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| 1 | Biliary complications following liver transplantation显示文摘Biliary tract complications are the most common complications after liver transplantation.These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients.Biliary complications remain a major source of morbidity in liver transplant patients,with an incidence of 5%-32%.Post liver transplantation biliary complications include strictures(anastomotic and non-anastomotic),leaks,stones,sphincter of Oddi dysfunction,and recurrence of primary biliary disease such as primary sclerosing cholangitis and primary biliary cirrhosis.The risk of occurrence of a specific biliary complication is related to the type of biliary reconstruction performed at the time of liver transplantation.In this article we seek to review the major biliary complications and their relation to the type of biliary reconstruction performed at the time of liver tranplantation. | Gursimran Kochhar Jose Mari Parungao Ibrahim A Hanouneh Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，19： | 41 |
| 2 | Fluid resuscitation in acute pancreatitis显示文摘Acute pancreatitis remains a clinical challenge,despite an exponential increase in our knowledge of its complex pathophysiological changes.Early fluid therapy is the cornerstone of treatment and is universally recommended;however,there is a lack of consensus regarding the type,rate,amount and end points of fluid replacement.Further confusion is added with the newer studies reporting better results with controlled fluid therapy.This review focuses on the pathophysiology of fluid depletion in acute pancreatitis,as well as the rationale for fluid replacement,the type,optimal amount,rate of infusion and monitoring of such patients.The basic goal of fluid epletion should be to prevent or minimize the systemic response to inflammatory markers.For this review,various studies and reviews were critically evaluated,along with authors’recommendations,for predicted severe or severe pancreatitis based on the available evidence. | Aakash Aggarwal Manish Manrai Rakesh Kochhar | 2014 | World Journal of Gastroenterology2014，20，48： | 14 |
| 3 | Endoscopic incisional therapy for benign esophageal strictures: Technique and results显示文摘Benign esophageal strictures refractory to the conventional balloon or bougie dilatation may be subjected to various adjunctive modes of therapy, one of them being endoscopic incisional therapy(EIT). A proper delineation of the stricture anatomy is a prerequisite. A host of electrocautery and mechanical devices may be used, the most common being the use of needle knife, either standard or insulated tip. The technique entails radial incision and cutting off of the stenotic rim. Adjunctive therapies, to prevent re-stenosis, such as balloon dilatation, oral or intralesional steroids or argon plasma coagulation can be used. The common strictures where EIT has been successfully used are Schatzki's rings(SR) and anastomotic strictures(AS). Short segment strictures(< 1 cm) have been found to have the best outcome. When compared with routine balloon dilatation, EIT has equivalent results in treatment na?ve cases but better long term outcome in refractory cases. Anecdotal reports of its use in other types of strictures have been noted. Post procedure complications of EIT are mild and comparable to dilatation therapy. As of the current evidence, incisional therapy can be used for management of refractory AS and SR with relatively short stenosis(< 1 cm) with good safety profile and acceptable long term patency. | Jayanta Samanta Narendra Dhaka Saroj Kant Sinha Rakesh Kochhar | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，19： | 14 |
| 4 | Pancreatic fluid collections: What is the ideal imaging technique?显示文摘Pancreatic fluid collections(PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walledoff necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging(MRI) performs better than computed tomography(CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis(seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis(solid debris delineation) and management(drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with ^(18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled. | Narendra Dhaka Jayanta Samanta Suman Kochhar Navin Kalra Sreekanth Appasani Manish Manrai Rakesh Kochhar | 2015 | World Journal of Gastroenterology2015，21，48： | 13 |
| 5 | Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures显示文摘Esophageal strictures are a problem frequently encountered by gastroenterologists. Dilation has been the customary treatment for benign esophageal strictures, and dilation techniques have advanced over the years. Depending on their characteristics and the response to treatment, esophageal strictures can be classified into two types: 1, simple (Schatzki rings, webs, peptic injury, and following sclerotherapy) - these are easily amenable to dilation, with a low recurrence rate after initial treatment; and 2, complex (caused by caustic ingestion, radiation injury, anastomotic strictures, and photodynamic therapy) - these are difficult to dilate and are associated with higher recurrence rates. Refractory strictures are those in which it is not possible to relieve the anatomic restriction successfully up to a diameter of 14 mm over five sessions at 2-weekly in- tervals, due to cicatricial luminal compromise or fibrosis; and recurrent strictures are those in which it is not possible to maintain a satisfactory luminal diameter for 4 wk once the target diameter of 14 mm has been achieved. There are no standard recommendations for the management of refractory strictures. The various techniques used include intralesional steroid injectioncombined with dilation; endoscopic incisional therapy, with or without dilation; placement of self-expanding metal stents, Polyflex stents, or biodegradable stents; self-bougienage; and endoscopic surgery. This review discusses the indications, technique, results, and complications of the use of intralesional steroid injections combined with dilation and endoscopic incisional therapy with dilation in refractory strictures. | Rakesh Kochhar Kuchhangi Suresh Poornachandra | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 11 |
| 6 | 嘎拉苹果高温处理与果实日灼的关系显示文摘高温处理对诱导果实增强对日灼的抗性有一定的作用 ,可降低日灼率。苹果果实在 4 5℃下处理 2h ,在3d后将处理果和对照果同时暴露在阳光下 ,结果发现 :热处理能够在一定程度上增强果实对日灼的抗性。在 4 5℃下处理 2、4和 6h后立即取样或室温下放置 2 4h后取样 ,对热激蛋白的分析表明 ,大分子量热激蛋白量变化不大 ,而小分子量热激蛋白可能在诱导果实抗热性方面起重要作用。随着处理时间延长 ,在一定时间范围内 ,热激蛋白抗热性水平增加。经测定 ,树冠外围充分曝光果和树冠内膛遮荫果对比 ,二者热激蛋白含量有显著差异 ,这可能是遮荫果对日灼更为敏感的原因。 | 张建光 刘玉芳 孙建设 KOCHHAR Sunita LARRY Schrader | 2003 | 中国农业科学2003，36，6： | 10 |
| 7 | Characterization of biofilms in biliary stents and potential factors involved in occlusion显示文摘AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation. | Chetana Vaishnavi Jayanta Samanta Rakesh Kochhar | 2018 | World Journal of Gastroenterology2018，24，1： | 8 |
| 8 | Endoscopic balloon dilation for benign gastric outlet obstruction in adults显示文摘Gastric outlet obstruction(GOO) includes obstruction in the antropyloric area or in the bulbar or post bulbar duodenal segments.Though malignancy remains the most common cause of GOO in adults,a significant number of patients have benign disease.The latter include peptic ulcer disease,caustic ingestion,post-operative anastomotic state and inflammatory causes like Crohn's disease and tuberculosis.Peptic ulcer remains the most common benign cause of GOO.Management of benign GOO revolves around confirmation of the etiology,removing the offending agent Helicobacter pylori(H.pylori),non-steroidal anti-inflammatory drugs,etc.and definitive therapy.Traditionally,surgery has been the standard mode of treatment for benign GOO.However,after the advent of through-the-scope balloon dilators,endoscopic balloon dilation(EBD) has emerged as an effective alternative to surgery in selected groups of patients.So far,this form of therapy has been shown to be effective in causticinduced GOO with short segment cicatrization and ulcer related GOO.In the latter,EBD must be combined with eradication of H.pylori.Dilation is preferably done with wire-guided balloon catheters of incremental diameter with the aim to reach the end-point of 15 mm.While it is recommended that fluoroscopic control be used for EBD,this is not used by most endoscopists.Frequency of dilation has varied from once a week to once in three weeks.Complications are uncommon with perforation occurring more often with balloons larger than 15 mm.Attempts to augment efficacy of EBD include intralesional steroids and endoscopic incision. | Rakesh Kochhar Suman Kochhar | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，1： | 7 |
| 9 | Old vs new: Risk factors predicting early onset colorectal cancer显示文摘BACKGROUND Colorectal cancer(CRC)is the second leading cause of all cancer related deaths in the United States and Europe.Although the incidence has been decreasing for individuals’≥50,it has been on the rise for individuals<50.AIM To identify potential risk factors for early-onset CRC.METHODS A population-based cohort analysis using a national database,Explorys,screened all patients with an active electronic medical record from January 2012 to December 2016 with a diagnosis of CRC.Subgroups were stratified based on age(25–49 years vs≥50 years).Demographics,comorbidities,and symptom profiles were recorded and compared between both age groups.Furthermore,the younger group was also compared with a control group consisting of individuals aged 25-49 years within the same timeframe without a diagnosis of CRC.Twentydata points for CRC related factors were analyzed to identify potential risk factors specific to early-onset CRC.RESULTS A total of 68860 patients were identified with CRC,of which 5710(8.3%)were younger than 50 years old,with 4140(73%)between 40-49 years of age.Multivariable analysis was reported using odds ratio(OR)with 95%CI and demonstrated that several factors were associated with an increased risk of CRC in the early-onset group versus the later-onset group.These factors included:African-American race(OR 1.18,95%CI:1.09-1.27,P<0.001),presenting symptoms of abdominal pain(OR 1.82,95%CI:1.72-1.92,P<0.001),rectal pain(OR 1.50,95%CI:1.28-1.77,P<0.001),altered bowel function(OR 1.12,95%CI:1.05-1.19,P=0.0005),having a family history of any cancer(OR 1.78,95%CI:1.67-1.90,P<0.001),gastrointestinal(GI)malignancy(OR 2.36,95%CI:2.18-2.55,P<0.001),polyps(OR 1.41,95%CI:1.08-1.20,P<0.001),and obesity(OR 1.14,95%CI:1.08-1.20,P<0.001).Comparing the early-onset cohort versus the control group,factors that were associated with an increased risk of CRC were:male gender(OR 1.34,95%CI:1.27-1.41),P<0.001),Caucasian(OR 1.48,95%CI:1.40-1.57,P<0.001)and African-American race(OR 1.25,95%CI:1.17-1.35,P<0.001),presenting symptoms of abdominal pain(OR 4.73,95%CI:4.49-4.98,P<0.001),rectal pain(OR 7.48,95%CI:6.42-8.72,P<0.001),altered bowel function(OR 5.51,95%CI:5.19-5.85,P<0.001),rectal bleeding(OR 9.83,95%CI:9.12-10.6,P<0.001),weight loss(OR 7.43,95%CI:6.77-8.15,P<0.001),having a family history of cancer(OR 11.66,95%CI:10.97-12.39,P<0.001),GI malignancy(OR 28.67,95%CI:26.64-30.86,P<0.001),polyps(OR 8.15,95%CI:6.31-10.52,P<0.001),tobacco use(OR 2.46,95%CI:2.33-2.59,P<0.001),alcohol use(OR 1.71,95%CI:1.62-1.80,P<0.001),presence of colitis(OR 4.10,95%CI:3.79-4.43,P<0.001),and obesity(OR 2.88,95%CI:2.74-3.04,P<0.001).CONCLUSION Pending further investigation,these potential risk factors should lower the threshold of suspicion for early CRC and potentially be used to optimize guidelines for early screening. | Aslam R Syed Payal Thakkar Zachary D Horne Heitham Abdul-Baki Gursimran Kochhar Katie Farah Shyam Thakkar | 2019 | World Journal of Gastrointestinal Oncology2019，11，11： | 6 |
| 10 | 面向中小企业的区域性虚拟组织实施策略与方法研究显示文摘通过分析区域性中小企业合作的基本组织形式及其特点,以当前中小企业群体中常见的中心卫星结构和企业集群两种典型合作方式及其混合结构为基础,提出建立垂直集成型、水平集成型和混合型虚拟组织的原则和方法,同时讨论了不同类型区域性虚拟组织的适用领域和实施策略。 | 李国富 叶飞帆 方志梅 Ashok Kochhar | 2005 | 中国机械工程2005，16，21： | 5 |
| 11 | Radiation-induced proctosigmoiditis显示文摘 | R. Kochhar F. Patel S. C. Sharma S. Ayyagari R. Aggarwal M. K. Goenka B. D. Gupta S. K. Mehta | 1991 | Digestive Diseases and Sciences1991，，： | 2 |
| 12 | Comparative study of endoscopy vs.transjugular intrahepatic portosystemic shunt in the management of gastric variceal bleeding显示文摘Background and Aim:Gastric varices are associated with high mortality.There have been conflicting reports on whether endoscopic treatment with cyanoacrylate or the placement of a transjugular intrahepatic portosystemic shunt(TIPS)is more effective in the treatment of gastric varices.We compared the outcomes of patients treated with cyanoacrylate glue or TIPS for the management of acute gastric variceal bleeding.Methods:The study was designed as a retrospective cohort analysis of patients undergoing either TIPS or endoscopic treatment with cyanoacrylate for acute gastric variceal bleeding at our institution from 2001 to 2011.Primary compared to studied between the two treatment modalities were the short-term treatment outcomes,including re-bleeding within 30 days,length of hospital stay and in-hospital mortality.Kaplan-Meier survival analysis was performed to assess factors associated with in-hospital mortality.Results:A total of 169 patients were included in the analysis.The TIPS arm contained 140 patients and the cyanoacrylate arm contained 29 patients.There was no evidence to suggest any significant differences in demographics or disease severity.There were no differences between the TIPS arm and the cyanoacrylate armtwo groups in treatment outcomes including re-bleeding within 30 days(17.4%vs.17.2%;P=0.98),median length of stay in the hospital(4.5 days vs.6.0 days;P紏0.35)or in-hospital mortality(9.0%vs.11.1%;P=0.74).In-hospital mortality was evaluated for 149 patients and lower albumin(P=0.015),higher MELD score(P<0.001),higher CTP score(P=0.005)and bleeding(P=0.008)were all significantly associated with in-hospital death.Conclusion:These findings suggest that both treatments are equally effective.Cyanoacrylate offers a safe,effective alternative to TIPS for gastric varices,and physician may choose the best therapy for each patient,factoring in the availability of TIPS or cyanoacrylate,the individual patient’s presentation,and cost. | Gursimran Singh Kochhar Udayakumar Navaneethan Jason Hartman Jose Mari Parungao Rocio Lopez Ranjan Gupta Baljendra Kapoor Paresh Mehta Madhu Sanaka | 2015 | Gastroenterology Report2015，3，1： | 2 |
| 13 | Aberrant promoter methylation of p16 in colorectal adenocarcinoma in North Indian patients显示文摘AIM:To investigate p16 gene methylation and its expression in 30 patients with sporadic colorectal adenocarcinoma in a North Indian population. METHODS:Methylation specific polymerase chain reaction was used to detect p16 gene methylation and immunohistochemistry was used to study the p16 expression in 30 sporadic colorectal tumors as well as adjoining and normal tissue specimens.RESULTS:Aberrant promoter methylation of p16 gene was detected in 12(40%)tumor specimens,whereas no promoter methylation was observed in adjoining and normal tissue.Immunohistochemistry showed expression of p16 protein in 26(86.6%)colorectal tumors whereas complete loss of expression was seen in 4(13.3%)and reduced expression was observed in 12(40%)tumors. In the adjoining mucosa,expression of p16 was in 11 (36.6%)whereas no clear positivity for p16 protein was seen in normal tissue.There was a significant difference in the expression of p16 protein in tumor tissue and adjoining mucosa(P<0.001).The methylation of the p16 gene had a significant effect on the expression of p16 protein(P=0.021).There was a significant association of methylation of p16 gene with the tumor size (P=0.015)and of the loss/reduced expression of p16 protein with the proximal site of the tumor(P=0.047). Promoter methylation and expression of p16 had no relation with the survival of the patients(P>0.05). CONCLUSION:Our study demonstrated that promoter hypermethylation of the p16 gene results in loss/reduced expression of p16 protein and this loss/reduced expression may contribute to tumor enlargement. | Pooja Malhotra Rakesh Kochhar Kim Vaiphei Jai Dev Wig Safrun Mahmood | 2010 | World Journal of Gastrointestinal Oncology2010，2，7： | 2 |
| 14 | Experience with hemoadsorption (CytoSorb~?) in the management of septic shock patients显示文摘BACKGROUND Cytokines and inflammatory mediators are the hallmarks of sepsis.Extracorporeal cytokine hemoadsorption devices are the newer clinical support system to overcome the cytokine storm during sepsis.AIM To retrospectively evaluate the clinical outcomes of patients admitted in intensive care unit with septic shock with different etiologies.METHODS The laboratory parameters including biomarkers such as procalcitonin,serum lactate and C-reactive protein;and the hemodynamic parameters;mean arterial pressure,vasopressor doses,sepsis scores,cytokine levels and other vital parameters were evaluated.We evaluated these outcomes among survivors and non-survivors.RESULTS Of 100 patients evaluated,40 patients survived.Post treatment,the vasopressors dosage remarkably decreased though it was not statistically different;34.15%(P=0.0816)for epinephrine,20.5%for norepinephrine(P=0.3099)and 51%(P=0.0678)for vasopressin.In the survivor group,a remarkable reduction of biomarkers levels;procalcitonin(65%,P=0.5859),C-reactive protein(27%,P=0.659),serum lactate(27%,P=0.0159)and bilirubin(43.11%;P=0.0565)were observed from baseline after CytoSorb^® therapy.A significant reduction in inflammatory markers;interleukin 6 and interleukin 10;(87%and 92%,P<0.0001)and in tumour necrosis factor(24%,P=0.0003)was also seen.Overall,28(28%)patients who were given CytoSorb^® therapy less than 48 h after onset of septic shock survived and the maximum duration of stay for 70%of these patients in intensive care unit was less than 15 d.CONCLUSION CytoSorb^® is a safe and well tolerated rescue therapy option in patients with septic shock.However,early(preferably within<48 h after onset of septic shock)initiation could result in better clinical outcomes.Further randomized trials are needed to define the potential benefits of this new treatment modality. | Yatin Mehta Chitra Mehta Ashish Kumar Joby Varghese George Aditi Gupta Saurabh Nanda Gourav Kochhar Arun Raizada | 2020 | World Journal of Critical Care Medicine2020，9，1： | 2 |
| 15 | Haematological and bacteriological studies in canine pyometra 显示文摘 | Gandotra V K Singgla V K Kochhar H P S | 1994 | Indian Vet1994，71，： | 1 |
| 16 | Institutions and capacity building for the evolution of intellectual property rights regime in India:analysis of review of TRIPS agreement and R&D prospect in indian agriculture under IPR regime显示文摘 | KOCHHAR S | 2007 | Journal of Intellectual Property Rights2007，13，5： | 1 |
| 17 | Effect of chronic continuous positive airway pressure (CPAP) therapy on upper airway size in patients with sleep/hypopnea syndrome显示文摘 | Kochhar P Douglas NJ | 1996 | Thorax1996，51，： | 1 |
| 18 | A slip above a slip:retrolisthesis of the motion segment above a spondylolytic spondylolisthesis显示文摘 | Mehta JS Kochhar S Harding IJ | 2012 | Eur Spine J2012，21，11： | 1 |
| 19 | Duration and severity of primary sclerosing cholangitis is not associated with risk of neoplastic changes in the colon in patients with ulcerative colitis显示文摘 | Navaneethan U Kochhar G Venkatesh PGK | 2012 | Gastrointes Endosc2012，75，5： | 1 |
| 20 | Direct and moderating effects of human capital on strategy and performance in professional service firms:a re- source - based perspective 显示文摘 | Hitt M A Leonard Bierman Katsuhiko Shimizu Rahul Kochhar | 2001 | Academy of Management Journal2001，44，1： | 1 |
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