Porta-caval fibrous connections - the lesser-known structure of intrahepatic connective-tissue framework: A unified view of liver extracellular matrix.

Knowledge about the connective-tissue framework of the liver is not systematized, the terminology is inconsistent and some perspectives on the construction of the hepatic matrix components are contradictory. In addition, until the last two decades of the 20 century, the connective-tissue sheaths of the portal tracts and the hepatic veins were considered to be independent from each other in the liver and that they do not make contact with each other. The results of the research carried out by Professor Shalva Toidze and his colleagues started in the 1970s in the Department of Operative Surgery and Topographic Anatomy at the Tbilisi State Medical Institute have changed this perception.

LIVER EXTRACELLULAR MATRIX PECULIARITIES IN MAMMALS AND AVIANS.

Analysis of liver matrix studies makes it obvious that knowledge about the connective tissue skeleton of the liver is not systematized, the terminology is contradictory, and the question of the construction of some components sometimes causes controversy. We set a goal to study the features of the construction of the connective tissue matrix of the liver of various mammals and birds in order to identify and systematize general and specific patterns of this structure. The liver of mammals with a gallbladder (pigs, sheep) and without a gallbladder (rats) and birds (domestic chickens with a gallbladder) was studied by the methods of anatomical preparation, histology, histochemistry, histotopography, immunohistochemistry, scanning electron microscopy of corrosion replicas and fluorescence microscopy.

Liver structural transformation after partial hepatectomy and repeated partial hepatectomy in rats: A renewed view on liver regeneration.

Background: The phenomenon of liver regeneration after partial hepatectomy (PH) is still a subject of considerable interest due to the increasing frequency of half liver transplantation on the one hand, and on the other hand, new surgical approaches which allow removal of massive space-occupying hepatic tumors, which earlier was considered as inoperable. Interestingly, the mechanisms of liver regeneration are extensively studied after PH but less attention is paid to the architectonics of the regenerated organ. Because of this, the question "How does the structure of regenerated liver differ from normal, regular liver?" has not been fully answered yet.

New corrosion cast media and its ability for SEM and light microscope investigation.

SEM of corrosion casts (CC) provides the opportunities to study the vessels and ducts in the phyllogenetic and ontogenetic (age-related) settings, as well as the pathogenesis, compensation, and sanogenesis in different diseases and experimental models. Along with the refinement of SEM CC, the requirements toward casting media (CM) as nontoxicity, low viscosity, quick polymerization, resistance to corrosion solutions, availability, and so on, gradually has developed. We aimed to adapt the sets widely used in dental practice toward the modern requirements to the CC.

Cholecystic Venous Anatomy: A Cadaveric Study with Implications for Portal Venous Interruption Procedure.

The techniques of portal vein embolization (PVE) or ligation (PVL) have the goals of combining an induced atrophy of metastatic segments with the rapid relative compensatory hypertrophy of the postresection future liver remnant (FLR). Our study examines the anatomy of right-left hepatic lobar venous connections in the adult cadaver using corrosion cast analysis in an effort to define some of the inherent anatomical reasons why both PVL and PVE may be technically unsuccessful. Corrosion cast models of 215 cadaveric liver specimens were evaluated for hepatopetal venous blood flow, with a particular emphasis on cholecystic venous drainage patterns, including 57 cases prepared after lobar portal venous ligation.

The posterior intrahepatic approach to the left portal pedicle using the ligamentum venosum: anatomical basis.

Purpose: Prevention of blood loss in liver resections is essential for reducing postoperative morbidity. The main method to control bleeding during surgery of the left hemiliver is occlusion of the left portal pedicle. This may be accomplished by hilar, fissural or posterior intrahepatic techniques.

Magnetic resonance-guided focused ultrasound surgery (MRgFUS). Four ablation treatments of a single canine hepatocellular adenoma.

Background: Canine hepatocellular adenomas are benign, well-differentiated, primary hepatic tumors. Surgical resection is technically demanding and is considered a major procedure with relatively high morbidity rates. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) uses focused ultrasonic energy to non-invasively create a heat-coagulated lesion deep within the body.

Magnetic resonance-guided focused ultrasound surgery (MRgFUS): ablation of liver tissue in a porcine model.

Background: Liver surgery is technically demanding and is considered a major procedure with relatively high morbidity rates. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) uses focused ultrasonic energy to create a heat coagulation lesion, which can be achieved in a totally controlled, very accurate manner (<1 mm). The aim of this study was to evaluate the safety and accuracy of non-invasive focal ablation of liver tissue achieved by consecutive MRgFUS sonications.

Management of hemorrhoidal disease in patients with chronic spinal cord injury.

Hemorrhoidal disease is a common pathology in patients with chronic spinal cord injury (SCI). We describe our experience with the primary approach to this problem at the Proctology Division of the Sheba Medical Center. We treated 29 patients (26 men) with paraplegia due to SCI between 1995 and 1999.

[Identification of sentinel and axillary node involvement in breast cancer].

Axillary node dissection for breast cancer is important for staging and prognosis. "Sentinel nodes" are the first nodes into which primary cancer drains. Identification, removal and pathological examination of those nodes indicates whether completion of axillary lymphadenectomy is required.

Avoiding diarrhea after subtotal colectomy with primary anastomosis in the treatment of colon cancer.

Background: Subtotal colectomy has been criticized as causing increased frequency of stool passage, thus adding to the patients' morbidity. We review our experience with subtotal colectomy and determine the factors affecting postoperative diarrhea.

Study Design: One hundred thirty-six patients with colon cancer were treated by primary subtotal colectomy.