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冷冻手术:肝脏组织在体内的早期超微结构变化

Cryosurgery: early ultrastructural changes in liver tissue in vivo.

作者信息

Korpan Nikolai N

机构信息

International Institute for Cryosurgery, Department of Surgery, Rudolfinerhaus, Vienna, Austria.

出版信息

J Surg Res. 2009 May 1;153(1):54-65. doi: 10.1016/j.jss.2008.02.063. Epub 2008 Mar 27.

DOI:10.1016/j.jss.2008.02.063
PMID:18486151
Abstract

BACKGROUND

Experimental observations with regard to freezing in vitro cell lines and fluid systems led to the application of low temperatures to in vivo biological systems. For the first time, this report describes the cryosurgical response of liver parenchyma and the early ultrastructural cellular changes in liver tissue, i.e., cryosurgery, in vivo.

MATERIALS AND METHODS

Forty-eight animals were used for the experiment. The dogs were divided into four groups. In group A, the liver tissue was frozen to -80 degrees C and in group B, to -180 degrees C. Temperatures of -80 degrees C and -180 degrees C in contact with liver tissue was selected for cryosurgical exposure. For transmission electron microscopy, the specimens were taken immediately and 1 h after the finishing of the freeze-thaw cycles intraoperatively. Further, the next specimens were taken in 24 h, this time also intraoperatively.

RESULTS

The electronic microscopic analysis showed that, after local cryodestruction at temperatures of -80 degrees C and -180 degrees C, similar processes occurred within the liver tissue in the early postcryosurgical phase-immediately and 1 h after cryosurgical session. The hepatocytes in the center of the cryozone changed upon thawing. Ultrastructural changes in the hepatic cells, where the first signs of dystrophic processes had been noticed, were increased.

CONCLUSIONS

Our new insights prove on the cell level that suddenly and progressively damaged liver cells in the postcryosurgical zone lead to aseptic cryoaponecrosis and then to aseptic cryoapoptosis of vital normal tissue. The vascular capillary changes and circulatory stagnation demonstrate together with cryoaponecrosis and cryoapoptosis the anti-angiogenesis mechanisms, which are some of the main mechanisms of biological tissue injury following the low temperature exposure.

摘要

背景

关于体外细胞系和流体系统冷冻的实验观察促使低温应用于体内生物系统。本报告首次描述了肝实质的冷冻手术反应以及肝组织中的早期超微结构细胞变化,即体内冷冻手术。

材料与方法

48只动物用于实验。狗被分为四组。A组将肝组织冷冻至-80℃,B组冷冻至-180℃。选择与肝组织接触的-80℃和-180℃温度进行冷冻手术暴露。对于透射电子显微镜检查,在术中完成冻融循环后立即和1小时取材。此外,下一批标本在24小时取材,同样在术中。

结果

电子显微镜分析表明,在-80℃和-180℃温度下进行局部冷冻破坏后,在冷冻手术后早期阶段(冷冻手术后立即和1小时)肝组织内发生了类似的过程。冷冻区中心的肝细胞在解冻时发生变化。肝细胞的超微结构变化增加,在这些肝细胞中已注意到营养不良过程的最初迹象。

结论

我们的新见解在细胞水平上证明,冷冻手术后区域中突然且逐渐受损的肝细胞会导致无菌性冷冻性坏死,进而导致重要正常组织的无菌性冷冻性凋亡。血管毛细血管变化和循环停滞与冷冻性坏死和冷冻性凋亡一起表明了抗血管生成机制,这是低温暴露后生物组织损伤的一些主要机制。

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