• Title/Summary/Keyword: 간문맥압

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Studies of Alterations in Spleno-Hepatic Reflex in Portal Hypertensive Cats (간문맥 고혈압 고양이에서 비-간 교감신경성 반사의 변동에 대한 연구)

  • Song, Hwan-Kyu;Rhim, Byung-Yong;Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.23 no.1
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    • pp.15-23
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    • 1987
  • To elucidate the mechanism of splanchnic hyperemia associated with chronic portal hypertension, we have investigated the alteration in visceral reflexes in conjuction with circulatory hemodynamics in portal ligated portal hypertension in cats. When capsaicin, bradykinin and vasopressin were injected via splenic artery of sham cat, respectively, they caused not only reflex excitation of systemic arterial pressure, but also elevation of splenic venous pressure with unchanged heart rates. Simultaneously, they evoked the sympathetic efferent excitation of liver (spleno-hepatic reflex) as well as of spleen (spleno-splenic reflex). Similarly, capsaicin upon pledging on the liver surface evoked a significant increase in the pressor reflex with hepatic nerve excitation (hepato-hepatic reflex). After portal ligation, the splenic venous pressure was gradually elevated in association with decrease in systemic arterial pressure. However, the excitation of pressor reflex was enhanced on the and day, thereafter, being returned to the control, and the reflexly induced spleno-splenic, spleno-hepatic and hepato-hepatic sympathetic excitations were significantly diminished on the 8th day following portal vein ligation. In conclusion, it is suggested that sympathetic reflexes to spleen and liver are specifically intervened by the same central pathways and furthermore, the diminution of these viscero-visceral reflex excitations after portal ligation may be related to the intestinal hyperemia.

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Experimental Studies on the Vascular Smooth Muscle of $Cd^{2+}$-poisoned Rabbits (카드뮴중독(中毒) 가토(家兎)의 동정맥(動靜脈)에 관하여)

  • Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.15 no.1_2 s.25
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    • pp.29-37
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    • 1979
  • The tension-length relationships and reactivity of vascular smooth muscle in longitudinal strips from portal vein ana in helical strips from thoracic aorta and pulmonary artery of normotensive control and cadmium-hypertensive rabbits were studied in vitro. 1. The mean arterial pressures of non-poisoned control rabbits was $87.0{\pm}4.7 mmHg$. However, Cd-poisoned group revealed the significant increase in pressure by $109.04{\pm}2.8 mmHg$ (p<0.005). 2. By tension-length studies, strips from portal vein of Cd-poisoned group stretched a greater percent increase in length in response to an applied resting force from 0.25 to 5 g than did those from non-poisoned group. On the contrary, strips from thoracic aorta of Cd-poisoned group showed less compliant than those from control, i.e. the former underwent a less percent increase in length than the latter. Passive tension-length relations of pulmonary artery was unaffected by Cd-hypertension. 3. The force of contraction(active tension) was significantly lowered in strips from aorta of Cd-hypertensive group throughout the range of $0.5{\sim}2g$ passive tension. However, there was no significant difference in the development of active tension of portal vein or pulmonary artery of both groups. 4. The $K^+$-contraction in the portal vein, aorta and pulmonary artery of Cd-poisoned group made no difference in the active force from those of control group. 5. The force of contraction in the strips from aorta of Cd-poisoned group was significanty decreased compared to that of control. The results suggested that the alterations in vascular reactivity to contracting substances and in distensibility to passive tension were induced in the Cd-hypertensive rabbits.

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Tumor Recurrence in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: Portal Hypertension as an Indicator of Recurrence of Hepatocellular Carcinoma (간세포암 환자의 고주파열치료 후 종양 재발: 예후인자로서 문맥고혈압)

  • Jang, Seong Won;Cho, Yun Ku;Kim, Ju Won;Gil, Je Ryung;Kim, Mi Young;Lee, Young
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.264-270
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    • 2018
  • Purpose: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). Materials and Methods: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. Results: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). Conclusion: For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.