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内脏切除对犬肝脏再生的影响。

The effect of splanchnic viscera removal upon canine liver regeneration.

作者信息

Starzl T E, Francavilla A, Porter K A, Benichou J, Jones A F

出版信息

Surg Gynecol Obstet. 1978 Aug;147(2):193-207.

Abstract

The influence of portal blood factors on canine liver regeneration was studied with graded nonhepatic splanchnic evisceration, coupled with 44 and 72 per cent hepatectomies. In one type of experiment, the pancreas was retained while the rest of the intra-abdominal gastrointestinal tract was removed. In a second variety, total pancreatectomy was performed with preservation of the intra-abdominal organs. In a third kind of experiment, total nonhepatic splanchnic evisceration was performed. Liver regeneration after hepatectomy was decreased by all three kinds of viscera removed as judged by deoxyribonucleic acid synthesis, autoradiography and mitotic index. Pancreatectomy and nonpancreatic splanchnic evisceration caused almost equal decreases in the regenerative response. Total nonhepatic splanchnic evisceration essentially halted regeneration during the first three postoperative days and intraportal infusions of insulin or glucagon, or both together, did not reverse this effect. The decrease in liver membrane bound adenyl cyclase activity and biphasic change in liver cyclic 3', 5' -adenosine monophosphate concentrations normally seen after partial hepatectomy were disrupted after the various eviscerations. Adenyl cyclase activity and cyclic 3', 5' -adenosine monophosphate concentrations tended to be higher than normal in the eviscerated dogs. These observations provide more support for our previously proposed hypothesis that control of liver regeneration is by multiple factors. Pancreatic hormones are important modifiers of this response but, by no means, exercise exclusive control. Other substances of gastrointestinal origin, presumably including hormones and nutrient supply apparently play important specific roles. The volume of portal flow is a secondary and nonspecific, but possibly significant, factor.

摘要

采用分级非肝内脏切除联合44%和72%肝切除术,研究门静脉血因素对犬肝再生的影响。在一种实验类型中,保留胰腺,同时切除腹腔内其余胃肠道。在第二种类型中,进行全胰切除术,保留腹腔内器官。在第三种实验中,进行全非肝内脏切除。根据脱氧核糖核酸合成、放射自显影和有丝分裂指数判断,三种内脏切除术后肝切除术后的肝再生均减少。胰切除术和非胰腺内脏切除导致再生反应几乎同等程度的降低。全非肝内脏切除在术后头三天基本停止了再生,门静脉内输注胰岛素或胰高血糖素,或两者同时输注,均不能逆转这种效应。部分肝切除术后通常出现的肝膜结合腺苷酸环化酶活性降低和肝环3',5'-腺苷单磷酸浓度的双相变化,在各种内脏切除术后受到破坏。在内脏切除的犬中,腺苷酸环化酶活性和环3',5'-腺苷单磷酸浓度往往高于正常水平。这些观察结果为我们先前提出的肝再生受多种因素控制的假说提供了更多支持。胰腺激素是这种反应的重要调节因子,但绝不是唯一的控制因素。其他胃肠道来源的物质,可能包括激素和营养供应,显然起着重要的特定作用。门静脉血流量是一个次要的、非特异性的,但可能很重要的因素。

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