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During several decades, patients with haemophilia have been treated using FVIII and FIX concentrates by haematologists working in specialized comprehensive haemophilia care centres. In the last fifteen years haemophilia treatments have been tremendously improved and novel treatment options have been developed. Gene therapy is one of these innovative approaches and will soon be available on the market. The European Association for Haemophilia and Allied Disorders and the European Haemophilia Consortium recently described a new healthcare setting for the management of patients who will receive gene therapy. This hub-and-spoke model aims to ensure the safe administration and monitoring of gene therapy by expert comprehensive haemophilia care centres, in close collaboration with the proximity haemophilia treatment centres where the patient is followed up. Any adverse events should be managed by both the expert "hubs" in collaboration with the spoke centre to provide the timeliest state-of-the-art treatment and management options to patients receiving gene therapy. All adverse events and efficacy data should be reported lifelong to a centralised registry. French reference centre for haemophilia and the patient's organization AFH worked together to adapt the European Hub and spoke model to the existing infrastructures and organization for rare bleeding disorders in France. This review describes the haemophilia patient's journey for gene therapy in France. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Haemangioma is the most frequent benign hepatic tumour. Haemangioma is generally asymptomatic but it can sometimes cause disabling symptoms depending on its size and location. Surgery and interventional radiology are the cornerstone of the treatment in this situation. Radiation therapy, already used with good efficacy and safety to treat hepatic malignant lesions as hepatocarcinoma and metastases, is a relevant option in case of contraindication to surgery because of multiple or very large lesions. In this context, we report the case of a patient presenting with multiple symptomatic hepatic haemangiomas, successfully treated by radiation therapy in our department. These good results justified a review of the literature to report series of patients treated in this indication and to describe the main treatment regimens used. [ABSTRACT FROM AUTHOR]

We present the update of the recommendations of the French society of oncological radiotherapy on hepatic tumours. Recent technological progress led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumours, as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. The tumour volume, its liver location close to the organs at risk determine the irradiation technique (repositioning method, total dose delivered, dose fractionation regimens). Tumour (and liver) breathing related motions should be taken into account. Strict dosimetric criteria must be observed with particular attention to the dose–volume histograms of non-tumoral liver as well as of the hollow organs, particularly in case of hypofractionated high dose radiotherapy "under stereotaxic conditions". Stereotactic body radiotherapy is being evaluated and is often preferred to radiofrequency for primary or secondary tumours (usually less than 5 cm). An adaptation can be proposed, with a conformal fractionated irradiation protocol with or without intensity modulation, for hepatocellular carcinomas larger than 5 cm. [ABSTRACT FROM AUTHOR]

Résumé: L'échinococcose kystique hépatique (EKH), dénomination remplaçant désormais celle de kyste hydatique, est une zoonose parasitaire cosmopolite. Elle sévit principalement dans les pays où l'élevage de moutons constitue une ressource importante, expliquant qu'en France la majorité des patients soient des migrants. L'homme est un hôte intermédiaire accidentel. Le foie est l'organe préférentiel pour le développement du stade larvaire d' Echinococcus granulosus (E. g) sensu lato. La progression d'une lésion d'EKH est extrêmement lente, comparable à celle d'un processus tumoral bénin. La présentation clinique est d'une grande diversité, souvent totalement asymptomatique et de découverte fortuite mais parfois révélée par un tableau clinique aigu pouvant mettre en jeu le pronostic vital, témoin d'une complication évolutive dont la plus fréquente expression est la fissuration du kyste dans les voies biliaires. Le diagnostic repose sur l'examen échographique de la lésion en se référant à la classification de l'OMS permettant d'en apprécier le stade évolutif qui guidera la réflexion de prise en charge. Selon la situation, pourront être proposés une simple surveillance ou un traitement combinant, selon le cas, prise médicamenteuse, sous la forme d'albendazole à activité parasitostatique, techniques instrumentales et chirurgie. L'hépato-gastroentérologue est en première ligne à chacune de ces étapes à l'issue desquelles les décisions bénéficient grandement d'une réflexion pluridisciplinaire permettant aussi d'éviter un sur-traitement. Des études prospectives sont en effet indispensables pour progresser sur les aspects thérapeutiques qui, à ce jour, reposent essentiellement sur avis d'experts. L'observatoire national de l'EK, OFREKYS initié depuis 2018 par le CNR Échinococcoses au CHU de Besançon devrait contribuer à la meilleure connaissance de cette parasitose dans notre pays. Cystic echinococcosis (CE), a denomination now replacing that of hydatid cyst, is a cosmopolitan parasitic zoonosis. It is present mainly in countries where sheep farming constitutes an important resource explaining that in France, the majority of patients are migrants. Humans is an accidental intermediate host. The liver is the organ of choice for the development of the larval stage of Echinococcus granulosus (E. g) sensu lato. The progression of the cyst is extremely slow, comparable to that of a benign tumor. The clinical presentation is of great diversity, often completely asymptomatic and of fortuitous discovery but sometimes revealed by an acute clinical picture which can be life-threatening, related to complications. The most frequent one is the cyst rupture within the bile ducts. The diagnosis is based on the ultrasound examination using the WHO classification. It also allows to assess the evolutionary stage that is crucial to make treatment decisions. Depending on the situation, simple monitoring or a treatment combining, as the case may be, medication in the form of a parasitostatic, albendazole, instrumental techniques and surgery may be offered. The hepato-gastroenterologist is on the front line at each of these steps, at the end of which decisions benefit greatly from a multidisciplinary discussion. This also makes it possible to avoid over-treatment. Prospective studies are needed to progress on the therapeutic aspects which, to date, are essentially based on expert opinion. The French observatory of CE, OFREKYS, initiated in 2018 by the National Reference Center on Echinococcosis at Besançon University Hospital should contribute to better knowledge of this disease in our country. [ABSTRACT FROM AUTHOR]

Malignant melanoma is a disease with high metastatic potential which starts in melanocytes. The liver is the organ most often targeted for metastatic spread. Nonetheless, primary liver melanoma is very rare. Few cases have been described. We here report the case of a female patient with primary liver melanoma diagnosed based on liver biopsy results and confirmed by histological and immunohistochemical analyses as well as by providing a comprehensive assessment excluding other localizations. [ABSTRACT FROM AUTHOR]

In patients with right-sided breast cancer (BC) the liver might be partially irradiated during adjuvant radiotherapy (RT). Thus, we performed a prospective observational study to evaluate the dose delivered to the liver, and its potential biological impact. We enrolled 34 patients with right-sided BC treated with adjuvant RT. The RT schedules were either the Canadian (42.5 Gy in 16 fx) or standard fractionated (50 Gy in 25 fx) regimen respectively with 9 (26.5%) and 25 (73.5%) patients each, ± a boost of 10–16 Gy. Each patient had a complete blood count and liver enzymes analysis, before starting and during the last week of treatment. A significant decrease in white blood cells and thrombocytes counts was observed during RT. We observed a significant correlation between certain hepatic parameters and the volume of the irradiated liver and/or the mean liver dose. A significant correlation between the volume of the right lung and the liver mean dose was found (P = 0.008). In the bivariate analysis, a significant correlation between fatigue and the white blood cell count's evolution was observed (P < 0.025). With the standard RT technique, incidental irradiation of the liver was documented in a large number of patients, and some significant hepatic parameters alterations were observed, without an apparent clinical impact, but this study cannot exclude them. The liver mean dose was correlated with the right lung volume suggesting that deep inspiration breath hold (DIBH) techniques may represent a way to decrease the liver dose. These findings need to be evaluated in further larger studies. [ABSTRACT FROM AUTHOR]

Sucrose drink induced obesity and metabolic syndrome in human and animal models. However, age-specific metabolic effects of sucrose beverages are not clear yet. The purpose of this study was then to investigate changes in plasma biochemical parameters, oxidative stress markers, as well as lipid and redox contents and lipolytic activities in insulin target organs (liver, adipose tissue) in sucrose drinking rats at 10% and 30% during one month (day 30) and three months (day 90). Our results emphasized that sucrose drink induced obesity, adipose tissue accumulation with hyperinsulinemia, hyperglycemia, hyperlipidemia, liver steatosis, alterations in lipases activities and oxidative stress. These metabolic alterations were worsened by the amount of sucrose in the drink (30% versus 10%). The changes were apparent in young rats at day 30 and persisted until adulthood at day 90. Adult rats presented more sucrose-induced-metabolic abnormalities. In conclusion, sucrose drink induced an early increase in metabolic syndrome components. These data indicate the need of corrective nutritional intervention for young people and also for adults. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Le traitement des larges fistules kysto biliaires ne fait pas l´unanimité des auteurs en l´absence de consensus ou de niveau de preuve élevé. Les méthodes chirurgicales sont controversées entre traitement radical permettant de suturer la fistule en zone saine et le traitement conservateur qui pose des problèmes de réparation. Le but de cette étude est de comparer les différentes techniques chirurgicales du traitement conservateur des larges fistules kysto-biliaires. METHODESetude rétrospective de 54 fistules larges, menée au service de chirurgie générale du CHU Habib Bourguiba à Sfax durant 9 ans (2010 - 2018). RESULTATS: il s´agit de 44 patients. L´échographie abdominale a permis de suspecter une ouverture dans les voies biliaires dans 18 cas (47,4%) alors que la TDM, a suspecté une ouverture chez 28 patients (68.3%). Le traitement des fistules était réalisé par la technique du DITFO dans 18 cas (33,3%), de PERDROMO dans 11 cas (20,4%) et le drainage bipolaire dans 25 cas. Le taux de morbidité chirurgicale spécifique était de 31,5% dominé par une fistule biliaire post opératoire dans 18,5% des cas. La technique de DITFO était associée à un séjour hospitalier le plus court (p=0,028) et une morbidité plus basse (22,2%) sans différence statistiquement significative. CONCLUSION:la technique de DITFO représente la technique de choix dans le traitement des FKB, elle a une morbidité moins élevée et le séjour hospitalier le plus court.

Grâce à une organisation histologique particulière, le foie permet l'assimilation de la plupart des nutriments et l'élimination des éléments toxiques ou pathogènes provenant du tractus digestif. Par ailleurs, la synthèse hépatique de la bile autorise l'absorption des lipides. Le foie joue aussi un rôle important dans de nombreuses fonctions physiologiques car c'est un lieu de synthèse et/ou de stockage majeur pour de nombreux éléments, notamment des protéines, des glucides, des vitamines et des ions. [ABSTRACT FROM AUTHOR]

Résumé: Les parasitoses hépatiques restent très fréquentes en Afrique où le niveau d'hygiène est précaire. Elles relèvent d'un problème de santé publique, associées à une mortalité considérable avec des expressions cliniques polymorphes. Deux grands groupes de parasitoses sont identifiés : les parasitoses dues aux protozoaires et celles dues aux métazoaires. L'amœbose hépatique, la schistosomose, l'échinococcose kystique, le paludisme et la leishmaniose viscérale sont les plus fréquentes. Le foie par son rôle de carrefour vasculaire, métabolique et immunitaire est atteint par les parasites. Pour les parasites ingérés, mais aussi pour ceux dont la migration implique un passage dans les vaisseaux drainés par le système porte, le foie est un site anatomique privilégié. Hepatic parasitosis remains very frequent in Africa where the level of hygiene is precarious. They are part of a public health problem, associated with considerable mortality with polymorphic clinical expressions. Two groups of parasitosis are identified: parasitosis caused by protozoa and those caused by metazoa. Liver amoebosis, schistosomiasis, cystic echinococcosis, malaria and visceral leishmaniasis are the most common. The liver, through its role as a vascular, metabolic and immune crossroads, is affected by parasites. For ingested parasites, but also for those whose migration involves passage through vessels drained by the portal system, the liver is an anatomical site of choice. [ABSTRACT FROM AUTHOR]

Introduction: the treatment of large biliocystic fistulas is not unanimous among authors in the absence of consensus or a high level of evidence. There is a controversy over the use of a radical approach which allows the fistula to be sutured in a healthy area or conservative treatment that poses repair issues. The purpose of this study is to compare different conservative techniques to treat large biliocystic fistulas. Methods: we conducted a retrospective study of 54 patients with large fistulas in the Department of General Surgery at the Habib Bourguiba University Hospital in Sfax over a period of 9 years (2010 - 2018). Results: fourty-four patients were enrolled in the study. Abdominal ultrasound suggested opening of the bile ducts in 18 cases (47.4%) while computed tomography (CT) scan suggested opening in 28 patients (68.3%). The treatment of fistulas was based on DITFO (internal trans-fistulary drainage) in 18 cases (33.3%), cystobiliary disconnection (PERDROMO) in 11 cases (20.4%) and bipolar drainage in 25 cases. Specific surgical morbidity rate was 31.5% and it was dominated by postoperative biliary fistula in 18.5% of cases. DITFO technique was associated with shorter hospital stay (p=0.028) and lower morbidity rates (22.2%) with no statistically significant difference. Conclusion: DITFO technique is the gold standard technique in the treatment of biliocystic fistula because it is associated with lower morbidity rates and the shortest hospital stay. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a disease whose physiopathology remains unclear, involving both inflammatory processes and clonal proliferation. It is observable at any given age, although about ten times more frequent in children than adults. Hepatic involvement is not rare, mostly part of a systemic disease, and linked to a poor prognosis. We report here a case of LCH with solitary hepatic involvement in a 74 year-old patient. This case demonstrated molecular anomaly of the MAPK pathway, BRAF N486&#95;P490del. Through this observation, we precise the epidemiological and histological aspects and diagnostic criteria of this rare disease., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Le pancréas ectopique (ou aberrant ou hétérotopie pancréatique) se définit par la présence de tissu pancréatique en situation anormale, sans rapport anatomique avec la glande principale. Son incidence est estimée entre 0,5 et 14 % sur les séries autopsiques, mais est probablement sous-estimée du fait de son caractère le plus souvent asymptomatique. Les localisations habituelles sont représentées par le duodénum (30-35%), l´estomac (30%) et le jéjunum (15%). Sa localisation hépatique est exceptionnelle. Nous en rapportons un nouveau cas de découverte fortuite. Il s´agit d´une patiente âgée de 54 ans, hypertendue, opérée deux ans auparavant pour un adénocarcinome du sigmoïde classé pT3N1b (A). L´évolution était marquée par l´installation de multiples nodules d´allure secondaire prédominant au niveau du lobe hépatique droit (B), d´où l´instauration d´une chimiothérapie néo-adjuvante (4 cures FOLFOX-ERBITUX). La patiente a bénéficié d´une lobectomie droite. L´examen histologique des différents prélèvements effectués a confirmé la présence d´une localisation secondaire hépatique d´un adénocarcinome moyennement différencié d´origine colorectale avec des limites d´exérèse saines. Le foie alentour était le siège d´une stéatose macrovacuolaire non systématisée estimée à 20%. Il s´y associait un foyer d´hétérotopie pancréatique englobant des acini et des canaux excréteurs organisés en lobule (C, D). Les suites opératoires immédiates étaient simples, cependant, l´évolution a été marquée par la récidive tumorale au niveau du foie gauche.

Il s'agit d'une patiente de 29 ans, reçue pour une toux évoluant depuis 7 jours. La radiographie du thorax montrait un parenchyme pulmonaire normal. Cependant, on notait une clarté sous la coupole diaphragmatique droite réalisant le signe de Chilaïditi. Un traitement médical pour les symptômes respiratoires avait permis une bonne évolution. Le signe de Chilaïditi est caractérisé par l'interposition d'une portion de l'intestin, le plus souvent le côlon, entre le foie et la coupole diaphragmatique droite. Il pose le problème de diagnostic différentiel avec le pneumopéritoine, d'où sa seconde appellation: pseudo-pneumopéritoine. Une bonne connaissance de ce signe permet d'éviter des gestes diagnostiques et/ou thérapeutiques inutiles.

La stéatohépatite non-alcoolique (NASH) est une maladie du foie responsable de complications et de mortalité de causes hépatique (fibrose, cirrhose, hépatocarcinome) et extra-hépatique (insulinorésistance, maladies cardiovasculaires). Actuellement, il n'existe pas de traitement approuvé dans cette indication. Toutefois, une perte de poids de 5 à 10 % du poids initial permet d'améliorer l'histologie hépatique. Cet objectif est cependant, soit difficile à atteindre chez tous les patients, soit peu efficace ou pas indiqué en cas de diagnostic de la maladie à un stade de cirrhose irréversible. Différents médicaments, à notre disposition dans le contexte dysmétabolique, sont présentés (statines, metformine...) avec leur impact sur la maladie hépatique. Récemment, de nombreux traitements à l'étude ont donné des résultats modestes mais encourageants. Plusieurs composés testés en phase 2 sont expliqués dans cet article, dont les agonistes FXR et TGR5, agonistes PPARα/δ/γ, le FGF21 recombinant, l'analogue du FGF19, l'agoniste du récepteur thyroïdien β1, les agonistes GLP-1, les inhibiteurs de la lipogenèse, l'antagoniste CCR2/5... Les résultats les plus avancés concernent l'évaluation intermédiaire de l'étude de phase 3 de l'acide obéticholique (agoniste FXR) qui a notamment confirmé une régression de la fibrose hépatique avec ce traitement. Quatre autres composés sont actuellement également testés en phase 3. L'article fait également le point sur le bénéfice potentiel d'une combinaison de traitements. D'autres pistes thérapeutiques, comme la chirurgie de l'obésité, la modulation du microbiote et l'endoscopie bariatrique, sont exposés. Non-alcoholic steatohepatitis (NASH) is a liver disease responsible for complications and mortality from hepatic (fibrosis, cirrhosis, hepatocellular carcinoma) and extrahepatic (insulin resistance, cardiovascular diseases) causes. Currently, there is no approved treatment for this indication. However, a weight loss of 5 to 10 % of the initial body weight is able to improve liver histology. However, it is difficult to achieve in all patients or ineffective/not indicated if the disease is diagnosed at an irreversible cirrhosis stage. Different drugs available in the dysmetabolic context are presented (statins, metformin, etc.) with their impact on liver disease. Recently, numerous agents have shown modest but positive results. Several compounds tested in phase 2 trials are explained in this article, including FXR or TGR5 agonists, PPARα/δ/γ agonists, recombinant FGF21, FGF19 analog, thyroid receptor agonist β1, GLP-1 agonists, inhibitors of lipogenesis, CCR2/5 antagonist... The most advanced results concern the interim analysis of the phase 3 study on obeticholic acid (FXR agonist) which notably confirmed a regression of hepatic fibrosis with this treatment. Four other compounds are also currently tested in phase 3 trials. The multi-mechanistic strategy of a combination therapy is also discussed. Other therapeutic approaches such as obesity surgery, microbiota modulation and bariatric endoscopy are exposed. [ABSTRACT FROM AUTHOR]

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Résumé: Les hépatopathies gravidiques sont les atteintes hépatiques les plus fréquentes au cours de la grossesse et peuvent être classées en fonction de leur survenue précoce (hyperemesis gravidarum) ou plus tardive (cholestase gravidique, foie toxémique incluant le HELLP syndrome et stéatose hépatique aiguë gravidique) au cours de la grossesse. Les anomalies du bilan hépatique associées aux vomissements sévères de la grossesse se corrigent après arrêt des vomissements. La cholestase gravidique est l'affection la plus fréquente et se caractérise par un prurit associé ou non à une augmentation des transaminases. L'acide ursodésoxycholique doit être débuté précocement et poursuivi jusqu'à l'accouchement. Le taux des acides biliaires est utile au diagnostic en cas de prurit sans anomalie du bilan hépatique et a une bonne valeur pronostique pour prédire le risque de mort fœtale in utero et la nécessité d'un accouchement prématuré. Les anomalies du bilan hépatique avec ou sans HELLP, associées à une pré-éclampsie se caractérisent par une cytolyse avec un risque d'hématome sous-capsulaire du foie. La stéatose hépatique aiguë gravidique est une maladie rare et grave qui se caractérise par des anomalies initialement modérées du bilan hépatique puis rapidement un ictère et une insuffisance hépatocellulaire. Le diagnostic se fait essentiellement par les critères composites de Swansea et par l'évolution de la stéatose à l'IRM en post-partum. Le traitement dans les formes graves repose sur l'évacuation utérine. En cas de retard de diagnostic et de prise en charge, le pronostic de la mère et de l'enfant est engagé. Pregnancy-related liver diseases are the most common cause of liver dysfunction in pregnancy. They can be classified as early (hyperemesis gravidarum) and later (intrahepatic cholestasis of pregnancy, pre-eclampsia with hepatic involvement including HELLP syndrome and acute fatty liver of pregnancy) specific liver diseases. Abnormal liver blood tests associated with severe vomiting of pregnancy resolve on cessation of vomiting. Intrahepatic cholestasis of pregnancy is the commonest pregnancy-specific liver disease and characterized by pruritus associated or not with elevated transaminases. Ursodeoxycholic acid should be prescribed early and continued until delivery. Serum bile acids level is useful for diagnosis in the event of pruritus without abnormal liver blood tests and has a good prognostic value for predicting stillbirth and the need of preterm delivery. Abnormal liver blood tests with or without HELLP syndrome, associated with pre-eclampsia are characterized by high transaminases levels with a risk of sub-capsular liver hematoma. Acute fatty liver of pregnancy is a rare and severe complication characterized by initially moderate liver tests abnormalities, rapidly evolving towards jaundice and hepatocellular insufficiency. The diagnosis is based on the Swansea composite criteria and by the resolution of steatosis on MRI during post-partum. The treatment in the severe forms is based on the rapid uterine evacuation. In the event of delayed diagnosis and/or need of supportive care, the prognosis is poor for the mother and the foetus. [ABSTRACT FROM AUTHOR]

Le foie est un organe filtre majeur et, de fait, peut héberger un certain nombre de parasites. Il peut s'agir aussi bien de protozoaires, c'est-à-dire de parasites unicellulaires, que d'helminthes beaucoup plus volumineux. Certains de ces parasites induisent une maladie essentiellement hépatique, tandis que d'autres sont impliqués dans un tableau multi-organes. Leur diagnostic n'est pas toujours aisé car il peut s'agir d'une localisation hépatique avec peu de répercussions sur le fonctionnement de l'organe, ou même d'une impasse parasitaire. Dans d'autres situations, la symptomatologie sera beaucoup plus bruyante à l'image d'un abcès amibien hépatique. C'est pourquoi, le diagnostic associe des techniques de mise en évidence directe du parasite à la sérologie et à l'imagerie. De manière intéressante, d'un point de vue tissulaire, le foie est capable de répondre très différemment à ces infections, avec une réponse qui peut être nécrotique, granulomateuse ou fibrotique. Les différents protozoaires pouvant être responsables d'atteintes hépatiques sont détaillés dans cet article. The liver is an organ assuming an important role in blood filtering, and because of that it can be in contact with numerous parasites. Protozoa i.e. unicellular eukaryotes, but also helminths that are much more voluminous can be responsible for hepatic localization. Some of them induce a disease mostly with hepatic symptoms, while others are involved in multi-organ manifestations. Diagnosis is sometimes difficult because of few functionnal consequences, or the parasite can even stop its development. Clinical manifestations can also be severe, as for the amoebic abscess of the liver. For these reasons, diagnosis combines direct exam with serology and imagery. Interestingly, the liver tissues are able to respond variously to these infections, with an immune reaction that can be necrotic, granulomatous or fibrotic. The different protozoan infecting liver are detailed in this article regarding their impact on liver functions. [ABSTRACT FROM AUTHOR]

La radiothérapie stéréotaxique hépatique est une technique de traitement en développement pour le traitement des tumeurs primitives et secondaires. Sa mise en œuvre est complexe du fait des particularités de l'organe traité et des comorbidités des patients. Elle représente cependant une opportunité de traitement efficace pour beaucoup de patients en impasse thérapeutique. Son niveau de preuve est jugé insuffisant par la Haute Autorité de Santé (HAS) pour une large diffusion en dehors des centres expérimentés. Il existe pourtant un nombre conséquent et grandissant d'études rétrospectives ou prospectives, mais peu de données comparatives. Cet article résume les particularités de la radiothérapie stéréotaxique pour cette localisation et reprend les résultats des études publiées pour les machines dédiées et non dédiées. Liver stereotactic body radiotherapy is a developing technique for the treatment of primary tumours and metastases. Its implementation is complex because of the particularities of the treated organ and the comorbidities of the patients. However, this technique is a treatment opportunity for patients otherwise in therapeutic impasse. The scientific evidence of liver stereotactic body radiotherapy has been considered by the French health authority as insufficient for its widespread use outside specialized and experienced centers, despite a growing and important number of retrospective and prospective studies, but few comparative data. This article focuses on the specific features of stereotactic body radiotherapy for liver treatments and the results of published studies of liver stereotactic body radiotherapy performed with classic linear accelerators and dedicated radiosurgery units. [ABSTRACT FROM AUTHOR]

Résumé: Les kystes simples ou biliaires sont très fréquents et le plus souvent asymptomatiques. Ce travail présente les éléments permettant de faire le diagnostic de cette lésion fréquente mais également des autres causes de lésions kystiques du foie. Cet article décrit l'aspect des kystes simples, de leurs formes compliquées et des autres lésions d'allure kystique telles que les lésions kystiques néoplasiques, inflammatoires et d'origine congénitale. En tenant compte du contexte clinique, le diagnostic repose sur le nombre de lésions, leur dissémination et leur aspect après injection d'un produit de contraste. Une approche systématique est nécessaire pour diagnostiquer les différentes lésions kystiques du foie. Un arbre décisionnel est proposé pour aider le clinicien. Benign and asymptomatic liver cysts are very frequent. This work presents the imaging features of these lesions but also other mimicking lesions. This article describes imaging features of uncomplicated and complicated liver cysts, cystic mass of various origins, such as developmental, neoplastic or inflammatory. The diagnostic approach should take in account the clinical context, the lesion number, their dissemination and their patterns before and after contrast media injection. A systematic approach is required to diagnose the large amont of liver cyst and a diagnostic tree is proposed to help the clinician. [ABSTRACT FROM AUTHOR]

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Copyright of Archives of Razi Institute is the property of Institut Razi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Razi Institute is the property of Institut Razi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le foie est un organe filtre majeur et, de fait, peut héberger un certain nombre de parasites. Il peut s'agir aussi bien de protozoaires, c'est-à-dire de parasites unicellulaires, que d'helminthe, beaucoup plus volumineux. Certains de ces parasites induisent une maladie essentiellement hépatique, tandis que d'autres sont impliqués dans un tableau multi-organe. Leur diagnostic n'est pas toujours aisé car il peut s'agir d'une localisation hépatique avec peu de répercussions sur le fonctionnement de l'organe, ou même d'une impasse parasitaire. Dans d'autres situations, la symptomatologie sera beaucoup plus bruyante. C'est pourquoi, le diagnostic associe des techniques de mise en évidence directe du parasite à la sérologie et à l'imagerie. De manière intéressante, d'un point de vue tissulaire, le foie est capable de répondre très différemment à ces infections, avec une réponse qui peut être nécrotique, granulomateuse ou fibrotique. The liver is an organ assuming an important role in blood filtering, and because of that it can be in contact with numerous parasites. Protozoa i.e. unicellular eukaryotes, but also helminths that are much more voluminous can be responsible for hepatic localization. Some of them induce a disease mostly with hepatic symptoms, while others are involved in multi-organ manifestations. Diagnosis is sometimes difficult because of few functionnal consequences, or the parasite can even stop its development. Clinical manifestations can also be severe. For these reasons, diagnosis combines direct exam with serology and imagery. Interestingly, the liver tissues are able to respond variously to these infections, with an immune reaction that can be necrotic, granulomatous or fibrotic. [ABSTRACT FROM AUTHOR]

Résumé: L'évaluation et la prise en charge des maladies du foie sont essentielles pour améliorer la survie des patients d'hématologie, notamment après greffe de cellules hématopoïétiques allogéniques. Donner un avis de consultant hépato-gastroentérologue est, en général, compliqué lorsque le patient a un cancer en cours de traitement, et qu'il développe un ictère, une prise de poids, une ascite, de la fièvre, des douleurs de l'hypochondre droit, et des tests hépatiques anormaux. Les avancées dans le domaine de la biologie moléculaire diagnostique et de l'imagerie ont rendu les démarches diagnostiques plus simples, et la biopsie hépatique n'est maintenant indiquée que dans de rares situations. Les algorithmes diagnostiques et thérapeutiques sont plus clairs pour orienter le clinicien et débuter rapidement un traitement. L'hématologie est une spécialité en pleine expansion et de nombreux médicaments arrivent sur le marché sans que leur sécurité hépatique soit parfaitement cernée. L'objectif de cette revue est de fournir au lecteur les clés pour être un praticien averti dans le domaine des maladies du foie des patients d'hématologie. The evaluation and management of liver diseases is essential to improve the survival of hematology patients, especially after transplantation of allogeneic hematopoietic cells. The consulting hepatologist may never see a more complex patient than a patient with cancer who develops jaundice, fluid retention, fever, liver pain, and abnormal serum liver tests – and in contrast to the situation where patients have a single diagnosis, there may be multiple causes of liver dysfunction in such a patient. However, medical progress in liver imaging and molecular methods of viral diagnosis have made evaluations more straight-forward, such that liver biopsy can be confined to the most puzzling cases. Diagnostic and therapeutic algorithms are clearer in guiding the clinician and starting treatment quickly, but one long-term goal should be to prevent liver injury in the first place. Hematology is a growing specialty and many drugs are coming to the market without their liver safety being fully understood. The purpose of this review is to provide the reader with the keys to be a knowledgeable practitioner in the field of liver disease in hematology patients. [ABSTRACT FROM AUTHOR]

Pyogenic liver abscess is characterized by a collection of pus in a neoformed cavity of the hepatic parenchyma. The most common complication is the rupture in the peritoneal, pleural or pericardial cavities. We describe a rare case of pyogenic liver abscess complicated by inferior vena cava thrombosis and bile duct compression. This is a 54-years-old patient, smoking, and alcoholic, who was received for pain of the right hypochondrium evolving for a month secondarily associated with jaundice. Examination of the abdomen found painful hepatomegaly with swelling of the right hypochondrium. The CT scan showed a segment II and IV abscess with compression on the superior biliary confluent with moderate dilatation of the intrahepatic bile ducts (Figure 1). There was also partial thrombosis of the inferior vena cava probably extended to the bilateral iliac and femoral veins confirmed by venous Doppler ultrasonography of the lower limbs. Drainage guided by ultrasonography with antibiotherapy and curative anticoagulation was initiated. The initial evolution was unfavorable towards death on the third day by probable pulmonary embolism. The abscess of the liver is a serious pathology. The occurrence of vena cava thrombosis with compression of the bile ducts is rare. Early diagnosis improves the prognosis. [ABSTRACT FROM AUTHOR]

Résumé: Les myopathies sont une cause rare de perturbations du bilan hépatique. Il peut s'agir d'une élévation des transaminases d'origine musculaire à différentier d'une atteinte hépatique qu'il faut reconnaitre pour éviter les explorations inutiles. Les perturbations peuvent aussi s'inscrire dans un cadre plus large où les atteintes hépatiques et musculaires ne sont que les symptômes d'une maladie sous-jacente, comme c'est le cas des cytopathies mitochondriales ou des maladies métaboliques. L'hépato-gastroentérologue doit connaître ces affections pour évoquer le diagnostic devant un bilan de cytolyse inexpliquée et orienter le malade vers une prise en charge spécialisée. Myopathies are rare causes of abnormal liver function tests. Muscular cytolysis, responsible for increase of transaminases predominant on AST, has to be recognized to avoid unnecessary investigations. The abnormalities might also be related to broader spectrum of diseases associating liver and muscular injuries such mitochondrial cytopathy or some metabolic diseases. Therefore, the hepato-gastroenterologist should always consider these extra-hepatic diseases when facing the problem of unexplained raise of transaminases for accurate diagnosis and treatment. [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate the impact of organic extracts of Bunium incrassatum seeds (Talghouda) on the evolution of some hematological parameters. The study was conducted on rabbits of the local population Oryctolagus cuniculus) the animals were divided into five groups and given daily orally at doses of 0.25, 50, 100 and 200 mg/kg/day. Dose 0 was taken as a control. After treatment, the rabbits were sacrificed, the organs were removed and fixed in 10% formalin and then stained with hematoxylin and eosin and the blood was collected in two tubes, one containing anticoagulant EDTA, and the other dry for the measurement of the different parameters. The obtained results show that treatment with the organic extract of Bunium incrassatum induced an increase in the body weight of treated rabbits compared to the control, as well as effects on the hematological parameters, characterized mainly by a significant increase in the rate of lymphocytes, hemoglobin. This result coincides with the increase in the relative weight of the kidney and liver target organs. We conclude that the components of this medicinal plant may, at specific doses, have a positive effect on certain hematological parameters. [ABSTRACT FROM AUTHOR]

La rupture intrapéritonéale du kyste hydatique du foie avec une membrane proligère intacte est rare. Nous rapportons le cas d'une patiente âgée de 63 ans qui avait consulté pour douleur de l'hypochondre droit sans fièvre ni ictère. L'imagerie trouvait un kyste hydatique du segment IV du foie associé à une lésion kystique pelvienne de 12cm x 06cm. L'exploration chirurgicale trouvait un kyste hydatique univésiculaire du foie rompu avec une membrane proligère intacte et libre dans la cavité péritonéale. Le but de ce travail est de rapporter un nouveau cas de rupture intrapéritonéale d'un kyste hydatique du foie avec membrane proligère intacte et de préciser les difficultés diagnostiques et thérapeutiques rencontrées au décRupture of hydatid cyst of liver with intact proligerous membrane is rare. We report the case of a 63 year-old female patient presenting with right hypocondrium pain without fever or jaundice. Diagnostic imaging examination showed hydatid cyst in segment IV of liver associated with pelvic cystic lesion measuring 12 cm x 06 cm. Surgical exploration revealed ruptured unilocular hydatid cyst of the liver with intact proligerous membrane and free in the peritoneal cavity. This study aims to report a new case of intraperitoneal rupture of hydatid cyst of liver with intact proligerous membrane and to highlight the diagnostic and therapeutic difficulties due to this complication.de cette complication.

Ectopic pancreas (or aberrant or pancreatic heterotopia) is defined as pancreatic tissue outside the boundaries of the pancreas, without anatomic connection to the main gland. Its incidence is between 0.5% and 14% in autopsy series, but it is probably underestimated because it is often asymptomatic. It most commonly affects the duodenum (30-35%), the stomach (30%), and the jejunum (15%). Hepatic involvement is exceptional. We here report a new case of unexpected detection. The study involved a 54-year-old, hypertense female patient who had undergone surgery for adenocarcinoma of the sigmoid classified pT3N1b (A) two years before. Disease progression was marked by the occurrence of multiple predominant secondary nodules in the right hepatic lobe (B). Neoadjuvant chemotherapy (4 cicles of FOLFOX-ERBITUX) was started. The patient received right lobectomy. The histological examination of the different surgical specimens confirmed the presence of secondary, moderately differentiated hepatic adenocarcinoma of colorectal origin with healthy surgical excision margins. The surrounding liver was the site of unsystematized macrovacuolar steatosis in 20% of cases. It was associated with a focus of pancreatic heterotopia, including some acini and excretory canals arranged in lobules (C, D). The postoperative course was simple; however, patient's outcome was marked by recurrence of cancer in the left lobe of the liver. [ABSTRACT FROM AUTHOR]

Résumé: Les symptômes gastro-intestinaux liés au coronavirus SARS-CoV-2 initialement décrits comme rares sont rapportés de plus en plus fréquemment. La diarrhée est le symptôme digestif le plus fréquent mais reste habituellement d'intensité modérée quel que soit le stade de l'infection. Ces symptômes sont le plus souvent le témoin une maladie respiratoire plus sévère. Les symptômes digestifs sont rarement isolés mais peuvent précéder l'atteinte respiratoire. Les atteintes hépatique et pancréatique sont minimes et transitoires et semblent associées à des formes plus sévères de COVID-19. GI symptoms associated with the SARS-CoV-2 coronavirus initially described as rare are being reported more frequently. Diarrhea is the most common digestive symptom but usually remains mild regardless of the stage of infection. These symptoms are mostly related to a more severe respiratory disease. GI symptoms are rarely isolated but may appears before respiratory involvement. Liver and pancreatic involvement is usually mild and transient and appears to be associated with a more severe form of COVID-19. [ABSTRACT FROM AUTHOR]

Rupture of hydatid cyst of liver with intact proligerous membrane is rare. We report the case of a 63 year-old female patient presenting with right hypocondrium pain without fever or jaundice. Diagnostic imaging examination showed hydatid cyst in segment IV of liver associated with pelvic cystic lesion measuring 12 cm x 06 cm. Surgical exploration revealed ruptured unilocular hydatid cyst of the liver with intact proligerous membrane and free in the peritoneal cavity. This study aims to report a new case of intraperitoneal rupture of hydatid cyst of liver with intact proligerous membrane and to highlight the diagnostic and therapeutic difficulties due to this complication. [ABSTRACT FROM AUTHOR]

Hepatokines are liver-secreted proteins with potential to influence glucose regulation and other metabolic parameters. This study investigated differences in adiposity status on 5 novel hepatokines and characterised their response to acute moderate-intensity exercise in groups of normal-weight and overweight/obese men. Twenty-two men were recruited into normal-weight and overweight/obese groups (body mass index: 18.5 to 24.9 and 25.0 to 34.9 kg·m−2). Each completed 2 experimental trials, exercise and control. During exercise trials, participants performed 60 min of moderate-intensity treadmill exercise (∼60% peak oxygen uptake) and then rested for 6 h. Participants rested throughout control trials. Circulating fibroblast growth factor-21 (FGF21), follistatin, leukocyte cell-derived chemotaxin 2 (LECT2), fetuin-A, and selenoprotein-P (SeP) were measured throughout. Fasted (resting) FGF21 and LECT2 were higher in overweight/obese individuals (129% and 55%; P ≤ 0.01) and correlated with indices of adiposity and insulin resistance; whereas circulating follistatin was lower in overweight/obese individuals throughout trial days (17%, P < 0.05). In both groups, circulating concentrations of FGF21 and follistatin were transiently elevated after exercise for up to 6 h ( P ≤ 0.02). Circulating fetuin-A and SeP were no different between groups ( P ≥ 0.19) and, along with LECT2, were unaffected by exercise ( P ≥ 0.06). These findings show that increased adiposity is associated with a modified hepatokine profile, which may represent a novel mechanism linking excess adiposity to metabolic health. Furthermore, acute perturbations in circulating FGF21 and follistatin after exercise may contribute to the health benefits of an active lifestyle. [ABSTRACT FROM AUTHOR]

Le lymphome hépatique primitif (LHP) est une tumeur maligne rare, représentant 0,016 % de tous les lymphomes non hodgkiniens. Il est caractérisé par une atteinte lymphomateuse hépatique isolée et constitue un diagnostic différentiel du carcinome hépatocellulaire. Nous rapportons le cas d'un patient âgé de 63 ans qui s'est présenté dans un tableau d'ictère cholestatique avec des signes généraux. Le scanner et l'imagerie par résonance magnétique (IRM) évoquaient en premier lieu un hépatocarcinome, mais la biopsie est revenue en faveur d'un lymphome diffus à grandes cellules B. Le diagnostic du LHP est important à connaître, car il présente un bien meilleur pronostic que le carcinome hépatocellulaire ou des métastases hépatiques. L'exploration radiologique par échographie, scanner ou IRM fournit des images non spécifiques et la biopsie reste indispensable pour poser le diagnostic. La chimiothérapie reste le traitement standard et doit prendre en considération l'atteinte hépatique pour éviter de grandes toxicités. [ABSTRACT FROM AUTHOR]

We com pile th e m ost im p o rta n t fin d in g s on organ dam age caused by an u ltra -m a ra th o n . A fte r an u ltra -m a ra th o n , cardiac biom arkers such as CK, CK-MB, cardiac tro p o n in I (cTnl) and N -te rm in a l p ro -brain n a triu re tic peptides (NT-pro BNP) m ay be elevated. Up to 8 0 % or m ore o f th e fin ish e rs com plain a bout digestive problem s, w hich are one o f th e m ain reasons to fo r not fin is h in g an u ltra m a ra th o n . Up to 90 % o f runners w ho give up an u ltra m a ra th o n com plain a bout nausea. A fte r an u ltra ¬ m arathon, liver values often rise and usually no serious consequences rem ain. Risk fa cto rs fo r renal im p a irm e n t include severe m uscle dam age w ith rhabdom yolysis, dehydration, hypotension, hyperuricem ia, hyponatraem ia, poor co m p e titio n , and th e use o f NSAIDs. U ltra runners often s u ffe r from upper re spiratory in fe ctio n s a fte r an ultra m a ra th o n . [ABSTRACT FROM AUTHOR]

Liver ischemia-reperfusion (IR) injury is inevitable in surgical procedures such as hepatic resection and liver transplantation. It represents a leading cause of liver graft dysfunction and primary nonfunction after transplantation. Phosphodiesterase (PDE) inhibitors are emerging as effective drugs able to reduce IR damage. The aim of this study was to investigate the effect of selective PDE-3 inhibitor olprinone (Olp) against liver IR injury. Male Wistar rats were subjected to 1 h of partial warm ischemia (70%) followed by 6 h of reperfusion. Before ischemia, rats were treated with saline (IR group), Olp (Olp group), or Olp with Akt inhibitor LY294002 (Olp plus LY group). After reperfusion, hepatic injury (transaminase activities), mitochondrial damage (glutamate dehydrogenase activity), oxidative stress (malondialdehyde and glutathione concentrations and catalase and superoxide dismutase activities), and protein kinase Akt activation were evaluated. Rat treatment with Olp reduced liver injury, prevented mitochondrial damage, decreased lipid peroxidation, and enhanced antioxidant enzymes. Also, Olp induced a significant activation in protein kinase Akt. Inhibition of Akt with LY294002 abolished all of the protective effects of Olp. In conclusion, Olp treatment may be an effective strategy in reducing liver IR injury through oxidative stress prevention and Akt activation. [ABSTRACT FROM AUTHOR]

Atorvastatin (ATO) was commonly used to lower blood cholesterol, but it caused harmful effects to organs, including the liver. Thymoquinone (TQ), a prominent constituent of Nigella sativa, has antioxidant, antiinflammatory, antiapoptotic, antimicrobial, and anticancer activity. The current study investigated the mechanism of ATO-induced hepatotoxicity, whether posttreatment TQ could reverse ATO-induced hepatic injury, and the mechanism of action of TQ as a hepatoprotective agent. Forty adult male Sprague Dawley rats were divided into four equal groups: control, TQ-treated, ATO-treated, and combined ATO/TQ-treated. Rats were treated for 8 weeks and 10 days and euthanized by cervical dislocation 3 days after the last treatment. Blood samples and livers were tested for liver enzymes, oxidative stress, and apoptosis markers and used for histopathological and ultrastructural examination. The ATO-treated group showed an increase in liver enzymes, decreases in reduced glutathione and catalase, and increases in the malondialdehyde lipid peroxidation marker, protein carbonylation, and caspase 3 activity. Posttreatment TQ in the ATO/TQ-treated group seemed to reverse these changes. Histopathological and ultrastructural examination supported these data. Results from the current study suggested that posttreatment TQ may reverse oxidative stress injury in rat liver produced by ATO, suggesting a potential clinical application of using TQ to prevent ATO-induced hepatic injury. [ABSTRACT FROM AUTHOR]

Goal: To evaluate the diagnosis and therapeutic aspects of the amoebic liver abscesses in the surgery« A» department of hospital du Point "G". Patients and methods: Were included in this study, patients admitted to surgery« A » department for amoebic liver abscess on the basis of amoebic serology, chocolate appearance of pus and absence of bacteria in the pus. Bacterial liver abscesses were excluded from this study. Results: Over a period of 10 years, 52 cases of patients diagnosed with amoebic liver abscess were collected in the department. There were 41 men and 11 women, with a sex ratio of 3,7. The medium age of the patients was 37.8 years with extremes of 15 years and 66 years. The most represented occupations were farmers (36.5%) followed by traders (26.7%) and students (11.5%). The average consultation time was 18.5 days (rate 5 days and 34 days). The most frequent clinical signs were pain in the right hypochondrium (86.5%), fever (78.8%) and hepatomegaly (61.5%). Abdominal ultrasound showed a single located abscess in 44 cases (84.6%) and these abscesses were localized in the right hepatic lobe in 34 cases (65.4%). The medium volume of the abscess was 366.5 cm3with the extremes of 36 cm3 and 1580 cm3. Amoebic serology was positive in 80.9%of patients (n = 38). Cytobacteriological analysis of pus in 37 cases (n = 71%) was negative. An ultrasound assisted needle aspiration of pus was performed in 65.4% of patients. The surgical procedure by laparotomy was performed in 7.7% of cases and a laparoscopic approach in 5.8%. The clinical course was uneventfulin 94.2%. The mean hospital stay was 16.5 days with extremes of 4 days and 29 days. No deaths were recorded during hospitalization. Conclusion: Amoebic liver abscess is an uncommon pathology in surgical setting. Abdominal ultrasound and puncture guided by echography allowed the diagnosis. Laparoscopic treatment minimizes the inconvenience of laparotomy. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the protective effect of Mentha spicata supplementation against nicotine-induced oxidative damage in the liver and erythrocytes of Wistar rats. Bioactive substances were determined by liquid chromatography - electrospray ionization - tandem mass spectrometry analysis. Animals were divided into 4 groups of 6 rats each: a normal control group, a nicotine-treated group (1 mg/kg), a group receiving M. spicata extract (100 mg/kg), and a group receiving both M. spicata extract (100 mg/kg) and nicotine (1 mg/kg). Many phenolic acids were identified in the M. spicata aqueous extract. After 2 months of treatment, nicotine induced an increase in the level of white blood cells and a marked decrease in erythrocytes, hemoglobin, and haematocrit. Aspartate transaminase, alanine transaminase, alkaline phosphatase, and lactate dehydrogenase activities were also found to be higher in nicotine-treated group than those of the control group. Furthermore, nicotine-treated rats exhibited oxidative stress, as evidenced by a decrease in antioxidant enzymes activities and an increase in lipid peroxidation level in liver and erythrocytes. Interestingly, the oral administration of M. spicata extract by nicotine-treated rats alleviated such disturbances. M. spicata contained bioactive compounds that possess important antioxidant potential and protected liver and erythrocytes against nicotine-induced damage. [ABSTRACT FROM AUTHOR]

The use of dietary supplements to enhance the benefit of exercise training is a common practice. The liver is the organ where all substances are metabolized, and certain supplements have been associated with liver injury. Vitamin A (VA), a liposoluble vitamin stored in the liver, is commonly used as an antioxidant supplement. Here, we evaluated the effect of chronic VA supplementation on oxidative damage and stress parameters in trained rats. Animals were divided into the following groups: sedentary (SE), sedentary/VA (SE+VA), exercise training (ET), and exercise training/VA (ET+VA). During 8 weeks, animals were subjected to swimming (0%, 2%, 4%, 6% body weight) for 5 days/week and a VA daily intake of 450 retinol equivalents/day. Parameters were evaluated by enzymatic activity analysis, ELISA, and Western blotting. VA caused liver lipid peroxidation and protein damage in exercised rats and inhibited the increase in HSP70 expression acquired with exercise alone. The ET group showed higher levels of antioxidant enzyme activity, and VA inhibited this adaptation. Expression of the pro-inflammatory cytokines, interleukin (IL)-1β, and tumor necrosis factor-α was reduced in the ET+VA group, while the anti-inflammatory cytokine, IL-10, was increased. Western blotting showed that both exercised groups had lower levels of the receptor for advanced glycation end products, suggesting that VA did not affect this receptor. Our study demonstrated that, although VA caused oxidative damage, a controlled administration might exert anti-inflammatory effects. Further studies with higher VA doses and longer ET interventions would elucidate more the effects of the supplementation and exercise on liver parameters. [ABSTRACT FROM AUTHOR]

L'hématome hépatique est une affection méconnue, peut être gravissime et son diagnostic se fait souvent lors de l'autopsie périnatale. Devant une symptomatologie clinique souvent non spécifique et un tableau biologique retardé. Le diagnostic est basé essentiellement sur l'échographie et son traitement est souvent conservatif. Nous rapportons un cas d'hématomes hépatiques chez un nouveau-né à terme, asymptomatique dans un contexte de traumatisme obstétrical.

Les lésions hépatiques nodulaires sont majoritairement tumorales. Le nodule nécrotique solitire du foie est rare. Le diagnostic preopératoire est difficile. Il s'agit d'une femme âgée de 43 ans qui était opérée d'un adénocarcinome du rectum métastatique au foie opéré.Le scanner abdominal de surveillance a révélé un nodule hépatique d'allure métastatique. Le second cas est celui d'un homme de 56 ans, admis pour cholécystectomie avec découverte per-opératoire d'un nodule hépatique. Dans les deux cas, le nodule hépatique était sous capsulaire et a été réséqué. L'examen anatomopathologique posait le diagnostic de nodule nécrotique solitaire du foie. Le nodule nécrotique non spécifique du foie est une lésion qui doit être évoquée, même dans un contexte néoplasique. Une caractérisation par l'imagerie et une ponction biopsie des lésions hépatiques peut être utile.

Résumé Les progrès de la radiothérapie sur les plans physique, informatique, de l’imagerie et de la biologie ont permis de faire bénéficier les patients atteints de tumeurs hépatiques de ces évolutions. Elle fait actuellement partie intégrante des recommandations pour le traitement des tumeurs hépatiques, à tous les stades de la maladie. La radiothérapie en conditions stéréotaxiques hépatique est à privilégier lorsqu’elle est réalisable car elle permet d’obtenir des équivalents biologiques de dose plus importants et est donc potentiellement plus efficace. Les procédures de planification et de délivrance de la radiothérapie stéréotaxique hépatique nécessitent une expérience importante et une qualité optimale à tous les maillons de la chaîne de traitement, limitant actuellement la technique à des centres experts. L’hétérogénéité importante des techniques rend l’évaluation multicentrique difficile. Les modalités techniques de gestion du mouvement respiratoire, d’immobilisation et de guidage par l’image sont tout aussi importantes que le choix de la machine de traitement. L’utilisation d’une imagerie de planification multimodale est un prérequis qualitatif indispensable pour la délinéation. L’efficacité du traitement est difficile à évaluer, mais le contrôle local est élevé et les toxicités rares. Ces résultats encourageants permettent d’intégrer la radiothérapie stéréotaxique dans l’arsenal thérapeutique multimodal et multidisciplinaire des tumeurs hépatiques. Thanks to the improvement in radiotherapy physics, biology, computing and imaging, patients presenting with liver tumors can be efficiently treated by radiation. Radiotherapy has been included in liver tumors treatment guidelines at all disease stages. Liver stereotactic radiotherapy has to be preferred to standard fractionated radiotherapy whenever possible, as potentially more efficient because of higher biological equivalent dose. Liver stereotactic radiotherapy planning and delivery require extensive experience and optimal treatment quality at every step, thus limiting its availability to specialized centres. Multicentre studies are difficult to develop due to a large technical heterogeneity. Respiratory management, image guidance and immobilization are considerations as important as machine type. The use of multimodal planning imaging is compulsory to achieve expected contouring quality. Treatment efficacy is difficult to assess following liver stereotactic radiotherapy, but local control is high and toxicity unusual. As a consequence, liver stereotactic radiotherapy is part of multimodal and multidisciplinary management of liver tumors. [ABSTRACT FROM AUTHOR]

Résumé Le foie est un organe essentiel qui assure de très nombreuses fonctions vitales telles que : le métabolisme de la bilirubine, du glucose, des lipides, la synthèse des facteurs de coagulation, la destruction de nombreuses toxines, etc. Le parenchyme hépatique peut être irradié lors de la prise en charge de tumeurs digestives hautes, basithoraciques droite, de l’œsophage, de l’abdomen in toto ou TBI. De plus, la radiothérapie de l’aire hépatique, principalement stéréotaxique, occupe désormais une place centrale dans le cadre de la prise en charge des tumeurs hépatiques primitives ou secondaires. L’irradiation de la totalité du foie, ou d’une partie, peut se compliquer d’hépatite radio-induite. Il est donc nécessaire de respecter des contraintes dosimétriques strictes tant en stéréotaxie qu’en irradiation de conformation afin de limiter l’irradiation non souhaitée du parenchyme hépatique qui peut varier selon les techniques de traitement, la fonction hépatique de base ou la taille lésionnelle. Le foie est un organe dont l’architecture est parallèle, il faudra donc considérer la dose moyenne tolérable dans l’ensemble du foie sain plutôt que la dose maximale tolérable en un point. Cet article aura pour but de proposer une mise au point des recommandations de doses lors d’une radiothérapie de conformation ou stéréotaxique du foie. The liver is an essential organ that ensures many vital functions such as metabolism of bilirubin, glucose, lipids, synthesis of coagulation factors, destruction of many toxins, etc. The hepatic parenchyma can be irradiated during the management of digestive tumors, right basithoracic, esophagus, abdomen in toto or TBI. In addition, radiotherapy of the hepatic area, which is mainly stereotactic, now occupies a central place in the management of primary or secondary hepatic tumors. Irradiation of the whole liver, or part of it, may be complicated by radiation-induced hepatitis. It is therefore necessary to respect strict dosimetric constraints both in stereotactic and in conformational irradiation in order to limit the undesired irradiation of the hepatic parenchyma which may vary according to the treatment techniques, the basic hepatic function or the lesion size. The liver is an organ with a parallel architecture, so the average tolerable dose in the whole liver should be considered rather than the maximum tolerable dose at one point. The purpose of this article is to propose a development of dose recommendations during conformation or stereotactic radiotherapy of the liver. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether ( E)-2-benzylidene-4-phenyl-1,3-diselenole (BPD) protects against hepatotoxicity induced by thioacetamide (TAA). On the first day of treatment, male adult Wistar rats received BPD (10 or 50 mg·kg-1). On the second day, the rats received a single intraperitoneal injection of TAA (400 mg·kg-1). Twenty-four hours after TAA administration, biochemical determinations and liver histological analysis were carried out. BPD (50 mg·kg-1) reduced plasma aspartate and alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase activities increased by TAA exposure. Treatment with BPD was effective against increased lipid peroxidation levels and attenuated a decrease in hepatic reduced glutathione and ascorbic acid levels as well as an inhibition of glutathione peroxidase activity caused by TAA exposure. The higher dose of BPD protected against the inhibition of hepatic δ-aminolevulinic dehydratase activity induced by TAA. Finally, histopathological examination of the liver showed that BPD markedly ameliorated TAA-induced hepatic injury. In conclusion, BPD protected against hepatotoxicity and oxidative stress caused by TAA exposure in rats. [ABSTRACT FROM AUTHOR]

Ketogenic diets induce hepatocyte fatty acid oxidation and ketone body production. To further evaluate how ketogenic diets affect hepatocyte bioenergetic infrastructure, we analyzed livers from C57Bl/6J male mice maintained for 1 month on a ketogenic or standard chow diet. Compared with the standard diet, the ketogenic diet increased cytosolic and mitochondrial protein acetylation and also altered protein succinylation patterns. SIRT3 protein decreased while SIRT5 protein increased, and gluconeogenesis, oxidative phosphorylation, and mitochondrial biogenesis pathway proteins were variably and likely strategically altered. The pattern of changes observed can be used to inform a broader systems overview of how ketogenic diets affect liver bioenergetics. [ABSTRACT FROM AUTHOR]