Conference Schedule

Day1: November 12, 2018

Keynote Forum

Biography

Gerald C Hsu has received an honorable Ph.D. in Mathematics and majored in Engineering at MIT. He has attended different universities over 17 years and studied seven academic disciplines. First, he studied six Metabolic Diseases and Food Nutrition during 2010-2013 and then conducted research during 2014-2018. His approach is math-physics and quantitative medicine based on mathematics, physics, engineering modeling; signal processing, computer science, big data analytics, statistics, machine learning, and AI. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have. 

Abstract

 

Introduction: This paper describes the quantitative and qualitative differences between fasting plasma glucose (FPG) and postprandial glucose (PPG).

Method: The author has been researching type 2 diabetes (T2D) for the past eight years. He followed the three stages: collected 8,878 glucose data (7,206 PPG and 1,672 FPG) for 5 years; studied and analyzed glucose to determine their influential factors with contributing ratios; developed predicted glucose models and then calculated the predicted hemoglobin A1C value. Glucose is not only a medical indicator but also involves lifestyle factors. Some healthcare professionals do not have a comprehensive understanding of this simple term, glucose.

Results: Table 1 shows glucose differences, analysis methods, and conclusions by using big data analytics (~1.5 million). Most people define glucose as blood sugar level and nothing more; however, FPG and PPG are quite different because their influential factors and contribution percentages are diverse. In addition, their behaviors are different in terms of changing speed, normal peak, sensitivity etc. The prediction methodologies are also not the same. The author believes in preventive medicine including prediction of glucose and controlling T2D via lifestyle management. The better you can predict their behavior, the better chance you can reduce their damage. He has spent three years to develop five prediction models to achieve approximately 99% of linear accuracy with high correlations (pattern similarity) between two biomedical signal waves, predicted and measured glucose.

Conclusion: Currently, the patient’s T2D is completely under control by using his developed methodology and five AI-based prediction tools. A deep understanding and quantitative sense of FPG and PPG will benefit the task of effectively controlling diabetes.                                                

 

Biography

Shunlin Ren, Professor of Medicine and Research Career Scientist, received his Medical Degree from Shanghai First Medical College, and his Ph.D. degree from Virginia Commonwealth University. He is a Principal Investigator. His research has been supported by NIH R01 and VA Merit Review grants, Research Career Scientist Award, American Liver Scholar Award, and Durect Corporation Research Agreement. He has published more than 50 papers in reputed journals and 55 US and World patents and patent application. He is serving as an Editorial Board Member of repute. His research has focused on the role of oxysterols and oxysterol sulfation in lipid metabolism, inflammatory responses, and cell proliferation.

 

Abstract

Background: Novel oxysterol sulfates, 25-hydroxycholesterol 3-sulfate (25HC3S) and 25-hydroxycholesterol 3, 25-disulfate (25HCDS) have been demonstrated to be potent regulators of lipid metabolism, inflammatory response, cell apoptosis, and cell survival. In the present study, we tested the chemicals’ potential to treat LPS-induced acute liver failure in a mouse model.

 

Methods: Acute liver failure mouse model was established by intravenous injection with LPS. The injured liver function was treated with intraperitoneal administration of 25HC3S or 25HCDS. Serum enzymatic activities were determined in our clinical laboratory. ELISA assays were used to detect pro-inflammatory factor levels in sera. Western blot, real-time quantitative PCR and RT2 Profiler PCR Array analysis were used to determine levels of gene expression.

 

Results: Administration of 25HC3S/25HCDS decreased serum liver-impaired markers; suppressed secretion of pro-inflammatory factors; alleviated liver, lung, and kidney injury; and subsequently increased the survival rate in the LPS-induced mouse model. These effects resulted from the inhibition of the expression of genes involved in the pro-inflammatory response and apoptosis and the simultaneous induction of the expression of genes involved in cell survival. Compared to 25HC, 25HC3S and 25HCDS exhibited significantly stronger effects in these activities, indicating that the cholesterol metabolites play an important role in the inflammatory response, cell apoptosis, and cell survival in vivo.

 

Conclusions: 25HC3S/25HCDS have potential to serve as novel biomedicines in the therapy of acute liver failure and acute multiple organ failure.

Biography

Hani Oweira is a Visceral Surgeon working in the Hirslanden Private Hospital Group in Zurich and Cham in Switzerland. He was trained in Charite Berlin and the University Hospital in Heidelberg in Germany. His research is focused on the predictive markers for liver dysfunction after liver surgery and transplantation.

Abstract

Liver resections are performed to manage benign and malignant focal lesions in the liver and the postoperative outcome was improved over time due to improvement surgical techniques which get benefited from understanding the liver anatomy and segmentation with an improvement of hemostasis techniques. Anatomy wise, the liver is divided into 2 lobes (right and left) and into 8 segments classified by couinaud based on vascular inflow and outflow. There are many techniques for liver parenchymal transection started with clamp crush technique and developed to ultrasonic vibration (harmonic shear), cavitron ultrasound surgical aspirator (CUSA), hydro jet, radiofrequency dissector and recently staplers. There are numerous types of resection that could be divided to major (>2 segments) and minor (<2 segments) and could be divided into anatomical (right and left hepatectomy, right anterior and posterior sectionectomy and left lateral sectionectomy), nonanatomical resection and individual segmentectomy. There are many other interventional procedures can be done during surgery for hepatic focal lesions rather than surgery as radiofrequency ablation (RFA), cryoablation or irreversible electroporation (IRE) which usually kept as a combined intervention with surgery in deep parenchymal lesions which is difficult to be removed without injuring or scarifying a major hepatic structure. Also one of the elegant techniques in the management of hepatic focal lesions especially malignant one is adjuvant or pre-operative angio-embolization or chemo/radio embolization which deprives the lesion of its blood supply and supplying it with chemo or radiotherapy which may decrease the size of the lesion and make it easier and accessible to be removed. In addition to that, systemic chemotherapy could have benefit in malignant lesions as it may decrease the size of the lesions and minimize the liver parenchyma needed to be resected to remove the whole lesion and sometimes it changes non-resectable liver lesions to resectable one.

Tracks

  • Hepatology | Hepatitis: Care and Cure | Liver Diseases | Hepatocellular Carcinoma & Pancreatic Cancer | Liver Transplantation & Liver Surgery | Viral & Non-viral Hepatitis | Drug Discovery for Treatment of Hepatitis | Viral Hepatitis B & C | Pancreatic Surgery
Location: Paris,France
Speaker

Shunlin Ren

Virginia Commonwealth University, USA

Chair

Speaker

Hani Oweira

Hirslanden Hospital Group, Switzerland

Co Chair

Biography

Dimitri Mikhalski currently working as a director of the transplantation department Hospital Erasme. He has completed his diploma in June 1998 at Katholieke  Universiteit Leuven (KUL) Leuven, Belgium and Masters degree in People Friendship University (PFU) – Moscou, USSA. His research interest includes Full member Council of Organ Transplantation of Belgium and Consultant-Adviser Department "Conservation of the human organs "Superior Council of Health Care Belgium.

 

 

Abstract

Background. Up to now, the general opinion is that vascular connections of a graft to its recipient are necessary and enough to ensure the graft satisfactory function. Nevertheless, a degradation of the functional performances of the grafts, especially pancreas ones, was observed in post-operation late delays in the absence of evident chronic rejection process.

The benefit of surgical reinnervation of syngeneic intestinal and pancreatic grafts was previously proved in experiments on dogs and rats: acceleration of functional recovery, good morphological and physiological results in late observation delays.

The aim of the present pilot study was to investigate the technical feasibility of surgical reconstruction of the nervous connections between graft and recipient during transplantation surgery, to evaluate the eventual risk and to test the short delay results.

Material and methods. A total of 30 patients were involved after similar kidney or pancreas transplantation: 10 with surgical reinnervation, 20 for control without it. Observation delay: up to 12 months. Post-transplantation investigations were provided as usual.

Results. A technique of suturing nervous plexus of the graft with the recipient sacral plexus nerves was elaborated. The manipulation did not exceed 10 min after decamping of the recipient blood vessels. No surgical or post-operation complication was registered. The early post-operation course was easy.

Conclusion. The first results of the surgically directed reinnervation of pancreas and kidney grafts were encouraging. The long delay functional results (5 years and more) are necessary to evaluate the possible benefit of the immediate reconstruction of both vascular and nervous connections between grafts and recipients, as well as a physiologic proof of their neuro reflex links restoration.

Biography

Diabetic foot ulcers are the main reason for hospitalization in diabetic patients. In 85% of cases, diabetic foot ulcers antecede lower limb amputations which have high post amputation five-year mortality. Diabetes mellitus has been proved to alter rheological properties of blood, however, there are little reports about hemorheology in people with diabetic foot ulcers. The study included 16 diabetic patients (2 females, 14 males) with foot's ulcerations (mean age: 66.66±9.39 years) and 20 healthy people (14 females, 2 males) with age: 52.6±7.24 years. In patients with diabetic foot ulcers, increased corrected blood viscosity and plasma viscosity was observed. Erythrocyte aggregation was also enhanced. Analysis of morphological and biochemical blood properties indicated the presence of a chronic vascular insult in the study group. Physical medicine modalities may effectively complement standard treatment of diabetic foot ulcers. Application of variable magnetic fields and local hyperbaric oxygen therapy stimulates numerous biological effects which may enhance wound healing. Angiogenesis, analgesia, anti-inflammatory effect, edema reduction, epithelization, and bactericidal effect are the most frequently listed. As physical medicine modalities have little side effects and contraindications, they should be widely applied in diabetic foot ulcers therapy.

 

Abstract

Grzegorz Onik has completed his Graduation in Physiotherapy from the Medical University of Silesia in Katowice. Currently, he is serving as a Lecturer at the Medical University of Silesia in Katowice in Department of Physical Medicine. He is a Member of the Polish Society of Cryotherapy (Board Member) and Polish Society of Gastroenterological Rehabilitation.

Biography

Tarek E Korah has completed his MD from Faculty of Medicine, Menoufiya University and then, he did his Postdoctoral studies. He was the Head of Gastroenterology and Hepatology Unit, in the same University during 2012 till 2015. He has published more than 30 papers in reputed medical journals and has been serving as a Reviewer in some of these journals.

Abstract

Serum alpha-fetoprotein (AFP) has insufficient sensitivity and specificity for detection of hepatocellular carcinoma (HCC). Recently, glypican-3 (GLP-3) was suggested as a new biomarker for the detection of HCC.

Objectives: To determine the role of serum GLP-3 levels in the early diagnosis and differentiation of small HCC from liver cirrhosis.

Methods: The study included 60 patients; 30 of them with hepatitis C virus (HCV) cirrhosis, and 30 patients with proved HCC. In addition, 20 healthy subjects were included as a control group.

Results: Serum levels of GLP-3 were significantly elevated in patients with HCC compared with HCV cirrhosis group (p<0.001). Also, these levels were significantly elevated in these two patients’ groups versus controls (p<0.001). Also, serum GLP-3 levels with a cut-off value of P240 ug/L had a higher sensitivity (100%) and same specificity (93.3%) than AFP with a cut-off value of P200 ng/ml, for detection of HCC. Moreover, GLP-3 levels showed a higher sensitivity than AFP (50% vs. 41.7%) for the detection of small HCC. The combined use of both markers (i.e. when either one of the two markers positive) improved the specificity to 88.9%. Regarding unicentric HCC, GLP-3 at a cut-off value of 6580 ug/L had better specificity than AFP at a cut-off value of 6765 ng/ml (57.1% vs. 42.9%). The combined use of both markers improved the sensitivity and specificity to 82.6% and 71.4% respectively.

Conclusion: Serum GLP-3 levels are higher in HCC versus HCV cirrhosis, which can differentiate HCC from liver cirrhosis. Also, serum GLP-3 is highly sensitive and specific for detecting HCC. Moreover, GLP-3 is more sensitive than AFP for the detection of small HCC. Furthermore, a combination of both serum markers yielded an improved specificity and both sensitivity and specificity for the diagnosis of small and unicentric HCC, respectively.

Biography

Soriba Naby Camara has completed his master’s in Surgery from Union Hospital Tongji Medical College in the year of 2012 and Ph.D. in Pancreatic Surgery in Union Hospital, Huazhong University of Sciences and Technology in the year of 2016. In 2004 he served as a teacher in Medical College in Gamal Abdel Nasser University of Conakry, and Physician in the Department of Visceral Surgery of the National Hospital of Donka Conakry, Guinea. He has published more than 18 papers in the reputed journals.

Abstract

Suppurative Collection in a newly formed cavity of the hepatic parenchyma, the hepatic abscess is a frequent and serious disease especially in the countries in the process of development.
The goal of this retrospective and a multicentric study was to determine the frequency, the epidemiologic, clinical and therapeutic aspects of this visceral affection at the departments of surgery of the CHU Donka and the friendship hospital of the Sino-Guinean of Kipe of 2012 to 2016.
For this period, 158 patients were hospitalized for abscess of the liver whose 124 cases were retained for the study.
The frequency of the 124 cases compared to the whole of the hospitalizations is of 1, 56 ‰. For the 124 cases selected, the male prevalence is clear with a sex-ratio H/F of 4, 42; Just as that of the young adults with a frequency of 47, 36 ‰ from 25 to 34 years.
The abscess was amoebic in 92, 10 ‰ cases, bacterial in 7,90 percent. In more than 50 ‰ of the cases, the evolution exceeded two weeks. The principal signs observed were the hepatic pains in 100 ‰ cases, the fever in 97, 36 and the hepatomegaly in 93, 42 ‰ of the cases.
The echography carried out in 104 cases out of 124 was of a great contribution to the diagnosis of the disease and its localization.
The surgical drainage after laparotomy was the principal treatment used with a rate of 80,26 ‰ of 9,21 ‰. The suppuration was the principal operational complication post: 6, 55 ‰.
It ya place to reinforce medical education, to improve and make more accessible the average diagnoses and therapeutics.

Biography

Dr. Very Coulic born in Belgium (1936), and has done primary and secondary school in Belgium and medical formation in Brussels University, Medicine Faculty (2.5 years) then Moscow 1st Medicine Institute named by IM Sechenov. There Ph.D. and High School Agreation degrees in Surgery. Docent in 1971, professor for Human Anatomy in 1971. Assistant, scientific worker, and teacher successively in the 1st Medicine Institute, the Academic Laboratory of organ and tissue Transplantation, at the People Friendship University.

Abstract

Background. Up to now, the general opinion is that vascular connections of a graft to its recipient are necessary and enough to ensure the graft satisfactory function. Nevertheless, a degradation of the functional performances of the grafts, especially pancreas ones, was observed in post-operation late delays in the absence of evident chronic rejection process.

The benefit of surgical reinnervation of syngeneic intestinal and pancreatic grafts was previously proved in experiments on dogs and rats: acceleration of functional recovery, good morphological and physiological results in late observation delays.

The aim of the present pilot study was to investigate the technical feasibility of surgical reconstruction of the nervous connections between graft and recipient during transplantation surgery, to evaluate the eventual risk and to test the short delay results.

Material and methods. A total of 30 patients were involved after similar kidney or pancreas transplantation: 10 with surgical reinnervation, 20 for control without it. Observation delay: up to 12 months. Post-transplantation investigations were provided as usual.

Results. A technique of suturing nervous plexus of the graft with the recipient sacral plexus nerves was elaborated. The manipulation did not exceed 10 min after decamping of the recipient blood vessels. No surgical or post-operation complication was registered. The early post-operation course was easy.

Conclusion. The first results of the surgically directed reinnervation of pancreas and kidney grafts were encouraging. The long delay functional results (5 years and more) are necessary to evaluate the possible benefit of the immediate reconstruction of both vascular and nervous connections between grafts and recipients, as well as a physiologic proof of their neuro reflex links restoration.

Biography

Marc Martin was born on 02/09/1959 in Antwerp and Currently working as an Deputy chief medical services, CHU Brugmann, Brussels

Abstract

Background. Previous investigations have proved that the use of differential temperature evolution as “energetic” feedback for monitoring the insulin treatment of severe hyperglycemia, was not worse and may be better than the classical schema, independently on the pathology leading to this glucose metabolism disorder. Nevertheless, some cases of hypoglycemia were still recorded.

The aim of the present work was to elaborate, and to test in experiments (and clinics?) a device which will be able to preview and correct the hypoglycemia development.

Material and methods. For the device elaboration with digital thermic sensors for body deep and superficial temperature registration, Atmel AVR processor, TFT touchscreen and injection pumps for insulin and glucose automated injection was used. The device was tested in observation and treatment regimens in 30 rats, 5 informed healthy volunteers and 10 informed patients. During the procedures body and room, temperatures were registered by the device and usual thermometer, peripheral glycemia was measured by strips (One Touch, Switzerland).

Results. In observation regimen, the device was able to detect temperature events predicting a hypoglycemia in animals and glucose metabolism disorder in humans. In treatment regimen in rats with Streptozotocin-induced diabetes, a quick normalization of glycemia could be reached by insulin injection, as well as a correction of temperature fall by glucose injection.

Conclusion. These first results have shown that it is possible to automate the treatment of severe acute glucose metabolism disorders by both insulin and glucose injection based on the evolution of body temperatures as a feedback. Further investigations are still necessary to confirm the device possibilities, particularly for chronic glucose disorders.

Biography

Khaled Elshaar, MBBCH, MS, MD, MRCSEng, Egyptian Consultant General and Colo-Rectal surgery with special interests in Laparoscopic and trauma Surgery, graduated in 1995 from the Faculty of Medicine, Alexandria University, Egypt. His Magister, MS, and Doctorate MD were in the field of Colo-Rectal Surgery. Worked for few years in the Alexandria University Hospitals, Egypt, moved after that to Saudi Arabia where he is working as a Consultant Surgeon in King Fahd Central Hospital Jazan since 2004 to date. He is a member of EAES and Egyptian society of colorectal surgery. Had published his researches in the field of GIT surgery, and currently, working on rare cases reports to be published.

Abstract

Posttraumatic pseudo-aneurysm of the hepatic artery and its branches is a rare complication of the abdominal injury. Timely intervention is essential as it can rupture and cause a life‑threatening hemorrhage. We report a complex case of thoracoabdominal injury in a 19 years old male victim of shrapnel of bomb blast, who had been transferred to our emergency department in a shocking state with tender and rigid abdomen and positive Focused Assessment with Sonography for Trauma (FAST). While resuscitation was going on we shifted the patient for emergency laparotomy. Formal exploration revealed hemoperitoneum, actively bleeding through and through liver laceration which was difficult to control with liver suturing alone but decreased significantly with liver packing. Cholecystectomy was done as the gallbladder was lacerated by the shrapnel which caused also big through and through the gastric perforation, which had been repaired. The 6x2x2 shrapnel found lodged in front of the duodenum from there it had been taken out.
After 72 hours and before shifting the patient to the operating theatre CECT done showed a big sized Intrahepatic pseudoaneurysm which emerged from an Intrahepatic branch of the left hepatic artery. Endovascular coil embolization is done, then the patient shifted for safe removal of the liver packs. Postoperative was quite hectic as the patient developed bile leak from the abdominal drain along with billions-pleural fistula which settled on conservative treatment.
Conclusion: Intrahepatic pseudoaneurysm following bomb blast injury is rarely if ever reported. Timely diagnosis is crucial. We suggest doing CECT after liver packing and before taking the patient for packs removal, as it may pick up a possible IHPA, to avoid the life-threatening complications of such pathology.

Biography

Triki Ismail as a gastroenterologist and specialist in the management of IBD has his hospital and liberal experience to treat Inflammatory bowel disease in all of these aspects, as he has done research work in this direction, he is also Member of several associations for a patient.

Abstract

The efficacy of non-selective beta-blockers (NSBBs) has been well established for the primary and secondary prophylaxis of variceal hemorrhage. With the progressive increase of portal hypertension over time in cirrhotic patients, blood pressure gradually decreases and heart rate increases to ensure appropriate perfusion of organs (especially the kidney). The use of NSBBs in severe cirrhotic patients in unstable hemodynamic conditions (especially after a spontaneous bacterial peritonitis (SBP) or in the presence of refractory ascites) increases the risk of hepatorenal syndrome and death, by counteracting the compensatory increase in cardiac output. In patients with decompensated cirrhosis or experiencing a drop in blood pressure, NSBBs should be stopped either transiently or definitively, depending on the hemodynamic outcome. Several studies have reported a deleterious effect of NSBBs after an SBP or in patients with refractory ascites. However, these findings lack robustness since most of themcome from observational studies yielding a selection bias that cannot be entirely controlled even though sophisticated statistical approaches were applied. A close monitoring of renal function, serum sodium, and blood pressure could allow a more appropriate management of NSBBs in patients hemodynamically unstable. Hence, in patients with compensated cirrhosis, the dose of propranolol and nadolol may be progressively increased, and carvedilol, a NSBB with intrinsic a1-blockage (which increases the hypotensive effect), may be used cautiously at a maximum dose of 12.5 mg/day. In patients with refractory ascites or SBP, NSBBs should be discontinued or reduced when systolic blood pressure decreases below90 mmHg or serum creatinine increases over 133 mmol/L ; furthermore, the dose of propranolol and nadolol should never exceed 160 mg/day and 80 mg/day, respectively, and carvedilol should be avoided in this context

Biography

Mensah Samuel Kodua is currently studying at the University
of Ghana, Ghana.

 

Abstract

Hepatitis B is an infection of the liver by the hepatitis B virus. It can be acute and self-resolving, or it can be chronic, leading to cirrhosis and liver cancer.
For most adults, HBV is a short-term illness that causes no permanent damage, but 2 to 6 percent of adults infected will develop a chronic infection that can potentially lead to liver cancer. Around 90 percent of infants with the virus will develop chronic infection.
There is no cure for HBV, but immunization can prevent initial infection. Antiviral medication can treat chronic infections.
Cause of Hepatitis B
Hepatitis B is caused by infection of the body with the hepatitis B virus.
The hepatitis B virus (HBV) is found in blood and bodily fluids. It can be transmitted through semen, vaginal fluids, and blood, and it can pass from a mother to a newborn during delivery.