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| 1 | Management of hypersplenism in non-cirrhotic portal hypertension:a surgical series显示文摘BACKGROUND:Hypersplenism is commonly seen in patients with non-cirrhotic portal hypertension(NCPH).While a splenectomy alone can effectively relieve the hypersplenism,it does not address the underlying portal hypertension.The present study was undertaken to analyze the impact of shunt and non-shunt operations on the resolution of hypersplenism in patients with NCPH.The relationship of symptomatic hypersplenism,severe hypersplenism and number of peripheral cell line defects to the severity of portal hypertension and outcome was also assessed.METHODS:A retrospective analysis of NCPH patients with hypersplenism managed surgically between 1999 and 2009 at our center was done.Of 252 patients with NCPH,64(45 with extrahepatic portal vein obstruction and 19 with non-cirrhotic portal fibrosis) had hypersplenism and constituted the study group.Statistical analysis was done using GraphPad InStat.Categorical and continuous variables were compared using the chi-square test,ANOVA,and Student's t test.The MannWhitney U test and Kruskal-Wallis test were used to compare non-parametric variables.RESULTS:The mean age of patients in the study group was 21.81±6.1 years.Hypersplenism was symptomatic in 70.3% with an incidence of spontaneous bleeding at 26.5%,recurrent anemia at 34.4%,and recurrent infection at 29.7%.The mean duration of surgery was 4.16±1.9 hours,intraoperative blood loss was 457±126(50-2000) mL,and postoperative hospital stay 5.5±1.9 days.Following surgery,normalization of hypersplenism occurred in all patients.On long-term followup,none of the patients developed hepatic encephalopathy and 4 had a variceal re-bleeding(2 after a splenectomy alone,1 each after an esophago-gastric devascularization and proximal splenorenal shunt).Patients with severe hypersplenism and those with defects in all three peripheral blood cell lineages were older,had a longer duration of symptoms,and a higher incidence of variceal bleeding and postoperative morbidity.In addition,patients with triple cell line defects had elevated portal pressure(P=0.001),portal biliopathy(P=0.02),portal gastropathy(P=0.005) and intraoperative blood loss(P=0.001).CONCLUSIONS:Hypersplenism is effectively relieved by both shunt and non-shunt operations.A proximal splenorenal shunt not only relieves hypersplenism but also effectively addresses the potential complications of underlying portal hypertension and can be safely performed with good long-term outcome.Patients with hypersplenism who have defects in all three blood cell lineages have significantly elevated portal pressures and are at increased risk of complications of variceal bleeding,portal biliopathy and gastropathy. | Rajesh Rajalingam Amit Javed Dharmanjay Sharma Puja Sakhuja Shivendra Singh Hirdaya H Nag Anil K Agarwal | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，2： | 7 |
| 2 | A marlkov random field model for classification of multisource satellite imagery 显示文摘 | Anne H Anil K | 1996 | IEEE Transactions on Geoscience and Remote Sensing1996，34，1： | 2 |
| 3 | Resetting semiactives tiffness damper for seismic response control 显示文摘 | Jann N Y Kim J H Anil K A | 2000 | ASCE Journal of Structural Engineering2000，126，14： | 1 |
| 4 | Temperate intercropping of cereals for forage: A review of the potential for growth and utilization with particular reference to the UK显示文摘 | Anil L J Park R H Phipps M F A | 1998 | Grass Forage Science1998，53，： | 1 |
| 5 | Temperate intercropping of cereals for forage: A review of the potential for growth and utilization with partlcular reference to the UK显示文摘 | Anil L Park J Phipps R H etal | 1998 | Grass Forage Science1998，53，： | 1 |
| 6 | A multi-channel approach to fingerprint classification 显示文摘 | ANIL K J SALIL P LING H | 2000 | IEEE PAMI2000，21，4： | 1 |
| 7 | Benzofurans and another constituent from seeds of Styrax officinalis显示文摘 | AKGUL Y Y ANIL H | 2003 | Phytochemistry2003，63，： | 1 |
| 8 | Face detection in color images 显示文摘 | REIN-LIEN H MOHAMED A ANIL K J | 2002 | IEEE Transactions on Pattern Analysis and Machine Intelligence2002，24，5： | 1 |
| 9 | Responses in the voluntary intake of hay or silage by lactating cows to intra- ruminal infusions of sodium acetate or sodium propionate, the tonicity of rumen fluid or rumen distension显示文摘 | Anil M H Mbanya J N Symonds H W | 1993 | British Journal of Nutrition1993，69，： | 1 |
| 10 | Cost of paid transplantation abroad: possible donor-origin early multiple myeloma in a renal transplant recipient treated using bortezomib 显示文摘 | Solak Y Atalay H Anil M | 2010 | Transplant Proc2010，42，7： | 1 |
| 11 | The potential of forage --maizeintercrops in ruminant nutrition 显示文摘 | Anil L Park J Phipps R H | 2000 | Anim Feed Sci Technol2000，86，3： | 1 |
| 12 | Benzofurans and another constituent from seeds of Styrax officinalis 显示文摘 | AKGUL Y Y ANIL H | 2003 | Phytochemistry2003，63，8： | 1 |
| 13 | Walekar,Turn-on fluorescence probe for selective and sensitive detection of d-penicillamine by Cd S quantum dots in aqueous media:Application to pharmaceutical formulation显示文摘 | Samadhan PP Anil H Laxman S | 2015 | Sens Actuators B Chem2015，209，： | 1 |
| 14 | Integrating faces and fingerprints for personal identification显示文摘 | Lin H Anil J | 1998 | IEEE Trans PAMI1998，20，12： | 1 |
| 15 | The instability of the shear layer separating froma bluff body 显示文摘 | Anil P Charles H K | 1997 | Journal of Fluid Meeh1997，333，： | 1 |
| 16 | Prospective use of bacteriocinogenic Pediococcus pentosaceus as direct-fed microbial having methane reducing potential显示文摘Direct-fed microbials(DFM), generally regarded as safe status, are successfully used in improving rumen ecology, gastro-intestinal health, feed efficiency, milk production and growth rate in ruminants. On the other hand, methanogenesis in rumen, which accounts for a significant loss of ruminant energy and increased greenhouse gas in environment, is of great concern, therefore, use of DFM for improving productivity without compromising the animal health and ecological sustainability is encouraged. The present study was conducted to investigate the methane reducing potential of bacteriocinogenic strain Pediococcus pentosaceus-34. Since, the culture showed no hemolysis on blood agar and DNase activity, hence, it was considered to be avirulent in nature, a prerequisite for any DFM. The culture also showed tolerance to pH 5.0 for 24 h with 0.5% organic acid mixture, whereas when given a shock for 2 h at different p H and organic acids concentrations, it showed growth at pH 3.0 and 4.0 with 0.1 and 1.0% organic acids, respectively, as having good animal probiotics attributes. The total gas production was significantly(P<0.05) higher in live pedicoccal culture(LPC) and dead pedicoccal culture(DPC) both with wheat straw, when compared to the control. In sugarcane bagasse, gas production was significantly lower(P<0.05) with LPC compared to the control and DPC both. Methane was reduced by the inclusion of LPC in sugarcane bagasse(0.07 mL CH4 mg–1 dry matter digestibility) with no effect on other rumen fermentation parameters. However, with wheat straw and LPC total gas, in vitro dry matter digestibility, total volatile fatty acids increased significantly but no reduction in methane production was observed in comparison to the control. Therefore, further research is warranted in this direction, if the bacteriocinogenic strains can be used as DFM for ruminants to improve the ruminant productivity. | Sanjay Kumar Sumit S Dagar Seyed H Ebrahimi Ravinder K Malik Ramesh C Upadhyay Anil K Puniya | 2015 | Journal of Integrative Agriculture2015，14，3： | 1 |
| 17 | Direct trajectory optimization using a variable low-order adaptive pseudospectral method 显示文摘 | CHRISTOPHER L D W LLLAM W H ANIL V R | 2011 | Journal of Spacecraft and Rockets2011，48，3： | 1 |
| 18 | Benzofuran from seeds of Styrax officinalis显示文摘 | AKGUL Y Y ANIL H | 2003 | Fitoterapia2003，74，78： | 1 |
| 19 | Integrating faces and fingerprints for personal identification显示文摘 | LIN H ANIL K J | 1998 | IEEE Transaction on Pattern Analysis and Machine Intelligence1998，20，12： | 1 |
| 20 | An hp-adaptive pseudospectral method for solving optimal control problems 显示文摘 | Christopher L D William W H Anil V R | 2011 | Optimal Control Applications and Methods2011，32，4： | 1 |
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