Bennet Cecil - Academia.edu (original) (raw)

Papers by Bennet Cecil

Gastroenterology, 2012

Habitual alcoholic patients, those with cardiac or renal disease, were excluded. Ten cases exclud... more Habitual alcoholic patients, those with cardiac or renal disease, were excluded. Ten cases excluding the exceptions mentioned above were selected as healthy controls. The research was approved by the ethics commission of our hospital and all subjects gave their informed consent prior to inclusion in the study. The recommended dose of sonazoid was injected intravenously, and liver segment 5-6 and the right kidney were viewed simultaneously on video images. The region of interest (ROI) focused on the kidney, and the point at which 80% of the ROI in the kidney was colored was set as 0 s. The time course was then divided by color images as red up to 5 s and yellow after 5 s, to create At-PI for the liver parenchyma. Based on the At-PI, the ratio of red area to the colored area of the whole liver was calculated using Image J imaging processing software. The ratio of red area and assessment by liver biopsy (F factor) were analyzed for trends using the Jonckheere-Terpstra test, whereas multiple comparisons were performed using the Steel-Dwass test. Moreover, the usability of At-PI for diagnosis of liver fibrosis was examined by ROC curve analysis. The liver markers albumin (Alb), platelets (PLT), and prothrombin time (PT%), and the red area of each case were compared to determine the correlation coefficients and significance of differences. US was performed by a single technologist to ensure the same conditions in all cases. Cases in which there was difficulty in visualizing the liver because of intracostal narrowing, etc., were excluded. [Results] The ratio of red area in each F factor increased with progression of liver fibrosis. The ratio of red area increased significantly with Alb, PLT, PT% (R2=0.31, P=0.028/ R2=0.45, P=0.0003/ R2= 0.51, P=0.0003). [Conclusion] Hepatic arterialization accompanying with liver fibrosis of chronic hepatitis C could be visualized by analysis using At-PI. In addition, progression of hepatic arterialization and F factor were correlated with Alb, PLT, and PT%, which are representative parameters of liver function. At-PI is a useful and convenient method because it permits visualization of hepatic arterialization with clear color images, and may be feasible for clinical use in the evaluation of liver function and progression of liver fibrosis in patients with chronic hepatitis C.

Journal of Hepatology, Mar 22, 2013

Journal of Hepatology, 2013

Journal of Hepatology, 2012

Gastrointestinal Endoscopy, 1993

The Cohen test has been recommended to evaluate the efficacy of pneumatic dilation of the lower e... more The Cohen test has been recommended to evaluate the efficacy of pneumatic dilation of the lower esophageal sphincter in patients with achalasia. It consists of ingestion of 8 ounces of heavy barium. Upright radiographs are performed 5 minutes later to determine the height of the barium column in the esophagus in relation to the diaphragm. A column less than 1 cm above the diaphragm is a negative test indicating successful dilation and the high probability of dysphagia resolution. A positive Cohen test, a column exceeding 1 cm, is said to correlate with persistent symptoms and need for redilation. We evaluated this in a prospective manner for a 6-year period. Twenty-eight patients underwent standard technique pneumatic dilation at our institution. Achalasia was confirmed in all patients by way of upper endoscopy and manometry. A Cohen test was performed in all patients. Post-dilation symptoms and weight were analyzed at follow-up 6 weeks after dilation. Contrary to the original report, relief of dysphagia after dilation was not related to the results of the Cohen test (p = 0.77). A positive Cohen test was inversely correlated with both symptom duration (0.037) and lower esophageal sphincter pressure before dilation (p = 0.005). Weight gain after dilation was unrelated to Cohen test results (p = 0.67). We conclude that the Cohen test is not an accurate predictor of symptom relief after dilation and do not recommend its use to determine the end point of therapy in patients with achalasia.

Gastroenterology, 2000

Hepatitis C patients should be treated using an individualized approach similar to the approach w... more Hepatitis C patients should be treated using an individualized approach similar to the approach with diabetes and hypertension. This will maximize efficacy and minimize side effects. This individualized approach is being used with approximately 200 patients and the results will be reported subseque ntly.