Pulmonary Complications of Liver Cirrhosis: A Concise Review

Pulmonary complications, in the form of hepatopulmonary syndrome (HPS), portopulmonary hypertension (PPH), and hepatic hydrothorax (HH), are rare occurrences in patients with portal hypertension and liver cirrhosis. These complications are associated with high morbidity and mortality. The only effective therapy is liver transplantation in patients who are suitable. In this chapter, each condition will be outlined in detail from clinical presentations to diagnosis and treatment as well as the challenges that clinicians may have encountered in managing patients with these complications

Stem cell therapy in liver disease

Liver cirrhosis is the fifth leading cause of death worldwide and the definitive treatment for liver cirrhosis is liver transplantation although there are limitations such as organ availability and surgical risks. Therefore, alternative therapies have been studied extensively and stem cell therapies have shown some promising results although most studies are small and not randomised. The aim of this thesis was to explore the effectiveness of stem cell therapy in patients with chronic liver disease as well as explore the mechanism behind fibrosis resolution achieved with cell therapy. There were three parts to the thesis: firstly, I examined the mechanistic actions behind fibrosis reduction by the infusion of bone marrow derived haematopoietic stem cells (HSC) in mice chronic fibrosis liver injury model. I worked on both immune-histochemical staining and qPCR to measure the effect oval cell response, matrix metalloproteinases and macrophage subsets within the liver with HSC therapies. Secondly, I recruited patients with chronic liver diseases for a multicentre, randomised, controlled trial to assess the clinical effectiveness of either subcutaneous granulocyte-colony stimulating factor (GCSF) or GCSF with repeated HSC infusions. The co-primary outcomes were improvement in severity of liver disease measured by model for end stage live disease (MELD) at 3 months and the trend of MELD change over time. The results showed that neither of the treatments improved the clinical outcomes. Lastly, I performed a systematic review of current published studies of stem cells therapies in liver diseases. The results showed that stem cells improved patients’ clinical parameters in the short term (<6 months) but had no benefit on long term outcomes. In conclusion, bone marrow derived stem cell therapy did not seem to be effective in liver cirrhosis

Clinical effectiveness of cell therapies in patients with chronic liver disease and acute-on-chronic liver failure: a systematic review protocol

PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) 2015 checklist: recommended items to address in a systematic review protocol*. (DOC 82 kb

Analysis of Cluster based Self Organization Map (SOM) Algorithm in Various Color Spaces Models

Image segmentation means separation process that can divide the original image into smaller area with similar attributes. In this proposed system, input images are taken from the Berkley Image Segmentation Database (BSD) for color image segmentation.  Various color space of images such as RGB, HSV and L*A*B* are used for the segmentation process. Due to effect of the color conversion function reduce the input images size is not flexible, Image J software is used to get the same size of images for different color space. The subjective and objective measured is applied to analyze the color images. Then the cluster based self-organization map (SOM) is applied to produce a low-dimensional input space of the training samples. SOM method develops the ratio of color images similarity and spatial relationship of objects within an image. In this system, the features of color similarity in the image is first segmented into cluster regions and  the resulting regions are treated by computing the spatial distance between any two cluster regions and then the labeling process is made by SOM

Non-alcoholic fatty liver disease:when to intervene and with what

Non-alcoholic fatty liver disease (NAFLD) is increasingly common due to the rising prevalence of obesity in both children and adults. It is associated with metabolic risk factors such as diabetes mellitus, dyslipidaemia and hypertension, and is associated with increased mortality both from cardiovascular-related and liver-related deaths. Identification of those individuals with significant inflammation and fibrosis is a critical part of the patient pathway. Current treatments for NAFLD include weight loss from lifestyle modification or bariatric surgery, management of underlying metabolic risk factors and for those with end stage liver disease, liver transplantation