Kevin Nguyen - Academia.edu (original) (raw)
Papers by Kevin Nguyen
Pancreas, 2010
Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Pa... more Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Pancreas. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed ...
Surgical Clinics of North America, 2010
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
We provide a historical perspective and review on the current status of radiofrequency ablation (... more We provide a historical perspective and review on the current status of radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). Currently, HCC accounts for 85–90% of primary liver cancer, which is the sixth most common cancer worldwide. For qualified candidates, liver transplantation and surgical resection provide the only chance for cure. For the subset of patients who do not qualify for transplantation or surgical resection, RFA provides a locoregional alternative to the treatment of HCC. RFA uses a radiofrequency energy-generated heat to destroy biological tissues and has been used to destroy unresectable malignant liver tumors since the early 1990s. Currently, there are three FDA-approved RFA systems: the RITA Starburst, LeVeen, and Cool-tip RFA systems. Liver transplantation and surgical resection provide the best change for cure and long-term survival. RFA should be reserved for those patients who are deemed unresectable, either based on tumor size, number, location, major blood vessel invasion, inadequate hepatic reserve, or significant comorbidities. Absolute contraindications to RFA include the presence of extrahepatic disease, life expectancy less than 6 months, altered mental status, active infection, and tumor abutting a major hepatic duct. Relative contraindications include lesions greater than 5 cm (especially in a cirrhotic liver), more than four lesions, severe pulmonary or cardiac disease, and refractory coagulopathy. Compared to surgical resection, RFA was associated with a higher local recurrence and a shorter overall and disease-free survival. However, RFA was superior to percutaneous ethanol injection (PEI) with more complete response while requiring less treatment sessions and significantly improved local recurrence-free survival, overall survival, and disease-free survival. The addition of transarterial chemoembolization (TACE) significantly improved survival compared to RFA alone or TACE alone. Finally, RFA also provides a safe bridge to transplant with significant complete necrosis observed with tumors
Annals of Surgical Oncology, 2009
The field of surgery has evolved to increasingly incorporate minimally invasive approaches. Altho... more The field of surgery has evolved to increasingly incorporate minimally invasive approaches. Although the use of laparoscopy gained rapid and widespread acceptance for the treatment of benign diseases such as biliary and gastroesophageal reflux diseases, its utility in the treatment of cancer has been more cautious due to initial concerns of compromising oncologic principles and fears of port-site recurrence. For colon cancer, a 10-year randomized clinical trial was conducted to compare laparoscopically assisted versus open colectomy, showing that the rates of recurrence were similar between the two groups and suggesting that the laparoscopic approach was an acceptable alternative to open resection for colon cancer.1 Liver surgery itself has evolved significantly with a better understanding of liver anatomical segments, enhanced imaging, improvements in anesthesia techniques including maintenance of low central pressures during liver mobilization and resection to prevent bleeding, and i ...
Future Oncology, 2008
The field of laparoscopic liver resection surgery has rapidly evolved, with more than 1000 cases ... more The field of laparoscopic liver resection surgery has rapidly evolved, with more than 1000 cases now reported. Laparoscopic hepatic resection was initially described for small, peripheral, benign lesions. Experienced teams are now performing laparoscopic anatomic resections for cancer. Operative times improved with experience. When compared with open cases, blood loss was less in most laparoscopic series, but was the main indication for conversion to an open procedure. Patients undergoing laparoscopic resection had shorter length of hospital stay and quicker recovery. Perioperative complications were comparable between the two approaches. Importantly, basic oncologic principles were maintained in the laparoscopic liver resections. The purpose of this review is to summarize the data available on outcomes for laparoscopic hepatic resection for cancer. This includes primary hepatocellular carcinoma, as well as metastatic colorectal cancer to the liver. The evidence to date suggests that laparoscopic results are comparable with the open approach in cancer patients.
Tetrahedron Letters, 1998
N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutr... more N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutral reaction conditions upon treatment with neat ammonium trifluoroacetate.N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutral reaction conditions upon treatment with neat ammonium trifluoroacetate.
ChemInform, 2007
A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective... more A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.
Perioperative Nursing Clinics, 2011
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
Surgical Clinics of North America, 2010
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
Hepatocellular Carcinoma, 2009
The aim of this study was to evaluate the feasibility of gadolinium ethoxybenzyl diethylene tri... more The aim of this study was to evaluate the feasibility of gadolinium ethoxybenzyl diethylene triamine pentaacetic acid (Gd-EOB-DTPA) in magnetic resonance imaging (MRI) to assess the ablative margin of radiofrequency (RF) ablation to hepatocellular carcinoma (HCC). RF ablation was performed in the livers of six pigs after the i.v. administration of Gd-EOB-DTPA 20 min before ablation. Three pigs were killed 2 h after administration (group A), and the other pigs were killed 7 days after ablation (group B). Thereafter, correlation between pathological findings and MRI was investigated. Moreover, the Gd concentrations were examined in ablated and non-ablated regions. An initial clinical evaluation was conducted for 28 HCC nodules. Percutaneous RF ablation was performed 20 min after administration, and T(1)-weighted images were taken 2, 24 and 72 h post-treatment. On T(1)-weighted images of the porcine liver, the RF ablated lesions showed hyperintense regions with hypointense rims, which histopathologically corresponded to sinusoidal congestion. The Gd concentrations in ablated regions in group A were significantly higher than those in non-ablated regions, while the concentrations in both regions in group B fell to nearly undetectable levels. In 27 of the 28 HCC nodules, the treated area consisted of a hypointense region, indicative of the tumor, and a surrounding hyperintense rim 2 h after ablation. Subsequently, a thin hypointense region was observed in the outermost layer 24 and 72 h after ablation. Administration of Gd-EOB-DTPA in conjunction with RF ablation of HCC may be feasible for the assessment of an accurate ablative margin.
Current Surgical Therapy, 2011
Tetrahedron, 1999
The N-bridge vicinal-6(6-Cl-3-pyridyl) and distal 6-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]octane ho... more The N-bridge vicinal-6(6-Cl-3-pyridyl) and distal 6-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]octane homologs of the potent nicotinic receptor agonist epibatidine have been synthesized. Key steps involve stereo-selective catalytic hydrogenations of both 6- and 5-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]oct-5-enes 12 and 17 on the face anti to the nitrogen containing bridges. The vicinal homolog appears to be a potent nicotinic agonist.Vicinal5 and distal6 methylene homologs of epibatidine have been synthesized.
Pancreas, 2010
ABSTRACT An abstract is unavailable. This article is available as HTML full text and PDF.
Annals of Surgical Oncology, 2009
Background Cholangiocarcinoma (CC) frequently presents at an advanced stage and the majority of p... more Background Cholangiocarcinoma (CC) frequently presents at an advanced stage and the majority of patients are unresectable at diagnosis. We sought to examine our recent experience with surgical resection for hilar and peripheral CC. Methods A review of all CC patients who presented to our multidisciplinary liver cancer center for evaluation of their CC between January 2000 and August 2008 was performed. Demographics, therapeutic management, pathologic characteristics, and overall survival were analyzed. Results A total of 280 patients were evaluated over the 8-year period, and 222 patients (79%) were unresectable at presentation. Fifty-eight out of 280 patients were candidates for resection, of whom, 51 patients underwent resection. Hilar CC was identified in 27 patients (53%) and peripheral CC was present in 24 patients (47%). Morbidity and 90-day mortality were 61 and 9.8%, respectively. Overall, negative margin (R0) resection was achieved in 26 patients (51%). Using multivariate Cox regression analysis, only margin status was found to be a significant predictor of survival (p = 0.009). Compared with peripheral CC, hilar CC was associated with shorter overall survival (p = 0.001) and higher rates of positive margins (p = 0.001) and perineural invasion (p = 0.02), and no difference in angiolymphatic, portal vein, and lymph node involvement. Conclusions Survival benefits can be achieved with resection for cholangiocarcinoma. Given the lack of effective alternative therapy, when confronted with the potential risk of positive margins or isolated nodal disease, we continue to advocate aggressive surgical resection for both hilar and peripheral CC with the ultimate goal of negative margin resection.
Annals of Surgical Oncology, 2010
Background Laparoscopic liver resection has thus far not gained widespread acceptance among liver... more Background Laparoscopic liver resection has thus far not gained widespread acceptance among liver surgeons. Valid questions remain regarding the relative clinical superiority of the laparoscopic approach as well as whether laparoscopic hepatectomy carries any economic benefit compared with open liver surgery. Objective The aim of this work is to compare the clinical and economic impact of laparoscopic versus open left lateral sectionectomy (LLS). Methods Between May 2002 and July 2008, 44 laparoscopic LLS and 29 open LLS were included in the analysis. Deviation-based cost modeling (DBCM) was utilized to compare the combined clinical and economic impact of the open and laparoscopic approaches. Results The laparoscopic approach compared favorably with the open approach from both a clinical and economic standpoint. Not only was the median length of stay (LOS) shorter by 2 days in the laparoscopic group (3 versus 5 days, respectively, P = 0.001), but the laparoscopic cohort also benefited from a significant reduction in postoperative morbidity (P = 0.001). Because the groups differed significantly in age and ratio of benign to malignant disease, a subgroup analysis limited to patients with malignant disease was undertaken. The same reduction in LOS and postoperative morbidity was evident within the malignant subgroup undergoing laparoscopic LLS (P = 0.003). The economic impact of the laparoscopic approach was noteworthy, with the laparoscopic approach US$1,527–2,939 more cost efficient per patient compared with the open technique. Conclusion Our study seems not only to corroborate the safety and clinical benefit of the laparoscopic approach but also suggests a fiscally important cost advantage for the minimally invasive approach.
![Research paper thumbnail of Identification and Characterization of 4-Methylbenzyl 4-[(Pyrimidin-2-ylamino)methyl]piperidine-1-carboxylate, an Orally Bioavailable, Brain Penetrant NR2B Selective N Methyl d Aspartate Receptor Antagonist](https://attachments.academia-assets.com/47336169/thumbnails/1.jpg)
](Journal of Medicinal Chemistry, 2007
The discovery of a novel series of NR2B subtype selective N-methyl-D-aspartate (NMDA) antagonists... more The discovery of a novel series of NR2B subtype selective N-methyl-D-aspartate (NMDA) antagonists is reported. Initial optimization of a high-throughput screening lead afforded an aminopyridine derivative 13 with significant NR2B antagonist potency but limited selectivity over hERG-channel and other off-target activities. Further structure-activity studies on the aminoheterocycle moiety and optimization of the carbamate led to the highly potent 2-aminopyrimidine derivative 20j with a significantly improved off-target activity profile and oral bioavailability in multiple species coupled with good brain penetration. Compound 20j demonstrated efficacy in in vivo rodent models of antinociception, allodynia, and Parkinson's disease.
Bioorganic & Medicinal Chemistry Letters, 2007
A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective... more A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.
Pancreas, 2010
Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Pa... more Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Pancreas. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed ...
Surgical Clinics of North America, 2010
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
We provide a historical perspective and review on the current status of radiofrequency ablation (... more We provide a historical perspective and review on the current status of radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). Currently, HCC accounts for 85–90% of primary liver cancer, which is the sixth most common cancer worldwide. For qualified candidates, liver transplantation and surgical resection provide the only chance for cure. For the subset of patients who do not qualify for transplantation or surgical resection, RFA provides a locoregional alternative to the treatment of HCC. RFA uses a radiofrequency energy-generated heat to destroy biological tissues and has been used to destroy unresectable malignant liver tumors since the early 1990s. Currently, there are three FDA-approved RFA systems: the RITA Starburst, LeVeen, and Cool-tip RFA systems. Liver transplantation and surgical resection provide the best change for cure and long-term survival. RFA should be reserved for those patients who are deemed unresectable, either based on tumor size, number, location, major blood vessel invasion, inadequate hepatic reserve, or significant comorbidities. Absolute contraindications to RFA include the presence of extrahepatic disease, life expectancy less than 6 months, altered mental status, active infection, and tumor abutting a major hepatic duct. Relative contraindications include lesions greater than 5 cm (especially in a cirrhotic liver), more than four lesions, severe pulmonary or cardiac disease, and refractory coagulopathy. Compared to surgical resection, RFA was associated with a higher local recurrence and a shorter overall and disease-free survival. However, RFA was superior to percutaneous ethanol injection (PEI) with more complete response while requiring less treatment sessions and significantly improved local recurrence-free survival, overall survival, and disease-free survival. The addition of transarterial chemoembolization (TACE) significantly improved survival compared to RFA alone or TACE alone. Finally, RFA also provides a safe bridge to transplant with significant complete necrosis observed with tumors
Annals of Surgical Oncology, 2009
The field of surgery has evolved to increasingly incorporate minimally invasive approaches. Altho... more The field of surgery has evolved to increasingly incorporate minimally invasive approaches. Although the use of laparoscopy gained rapid and widespread acceptance for the treatment of benign diseases such as biliary and gastroesophageal reflux diseases, its utility in the treatment of cancer has been more cautious due to initial concerns of compromising oncologic principles and fears of port-site recurrence. For colon cancer, a 10-year randomized clinical trial was conducted to compare laparoscopically assisted versus open colectomy, showing that the rates of recurrence were similar between the two groups and suggesting that the laparoscopic approach was an acceptable alternative to open resection for colon cancer.1 Liver surgery itself has evolved significantly with a better understanding of liver anatomical segments, enhanced imaging, improvements in anesthesia techniques including maintenance of low central pressures during liver mobilization and resection to prevent bleeding, and i ...
Future Oncology, 2008
The field of laparoscopic liver resection surgery has rapidly evolved, with more than 1000 cases ... more The field of laparoscopic liver resection surgery has rapidly evolved, with more than 1000 cases now reported. Laparoscopic hepatic resection was initially described for small, peripheral, benign lesions. Experienced teams are now performing laparoscopic anatomic resections for cancer. Operative times improved with experience. When compared with open cases, blood loss was less in most laparoscopic series, but was the main indication for conversion to an open procedure. Patients undergoing laparoscopic resection had shorter length of hospital stay and quicker recovery. Perioperative complications were comparable between the two approaches. Importantly, basic oncologic principles were maintained in the laparoscopic liver resections. The purpose of this review is to summarize the data available on outcomes for laparoscopic hepatic resection for cancer. This includes primary hepatocellular carcinoma, as well as metastatic colorectal cancer to the liver. The evidence to date suggests that laparoscopic results are comparable with the open approach in cancer patients.
Tetrahedron Letters, 1998
N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutr... more N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutral reaction conditions upon treatment with neat ammonium trifluoroacetate.N-(2-Oxo)-amides were efficiently converted to tri- and tetra- substituted imidazoles under neutral reaction conditions upon treatment with neat ammonium trifluoroacetate.
ChemInform, 2007
A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective... more A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.
Perioperative Nursing Clinics, 2011
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
Surgical Clinics of North America, 2010
• Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal... more • Laparoscopic liver resection • Laparoscopic hepatic resection • Liver cancer • HCC • Colorectal cancer metastases Laparoscopic hepatic resection is an emerging option in the field of hepatic surgery. With almost 3000 laparoscopic hepatic resections reported in the literature for benign and malignant tumors, with a combined mortality of 0.3% and morbidity of 10.5%, there will be an increasing demand for minimally invasive liver surgery. 1 Multiple series have been published on laparoscopic liver resections; however, no randomized controlled trial has been reported that compares laparoscopic with open liver resection. Large series, meta-analyses, and reviews have thus far attested to the feasibility and safety of minimally invasive hepatic surgery for benign and malignant lesions. 2-17 The largest single-center experience was published by Koffron and colleagues 3 and describes various minimally invasive approaches to liver resection, including pure laparoscopic, hand-assisted laparoscopic, and laparoscopic-assisted open (hybrid) techniques. The choice of the minimally invasive approach should depend on surgeon experience, tumor size, location, and the extent of liver resection.
Hepatocellular Carcinoma, 2009
The aim of this study was to evaluate the feasibility of gadolinium ethoxybenzyl diethylene tri... more The aim of this study was to evaluate the feasibility of gadolinium ethoxybenzyl diethylene triamine pentaacetic acid (Gd-EOB-DTPA) in magnetic resonance imaging (MRI) to assess the ablative margin of radiofrequency (RF) ablation to hepatocellular carcinoma (HCC). RF ablation was performed in the livers of six pigs after the i.v. administration of Gd-EOB-DTPA 20 min before ablation. Three pigs were killed 2 h after administration (group A), and the other pigs were killed 7 days after ablation (group B). Thereafter, correlation between pathological findings and MRI was investigated. Moreover, the Gd concentrations were examined in ablated and non-ablated regions. An initial clinical evaluation was conducted for 28 HCC nodules. Percutaneous RF ablation was performed 20 min after administration, and T(1)-weighted images were taken 2, 24 and 72 h post-treatment. On T(1)-weighted images of the porcine liver, the RF ablated lesions showed hyperintense regions with hypointense rims, which histopathologically corresponded to sinusoidal congestion. The Gd concentrations in ablated regions in group A were significantly higher than those in non-ablated regions, while the concentrations in both regions in group B fell to nearly undetectable levels. In 27 of the 28 HCC nodules, the treated area consisted of a hypointense region, indicative of the tumor, and a surrounding hyperintense rim 2 h after ablation. Subsequently, a thin hypointense region was observed in the outermost layer 24 and 72 h after ablation. Administration of Gd-EOB-DTPA in conjunction with RF ablation of HCC may be feasible for the assessment of an accurate ablative margin.
Current Surgical Therapy, 2011
Tetrahedron, 1999
The N-bridge vicinal-6(6-Cl-3-pyridyl) and distal 6-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]octane ho... more The N-bridge vicinal-6(6-Cl-3-pyridyl) and distal 6-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]octane homologs of the potent nicotinic receptor agonist epibatidine have been synthesized. Key steps involve stereo-selective catalytic hydrogenations of both 6- and 5-(6-Cl-3-pyridyl)-2-azabicyclo[2.2.2]oct-5-enes 12 and 17 on the face anti to the nitrogen containing bridges. The vicinal homolog appears to be a potent nicotinic agonist.Vicinal5 and distal6 methylene homologs of epibatidine have been synthesized.
Pancreas, 2010
ABSTRACT An abstract is unavailable. This article is available as HTML full text and PDF.
Annals of Surgical Oncology, 2009
Background Cholangiocarcinoma (CC) frequently presents at an advanced stage and the majority of p... more Background Cholangiocarcinoma (CC) frequently presents at an advanced stage and the majority of patients are unresectable at diagnosis. We sought to examine our recent experience with surgical resection for hilar and peripheral CC. Methods A review of all CC patients who presented to our multidisciplinary liver cancer center for evaluation of their CC between January 2000 and August 2008 was performed. Demographics, therapeutic management, pathologic characteristics, and overall survival were analyzed. Results A total of 280 patients were evaluated over the 8-year period, and 222 patients (79%) were unresectable at presentation. Fifty-eight out of 280 patients were candidates for resection, of whom, 51 patients underwent resection. Hilar CC was identified in 27 patients (53%) and peripheral CC was present in 24 patients (47%). Morbidity and 90-day mortality were 61 and 9.8%, respectively. Overall, negative margin (R0) resection was achieved in 26 patients (51%). Using multivariate Cox regression analysis, only margin status was found to be a significant predictor of survival (p = 0.009). Compared with peripheral CC, hilar CC was associated with shorter overall survival (p = 0.001) and higher rates of positive margins (p = 0.001) and perineural invasion (p = 0.02), and no difference in angiolymphatic, portal vein, and lymph node involvement. Conclusions Survival benefits can be achieved with resection for cholangiocarcinoma. Given the lack of effective alternative therapy, when confronted with the potential risk of positive margins or isolated nodal disease, we continue to advocate aggressive surgical resection for both hilar and peripheral CC with the ultimate goal of negative margin resection.
Annals of Surgical Oncology, 2010
Background Laparoscopic liver resection has thus far not gained widespread acceptance among liver... more Background Laparoscopic liver resection has thus far not gained widespread acceptance among liver surgeons. Valid questions remain regarding the relative clinical superiority of the laparoscopic approach as well as whether laparoscopic hepatectomy carries any economic benefit compared with open liver surgery. Objective The aim of this work is to compare the clinical and economic impact of laparoscopic versus open left lateral sectionectomy (LLS). Methods Between May 2002 and July 2008, 44 laparoscopic LLS and 29 open LLS were included in the analysis. Deviation-based cost modeling (DBCM) was utilized to compare the combined clinical and economic impact of the open and laparoscopic approaches. Results The laparoscopic approach compared favorably with the open approach from both a clinical and economic standpoint. Not only was the median length of stay (LOS) shorter by 2 days in the laparoscopic group (3 versus 5 days, respectively, P = 0.001), but the laparoscopic cohort also benefited from a significant reduction in postoperative morbidity (P = 0.001). Because the groups differed significantly in age and ratio of benign to malignant disease, a subgroup analysis limited to patients with malignant disease was undertaken. The same reduction in LOS and postoperative morbidity was evident within the malignant subgroup undergoing laparoscopic LLS (P = 0.003). The economic impact of the laparoscopic approach was noteworthy, with the laparoscopic approach US$1,527–2,939 more cost efficient per patient compared with the open technique. Conclusion Our study seems not only to corroborate the safety and clinical benefit of the laparoscopic approach but also suggests a fiscally important cost advantage for the minimally invasive approach.
Journal of Medicinal Chemistry, 2007
The discovery of a novel series of NR2B subtype selective N-methyl-D-aspartate (NMDA) antagonists... more The discovery of a novel series of NR2B subtype selective N-methyl-D-aspartate (NMDA) antagonists is reported. Initial optimization of a high-throughput screening lead afforded an aminopyridine derivative 13 with significant NR2B antagonist potency but limited selectivity over hERG-channel and other off-target activities. Further structure-activity studies on the aminoheterocycle moiety and optimization of the carbamate led to the highly potent 2-aminopyrimidine derivative 20j with a significantly improved off-target activity profile and oral bioavailability in multiple species coupled with good brain penetration. Compound 20j demonstrated efficacy in in vivo rodent models of antinociception, allodynia, and Parkinson's disease.
Bioorganic & Medicinal Chemistry Letters, 2007
A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective... more A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.A novel series of cyclic benzamidines was synthesized and shown to exhibit NR2B-subtype selective NMDA antagonist activity. Compound 29 is orally active in a carrageenan-induced rat hyperalgesia model of pain.