Chaim Abittan - Academia.edu (original) (raw)

Papers by Chaim Abittan

Research paper thumbnail of A Gastroenterological List for the Millennium

Journal of Clinical Gastroenterology, Dec 1, 1999

To determine the 10 most significant advances in gastroenterology during this century as we appro... more To determine the 10 most significant advances in gastroenterology during this century as we approach the millennium, the authors polled 50 distinguished active clinicians and leading researchers in the field, including workers in liver disease and the pathology of the gut and its associated glands. Forty-five persons (90%) responded and listed 58 different items. These were then organized into four groups: group A, with 10 categories that received between 42 and 11 votes; group B, with 10 categories that received between 10 and 3 votes; group C, with 3 items receiving 2 votes each; and group D, with the remaining 14 items receiving 1 vote each. The respondents did not indicate their choices in rank order. The top 10 leading choices (group A, containing between 42 and 11 votes) included Helicobacter pylori, fiberoptic endoscopy, gastrointestinal imaging by radiograph and computed tomographic scan, Australia antigen including vaccines for hepatitis A and B, the molecular basis of colon cancer, liver transplantation, laparoscopic-assisted surgery, therapy for peptic ulcer disease including H2-receptor antagonists and proton pump inhibitors, the discovery of gastrointestinal hormones beginning with secretin, and lastly the discovery of the role for gluten in celiac disease.

Research paper thumbnail of Contribution of Gastric Oxidation to Ethanol First Pass Metabolism in Baboons

Alcoholism: Clinical and Experimental Research, Jul 1, 2000

Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pa... more Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pass metabolism (FPM) during gastric and hepatic circulation. Methods: To determine whether the stomach can metabolize sufficient ethanol to account for the FPM, and to what extent gastric alcohol dehydrogenase (ADH) activity is responsible, the hepatic vein, the portal vein, and the aorta were cannulated nonocclusively in baboons to measure the conversion of ethanol to acetate in vivo. 14C-ethanol (300 m a g as a 15% solution) was given intragastrically (IG) whereas 3Hacetate was continuously infused intravenously (IV).14C-acetate was measured after exhaustive evaporation of ethanol. Simultaneous sampling of hepaticvenous, portal and arterial blood was carried out for 3 hr, at the end of which the same alcohol dose was given IV to calculate the Michaelis-Menten parameters of elimination. Results: Analysis of the IV and IG ethanol curves revealed a FPM of 94 t 11 mgikg (31% of dose). The portal-arterial differences were negative for 3H-acetate (indicating net extraction) and positive for 14Cethanol and 14C-acetate (indicating net output). Portal acetate production (extraction plus net output multiplied by the portal plasma flow) increased with time and accounted, over the first 3 hr (82 2 13 mgikg), for 87% of the FPM. Alcohol oxidation by gastric ADH activity (28.7 ? 7.2 m a g) accounted for only 31% of the FPM. Conclusions: The in vivo oxidation of ethanol to acetate in the upper digestive tract accounts for the FPM of ethanol and is mediated, at least in part, by ADH activity.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, Jul 1, 1999

Research paper thumbnail of Respective roles of gastric emptying and alcohol metabolism in the gender difference of ethanol’s first-pass metabolism

Research paper thumbnail of Gender Differences in Pharmacokinetics of Alcohol

Alcoholism: Clinical and Experimental Research, Apr 1, 2001

Background: The enhanced vulnerability of women to develop alcohol-related diseases may be due to... more Background: The enhanced vulnerability of women to develop alcohol-related diseases may be due to their higher blood alcohol levels after drinking, but the mechanism for this effect is debated. Methods: Sixty-five healthy volunteers of both genders drank 0.3 g of ethanol/kg of body weight (as 5%, 10%, or 40% solutions) postprandially. Blood alcohol concentrations were monitored by breath analysis and compared with those after intravenous infusion of the same dose. First-pass metabolism was quantified (using Michaelis-Menten kinetics) as the route-dependent difference in the amount of ethanol reaching the systemic blood. Gastric emptying was assessed by nuclear scanning after intake of 300 Curie of technetium-labeled diethylene triamine pentacetic acid in 10% ethanol. The activities of alcohol dehydrogenase isozymes were assessed in 58 gastric biopsies, using preferred substrates for ␥-ADH (acetaldehyde) and for-ADH (m-nitrobenzaldehyde) and a specific reaction of-ADH (glutathione-dependent formaldehyde dehydrogenase). Results: Women had less first-pass metabolism than men when given 10% or 40%, but not 5%, alcohol. This was associated with lower gastric-ADH activity; its low affinity for ethanol could explain the greater gender difference in first-pass metabolism with high rather than with low concentrations of imbibed alcohol. Alcohol gastric emptying was 42% slower and hepatic oxidation was 10% higher in women. A 7.3% smaller volume of alcohol distribution contributed to the higher ethanol levels in women, but it did not account for the route-dependent effects. Conclusions: The gender difference in alcohol levels is due mainly to a smaller gastric metabolism in females (because of a significantly lesser activity of-ADH), rather than to differences in gastric emptying or in hepatic oxidation of ethanol. The concentration-dependency of these effects may explain earlier discrepancies. The combined pharmacokinetic differences may increase the vulnerability of women to the effects of ethanol.

Research paper thumbnail of Endoscopic Diagnosis of Bleeding Meckel's Diverticulum in a Multivisceral Transplant Recipient

American Journal of Transplantation, 2003

Small bowel transplantation has become a life-saving procedure for patients with intestinal failu... more Small bowel transplantation has become a life-saving procedure for patients with intestinal failure who fail conventional therapy. Meckel's diverticulum is a rare cause of occult gastrointestinal bleeding that has not been reported in patients receiving intestinal allografts. We report a case in which transplantation of an asymptomatic Meckel's diverticulum as part of a multivisceral allograft led to intestinal bleeding requiring surgical intervention. Endoscopy identified the actual bleeding diverticulum. Diverticulectomy at the time of transplant was not performed due to the difficult operative course, and the need for frequent surveillance ileoscopy, which would be performed across a fresh intestinal anastomosis. The patient underwent resection of the diverticulum, along with 40 cm of ileum, and did not experience further bleeding.

Research paper thumbnail of A 48-Year-Old Obese Man with a 3 cm Liver Lesion and a History of Hemochromatosis and Lymphoma

Seminars in Liver Disease, 2004

A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum... more A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum ferritin level of greater than 1000 ng/mL (normal = 20 to 380). A bone marrow biopsy was unremarkable. He was diagnosed with hemochromatosis and was treated with ...

Research paper thumbnail of Respective roles of gastric emptying and alcohol metabolism in the gender difference of ethanol’s first-pass metabolism

Research paper thumbnail of A Gastroenterological List for the Millennium

Journal of Clinical Gastroenterology, 1999

To determine the 10 most significant advances in gastroenterology during this century as we appro... more To determine the 10 most significant advances in gastroenterology during this century as we approach the millennium, the authors polled 50 distinguished active clinicians and leading researchers in the field, including workers in liver disease and the pathology of the gut and its associated glands. Forty-five persons (90%) responded and listed 58 different items. These were then organized into four groups: group A, with 10 categories that received between 42 and 11 votes; group B, with 10 categories that received between 10 and 3 votes; group C, with 3 items receiving 2 votes each; and group D, with the remaining 14 items receiving 1 vote each. The respondents did not indicate their choices in rank order. The top 10 leading choices (group A, containing between 42 and 11 votes) included Helicobacter pylori, fiberoptic endoscopy, gastrointestinal imaging by radiograph and computed tomographic scan, Australia antigen including vaccines for hepatitis A and B, the molecular basis of colon cancer, liver transplantation, laparoscopic-assisted surgery, therapy for peptic ulcer disease including H2-receptor antagonists and proton pump inhibitors, the discovery of gastrointestinal hormones beginning with secretin, and lastly the discovery of the role for gluten in celiac disease.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, 1999

A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeate... more A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeates all organs of the body and affects many of their vital functions. The most important ones, the likely mechanisms, as well as associated alcohol-drug interactions will be reviewed, with only brief mention of the classic, well-documented cutaneous signs of alcoholism and some newer emerging associations, which are discussed in detail elsewhere in this issue.

Research paper thumbnail of Alcoholic liver disease

Current Treatment Options in Gastroenterology, 1999

Research paper thumbnail of Alcoholic liver disease

Research paper thumbnail of Recurrent hepatitis C after retransplantation: Factors affecting graft and patient outcome

Liver Transplantation, 2005

Retransplantation (re-LT) of patients with recurrent hepatitis C virus (HCV) carries significant ... more Retransplantation (re-LT) of patients with recurrent hepatitis C virus (HCV) carries significant morbidity and mortality, negatively impacting on an already scarce donor allograft pool. In this study, we investigated the outcome of allografts and patients after re-LT due to recurrent HCV. Between 1989 and 2002, 47 patients were retransplanted at our institution due to HCV-related graft failure. Clinical HCV recurrence after re-LT was diagnosed when patients had acute liver enzyme elevation correlated with histological recurrence. The independent influence of these variables on survival was tested using Cox regression model. Chi-squared tests were used to examine the influence of individual demographic and pre/ perioperative variables on recurrence. Thirty-one (66%) patients died after re-LT (median 2.2 months). Donor age >60, clinical HCV recurrence, and graft failure due to cirrhosis were significant risk factors for mortality (risk ratios of 3.6, 3.3, and 2.4, respectively). Pre-LT MELD score was lower among survivors (22 ؎ 5 vs. 27 ؎ 8). Following re-LT, 38 patients had at least one biopsy due to acute liver dysfunction; 19 of them (50%) had recurrence within the first 3 months. High-dose solumedrol was correlated with early recurrence. No association was found between time of recurrence after the first LT and time of recurrence after re-LT. In conclusion, patients with cirrhosis due to recurrent HCV undergoing re-LT have an extremely high mortality rate; older allografts should be avoided in retransplanting these patients. The timing of clinical recurrence after initial liver transplan-tation is not predictive of the timing of recurrence after re-LT. Patients experiencing early graft failure due to accelerated forms of HCV should not be denied re-LT with the expectation that a similar disease course will occur after re-LT.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, 1999

A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeate... more A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeates all organs of the body and affects many of their vital functions. The most important ones, the likely mechanisms, as well as associated alcohol-drug interactions will be reviewed, with only brief mention of the classic, well-documented cutaneous signs of alcoholism and some newer emerging associations, which are discussed in detail elsewhere in this issue.

Research paper thumbnail of Endoscopic Diagnosis of Bleeding Meckel's Diverticulum in a Multivisceral Transplant Recipient

American Journal of Transplantation, 2003

Small bowel transplantation has become a life-saving procedure for patients with intestinal failu... more Small bowel transplantation has become a life-saving procedure for patients with intestinal failure who fail conventional therapy. Meckel's diverticulum is a rare cause of occult gastrointestinal bleeding that has not been reported in patients receiving intestinal allografts. We report a case in which transplantation of an asymptomatic Meckel's diverticulum as part of a multivisceral allograft led to intestinal bleeding requiring surgical intervention. Endoscopy identified the actual bleeding diverticulum. Diverticulectomy at the time of transplant was not performed due to the difficult operative course, and the need for frequent surveillance ileoscopy, which would be performed across a fresh intestinal anastomosis. The patient underwent resection of the diverticulum, along with 40 cm of ileum, and did not experience further bleeding.

Research paper thumbnail of Contribution of Gastric Oxidation to Ethanol First-Pass Metabolism in Baboons

Alcoholism: Clinical and Experimental Research, 2000

Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pa... more Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pass metabolism (FPM) during gastric and hepatic circulation.

Research paper thumbnail of Gender Differences in Pharmacokinetics of Alcohol

Alcoholism: Clinical and Experimental Research, 2001

The enhanced vulnerability of women to develop alcohol-related diseases may be due to their highe... more The enhanced vulnerability of women to develop alcohol-related diseases may be due to their higher blood alcohol levels after drinking, but the mechanism for this effect is debated.

Research paper thumbnail of A 48-Year-Old Obese Man with a 3 cm Liver Lesion and a History of Hemochromatosis and Lymphoma

Seminars in Liver Disease, 2004

A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum... more A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum ferritin level of greater than 1000 ng/mL (normal = 20 to 380). A bone marrow biopsy was unremarkable. He was diagnosed with hemochromatosis and was treated with ...

Research paper thumbnail of A Gastroenterological List for the Millennium

Journal of Clinical Gastroenterology, Dec 1, 1999

To determine the 10 most significant advances in gastroenterology during this century as we appro... more To determine the 10 most significant advances in gastroenterology during this century as we approach the millennium, the authors polled 50 distinguished active clinicians and leading researchers in the field, including workers in liver disease and the pathology of the gut and its associated glands. Forty-five persons (90%) responded and listed 58 different items. These were then organized into four groups: group A, with 10 categories that received between 42 and 11 votes; group B, with 10 categories that received between 10 and 3 votes; group C, with 3 items receiving 2 votes each; and group D, with the remaining 14 items receiving 1 vote each. The respondents did not indicate their choices in rank order. The top 10 leading choices (group A, containing between 42 and 11 votes) included Helicobacter pylori, fiberoptic endoscopy, gastrointestinal imaging by radiograph and computed tomographic scan, Australia antigen including vaccines for hepatitis A and B, the molecular basis of colon cancer, liver transplantation, laparoscopic-assisted surgery, therapy for peptic ulcer disease including H2-receptor antagonists and proton pump inhibitors, the discovery of gastrointestinal hormones beginning with secretin, and lastly the discovery of the role for gluten in celiac disease.

Research paper thumbnail of Contribution of Gastric Oxidation to Ethanol First Pass Metabolism in Baboons

Alcoholism: Clinical and Experimental Research, Jul 1, 2000

Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pa... more Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pass metabolism (FPM) during gastric and hepatic circulation. Methods: To determine whether the stomach can metabolize sufficient ethanol to account for the FPM, and to what extent gastric alcohol dehydrogenase (ADH) activity is responsible, the hepatic vein, the portal vein, and the aorta were cannulated nonocclusively in baboons to measure the conversion of ethanol to acetate in vivo. 14C-ethanol (300 m a g as a 15% solution) was given intragastrically (IG) whereas 3Hacetate was continuously infused intravenously (IV).14C-acetate was measured after exhaustive evaporation of ethanol. Simultaneous sampling of hepaticvenous, portal and arterial blood was carried out for 3 hr, at the end of which the same alcohol dose was given IV to calculate the Michaelis-Menten parameters of elimination. Results: Analysis of the IV and IG ethanol curves revealed a FPM of 94 t 11 mgikg (31% of dose). The portal-arterial differences were negative for 3H-acetate (indicating net extraction) and positive for 14Cethanol and 14C-acetate (indicating net output). Portal acetate production (extraction plus net output multiplied by the portal plasma flow) increased with time and accounted, over the first 3 hr (82 2 13 mgikg), for 87% of the FPM. Alcohol oxidation by gastric ADH activity (28.7 ? 7.2 m a g) accounted for only 31% of the FPM. Conclusions: The in vivo oxidation of ethanol to acetate in the upper digestive tract accounts for the FPM of ethanol and is mediated, at least in part, by ADH activity.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, Jul 1, 1999

Research paper thumbnail of Respective roles of gastric emptying and alcohol metabolism in the gender difference of ethanol’s first-pass metabolism

Research paper thumbnail of Gender Differences in Pharmacokinetics of Alcohol

Alcoholism: Clinical and Experimental Research, Apr 1, 2001

Background: The enhanced vulnerability of women to develop alcohol-related diseases may be due to... more Background: The enhanced vulnerability of women to develop alcohol-related diseases may be due to their higher blood alcohol levels after drinking, but the mechanism for this effect is debated. Methods: Sixty-five healthy volunteers of both genders drank 0.3 g of ethanol/kg of body weight (as 5%, 10%, or 40% solutions) postprandially. Blood alcohol concentrations were monitored by breath analysis and compared with those after intravenous infusion of the same dose. First-pass metabolism was quantified (using Michaelis-Menten kinetics) as the route-dependent difference in the amount of ethanol reaching the systemic blood. Gastric emptying was assessed by nuclear scanning after intake of 300 Curie of technetium-labeled diethylene triamine pentacetic acid in 10% ethanol. The activities of alcohol dehydrogenase isozymes were assessed in 58 gastric biopsies, using preferred substrates for ␥-ADH (acetaldehyde) and for-ADH (m-nitrobenzaldehyde) and a specific reaction of-ADH (glutathione-dependent formaldehyde dehydrogenase). Results: Women had less first-pass metabolism than men when given 10% or 40%, but not 5%, alcohol. This was associated with lower gastric-ADH activity; its low affinity for ethanol could explain the greater gender difference in first-pass metabolism with high rather than with low concentrations of imbibed alcohol. Alcohol gastric emptying was 42% slower and hepatic oxidation was 10% higher in women. A 7.3% smaller volume of alcohol distribution contributed to the higher ethanol levels in women, but it did not account for the route-dependent effects. Conclusions: The gender difference in alcohol levels is due mainly to a smaller gastric metabolism in females (because of a significantly lesser activity of-ADH), rather than to differences in gastric emptying or in hepatic oxidation of ethanol. The concentration-dependency of these effects may explain earlier discrepancies. The combined pharmacokinetic differences may increase the vulnerability of women to the effects of ethanol.

Research paper thumbnail of Endoscopic Diagnosis of Bleeding Meckel's Diverticulum in a Multivisceral Transplant Recipient

American Journal of Transplantation, 2003

Small bowel transplantation has become a life-saving procedure for patients with intestinal failu... more Small bowel transplantation has become a life-saving procedure for patients with intestinal failure who fail conventional therapy. Meckel's diverticulum is a rare cause of occult gastrointestinal bleeding that has not been reported in patients receiving intestinal allografts. We report a case in which transplantation of an asymptomatic Meckel's diverticulum as part of a multivisceral allograft led to intestinal bleeding requiring surgical intervention. Endoscopy identified the actual bleeding diverticulum. Diverticulectomy at the time of transplant was not performed due to the difficult operative course, and the need for frequent surveillance ileoscopy, which would be performed across a fresh intestinal anastomosis. The patient underwent resection of the diverticulum, along with 40 cm of ileum, and did not experience further bleeding.

Research paper thumbnail of A 48-Year-Old Obese Man with a 3 cm Liver Lesion and a History of Hemochromatosis and Lymphoma

Seminars in Liver Disease, 2004

A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum... more A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum ferritin level of greater than 1000 ng/mL (normal = 20 to 380). A bone marrow biopsy was unremarkable. He was diagnosed with hemochromatosis and was treated with ...

Research paper thumbnail of Respective roles of gastric emptying and alcohol metabolism in the gender difference of ethanol’s first-pass metabolism

Research paper thumbnail of A Gastroenterological List for the Millennium

Journal of Clinical Gastroenterology, 1999

To determine the 10 most significant advances in gastroenterology during this century as we appro... more To determine the 10 most significant advances in gastroenterology during this century as we approach the millennium, the authors polled 50 distinguished active clinicians and leading researchers in the field, including workers in liver disease and the pathology of the gut and its associated glands. Forty-five persons (90%) responded and listed 58 different items. These were then organized into four groups: group A, with 10 categories that received between 42 and 11 votes; group B, with 10 categories that received between 10 and 3 votes; group C, with 3 items receiving 2 votes each; and group D, with the remaining 14 items receiving 1 vote each. The respondents did not indicate their choices in rank order. The top 10 leading choices (group A, containing between 42 and 11 votes) included Helicobacter pylori, fiberoptic endoscopy, gastrointestinal imaging by radiograph and computed tomographic scan, Australia antigen including vaccines for hepatitis A and B, the molecular basis of colon cancer, liver transplantation, laparoscopic-assisted surgery, therapy for peptic ulcer disease including H2-receptor antagonists and proton pump inhibitors, the discovery of gastrointestinal hormones beginning with secretin, and lastly the discovery of the role for gluten in celiac disease.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, 1999

A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeate... more A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeates all organs of the body and affects many of their vital functions. The most important ones, the likely mechanisms, as well as associated alcohol-drug interactions will be reviewed, with only brief mention of the classic, well-documented cutaneous signs of alcoholism and some newer emerging associations, which are discussed in detail elsewhere in this issue.

Research paper thumbnail of Alcoholic liver disease

Current Treatment Options in Gastroenterology, 1999

Research paper thumbnail of Alcoholic liver disease

Research paper thumbnail of Recurrent hepatitis C after retransplantation: Factors affecting graft and patient outcome

Liver Transplantation, 2005

Retransplantation (re-LT) of patients with recurrent hepatitis C virus (HCV) carries significant ... more Retransplantation (re-LT) of patients with recurrent hepatitis C virus (HCV) carries significant morbidity and mortality, negatively impacting on an already scarce donor allograft pool. In this study, we investigated the outcome of allografts and patients after re-LT due to recurrent HCV. Between 1989 and 2002, 47 patients were retransplanted at our institution due to HCV-related graft failure. Clinical HCV recurrence after re-LT was diagnosed when patients had acute liver enzyme elevation correlated with histological recurrence. The independent influence of these variables on survival was tested using Cox regression model. Chi-squared tests were used to examine the influence of individual demographic and pre/ perioperative variables on recurrence. Thirty-one (66%) patients died after re-LT (median 2.2 months). Donor age >60, clinical HCV recurrence, and graft failure due to cirrhosis were significant risk factors for mortality (risk ratios of 3.6, 3.3, and 2.4, respectively). Pre-LT MELD score was lower among survivors (22 ؎ 5 vs. 27 ؎ 8). Following re-LT, 38 patients had at least one biopsy due to acute liver dysfunction; 19 of them (50%) had recurrence within the first 3 months. High-dose solumedrol was correlated with early recurrence. No association was found between time of recurrence after the first LT and time of recurrence after re-LT. In conclusion, patients with cirrhosis due to recurrent HCV undergoing re-LT have an extremely high mortality rate; older allografts should be avoided in retransplanting these patients. The timing of clinical recurrence after initial liver transplan-tation is not predictive of the timing of recurrence after re-LT. Patients experiencing early graft failure due to accelerated forms of HCV should not be denied re-LT with the expectation that a similar disease course will occur after re-LT.

Research paper thumbnail of Pharmacology and metabolism of alcohol, including its metabolic effects and interactions with other drugs

Clinics in Dermatology, 1999

A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeate... more A lcohol is a small molecule that is both water and lipid soluble. Therefore, it readily permeates all organs of the body and affects many of their vital functions. The most important ones, the likely mechanisms, as well as associated alcohol-drug interactions will be reviewed, with only brief mention of the classic, well-documented cutaneous signs of alcoholism and some newer emerging associations, which are discussed in detail elsewhere in this issue.

Research paper thumbnail of Endoscopic Diagnosis of Bleeding Meckel's Diverticulum in a Multivisceral Transplant Recipient

American Journal of Transplantation, 2003

Small bowel transplantation has become a life-saving procedure for patients with intestinal failu... more Small bowel transplantation has become a life-saving procedure for patients with intestinal failure who fail conventional therapy. Meckel's diverticulum is a rare cause of occult gastrointestinal bleeding that has not been reported in patients receiving intestinal allografts. We report a case in which transplantation of an asymptomatic Meckel's diverticulum as part of a multivisceral allograft led to intestinal bleeding requiring surgical intervention. Endoscopy identified the actual bleeding diverticulum. Diverticulectomy at the time of transplant was not performed due to the difficult operative course, and the need for frequent surveillance ileoscopy, which would be performed across a fresh intestinal anastomosis. The patient underwent resection of the diverticulum, along with 40 cm of ileum, and did not experience further bleeding.

Research paper thumbnail of Contribution of Gastric Oxidation to Ethanol First-Pass Metabolism in Baboons

Alcoholism: Clinical and Experimental Research, 2000

Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pa... more Background A portion of ingested alcohol does not reach the systemic blood, undergoing a first-pass metabolism (FPM) during gastric and hepatic circulation.

Research paper thumbnail of Gender Differences in Pharmacokinetics of Alcohol

Alcoholism: Clinical and Experimental Research, 2001

The enhanced vulnerability of women to develop alcohol-related diseases may be due to their highe... more The enhanced vulnerability of women to develop alcohol-related diseases may be due to their higher blood alcohol levels after drinking, but the mechanism for this effect is debated.

Research paper thumbnail of A 48-Year-Old Obese Man with a 3 cm Liver Lesion and a History of Hemochromatosis and Lymphoma

Seminars in Liver Disease, 2004

A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum... more A 41-year-old obese, but otherwise healthy man was found on routine blood testing to have a serum ferritin level of greater than 1000 ng/mL (normal = 20 to 380). A bone marrow biopsy was unremarkable. He was diagnosed with hemochromatosis and was treated with ...