Search PubMed⌕ Search

Biomedical subjects

I Segal

Publications and source records attributed to I Segal.

At least 19 recordsLinked to original sources
PubMed1992

Choledochoduodenal fistula from a penetrating duodenal ulcer. A case report.

Choledochoduodenal fistula is an uncommon complication of duodenal ulcer disease. The role of medical therapy is unclear and surgical management has been recommended for the condition. A patient who was treated with ranitidine 150 mg twice daily for 8 weeks for a giant duodenal ulcer with a choledochoduodenal fistula is reported. Both the ulcer and the fistula completely healed on medical therapy. Medical therapy may now become the treatment of choice for this condition due to the availability of potent acid-reducing agents.

Adult↗
PubMed1992

Oesophageal cancer in three regions of South Africa.

Cancer of the oesophagus is the commonest cancer in South African black males. The highest incidence rates occur in the south of Transkei. The rate among urban blacks, especially in Soweto, is also high. This study determined risk factors for oesophageal cancer in patients in three different environments--urban Soweto, rural Ciskei and rural-urban Bophuthatswana. Males were affected more than females. The majority of patients in all three regions were smokers. With regard to alcohol consumption, most Sowetans (84%) and Ciskeians (91%), but only 57% of patients from Bophuthatswana, were drinkers. Home-brewed drinks were the main source of alcohol. Oesophageal cancer occurs in both rural and urban environments, affects people without regard to tribal ethnicity, and occurs mainly in the 6th decade; moreover, almost all patients present with advanced disease.

Age Factors↗
PubMed1992

Pancreatic ascites and effusion. Risk factors for failure of conservative therapy and the role of octreotide.

The possible risk factors for failure of medical therapy were examined in 23 patients with pancreatic ascites or effusion. The ascites or effusion resolved completely in 10 patients after a mean (+/- SEM) of 30 +/- 2 days of conventional medical treatment. In five patients in whom conventional medical therapy failed, the addition of an octreotide (SMS 201-995) analogue to the medical therapy led to a resolution of the ascites (three patients) or effusion (two patients). Six patients underwent surgery after failed medical therapy, one patient died while receiving conservative therapy, and one patient refused hospital treatment. Serum sodium and albumin levels were significantly lower, and the ratio of total fluid protein to total serum protein was significantly higher in the group that failed to heal in response to conventional medical therapy. Nine of 11 patients with mild to moderately severe chronic pancreatitis healed in response to conservative therapy. Only one of 10 patients with advanced pancreatitis healed in response to conventional medical therapy. Our results suggest that a selective surgical approach is warranted to treat pancreatic ascites and effusion. In patients with mild or moderately severe pancreatitis, medical therapy is recommended. Patients with advanced pancreatic disease should be selected for early surgery. Octreotide may be useful in the patient in whom surgery may be associated with a prohibitive morbidity or mortality.

Ascites↗
PubMed1992

Colonic pH: a comparison between patients with colostomies due to trauma and colorectal cancer.

Colonic pH is important in the regulation of colonic cell growth, control of absorption and secretion, and bile acid degradation, which may be a key step in the development of colon cancer. This study determined the mucosal, luminal, and fecal pH in right and left colons of otherwise healthy patients who underwent colostomies because of trauma. The pH was evaluated while patients consumed a western diet. In addition, the mucosal, luminal, and fecal pH in patients with colostomies carried out for colorectal cancer also was assessed. All patients were blacks--a low-risk group for colorectal cancer. The results showed that mucosal pH was alkaline (pH 8) and was similar on both sides of the colon of healthy colostomates and in colon cancer patients. Luminal pH (7.6) was the same in healthy right colostomates and cancer patients and was significantly lower that mucosal pH. Fecal pH was significantly lower in right colostomates (6.0) than in left (6.5), and in healthy right colostomates compared with colon cancer patients (6.6). In addition, fecal pH was significantly lower than mucosal and luminal pH.

Adult↗
PubMed1991

Malabsorption of carbohydrate foods by urban blacks.

Prevalences of non-infective bowel diseases are very low in South African urban blacks compared with the white population. In seeking elucidation, using breath hydrogen measurements in series of black and white subjects, small-bowel transit time was determined, and the malabsorption of maize, wheat, and rice investigated. Median transit times in both ethnic groups were similar. Rice was fully, but wheat incompletely absorbed by both groups. Maize, the staple food of blacks, was incompletely absorbed by them, although completely absorbed by the white subjects. Carbohydrate consumption is high in the black population (60-65% of total energy intake). It is probable that in blacks, despite their now eating a low-fibre diet, an expected increase in large-bowel diseases has been inhibited in part by the protective mechanism of fermentation of malabsorbed maize and wheat.

Adult↗
PubMed1991

Glycaemic responses to different carbohydrate foods in healthy and diabetic blacks in Soweto.

Diabetes mellitus is uncommon in rural southern African blacks. With urbanisation and lifestyle changes, incidence rises to that in western populations. To assess associated changes in carbohydrate metabolism, glycaemic responses to glucose, refined maize, refined rice and bread were studied in 8 healthy and 8 non-insulin-dependent diabetic urban blacks. Additionally, in the healthy group serum insulin responses were measured. In the healthy, maize (the staple food of blacks) elicited the highest glucose response (207 mmol/l/min) and bread the lowest (107 mmol/l/min). The glycaemic indices of maize and glucose were similar. Serum insulin responses to maize were significantly lower than that of bread at 90 minutes (maize 66 muU/ml; bread 93 muU/ml; P = 0.02). In diabetics, maize and glucose elicited similar glycaemia (928 mmol/l/min and 921 mmol/l/min respectively). The high glucose response to maize could relate to its processing and physical form. The low insulin secretion could be due to inadequate stimulation by the 'entero-insular' axis. Moreover, variability in glucose insulin responses could stem from ethnic or genetic reasons. In the dietary management of black diabetics, refined maize should be replaced by other cereals.

Adult↗
PubMed1991

Use of a stationary bed reactor and serum-free medium for the production of recombinant proteins in insect cells.

Insect cells (Spodoptera frugiperda) have been cultured in a stationary bed reactor, packed with a fibrous polyester carrier. When the bioreactor was perfused with serum-supplemented medium, a cell density of 6 x 10(6) cells ml-1 packed carrier was reached. Scanning electron microscopy investigations have shown that the insect cells grew along the three-dimensionally oriented fibers of the Fibra-cel carrier. After infection of the logarithmically growing cells with a recombinant baculovirus (Autographa californica) containing the gene coding for beta-galactosidase, the medium in the bioreactor was changed to serum-free medium. At day 13 postinfection (p.i.), a beta-galactosidase level of 320 microgram ml-1 and, at day 17 p.i., a virus titer of 2.1 x 10(8) TCID50 units ml-1 (day 17 p.i.) were reached. In another bioreactor, operated in a similar way but with serum-containing medium, a beta-galactosidase concentration of 360 microgram ml-1 and a virus titer of 2.3 x 10(8) TCID50 units ml-1 were obtained. These results indicate the potential use of this production system for the production of recombinant protein and baculovirus in insect cells.

Animals↗
PubMed1979

The witchdoctor and the bowel.

Most urban Blacks consult witchdoctors for diverse reasons. The potent effects of their herbal medicines can result in damage to almost any part of the gastro-intestinal tract, and the outcome may be fatal. Diseases induced by witchdoctors therefore constitute an important facet of the disease spectrum of recently urbanized Blacks. Possible reasons for the strong influence of the witchdoctor are given. It is suggested that there should be a reappraisal of medical training in a Black society, so that cognizance can be taken of the important role played by witchdoctors.

Adult↗
PubMed1979

Endoscopic retrograde cholangiopancreatography in the management of traumatic pancreatic pseudocysts. A report of 2 cases.

The results of endoscopic retrograde cholangiopancreatography (ERCP) in 2 patients with traumatic pancreatic pseudocysts are described. As a pre-operative procedure, this investigation provided useful information on the exact site of duct disruption. In both patients, the pancreatic pseudocysts were drained via a posterior cyst gastrostomy, and they have remained well since surgery. Follow-up ERCP at 6 and 12 months demonstrated complete stenosis at the site of duct disruption. The value of ERCP in the pre-operative and follow-up management of traumatic pancreatic pseudocysts is discussed.

Adolescent↗
PubMed1979

Diagnosis of upper gastro-intestinal lesions by endoscopy, cytology and biopsy.

A prospective consecutive series of 210 upper gastrointestinal endoscopic procedures, at which material for both cytological and histopathological examination was obtained, was conducted at Baragwanath Hospital. The purpose of the study was to determine the respective and combined diagnostic value of endoscopic visualization, cytological brushings and histological sections in benign and malignant lesions of the oesophagus and stomach; and in particular to assess the contribution, if any, of exfoliative cytology to the diagnostic regimen. Endoscopic visualization alone was inconclusive or incorrect in 13% of procedures, cytology alone in 9%, and biopsy alone in 12% (the latter 2 figures corrected for adequacy of material submitted). When assessed together, the diagnostic accuracy achieved by all 3 techniques was 99%. The major contribution of cytology was the correct positive diagnosis in 20% of procedures, performed on patients with malignant lesions, whose initial biopsy specimen was inadequate or normal. It is concluded that for maximal diagnostic accuracy of upper gastro-intestinal lesions, a combined approach, utilizing endoscopic examination, lesion-directed brushings and biopsy specimens, is required.

Adult↗
PubMed1979

Faecal pH value and its modification by dietary means in South African black and white schoolchildren.

Mean faecal pH values did not differ significantly in groups of rural South African Black schoolchildren of 10--12 years who ate their traditional high-fibre low-fat diet, and urban dwellers who consumed a partially westernized diet. However, both means were significantly lower than those of groups of White schoolchildren. In feeding studies of 5 days' duration, mean faecal pH value of Black children became significantly less acid when white bread replaced maize meal, and became significantly more acid when a supplement of 6 oranges was consumed daily. Supplements which consisted of skim milk, butter, and sugar had no significant effect on mean faecal pH value. In White children in an institution, the mean pH value of faeces became significantly more acid when a supplement of 6 oranges, although not of bran 'crunchies', was consumed daily.

Black or African American↗
PubMed1979

Amoebic liver abscess in patients presenting with jaundice. A report of 5 cases.

Five patients with severe jaundice resulting from amoebic liver abscess are described. All had features of hepatic parenchymal damage and cholestasis, and 1 patient developed hepatic coma. In addition, acute tubular necrosis and renal failure occurred in 3 patients. Four patients in the series survived. The importance of early recognition and treatment of amoebic liver abscess in patients presenting with jaundice is emphasized, so that the serious and often fatal complications of hepatic and renal failure can be prevented.

Adult↗
PubMed1979

Epidemiology of noninfective intestinal diseases in various ethnic groups in South Africa.

The prevalences of bowel diseases (hemorrhoids, appendicitis, polyps, ulcerative colitis, irritable bowel syndrome, diverticular disease, and colon cancer) are similar in South African whites and in populations of prosperous western countries. Among rural South African blacks with a traditional life style, these diseases are very uncommon or almost unknown. Among the urban South African blacks with a partially westernized life style, the diseases remain uncommon. Frequencies of appendectomies and colon cancer in urban blacks have increased little during the last three decades, although an increase undoubtedly has occurred in the frequency of diverticular disease. Frequencies of bowel diseases in South African Indian and colored (Eurafrican, Malay) populations are intermediate. Because the diseases are almost entirely of environmental causation (due to principally to changes in diet), prevalences almost certainly will increase in blacks, Indians and coloreds, as their way of life becomes further westernized.

Adolescent↗