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| 1 | Cirrhotic ascites review: Pathophysiology, diagnosis and management显示文摘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. | Christopher M Moore David H Van Thiel | 2013 | World Journal of Hepatology2013，5，5： | 13 |
| 2 | Procalcitonin,and cytokines document a dynamic inflammatory state in non-infected cirrhotic patients with ascites显示文摘AIM:To quantitate the simultaneous serum and ascitic fluid levels of procalcitonin and inflammatory markers in cirrhotics with and without ascites.METHODS: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 ascites.Group 1 consisted of 41 cirrhotic patients with massive ascites,as demonstrated by necessity for therapeutic large-volume paracentesis.Group 2consisted of 47 cirrhotic patients without any clinically documented ascites to include either a recent abdominal computed tomography scan or ultrasound study.Serum 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 1.The 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 P<0.05).There were significantly greater serum 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 NPP.There was no significant difference for IL-1A,IL-1B,IL-2,IL-4 and IFNγlevels between these two groups.Serum procalcitonin levels were increased in cirrhotics with ascites compared to cirrhotics without ascites,but serum levels were similar to ascites levels within the ascites group.Furthermore,many of these cytokines,but not procalcitonin,demonstrate an ascites-to-serum gradient.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 C virus and alcoholic cirrhosis subgroups.CONCLUSION:Procalcitonin in the ascitic fluid,but not in the serum,differentiates between cirrhotic subgroup reflecting the dynamic interplay of ascites,bacterial translocation and the peri-peritoneal cytokine. | Bashar M Attar Christopher M Moore Magdalena George Nicolae Ion-Nedelcu Rafael Turbay Annamma Zachariah Guiliano Ramadori Jawed Fareed David H Van Thiel | 2014 | World Journal of Gastroenterology2014，20，9： | 4 |
| 3 | Disease dependent qualitative and quantitative differences in the inflammatory response to ascites occurring in cirrhotics显示文摘AIM:To assess differing patterns and levels of ascitic fluid cyctokine and growth factors exist between those with a high risk and low risk of spontaneous bacterial peritonitis(SBP). METHODS: A total of 57 consecutive patients with ascites requiring a large volume paracentesis were studied. Their age, gender, specific underlying disease conditions were recorded after a review of their clinical records. Each underwent a routine assessment prior to their paracentesis consisting of a complete blood count, complete metabolic profile and prothrombin time/international normalized ratio(INR) determination. The ascitic fluid was cultured and a complete cellcount and albumin determination was obtained on the fluid. In addition, blood and ascitic fluid was assessed for the levels of interleukin interleukin(IL)-1A, IL-1B, IL-2, IL-4, IL-8, IL-10, monocyte chemotactic protein(MCP)-1, tumor necrosis factor(TNF)-α, interferon(IFN)-γ, vascular endothelial growth factor(VEGF) and epidermal growth factor(EGF) utilizing the Randox Biochip platforms(Boston, MA). A serum-ascites gradient, for each cytokine and growth factor was calculated. The results are reported as mean ± SEM between disease groups with statistical analysis consisting of the student t-test(two tailed) with a P value of 0.05 defining significance. RESULTS: No clinically important demographic or biochemical differences between the 4 groups studied were evident. In contrast, marked difference in the cytokine and growth factors levels and pattern were evident between the 4 disease groups. Individuals with alcoholic cirrhosis had the highest levels of IL-1A, IL-1B, IL-4, IFNγ. Those with malignant disease had the highest levels of IL-2. Those with hepatitis C virus(HCV) associated cirrhosis had the highest value for IL-6, IL-8, IL-10, MCP-1 and VEGF. Those with cardiac disease had the highest level of TNF-α and EGF. The calculated serum- ascites gradients for the cardiac and malignant disease groups had a greater frequency of negative values signifying greater levels of IL-8, IL-10 and MCP-1 in ascites than did those with alcohol or HCV disease. CONCLUSION: These data document important differences in the cytokine and growth factor levels in plasma, ascitic fluid and the calculated plasma- ascites fluid gradients in cirrhotics requiring a large volume paracentesis. These differences may be important in determining the risk for bacterial peritonitis. | Bashar M Attar Magdalena George Nicolae Ion-Nedelcu Guilliano Ramadori David H Van Thiel | 2014 | World Journal of Hepatology2014，6，2： | 3 |
| 4 | Diabetes Mellitus and the Liver显示文摘 | Bradford Stone David Van Thiel | 1985 | Semin Liver Dis1985，，： | 2 |
| 5 | Effect of temsirolimus versus interferon-α on outcome of patients with advanced renal cell carcinoma of different tumor histologies显示文摘 | Janice P. Dutcher Paul Souza David McDermott Robert A. Figlin Anna Berkenblit Alexandra Thiele Mizue Krygowski Andrew Strahs Jay Feingold Gary Hudes | 2009 | Medical Oncology2009，，： | 1 |
| 6 | Wetting of textured surfaces显示文摘 | JOSE BICO UWE THIELE DAVID QUERE | 2002 | Colloids and Surfaces A:Physicochemical and Engineering Aspects2002，206，： | 1 |
| 7 | Measuring Near Zero Automotive Exhaust Emissions-Zero Is a Very Small Precise Number 显示文摘 | Wolfgang Thiel Roman Woegerbauer David Eason BMW Group | 2010 | SAE Technical Paper2010，，： | 1 |
| 8 | Hepatitis C–related hepatocellular carcinoma in the United States: influence of ethnic status显示文摘 | Adrian M Di Bisceglie Andre C Lyra Myron Schwartz Rajender K Reddy Paul Martin Gregory Gores Anna S.F Lok Khozema B Hussain Robert Gish David H Van Thiel Zobair Younossi Myron Tong Tarek Hassanein Luis Balart Jacquelyn Fleckenstein Stephen Flamm Andres Bl | 2003 | The American Journal of Gastroenterology2003，，9： | 1 |
| 9 | Hepatitis C virus: A time for decisions. Who should be treated and when?显示文摘Cirrhosis is the most important risk factor for hepatocellular carcinoma(HCC) regardless of the etiology of cirrhosis. Compared to individuals who are antihepatitis C virus(HCV) seronegative, anti-HCV seropositive individuals have a greater mortality from both hepatic as well as nonhepatic disease processes. The aim of this paper is do describe the burden of HCV infection and consider treatment strategies to reduce HCV-related morbidity and mortality. The newly developed direct acting antiviral(DAA) therapies are associated with greater rates of drug compliance, fewer adverse effects, and appear not to be limited by the presence of a variety of factors that adversely affect the outcome of interferon-based therapies. Because of the cost of the current DAA, their use has been severely rationed by insurers as well as state and federal agencies to those with advanced fibrotic liver disease(Metavir fibrosis stage F3-F4). The rationale for such rationing is that many of those recognized as having the disease progress slowly over many years and will not develop advanced liver disease manifested as chronic hepatitis C, cirrhosis, and experience any of the multiple complications of liver disease to include HCC. This mitigation has a short sided view of the cost of treatment of hepatitis C related disease processes and ignores the long-term expenses of hepatitis C treatment consisting of the cost of treatment of hepatitis C, the management of cirrhosis with or without decompensation as well as the cost of treatment of HCC and liver transplantation. We believe that treatment should include all HCV infected patients including those with stage F0-F2 fibrosis with or without evidence of coexisting liver disease. Specifically, interferon(IFN)-free regimens with the current effective DAAs without liver staging requirements and including those without evidence of hepatic diseases but having recognized extrahepatic manifestations of HCV infection is projected to be the most cost-effective approach for treating HCV in all of its varied presentations. Early rather than later therapy of HCV infected individuals would be even more efficacious than waiting particularly if it includes all cases from F0-F4 hepatic disease. Timely therapy will reduce the number of individuals developing advanced liver disease, reduce the cost of treating these cases and more importantly, reduce the lifetime cost of treatment of those with any form of HCV related disease as well as HCV associated all- cause mortality. Importantly, HCV treatment regimens without any restrictions would result in a substantial reduction in health care expenditure and simultaneously reduce the number of infected individuals who are infecting others. | Bashar M Attar David H Van Thiel | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 1 |
| 10 | Transjugular Liver Biopsy: Comparison of Sample Adequacy with the Use of Two Automated Needle Systems显示文摘 | George Behrens Hector Ferral Deborah Giusto Jay Patel David H. Van Thiel | 2011 | Journal of Vascular and Interventional Radiology2011，，3： | 1 |
| 11 | Gastrointestinal Manifestations of Behcet’s Disease显示文摘 | Yusuf Bayraktar Ersan ?zaslan David H. Van Thiel | 2000 | Journal of Clinical Gastroenterology2000，，2： | 1 |
| 12 | Quantitation of estrogen and androgen receptors in hepatocellular carcinoma and adjacent normal human liver显示文摘 | Patricia K. Eagon Antonio Francavilla Alfredo DiLeo Mary S. Elm Leandro Gennari Vincenzo Mazzaferro Giovanni Colella David H. Thiel Thomas E. Starzl | 1991 | Digestive Diseases and Sciences1991，，9： | 1 |
| 13 | Greater body mass index is associated with better pathologic features and improved outcome among patients treated surgically for clear cell renal cell carcinoma显示文摘 | Alexander S. Parker Christine M. Lohse John C. Cheville David D. Thiel Bradley C. Leibovich Michael L. Blute | 2006 | Urology2006，，4： | 1 |
| 14 | Mesenchymal Tumors Of The Liver显示文摘 | Haresh Mani David H. Van Thiel | 2001 | Clinics in Liver Disease2001，，1： | 1 |
| 15 | Neurologic Manifestations of Angelman syndrome显示文摘 | Ronald L. Thibert Anna M. Larson David T. Hsieh Annabel R. Raby Elizabeth A. Thiele | 2012 | Pediatric Neurology2012，，： | 1 |
| 16 | Further steps of hepatic stimulatory substance purification显示文摘 | Dr. Antonio Francavilla MD Michele Barone MD David H. Thiel MD Vincenzo Mazzaferro MD John G. Prelich MS Thomas E. Starzl MD PhD | 1991 | Digestive Diseases and Sciences1991，，5： | 1 |
| 17 | Hepatic Resection Versus Transplantation for Hepatocellular Carcinoma显示文摘 | SHUNZABURO IWATSUKI THOMAS E. STARZL DANIEL G. SHEAHAN ITSUO YOKOYAMA ANTHONY J. DEMETRIS SATURO TODO ANDREAS G. TZAKIS DAVID H. VAN THIEL BRIAN CARR RICHARD SELBY JUAN MADARIAGA | 1991 | Annals of Surgery1991，，3： | 1 |
| 18 | Pregnancy-Associated Sex Steroids and Their Effects on the Liver显示文摘 | David Van Thiel Judith Gavaler | 1987 | Semin Liver Dis1987，，01： | 1 |
| 19 | A mechanism for the production of electromagnetic radiation during fracture of brittle materials显示文摘 | Steven G. O’Keefe David V. Thiel | 1995 | Physics of the Earth and Planetary Interiors1995，，1： | 1 |
| 20 | Response to hepatitis B vaccination by liver transplant candidates显示文摘 | Dr. David H. Thiel MD Lobna El-Ashmawy MD Kristin Love BS Judith S. Gavaler PhD Thomas E. Starzl MD PhD | 1992 | Digestive Diseases and Sciences1992，，8： | 1 |
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