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Metabolic liver disease of obesity and role of adipose tissue in the pathogenesis of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2007年第26期13卷 3540-3553页

作者： kamran qureshi Gary A Abrams Department of Medicine University of Alabama at BirminghamUnited States

Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized cause of liver-related morbidity and mortality. It can develop secondary to numerous causes but a great majority of NAFLD cases occur in patients who are obese or present with other components of metabolic syndrome (hypertension, dyslipidemia, diabetes). This is called primary NAFLD and insulin resistance plays a key role in its pathogenesis. Obesity is characterized by expanded adipose tissue, which is under a state of chronic inflammation. This disturbs the normal storage and endocrine functions of adipose tissue. In obesity, the secretome (adipokines, cytokines, free fatty acids and other lipid moieties) of fatty tissue is amplified, which through its autocrine, paracrine actions in fat tissue and systemic effects especially in the liver leads to an altered metabolic state with insulin resistance (IR). IR leads to hyperglycemia and reactive hyperinsulinemia, which stimulates lipid-accumulating processes and impairs hepatic lipid metabolism. IR enhances free fatty acid delivery to liver from the adipose tissue storage due to uninhibited lipolysis. These changes result in hepatic abnormal fat accumulation, which may initiate the hepatic IR and further aggravate the altered metabolic state of whole body. Hepatic steatosis can also be explained by the fact that there is enhanced dietary fat delivery and physical inactivity. IR and NAFLD are also seen in various lipodystrophic states in contrary to popular belief that these problems only occur due to excessive adiposity in obesity. Hence, altered physiology of adipose tissue is central to development of IR, metabolic syndrome and NAFLD.

关键词：代谢性肝疾病脂肪肝脂肪组织病理机制

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Hemorrhagic ascites from spontaneous ectopic mesenteric varices rupture in NASH induced cirrhosis and successful outcome:A case report

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World Journal of Gastroenterology 2014年第25期20卷 8292-8297页

作者： Raja GR Edula kamran qureshi Hicham Khallafi Department of Medicine Division of Gastroenterology and HepatologyRutgers New Jersey Medical SchoolNewarkNJ 07103United States Department of Hepatology Florida Hospital Transplant CenterOrlando FL 32804United States

Bleeding from gastro-esophageal varices can often present as the first decompensating event in patients with cirrhosis. This can be a potentially life threatening event associated with a 15%-20% early mortality. We present a rare case of new onset ascites due to intra-abdominal hemorrhage from ruptured mesenteric varices; in a 37 years old male with newly diagnosed nonalcoholic steatohepatitis induced cirrhosis as the first decompensating event. The patient was successfully resuscitated with emergent evacuation of ascites for diagnosis, identification and control of bleeding mesenteric varices and eventually orthotopic liver transplantation with successful outcome. Various clinical presentations, available treatment options and outcomes of ectopic variceal bleeding are discussed in this report.

关键词： Cirrhosis Nonalcoholic steatohepatitis Ectopic var

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Thrombopoietin-receptor agonists in perioperative treatment of patients with chronic liver disease

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World Journal of Meta-Analysis 2020年第3期8卷 220-232页

作者： kamran qureshi Alan Bonder Department of Internal Medicine Division of Gastroenterology and HepatologySaint Louis University School of MedicineSt.LouisMO 63104United States Division of Gastroenterology/Liver Center Beth Israel Deaconess Medical CenterBostonMA 02215United States

Thrombocytopenia is a multifactorial disorder that is common in patients with chronic liver disease(CLD),leading to challenging perioperative planning.As thrombocytopenia in CLD is associated with thrombopoietin(TPO)deficiency,the use of TPO-receptor agonists(TPO-RAs)to increase platelet counts is a promising approach.This has led to the development of various TPO-RAs,including romiplostim,eltrombopag,avatrombopag,and lusutrombopag.Of these,only avatrombopag and lusutrombopag are approved by the United States Food and Drug Administration for the perioperative treatment of thrombocytopenia in patients with CLD.Platelet transfusion is commonly used for the clinical management of thrombocytopenia in patients with CLD undergoing invasive procedures.However,the limitations and possible risks of transfusion,including short duration of efficacy,development of antiplatelet antibodies,risk of infections and such complications as transfusion-related acute lung injury or circulatory overload,and possibility of refractoriness,limit its use.Moreover,there is no consensus among guidelines as to the platelet count at which transfusions are indicated.Results from studies using TPO-RAs perioperatively in patients with thrombocytopenia and CLD are promising and provide an alternative to platelet transfusions in the pre-and post-operative setting.These TPO-RAs are the subject of this review,with focus on their use in the perioperative setting in patients with thrombocytopenia,associated supporting clinical trials,efficacy and safety data,and their use with respect to platelet transfusions.

关键词： Chronic liver disease Thrombocytopenia Thrombopoietin Receptor agonist Avatrombopag Lusutrombopag Romiplostim Perioperative

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Acute cytomegalovirus infection in liver transplant recipients:An independent risk for venous thromboembolism

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World Journal of Hepatology 2013年第12期5卷 692-695页

作者： Raja GR Edula kamran qureshi Hicham Khallafi Department of Medicine Division of Gastroen-terology and HepatologyRutgers New Jersey School of Medi-cineNewark Department of Hepatology Florida Hospital Transplant Center

Acute cytomegalovirus(CMV) infection is a commonly encountered complication in the post liver transplant setting. We present a case of a 71-year-old male with acute CMV infection, initially presenting with a gastro- intestinal bleed due to acute CMV gastritis and later on complicated by acute venous thromboembolism occur- ring as an unprovoked event in the post liver transplant period. Traditional risk factors for venous thromboem- bolism have been well described in the medical litera- ture. Sporadic cases of thromboembolism due to CMV infection in the immune compromised patients have been described, especially in the post kidney transplant patients. Liver transplant recipients are equally prone to CMV infection particularly in the first year after suc- cessful transplantation. Venous thromboembolism in this special population is particularly challenging due to the fact that these patients may have persistent throm- bocytopenia and anticoagulation may be a challenge for the treating physician. Since liver transplantation is severely and universally limited by the availability of donor organs, we feel that this case report will provide valuable knowledge in the day to day management of these patients, whose clinical needs are complex and require a multidisciplinary approach in their care and management. Evidence and pathophysiology link- ing both the conditions is presented along with a brief discussion on the management, common scenarios en- countered and potential impact in this special group of patients.

关键词： Cytomegalovirus Venous thromboembo-lism Orthotopic liver transplantation Thrombocytope-nia Hypersplenism

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用于底栖生物研究的可调物镜水下显微镜设计与测试

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Journal of Marine Science and Application 2021年第1期20卷 170-178页

作者： kamran Shahani 宋宏 Syed Raza Mehdi Awakash Sharma Ghulam Tunio Junaidullah qureshi Noor Kalhoro Nooruddin Khaskheli Ocean Engineering and Technology Ocean CollegeZhejiang UniversityZhoushan 316000China Marine Science Ocean CollegeZhejiang UniversityZhoushan 316000China Port and Coastal offshore Engineering Ocean CollegeZhejiang UniversityZhoushan 316000China

Monitoring the ecology and physiology of corals,sediments,planktons,and microplastic at a suitable spatial resolution is of great importance in oceanic scientific research.To meet this requirement,an underwater microscope with an electrically controlled variable lens was designed and tested.The captured microscopic images of corals,sediments,planktons,and microplastic revealed their physical,biological,and morphological characteristics.Further studies of the images also revealed the growth,degradation,and bleaching patterns of corals;the presence of plankton communities;and the types of microplastics.The imaging performance is majorly influenced by the choice of lenses,camera selection,and lighting method.Image dehazing,global saturation masks,and image histograms were used to extract the image features.Fundamental experimental proof was obtained with micro-scale images of corals,sediments,planktons,and microplastic at different magnifications.The designed underwater microscope can provide relevant new insights into the observation and detection of the future conditions of aquatic ecosystems.

关键词： Underwater microscope Optics Corals Sediments Planktons Microplastic Arduino

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T4N0头颈癌患者辅助放化疗的作用:国家癌症数据库分析

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中国口腔颌面外科杂志 2018年第2期16卷 148-148页

作者： Kirke DN qureshi MM kamran SC 张凌

该文旨在评估术后放疗（RT）与术后同期放化疗（CRT）在T4N0M0头颈鳞癌（HNSCC）患者中的作用。选取1998-2011年间3518例HNSCC患者中接受手术联合RT或CRT的885例患者进行回顾分析,以3年总生存率（OS）作为评估指标。结果：平均随访41.8... 详细信息

该文旨在评估术后放疗（RT）与术后同期放化疗（CRT）在T4N0M0头颈鳞癌（HNSCC）患者中的作用。选取1998-2011年间3518例HNSCC患者中接受手术联合RT或CRT的885例患者进行回顾分析,以3年总生存率（OS）作为评估指标。结果：平均随访41.8个月,2193例患者死亡。3年OS,手术联合RT组和手术联合CRT组分别为67.5%和70.5%（P=0.013）;切缘阴性患者3年OS分别为70.1%和74.9%（P=0.005）,

关键词： CRT OS

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