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Biomedical subjects

J Korula

Publications and source records attributed to J Korula.

50 records · Page 3Linked to original sources
PubMed1987

Effects of sodium tetradecyl sulfate endoscopic variceal sclerotherapy on the esophagus. A prospective clinical and histopathologic study.

A prospective clinical, endoscopic, and histopathologic study of the esophagus was carried out in 24 patients with advanced liver disease who underwent esophageal variceal sclerotherapy (EVS) and who eventually came to autopsy. Patients were arbitrarily divided into three groups: acute (group I), intermediate (group II), and chronic (group III) based on the interval between the first EVS and death. EVS with sodium tetradecyl sulphate (STS) initially produced thrombosis with varying degrees of necrosis and inflammation followed by ulceration, recanalization, and eventually fibrosis with obliteration of varices. Recurrent variceal hemorrhage (VH) leading to death was highest in the acute group since all patients died of uncontrollable VH (100%); it ranged between 50-60% in both the intermediate and chronic groups. Despite variceal obliteration, recurrent hemorrhage developed in the chronic group due to gastric varices or other venous channels in the esophagus or stomach. Additionally, we describe findings not previously reported, such as the presence of sclerosant outside the varices after intravariceal injection, thrombosis of gastric varices after esophageal injections, and the development of muscular wall thickening.

Adult↗
PubMed1986

Outpatient esophageal variceal sclerotherapy: safe and cost-effective. A prospective study.

A study to determine the safety and cost-effectiveness of outpatient esophageal variceal sclerotherapy (EVS) was undertaken between May 1983 and April 1984. A total of 117 EVS treatments were performed on 34 patients. Complications were minor and no patients required immediate hospitalization following treatment. A cost benefit was realized with outpatient EVS compared to inpatient EVS.

Adult↗
PubMed1986

Effect of esophageal variceal sclerotherapy (EVS) on lung function. A prospective controlled study.

A prospective, controlled study to determine the short- and long-term effects of esophageal variceal sclerotherapy (EVS) on lung function was carried out on 11 patients with cirrhotic portal hypertension and variceal hemorrhage. Eleven patients with chronic liver disease undergoing diagnostic endoscopy served as controls. There was no difference in lung function tests and gas exchange in both the EVS or control groups after either procedure. No change in these parameters was noted during follow-up on continued sclerotherapy in the EVS group. Ventilation-perfusion scans and chest roentgenograms, performed before and after EVS, demonstrated no significant change. We conclude that in patients with stable liver disease and without hepatic failure, EVS does not result in serious short- and long-term impairment of lung function.

Adult↗
PubMed1985

Pseudotumor of the esophagus: an unusual complication of esophageal variceal sclerotherapy.

A case of esophageal pseudotumor most likely due to a submucosal hematoma and occurring as a complication of esophageal variceal sclerotherapy is described. Resolution occurred spontaneously and did not lead to residual complications such as strictures or dysmotility. Continued, uncomplicated chronic sclerotherapy resulting in variceal obliteration was possible after the lesion resolved.

Esophageal Diseases↗
PubMed1982

Acute fatty liver of pregnancy.

Acute fatty liver of pregnancy (AFLP) is rare and is peculiar to the latter half of pregnancy. Despite the high rates of death among affected mothers and their fetuses, early recognition of the disease and immediate delivery of the infant may improve the chances of survival. This paper describes a case of AFLP, characterized by a rapid decrease in the size of the liver, a greatly prolonged prothrombin time and minimal increases in the serum transaminase levels, in which an immediate cesarean section followed by vigorous supportive care led to survival of both mother and infant. It is clear that guidelines on treatment are necessary if the management of such cases is to be successful.

Acute Disease↗
PubMedDate not supplied

A prospective, randomized controlled trial of chronic esophageal variceal sclerotherapy.

The results of a prospective, randomized controlled trial of chronic esophageal variceal sclerotherapy conducted over a 38-month period are presented. One-hundred twenty patients were randomized following variceal bleeding, 63 to esophageal variceal sclerotherapy and 57 to control. Mean follow-up was similar in both groups (esophageal variceal sclerotherapy, 12.5 +/- 8.8 months; control, 14.9 +/- 6.6 months). Twenty-one percent of the patients in each group were lost to follow-up. Esophageal variceal sclerotherapy decreased rebleeding as evidenced by a decrease in the mean bleeding risk factor, transfusion requirement and by an increase in bleeding free interval; differences between the treated and control groups in these parameters were especially significant after variceal obliteration. A high incidence of asymptomatic ulceration and low frequency of strictures were notable effects of esophageal variceal sclerotherapy. Cumulative life table analysis revealed no differences in survival between esophageal variceal sclerotherapy and control groups. However, when patients who received portal-systemic shunt surgery (esophageal variceal sclerotherapy, 6%; control, 28%) were removed from the analysis at the time the shunt surgery was performed (defining the shunt as an endpoint, a significant difference in survival (p less than 0.05, F ratios) in favor of esophageal variceal sclerotherapy was observed.

Adult↗
PubMedDate not supplied

Acute esophageal variceal sclerotherapy. Results of a prospective randomized controlled trial.

Within 48 hours of variceal hemorrhage, 82 patients were randomly assigned to conventional treatment including balloon tamponade or to conventional treatment supplemented by sclerotherapy. The prerandomization general clinical characteristics of the two groups were similar. Seventy-nine percent of patients were alcoholic and 57% were in Child's class C. In the sclerotherapy group of 44 patients, sclerotherapy was performed twice in 28 patients and thrice in 13 patients over the two weeks of follow-up. The number of patients who rebled was significantly lower in the sclerotherapy group than in the group treated conventionally (23% vs 53%). The number of bleeding episodes also was significantly lower in the sclerotherapy group (15 vs 32). Moreover, blood transfusion requirements were significantly decreased in the sclerotherapy group. This was true even for patients who were bleeding at the time of randomization or who were in Child's class C, but this primarily was because fewer patients who underwent sclerotherapy (10 of 24 vs 18 of 23) required transfusions. Although there was no difference in survival between the two groups, we conclude that sclerotherapy is better than conventional treatment in the acute management of variceal bleeding.

Adult↗