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Biomedical subjects

T Gilat

Publications and source records attributed to T Gilat.

208 records · Page 12Linked to original sources
PubMedDate not supplied

Frequency of papillary dysfunction among cholecystectomized patients.

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.

Aged↗
PubMedDate not supplied

Cholesterol nucleation from its carriers in human bile.

This study was performed to determine whether biliary cholesterol nucleates primarily from vesicles or micelles. Twenty gallbladder biles and 12 hepatic biles from patients with gallstones as well as 16 model biles were examined. The nucleation times (days) of the biles as well as their isolated vesicular and micellar fractions were determined and their lipid composition was analyzed. In 41 of 46 comparisons, cholesterol nucleated faster from vesicles than micelles; in only one case was the opposite found. The mean (+/- S.D.) nucleation times of vesicles and micelles in gallbladder biles were 8.9 +/- 5.4 vs. 15.4 +/- 8.6, in hepatic biles 14.6 +/- 9.4 vs. 20.6 +/- 9.1, and in model biles 9.0 +/- 3.7 vs. 18.9 +/- 9.1 days, respectively. All these differences were significant (p less than 0.005). Gallbladder biles (n = 7) devoid of vesicles nucleated more slowly (9.0 +/- 9.5 days), as compared to gallbladder biles (n = 13) containing vesicles (3.8 +/- 2.2 days). The nucleation time of gallbladder and hepatic biles was significantly correlated with the nucleation time of the vesicles from these biles (r = 0.847, p less than 0.05). There was no correlation with the nucleation time of micelles from the same biles. The percentage of cholesterol carried by vesicles in bile was positively correlated to the molar percentage of biliary cholesterol and the cholesterol saturation index and negatively correlated to the molar percentage of bile salts. Our data suggest that phospholipid vesicles are the major vehicle for cholesterol precipitation in bile as well as an important determinant of the nucleation time of bile.

Bile↗
PubMedDate not supplied

Colonoscopy in the differential diagnosis of colonic strictures: report of four cases.

Colonoscopy was performed on ten patients who had colonic strictures demonstrated by barium-enema examination. In all cases the diagnosis of carcinoma had been considered, but it was confirmed by colonoscopic examination, cytology, and biopsies in only two patients. Five patients were shown to have benign inflammatory strictures due to ischemic colitis, ulcerative colitis, Crohn's disease, irradiation colitis, or postoperative strictures. The remaining three patients were shown to have no intrinsic lesion. These eight patients were thereby spared further diagnostic procedures, and even unnecessary laparotomy.

Aged↗
PubMedDate not supplied

Endoscope-induced colitis: description, probable cause by glutaraldehyde, and prevention.

Six cases of acute, self-limited colitis that occurred after screening flexible sigmoidoscopy were deduced to be iatrogenic, probably caused by glutaraldehyde residues in the endoscopes after disinfection in an automatic disinfecting machine. The concentration of these residues was indirectly estimated by conductivity measurements of electrolyte concentration in the rinse-water tank of the disinfecting machine during and after five cycles and also in fluid remaining on the surface of the endoscopes and in the endoscope channels. After five cycles, residues in both the rinse water and fluid in the endoscope channels contained the equivalent of 0.2% glutaraldehyde. This was the result of a combination of technical and human errors. It can be prevented by changing the rinse water after each cycle, using forced air to dry the instruments, and washing the endoscopes before use. Users of the automatic disinfecting machine should be aware of the potential accumulation of toxic levels of residues that remain in endoscopes after disinfection.

Acute Disease↗
PubMedDate not supplied

Measles is more prevalent in Crohn's disease patients. A multicentre Israeli study.

The question whether there is a transmissible pathogenetic agent as a cause for Crohn's disease, remains unanswered. Measles virus has been the subject of many intensive studies, in the attempt to find a role for it in the pathogenesis of inflammatory bowel disease. Whether an early infection with measles virus may predispose to Crohn's disease in later life is still not clear. We conducted a large scale multicentre study, in order to obtain sufficient data to answer this question. To do so, we compared inflammatory bowel disease patients, with Crohn's disease or ulcerative colitis, with two matched control groups: clinical controls, and community controls. A total of 531 patients, 271 with ulcerative colitis and 260 with Crohn's disease were interviewed, as well as 903 matched controls. Blood from 104 inflammatory bowel disease patients and 50 controls was tested for antibodies to measles virus. We did not find any differences related to measles vaccination, either in Crohn's disease or in ulcerative colitis. Exposure to measles in childhood was more frequent in Crohn's disease patients than in their controls, the difference being statistically significant (p < 0.05) in relation to community controls. The presence of IgG antibodies to measles virus was higher in patients with Crohn's disease than in patients with ulcerative colitis or controls (p = 0.084). Another observation of interest was the finding that Crohn's disease patients who had measles in childhood, more frequently had large bowel disease than those who had not had measles. These data lead us to postulate that there may be a role for measles infection in Crohn's disease, even if, at present, this role remains unclear.

Adult↗
PubMedDate not supplied

Methane production in patients with cystic fibrosis.

Methane production was studied in 28 cystic fibrosis patients aged 3-16 years and in 290 healthy children. The percentages of methane producers in the cystic fibrosis and control groups were 60.7 and 20.6%, respectively. In the patient group there was no difference between methane producers and nonproducers with respect to the degree of malabsorption or the administration of pancreatic supplements or antibiotics. We hypothesize that the high proportion of methane producers in cystic fibrosis patients may be associated with the presence of specific substrate(s) (glycoprotein?) in their intestinal contents. Changes of the intestinal microenvironment may favor the development of a methanogenic flora.

Adolescent↗
PubMedDate not supplied

Fatty acid bile acid conjugates inhibit atherosclerosis in the C57BL/6 mouse model.

OBJECTIVE: The aim of the current research was to study whether fatty acid bile acid conjugates (FABACs) have a beneficial effect on atherosclerosis progression and blood lipid levels in mice. METHODS: C57BL/6 female mice, fed a high-fat Paigen diet, were administered an oral dose of FABAC or DDH2O daily. Quantification of atherosclerotic fatty-streak lesions at the aortic sinus was performed. RESULTS: The FABAC-treated mice showed a significant reduction in the atherosclerotic lesion areas as compared to the control group (p = 0.019). A significant elevation in total cholesterol levels was observed in both the FABAC and control groups. Higher FABAC levels were measured in the high-density lipoprotein fraction as compared to the very-low-density and low-density lipoprotein fractions. CONCLUSION: Our findings demonstrate that FABACs, given orally, reduce the development of atherosclerosis in mice fed a high-fat high-cholesterol diet, despite a lack of effect on plasma lipid levels.

Administration, Oral↗