Thesis (M. S.)--University of Hong Kong, 2005. / Title proper from title frame. Also available in printed format.

Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (M.D.) -- University of Pennsylvania, 1805. / Film 633 reel 26 is part of Research Publications Early American Medical Imprints collection (RP reel 26, no. 487). DNLM

Thesis (M.D.)—Boston University

目的：評價中西醫結合治療肝纖維化的療效。 方法：以＂肝纖維化＂，或＂Hepatic Fibrosis＂，並且＂中醫＂，或＂中西醫＂，或＂中藥＂或＂Chinese medicine＂為檢索詞，在中國期刊全文資料庫（CNKI）、中文科技期刊全文資料庫維普資訊（VIP）、萬方資料知識平臺、PubMed、EmBase檢索近20年（1995-2015年）發表的有關中西醫結合治療肝纖維化的臨床研究文獻。設定文獻選入標準及文獻剔除標準。選取隨機對照試驗（RCT）。對文獻進行Jadad評分。並提取文獻資料資料。評分大於或等於2 者納人meta分析。採用Revman5.3軟體進行Meta分析。採用隨機效應模型，應用倒漏斗圖檢測是否存在發表偏倚。 結果：檢索出文獻共537篇，根據文獻選入及剔除標準，共12篇納入分析。總病例數1350.對照組620例，試驗組730例。以肝纖維化血清學指標血清透明質酸酶（HA）、血清層粘蛋白（LN）、III型前膠原（PCIIl）、IV型膠原(IV-C）為分析指標。中西醫結合治療肝纖維化HA 的合併效應量WMD=-61.87，95%可信區間為[-79.74,-44.09]。Z=6.79(p<0.00001）。差異有統計學意義：治療組在降低HA方面較對照組有明顯優勢。中西醫結合治療肝纖維化LN的合併效應量WMD=-43. 21，95%可信區間為[-57.61，-28.81]。Z=5.88(p

No description available.

Acute Liver Failure (ALF) is a devastating ailment with a high mortality rate and limited treatment alternatives. This study presents a methodology for the design and development of a bio-artificial bioreactor to be used in a Bio-Artificial Liver Support System. The system will ultimately be used either to bridge a patient to orthotopic liver transplant (OLT), the only current cure for end stage ALF, or spontaneous recovery. Methods to optimize and visualize the flow and related mass transfer in the BR are presented. The use of magnetic resonance imaging (MRI), scanning electron microscopy (SEM) and simple testing methodology is applied with emphasis on modeling the flow conditions in the BR. The bioreactor (BR) used in the Bio-Artificial Liver Support System (BALSS), currently under-going animal trials at the University of Pretoria, was modeled and simulated for the flow conditions in the device. Two different perfusion steps were modeled including the seeding of hepatocyte cells and later the clinical perfusion step. It was found that the BR geometry was not optimal with “dead spots” and regions of retarded flow. This would restrict the effective transport of nutrients and oxygen to the cells. The different perfusion rates for the seeding and clinical perfusion steps allowed for different velocity contours with cells seeing inconsistent flow patterns and mass transfer gradients. An optimized BR design is suggested and simulated, that effectively reduces the areas of retarded flow (dead spots) and increases the flow speed uniformly through the BR to an order of magnitude similar to that found in the sinusoidal range. The scaffolding volume was also decreased to allow a larger local cell density promoting cell-cell interaction. Finally a summarized design table for the design of a hepatic BR is presented. / Dissertation (MEng (Mechanical))--University of Pretoria, 2008. / Mechanical and Aeronautical Engineering / unrestricted

The amino acid, tryptophan, obtained through dietary means, is metabolised by the enzymes tryptophan 2,3-dioxygenase (TDO), indoleamine 2,3-dioxygenase (IDO) and tryptophan hydroxylase. All the enzymes have an effect on circulating tryptophan levels, especially TDO, since it is the major site of tryptophan catabolism in the liver and results in the production of kynurenine metabolites, viz. kynurenine, kynurenic acid, 3-hydroxyanthranilic acid and quinolinic acid. Extrahepatically, IDO is responsible for the synthesis of the kynurenine metabolites. Tryptophan 2,3-dioxygenase and IDO activity is increased by hormones or substrates such as tryptophan, and inflammation, in the case of IDO. Tryptophan availability for serotonin (5-HT) synthesis by the enzyme tryptophan hydroxylase is primarily dependent on TDO activity. A study was attempted in order to ascertain whether any of the endogenous metabolites of the kynurenine and serotonergic pathways would be able to inhibit TDO activity. Results showed that although the kynurenines had no effect, the indoleamines, except for the indoleacetic acids, were able to reduce TDO activity. 6-Methoxy-2-benzoxazolinone (6-MBOA), a structural analogue to melatonin, was the most potent inhibitor with a reduction in activity of 55 % compared with the control. The pineal gland in the rat brain has been shown to have the highest IDO activity. With induction, the kynurenine metabolite concentrations of kynurenic acid and quinolinic acid are increased. The effects of both compounds were determined on the serotonergic pathway. Although kynurenic acid produced no significant effect, quinolinic acid significantly reduced N-acetylserotonin and melatonin synthesis at concentrations of lOJLM and 100 JLM respectively. Many authors have implicated oxygen derived species as causative agents in the important neurodegenerative disorders such as Parkinson's and Huntington's disease. Increased radical generation and lipid peroxidation have been suggested to be responsible for the toxic destruction of neurons, especially in the brain because of its high lipid content and oxygen demand. The brain is therefore vulnerable to oxidative attack. During inflammatory diseases, IDO is induced with a resultant increase in kynurenines. This study was also an attempt at determining the effect of kynurenines on lipid peroxidation. All metabolites of the kynurenine pathway were able to induce lipid peroxidation significantly. The antioxidative potential of various tryptophan analogues, viz. serotonin, melatonin and 6-methoxy-2-benzoxazolinone, was determined using quinolinic acid-induced lipid peroxidation. Serotonin, melatonin and 6-MBOA were able to significantly reduce quinolinic acid-induced lipid peroxidation.

A comparison has been made of the formate-C¹⁴ incorporation into the nucleic acid purines and thymine of regenerating rat liver and Novikoff hepatoma in vivo. The effects of these tissues on one another, and on the host tissues has been studied. The utilization of formate by the nucleic acids of Novikoff hepatoma and regenerating rat liver was not significantly altered in animals containing both of these rapidly dividing tissues. The results indicated that the demand for formate by one of the rapidly growing tissues did not lower the uptake of formate by the nucleic acids of the other tissue. Furthermore it was indicated that nucleic acid synthesis in regenerating liver did not alter the synthesis of nucleic acids in other tissues. Regenerating liver and Novikoff hepatoma had no effect on the nucleic acid metabolism of the host tissues of animals bearing one or both of these tissues. These results are not completely in agreement with those reported in the literature. In a preliminary experiment a radioactive suspension of Novikoff hepatoma was transplanted into rats. Twenty percent of the injected radioactivity was recovered in the urine during the first 24 hours of tumor growth. The specific activities of the nucleic acid bases of the tumor, obtained after 24 hours of growth, were negligible. These findings indicated that the nucleic acids of the donor tumor suspension were not utilized in the synthesis of the nucleic acids of the growing tumor. / Medicine, Faculty of / Biochemistry and Molecular Biology, Department of / Graduate

Liver resection, or hepatectomy, is a major abdominal surgery performed most often for the removal of malignant tumors of the liver, either primary or metastatic. It is often associated with significant blood loss and therefore, with blood transfusions. While transfusions are common, there is incomplete knowledge of their effects on clinical outcomes. Furthermore, both current practices and best practices in perioperative blood management, including blood product administration, are not well defined. This manuscript-based thesis will examine the clinical impact, current practices, and appropriate use of perioperative red blood cell transfusions for patients undergoing liver resection.