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Biomedical subjects

E Granot

Publications and source records attributed to E Granot.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Neonatal hepatitis and biliary atresia].

The differential diagnosis between intrahepatic and extrahepatic cholestasis in the newborn is difficult and has therapeutic implications. 61 cases of neonatal cholestasis were retrospectively analyzed to assess the efficacy of various tests and procedures in differentiating between the 2 types. Determination of serum gamma-glutamyl transpeptidase, ultrasonography and radionuclide scanning differed significantly in the 2 types (p '0.05 for all 3 determinations). A diagnostic program for evaluation of infants with neonatal cholestasis is proposed.

Biliary Atresia↗
PubMed1994

[Reduced-size liver transplants in children].

Orthotopic liver transplantation is now used for children with end-stage liver disease, but the scarcity of size-matched liver allografts for children has limited its use. Reduced-size liver transplantation, in which only part of the liver is used as a graft, overcomes size disparity and increases significantly the potential donor pool for children. A 4-year-old boy with fulminating hepatic failure due to hepatitis became the first case of reduced-size liver transplantation in Israel. A left hepatic lobe allograft from an adult donor was used. The boy is home and well 9 months after transplantation. Reduced-size liver transplantation was first performed in a child by Bismuth and Houssin in 1984. Reports from several centers show that survival of recipients of reduced-size liver allografts and the rate of retransplantation does not differ significantly from that in recipients of full-sized livers.

Child↗
PubMed1994

Salivary IgA antibodies to Giardia lamblia in day care center children.

An enzyme-linked immunosorbent assay was developed for the detection of specific salivary IgA antibodies to Giardia lamblia. Among 73 infants and children in a day care center 9 asymptomatic subjects had stools positive for G. lamblia. Salivary antigiardia IgA concentrations, expressed as OD units, were higher in the 2- to 4-year-old group: 0.899 +/- 0.03 vs. 0.660 +/- 0.03 in the < 2-year old group (P < 0.001). In both groups values were higher in the infected children (1.099 +/- 0.04 vs. 0.629 +/- 0.09 in the < 2-year-old group and 1.053 +/- 0.07 vs. 0.859 +/- 0.03 in the 2- to 4-year-old group). In children infected throughout the study period, salivary antigiardia antibodies remained consistently high and in 2 children whose stools were initially negative a significant rise in OD value was observed after stools tested positive. Total salivary IgA did not differ between the two age groups and did not correlate with specific salivary antigiardia antibodies in individual subjects. The enzyme-linked immunosorbent assay for detection of specific salivary antibodies to G. lamblia can be used in the study of the mucosal immune response to the parasite, and may serve as an screening tool in monitoring the exposure of various populations to G. lamblia.

Animals↗
PubMed1994

"Early" vs. "late" diagnosis of celiac disease in two ethnic groups living in the same geographic area.

Despite studies documenting existence of celiac disease worldwide, its prevalence in many parts of the world is underestimated and cases remain unrecognized. In Israel, celiac disease is relatively common among the Jewish population but considered to be rarer among the Arab population. We compared the manifestations of celiac disease in children of both ethnic groups and questioned whether differences in presentation relate to degree of awareness for celiac disease in each group. Age at presentation, time interval between onset of symptoms and diagnosis, prevalence of gastrointestinal symptoms, presence of signs of malabsorption and degree of growth retardation varied markedly between both groups. In populations in which there is a low index of suspicion for celiac disease, symptoms may be wrongly attributed to the post-gastroenteritis syndromes or protein-calorie malnutrition, thus resulting in a detrimental delay in diagnosis. Undiagnosed cases may in later childhood manifest predominantly as short stature.

Adolescent↗
PubMed1993

Chronic diffuse varioliform gastritis in a child. Total gastrectomy for acute massive bleeding.

Chronic diffuse varioliform gastritis is an uncommon, subacute, inflammatory gastric mucosal disease characterized by swollen congested rugae and disseminated mucosal erosions. The entity is exceptionally rare in children. The spectrum of reported symptoms is broad; frank hematemesis has never been reported in childhood. We present a child in whom the disease had a remarkably unusual clinical course. Because many caretakers were unaware of the existence of the disease in children, the patient had numerous hospitalizations and surgical procedures, until massive gastric bleeding resulted in unavoidable emergency total gastrectomy. Microscopical examination and immunofluorescent staining of the gastric mucosa confirmed the diagnosis of chronic diffuse varioliform gastritis.

Child↗
PubMed1993

Histological comparison of suction capsule and endoscopic small intestinal mucosal biopsies in children.

Small intestinal biopsies are part of the routine evaluation of children with chronic diarrhea and malabsorption, and are commonly performed via suction capsule. Because this technique entails x-ray exposure, longer procedure time, and technical failures, most small intestinal biopsies in adults are currently obtained via endoscopy. Endoscopy is believed to yield morphologically inferior specimens, and, therefore, its use for obtaining small intestinal biopsies in children has remained limited. The histological adequacy of biopsy specimens obtained in 30 children by endoscopy and in 30 children by suction capsule was compared. Biopsies were assessed for quality of orientation, size (length and depth), presence of Brunner's glands and crush artifact, and for the ability to confirm or exclude a mucosal abnormality. Small intestinal biopsies obtained via endoscopy were shown to yield tissue specimens that are histologically comparable to those obtained by suction capsule, and that are equally suitable for interpretation.

Biopsy↗
PubMed1993

Familial hypobetalipoproteinemia--differences in lipoprotein structure and composition.

Familial hypobetalipoproteinemia represents a heterogeneous group of genetic defects in which the concentrations of plasma apolipoprotein B and apo-B-containing lipoproteins VLDL and LDL are abnormally low. To explore potential effects of different genotypes on plasma lipid patterns, the lipoproteins of two families with hypobetalipoproteinemia were compared using zonal ultracentrifugation and chemical analyses. Heterozygotes differed between families not only in level and composition of apo-B-containing lipoproteins but also in HDL subclass distribution. In one family, heterozygotes had very low apo B levels and their major HDL subfraction was HDL2 as in abetalipoproteinemia, whereas in the second family heterozygotes had apo B levels approximately half on normal and the major HDL subfraction was HDL3 with an HDL elution pattern intermediate between that observed in abetalipoproteinemia and normal subjects. Observations on the HDL system in these two families substantiate the role of cholesteryl ester/triglyceride exchange between HDL and lower-density lipoproteins in the remodelling of HDL in plasma.

Adolescent↗
PubMed1993

Peripheral blood lymphocyte subsets in infants with diarrhea with and without Giardia lamblia infection.

The aim of the present study was to define the cellular immune response during gastrointestinal Giardia lamblia infection in young children. The level of lymphocyte subsets was determined in the peripheral blood of infants with G. lamblia-associated diarrhea or acute gastroenteritis and from control infants without diarrhea. The proportion of peripheral blood lymphocytes (PBL) expressing the CD8 marker (suppressor cytotoxic T cells) and the CD57 marker (natural killer cells and subset of CD8+ T cells) was highest in infants with acute gastroenteritis, lower in infants without diarrhea, and lowest among those with G. lamblia-associated diarrhea. The level of CD4+ PBL (helper T cells) did not differ significantly among the three groups of children tested. The level of memory, or helper-inducer, CD4+CD29+ PBL was increased markedly in acute gastroenteritis as compared with their level among the other two groups, whereas naive or virgin CD4+CD45RA+ PBL had the reciprocal distribution among the three groups of infants. In contrast to acute gastroenteritis from other causes, G. lamblia-associated diarrhea did not elicit changes in lymphocyte subsets.

Antibodies, Monoclonal↗
PubMed1993

Minimal middle ear effusion: an indication for ventilation tubes in infants with protracted vomiting.

We have lately treated six infants hospitalized in our hospital for persistent vomiting and failure to thrive with no overt explanation for their condition. Examination of the ears of these infants revealed various degrees of serous otitis media. They all had myringostomies and insertion of ventilation tubes after which they stopped vomiting and gained in weight. We wish to revive the often overlooked association between protracted vomiting and middle ear effusion. It seems that minimal degrees of middle ear effusion may cause vomiting and patients with this condition may benefit from ventilation tubes.

Failure to Thrive↗
PubMed1992

Antigenic differences between subsets of peripheral blood lymphocytes differing in their right angle light scatter in flow cytometric analysis.

The expression of various cell surface markers on peripheral blood lymphocytes (PBL) of young children and of adults was determined by flow cytometry among cells with either high or low light side scatter (SSC). In adults and in children, CD4+ lymphocytes (helper T cells) were more abundant among PBL with low SSC than among PBL with high SSC. The proportion of CD57+ (Leu-7+) cells (NK cells and a subset of CD8+ T cells) was significantly elevated among high SSC PBL, while that of CD8+ PBL (cytotoxic suppressor T cells) was only slightly elevated. CD4+ and CD8+ lymphocytes which coexpressed the CD29 marker, characteristic for activated or memory T cells, were significantly more abundant among lymphocytes with high SSC. In adults, the proportion of CD4+ CD45RA+ lymphocytes, naive T cells, was significantly higher among low SSC cells. The present study indicates that determination of the SSC of lymphocyte subsets by flow cytometry can improve the discrimination among lymphocyte subpopulations and contribute to assessment of their state of activation.

Adolescent↗
PubMed1992

Pneumococcal empyema following endoscopic sclerotherapy in a child with cavernous transformation of the portal vein.

Esophageal sclerotherapy is widely used in the treatment of bleeding esophageal varices. Complications vary from chest pain to esophageal perforation. Our patient, suffering from cavernous transformation of the portal vein, developed massive empyema following sclerotherapy. Although small asymptomatic pleural effusions have been reported, massive empyema requiring surgical drainage, without evidence of esophageal perforation, has, to our knowledge, not been described.

Anti-Bacterial Agents↗
PubMed1991

[Acute hypertrophic gastropathy of childhood].

Acute hypertrophic gastropathy of childhood is a rare disease characterized by gastrointestinal complaints and hypoalbuminemia due to protein loss from the stomach. The disease is benign, with complete recovery within a few months. We describe 2 girls with this condition, both 3 years old, in whom a detailed workup was performed, including upper gastrointestinal tract X-rays, ultrasound examination of the abdomen, and gastroscopy with mucosal biopsy. Gastrointestinal protein loss was demonstrated by measuring alpha 1 antitrypsin in the feces. Both children recovered spontaneously within a few weeks.

Acute Disease↗
PubMed1991

Prevalence of HBsAg carriers in native and immigrant pregnant female populations in Israel and passive/active vaccination against HBV of newborns at risk.

Israel has no official prevention policy at present against perinatal and horizontal transmission of hepatitis B virus (HBV) infection in newborns and children at risk. The present study was designed to assess the prevalence of HBV carrier state in a population of 11,123 pregnant women at term. Among this population (mean age 29.7 +/- 5.9), 98 women (0.88%) were found to be asymptomatic HBsAg+ carriers, and 97% of these carriers were anti-HBe+. Evidence for HBV replication, as determined by serum HBV-DNA, was established in 6.6% of the HBsAg+/anti-HBe+ population. The HBsAg carrier rate was strongly influenced by religion, continent, and country of birth of the carrier mothers. The highest relative carrier rate was found among women of Moslem origin (4.3%), as compared to Jewish women (0.67%). Most carrier women were born in Israel (56.1%) to mothers who had emigrated from regions with intermediate or high endemicity of HBV, such as North Africa or the Middle East. In these groups, the HBsAg carrier rate ranged between 1.2 and 3.0%. Ninety-three percent of newborns receiving passive/active vaccination against HBV developed protective levels of anti-HBs. Finally, evidence for horizontal transmission of HBV was found in 19.3% of 83 non-vaccinated children in families of HBsAg carriers. The present study therefore establishes HBsAg prevalence rates in specific risk groups of women at term and confirms the need for an official policy on immunization against HBV in Israel. Since over 50% of women at term belong to the defined risk groups, universal active vaccination of the entire newborn population each year is suggested as the most rational and needed policy in Israel.

Adolescent↗
PubMed1991

Sarcoma botryoides of the common bile duct: preoperative diagnosis by coronal CT and PTC.

Sarcoma botryoides of the extrahepatic bile ducts is a rare cause of obstructive jaundice in the pediatric population. It is rarely diagnosed preoperatively. We present a case of this tumor which was diagnosed by ultrasound, computerised tomography and PTC. Coronal CT sections were particularly useful in demonstrating the relationship of the tumor to the porta hepatis, pancreas and duodenum.

Child, Preschool↗
PubMed1991

Gastrointestinal protein loss in children recovering from burns.

Qualitative gastrointestinal protein loss was evaluated in 10 children with second- and/or third-degree burns covering 10% or more of their body surface area (BSA) by using fecal alpha-1-antitrypsin (FA-1-AT) as a marker. Patients were subdivided according to the extent of the burned area: group I (5 patients) had burns covering less than 20% of BSA; group II (5 patients) had burns covering more than 20% of BSA (mean, 37.2% = 24.9%). Results were compared with those of 12 healthy normal controls. Mean maximal FA-1-AT excretion in group II patients (2.71 +/- 1.35 mg/g) was significantly greater than that found in group I children (0.43 +/- 0.26 mg/g; P = .006) and in the controls (0.62 +/- 0.25 mg/g; P = .004). The mean maximal FA-1-AT excretion positively correlated to the percent of BSA covered with burns (r = 0.83). Although the mean septic score (SS) of group I patients (7 +/- 2.9) was significantly greater than that calculated for group II children (3 +/- 2.45; P = .047), only 2 patients in group II had positive microbiological cultures. Patients in both groups had received more than the recommended enteral caloric and protein allowance during the 96 hours prior to the maximal FA-1-AT measurements. Within this range, no correlation was found between the amount of FA-1-AT and the number of calories per kilogram protein consumed. By using the method of FA-1-AT quantification, this study provides the first report on postburn intestinal protein loss in children.

Burns↗
PubMed1991

Orocaecal transit time in Duchenne muscular dystrophy.

Smooth muscle degeneration may occur in Duchenne muscular dystrophy. We measured fasting orocaecal transit time in patients with advanced Duchenne muscular dystrophy and other muscular dystrophies and in healthy controls. No significant differences were found. In contrast to reports of gastric hypomotility in Duchenne muscular dystrophy, we found no evidence of impaired small intestinal motility.

Adolescent↗
PubMed1990

Isolated lipase and colipase deficiency in two brothers.

Two brothers of Arab origin, aged 15 and 10 years, with isolated congenital lipase and colipase deficiency are described. Both were normally developed with a history of passing greasy stools since early infancy. Both have remarkable steatorrhoea and low serum carotene and vitamin E concentrations. After exocrine pancreatic stimulation, lipase and colipase activities in the duodenal fluid were almost completely absent, while amylase trypsin, bile salt, and pH values were normal. No other aetiology for exocrine pancreatic insufficiency was found. This is the first report of congenital combined lipase and colipase deficiency in two brothers.

Adolescent↗