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Long-term outcomes of pediatric liver transplantation in acute liver failure vs end-stage chronic liver disease:A retrospective observational study

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World Journal of Transplantation 2023年第3期13卷 96-106页

作者： Amr M Alnagar Abdul R Hakeem Khaled Daradka Eirini Kyrana Marumbo Methga KarthikeyanPalaniswamy Sanjay Rajwal Jamila Mulla Moira O'meara Vivek Upasani dhakshinamoorthy vijayanand Raj Prasad Magdy S Attia Department of General Surgery Faculty of MedicineAlexandria UniversityAlexandria 21615Egypt Liver and Transplant Surgery The Leeds Teaching HospitalsNHS Foundation TrustLeeds LS97TFUnited Kingdom

BACKGROUND Children with acute liver failure(ALF)who meet the criteria are eligible for super-urgent transplantation,whereas children with end-stage chronic liver disease(ESCLD)are usually transplanted *** liver transplantation(PLT)in ALF and ESCLD settings has been well described in the literature,but there are no studies comparing the outcomes in these two *** To determine if there is a difference in post-operative complications and survival outcomes between ALF and ESCLD in *** This was a retrospective observational study of all primary PLTs performed at a single center between 2000 and *** and ESCLD groups were compared for pretransplant recipient,donor and operative parameters,and post-operative outcomes including graft and patient *** Over a 20-year study period,232 primary PLTs were performed at our center;195 were transplanted for ESCLD and 37 were transplanted for *** ALF recipients were significantly older(median 8 years vs 5.4 years;P=0.031)and heavier(31 kg vs 21 kg;P=0.011).Living donor grafts were used more in the ESCLD group(34 vs 0;P=0.006).There was no difference between the two groups concerning vascular complications and rejection,but there were more bile leaks in the ESCLD ***-transplant patient survival was significantly higher in the ESCLD group:1-,5-,and 10-year survival rates were 97.9%,93.9%,and 89.4%,respectively,compared to 78.3%,78.3%,and 78.3%in the ALF group(P=0.007).However,there was no difference in 1-,5-,and 10-year graft survival between the ESCLD and ALF groups(90.7%,82.9%,77.3%vs 75.6%,72.4%,and 66.9%;P=0.119).CONCLUSION Patient survival is inferior in ALF compared to ESCLD recipients;the main reason is death in the 1st year post-PLT in ALF *** the ALF children overcome the 1st year after transplant,their survival stabilizes,and they have good long-term outcomes.

关键词： Pediatric liver transplantation Acute liver failure End-stage chronic liver disease Graft failure Patient survival Complications

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Application of an immobilized microbial consortium for the treatment of pharmaceutical wastewater: Batch-wise and continuous studies

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Chinese Journal of Chemical Engineering 2021年第1期34卷 391-400页

作者： Shabnam Murshid Gnana Prakash dhakshinamoorthy Department of Chemical Engineering SSN College of EngineeringKalavakkamTamil Nadu 603110India

In the present investigation,a microbial consortium consisting of four bacterial strains was selected for the treatment of pharmaceutical industry wa *** consortium was immobilized on a natural support matrixLuffa and used for the treatment of real-time pharmaceutical wastewater in batch and continuous *** batch process was carried out to optimize the culture conditions and monitor the enzymatic *** array of enzymes such as alcohol dehydrogenase,aldehyde dehydrogenase,monooxygenase,catechol 2,3-dioxygenase and hydroquinol 1,2-dioxygenase were produced by the *** kinetics of the degradation in the batch process was analyzed and it was noted to be a first-order *** the continuous study,an aerobic fixed-film bioreactor(AFFBR) was utilized for a period of 61 days with variable hydraulic retention time(HRT) and organic loading rate(OLR).The immobilized microbes treated the wastewater by reducing the COD,phenolic contaminants and suspended *** OLR ranged between(0.56±0.05) kg COD·m^(-3) d^(-1) to 3.35 kg COD·m^(-3)·d^(-1) and the system achieved an average reduction of 96.8% of COD,92.6% of phenolic compounds and 95.2% of suspended *** of the continuous process was interpreted by three different models,where the modified Stover Kincannon model and the Grau second-order model proved to be best fit for the degradation reaction with the constant for saturation value,k_(L) being 95.12 g·L^(-1)·d^(-1).the constant for maximum utilization of the substrate U_(max) being 90.01 g·L^(-1) d^(-1) and substrate removal constant KY was1.074 d^(-1) for both the ***-MS analysis confirmed that most of the organic contaminants were degraded into innocuous metabolite s.

关键词： Pharmaceutical wastewater Microbial consortium Immobilization Batch study Fixed film bioreactor Kinetic studies

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Current update on molecular cytogenetics, diagnosis and management of gastrointestinal stromal tumors

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World Journal of Gastroenterology 2021年第41期27卷 7125-7133页

作者： Mindy X Wang Catherine Devine Nicole Segaran dhakshinamoorthy Ganeshan Department of Diagnostic Imaging University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Radiology Mayo Clinic ArizonaPhoenixAZ 85259United States

Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal(GI)tract and are thought to arise from precursors of the interstitial cells of *** can arise anywhere in the GI tract,but most commonly originate from the stomach and small *** majority of GISTs occur as a result of activating mutations in two receptor protein tyrosine kinases:KIT and/or platelet-derived growth factor receptor-α.Mutational analyses allow for predicting patient prognosis and treatment *** presentations can vary from no symptoms,typical in the case of small incidentally found tumors,to GI bleeding,abdominal discomfort,and ulcer-related symptoms when the tumor is *** plays a critical role in the diagnosis and management of these tumors with multiphasic computed tomography serving as the imaging modality of *** resonance imaging and positron emission tomography-computed tomography can serve as imaging adjuncts in lesion characterization,especially with liver metastases,and subsequent staging and assessment for treatment response or *** resection is the preferred management for small GISTs,while tyrosine kinase inhibitors−imatinib mesylate and sunitinib malate−serve as crucial molecular-targeted therapies for locally advanced and metastatic *** review article highlights the clinical presentation,pathology and molecular cytogenetics,imaging features,and current management of GISTs.

关键词： Gastrointestinal stromal tumors Cytogenetics Diagnostic imaging Computed tomography Magnetic resonance imaging Imatinib mesylate

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Current update on imaging for pancreatic neuroendocrine neoplasms

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World Journal of Clinical Oncology 2021年第10期12卷 897-911页

作者： Nicole Segaran Catherine Devine Mindy Wang dhakshinamoorthy Ganeshan Department of Radiology Mayo Clinic ArizonaPhoenixAZ 85259United States Department of Diagnostic Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Diagnostic Radiology Abdominal ImagingThe University of Texas MD Anderson Cancer CenterHoustonTX 77030United States

Pancreatic neuroendocrine neoplasms(panNEN)are a heterogeneous group of tumors with differing pathological,genetic,and clinical *** on clinical findings,they may be categorized into functioning and nonfunctioning *** of the 2017 World Health Organization classification system,particularly its differentiation between grade 3,well-differentiated pancreatic neuroendocrine tumors(panNET)and grade 3,poorly-differentiated pancreatic neuroendocrine carcinomas(panNEC)has emphasized the role imaging plays in characterizing these *** ultrasound can help obtain biopsy specimen and assess tumor margins and local *** patterns on computed tomography(CT)and magnetic resonance imaging(MRI)may be used to classify *** enhanced MRI and diffusion-weighted imaging have been reported to be useful for characterization of panNEN and quantifying metastatic *** and emerging radiotracers have broadened the utility of functional imaging in evaluating ***-18 fluorodeoxyglucose positron emission tomography(PET)/CT and somatostatin receptor imaging such as Gallium-681,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid–octreotate PET/CT may be useful for improved identification of panNEN in comparison to anatomic *** new techniques can also play a direct role in optimizing the selection of treatment for individuals and predicting tumor response based on somatostatin receptor *** addition,emerging methods of radiomics such as texture analysis may be a potential tool for staging and outcome prediction in panNEN,however further investigation is required before clinical implementation.

关键词： Pancreatic neuroendocrine neoplasms Computed tomography Ultrasound Positron emission tomography Magnetic resonance imaging Peptide receptor radionuclide therapy

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Features of primary pancreatic lymphoma:A bi-institutional review with an emphasis on typical and atypical imaging features

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World Journal of Clinical Oncology 2021年第9期12卷 823-832页

作者： Nicole Segaran Kumaresan Sandrasegaran Catherine Devine Mindy X Wang Chintan Shah dhakshinamoorthy Ganeshan Department of Radiology Mayo Clinic ArizonaPhoenixAZ 85054United States Department of Diagnostic Imaging University of Texas MD Anderson Cancer CenterHoustonTX 77030United States

BACKGROUND Primary pancreatic lymphoma(PPL)is a rare *** able to distinguish it from other pancreatic malignancies such as pancreatic ductal adenocarcinoma(PDAC)is important for appropriate *** PDAC,PPL is highly sensitive to chemotherapy and usually does not require ***,being able to identify PPL preoperatively will not only direct physicians towards the correct avenue of treatment,it will also avoid unnecessary surgical *** To evaluate the typical and atypical multi-phasic computed tomography(CT)imaging features of *** A retrospective review was conducted of the clinical,radiological,and pathological records of all subjects with pathologically proven PPL who presented to our institutions between January 2000 and December *** review board approval was obtained for this *** collected data were analyzed for subject demographics,clinical presentation,laboratory values,CT imaging features,and the treatment *** of all CT imaging findings including size,site,morphology and imaging characteristics of PPL such as the presence or absence of nodal,vascular and ductal involvement in these subjects were *** those subjects who had a pre-treatment multiphasic CT of the abdomen were included in the *** Twenty-nine cases of PPL were diagnosed between January 2000 and December 2020(mean age 66 years;13 males/16 females).All twenty-nine subjects were symptomatic but only 4 of the 29 subjects(14%)had B *** jaundice occurred in 24%of *** lactate dehydrogenase was seen in 81%of cases,whereas elevated cancer antigen 19-9 levels were present in only 10%of cases for which levels were *** vast majority(90%)of tumors involved the pancreatic head and uncinate *** tumor size was 7.8 cm(range,4.0-13.8 cm).PPL presented homogenous hypoenhancement on CT in 72%of *** volume peripancreatic lymphadenopathy was seen in 28%

关键词： Pancreatic tumors Primary pancreatic lymphoma Pancreatic ductal adenocarcinoma Imaging features Diagnosis Computed tomography

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Extrahepatic 胆汁的癌症: 新阶段分类

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World Journal of Radiology 2012年第8期4卷 345-352页

作者： dhakshinamoorthy Ganeshan Fanny E Moron Janio Szklaruk Department of Diagnostic Radiology Division of Diagnostic ImagingThe University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Diagnostic Radiology Baylor College of MedicineHoustonTX 77030 United States

Tumor staging defines the point in the natural history of the malignancy when the diagnosis is made. The most common staging system for cancer is the tumor, node, metastases classification. Staging of cancers provides useful parameters in the determination of the extent of disease and prognosis. Cholangiocarcinoma are rare and refers to cancers that arise from the biliary epithelium. These tumors can occur anywhere along the biliary tree. These tumors have been previously divided into extrahepatic and intrahepatic lesions. Until recently the extrahepatic bile duct tumors have been considered as a single entity per American Joint Com- mission on Cancer (AJCC) staging classification. The most recent changes to the AJCC classification of bile duct cancers divide the tumors into two major catego- ries: proximal and distal tumors. This practical classifi- cation is based on anatomy and surgical management. High quality cross-sectional computed tomography (CT) and/or magnetic resonance (MR) imaging of the abdomen are essential information to accurately stage this tumors. Imaging plays an important role in diag-nosis, localization, staging and optimal management of cholangiocarcinoma. For example, it helps to localize the tumor to either perihilar or distal bile duct, both of which have different management. Further, it helps to accurately stage the disease and identify the presence of significant nodal and distant metastasis, which may preclude surgery. Also, it helps to identify the extent of local invasion, which has a major impact on the management. For example, extensive involvement of hepatic duct reaching up to second-order biliary radi- cals or major vascular encasement of portal vein or hepatic arteries precludes curative surgery and patient may be managed by palliative therapy. Further, imag- ing helps to identify any anatomical variations in the hepatic arterial or venous circulation and biliary ductal system, which is vital information for surgical planning. Th

关键词： American Joint Commission on Cancer Stag- ing Bile duct tumors Computed tomography Magnetic resonance

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香叶天竺葵(Pelargonium graveolens L'Herit)养料吸收研究

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香料香精化妆品 1980年第4期 50-50页

作者： M.dhakshinamoorthy R.Arumugam P.S.Srinivasan P.Duraisamy 金怀荣

关于香叶天竺葵 Pelargonium graveolens L’Herit(译者注:下简称为香叶)的养料分布与吸收没有资料报导,因而研究了它在不同生长阶段的主要养料吸收量和分布情况,并制订了施肥方案。土地不加粪肥和化肥,行株距60×40厘米。从每一块地中... 详细信息

关于香叶天竺葵 Pelargonium graveolens L’Herit(译者注:下简称为香叶)的养料分布与吸收没有资料报导,因而研究了它在不同生长阶段的主要养料吸收量和分布情况,并制订了施肥方案。土地不加粪肥和化肥,行株距60×40厘米。从每一块地中随便选十株植物,在种后第四个月收集样品。整株植物分成不同的部份如根茎、叶和叶柄,分别地乾燥和研成粉末,分析

关键词：香叶天竺葵 Pelargonium graveolens L’Herit 氧化钾

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