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Biomedical subjects

J Eshchar

Publications and source records attributed to J Eshchar.

At least 19 recordsLinked to original sources
PubMed1997

Esophagogastric mucosal junction (EGMJ): its location as measured by endoscopy.

The "esophageal" length, i.e., incisors-esophagogastric mucosal junction distance, was measured endoscopically in 758 patients, retrospectively. Two hundred twenty-five additional patients were evaluated prospectively and their height and weight were measured. All patients were analyzed according to their age and sex, indication for the procedure, and its endoscopic diagnosis. "Esophageal" length was found to be significantly longer in male patients. Fifty-three percent of the examined population had "esophageal" length shorter than 38 cm, whereas 99% of patients with normal endoscopy had "esophageal" length of 38-40 cm. Linear correlation was found between "esophageal" length and height, but not with weight. Patients with dyspepsia and esophagitis had a "shorter" esophagus, whereas those with tumors of the upper gastrointestinal tract and those with duodenal ulcer had a "longer" esophagus.

Adolescent↗
PubMed1996

Superoxide dismutase activity in Helicobacter pylori-positive antral gastritis in children.

Reactive oxygen metabolites have been implicated in gastric mucosal injuries. Superoxide dismutase, a scavenger of superoxide radical, is a key enzyme in gastric mucosal protection against several damaging factors. This study was aimed at investigating the relationship of superoxide dismutase activity to Helicobacter pylori-induced antral gastritis in children. Two groups of 11 children each, one positive and the other negative for Helicobacter pylori, were studied. Biopsies from the antrum and corpus were obtained for evaluation of Helicobacter pylori by CLOtest and histology as well as for superoxide dismutase activity (cytochrome c method). Erythrocytic and serum superoxide dismutase levels were determined as well. Superoxide dismutase activity was significantly higher only in the antrum of children with Helicobacter pylori-induced antral gastritis. There was no significant difference in superoxide dismutase activity in the corpus, erythrocytes, or serum of both groups. These findings may suggest a pathogenic relationship between the presence of Helicobacter pylori and oxygen radicals in inducing antral mucosal injury.

Adolescent↗
PubMed1996

Superoxide dismutase activity in duodenal ulcer patients.

OBJECTIVE: To investigate whether duodenal ulcer (DU) is associated with increased free radical generation at the site of ulceration and to attempt, indirectly, to confirm the hypothesis by determining activity of free radical scavengers such as superoxide dismutase (SOD). STUDY DESIGN: Prospective study comparing SOD activity in biopsies taken from the ulcer edge, and antrum in DU patients before and after one month of treatment to SOD activity in biopsies from the duodenal bulb and antrum in a control population. SETTING: Institute of Gastroenterology of a university hospital. STUDY POPULATION: Twenty-five patients with DU. The diagnosis was confirmed by endoscopy. MEASUREMENTS: SOD activity in biopsy specimen, red blood cells (RBC) and serum was measured using the cytochrome c method by spectrophotometry and expressed as U SOD/mg protein. Helicobacter pylori was diagnosed by the rapid urease test (CLO test) from antral biopsies. RESULTS: SOD activity was markedly depleted in the ulcer edge (2.78 +/- 0.9 U SOD/mg protein) as compared to the same patients after one month of treatment (4.59 +/- 2.2 U SOD/mg protein) (P = 0.05) and to biopsies from the duodenal bulb in control population (6.7 +/- 2.4 U.SOD/mg protein) (P = 0.05). SOD activity in the antrum of both groups was similar. There was no difference in SOD activity in RBC and serum of both groups. CONCLUSION: Products of free radical reactions are implicated in the pathogenesis of DU disease. SOD, which is a key enzyme in gastric mucosal protection, is depleted significantly in the ulcer edge compared with controls and increases after healing. However, it is not clear whether this abnormality in oxygen free radical metabolism reflects, rather than causes, the condition which characterizes DU.

Biopsy↗
PubMed1995

Gastrointestinal patients in the emergency room.

Of 4,839 patients who visited the Emergency Room (ER) of a 650-bed general hospital (serving a regional population of 220,000) over a period of 28 consecutive days, 436 were suffering from gastrointestinal (GI) problems. The patients, together with their 140 ER doctors, were interviewed by 40 trained interviewers and information concerning demographic data, tests performed, diagnosis, treatment and hospitalization was collected and evaluated. Most of the GI patients (39.9%) were aged 16 years or younger, were Israeli born and were suffering from infections of the GI system. Twenty percent of all GI patients were hospitalized. Most came to the ER on working days although their symptoms began at home. A total of 77.9% of the GI group expected to be treated in the ER and sent home without being hospitalized. The ER, which is open for 24 hours a day, is considered by the population as a kind of an outpatient clinic.

Abdominal Pain↗
PubMed1994

"Rendez-vous" procedure (RVP) for obstructive jaundice.

Seven patients with obstructive jaundice were palliatively treated with the "rendez-vous" procedure, which combines a percutaneous and an endoscopic approach to stent insertion into the biliary system. In six cases, pretreatment papillotomy was not needed. Endoscopy was also not really necessary for stenting in one patient. This procedure should be restricted for use in cases of endoscopic failure.

Aged↗
PubMed1994

[Groove pancreatitis and adenocarcinoma of the pancreatic head].

A mass within the head of the pancreas causing obstructive jaundice is frequently adenocarcinoma, or infrequently focal pancreatitis. Groove pancreatitis is an inflammation of the head of the pancreas which fills the anatomic space between the head of the pancreas on 1 side and the second part of the duodenum on the other. Obstruction from either cause may cause vomiting, abdominal pain, and loss of weight. It is sometimes impossible to differentiate between the 2 conditions clinically. We present 2 women, aged 41 and 42 years, respectively, with recent onset of diabetes mellitus, obstructive jaundice, abdominal pain and severe loss of weight in whom diagnosis was difficult. In 1 repeated fine needle biopsy directly from the mass did not show adenocarcinoma, but she died of the disease a few months later. The other, in whom malignancy was also suspected, recovered from what was retrospectively diagnosed as groove pancreatitis.

Adenocarcinoma↗
PubMed1993

[Endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy].

In 11 of 82 patients undergoing laparoscopic cholecystectomy, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed. Indications were biliary pancreatitis in 5 and suspected common bile duct (CBD) stones in the other 6 (based on US or liver function tests, or both). The biliary tree was normal in 9 and laparoscopic cholecystectomy was performed. In 8 there was uneventful recovery but in the ninth open surgery was required when the attempted cholecystectomy resulted in uncontrolled cystic artery bleeding. Of the remaining 3 patients, 1 underwent sphincterotomy via ERCP and 3 weeks later, laparoscopic cholecystectomy. In the others, we intended to explore the CBD by laparoscopy, but had to resort to open cholecystectomy due to technical difficulties resulting from unsuspected acute cholecystitis. Based on our short experience, ERCP combined with laparoscopic cholecystectomy seems to be both safe and effective.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

Vaccination against hepatitis B in a general hospital in Israel: antibody level before vaccination and immunogenicity of vaccine.

We offered hepatitis B vaccine (Heptavax B) to 809 of the health care personnel of a 650-bed regional hospital; 290 accepted the offer. Anti-HBs measurement was done by enzyme immunoassay (AUSAB EIA, Abbott, UK) and expressed in mIU/ml. Seroconversion was determined at a level of 2.1 mIU/ml. Of 290 employees 58 (20%) were found positive for hepatitis B antibodies before vaccination. Of the laboratory technicians, 40.9% were found positive for antibodies before vaccination, as were 26.5% of nurses and 10.9% of physicians. Among vaccine recipients 35.8% responded after the first dose, 86.6% after the second and 92.7% after the third. Seventeen workers (7.3%) were nonresponders, of whom 14 received the whole vaccine series. There was no difference in immune responses to the vaccine between men and women. The present study confirms the relatively high prevalence of HBV infection in health care workers. Furthermore, vaccination of employees has been highly effective and well tolerated. The present data, therefore, support the introduction of active vaccination against HBV in health care workers in Israel.

Adult↗
PubMed1993

Miliary Crohn's disease: early or different?

We describe what we take to be the eighth case of miliary Crohn's disease since 1967 with a view to the possibility that miliary Crohn's disease is a disease different from Crohn's disease, and not just an early stage. Miliary Crohn's disease might be a different disease because (a) miliary tubercles are seen so rarely on the serosal surface of the bowel, (b) the 100% chance of finding crowded, typical granulomas in the bowel wall, and (c) the anatomic distribution of the lesion.

Adolescent↗
PubMed1992

[Percutaneous endoscopic gastrostomy].

Although percutaneous endoscopic gastrostomy (PEG) for feeding purposes has been in use for the past 10-12 years, many practitioners are unaware of this option. We describe 10 patients who underwent PEG with only 1 major, but nonfatal, complication. We stress that PEG is indicated for those who cannot swallow, and is safe, easy to perform, and a relatively cheap procedure. It is therefore a useful substitute for surgical gastrostomy.

Adult↗
PubMed1992

Serum B-N-acetyl hexosaminidase levels in rats with experimental acute pancreatitis, small-bowel ischemia, and small-bowel obstruction.

B-N-acetyl hexosaminidase (B-NAH), a lysosomal hydrolase, was measured in the blood of rats with induced acute pancreatitis, massive small-bowel ischemia, and small-bowel closed-loop obstruction. B-NAH was not significantly elevated within 24 h after induction of the above conditions. This suggests that B-NAH is not an acute phase reactant in a severe acute abdominal catastrophe, such as those mentioned above. Some rats showed an extremely high level of B-NAH, and this may imply a fatal prognosis in such animals.

Acute Disease↗
PubMed1992

Helicobacter pylori Before and After Gastric Reduction for Morbid Obesity.

Nine patients with morbid obesity were evaluated for the presence of Helicobacter pylon (Hp) before gastric reduction, and all were negative. Fifteen patients, Including those nine, were evaluated for the presence of Hp in antral and 'channel' region biopsies by culture and urease test after gastric reduction. Hp-negative patients totaled 73.3% by both tests, although chronic superficial gastritis type 'B' was found In eight out of 13 (61.5%), and six out of seven (85.7%) gastritis patients were positive for Holicobacter-like organisms in the hematoxylin- and eosin-stained biopsies. Our data suggest that in stomachs of morbid obesity patients before as well as after gastric reduction procedures, the incidence of Hp is very low, and the reasons for this observation are yet unknown.

Journal Article↗
PubMed1992

Appreciation of pain in the elderly.

Pain was evaluated in 333 duodenal ulcer patients, and 86 myocardial infarction patients by the verbal rating scale method. We compared older patients (greater than 65 years of age) to younger controls and found a highly significant association between old age with mild pain and young age with moderate or severe pain in both diseases. We investigated two totally different diseases and got similar results. Thus, it could be concluded that age itself might be the underlying reason for the association with pain severity and not the character or origin of the pain.

Adult↗