Publications by authors named "David Thiel"

Background/aims: The prevalence of hepatitis C virus infection in the USA is higher among African-Americans than among Caucasians. Despite this, little information is available on the course of hepatitis C virus infection in Blacks and in other minority groups. The aim of this retrospective case-control study was to determine the response rate to high dose interferon-alpha treatment in two racial groups with chronic hepatitis C virus infection.

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Background/aims: Standard chemotherapy approaches for hepatic neoplasms are effective in only 20-30% of cases. The vast majority of patients treated with chemotherapy experience little or no benefit with considerable toxicity. In an effort to identify specific agents potentially effective in individual cases, 22 individuals with a hepatoma were biopsied and their tumor cells were grown in culture such that the expanded tumor cell population could be assessed for chemosensitivity to 14 different commonly used chemotherapeutic agents.

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Hypothesis: Hepatic allografts from donors positive for antibody to hepatitis B core antigen (anti-HBc) frequently transmit hepatitis B virus (HBV) infection to recipients. Therefore, most transplantation centers will not use these organs for orthotopic liver transplantation (OLT). Although it is expensive and not always efficacious, hepatitis B immune globulin (HBIG) has been used routinely for indefinite periods to prevent HBV infection in liver allograft recipients.

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Objectives: The efficacy of the standard hepatitis B virus (HBV) vaccination schedule in individuals with chronic hepatitis C is reported to be reduced. Our aim was to assess the response rate to high dose, short interval HBV vaccination in such individuals.

Methods: A total of 152 individuals with chronic hepatitis C were vaccinated with 40 microg of vaccine administered monthly for 3 months.

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The exacerbation of a co-existing autoimmune disease is often a concern for physicians who use immunomodulating agents for the treatment of a concomitant process. As physicians begin to treat chronic hepatitis C more often and more aggressively, this potential problem with occur more frequently. Herein we reported a case of reactivation of sarcoidosis occurring during the treatment of chronic hepatitis C, and we present a literature review of other centers' experiences with this problem.

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A number of disorders for which an association with hepatitis C virus infection exist. These disorders include essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and idiopathic pulmonary fibrosis. This study was initiated to investigate the cellular content and lymphocyte subpopulations of bronchoalveolar lavage fluid obtained from individuals with chronic hepatitis C and to compare the results to those of controls.

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Most candidates for liver transplantation have irreversible cirrhosis caused by years of heavy alcohol consumption. Arguments against liver transplantation for alcoholics include the presumption of relapse to heavy drinking, which might damage the new liver or lead to its rejection. Corresponding ethical arguments focus on the presumption that alcoholics brought their condition upon themselves and should not compete with nonalcoholics for scarce donor livers.

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Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with the macrolide immunosuppressive agent FK506. A discussion of the clinical presentation and course of Kaposi's sarcoma in these 2 patients, as well as a review of the past literature on Kaposi's sarcoma in organ transplant recipients, emphasizes the therapeutic difficulties encountered.

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We have reviewed the long term results of the first 500 liver transplant recipients performed by our group during the cyclosporine era. Three hundred and forty-nine recipients lived (69.8%) more than 1 year and the projected 5 year actuarial survival for this sub-group of patients is 88%.

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