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Cirrhotic ascites review: Pathophysiology, diagnosis and management

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World Journal of Hepatology 2013年第5期5卷 251-263页

作者： christopher m moore David H Van Thiel Section of Hepatology Department of MedicineRush University Medical CenterChicagoIL 60612United States

Ascites is a pathologic accumulation of peritoneal fluidcommonly observed in decompensated cirrhotic states. Its causes are multi-factorial, but principally involve significant volume and hormonal dysregulation in the setting of portal hypertension. The diagnosis of ascites is considered in cirrhotic patients given a constellation of clinical and laboratory findings, and ultimately confirmed, with insight into etiology, by imaging and paracentesis procedures. Treatment for ascites is multimodal including dietary sodium restriction, pharmacologic therapies, diagnostic and therapeutic paracentesis, and in certain cases transjugular intra-hepatic portosystemic shunt. Ascites is associated with numerous complications including spontaneous bacterial peritonitis, hepato-hydrothorax and hepatorenal syndrome. Given the complex nature of ascites and associatedcomplications, it is not surprising that it heralds increased morbidity and mortality in cirrhotic patients and increased cost-utilization upon the health-care system. This review will detail the pathophysiology of cirrhotic ascites, common complications derived from it, and pertinent treatment modalities.

关键词： Ascites Cirrhosis Hepato-hydrothorax Hepatorenal syndrome Spontaneous bacterial peritonitis

Successful transjugular intrahepatic portal-systemic shunt in an ineligible liver transplant patient with primary biliary cirrhosis with refractory ascites and aplastic anemia

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Open Journal of Gastroenterology 2013年第1期3卷 1-4页

作者： christopher m. moore George Behrens Hector Ferral David H. Van Thiel Section of Hepatology Department of Medicine Rush University Medical Center Chicago USA Section of Interventional Radiology Department of Radiology Rush University Medical Center Chicago USA

A transjugular intrahepatic portal-systemic shunt (TIPS) is a standard way to decompress the portal system in cirrhotic patients as a bridge to orthotopic liver transplantation (OLT). Traditionally, TIPS has been indicated for certain portal hypertensive sequelae such as refractory ascites, varices treatment and even hepato-hydrothorax. Herein is a case report on the efficacy of TIPS in an OLT ineligible patient with primary biliary cirrhosis and aplastic anemia who had developed refractive ascites requiring serial paracentesis and esophageal varices. He survived 2.5 years post-TIPS placement and died from complications related to severe leucopenia and the development of sepsis.

关键词： Aplastic Anemia Ascites Liver Transplantation Paracentesis TIPS

Colonic perforation with duodenal-colic fistula formation by a biliary stent in a liver transplant recipient

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Open Journal of Gastroenterology 2012年第2期2卷 91-92页

作者： christopher m. moore Raza Hamdani Hector Ferral David H. Van Thiel Advanced Gastroenterology Yorkville USA Section of Hepatology Rush University Medical Center Chicago USA Section of Radiology Rush University Medical Center Chicago USA

Endoscopic retrograde cholangio-pancreatography (ERCP) is increasing utilized in the setting of liver transplantation for a number of post-operative related biliary issues. Although ERCP represents an excellent technology, it is not without attendant risk including sepsis, bleeding and perforation. In this case report, the first of its kind, is described the occurrence of a migrated biliary stent induced duodenal-colic fistula formation in a liver transplantation patient who had required dual biliary stenting given post-operative biliary structuring. The placement of dual stents and their size are likely implicated in the cause of perforation. The enteric anatomy and the medical immunosuppression likely contributed to a delay in diagnosis and worse outcome.

关键词： Biliary Stent Colonic Perforation Duodenal-Colic Fistula Hepatitis C Virus Orthotopic Liver Transplant

Surgeon preferences in the treatment of thumb carpometacarpal osteoarthritis

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World Journal of Orthopedics 2024年第5期15卷 435-443页

作者： Edward J Wu Bradley W Fossum Wyatt Vander Voort christopher O Bayne Robert m Szabo Department of Orthopedic Surgery University of Minnesota Medical SchoolMinneapolisMN 55455United States Department of Orthopaedic Surgery UC Davis School of MedicineSacramentoCA 95817United States

BACKGROUND Primary thumb carpometacarpal(CmC)osteoarthritis is one of the most common conditions encountered by hand *** the vast number of operations that have been proposed,none have demonstrated results significantly superior to trapeziectomy *** The purpose of our study was to determine why surgeons opt for their technique in treating CmC *** A cross-sectional survey of active members of the American Society for Surgery of the Hand was conducted to evaluate the reasons behind their preferred technique in the treatment of isolated thumb CmC *** were contacted by email once and provided with a link to a de-identified survey consisting of 5 treatment questions and 5 demographic *** Of 950 responses were received.40.5%of surgeons preferred trapeziectomy+ligament reconstruction tendon interposition(LRTI),followed by trapeziectomy+suspensionplasty(28.2%),suture button suspension(5.9%),trapeziectomy alone(4.6%),prosthetic arthroplasty(3.2%),arthrodesis(1.1%),and other(6.6%).Proponents of trapeziectomy+LRTI cited familiarity(73.2%),exposure during fellowship(48.8%)and less proximal migration(60%)to be the main reasons affecting their *** who preferred trapeziectomy+suspensionplasty most reported simplicity(74.9%),fewer complications(45.3%),less proximal migration(43.8%),and avoidance of autogenous tissue harvest(42.7%).Advocates of suture button suspension cited avoidance of autogenous tissue harvest(80.4%),shorter immobilization(76.8%),and quicker recovery(73.2%)with their *** of trapeziectomy alone cited simplicity(97.7%),fewer complications(86.4%),and avoidance of autogenous tissue harvest(59.1%).In their comments,45%of surgeons choosing trapeziectomy alone cited evidence as an additional *** of prosthetic arthroplasty cited improved pinch strength(83.3%)and improved range of motion(63.3%),while those preferring arthrodesis cited better pinch strength(90%)and freque

关键词： Thumb carpometacarpal Osteoarthritis Trapeziectomy Ligament reconstruction tendon interposition Suspensionplasty Preferences Trends

Tribological behavior of shape-specific microplate-enriched synovial fluids on a linear two-axis tribometer

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Friction 2024年第3期12卷 539-553页

作者： Agnese FRAGASSI Antonietta GRECO martina DI FRANCESCO Luca CESERACCIU Aiman ABU AmmAR Israel DVIR Thomas Lee moore Haytam KASEm Paolo DECUZZI Laboratory of Nanotechnology for Precision medicine Fondazione Istituto Italiano di TecnologiaGenova 16163Italy Department of Chemistry and Industrial Chemistry University of GenovaGenoa 16146Italy materials Characterization Facility Istituto Italiano di TecnologiaGenova 16163Italy Department of Pharmaceutical Engineering Azrieli College of Engineering JerusalemJerusalem 9103501Israel Department of mechanical Engineering Azrieli College of Engineering JerusalemJerusalem 9103501Israel

Nano-and micro-particles are being increasingly used to tune interfacial frictional properties in diverse applications,from friction modifiers in industrial lubrication to enhanced biological fluids in human osteoarthritic ***,we assessed the tribological properties of a simulated synovial fluid enriched with non-spherical,poly lactic-co-glycolic acid(PLGA)microparticles(μPL)that have been previously demonstrated for the pharmacological management of osteoarthritis(OA).Three different μPL configurations were fabricated presenting a 20μm×20μm square base and a thickness of 5μm(thin,5H μPL),10μm(10H μPL),and 20μm(cubical,20H μPL).After extensive morphological and physicochemical characterizations,the apparent Young’s modulus of the μPL was quantified under compressive loading returning an average value of~6 kPa,independently of the particle ***,using a linear two-axis tribometer,the static(μ_(s))and dynamic(μ_(d))friction coefficients of the μPL-enriched simulated synovial fluid were determined in terms of particle configuration and concentration,varying from 0(fluid only)to 6×10^(5) μPL/*** particle morphology had a modest influence on friction,possibly because the μPL were fully squeezed between two mating surfaces by a 5.8 N normal load realizing boundary-like lubrication ***,friction was observed to depend on the dimensionless parameterW,defined as the ratio between the total volume of the μPL enriching the simulated synovial fluid and the volume of the fluid *** coefficients of friction were documented to grow withWreaching a plateau of μ_(s)~0.4 and μ_(d)~0.15,already at Ω~2×10^(-3).Future investigations will have to systematically analyze the effect of sliding velocity,normal load,and rigidity of the mating surfaces to elucidate in full the tribological behavior of μPL in the context of osteoarthritis.

关键词： osteoarthritis microparticles tribology synovial fluid pin on plate

High-Dose Intra-Dermal Hepatitis B Vaccine in a Liver Transplant Patient Who Failed Prior Intramuscular Vaccination: A Brief Case Report

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World Journal of Vaccines 2013年第1期3卷 16-18页

作者： Sonu Dhillon Kartik Sampath christopher m. moore Anil Dosanjh David H. Van Thiel Division of Gastroenterology and Hepatology Saint Francis Medical Center Peoria USA Divison of Digestive Diseases Rush University Medical Center Chicago USA University of California Davis USA

Hepatitis B virus (HBV) chronic infection represents a significant cause of morbidity and mortality worldwide. While traditional intramuscular (Im) HBV vaccination is an excellent method for robust and sustained seroconversion in healthy individuals, its efficacy in chronic liver disease is sub-optimal and scant data exists in the post-liver transplant state. Importantly, HBV complications are even more severe in these same immunocompromised populations. Intra-dermal (ID) vaccination has shown initial promise as a successful alternative to achieving HBV seroconversion in patients refractory to standard vaccination protocols. Herein is a case report of a 61 year-old female who underwent liver transplantation for chronic HBV infection and achieved HBsAg seroconversion with a robust HSsAb titer with ID vaccination after having failed both standard and double dose Im vaccination.

关键词： Hepatitis B Virus Intra-Dermal Vaccination Orthotopic Liver Transplant

Dynamics of self-hybridized exciton–polaritons in 2D halide perovskites

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Light(Science & Applications) 2024年第1期13卷 13-22页

作者： Surendra B.Anantharaman Jason Lynch christopher E.Stevens christopher munley Chentao Li Jin Hou Hao Zhang Andrew Torma Thomas Darlington Francis Coen Kevin Li Arka majumdar PJames Schuck Aditya mohite Hayk Harutyunyan Joshua R.Hendrickson Deep Jariwala Department of Electrical and Systems Engineering University of PennsylvaniaPhiladelphiaPA19104USA KBR Inc. BeavercreekOH45431USA Air Force Research Laboratory Sensors DirectorateWright-Patterson Air Force BaseOH45433USA Department of Physics University of WashingtonSeattleWA98195USA Department of Physics Emory UniversityAtlantaGA30322USA Department of Chemical and Biomolecular Engineering Rice UniversityHoustonTX77005USA Department of materials Science and Nanoengineering Rice UniversityHoustonTX77005USA Applied Physics Program Smalley‐Curl InstituteRice UniversityHoustonTX77005USA Department of mechanical Engineering Columbia UniversityNew YorkNY10027USA Department of Electrical and Computer Engineering University of WashingtonSeattleWA98195USA

Excitons,bound electron–hole pairs,in two-dimensional hybrid organic inorganic perovskites(2D HOIPs)are capable of forming hybrid light-matter states known as exciton-polaritons(E–Ps)when the excitonic medium is confined in an optical *** the case of 2D HOIPs,they can self-hybridize into E–Ps at specific thicknesses of the HOIP crystals that form a resonant optical cavity with the ***,the fundamental properties of these self-hybridized E–Ps in 2D HOIPs,including their role in ultrafast energy and/or charge transfer at interfaces,remain ***,we demonstrate that>0.5µm thick 2D HOIP crystals on Au substrates are capable of supporting multiple-orders of self-hybridized E–P *** E–Ps have high Q factors(>100)and modulate the optical dispersion for the crystal to enhance sub-gap absorption and *** varying excitation energy and ultrafast measurements,we also confirm energy transfer from higher energy E–Ps to lower energy E–***,we also demonstrate that E–Ps are capable of charge transport and transfer at *** findings provide new insights into charge and energy transfer in E–Ps opening new opportunities towards their manipulation for polaritonic devices.

关键词： charge polar excitation

Heterogeneity of mature oligodendrocytes in the central nervous system

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Neural Regeneration Research 2025年第5期20卷 1336-1349页

作者： Chao Weng Adam m.R.Groh moein Yaqubi Qiao-Ling Cui Jo Anne Stratton G.R.Wayne moore Jack P.Antel Neuroimmunology Unit Montreal Neurological Institute-HospitalDepartment of Neurology and NeurosurgeryMcGill UniversityMontrealQCCanada Department of Neurology Renmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina

mature oligodendrocytes form myelin sheaths that are crucial for the insulation of axons and efficient signal transmission in the central nervous *** evidence has challenged the classical view of the functionally static mature oligodendrocyte and revealed a gamut of dynamic functions such as the ability to modulate neuronal circuitry and provide metabolic support to *** the recognition of potential heterogeneity in mature oligodendrocyte function,a comprehensive summary of mature oligodendrocyte diversity is *** delve into early 20th-century studies by Robertson and Río-Hortega that laid the foundation for the modern identification of regional and morphological heterogeneity in mature ***,recent morphologic and functional studies call into question the long-assumed homogeneity of mature oligodendrocyte function through the identification of distinct subtypes with varying myelination ***,modern molecular investigations,employing techniques such as single cell/nucleus RNA sequencing,consistently unveil at least six mature oligodendrocyte subpopulations in the human central nervous system that are highly transcriptomically diverse and vary with central nervous system *** and disease related mature oligodendrocyte variation denotes the impact of pathological conditions such as multiple sclerosis,Alzheimer's disease,and psychiatric ***,caution is warranted when subclassifying mature oligodendrocytes because of the simplification needed to make conclusions about cell identity from temporally confined *** studies leveraging advanced techniques like spatial transcriptomics and single-cell proteomics promise a more nuanced understanding of mature oligodendrocyte *** research avenues that precisely evaluate mature oligodendrocyte heterogeneity with care to understand the mitigating influence of species,sex,central nervous system region,age,and disease,

关键词： aging central nervous system diseases electron microscopy heterogeneity immunohistochemistry myelin sheath natural history neuroglia oligodendroglia single-cell gene expression analysis

Procalcitonin,and cytokines document a dynamic inflammatory state in non-infected cirrhotic patients with ascites

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World Journal of Gastroenterology 2014年第9期20卷 2374-2382页

作者： Bashar m Attar christopher m moore magdalena George Nicolae Ion-Nedelcu Rafael Turbay Annamma Zachariah Guiliano Ramadori Jawed Fareed David H Van Thiel Division of Gastroenterology and Hepatology John H Stroger Hospital of Cook County Chicago IL 60612 United States David H Van Thiel Division of Gastroenterology and HepatologyRush University Medical Center Chicago IL 60612 United States Division of Gastroenterology and Hepatology Victor Babes Infectious Clinic 050094 Bucharest Romania Division of Gastroenterology and Hepatology August Georg University D-37075 Gottingen Germany Division of Gastroenterology and Hepatology Loyola University Medical Center Maywood IL 60153 United States

AIm:To quantitate the simultaneous serum and ascitic fluid levels of procalcitonin and inflammatory markers in cirrhotics with and without ***:A total of 88 consecutive severe cirrhotic patients seen in a large city hospital liver clinic were studied and divided into two groups,those with and without *** 1 consisted of 41 cirrhotic patients with massive ascites,as demonstrated by necessity for therapeutic large-volume *** 2consisted of 47 cirrhotic patients without any clinically documented ascites to include either a recent abdominal computed tomography scan or ultrasound *** and ascitic fluid levels of an array of inflammatory markers,including procalcitonin,were measured and compared to each other and a normal plasma panel(NPP).RESULTS:The values for inflammatory markers assayed in the serum of Groups 1 and 2,and ascitic fluid of the Group *** plasma levels of the inflammatory cytokines interleukin(IL)-2,IL-4,IL-6,IL-8,interferon gamma(IFNγ)and epidermal growth factor(EGF)were all significantly greater in the serum of Group 1as compared to that of the serum obtained from the Group 2 subjects(all Pm levels of IL-6,IL-8,IL-10,monocyte chemoattractant protein-1,tumor necrosis factor-α,vascular endothelial growth factor and EGF when comparing Group 2 to the *** was no significant difference for IL-1A,IL-1B,IL-2,IL-4 and IFNγlevels between these two *** procalcitonin levels were increased in cirrhotics with ascites compared to cirrhotics without ascites,but serum levels were similar to ascites levels within the ascites ***,many of these cytokines,but not procalcitonin,demonstrate an ascites-to-serum *** procalcitonin does not demonstrate any significant difference segregated by liver etiology in the ascites group;but ascitic fluid procalcitonin is elevated significantly in car-diac cirrhosis/miscellaneous subgroup compared to the hepatitis

关键词： Ascites Bacterial translocation Inflammatory marke