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Comparison of esophageal capsule endoscopy and esophagogastroduodenoscopy for diagnosis of esophageal varices

World journal of Gastroenterology 2008年第28期14卷 4480-4485页

作者： Catherine T Frenette john G Kuldau donald j hillebrand jill Lane Paul j Pockros Division of Gastroenterology and Hepatology Scripps ClinicLa JollaCaliforniaSan Francisco 94115United States

AIM： To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices. METHODS： Cirrhotic patients who were undergoing esophagogastroduodenoscopy （EGD） for variceal screening or surveillance underwent capsule endoscopy. Two separate blinded investigators read each capsule endoscopy for the following results： variceal grade, need for treatment with variceal banding or prophylaxis with beta-blocker therapy, degree of portal hypertensive gastropathy, and gastric varices. RESULTS： Fifty patients underwent both capsule and EGD. Forty-eight patients had both procedures on the same day, and 2 patients had capsule endoscopy within 72 h of EGD. The accuracy of capsule endoscopy to decide on the need for prophylaxis was 74%, with sensitivity of 63% and specificity of 82%. Interrater agreement was moderate （kappa = 0.56）. Agreement between EGD and capsule endoscopy on grade of varices was 0.53 （moderate）. Inter-rater reliability was good （kappa = 0.77）. In diagnosis of portal hypertensive gastropathy, accuracy was 57%, with sensitivity of 96% and specificity of 17%. Two patients had gastric varices seen on EGD, one of which was seen on capsule endoscopy. There were no complications from capsule endoscopy.CONCLUSION： We conclude that capsule endoscopy has a limited role in deciding which patients would benefit from EGD with banding or beta-blocker therapy. More data is needed to assess accuracy for staging esophageal varices, PHG, and the detection of gastric varices.

关键词： Esophageal varices Capsule endoscopy Portal hypertension

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Hepatic intra-arterial infusion of yttrium-90 microspheres in the treatment of recurrent hepatocellular carcinoma after liver transplantation: A case report

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World journal of Gastroenterology 2006年第35期12卷 5729-5732页

作者： Louis Rivera Huan Giap William Miller jonathan Fisher donald j hillebrand Christopher Marsh Randolph L Schaffer Naval Medical Center San Diego San Diego CA 92134 United States Department of Radiation Oncology Scripps Clinic/ Green Hospital La Jolla CA 92037 United States Department of Hematology/Oncology Scripps Clinic/Green Hospital La Jolla CA 92037 United States Scripps Center for Organ and Cell Transplantation Scripps Clinic/Green Hospital La Jolla CA 92037 United States

Hepatocellular carcinoma （HCC） recurs with a reported frequency of 12%-18% after liver transplantation. Recurrence is associated with a mortality rate exceeding 75%. Approximately one-third of recurrences develop in the transplanted liver and are therefore amenable to local therapy. A variety of treatment modalities have been reported including resection, transarterial chemoembolization （TACE）, radiofrequency ablation （RFA）, ethanol ablation, cryoablation, and external beam irradiation. Goals of treatment are tumor control and the minimization of toxic effect to functional parenchyma. Efficacy of treatment is mitigated by the need for ongoing immunosuppression. Yttrium-90 microspheres have been used as a treatment modality both for primary HCC and for pre-transplant management of HCC with promising results. Twenty-two months after liver transplantation for hepatitis C cirrhosis complicated by HCC, a 42-year old man developed recurrence of HCC in his transplant allograft. Treatment of multiple right lobe lesions with anatomic resection and adjuvant chemotherapy was unsuccessful. Multifocal recurrence in the remaining liver allograft was treated with hepatic intra-arterial infusion of yttrium-90 microspheres （SIR-Spheres, Sirtex Medical Inc., Lake Forest, IL, USA）. Efficacy was demonstrated by tumor necrosis on imaging and a decrease in alpha-fetoprotein （AFP） level. There were no adverse consequences of initial treatment.

关键词： Recurrent hepatocellular carcinoma Yttrium-90 microspheres Liver transplantation

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Validation of a liquid chromatographic method for the pharmaceutical quality control of products containing elacridar

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journal of Pharmaceutical Analysis 2016年第4期6卷 268-275页

作者： Emilia Sawicki Michel j.hillebrand Hilde Rosing jan H.M.Schellens Bastiaan Nuijen jos H.Beijnen Department of Pharmacy & Pharmacology The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital Division of Clinical Pharmacology Department of Medical OncologyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital Division of Pharmacoepidemiology & Clinical Pharmacology.Department of Pharmaceutical Sciences Faculty of Science.Utrecht University

Many anticancer drugs have an impaired bioavailability and poor brain penetration because they are substrates to drug efflux pumps such as P-glycoprotein and Breast Cancer Resistance *** is a strong inhibitor of these two drug efflux pumps and therefore has great potential to improve oral absorption and brain penetration of many anticancer ***,a clinical formulation of elacridar is unavailable and therefore the pharmaceutical development of a drug product is highly *** also necessitates the availability of an analytical method for its quality control.A reverse-phase high-performance liquid chromatographic method with ultraviolet detection was developed for the pharmaceutical quality control of products containing elacridar as the active pharmaceutical *** analytical method was validated for linearity,accuracy,precision,selectivity,carry-over,stability of stock and reference solutions,stability of the final extract,stability-indicating capability and impurity *** found that elacridar is unstable in aqueous solutions that are exposed to light because a hydroxylation product of elacridar is ***,sample solutions with elacridar must be protected from light.

关键词： GF120918 Solid dispersion Dissolution Hydroxylation HPLC-UV

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