Biomedical subjects

G Kanel

Publications and source records attributed to G Kanel.

25 records · Page 2Linked to original sources

PubMed1987

Effects of sodium tetradecyl sulfate endoscopic variceal sclerotherapy on the esophagus. A prospective clinical and histopathologic study.

A prospective clinical, endoscopic, and histopathologic study of the esophagus was carried out in 24 patients with advanced liver disease who underwent esophageal variceal sclerotherapy (EVS) and who eventually came to autopsy. Patients were arbitrarily divided into three groups: acute (group I), intermediate (group II), and chronic (group III) based on the interval between the first EVS and death. EVS with sodium tetradecyl sulphate (STS) initially produced thrombosis with varying degrees of necrosis and inflammation followed by ulceration, recanalization, and eventually fibrosis with obliteration of varices. Recurrent variceal hemorrhage (VH) leading to death was highest in the acute group since all patients died of uncontrollable VH (100%); it ranged between 50-60% in both the intermediate and chronic groups. Despite variceal obliteration, recurrent hemorrhage developed in the chronic group due to gastric varices or other venous channels in the esophagus or stomach. Additionally, we describe findings not previously reported, such as the presence of sclerosant outside the varices after intravariceal injection, thrombosis of gastric varices after esophageal injections, and the development of muscular wall thickening.

Adult↗

PubMed1986

Frequency-demodulated US: evaluation in the liver. Work in progress.

Frequency modulated (FM) imaging is a new ultrasound (US) modality that uses pulse-echo signal instantaneous frequency in addition to the conventional envelope information. Eight features of the FM image in nondiseased livers are described. The technique is evaluated in a study of 34 patients with biopsy-proved diffuse liver disease. Visual grading of FM US image features shows good correlation with levels of biopsy-graded hepatic fibrosis. Patients with diffuse parenchymal liver disease often exhibit evidence of the abnormality when FM liver imaging is used, while such evidence is not as well demonstrated with conventional envelope (AM) imaging.

Humans↗

PubMed1986

FM sonography in diffuse liver disease: prospective assessment and blinded analysis.

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.

Hepatitis↗

PubMed1984

Phencyclidine-induced malignant hyperthermia causing submassive liver necrosis.

This report describes three male patients arrested for aggressive and combative behavior, characteristic of phencyclidine intoxication, in whom severe hyperthermia, respiratory failure, and coma developed. Two days after the malignant hyperthermic event, serum transaminase levels rose acutely to extremely high levels with concomitant elevations in bilirubin levels and a fall in prothrombin activity. Liver biopsy specimens in two patients showed marked perivenular necrosis and collapse. No specific treatment was directed at the phencyclidine intoxication. Two of the three patients survived. Submassive liver necrosis caused by malignant hyperthermia is an unusual complication of phencyclidine abuse.

Adult↗

PubMed1982

Portasystemic shunts in primary biliary cirrhosis: survival is the same as in patients with Laennec's cirrhosis and postnecrotic cirrhosis.

There is little information regarding survival of patients with primary biliary cirrhosis (PBC) who undergo portasystemic shunt operations. The few published reports suggest that survival may be better in this group than in patients with other types of cirrhosis who undergo this procedure. Therefore, we reviewed our experience with 17 patients with PBC who underwent portasystemic shunts and compared their survival with 100 patients with Laennec's and postnecrotic cirrhosis, using the life-table method. We find that survival rates are the same in patients with PBC, Laennec's cirrhosis, and postnecrotic cirrhosis following portasystemic anastomosis.

Adult↗

PubMed1982

Double-blind, controlled trial of propylthiouracil in patients with severe acute alcoholic hepatitis.

Sixty-seven patients entered a double-blind, controlled trial to evaluate the efficacy of propylthiouracil treatment in severe alcoholic hepatitis. Twenty-three percent (7 of 31) given propylthiouracil and 19% (7 of 36) given placebo died during the 6-wk study. Propylthiouracil treatment did not reduce the frequency and incidence of complications in alcoholic hepatitis, but induced hypothyroidism in 4 patients. Treatment produced no beneficial effect on any of the hepatic biochemical tests. We were unable to show any beneficial effect of propylthiouracil treatment on morbidity and mortality in patients with severe acute alcoholic hepatitis.

Adult↗

PubMedDate not supplied

Live-donor liver transplantation: the USC experience.

BACKGROUND: Liver transplantation is currently the standard of care for patients with end stage liver disease. However due to the cadaveric organ shortage, live donor liver transplantation (LDLT), has been recently introduced as a potential solution. We analyzed and support our initial experience with this procedure at USC. MATERIAL AND METHODS: From September 1998 until July 2000, a total of 27 patients underwent LDLT at USC University Hospital and Los Angeles Children's Hospital. There were 12 children with the median age of 10 months (4-114) and 15 adults with the median age of 56 years (35-65). The most common indication for transplantation was biliary atresia for children and hepatitis C for adults. RESULTS: All donors did well postoperatively; the median postoperative stay was five days (5-7) for left lateral segmentectomy and seven days (4-12) for lobar donation. None of the donors required blood transfusion, re-operation or postoperative invasive procedure. However, five of them (18%) experienced minor complications. The survival rate in pediatric patients was 100% and only one graft was lost at nine months due to rejection. Two adult recipients died in the postoperative period, one from graft non-function and one from necrotizing fascitis. 37% of adult recipients experienced postoperative complications, mainly related to biliary reconstruction. Also 26% of the recipients underwent reoperation for some of these complications. CONCLUSION: LDLT is an excellent alternative to cadaveric transplantation with excellent results in the pediatric population. However, in adult patients it still carries a significant complication rate and it should be used with caution.

Adult↗