Publications (52) View all
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Article: Letter: the reversal of liver cirrhosis - what we know and what we need to know - authors' reply.
Alimentary Pharmacology & Therapeutics 02/2013; 37(3):371-2. · 3.77 Impact Factor -
Article: Review article: the reversibility of cirrhosis.
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ABSTRACT: BACKGROUND: Cirrhosis is the end result of many types of chronic liver diseases. Recent developments in the understanding of the process of hepatic fibrogenesis have revealed that the process is a dynamic one and a capacity for recovery from any degree of fibrosis including those associated with cirrhosis is plausible. AIM: To review current evidence of histopathological reversibility following drug therapy of more common aetiologies of cirrhosis. METHODS: A PubMed search was performed and the evidence for histopathological regression of advanced fibrosis/cirrhosis following drug therapy was reviewed as of the end of February 2012. RESULTS: There is abundant clinical evidence in support of the idea of the reversibility of cirrhosis in patients with different aetiologies of advanced hepatic disease including viral, autoimmune and metabolic/infiltrative liver disease. CONCLUSIONS: The concept of cirrhosis has changed from being a form of static and irreversible entity to a dynamic and reversible diseases stage. Novel therapeutic strategies are under investigation to target specific steps in the process of fibrogenesis with the aim of reversing advanced fibrosis/cirrhosis.Alimentary Pharmacology & Therapeutics 09/2012; · 3.77 Impact Factor -
Article: Cystsic lesions of the pancreas.
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ABSTRACT: Pancreatic cysts (PCs) are being increasingly detected due to the widespread use of high-resolution abdominal imaging. The main imaging modalities to diagnose PCs include high-resolution spiral CT scan, MRI, and endoscopic ultrasound (EUS). EUS has the added benefit of enabling cyst fluid sampling through FNA and significantly improves clinical diagnosis of PCs. Some PCs like pseudocysts, serous cystadenomas, and lymphoepethelial cysts are entirely benign lesions and can be managed non-operatively. However, other lesions like mucinous cystic neoplasms, or cystic neuroendocrine tumors are pre-malignant or malignant lesions and require surgical intervention. In this review, we describe diagnosis and management of common pancreatic cystic lesions.Archives of Iranian medicine 04/2013; 16(4):233-9. · 0.97 Impact Factor -
Article: Surveillance for Hepatocellular Carcinoma after Autologous Stem Cell Transplantation in Cirrhosis
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ABSTRACT: BACKGROUND:During the resent years there has been interest in using bone marrow stem cells to treat liver cirrhosis. However, there is a potential concern for malignant transformation after stem cell therapy. The aim of this study was to evaluate the development of hepatocellular carcinoma (HCC) after autologous bone marrow stem cell transplantation for liver cirrhosis.METHODS:All the patients who underwent autologous stem cell transplantation for liver cirrhosis between 2005 and 2011 at our center were enrolled. Cel�lular infusion was made through peripheral vein, portal vein, or hepatic artery.The patients were invited to undergo screening for hepatocellular carcinoma. The screening was made with ultrasonography and alpha-feto protein (AFP) measurement. RESULTS: Thirty two patients (18 males) were included in the study. Mean age of patients was 45.7 years. Fifteen patients (47%) received mesenchymal stem cell (MSC), 9 (28%) received bone marrow mononuclear cells, 5 (16%) were given CD 133-positive bone marrow cells, and 3 (9%) pa�tients received CD 34-positive bone marrow cells. Mean duration of follow up was 20.5months. Mean serum level of AFP was 2.8 ng/ml at baseline and 3.4ng/ml at the end of follow up (p= 0.3). One patient was found to have hepatocellular carcinoma three months after infusion of bone marrow mononuclear cells. The incidence rate for HCC was 1.8 cases per 100 person-years in this studyMiddle East Journal of Digestive Diseases. 07/2012; 4(3):145. -
Article: Surveillance for Hepatocellular Carcinoma after Autologous Stem Cell Transplantation in Cirrhosis
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ABSTRACT: Background: During the resent years there has been interest in using bone marrow stem cells to treat liver cirrhosis. However, there is a potential concern for malignant transformation after stem cell therapy. The aim of this study was to evaluate the development of hepatocellular carcinoma (HCC) after autologous bone marrow stem cell transplantation for liver cirrhosis. Methods: All the patients who underwent autologous stem cell transplantation for liver cirrhosis between 2005 and 2011 at our center were enrolled. Cellular infusion was made through peripheral vein, portal vein, or hepatic artery. The patients were invited to undergo screening for hepatocellular carcinoma. The screening was made with ultrasonography and alpha-feto protein (AFP) measurement. Results: Thirty two patients (18 males) were included in the study. Mean age of patients was 45.7 years. Fifteen patients (47%) received mesenchymal stem cell (MSC), 9 (28%) received bone marrow mononuclear cells, 5 (16%) were given CD 133-positive bone marrow cells, and 3 (9%) patients received CD 34-positive bone marrow cells. Mean duration of follow up was 20.5 months. Mean serum level of AFP was 2.8 ng/ml at baseline and 3.4 ng/ml at the end of follow up (p= 0.3). One patient was found to have hepatocellular carcinoma three months after infusion of bone marrow mononuclear cells. The incidence rate for HCC was 1.8 cases per 100 person-years in this study. Conclusion: Autologous bone marrow stem cell infusion does not appear to increase the risk of hepatocellular carcinoma. The incidence rate of HCC in this study is comparable or even less than the reported rates of HCC in cohort studies of cirrhotic patients.The American Journal of Digestive Diseases 01/2012;
