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Biomedical subjects

Y Niv

Publications and source records attributed to Y Niv.

At least 73 records · Page 4Linked to original sources
PubMed1997

Association between pancreatic cystadenocarcinoma, malignant liver cysts, and polycystic disease of the kidney.

Polycystic kidney disease is an autosomal dominant disease that may be associated with cystic disease of the liver. In women, the cysts may develop early and be more troublesome than in men. Cystadenocarcinoma of the pancreas is uncommon, comprising 1% of primary pancreatic malignancies. This case report is the first to describe a familial association between polycystic kidney disease and cystadenocarcinoma of the pancreas and liver in the English medical literature. A patient with autosomal dominant polycystic kidney disease (ADPKD) and multiple hepatic cysts developed cystadenocarcinoma of the pancreas with multiple malignant liver cysts. The patient's mother, sister, and niece had ADPKD, and the patient's sister also died of pancreatic cystadenocarcinoma. We believe that the development of these two disease entities in which the primary pathology is cyst formation has a genetic association.

Aged↗
PubMed1997

Transient hepatocellular injury during attacks of cholinergic urticaria.

Cholinergic urticaria presents as wheals and erythroderma that develop in response to a variety of factors which stimulate muscarinic receptors, including exercise, heat, cold, sweat and emotional stress. We describe a 25-year-old man with ulcerative colitis who developed cholinergic urticaria diagnosed by a metacholine test. He had had seven previous attacks over 8 years, and the finding of elevated liver enzymes required admission to four different hospitals. The clinical picture was identical: urticaria, hepatosplenomegaly, lymphadenopathy and elevation of liver enzymes. The causative agent was never identified and recovery was complete, with or without antibiotic therapy. To the best of our knowledge, this is the first description of liver involvement in cholinergic urticaria noted in the English-language medical literature.

Adult↗
PubMed1997

Gastrin levels in colorectal cancer.

Our objective was to determine whether colorectal cancer tissue synthesizes and secretes biologically active gastrins resulting in a rise of gastrin levels in patients with adenocarcinoma of the colon. Blood samples for gastrin determination were taken from the artery feeding, and from the vein draining colon tumors, from a vein draining an uninvolved colon segment and from a peripheral vein. Tissue gastrin levels were measured in tumor tissues and normal mucosa taken by colonoscopic biopsy from colon cancer patients and healthy controls. The setting was a university hospital research laboratory. We had seventeen patients with colorectal cancer and 23 controls. No significant difference was found in peripheral venous blood gastrin levels between the cancer and the control groups. Serum gastrin concentration was not significantly different in the arterial blood which supplied the tumor area, the venous blood draining the tumor, the "uninvolved" mucosa or the control normal epithelium. Cancer tissue gastrin levels were lower than those measured in biopsies of uninvolved mucosa from cancer patients and normal controls. The present results show no rise of gastrin blood levels in patients with colon cancer, nor any evidence of gastrin-increased synthesis by the tumors.

Adenocarcinoma↗
PubMed1997

Effect of octreotide on gastrostomy, duodenostomy, and cholecystostomy effluents: a physiologic study of fluid and electrolyte balance.

OBJECTIVES: Octreotide, a somatostatin analog, reduces stool and fistula outputs by a mechanism that is not completely understood. Our aim was to study its effect on gastrostomy, duodenostomy, and cholecystostomy effluents in a patient with colorectal cancer. METHODS: Effluents of gastrostomy, duodenostomy, and cholecystostomy were collected in three separate shifts over 24-h periods beginning 3 days before octreotide therapy and continuing for 15 treatment days. Fifty-four samples were tested for volume, pH, acid, and bicarbonate production, and biochemical profiles. RESULTS: A positive fluid balance was achieved immediately with octreotide therapy. Significant decreases in gastrostomy and duodenostomy outputs and in gastric acid production were observed (1433.33 +/- 33.33 ml/24 h to 535.71 +/- 55.31 ml/24 h,p < 0.0001; 2066.67 +/- 66.67 ml/24 h to 247.14 +/- 36.04 ml/24 h, p < 0.0001; and 67.50 +/- 3.20 mEq/h to 13.00 +/- 1.50 mEq/h, p < 0.0001; respectively). Gastrostomy tachyphylaxis was observed after 6 days of treatment. Remarkable dose-dependent increases were found in cholesterol and bilirubin concentrations in the cholecystostomy effluent. CONCLUSIONS: Octreotide's primary effect is a decrease in gastric and pancreatic secretions. The increased concentrations of cholesterol and bilirubin may explain the occurrence of gallstones in patients treated with octreotide.

Adenocarcinoma↗
PubMed1996

[Ambulatory liver biopsy].

During 1992-1994 we performed 77 needle liver biopsies on ambulatory patients. 59 patients were observed for 6 hours and then released. 15 who lived more than 40 km away and 3 in whom complications were feared were hospitalized. All were released within 24 hours and there were no complications. We conclude that ambulatory needle biopsy of the liver is safe and cost-effective is selected patients.

Biopsy, Needle↗
PubMed1996

Serious bacterial infections after endoscopic procedures.

Transient bacteremia during and after endoscopic procedures is a well- documented phenomenon, but complicated bacteremia such as endocarditis in patients at risk is considered to be extremely rare. The recommendations for prophylaxis before endoscopy in patients with valvular heart disease were recently released. We discuss 16 cases of complicated bacteremia that developed after endoscopy (eight cases previously published in the literature and eight cases we encountered). The endoscopic procedures were gastroscopy (five cases), sclerotherapy (six cases), sigmoidoscopy (three cases), and esophageal dilation (two cases). Fourteen patients had underlying disease: valvular heart disease (six patients), cirrhosis of the liver (five patients, one of whom also had a prosthetic knee), valvular heart disease and cirrhosis of the liver (two patients), and gastric carcinoma (one patient). The organisms involved were Streptococcus viridans (six cases), streptococcus group D (three cases), Streptococcus pneumoniae (two cases), Streptococcus microaerophilicus (two cases), Staphylococcus aureus (two cases), and Cardiobacterium hominis (one case). The patients presented with the following infections: endocarditis (12 patients), spontaneous bacterial peritonitis (two patients), septic arthritis (one patient), and brain abscess (one patient). The outcome was good in 15 patients; one patient died. Patients with valvular heart disease, cirrhosis of the liver, ascites, malignancies, or prosthetic joints who undergo endoscopic procedures should be considered for antibiotic prophylaxis.

Adult↗
PubMed1996

Histochemical characterization of mucosal mucin in serial biopsies along the human colon.

To establish patterns of mucin staining in the colon, a differential staining method was developed separating acid mucins into sialomucins and sulfomucins, and their distribution was studied along the colon of 9 normal subjects, 6 patients with ulcerative colitis in remission and 9 with colon cancer. Serial mucosal biopsies from the cecum to the rectum, were taken at colonoscopy and stained with aldehyde-fuchsin and alcian blue. The mean score of staining intensity in normals for sialomucins was higher than for sulfomucins, 1.85 +/- 0.05 versus 0.60 +/- 0.08 (p < 0.05). A significantly lower staining score for sulfomucins was found in the descending colon and in the cecum when compared with the rectum. Ninety-seven percent of the slides were positive for sialomucins, but only 50% for sulfomucins (p < 0.05). The mean (+/- SE) staining intensity for sialomucins in the ulcerative colitis and cancer group was 1.60 +/- 0.08 and 1.60 +/- 0.05 (p = 0.002 and p < 0.05 when compared with the controls, respectively). A difference in the percentage of biopsies positive for sulfomucins, in controls and proctosigmoiditis groups, was also observed: 50.0 and 33.3%, respectively (p = 0.013). No significant change was demonstrated in the mean sulfomucin staining score comparing normal and colon cancer patients. Our results may be used as a baseline for further research on mucin staining patterns in colorectal inflammatory and neoplastic diseases.

Biopsy↗
PubMed1996

Helicobacter pylori infection and blood groups.

OBJECTIVES: Bacterial attachment is a prerequisite for colonization of the gastric epithelial surface. Recently, it was demonstrated that the receptor for Helicobacter pylori is the blood group antigen Lewis b, which is exposed only in blood group O. We prospectively examined the prevalence of blood groups in H. pylori-positive and -negative patients. To avoid a genetic bias, we compared blood group prevalence of our patients with the general population of Israel. METHODS: In the 187 consecutive patients we studied, in addition to regular upper endoscopy, H. pylori status and blood group. Exposure to H. pylori was diagnosed when the results of two or more of three methods were found to be positive. RESULTS: Exposure was found in 123 patients and 64 negative. The groups were similar in average age and origin, and no significant difference was demonstrated for blood group. Blood group distribution between any given origin was not significantly different in our patients and in a sample of 182,701 blood donors. CONCLUSIONS: Positivity for H. pylori was not associated with blood group O. Our observation does not support the conclusion that the receptor for H. pylori in the gastric mucosa is the blood group antigen Lewis b.

Adolescent↗
PubMed1996

Diabetes mellitus is associated with chronic hepatitis C but not chronic hepatitis B infection.

Glucose intolerance is associated with chronic liver disease, particularly cirrhosis, and overt diabetes mellitus is two to four times more common than in the general population. Little attention has been paid to the relationship between the cause of cirrhosis and the development of glucose intolerance or whether cirrhosis is a prerequisite. We found glucose intolerance to be particularly common in patients with chronic hepatitis C, and in this retrospective study we attempt to confirm this possible association. To investigate this question we reviewed the files of 128 patients with chronic hepatitis C and 40 with chronic hepatitis B and active liver disease. Demographic, laboratory, imaging and pathology data were abstracted. The mean fasting blood glucose (+/-SD) in the hepatitis C and B groups was 160 +/- 83 and 103 +/- 18 mg/dl (P < 0.0001) with 2.5% and 39.1% respectively being overtly diabetic (P < 0.00001). However, the mean age of the hepatitis C group was much higher (45.6 +/- 12.5 vs. 60.1 +/- 12.3 years, P < 0.00001). The prevalence of diabetes was much higher among the hepatitis C patients than in the general population. Cirrhosis was not more frequent in biopsies from hepatitis C diabetic patients compared with non-diabetic or hepatitis B patients. Multivariate analysis showed that type of hepatitis and age were significant and independent predictors for developing diabetes. We conclude that there appears to be an association between diabetes mellitus and chronic hepatitis C that is not present in patients with chronic hepatitis B.

Adult↗
PubMed1996

Screening for colonic neoplastic lesions using flexible sigmoidoscopy in employees of a nuclear research center and members of collective settlements.

It has been shown that screening of average risk individuals reduces the incidence of colorectal cancer. The most effective method for screening has yet to be determined in terms of cost-effectiveness, but approximately two-thirds of colorectal neoplastic lesions are within the reach of the flexible sigmoidoscope. It has been estimated that a single such examination at the end of the sixth decade may reduce the colorectal cancer incidence by 60%. As part of a screening program for colon cancer, short colonoscopy was performed on 399 employees of a nuclear research center and 228 members of a collective settlement (kibbutz). The examinations were carried out on individuals aged > or = 40 years by two experienced endoscopists. The splenic flexure or transverse colon was reached in 95% of the procedures. Neoplastic lesions were found in 24 (6.0%) and 8 (3.5%) screenees (not significant) in the Nuclear Research Center and kibbutz populations respectively. Polyps <1 cm in diameter were significantly more common in the Nuclear Research Center population but larger polyps and cancers were not. In 47 Nuclear Research Center screenees with a family history positive in a first-degree relative, findings increased to 14.9% (P = 0.016). A family history of malignancy was found in 33.8% of kibbutz members but in only 11.8% of Nuclear Research Center employees. There was no evidence to suggest that working at the Nuclear Research Center increased the risk of colonic neoplasms. We conclude that flexible sigmoidoscopy is a valuable screening tool, especially for individuals with a first-degree relative with cancer. The yield of neoplastic lesions in the Israeli Nuclear Research Center and kibbutz populations is similar to that of the general population in the western world. Compliance rates are high in well-defined populations.

Adult↗
PubMed1995

Six patients whose perianal and ileocolic Crohn's disease improved in the Dead Sea environment.

Hyperbaric oxygen has been used in the management of perianal Crohn's disease on the assumption that tissue oxygenation is impaired. The Dead Sea region of Israel is the lowest point on earth (402 m below sea level), and therefore the oxygen pressure is increased. We hypothesized that this elevation in oxygen pressure over an extended time might be as effective as shorter periods of high-pressure oxygen in a hyperbaric chamber. So we investigated whether the Dead Sea environment might affect the activity and perianal complications of Crohn's disease. Six patients with Crohn's disease unresponsive to medical treatment spent periods of 1-3 weeks at the Dead Sea. Four patients had discharging perianal fistulas. All were given advice concerning diet, physical activity, and immersion in the Dead Sea. The Clamp-Softley modification of the Harvey-Bradshaw Crohn's disease activity index was used to assess disease activity initially and at weekly intervals during treatment. Drug therapy was tailored to patient symptoms. Mean disease activity index before treatment was 9.0 +/- 1.4 (mean +/- SEM) and after a week at the Dead Sea 3.5 +/- 1.4 (p = 0.006). After 2 weeks the index decreased to 2.0 +/- 0.4 (p = 0.037) in four patients. In one patient, complete healing of perianal fistulae occurred after 2 weeks, and in two others there was striking improvement. Two patients with active Crohn's disease and on high-dose corticosteroids were able to stop all medication during their stay. Decrease in activity index occurred rapidly, whereas the improvement in perianal disease was more gradual. The Dead Sea environment was highly effective in managing patients with severe Crohn's disease, including perianal complications in this small, uncontrolled series.

Adult↗
PubMed1995

Estrogen-progestin therapy and coronary heart disease in radiation-induced rectal telangiectases.

We describe two elderly men with preexisting coronary heart disease (CHD) and prostatic carcinoma who presented with intractable anemia due to radiation-induced rectal telangiectases and bleeding. Remission of the bleeding was achieved in both patients by treatment with an estrogen-progestin preparation. However, aggravation of the CHD occurred in both patients. We believe that estrogen-progestin preparations have a potential in the treatment of men with radiation-induced rectal telangiectases, but additional studies are needed to evaluate their long-term effects and optimal dose.

Aged↗
PubMed1995

Sensitivity, specificity, and predictive value of fecal occult blood testing (Hemoccult II) for colorectal neoplasia in symptomatic patients: a prospective study with total colonoscopy.

OBJECTIVES: To evaluate the specificity, sensitivity, and positive predictive value of fecal occult blood testing (FOBT) in symptomatic patients, with colonoscopy as the gold standard, and to assess the usefulness of FOBT as an ancillary examination in symptomatic patients for whom total colonoscopy is indicated. METHODS: We studied 439 consecutive patients who underwent Hemoccult II testing before total colonoscopy. RESULTS: The sensitivity, specificity, and positive predictive value for colorectal neoplasia (cancer and adenomatous polyps) was 76.5%, 56.7%, and 27.6%, respectively. The sensitivity, specificity, and positive predictive value for colorectal cancer were 69.2%, 73.2%, and 7.3%, respectively. CONCLUSIONS: The sensitivity, specificity, and positive predictive value of FOBT are difficult to estimate from screening programs, because Hemoccult-negative individuals do not undergo examination of the colon, and many of the Hemoccult-positive cases do not undergo total colonoscopy. With total colonoscopy serving as the gold standard, FOBT does not appear to be of much value as an ancillary examination in patients with symptoms potentially attributable to the lower gastrointestinal tract.

Adenomatous Polyps↗
PubMed1995

Is there a need for diagnostic upper gastrointestinal endoscopy before cholecystectomy?

Cholecystectomy is recommended for symptomatic gallstone disease, however atypical abdominal symptoms may be incorrectly attributed to gallstones found by chance at ultrasound. High rates of post-cholecystectomy symptoms confirm that surgery is often performed inappropriately in patients whose complaints do not derive from the biliary tract. We therefore performed esophagogastroduodenoscopy (EGD) in 56 symptomatic patients with gallstones to determine if there was an alternative explanation for patient symptoms. A surgeon then assessed the patient in the light of these findings and decided whether to operate. Of 41 patients who were questioned 12.4 +/- 7.3 months after entry, 1 of 22 patients who underwent surgery, and 5 of 19 patients treated conservatively, were symptomatic (P < 0.05). In the surgical group, one of seven patients with an endoscopic finding remained symptomatic, and in the nonsurgical group one of nine patients remained symptomatic (NS). However, in patients without endoscopic findings, none of the 15 surgical patients but 4 of 10 nonsurgical patients (40.0%) remained symptomatic (P < 0.01). We conclude that patients with gallstone disease and negative EGD who undergo cholecystectomy are less likely to remain symptomatic than those treated conservatively. Thus, endoscopy of the upper gastrointestinal tract in patients with gallstones may provide important information for the surgeon, prior to the making of therapeutic decisions.

Adolescent↗
PubMed1995

Effect of serum in the growth medium on mucin synthesis by colon cancer cell line.

A positive correlation has been described between mucin synthesis, tumorigenicity, and a poor prognosis in human colorectal cancer. Serum growth factors and hormones have been implicated in the regulation of biological behavior of the neoplasm, including growth and differentiation. Growth and differentiation of cancer cells have been observed to be involved in altered expression of mucin mRNA and synthesis. In the present study, the relationship between serum growth factors and mucin synthesis was studied in LS174T colon cancer cells grown in medium with different serum concentrations, and with 20% serum that was heated to 80 degrees C for 60 min or dialysed against saline. Mucin synthesis was estimated by measuring the amount of [3H]glucosamine-labeled glycoprotein excluded on a Sepharose CL-4B column. When the cells were compared on the basis of the same cell number, the higher the serum concentration of the medium, the more mucin produced. There was no decrease in mucin production after heating or after dialysis, indicating that there is a heat-stable non-dializable serum factor which induces mucin synthesis.

Adenocarcinoma↗
PubMed1995

Mercury levels among dental personnel in Israel: a preliminary study.

Amalgam, the most prevalent dental restoration material used in dentistry, is potentially toxic because it contains mercury. Recent international publications confirm that mercury is potentially hazardous to dental personnel, who are exposed to mercury vapors both during their work at the office and from amalgam restorations in their own oral cavities. The purpose of our study was to compare urinary mercury levels of dental personnel with a control group, and to explore possible correlations between environmental factors in the dental office and the urinary level of the personnel. Our results indicate that the urinary mercury levels of the tested dental professionals were significantly higher than those of the control group (2.39 +/- 0.319 vs. 0.899 +/- 0.34 micrograms mercury/g creatinine). Of the dental personnel examined, 72% had detectable levels of urinary mercury, compared to 27% of the control group. Although mercury levels in all participants did not exceed the toxic limit, the above findings clearly point to the need for a continuation of this survey.

Adult↗