactosyl human serum albumin (99mTc-GSA) scintigraphy, and its clinical significance, we examined 16 patients with a background liver status of either normal liver function (n=4), chronic hepatitis or cirrhosis (n=7), or obstructive jaundice (n=5). In five patients who underwent preoperative portal vein embolization (PVE), volumetric measurement was performed 2 weeks after PVE. The mean values of CT-vol and RI-vol of the right lobe were 692+/-147 cm3 (66.1+/-10.7%) and 668+/-159 cm3 (67.8+/-13.2%), respectively, and those of the left lobe were 329+/-138 cm3 (33.9+/-10.6%) and 328+/- 170 cm3 (32.2+/-13.2%), respectively. ⋯ The mean values of post-PVE CT-vol and RI-vol of the right lobe in five patients were significantly different (628+/-149 and 456+/-211 cm3, respectively; P=0.033). However, the mean values of post-PVE CT-vol and RI-vol of the left lobe were not different (496+/-124 and 483+/-129 cm3, respectively). We propose that volumetric measurement by 99mTc-GSA scintigraphy is useful for detecting changes in functional volume of individual lobes of the liver and is a more dynamic method compared with detection of morphological changes by CT scan.
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Model for Endstage Liver Disease (MELD) score has been used to allocate organs since February 2002. This policy allocates organs to candidates with regard to severity of their underlying liver disease except in the case of hepatocellular carcinoma (HCC) patients. The purpose of this study was to determine the impact of MELD on waiting times, dropout rates, and transplantation rates in all patients awaiting liver transplantation at our center. ⋯ HCC candidates under the new allocation policy have an increased incidence of DDLT in our institution. However, this has not disadvantaged patients with non-HCC diagnoses. Thus, the new MELD-based allocation policy has benefited all candidates by allowing more timely transplants.