epidermal-growth-factor and Postoperative-Complications

Cancer therapies have led to remarkable results due to improved toxicity profiles and effects on survival. While these medical, surgical, and radiation protocols are chiefly responsible for these noteworthy contributions, an unexpected constellation of toxicities has emerged. Most notably, dermatologic adverse events have gained considerable attention, due to their high frequency, visibility, and impact on physical and psychosocial health, all of which affect dose intensity and possibly clinical outcome. Consequently, increased attention to cutaneous health in oncology has resulted in supportive oncodermatology clinical programs and toxicity-driven investigations, aiming to mitigate these untoward events and permit the continued optimization of cancer treatments.

Topics: Antineoplastic Agents; Epidermal Growth Factor; Humans; Neoplasms; Neoplasms, Radiation-Induced; Postoperative Complications; Radiodermatitis; Radiotherapy; Skin Diseases

This study examined the effects of enterally administered epidermal growth factor (EGF) on nutrient absorption and tolerance of enteral feeds in pediatric patients with short bowel syndrome (SBS).. Patients identified with severe SBS (<25% bowel length predicted for age) were prospectively enrolled in treatment using human recombinant EGF (1-53); 100 microg/kg per day given mixed with enteral feeds and patients were treated for 6 weeks. End points followed were patient weight, tolerance of enteral feeds, nutrient absorption, and intestinal permeability as determined using carbohydrate probes and hematologic values for liver function parameters.. Five patients were treated with EGF; all showed a significant improvement in carbohydrate absorption (3-0 methylglucose): absorption 24.7% +/- 9.7% pretreatment vs 34.1% +/- 13.8% posttreatment and improved tolerance of enteral feeds (enteral energy as % of total energy, 25% +/- 28% pretreatment vs 36% +/- 24% posttreatment; mean +/- SD; P < .05 by Wilcoxon's signed rank test). Epidermal growth factor treatment was not associated with significant changes in intestinal permeability, the rate of weight gain, or liver function tests. During the treatment phase, no patients developed episodes of sepsis; however, within 2 weeks of discontinuation of EGF treatment, 3 patients developed septic episodes. No adverse effects of EGF administration were noted.. These results suggest that enteral treatment with EGF in pediatric SBS improves nutrient absorption, increases tolerance with enteral feeds, and may improve the infection rate. Further studies exploring treatment strategies including the timing and duration of EGF administration are indicated.

Topics: 3-O-Methylglucose; Child, Preschool; Dietary Carbohydrates; Enteral Nutrition; Enterocolitis, Necrotizing; Epidermal Growth Factor; Gastroschisis; Humans; Infant; Infant Food; Intestinal Absorption; Intestinal Volvulus; Lactulose; Liver Function Tests; Male; Mannitol; Pilot Projects; Postoperative Complications; Recombinant Proteins; Sepsis; Short Bowel Syndrome; Weight Gain

To test the efficacy and safety of recombinant human epidermal growth factor (hEGF) on corneal re-epithelialisation following penetrating keratoplasty.. A prospective, randomised, placebo controlled study was carried out in which patients were matched for diagnosis and received either hEGF ophthalmic solution (30 micrograms/ml or 100 micrograms/ml) or placebo in a double masked fashion. Matched pairs of patients received donor corneas from the same donor and were operated by the same surgeon on the same day. At the end of surgery all donor epithelium was removed mechanically. Patients were examined twice daily and fluorescein stained photographs were taken until the epithelium had closed. The area of the defect was measured by planimetry of the fluorescein stained defect on the photographs.. There were no significant differences in re-epithelialisation of the donor cornea between the placebo group and the group treated with 30 micrograms/ml hEGF. Time until complete closure was slightly longer with 100 micrograms/ml hEGF compared with 30 micrograms/ml hEGF and with placebo. Mean healing rate of the epithelial defect with 100 micrograms/ml hEGF was significantly slower than in the other groups.. No significant acceleration of corneal re-epithelialisation was demonstrated with the use of recombinant hEGF after penetrating keratoplasty in humans.

Topics: Administration, Topical; Adult; Double-Blind Method; Endothelium, Corneal; Epidermal Growth Factor; Female; Follow-Up Studies; Humans; Keratoplasty, Penetrating; Male; Middle Aged; Postoperative Complications; Prospective Studies; Time Factors; Wound Healing

The ability of DexSol medium, supplemented with two growth factors, human epidermal growth factor (hEGF) and human insulin, to improve long-term endothelial survival after penetrating keratoplasty was evaluated in a multi-center, randomized, prospective, double-masked clinical trial.. Donor cornea pairs, one stored in DexSol and the other in DexSol with hEGF (10 ng/ml) and human insulin (10 micrograms/ml) (ProCell), were transplanted into 105 pairs of recipients matched by diagnosis and procedure and followed postoperatively for graft and endothelial survival.. No primary donor failures occurred in either group. Graft clarity did not differ between the ProCell and DexSol groups at all postoperative periods: 3 months (98% versus 99%), 6 months (94% versus 98%), and 1 year (95% versus 97%), respectively. Postoperative complications (e.g., glaucoma, rejection) occurred with comparable frequencies in both groups. Mean endothelial cell loss did not significantly differ between the ProCell and DexSol groups at 3 months (5.7% versus 5.1%), 6 months (8.1% versus 10.1%), and 1 year (12.3% versus 15.6%), respectively. Similarly, there were no clinically and statistically significant differences in other endothelial morphometric parameters.. The use of corneas stored in DexSol medium with added hEGF and insulin in corneal transplantation resulted in a safety and efficacy profile comparable with that observed in patients receiving DexSol-stored corneas; however, there were no clinically and statistically significant differences in postoperative endothelial morphometric parameters.

Topics: Adult; Aged; Cell Count; Cell Survival; Chondroitin Sulfates; Cornea; Cryopreservation; Culture Media, Serum-Free; Double-Blind Method; Endothelium, Corneal; Epidermal Growth Factor; Female; Follow-Up Studies; Glycoside Hydrolases; Graft Survival; HEPES; Humans; Insulin; Keratoplasty, Penetrating; Male; Organ Preservation; Organic Chemicals; Postoperative Complications; Prospective Studies

We evaluated the effect of topical epidermal growth factor treatment on healing of chronic wounds in a prospective, open-label, crossover trial. Five males and four females who ranged in age from 40 to 72 years (average 57 +/- 9 years) were enrolled. Four patients had adult-onset diabetes mellitus, two had rheumatoid arthritis, two had old burn scars, and one had a failed abdominal incision. The average duration of the ulcers prior to treatment with epidermal growth factor was 12 +/- 5 months (range 1 to 48 months). Following failure of the wounds to heal with conventional therapies, including debridement, skin graphs, and vascular reconstruction, wounds were treated twice daily with Silvadene alone for periods ranging from 3 weeks to 6 months. No evidence of healing was observed in any of the patients' wounds during Silvadene treatment, and patients were crossed over to twice a day treatment with Silvadene containing 10 micrograms epidermal growth factor per gram. Wounds of eight patients healed completely with epidermal growth factor-Silvadene treatment in an average of 34 +/- 26 days (mean +/- SD, range 12 to 92 days) and did not reoccur for periods ranging from 1 to 4 years. One patient failed therapy. These results suggest that topical treatment of chronic wounds with epidermal growth factor may stimulate healing.

Topics: Administration, Cutaneous; Adult; Aged; Arthritis, Rheumatoid; Burns; Chronic Disease; Diabetes Mellitus, Type 2; Epidermal Growth Factor; Female; Humans; Male; Middle Aged; Pilot Projects; Postoperative Complications; Prospective Studies; Silver Sulfadiazine; Skin Ulcer; Wound Healing

Early graft failure (EGF) after coronary artery bypass grafting (CABG) occurs in up to 12% of grafts, but is often clinically unapparent. EGF may result in perioperative myocardial infarction with consequently increased mortality. The aim of the present study was to analyze the incidence of clinically apparent EGF in patients undergoing CABG and the influence on mortality.. We analyzed outcomes of consecutive patients undergoing CABG from January 2015 to December 2018 with respect to postoperative emergency coronary angiography (CAG) due to suspected EGF and 30-day mortality. Patients with CAG-documented EGF were matched to patients without EGF to examine predictors of mortality.. The analysis included 5638 patients undergoing CABG. Eighty-six patients (1.5%) underwent emergency CAG due to suspected EGF. Clinically apparent EGF was observed in 61 of these patients (70.9%), whereas 14 (16.3%) had a culprit lesion in a native coronary artery. The majority of patients (n = 45; 52.3%) were treated with percutaneous coronary intervention and 31 (36%) underwent re-do CABG. The remaining patients were treated conservatively. The 30-day mortality rate of suspected EGF patients undergoing CAG was 22.4% (n = 19), which was higher than the mortality rate of 2.8% overall (P<.001); this remained higher after matching the EGF patients with the control group (11 [20.4%] vs 2 [4.0%]; P=.02).. Emergency CAG after CABG is rare and is primarily carried out in patients with EGF. The 30-day mortality rate of these patients is high, and EGF is an independent predictor of mortality. Perioperative CAG with subsequent treatment is mandatory in these patients.

Topics: Coronary Artery Bypass; Coronary Artery Disease; Epidermal Growth Factor; Humans; Myocardial Infarction; Postoperative Complications; Treatment Outcome

Postoperative inflammatory response may act as a major determinant of anastomotic failure after pancreaticoduodenectomy. In this pilot study, we investigated the potential role of drain fluid cytokines in predicting postoperative pancreatic fistula (POPF).. Drain fluid TGF-β, IGF-1, EGF, and IL-6, together with serum amylase and drain fluid amylase, were measured on POD1 and correlated with the development of POPF.. The study population consisted of 66 patients. POPF and Clavien-Dindo ≥3 morbidity rates were 12.1% and 9.1%, respectively. Patients developing POPF presented significantly higher values of POD1 serum amylase level (477 vs. 54 UI/L, p < 0.001), drain fluid amylase (7,500 vs. 127 UI/L, p < 0.001), TGFβ (94 vs. 40 pg/g, p = 0.045), and EGF (17 vs. 13, p = 0.015). There were no differences in terms of IGF-1 and IL-6 values.. Assessing the local inflammatory response after pancreatoduodenectomy could represent a promising field of research since both TGFβ and EGF seem to be associated with the occurrence of POPF.

Topics: Amylases; Drainage; Epidermal Growth Factor; Humans; Insulin-Like Growth Factor I; Interleukin-6; Pancreatic Fistula; Pancreaticoduodenectomy; Pilot Projects; Postoperative Complications; Risk Factors; Transforming Growth Factor beta; Transforming Growth Factors

BACKGROUNDAssessment of chronic kidney disease (CKD) risk after acute kidney injury (AKI) is based on limited markers primarily reflecting glomerular function. We evaluated markers of cell integrity (EGF) and inflammation (monocyte chemoattractant protein-1, MCP-1) for predicting long-term kidney outcomes after cardiac surgery.METHODSWe measured EGF and MCP-1 in postoperative urine samples from 865 adults who underwent cardiac surgery at 2 sites in Canada and the United States and assessed EGF and MCP-1's associations with the composite outcome of CKD incidence or progression. We used single-cell RNA-Seq (scRNA-Seq) of AKI patient biopsies to perform transcriptomic analysis of programs corregulated with the associated genes.RESULTSOver a median (IQR) follow-up of 5.8 (4.2-7.1) years, 266 (30.8%) patients developed the composite CKD outcome. Postoperatively, higher levels of urinary EGF were protective and higher levels of MCP-1 were associated with the composite CKD outcome (adjusted HR 0.83, 95% CI 0.73-0.95 and 1.10, 95% CI 1.00-1.21, respectively). Intrarenal scRNA-Seq transcriptomes in patients with AKI-defined cell populations revealed concordant changes in EGF and MCP-1 levels and underlying molecular processes associated with loss of EGF expression and gain of CCL2 (encoding MCP-1) expression.CONCLUSIONUrinary EGF and MCP-1 were each independently associated with CKD after cardiac surgery. These markers may serve as noninvasive indicators of tubular damage, supported by tissue transcriptomes, and provide an opportunity for novel interventions in cardiac surgery.TRIAL REGISTRATIONClinicalTrials.gov NCT00774137.FUNDINGThe NIH funded the TRIBE-AKI Consortium and Kidney Precision Medicine Project. Yale O'Brien Kidney Center, American Heart Association, Patterson Trust Fund, Dr. Adam Linton Chair in Kidney Health Analytics, Canadian Institutes of Health Research, ICES, Ontario Ministry of Health and Long-Term Care, Academic Medical Organization of Southwestern Ontario, Schulich School of Medicine & Dentistry, Western University, Lawson Health Research Institute, Chan Zuckerberg Initiative Human Cell Atlas Kidney Seed Network.

Topics: Acute Kidney Injury; Aged; Aged, 80 and over; Cardiac Surgical Procedures; Chemokine CCL2; Disease Progression; Epidermal Growth Factor; Female; Gene Expression Profiling; Humans; Incidence; Male; Postoperative Complications; Proportional Hazards Models; Renal Insufficiency, Chronic; RNA-Seq; RNA, Messenger; Single-Cell Analysis

Angiogenic effects of epidermal growth factor (EGF), a potent mitogen, have been demonstrated previously. Moreover, different in vitro studies showed that EGF affects processes associated with bone healing, such as osteoblast differentiation and bone resorption. The aim of this study was to investigate the effect of combined core decompression (CD) and recombinant human EGF (rhEGF) treatment on early-stage osteonecrosis of the femoral head (ONFH) surgically induced in rats. ONFH was induced by dissecting the cervical periosteum and placing a ligature tightly around the femoral neck. Thirty rats were assigned to one of the following groups (n = 10 each group): sham-operated control, CD, and CD+rhEGF group. rhEGF was injected intraosseously into infarcted areas 2 weeks after the surgery. Preservation of femoral head architecture was assessed at 8 weeks post treatment by radiographic and histomorphological analyses. Osteopontin (OPN) and cluster of differentiation 31 (CD31) were detected by immunochemistry, as indicators of bone remodeling and vascular density, respectively. Inter- and intra-group (non-operated left and operated right femur) differences in radiographic and histomorphological results were analyzed. The femoral head area and sphericity were more preserved in CD+rhEGF compared to CD and sham-control group. CD31 levels were significantly different between the three groups, and were higher in CD+rhEGF compared to CD group. OPN levels were increased in CD and CD+rhEGF groups compared to sham control, but with no significant difference between CD and CD+rhEGF groups. Overall, our results indicate that EGF promotes bone formation and microvascularization in ONFH and thus positively affects the preservation of femoral head during healing.

Topics: Angiogenesis Inducing Agents; Animals; Bone Remodeling; Epidermal Growth Factor; Femur Head; Femur Head Necrosis; Infusions, Intraosseous; Male; Neovascularization, Physiologic; Osteopontin; Platelet Endothelial Cell Adhesion Molecule-1; Postoperative Complications; Rats; Rats, Sprague-Dawley; Recombinant Proteins; Wound Healing

Hepatitis C virus (HCV) infection is accelerated following liver transplantation (LT). Single nucleotide polymorphisms (SNPs) near the epidermal growth factor (EGF) (rs4444903), IL28B (rs12979860), and PNPLA3 (rs738409) loci are associated with treatment response, fibrosis, and hepatocellular carcinoma in non-transplant hepatitis C, but allograft population data are limited. We sought to determine the role of these SNPs in 264 patients with HCV who underwent LT between 1990 and 2008. Genotypes were determined from donor wedge/allograft biopsies and recipient explants. Cox proportional hazards model was used to assess time to cirrhosis, liver-related death, and retransplantation, adjusting for donor age and sustained virological response (SVR). Over a median follow-up of 6.3 yr, a trend toward increased progression to graft cirrhosis was observed among recipients of an EGF non-AA vs. AA donor liver (adjusted HR 2.01; 95% CI 0.93-4.34; p = 0.08). No other genotypes predicted cirrhosis development or graft survival. The CC IL28B variant in both recipients and donors was associated with increased rate of SVR (R-CC/D-CC 8/12[67%], R-non-CC/D-CC or R-CC/D-non-CC 23/52[44%], R-non-CC/D-non-CC 12/45[27%], p linear trend = 0.009). Recipient EGF, IL28B, and PNPLA3, and donor IL28B and PNPLA3 genotypes do not predict adverse outcomes in HCV LT recipients. A potential association exists between donor EGF genotype and cirrhosis.

Topics: Adult; Allografts; Antiviral Agents; Carcinoma, Hepatocellular; Cohort Studies; Disease Progression; Epidermal Growth Factor; Female; Follow-Up Studies; Genotype; Graft Rejection; Graft Survival; Hepacivirus; Hepatitis C, Chronic; Humans; Interferons; Interleukins; Lipase; Liver Cirrhosis; Liver Neoplasms; Liver Transplantation; Male; Membrane Proteins; Middle Aged; Polymorphism, Single Nucleotide; Postoperative Complications; Prognosis; Risk Factors; Tissue Donors; Transplantation, Homologous; Young Adult

The effects of locally administered low-dose epidermal growth factor in a steroid-inhibited wound healing were investigated in a rat model.. Long-acting release of epidermal growth factor was enabled using microspheres embedded in gelatin sponge. Study groups consisted of 60 rats with 10 in each: colonic anastomosis only (C), plus pure gelatin sponge (CG), plus epidermal growth factor loaded sponge (CE), colonic anastomosis and steroid (S), plus gelatine sponge (SG), and plus epidermal growth factor-loaded gelatine sponge (SE) groups. Bursting pressure and wound hydroxy-proline content were measured. Bursting sites were recorded. Collagen deposits, inflammation, and foreign body reactions were evaluated.. Bursting pressure and hydroxy-proline contents were found lowest in the S and highest in the CE groups (P <.01). There was almost no difference between C and SE groups. Bursts were encountered in peri-anastomotic normal colon sites in the nonsteroid-treated C, CG, and CE groups. They were noted overwhelmingly at the anastomosis in steroid-inhibited S, SG, and SE groups. Histopathology results showed a standstill at the inflammatory phase of healing in S and SG groups. The best healing was observed in the CE group. Degree of collagen accumulation was well correlated with bursting pressure and hydroxy-proline content data with a negligible foreign body reaction to gelatine sponge.. Continuous local epidermal growth factor administration by microspheres in gelatin increases wound collagen and further enhances healing in colonic anastomoses even with steroid inhibition.

Topics: Anastomosis, Surgical; Animals; Colitis, Ulcerative; Collagen; Colon; Dexamethasone; Drug Evaluation, Preclinical; Drug Implants; Epidermal Growth Factor; Female; Foreign-Body Reaction; Gelatin; Hydroxyproline; Microspheres; Postoperative Complications; Pressure; Rats; Rats, Sprague-Dawley; Surgical Sponges; Surgical Wound Dehiscence; Suture Techniques; Tensile Strength; Wound Healing

Corneal wound healing is of critical importance for the postoperative outcome of excimer laser PRK. Wound healing is a complex biological process that is well characterised at the microscopic level, but its regulation is poorly understood at the molecular level. Among various cytokines, epidermal growth factor (EGF) plays an important role in superficial wound healing. The synthesis of EGF varies individually; therefore, by determining the EGF concentration in the tear fluid, patients with increased wound healing activity might be traced.. In this study we measured the EGF concentration pre- and postoperatively in the tear fluid of 50 eyes using a ELISA test. The preoperative refraction was between -2.00 and -10.00 dioptres. The maximum follow-up was 6 months.. Preoperatively, in all eyes the EGF concentration in the tear fluid was between 0.2 and 1.7 ng/ml. In contrast, 1 week postoperatively, these values increased (0.21-22.50 ng/ml); 4 weeks postoperatively, the EGF concentration was in all eyes back to preoperative levels. In eyes with high EGF tear fluid concentration 1 week after surgery, refraction at 6 months was outside the intended correction of +/- 1.0 D. We could not find any correlation between EGF concentration and "corneal haze".. EGF may play an important role in postoperative wound healing after excimer laser PRK. Investigations concerning a pharmaceutical control of EGF should be undertaken.

Topics: Adult; Corneal Opacity; Enzyme-Linked Immunosorbent Assay; Epidermal Growth Factor; Female; Follow-Up Studies; Humans; Lasers, Excimer; Male; Myopia; Photorefractive Keratectomy; Postoperative Complications; Refraction, Ocular; Tears; Vision Disorders; Wound Healing

It has been assumed that lens epithelial cells (LECs) existing at the capsulotomy edge have been traumatized through anterior capsulotomy in cataract extraction. In this study, the correlation between traumatized LECs remaining at the anterior capsulotomy edge and epidermal growth factor (EGF) found in the aqueous humor, a cell growth factor though to affect cell morphology, was determined. Anterior lens capsules with adhering LECs were obtained following anterior capsulotomy performed during cataract surgery to first confirm the presence of EGF receptors on LECs, which are needed for EGF to be biologically active. Besides, to identify any EGF receptors on traumatized LECs, I next intentionally traumatized the cells by pressing them with a forceps from the anterior capsular side. It has been found that the LECs containing EGF receptors were always those existing at the edge of the anterior capsular opening and LECs containing EGF receptors existed along the pressed region too. The present results indicate that traumatized LECs along the capsulotomy edge have undergone changes to manifest EGF receptors, thus allowing EGF from the aqueous humor to become more active. The physiological effect of EGF upon these LECs may therefore be one of the causative factors of fibrous opacification of the anterior capsulotomy edge after cataract extraction.

Topics: Aged; Aged, 80 and over; Aqueous Humor; Cataract; Cataract Extraction; Coloring Agents; Epidermal Growth Factor; Epithelial Cells; ErbB Receptors; Fibrosis; Humans; Lens Capsule, Crystalline; Middle Aged; Postoperative Complications; Trypan Blue; Wounds, Nonpenetrating

Our purpose was to determine the presence and cellular distribution of epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor in surgically induced pelvic fibrous adhesions in rat uterine horns subjected to burn, crush, and debridement injury and intraperitoneal fibrous adhesions formed to various organs in the human.. A total of 15 injured and five uninjured rats were used in this study, and fibrous adhesions and intact peritoneum were removed for processing 2 weeks after surgery. Fibrous adhesions formed to uterine, ovarian, and oviductal tissues and the peritoneal wall from eight patients who had gynecologic surgery were also collected. The tissues were processed for immunohistochemical localization of epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor with specific antibodies to human and rat epidermal growth factor and transforming growth factor-alpha and the extracellular binding domain of the epidermal growth factor receptor.. All the cell types in the rat fibrous adhesion immunostained for epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor. The highest immunostaining intensity for epidermal growth factor was associated with inflammatory cells infiltrated into the fibrous adhesion, followed by arteriole endothelial and smooth muscle cells, fascial striated muscle, and fibroblasts of the fibrous adhesion. In the uterine tissue at the site of injuries myometrial smooth muscle cells, in addition to inflammatory cells that migrated among stromal cells, also immunostained for epidermal growth factor. Fibrous adhesions also immunostained for transforming growth factor-alpha with three separate polyclonal antibodies to the amino and carboxy termini of transforming growth factor-alpha precursor and the mature transforming growth factor-alpha, with no substantial differences in their intensity and pattern compared with epidermal growth factor. The pattern and cellular distribution of epidermal growth factor receptor was similar to that seen for epidermal growth factor and transforming growth factor-alpha. Fibrous adhesions from patients with intraperitoneal adhesions immunostained for epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor with a pattern and intensity similar to that observed in fibrous adhesions in the rats.. The data suggest that epidermal growth factor and transforming growth factor-alpha may play a key role both in normal mechanism of peritoneal repair after injury and formation and maintenance of fibrous adhesions.

Topics: Animals; Epidermal Growth Factor; ErbB Receptors; Female; Humans; Ovary; Peritoneal Diseases; Peritoneum; Postoperative Complications; Rats; Rats, Sprague-Dawley; Tissue Adhesions; Transforming Growth Factor alpha; Uterine Diseases; Uterus

We carried out studies on the expression of liver-specific genes during regeneration of the liver and searched for changes in the expression of oncogenes and housekeeping genes. Albumin and ornithine transcarbamylase genes were the liver-specific genes examined by Northern blot analysis, using total RNAs isolated from residual livers of Sprague-Dawley rats subjected to a 68% partial hepatectomy. The mRNA levels of both genes began to decrease 8 hr after hepatectomy, both reaching the lowest levels at 24 hr, and then recovered to some extent at 48 hr. In contrast, these levels in the housekeeping and growth-related genes were augmented during this period. This would suggest that there is a selective expression of growth-related and housekeeping genes, in preference to liver-specific genes during liver regeneration. The expression of these genes in the regenerating liver was simulated in primary cultured hepatocytes during the dedifferentiation processes. It would appear that the first step in regeneration of the residual liver is dedifferentiation, in which the depression of liver-specific genes may be linked to liver dysfunction following hepatectomy.

Topics: Animals; Cells, Cultured; Epidermal Growth Factor; Gene Expression; Hepatectomy; Liver; Liver Diseases; Liver Regeneration; Ornithine Carbamoyltransferase; Postoperative Complications; Postoperative Period; Rats; Rats, Inbred Strains; Serum Albumin; Transcription, Genetic

The pathophysiological structure shows aggressors like increased acid and pepsin, an impaired defence system of the mucosa (mucus, mucosal circulation and possibly PG's and epidermal growth hormone). Disturbances in the interdigestive and digestive motility brings about most clearly the pathophysiological differences between GU and DU. Therapeutic corrections of the high secretion lead to pathological reactions in other parts of the system (gastrin). SPV is the only therapeutic procedure which reduces irreversibly the enlarged secretory capacity of the gastric mucosa (parietal cell reduction). This surgical treatment should therefore have priority in the treatment also of uncomplicated duodenal ulcers and with some exceptions of GU.

Topics: Duodenal Ulcer; Epidermal Growth Factor; Epithelium; Gastric Acid; Gastric Emptying; Gastric Mucosa; Gastrointestinal Motility; Histamine Release; Humans; Membrane Potentials; Postoperative Complications; Prostaglandins; Stomach Ulcer; Vagotomy, Proximal Gastric