Histopathological Analysis of Liver During Pregnancy Toxemia in Small-tailed Han Sheep

The present work aimed to investigate the microscopic and ultramicro- scopic structure of the liver to assess the level of hepatic impairment during preg- nancy toxemia. Seven pregnant small-tailed Han sheep of negative urine ketone bodies were assessed in this study. Toxemia was induced by limiting food and movement tate in pregnancy. Three sheep developed obvious clinical symptoms with motor weakness, depression, anorexia, locomotion disturbances, blindness and lan- guishment. We harvested their liver tissues as pathological material, and used rou- tine histological and electronic microscopy methods to observe the histopathological changes in small-tailed Han sheep induced by pregnancy toxemia. Autopsy of the livers of the sheep revealed deep yellow coloration, intumescence and hemorrhage on the surface. Microstructural features indicated fatty degeneration, which is a main characteristic of fatty liver. Hepatocellular ultrastructural changes were observed un- der an electronic microscope. The characteristic findings were nucieolus concentra- tion, vacuolation of mitochondria and excessive glycogen granules in the cytoplasm. Via this experimental protocol, pregnancy toxemia of sheep was successfully in- duced, providing a pathological model for the study of this disease. After the experi- mental induction of pregnancy toxemia, the clinical symptoms of pathogenic sheep and pathological changes to their livers exhibited obvious characteristics of pregnan- cy toxemia.

Vibration-controlled Transient Elastography for Assessment of Liver Fibrosis at a USA Academic Medical Center

Background and Aims:Vibration-controlled transient elastography(VCTE)is a noninvasive tool that uses liver stiffness measurement(LSM)to assess fibrosis.Since real-life data during everyday clinical practice in the USA are lacking,we describe the patterns of use and diagnostic performance of VCTE in patients at an academic medical center in New York City.Methods:Patients who received VCTE scans were included if liver biopsy was performed within 1 year.Diagnostic performance of VCTE in differentiating dichotomized fibrosis stages was assessed via area under the receiver operating characteristics(AUROC).Fibrosis stage determined from VCTE LSM was compared to liver biopsy.Results:Of 109 patients,49 had nonalcoholic fatty liver disease,16 chronic hepatitis C,15 congestive hepatopathy,and 22 at least two etiologies.AUROC was 0.90 for differentiating cirrhosis(stage 4)with a positive predictive value(PPV)range of 0.28 to 0.45 and negative predictive value range of 0.96 to 0.98.For 31(32%)patients,VCTE fibrosis stage was at least two stages higher than liver biopsy fibrosis stage.Thirteen of thirty-five pa-tients considered to have cirrhosis by VCTE had stage 0 to 2 and 12 stage 3 fibrosis on liver biopsy.Conclusions:VCTE has reasonable diagnostic accuracy and is reliable at ruling out cirrhosis.However,because of its low PPV,caution must be exercised when used to diagnose cirrhosis,as misdiagnosis can lead to unnecessary health care interventions.In routine practice,VTCE is also sometimes performed for disease etiologies for which it has not been robustly validated.