Search PubMed⌕ Search

Biomedical subjects

I Segal

Publications and source records attributed to I Segal.

At least 127 records · Page 7Linked to original sources
PubMed1984

Hormonal profile after insulin-induced hypoglycemia in chronic calcific pancreatitis. Pancreatic, pituitary and adrenal responses.

The present investigation defined the pattern of pancreatic, pituitary and adrenal responses after insulin-induced hypoglycemia in chronic calcific pancreatitis (CCP) related to alcohol abuse, and assessed the role of some of these hormones in the counterregulation of blood glucose. We studied 6 Black men with recently diagnosed CCP, all showing radiological evidence of pancreatic calcification and normal glucose tolerance, as well as 7 matched nonobese male controls. After a standard iv insulin tolerance test inducing marked hypoglycemia, patients with CCP showed significantly impaired mean plasma pancreatic glucagon and pancreatic polypeptide responses compared to the controls. Mean basal plasma somatostatin levels tended to be higher in chronic pancreatitis and remained so throughout the test without altering consistently; in the controls somatostatin peaked significantly at 30 min. Concerning extrapancreatic hormonal changes, plasma growth hormone, prolactin and total catecholamines responded normally in CCP, but plasma cortisol rose to significantly higher levels than controls at 60 and 120 min after the injection of insulin. This, coupled with the brisk output of catecholamines, may have prevented the heightened sensitivity to insulin anticipated because of their hypoglucagonemia. We conclude that patients with CCP show impaired pancreatic hormone release after insulin hypoglycemia with the exception of somatostatin; there is also an excessive rise in plasma cortisol, possibly related to the long standing abuse of alcohol in the past.

Adrenal Glands↗
PubMed1984

Tuberculosis hepatitis: a clinical review of 96 cases.

Hepatic tuberculosis was confirmed in 96 patients presenting with the features of liver disease, only 14 of whom had other concomitant hepatic pathology. Although respiratory symptoms occurred in 74 per cent of cases, these were overshadowed by the abdominal manifestations. The latter most frequently included right hypochondrial pain, abdominal distension, firm tender hepatomegaly, splenomegaly and ascites. Icterus was observed in 11 cases (only one of whom had concurrent hepatic pathology) and liver failure was found in 10 patients. A surgical presentation occurred in three patients. Four of 15 patients with pancytopenia were noted to have hypersplenism. Abnormalities in coagulation were noted in 26 patients (24 with low prothrombin index and two with moderately raised fibrinogen degradation products). The characteristic serum profile included hyponatraemia (64 per cent of cases), raised alkaline phosphatase (83 per cent) and gamma glutamyl transferase (77 per cent), hypoalbuminaemia (63 per cent) and hypergammaglobulinaemia (83 per cent). Transaminase levels were moderately elevated in 78 per cent of cases. Hepatic imaging techniques were frequently misleading. Chest radiographs aided the diagnosis but were normal in 25 per cent of cases. Histologically, acid fast bacilli, caseation and granulomas were seen in 9, 83 and 96 per cent of cases respectively. Adverse prognostic features included age (below 20 years), miliary TB, coagulation defects and the presence of predisposing factors; these were of value in selecting appropriate therapy. The overall mortality was 42 per cent. Liver biopsy was the most useful aid to correct diagnosis which was suspected clinically in only 47 per cent of cases.

Adolescent↗
PubMed1984

Isolated granulomatous pancreatitis.

Only five patients with clinically apparent noncaseating granulomatous pancreatitis have been recorded, so far as we can tell. We describe a patient with noncaseating granulomas confined to the pancreas who developed obstructive jaundice and acute abdominal pain.

Abdomen↗
PubMed1983

Simultaneous hepatic tuberculosis, cirrhosis and hepatoma. A case report.

Multiple hepatic disease is unusual. An association between tuberculosis of the liver and cirrhosis has occasionally been described, but the occurrence of hepatoma and tuberculous hepatitis has not been reported previously. Clinically it may be difficult to distinguish hepatic tuberculosis from cirrhosis or hepatoma, and diagnostic procedures may not be helpful. We report a patient with tuberculous hepatitis, hepatoma and cirrhosis in whom the diagnosis alternated between the last two conditions until autopsy finally revealed the presence of all three.

Aged↗
PubMed1983

Duodenal and gastric ulcer in Soweto.

Duodenal ulcer is being observed with increasing frequency in the Black population of South Africa, this increase occurring pari passu with industrialization. It is noteworthy that the type of ulcer seen is the 'Western' type of duodenal ulcer, haemorrhage and perforation being the major complications. This picture contrasts with that of gastric outlet obstruction resulting from the 'stenosing' type of ulcer which occurs in rural, non-westernized areas of Africa. The specific characteristics of gastric ulcer in the Sowetan population are outlined, and it is emphasized that gastric ulcer is still uncommon among South African urban Blacks. Protective factors may account for the paucity of gastric ulcer in this group.

Adolescent↗
PubMed1983

Sinus bradycardia in obstructive jaundice--correlation with total serum bile acid concentrations.

Obstructive jaundice is often listed among the causes of sinus bradycardia. The latter is usually attributed to the effect of bile salts on the sino-atrial node. The purpose of this study was to determine the frequency of sinus bradycardia (heart rate less than 50/min) in 50 patients with severe or moderate cholestasis, and to relate sinus rate and intracardiac conduction to total serum conjugated bile acid concentrations. The latter were measured using a solid-phase 125I radio-immunoassay. The mean sinus rate (+/- SD) in the patients was 74.1 +/- 11.6/min (range 47-100/min). One patient had a sinus rate of less than 50/min and 2 had rates of 50-60/min. The mean total serum conjugated bile acid concentration was 251.1 +/- 198.8 mumol/l (range 13-1000 mumol/l). There was no correlation in individual patients between total serum bile acid concentration and sinus rate (r = +0.097), P-R interval (r = +0.210) or corrected Q-T interval (r = -0.085). We conclude that sinus bradycardia is not a feature of obstructive jaundice and that high serum bile acid concentrations do not exert a slowing effect on the sino-atrial node.

Adult↗
PubMed1983

Tuberculous abscess of the liver. A case report.

Tuberculous abscess of the liver is rare. A case is reported and the southern African literature briefly reviewed. The clinical similarities to amoebic and pyogenic liver abscesses and primary or secondary neoplasms of the liver are emphasized. Laboratory tests and hepatic scintiscans may not assist in differentiating between these conditions.

Child, Preschool↗
PubMed1983

Primary tuberculosis of the liver-a case report.

Primary hepatic tuberculosis is a rare manifestation of tuberculosis. We report a case and briefly review the literature. Criteria for the diagnosis include evidence of a recent tuberculous infection, demonstration of tuberculosis in the liver with or without local lymph node involvement and absence of older tuberculous lesions elsewhere. Liver biopsy and culture is the investigation of choice, together with clinical and radiological exclusion of extrahepatic disease.

Humans↗
PubMed1983

Lactase deficiency in the South African black population.

H2 breath analysis was carried out to determine the prevalence of lactase deficiency in different tribes of the South African Black population. Lactase deficiency was common (78%), despite the fact that two of the largest tribes (Zulu and Xhosa) are cattle herders and milk drinkers. This apparent anomaly is due to the consumption of a traditional fermented buttermilk, ("amasi" which has a low lactose content) instead of fresh milk. The most important reason for lactase deficiency, however, is that the South African Blacks originated in the West and Central African zone of nonmilking and took up dairying and milk use fairly recently. Thus they have not had enough time for genetic selection for lactase deficiency through life. The implications inherent in this study are that it would be more prudent to supply milk to developing countries in the form of a fermented milk product such as buttermilk. This is readily accepted by the Black population and would not be counter to accepted cultural practice.

Adult↗