Management of carbon tetrachloride-induced acute liver injury in rats by syngeneic hepatocyte transplantation in spleen and peritoneal cavity

AIM:Acute hepatitis may seldom have a fulminant course. In the treatment of this medical emergency,potential liver support measure must provide immediate and sufficient assistance to the hepatic function.The goal of our study was to study the adequacy of hepatocyte transplantation (HCTx)in two different anatomical sites,splenic parenchyma and peritoneal cavity,in a rat model of reversible acute hepatitis induced by carbon tetrachloride(CCl_4). METHODS:After CCl_4 intoxication,84 male Wistar rats used as recipients were divided in to four experimental groups accordingly to their treatment:Group A(n=-24):intrasplenic transplantation of 10×10~6 isolated hepatocytes,Group B(n=24): intraperitoneal transplantation of 20×10~6 isolated hepatocytes attached on plastic microcarriers,Group C(n=-18):intrasplenic injection of 1 mL normal saline(sham-operated controls), Group D(n=-18):intraperitoneal injection of 2.5 mL normal saline(sham-operated controls).Survival,liver function tests (LFT)and histology were studied in all four groups,on d 2, 5 and 10 post-HCTx. RESULTS:The ten-day survival(and mean survival)in the 4 groups was 72.2%(8.1±3.1),33.3%(5.4±3.4),0% (3.1±1.3)and 33.3%(5.4±3.6)in groups A,B,C,D, respectively(P_(AB0<0.05,P_(AC)<0.05,P_(BD)=NS).In the final survivors,LFT(except alkaline phosphatase)and hepatic histology returned to normal,independently of their previous therapy.Viable hepatocytes were identified within splenic parenchyma(in group A on d 2)and both in the native liver and the fatty tissue of abdominal wall(in group B on d 5). CONCLUSION:A significantly better survival of the intrasplenically transplanted animals has been demonstrated. Intraperitoneal hepatocytes failed to promptly engraft.A different timing between liver injury and intraperitoneal HCTx may give better results and merits further investigation.

THE RELATIONSHIP BETWEEN SEROSAL TYPES, PATHOLOGICAL CHARACTERISTICS AND FREE CANCER CELLS IN THE PERITONEAL CAVITY OF GASTRIC CANCER PATIENTS

The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.

Comparison of the characteristics of macrophages derived from murine spleen, peritoneal cavity, and bone marrow

Macrophages have a diverse set of functions based upon their activation states. The activation states, including resting（M0） and polarizing（M1 and M2） states, of macrophages derived from the mouse bone marrow, spleen, and peritoneal cavity（BMs, SPMs, and PCMs, respectively） were compared. We evaluated the macrophage yield per mouse and compared the surface markers major histocompatibility complex（MHC） Ⅱ and CD86 by flow cytometry. The relative mRNA levels of tumor necrosis factor-α（TNF-α）, interleukin（IL）-1β, mannose receptor（MR）, and Ym1 in the M0, M1, and M2 states were also compared using real-time polymerase chain reaction（PCR） analysis. Bone marrow yielded the most macrophages with the best homogeneity, but they were polarized toward the M2 phenotype. All three types of macrophages had the capacity to polarize into the M1 and M2 states, but SPMs had a stronger capacity to polarize into M1. The three types of macrophages showed no differences in their capacity to polarize into the M2 state. Therefore, the three types of macrophages have distinct characteristics regardless of their resting or polarizing states. Although bone marrow can get large amounts of homogeneous macrophages, the macrophages cannot replace tissue-derived macrophages.

Sustained dialysis with misplaced peritoneal dialysis catheter outside peritoneum:A case report

BACKGROUND In patients undergoing peritoneal dialysis(PD),catheter dysfunction is a common complication.A misplaced catheter is one of the reasons contributing to its dysfunction.The present study aimed to describe a case of misplaced PD catheter with an unusual location of the catheter tip.CASE SUMMARY A 61-year-old man undergoing PD for 4 years was investigated for progressive nausea and fatigue of 3 mo.Dialysis adequacy studies indicated inefficient dialysis.Imaging discovered that the PD catheter tip was mispositioned in the pelvic cavity with its tip outside the peritoneal cavity.Despite the dialysate accumulating outside the peritoneal cavity,the patient had not developed perineal or scrotal edema.The patient had experienced a sustainable prolonged dialysis efficacy in this case until the renal function deteriorated further in view of the poor dialysis outcome and worsening health condition.The patient was subsequently transitioned to hemodialysis.CONCLUSION Proper placement of the catheter in the peritoneal cavity should always be confirmed and rechecked when necessary in patients undergoing PD to ensure dialytic adequacy.

Intraperitoneal distribution of alginate microcapsules in mice

Introduction: Improved drug delivery mechanisms for the treatment of residual peritoneal cancer cells following cytoreduction surgery are needed. Alginate microcapsules are a potentially useful mechanism for delivery of bioengineered cells, but when injected into the peritoneum, their distribution and properties are not well described. Methods: Aliquots of 300, 600 or 1200 microcapsules were injected into the peritoneum of 81 mice. Mice were sacrificed at 6, 12, 18, and 48 days and laparotomy was performed to quantify the distribution of microspheres. Results: The injections were well tolerated for up to 48 days. No peritoneal adherence or inflammatory reaction was noted to the microcapsules. Injection of 1200 microcapsules resulted in a better overall persistence and widespread peritoneal distribution at up to 48 days. The volume of fluid used for injection of the microcapsules did not affect their distribution or persistence. Conclusion: The intraperitoneal injection of alginate microspheres allows wide and persistent distribution throughout the abdominal cavity. The next step is to test the distribution of microcapsules when delivered following surgery in a rodent model.