Biomedical subjects
I Segal
Publications and source records attributed to I Segal.
Total obstruction of the ascending colon complicating acute pancreatitis.
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Air-flow studies in excessive flatulence.
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Breast cancer and diet.
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Dietary fibre and survival.
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A suction-abrasive cytology tube for the diagnosis of esophageal carcinoma.
A simple, easily constructed, and inexpensive suction-abrasive cytology tube was developed to study esophageal cytology. The reliability of this method for the diagnosis of esophageal carcinoma was evaluated in 101 patients. Of 47 patients with esophageal carcinoma, 93% were diagnosed correctly on exfoliative cytology. There were no false diagnoses of cancer. The cytology tube was well tolerated by all patients and provided a rapid and reliable method of diagnosis. As a screening procedure, this method may be applicable for widespread use to detect early esophageal cancer in high-risk populations.
Defaecation frequencies in Black, Indian, Coloured and White populations - what do they signify?
Using questionnaires covering a 7-day period, frequencies of defaecation were determined in a total of 2937 Black, Indian. Coloured and White subjects aged from 10 years upwards. It transpired that the overall frequency in rural Blacks was roughly twice that of Whites. Among rural Blacks defaecation frequencies of 5-7 per week were recorded in 16%, and from 1-3 per day in 80%. The corresponding figures among urban Blacks were 25% and 71%, among Indians 58% and 34%, among Coloureds 46% and 39%, and among Whites 59% and 29%. The wide differential in frequencies between Blacks and Whites is consistent with the wide differential prevailing in proneness to noninfective bowel diseases. On the other hand, Indians and Coloureds had defaecation frequencies little different on average from those of Whites, yet the former two populations are far less prone to bowel diseases. Hence caution must be exercised in correlating defaecation frequency with proneness to bowel diseases. Since bowel behaviour includes numerous aspects, defaecation frequency should not be regarded in isolation.
High serum gastrin in ulcerative colitis.
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Intramural haematoma of the oesophagus. The role of endoscopy.
The clinical, radiological and endoscopic aspects of 2 cases of intramural oesophageal haematoma are presented. The diagnosis was firmly established at endoscopy, and both patients responded to conservative therapy. The value of endoscopy in the diagnosis and management of this condition is emphasized.
Tonsillectomy and appendicectomy--do they prejudice subsequent health?
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Thyrotoxicosis presenting as dysphagia. A case report.
Thyrotoxicosis may manifest with dysphagia. The case of an elderly male with dysphagia as the initial symptom is discussed. It is suggested that thyrotoxicosis is included in the differential diagnosis of dysphagia in the elderly, particularly if muscle weakness is also present.
Pancreatic abscess and computed tomographic scanning.
A 42-year-old man presented with acute haemorrhagic pancreatitis. He developed all the major complications of acute pancreatitis including a pancreatic abscess which was shown to progress on serial computed tomography (CT) scans. The diagnostic value of CT in acute pancreatitis is emphasized.
Endoscopic experiences in the Republic of South Africa.
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Terminology of sclerosing cholangitis.
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Appendicectomy prevalences in South African adolescents.
From questioning 16,939 South African pupils of 16-18 years, in 56 high schools, mean prevalences of appendicectomies in representative segments of ethnic groups were found to be: rural Blacks 0.6%; urban Blacks 0.7%; Indians, 2.9%; Coloureds (Eur-African-Malay), 1.7%; Whites, 10.5%. Percentages in the sexes were similar. Only those of Indian and Coloured pupils appear to be increasing. Blacks and Whites, respectively, have high and low intakes of fibre-containing foods, which are negatively correlated with appendicectomy prevalences. However, although intakes of fibre-containing foods are slightly higher in Indians and Coloureds than in Whites, the former's appendicectomy prevalences are lower than would be dietarily expected.
Diverticular disease in urban Africans in South Africa.
At Baragwanath Hospital, Johannesburg, South Africa, during a 3-year period diverticular disease was diagnosed in 42 Black patients (16 men, 26 women), from an urban population approaching 1,5 million. Patients presented mainly with rectal bleeding, abdominal mass or pain. Of average age 62 years, all were among the more privileged. The persisting very low frequency of the disease, which is in consonance with low frequencies of other bowel diseases (appendicitis, ulcerative colitis, colon cancer), is deemed valid. The mean daily dietary fibre intake, 26.5 +/- 8.5 g, was higher than that of local Whites, 22.4 +/- 6.0 g, but significantly less than that of a sex-age matched urban Black control group, 32.5 +/- 11.4 g. Although a measure of westernization of diet has obviously occurred, its extent, also the period of exposure, would seem to have been insufficient to have evoked significant rises in the occurrence of diverticular disease.
Chronic pancreatitis and the hepatobiliary system.
Alcohol-induced chronic pancreatitis involving the head of pancreas may have profound effects on the hepatobiliary system. The natural history, complications, and management of the syndrome are presented, using selected cases to emphasize important features. Chronic pancreatitis can cause mechanical obstruction to both the distal common bile duct and the proximal pancreatic duct. In the common bile duct this will result in proximal dilatation above the stenosis with bile stasis. Possible sequelae are ascending cholangitis, cholecystitis, biliary calculi formation, and secondary biliary cirrhosis. The mechanical effects of stricture of the proximal pancreatic duct may exacerbate pancreatic dysfunction. The clinicopathological spectrum of chronic pancreatitis with biliary obstruction encompasses three clinical types--"transient," "recurrent", and "persistent." The widespread effects of the syndrome are evident from the involvement of pancreas, proximal pancreatic duct, papilla of Vater, liver, peripheral biliary tree, common bile duct, gallbladder, and reticuloendothelial system. Essential to management is surgery which should be considered when there is objective evidence of obstruction to the common bile duct. Choledochoduodenostomy is the preferred type of operation. If dilatation is mild and jaundice transient, conservative therapy with careful observation is advocated.
Amoebiasis in an urban black population.
Amoebiasis is a common cause of dysentery and liver abscess at Baragwanath Hospital, Johannesburg. Forty-eight adult patients with amoebiasis were diagnosed during the 8-month period 1 December 1979 to 31 July 1980. There was a high incidence of extra-intestinal complications (38%) and a high mortality rate (12.5%) in this series. The importance of early surgery in fulminating dysentery which has not responded to amoebicidal therapy is emphasized. The need for early diagnosis is crucial, since failure to consider the possibility of the presence of amoebiasis may result in serious complications. This study demonstrates that endemic 'pockets' of amoebiasis are probably present in Soweto, Johannesburg. It is suggested that those involved in the preparation or handling of food for public consumption be clinically examined, and their stools examined for cysts of Entamoeba histolytica.