Portal vein embolization before right hepatectomy: prospective clinical trial.

OBJECTIVE: To assess the impact of liver hypertrophy of the future liver remnant volume (FLR) induced by preoperative portal vein embolization (PVE) on the immediate postoperative complications after a standardized major liver resection. SUMMARY BACKGROUND DATA: PVE is usually indicated when FLR is estimated to be too small for major liver resection. However, few data exist regarding the exact quantification of sufficient minimal functional hepatic volume required to avoid postoperative complications in both patients with or without chronic liver disease. METHODS: All consecutive patients in whom an elective right hepatectomy was feasible and who fulfilled the inclusion and exclusion criteria between 1998 and 2000 were assigned to have alternatively either immediate surgery or surgery after PVE. Among 55 patients (25 liver metastases, 2 cholangiocarcinoma, and 28 hepatocellular carcinoma), 28 underwent right hepatectomy after PVE and 27 underwent immediate surgery. Twenty-eight patients had chronic liver disease. FLR and estimated rate of functional future liver remnant (%FFLR) volumes were assessed by computed tomography. RESULTS: The mean increase of FLR and %FFLR 4 to 8 weeks after PVE were respectively 44 +/- 19% and 16 +/- 7% for patients with normal liver and 35 +/- 28% and 9 +/- 3% for those with chronic liver disease. All patients with normal liver and 86% with chronic liver disease experienced hypertrophy after PVE. The postoperative course of patients with normal liver who underwent PVE before right hepatectomy was similar to those with immediate surgery. In contrast, PVE in patients with chronic liver disease significantly decreased the incidence of postoperative complications as well as the intensive care unit stay and total hospital stay after right hepatectomy. CONCLUSIONS: Before elective right hepatectomy, the hypertrophy of FLR induced by PVE had no beneficial effect on the postoperative course in patients with normal liver. In contrast, in patients with chronic liver disease, the hypertrophy of the FLR induced by PVE decreased significantly the rate of postoperative complications.

Cell-matrix interactions in Schistosomal portal fibrosis: a dynamic event

In recent years, one of the most significant progress in the understanding of liver diseases was the demonstration that liver fibrosis is a dynamic process resulting from a balance between synthesis and degradation of several matrix components, collagen in particular. Thus, fibrosis has been found to be a very early event during liver diseases, be it of toxic, viral or parasitic origin, and to be spontaneously reversible, either partially or totally. In liver fibrosis cell matrix interactions are dependent on the existence of the many factors (sometimes acting in combination) which produce the same events at the cellular and molecular levels. These events are: (i) the recruitment of fiber-producing cells, (ii) their proliferation, (iii) the secretion of matrix constituents of the extracellular matrix, and (iv) the remodeling and degradation of the newly formed matrix. All these events represent, at least in principle, a target for a therapeutic intervention aimed at influencing the experimentally induced hepatic fibrosis. In this context, hepatosplenic schistosomiasis is of particular interest, being an immune cell-mediated granulomatous disease and a model of liver fibrosis allowing extensive studies in human and animals as well as providing original in vitro models.

"El Portalet": portal del centre per a dispositius mòbils

Treball de recerca realitzat per una alumna d’ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l’any 2008. S’ha treballat per generar una web consultable a través de dispositius mòbils.

Portal web inmobiliario Luxury Properties con posicionamiento SEO

Este documento explica la metodología de trabajo utilizada durante el desarrollo de este proyecto. El resultado obtenido ha sido un producto que forma parte del portal web Luxury Porperties. Luxury Properties es una marca comercial, creada por la compañía Luxury Dreams, para identificar un portal web especializado en las propiedades de lujo. Para desarrollar este concepto, la empresa compró el dominio luxuryproperties.es con el objetivo de crear un sistema que implemente toda la lógica de negocio necesaria para la publicidad y mercadeo de sus productos. Al final del documento se encuentran las recomendaciones y las futuras valoraciones a tener en cuenta por el cliente en futuras ampliaciones del portal.

Portal-foro para el aprendizaje de lenguas hispano-japonesas

El trabajo descrito en esta memoria es el resultado de un proyecto de colaboración universitaria entre la Universidad Autónoma de Bellaterra, la Universidad Complutense de Madrid y la Keio University Shonan Fujisawa Campus de Japón, cuya finalidad es la de ayudar a estudiantes de lenguas japonesa y española en horas extra escolares a mejorar y practicar sus conocimientos elementales de las lenguas de estudio mediante el empleo de tecnologías Web. Se describe aquí la plataforma seleccionada para el desarrollo de un foro conversacional y otras utilidades que ayudará y reforzará a los estudiantes los conocimientos del idioma japonés suministrados en horarios de clase.

Comparison of four embolic materials for portal vein embolization: experimental study in pigs.

Different embolic materials for portal vein embolization (PVE) were evaluated. Twenty pigs received left and median PVE. Hydrophilic phosphorylcholine, N-butyl cyanoacrylate, hydrophilic gel, and polyvinyl alcohol (PVA) particles measuring either 50-150 microm or 700-900 microm were used in five pigs each. Portography and portal vein pressure measurement were performed before, immediately after PVE, and before being euthanized at day 7. Tissue wedges from embolized, and non-embolized liver were obtained for pathology. After complete embolization, recanalization occurred at 7 days in one gel and one 700-900 PVA embolization. Post-PVE increase in portal pressure was found in all groups (p = 0.01). The area of the hepatic lobules in non-embolized liver was larger than in the embolized liver in all groups (p = 0.001). The ratios of the areas between non-embolized/embolized livers were 1.65, 2.19, 1.57, and 1.32 for gel, NBCA, 50-150 PVA and 700-900 PVA, respectively; the ratios of fibrosis between the embolized and non-embolized livers were 1.37, 3.01, 3.49, and 2.11 for gel, NBCA, 50-150 PVA and 700-900 PVA, respectively. Hepatic lobules in non-embolized liver were significantly larger with NBCA than in other groups (p = 0.01). Fibrosis in embolized liver was significantly higher for NBCA and 50-150 PVA (p = 0.002). The most severe changes in embolized and non-embolized liver were induced by 50-150 PVA and NCBA PVE.

The value of ultrasonography in assessment of portal hypertension in hepatosplenic schistosomiasis

Ultrasonography can reveal most of the manifestations of portal hypertension complicating hepatosplenic, schistosomiasis. However, direct demonstration of gastroesophageal varices by ultrasonography is still very difficult. An attempt was done to correlate sonographic features of portal hypertension with the degree of fibrosis to screen patients having varices and predicting their chance of bleeding. The results obtained were found to be consistent with the esophagogastric endoscopy and with history of hematemesis. Four parameters were used, size of spleen, degree of periportal fibrosis, presence of collaterals and portal vein diameter. A pilot field survey was also done adopting the same principle.

Diseño e implementación de un portal web para una empresa de sistemas de control de iluminación

El objetivo del proyecto es facilitar a los clientes de la empresa el acceso a las actualizaciones de software y a los modelos de funcionamiento a través de un portal WEB. Además, se desea mejorar la imagen de empresa que se ofrece a los clientes y futuros clientes incluyendo información relacionada con la empresa y sus productos. Para cumplir con estos requisitos la aplicación hará uso del lenguaje de etiquetas HTML junto con CSS, el lenguaje de programación PHP y el sistema gestor de datos MySQL para generar contenidos dinámicos.

Estudi, disseny i implementació d'un portal WEB per a una empresa d'informàtica

Creació d’un portal web per a una petita empresa informàtica. Utilitzarem un gestor de continguts com a eina principal per la implementació, i posarem en funcionament el portal. Aquest tindrà un usuari administrador de continguts, que s’encarregarà d’actualitzar, ampliar i gestionar tots els continguts de la web, adaptant-los a les necessitats de l’empresa. Els visitants tindran la possibilitat de registrar-se accedint així a diverses funcionalitats, com un servei d’ajut online o un petit catàleg de material. La part pública del portal tindrà tot tipus d’informació sobre l’empresa i la pròpia web. Aquestes seccions s’aniran actualitzant quan l’empresa així ho requereixi.

Portal hypertension in schistosomiasis: pathophysiology and treatment

In heavily infected young patients, there is a "non-congestive" phase of the disease with splenomegaly which can improve after chemoterapy. A strong correlation between hepatosplenic form and worm burden in young patients has been repeatedly shown. The pattern of vascular intrhepatic lesions seems to depend on two mechanisms: (a) egg embolization, with a partial blocking of the portal vasculature; (b) the appearance of small portal collaterals along the intrahepatic portal sistem. The role played by hepatitis B virus (HBV) and C virus infections in the pathogenesis of liver lesions is variably considered. Selective arteriography shows a reduced diameter of hepatic artery with thin and arched branches outlining vascular gaps. A rich arterial network , as described in autopsy cases, is usually not seen in vivo, except after splenectomy or shunt surgery. An augmented hepatic arterial flow was demonstrated in infected animals. These facts suggest that the poor intrahepatic arterial vascularization demonstrated by selective arteriography in humans is due to a "functional deviation"of arterial blood to the splenic territory. The best results obtained in treatment of portal hypertension were: esophagogastric desvascularization and splenectomy (EGDS), although risk of rebleeding persists; classical (proximal) splenorenal shunt (SRS) should be abandoned; distal splenorenal shunt may complicate with hepatic encephalopaty, although later and in a lower percentage than in SRS. Propranolol is currently under investigation. In our Department, schistosomotic patients with esophageal varices bleeding are treated by EGDS and, if rebleeding occurs, by sclerosis of the varices.

Avaliação crítica da cirurgia na hipertensão portal esquistossômica

There are over 100.000 patients affected by schistosomotic portal hipertension, that may suffer rupture of the esophageal varices. Besides the portal hypertension, local factors must be emphazised as responsible for the three distal centimeters of the esophagus, called "zona vulnerável" (vulnerable zone). The beter liver functional reserve of these schistosomotic patients as compared to the cirrhotic, present two favorable condititions: (1) beter possibility of conservative treatment during acute hemorrhage; (2) elective surgical treatment may be undergo without a mandatory step of large portal descompression. The Author only indicate surgical treatment in patients with hemorrhage antecedence and his preference consist in splenectomy plus obliterative suture of the varices at the "vulnerable zone" and when possible, ligature of left gastric vein also; 358 patients were undergone surgery with operative mortality 3.07%, 347 were followed during 1 to 25 years; late mortality 8.38%; recurrence hemorrage 11.58%; none porto-sustemic encephalopaty was observed.

DUGi, portal d'accés als materials en obert de la UdG

Desprès d'un cert temps de rodatge amb els tres repositoris institucionals de la UdG: DUGiDocs, DUGiMedia i DUGiFonsEspecials, haver-los migrat a la versió 1.5.2 de Dspace, i millorat les prestacions que ens permet el programari, ha arribat el moment de millorar l'eina que ens permet fer que el DUGi sigui un portal útil des del punt de vista de la usabilitat, visibilitat i difusió dels materials que es poden consultar als diferents repositoris.

L'aprenentatge basat en problemes (PBL) en la regulació del metabolisme. Desenvolupament del portal per a l'intercanvi d'experiències en PBL en ciències biomèdiques

L’aprenentatge basat en problemes està en fase experimental en tot el món i és objecte d’anàlisi i reflexió en moltes reunions internacionals. Tanmateix, no hi ha massa feina feta en aquesta direcció en el nostre camp més proper. Hem elaborat problemes per l’aprenentatge de la Regulació del Metabolisme i els hem incorporat a un porta virtual (http://www.ub.edu/GID-BBM). La finalitat d’aquesta estratègia és que mitjançant l’aprenentatge basat en problemes reals o simulacions de problemes reals s’aconsegueixi motivar l’alumnat a treballar de forma continuada durant tot el curs. La millora dels resultats acadèmics haurà de ser la conseqüència lògica d’aquest treball. La finalitat última del projecte que hem desenvolupat és preparar l’alumnat per la seva futura activitat professional a on serà molt important i valorat la seva capacitat de resposta davant de diferents problemes

Portal corporatiu: intranet per a la relació treballadors - empresa

Aplicació web per a empreses mitjanes amb un nombre considerable de treballadors per tal que puguin mantenir un control sobre les seves activitats i poder automatitzar unes altres. També serà per als treballadors ja que es fomentarà la comunicació entre iguals. Tindrem diversos tipus d’usuaris segons el seu càrrec i responsabilitat dins l’empresa, amb interfícies d'usuari diferents.