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RISS 인기검색어
- 검색키워드
- 저자 : ( Ashish Goel ) (검색결과 4 건)
- 무료
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- 유료
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Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
Nanda Chhavi,Kiran Zutshi,Niranjan Kumar Singh,Ashish Awasthi,Amit Goel 대한소아소화기영양학회 2014 Pediatric gastroenterology, hepatology & nutrition Vol.17 No.3
Purpose: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). Methods: Singleton term newborns with BA and ≤72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. Results: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate- for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. Conclusion: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.
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Manmeet Singh,Samarth Agarwal,Apul Goel,Manoj Kumar,Ashish Sharma,Siddharth Pandey,Satynarayan Sankhwar 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.3
Purpose: We report the results and experience of a tertiary care center in laparoscopic transperitoneal heminephrectomy for the treatment of a non-functioning upper pole moiety of duplex kidney in adults. Materials and Methods: The key point of the technique included the placement of a 6-Fr ureteric catheter in the healthy ureter at the beginning of the procedure under fluoroscopic guidance cystoscopically. A standard laparoscopic 3- to 4-port placement was done after placing the patient in a 45 to 90 degrees lateral decubitus position. The upper pole was mobilized transperitoneally and transected using a harmonic scalpel. Results: A total of 17 patients aged 19 to 44 years underwent laparoscopic upper pole heminephrectomy. All patients had a complete duplicated renal collecting system on the ipsilateral side. Three patients were found to have ureterocele. The average blood loss was minimal (50–150 mL) with a mean of 95 ml. None of the patients required any blood transfusions. The mean operative time was 220 minutes (range, 160–315 minutes). The average length of hospital stay was 3 days (range, 2–4 days). Only 2 patients had Clavien-Dindo grade 3a complications, which were managed by double J stenting and percutaneous aspiration, respectively. Conclusions: Laparoscopic heminephrectomy is playing a cornerstone role in the treatment of the non-functioning moiety of duplex kidneys. The procedure is safe, efficient and offers the typical preoperative and postoperative benefits of laparoscopic surgery. The rate of complications in adults is acceptable and is similar to that reported in pediatric patients.
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Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
Chhavi, Nanda,Zutshi, Kiran,Singh, Niranjan Kumar,Awasthi, Ashish,Goel, Amit The Korean Society of Pediatric Gastroenterology 2014 Pediatric gastroenterology, hepatology & nutrition Vol.17 No.3
Purpose: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). Methods: Singleton term newborns with BA and ${\leq}72$ hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. Results: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. Conclusion: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.
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( Do Seon Song ),( Dong Joon Kim ),( Ji Dong Jia ),( Ashok Kumar Choudhury ),( Mamun Al Mahtab ),( Harshad Devarbhavi ),( Z Duan ),( Chen Yu ),( C E Eapen ),( Ashish Goel ),( Q Ning ),( Ke Ma ),( Y K 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: To compare the existing various prognostic scoring mod els and newly proposed scores for acute-on-chronic liver failure (ACLF) and evaluate usefulness of stratification for the predic tion of short-term morality in patients with alcoholic hepatitis (AH). Methods: A total of 705 clinical AH patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day fol low-up, were analyzed. AARC-ACLF score, Maddrey discrimina tion function (DF) score, age, bilirubin, international normalized ratio and creatinine score (ABIC), Glasgow Alcoholic Hepatitis Score (GAHS), Child-Turcott-Pugh (CTP) score, model for end-stage liver disease (MELD), and MELD-Sodium (Na) scores were used to compare the performance for predicting 30-day and 90-day mortality. AARC-ACLF scores were categorized into three grades (Gr I: 5-7; II: 8-10; and III: 11-15 points) and sur vival curves by the Kaplan-Meier method were created and compared using log-rank test. Results: Of 708 patients, 286 (40.4%) and 363 (51.3%) pa tients died within 30 days and 90 days, respectively. The area under receiver operating characteristics curve (AUC) of AARC-ACLF, DF, ABIC, GAHS, CTP, MELD, and MELD-Na was 0.752 (0.705-0.799), 0.630 (0.575-0.685), 0.658 (0.604-0.711), 0.577 (0.523-0.631), 0.641 (0.589-0.694), 0.705 (0.653-0.756), 0.703 (0.651-0.755), respectively, for 30-day mortality. The AUC of various prognostic scores for the prediction of 90-day mortality is similar. The performance of AARC-ACLF was superior to that of DF, ABIC, GAHS, CTP, while comparable to that of MELD and MELD-Na in predicting short-term mortality. According to AARC-ACLF grades, short-term cumulative survivals was statis tically different (30-day, 82.4, 70.4, and 35.3%, P<0.001; 90- day, 76.9, 56.0, and 26.4%, P<0.001). Conclusions: Compared to the previous AH prognostic scores, AARC-ACLF score and grades are simple and useful for predict ing the short-term mortality in patients with AH. Further studies are needed to confirm these implications.
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