Support In Clinical Settings Research Articles

Fusion of Color Correction and HSV Segmentation Techniques for Automated Segmentation of Acute Lymphoblastic Leukemia.

This article presents an enhanced segmentation methodology for the accurate detection of acute lymphoblastic leukemia (ALL) in blood smear images. The proposed approach integrates color correction techniques with HSV color space segmentation to improve white blood cell analysis. Our method addresses common challenges in microscopic image processing, including sensor nonlinearity, uneven illumination, and color distortions. The key objectives of this study are to develop a robust preprocessing pipeline that normalizes blood smear images for consistent analysis, implement an HSV-based segmentation technique optimized for leukocyte detection, and validate the method's effectiveness across various ALL subtypes using clinical samples. The proposed technique was evaluated using real-world blood smear samples from ALL patients. Quantitative analysis demonstrates significant improvements in segmentation accuracy compared to traditional methods. Our approach shows strong capability in reliably detecting and segmenting ALL subtypes, offering the potential for enhanced diagnostic support in clinical settings.

Deep Neural Network Integrated into Network-Based Stratification (D3NS): A Method to Uncover Cancer Subtypes from Somatic Mutations.

(1) Background: The identification of tumor subtypes is fundamental in precision medicine for accurate diagnoses and personalized therapies. Cancer development is often driven by the accumulation of somatic mutations that can cause alterations in tissue functions and morphologies. In this work, a method based on a deep neural network integrated into a network-based stratification framework (D3NS) is proposed to stratify tumors according to somatic mutations. (2) Methods: This approach leverages the power of deep neural networks to detect hidden information in the data by combining the knowledge contained in a network of gene interactions, as typical of network-based stratification methods. D3NS was applied using real-world data from The Cancer Genome Atlas for bladder, ovarian, and kidney cancers. (3) Results: This technique allows for the identification of tumor subtypes characterized by different survival rates and significant associations with several clinical outcomes (tumor stage, grade or response to therapy). (4) Conclusion: D3NS can provide a base model in cancer research and could be considered as a useful tool for tumor stratification, offering potential support in clinical settings.

The Rights of Physicians and Future Physicians Who Are Lactating, Breastfeeding, or Chestfeeding: An American Medical Women's Association Position Article.

Breastfeeding is a fundamental and biologically normal function with well-established benefits for both lactating parents and infants. Despite these benefits, physicians, particularly those in training, often face significant obstacles when attempting to meet their breastfeeding and pumping goals. In response to these challenges, the American Medical Women's Association (AMWA) and a diverse group of health care professionals have come together to advocate for comprehensive lactation support policies in medical learning environments and workplaces. This position article highlights the ethical necessity of comprehensive lactation support in medical educational and workplace settings, emphasizing the importance of not only providing physical accommodations but also fostering a cultural shift, educational initiatives, and policy reforms to empower lactating parents. It offers an examination of the difficulties encountered by lactating parents within medical environments and proposes guidelines for the formulation and enhancement of supportive policies. The position article envisions a future where medical professionals can thrive in both their careers and parenthood through collaborative efforts and a commitment to the key elements of Effective Lactation Support Programs in medical workplaces based on the following: (1) well-equipped lactation facilities, (2) customized work schedules, (3) mentorship and support networks, (4) lactation support in clinical settings, and (5) research and advocacy.

Development and External Validation of an Artificial Intelligence-Based Method for Scalable Chest Radiograph Diagnosis: A Multi-Country Cross-Sectional Study.

Problem: Chest radiography is a crucial tool for diagnosing thoracic disorders, but interpretation errors and a lack of qualified practitioners can cause delays in treatment. Aim: This study aimed to develop a reliable multi-classification artificial intelligence (AI) tool to improve the accuracy and efficiency of chest radiograph diagnosis. Methods: We developed a convolutional neural network (CNN) capable of distinguishing among 26 thoracic diagnoses. The model was trained and externally validated using 795,055 chest radiographs from 13 datasets across 4 countries. Results: The CNN model achieved an average area under the curve (AUC) of 0.961 across all 26 diagnoses in the testing set. COVID-19 detection achieved perfect accuracy (AUC 1.000, [95% confidence interval {CI}, 1.000 to 1.000]), while effusion or pleural effusion detection showed the lowest accuracy (AUC 0.8453, [95% CI, 0.8417 to 0.8489]). In external validation, the model demonstrated strong reproducibility and generalizability within the local dataset, achieving an AUC of 0.9634 for lung opacity detection (95% CI, 0.9423 to 0.9702). The CNN outperformed both radiologists and nonradiological physicians, particularly in trans-device image recognition. Even for diseases not specifically trained on, such as aortic dissection, the AI model showed considerable scalability and enhanced diagnostic accuracy for physicians of varying experience levels (all P < 0.05). Additionally, our model exhibited no gender bias (P > 0.05). Conclusion: The developed AI algorithm, now available as professional web-based software, substantively improves chest radiograph interpretation. This research advances medical imaging and offers substantial diagnostic support in clinical settings.

A multi-channel deep convolutional neural network for multi-classifying thyroid diseases

Background and Objective:Thyroid disease instances have been continuously increasing since the 1990s, and thyroid cancer has become the most rapidly rising disease among all the malignancies in recent years. Most existing studies focused on applying deep convolutional neural networks for detecting thyroid cancer. Despite their satisfactory performance on binary classification tasks, limited studies have explored multi-class classification of thyroid disease types; much less is known of the diagnosis of co-existence situation for different types of thyroid diseases. Method:This study proposed a novel multi-channel convolutional neural network (CNN) architecture to address the multi-class classification task of thyroid disease. The multi-channel CNN merits from computed tomography characteristics to drive a comprehensive diagnostic decision for the overall thyroid gland, emphasizing the disease co-existence circumstance. Moreover, this study also examined alternative strategies to enhance the diagnostic accuracy of CNN models through concatenation of different scales of feature maps. Results:Benchmarking experiments demonstrate the improved performance of the proposed multi-channel CNN architecture compared with the standard single-channel CNN architecture. More specifically, the multi-channel CNN achieved an accuracy of 0.909±0.048, precision of 0.944±0.062, recall of 0.896±0.047, specificity of 0.994±0.001, and F1 of 0.917±0.057, in contrast to the single-channel CNN, which obtained 0.902±0.004, 0.892±0.005, 0.909±0.002, 0.993±0.001, 0.898±0.003, respectively. In addition, the proposed model was evaluated in different gender groups; it reached a diagnostic accuracy of 0.908 for the female group and 0.901 for the male group. Conclusion:Collectively, the results highlight that the proposed multi-channel CNN has excellent generalization and has the potential to be deployed to provide computational decision support in clinical settings.

Evaluating outcomes of a community-based parent training program for Japanese children with developmental disabilities: a retrospective pilot study

Parent training (PT) for parents of children with developmental disabilities (DDs) has recently been recommended in community settings in many countries, including Japan. Research has shown PT could improve parenting skills and mental health in parents as well as improve adaptive skills and reduce behavioral problems in children. Despite evidence concerning the beneficial effects of PT on both parents and children, there is a lack of evidence concerning the potential benefits of PT in real world settings. Moreover, no research has examined whether PT programs implemented in clinical settings have a similar impact on all parents of children with various type of DDs. The present pilot study aimed to examine whether positive changes occur similarly in parental mental health and in the adaptive skills of children with DDs as a result of PT, irrespective of the children’s disability type. The study used data from 128 parents who had participated in a PT program in a clinical setting and data concerning 128 children aged 2–17 years with a wide range of DDs, namely autism spectrum disorder, intellectual disability, and other DDs, generated through parental reports and retrospectively assessed the impact of PT on parents and their children. Specifically, changes in parental mental health and the adaptive skills of children were analyzed. The PT program was designed to help parents teach their children adaptive skills at home using applied behavior analytic techniques. The results showed that the parents improved their mental health significantly after completing the PT, irrespective of their child’s disability type. During the PT period, almost all the parents were able to implement several instructional tasks targeted toward their children; some children with DDs acquired several adaptive skills. However, these positive changes were not observed in all the parents and their children. These findings suggest that some parents and their children with DDs may benefit from the PT program in a clinical setting. Concurrently, these findings highlight the importance of providing sustained additional support in clinical settings to parents and their children with DDs.

Maternal temperament and character: associations to child behavior at the age of 3 years

BackgroundThe influence of maternal temperament on child behavior, and whether maternal temperament impact boys and girls differently is not thoroughly studied. The aim was to investigate the impact of maternal temperament and character on child externalizing and internalizing problems at age 3.MethodsA birth-cohort of 1723 mothers and their children were followed from birth to age 3. At the child’s age of 3 months, the mothers filled out standardized instruments on their temperament and character using the Temperament and Character Inventory (TCI) and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). At the child’s age of 3 years, the mothers reported on child behavior using the Child Behaviour Checklist (CBCL).ResultsMaternal temperamental trait novelty seeking was positively associated with externalizing problems in the total population and in girls. Harm avoidance was positively associated with externalizing problems in the total population and in boys, and with internalizing problems in the total population and boys and girls respectively. Maternal character traits of self-directedness and cooperativeness were negatively associated with both externalizing and internalizing problems in the total population and in boys and girls respectively.ConclusionsMaternal character traits were more influential on child behavior than were temperamental traits, and thus the opportunities for intervention targeted at parental support are good. Maternal mental health and socioeconomic aspects also increased the risk for child behavior problems, indicating the need for recognition and support in clinical settings.

Incorporating Empathic Responses into Postpartum Depression Psychotherapy

This study aims to delve into linguistic evidence for therapists to achieve better therapeutic outcomes by empowering women suffering from postpartum depression with empathic responses. Conversation samples are transcribed from videos for analysis. The focus of analysis is on language features of two postpartum women based on the Postpartum Voice of Depression Response Model. Expressions of negative feelings fall into four emotional domains. Language features of negative feelings are salient in postpartum women, often represented by a frequent use of negative words and sustaining on a sad topic. In clinical settings, therapists can help postpartum women get out of disturbing states by means of eliciting their inner feelings, identifying negative expressions and offering empathic responses accordingly. An empathic attitude matters in a person-centered clinical setting, which means a reassuring expression from the therapist can ease anxiety of the pa-tient. The application of the Model has implications for emotional support in clinical settings, particularly in terms of differentiating between four emotional domains and showing understandings of negative feelings experienced by postpartum women.

Social vulnerability and COVID-19: A call to action for paediatric clinicians.

The COVID-19 pandemic has had dramatic effects on the lives of children globally. However, socially vulnerable children have been particularly impacted. Certain populations have increased vulnerabilities, including children and youth experiencing homelessness. Increased infection risk due to congregant living and challenges with physical distancing are contributing factors. An urgent need exists for a wholistic approach to care with unique cross-sectoral partnerships across disciplines. A recognition of the unintended consequence of the COVID-19 pandemic on this population is urgently required by all those supporting children. Families should receive direct support in clinical settings to identify their social needs. Partnership with community agencies and advocacy for appropriate isolation facilities for patients experiencing homelessness are critical.

Factors associated with receipt of the 5As model of brief intervention for smoking cessation among hospitalized patients.

Guidelines recommend the 5As model of brief intervention for providing smoking cessation support in clinical settings. This study assessed patient and hospital characteristics associated with self-reported receipt of the 5As (ask, advise, assess, assist and arrange). Multi-center cross-sectional study. Adult inpatients (n=1047) were randomly selected from 13 hospitals in the Barcelona province of Spain in 2014-2015. We explored participants' receipt of the 5As through a questionnaire. Given the progressiveness of the 5As, we recoded the fulfillment of the intervention as: A0 : no intervention; A1 : ask; A2 : ask and advise; A3 : A2 and assess; A4 : A3 and assist; and A5 : A4 and arrange a follow-up. We explored patient (e.g. age, sex, comorbidities) and hospital (e.g. type of hospital, unit) characteristics. We adjusted multi-level robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of the association between the recoded 5As intervention received. A total of 60.4% (n=624) of patients had been asked (A1 ) about their smoking status. Among smokers, 46.5% (n=90) were advised (A2 ), 26.6% (n=48) assessed (A3 ) and 4.6% (n=10) received all the components of the 5As (A5 ). Middle-aged smokers [aPR=3.63; 95% confidence interval (CI)=1.69-7.79] with a respiratory disease (aPR=2.19; 95% CI=1.11-4.34) were most likely to have been asked, advised and assessed (A3 ). The cessation intervention was most frequently performed by physicians. In the Barcelona province of Spain, it appears that fewer than half of hospitalized patients who smoke were advised to quit and few received the full 'five As' brief intervention for smoking cessation.

Integrating mental health peer support in clinical settings: Lessons from Canada and Norway.

Mental health peer support is an evidence-based approach called for by Canada's mental health strategy that presents health leaders with an opportunity to transform mental health service experiences, improve health outcomes, and lower overall system costs. Originally offered in community settings, peer support has been expanding to clinical settings, but challenges to integration exist. This qualitative case study of peer support in clinical settings in Canada and Norway examines the perceived value of peer support and change management strategies that health leaders, managers, staff, and peer support providers can use to support integration of peer support in existing healthcare teams in clinical settings. Recommended strategies for health leaders include adopting a gradual approach to integration, building champions, demonstrating value, focusing on resistant groups, adopting a continuous improvement approach, setting peer support as an organizational priority, and linking peer support to patient-centred care.

Academic monitoring and support of undergraduate nursing education programme: A middle-range theory.

BackgroundGlobally, there is consensus on the need for student support to address high student attrition and low throughputs, especially in nursing and midwifery programmes.ObjectivesThis study analysed the implementation of academic monitoring and support (AMS) in an undergraduate nursing programme to generate a context-informed academic monitoring and support middle-range theory.MethodAn ethnographic design and grounded theory approach were adopted in this study. Data sources included individual and focus group interviews, observations, reflective conversations and document analysis. Ethical clearance was obtained from the University Research Ethics Board, and ethical principles were maintained throughout the study.ResultsThe country’s contextual conditions emerged as conditions that necessitated a comprehensive approach to student support to increase throughput in a nursing programme that attracted students from diverse backgrounds. A shared common vision, supportive leadership, collaboration and investing resources in a student support programme that uses a comprehensive and holistic approach emerged as key to an AMS model that will yield the desired outcomes. Major concepts in an AMS middle-ranged theory generated included education for social justice, visionary leadership, comprehensive, holistic and intentional student support, AMS pillars, AMS threats and process and goal-oriented consequences.ConclusionAcademic monitoring and support is a tool used to facilitate access of all deserving students to an undergraduate nursing programme and to ensure that they all have an equal chance to succeed academically, resulting in improved throughput rates. Strengthening support in clinical settings is recommended and further research to improve effectiveness of AMS programmes is suggested.

Support in Clinical Settings as Perceived by Nursing Students in Iran: A Qualitative Study.

BackgroundAlthough support is one of the most substantial needs of nursing students during clinical education, it is not clearly defined in the literature.ObjectivesThe current study aimed to explore the concept of support in clinical settings as perceived by nursing students.Materials and MethodsA qualitative content analysis was used to explore the meaning of student support in clinical settings. A purposive sampling with maximum variation was used to select the participants among bachelor nursing students in the nursing school of Babol University of Medical Sciences in the north of Iran. Semi-structured interviews were conducted to gather the perceptions and experiences of seventeen nursing students. Conventional content analysis was applied to analyze the data.ResultsIn the current study, the main theme, nurturance, was emerged with seven subthemes of humanistic behavior with the student, respectful communication with students, accepting the student in the clinical setting, sustaining confidence, need based supervision, accepting the profession in the society and empowerment.ConclusionsNursing students support in the clinical education requires a nurturing care; a care that leads to the sense of worthiness and respectability in students and contributes to the improvement of their clinical abilities.

Temporally divergent significant meanings, biographical disruption and self-management for chronic joint pain.

Self-management is recommended by policy and clinical guidelines as a way to contend with the growing incidence of osteoarthritis-related joint pain in an ageing population. Sociologists assert that self-management is as much about lay strategies for dealing with the biographically disruptive qualities of chronic illness as opposed to solely complying with medical regimens. The original concept of biographical disruption coined by Bury is not uncontested. Chronic joint pain has been characterised as featuring 'co-existing meanings' of significance and consequence. The former conferring no biographical disruption due to osteoarthritis being associated with 'normal ageing' and the latter causing biographical disruption due to the corporeal limitations joint pain imparts, which, in turn, can influence whether, why and how self-management is undertaken. This article reports findings from repeat interviews and a diary study completed by 22 participants with chronic knee pain. We explore the co-existing but temporally divergent 'meanings as significance' associated with knee pain. Participants describe the onset and current experience of the pain in terms of biographical normality (retrospective or contemporaneous meanings). Future meanings as significance are mediated by cultural beliefs about ageing and current physical consequences of the condition, and also have a distinct character of their own. Knee pain is associated with the possibility of disability and harbours a distinct risk; potential disruption to everyday social relationships, notably relating to care and dependency. In turn, future meanings of significance influence the preventative self-management strategies that people utilise. We argue for a more cogent theoretical understanding of temporal dimensions of biographical disruption, biographical work and subsequent self-management by utilising and extending the thought of Bury, and Corbin and Strauss. Doing so helps to understand patient self-management strategies and facilitates self-management support in clinical settings for osteoarthritis and potentially other chronic conditions.

Changes in Capacity and Performance in Mobility Across Different Environmental Settings in Children with Cerebral Palsy: An Exploratory Study.

Children with cerebral palsy, although having similar diagnosis, varies in their abilities & level of functioning within & across different environmental context e.g. home, school or community setting. Capacity (what a child can do in standardized, controlled environment) may or may not be the same as performance (what a child actually does do in her/her daily environment). After getting approval from Institutional Ethic's Committee (IEC), 63 children with cerebral palsy (4-16 year, mean 7.4 year with SD 0.39) of all clinical types, Gross Motor Functional Classification System (GMFCS) level I-V were examined for mobility using Gross Motor Functional Measure 88 (GMFM). Motor capacity was assessed in clinical setting by highest of 3 GMFM items attained, i.e., crawling (44), walks with support (68) & walks without support (70). Motor performance was measured by Functional Mobility Scale version 2. On analysis of motor capacity 42.85% children were walking without support, 15.87% were able to crawl & 26.98% were able walk with support in clinical setting. Spearman's Correlation was done between GMFM item 70 with FMS 5 (home setting) to check correlation of capacity with performance & was found to be significantly correlated (r=0.586, p=0.04). All three GMFM items were correlated with FMS 5, 50, 500 & found positively correlated. For community setting (FMS 500), 52.38% children were lifted by parents & only 6.34% were using wheel chair mobility. A total of 21.87% patients were able to walk with or without support & still lifted by parents in school or community setting. Change in capacity and performance of mobility exists mainly in school and community setting in studied population. Context should be given importance to prioritize rehabilitation process.

Multi-label classification of chronically ill patients with bag of words and supervised dimensionality reduction algorithms

ObjectiveThis research is motivated by the issue of classifying illnesses of chronically ill patients for decision support in clinical settings. Our main objective is to propose multi-label classification of multivariate time series contained in medical records of chronically ill patients, by means of quantization methods, such as bag of words (BoW), and multi-label classification algorithms. Our second objective is to compare supervised dimensionality reduction techniques to state-of-the-art multi-label classification algorithms. The hypothesis is that kernel methods and locality preserving projections make such algorithms good candidates to study multi-label medical time series. MethodsWe combine BoW and supervised dimensionality reduction algorithms to perform multi-label classification on health records of chronically ill patients. The considered algorithms are compared with state-of-the-art multi-label classifiers in two real world datasets. Portavita dataset contains 525 diabetes type 2 (DT2) patients, with co-morbidities of DT2 such as hypertension, dyslipidemia, and microvascular or macrovascular issues. MIMIC II dataset contains 2635 patients affected by thyroid disease, diabetes mellitus, lipoid metabolism disease, fluid electrolyte disease, hypertensive disease, thrombosis, hypotension, chronic obstructive pulmonary disease (COPD), liver disease and kidney disease. The algorithms are evaluated using multi-label evaluation metrics such as hamming loss, one error, coverage, ranking loss, and average precision. ResultsNon-linear dimensionality reduction approaches behave well on medical time series quantized using the BoW algorithm, with results comparable to state-of-the-art multi-label classification algorithms. Chaining the projected features has a positive impact on the performance of the algorithm with respect to pure binary relevance approaches. ConclusionsThe evaluation highlights the feasibility of representing medical health records using the BoW for multi-label classification tasks. The study also highlights that dimensionality reduction algorithms based on kernel methods, locality preserving projections or both are good candidates to deal with multi-label classification tasks in medical time series with many missing values and high label density.

How effective is bibliotherapy-based self-help cognitive behavioral therapy with Internet support in clinical settings? Results from a pilot study

Cognitive behavioral therapy-based guided self-help (CBT-GSH) via the Internet has been shown to be effective in the treatment of bulimia nervosa (BN) and similar eating disorders (EDs), but it is rarely offered, and little is known about the effects, in clinical settings. The present study investigated the effects of a bibliotherapy-based CBT-GSH with Internet support in a clinical setting. Participants were 48 adult outpatients who were recruited without randomization from a specialized ED clinic, diagnosed with BN or similar eating disorder. Forty-eight patients in an intensive day patient program (DPP) were used as comparison group. The Eating Disorder Examination Questionnaire (EDE-Q) and the Eating Disorder Inventory 2 measured pre- and post treatment symptoms. Results showed that both groups attained significant improvements in core- as well as related ED symptoms in both instruments. As expected, treatment effects were larger in the more intensive DPP. Nonetheless, bibliotherapy CBT-GSH appears to be a cost-effective treatment that represents a new way to provide more CBT in clinical settings.

The Influence of Literacy on Patient-Reported Experiences of Diabetes Self-Management Support

Variability in disease-related outcomes may relate to how patients experience self-management support in clinical settings. The purpose of this study was to identify factors associated with experiences of self-management support during primary care encounters. A cross-sectional survey was conducted of 208 patients seen in a multidisciplinary diabetes program in an academic medicine clinic. Multiple regression analysis was used to test associations between patient-rated experiences of self-management support (Patient Assessment of Chronic Illness Care) and race, gender, insurance status, literacy, duration of diabetes, and intensity of care management. The Patient Assessment of Chronic Illness Care ratings decreased with age (r = -.235, p = .001), were higher for women than for men (3.95 vs. 3.65, t = 2.612, p= .010), and were greater for those with more education (F= 3.927, p = .009) and greater literacy skills (t = 3.839, p< .001). The ratings did not vary between racial (t = -1.108, p = .269) or insurance (F = 1.045, p = .374) groups and were unaffected by the duration of diabetes (r= .052, p = .466) and the intensity of care management (F = 1.028, p = .360). In multivariate models, literacy was the only variable contributing significantly to variation in self-management support ratings. Even when considering the objective intensity of health services delivered, literacy was the sole variable contributing to differences in patient ratings of self-management support. Although conclusions are limited by the cross-sectional nature of this study, the results emphasize the need to consider literacy when developing and communicating treatment plans requiring self-management skills.

A Brief Measure of Perceived Clinician Support by Patients With Bipolar Spectrum Disorders

The quality of the patient-provider relationship is regarded as an essential ingredient in the treatment of serious mental illnesses, and is associated with favorable outcomes including improved treatment adherence. However, monitoring the strength and influence of provider support in clinical settings is challenged by the absence of brief, psychometrically sound, and easily administered assessments. The purpose of this study was to test the factor structure and examine the clinical and psychosocial correlates of a brief measure of provider support. Participants were recruited from the continuous improvement for veterans in care-Mood Disorders study (N = 429). The hypothesized factor structure exhibited a good fit with the data. At baseline, provider support was associated with higher levels of service access and medication compliance and lower levels of alcohol use and suicidality. Regular monitoring of provider support may provide useful when tailoring psychosocial treatment strategies, especially in routine care settings.

Enhanced proliferation of hepatic progenitor cells in rats after portal branch occlusion.

It is known that hepatic progenitor cells increase in number after liver injury caused by carcinogens, but this injury cannot be reproduced in humans. In order to create a practical source of hepatic progenitor cells, changes in the number of liver epithelial cells (LECs), a type of hepatic progenitor cell, were examined following partial interruption of the portal flow. Efficiency in this isolation procedure was investigated, and isolated LECs were transplanted into livers to demonstrate their differentiation into hepatocytes in vivo.A volume of 70% of Sprague-Dawley rat's livers was exposed to portal vein ligation. LECs, identified as alpha-fetoprotein (AFP)-positive and albumin-negative cells, were counted and LECs isolated from the portal vein ligated-lobe were characterized by immunostaining and Western blotting. Isolated cells were subjected to a 1-week-culture, and the number of colonies formed on dishes was counted. The cells were then transplanted to the livers of genetic analbuminemic rats and identified by immunohistochemistry. The number of LECs in the portal ligated-lobes on day 7 was 14.7 +/- 6.5 cells/1,000 hepatocytes: 18 times higher than numbers in a normal liver. A significant increase was noted from day 3 until day 28. Isolated LECs were AFP-positive, albumin-negative, and cytokeratin-19-positive cells. The number of colonies on the 7th day following portal vein ligation was 42 times higher than in a normal liver. After transplantation of the LECs to the analbuminemic rat, a cluster of albumin-producing cells was present until day 56, suggesting that they differentiate into hepatocytes. We conclude that after portal vein occlusion, the liver can be a good source of hepatic progenitor cell. These results open up the possibility of cellular transplantation for liver functional support in clinical settings.