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S Bar-Meir

Publications and source records attributed to S Bar-Meir.

At least 109 records · Page 6Linked to original sources
PubMed1982

Manometric study during endoscopic retrograde cholangiopancreatography--a new technique for the evaluation of pathology in the pancreatic and biliary systems.

During endoscopic retrograde cholangiopancreatography, pressures of the common bile duct, the pancreatic duct and the sphincter of Oddi were recorded in 64 patients with various diseases of the pancreaticobiliary system. The manometric study was found to be helpful in the diagnosis of papillary dysfunction and in the assessment of the adequacy of papillotomy and the size of a choledochoduodenostomy. Furthermore, it is possible that nitrates may be effective in the treatment of patients with papillary dysfunction.

Aged↗
PubMed1981

Effects of liquid formula diets on proximal gastrointestinal function.

Upper gastrointestinal function in response to liquid test meals of varying osmolality (337, 519, and 696 mosmol/kg) was studied in volunteers. The osmolality was varied by changing the carbohydrate component from a glucose polymer (Polycose) to sucrose. During the first hour, the least hypertonic meal was emptied most rapidly, leading to the highest rate of nutrient delivery to the duodenum. Most carbohydrate was hydrolyzed and absorbed (65-82%) in the duodenum. Higher flow rate and carbohydrate load at the ligament of Treitz soon after administering the Polycose meal had to be compensated by increased water and monosaccharide absorption in the first 30 cm of jejunum. Thus, at a point 30 cm into the jejunum, there were no significant differences in the flow and composition of chyme; all but about 10% of the carbohydrate load was absorbed; and the flow rate was no higher than after an ordinary meal.

Adult↗
PubMed1981

Endoscopic removal of colonic lipoma.

A 71-year-old female with symptomatic colonic lipoma is described. An uneventful colonoscopic removal of the lipoma was performed. Colonoscopic removal of symptomatic pedunculated submucosal colonic lipoma may be recommended.

Aged↗
PubMed1980

Absorption of short-chain fatty acids by the colon.

Short-chain fatty acids (SCFAs) constitute the major solute fraction of normal stool water and are responsible for the diarrhea associated with carbohydrate (CHO) malabsorption. Although SCFA absorption from the human small bowel has been reported previously, the fate of SCFAs in the colon--their major site of production--was investigated in the present study. The colon of normal volunteers was perfused with neutral, isotonic solutions containing SCFA, 0-90 mM. Propionate was studied in detail with limited observations on acetate and n-butyrate. SCFA absorption was concentration-dependent; back diffusion of metabolic products, ketone bodies, was quantitatively insignificant. The transport process was accompanied by increased Na, K, and water absorption, by luminal alkalinization due to bicarbonate accumulation, and by a fall in lumen PCO2. The results are consistent with the existence of two mechanisms for colonic SCFA absorption: first, nonionic diffusion of protonated SCFA involving consumption of luminal CO2; this process accounts for about 60% of total SCFA absorption; and second, cellular uptake by ionic diffusion of the Na or K salt of the SCFA.

Adult↗
PubMed1979

Biliary and pancreatic duct pressures measured by ERCP manometry in patients with suspected papillary stenosis.

Papillary stenosis is an imprecisely defined clinical syndrome which eludes definitive diagnosis. In this study we evaluated 26 patients with suspected papillary stenosis by manometric examination of the sphincter of Oddi done during ERCP examination. Basal pressure in the sphincter of Oddi was elevated in 14 of the patients. Of these 14 patients, 10 underwent sphincterotomy and all experienced improvement in clinical symptoms after their surgery. We suggest that ERCP manometry is a useful procedure for identifying patients with papillary stenosis who may benefit from sphincterotomy.

Ampulla of Vater↗
PubMed1979

Analysis of ascitic fluid in cirrhosis.

In order to determine the composition of "normal" ascitic fluid, the results of analysis of the first paracentesis on 347 consecutive cirrhotic patients with ascites at the West Haven Veterans Administration Hospital between 1955 and 1976 were examined. The ascites was considered "normal" in 259 patients. Bacterial peritonitis was present in 51, malignant ascites in 18, pancreatitic ascites in 15, and ascites of other types in 4 patients. Normal ascites is sterile, usually clear, and contains 281 +/- 25 leukocytes/mm3 (mean +/- SEM), 27 +/- 2% of which are polymorphonuclear. In spontaneous bacterial peritonitis the fluid is usually cloudy, contains 6084 +/- 858 white blood cells/mm3, 77 +/- 4% of which were PMN and culture is positive for a single bacterial species, usually enteric in origin. Malignant and pancreatitis ascites are sterile, often cloudy, and contain an average of 696 +/- 273 and 1821 +/- 833 leukocytes/mm3, respectively, about half of which are polymorphonuclear. Amylase activity is increased in pancreatitic ascites, but not in other types of ascites. Stained smears of sediment for bacteria are often positive in bacterial peritonitis, but not in the other categories. Neither the specific gravity, protein concentration, nor glucose level is useful in the differential diagnosis of ascites. Based on the critical number of leukocytes alone, (500/mm3), one can accurately differentiate infected from uninfected fluid in over 90% of ascitic patients.

Amylases↗
PubMed1979

A controlled comparison of continuous intraarterial and intravenous infusions of vasopressin in hemorrhage from esophageal varices.

Infusions of intraarterial vasopressin (IAV) into the superior mesenteric artery have been shown to be effective in controlling hemorrhage from esophagogastric varices. Intravenous infusions of vasopressin (IVV), which can be initiated rapidly and require less sophisticated equipment and personnel, have also been reported to control variceal hemorrhage. We undertook a controlled clinical trial to compare these two routes of administration. Twenty-two cirrhotic patients with massive hemorrhage from varices were randomized to receive either IVV or IAV. Intraarterial vasopressin was begun at 0.1 U/min and increased progressively as needed to 0.2, 0.3, 0.4, and 0.5 U/min. Intravenous vasopressin was begun at 0.3 U/min and increased progressively as needed to 0.6, 0.9, 1.2, and 1.5 U/min. Hemorrhage was controlled in 5 of 10 episodes (50%) with IVV and in 6 of 12 episodes (50%) with IAV. Seven of the ten episodes treated with IVV (70%) ended fatally compared with 9 of 12 treated with IAV (75%). Side-effects and complications occurred with similar frequency in the two groups. The two routes of administration are equal in effects, side-effects, and complications. We recommend that IVV, which can be administered more easily, be given a brief therapeutic trial early in the management of hemorrhage from varices.

Adult↗
PubMed1979

Acute myocardial infarction in a hemophiliac.

An acute myocardial infarction was observed in a 62-year-old patient with hemophilia A, as well as myxedema, hypertension, obesity, hypercholesterolemia and angina pectoris. The occurrence of myocardial infarction in hemophiliacs is rare, and, to the best of our knowledge, this patient represents the fourth documented case in the literature.

Hemophilia A↗
PubMed1978

Spontaneous meningococcal peritonitis: a report of two cases.

Two patients with spontaneous bacterial peritonitis caused by Neisseria meningitidis are described. In both cases immediate diagnosis was possible by examination of the ascitic fluid. Meningococcal peritonitis supports the hypothesis that the hematogenous spread of bacteria into the ascitic fluid may be one of the mechanisms of spontaneous bacterial peritonitis.

Adult↗
PubMed1977

Coincidence of sarcoidosis and amyloidosis.

Amyloidosis was diagnosed in a patient with sarcoidosis. There was no evidence of any other disease known to be associated with amyloidosis. The joint occurrence of amyloidosis and sarcoidosis appears to be extremely rare, and to our knowledge, this is the second such patient to be reported. Whether the association of the two diseases in this patient represents a causal relationship remains an open question.

Amyloidosis↗
PubMed1976

Spontaneous bacterial peritonitis induced by intraarterial vasopressin therapy.

Two patients developed spontaneous bacterial peritonitis after infusions of vasopressin into the superior mesenteric or gastroduodenal arteries for upper gastrointestinal hemorrhage. The peritonitis in these patients differed from the typical picture in which a single aerobic organism is responsible, by the presence of multiple organisms, some of which were anaerobic. These findings suggest that the arterial vasoconstriction decreased the integrity of the intestinal mucosal barrier and permitted the transmural migration of enteric organisms from the lumen of the bowel into the ascites-filled peritoneal cavity.

Anaerobiosis↗