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Biomedical subjects

Z Gimmon

Publications and source records attributed to Z Gimmon.

At least 37 records · Page 2Linked to original sources
PubMed1991

[A decade of experience with home total parenteral nutrition].

Between August 1980 and October 1990 we treated 36 patients with home total parenteral nutrition (HTPN) with a cumulative treatment duration of 92 years. They included 14 females and 22 males ranging in age from newborn to 75 years, with a mean of 38 +/- 21. The 4 commonest indications for HTPN were short bowel syndrome (mainly due to mesenteric occlusion (50%), inflammatory bowel disease 14%), motility disorders (14%) and malabsorption (11%). All-in-one nutritional mixtures utilizing the big-bag technique were used for all patients. Broviac or Hickman catheters were implanted in 35 patients and an infusion port in 2. Infusions were administered during the night for 8-12 hours with a volumetric pump. 14 patients are still receiving HTPN (39%) while in 8 it was discontinued as they can maintain their nutritional status by the gastrointestinal route (22%). 14 patients have died (39%), 3 from HTPN-related causes (2 of sepsis and 1 of liver failure). Catheter-related sepsis was 0.42/year of HTPN. Other common complications were metabolic bone disease, deranged liver function and cholecystolithiasis. 80% were able to return to work, school, or housekeeping activities, or at least to take care of themselves and cope with HTPN unaided. Social rehabilitation was full or partial in 72% and only 29% were house-bound and needed major assistance. Patients with a poor life quality tended to be older and suffer from intestinal diseases as a manifestation of a systemic disorder, such as atherosclerosis or malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

High incidence of cholelithiasis in older patients with homozygous beta-thalassemia.

The records of 48 patients with homozygous beta-thalassemia were reviewed for evidence of cholelithiasis by abdominal ultrasonography or plain abdominal X-ray. The presence of cholelithiasis was reported in 25 patients (52%). The incidence increased with age to 83% in patients over 31 years of age. Gallstones were more frequent among patients with beta-thalassemia intermedia and with less blood transfusion requirements. Eleven patients with cholelithiasis (44%) became symptomatic. Eight received operations on an elective or semielective basis. Another patient had incidental cholecystectomy during splenectomy. The preoperative evaluation included abdominal ultrasonography, nucleotide biliary scan and evaluation of the cardiopulmonary status. Due to the longer survival of patients with homozygous beta-thalassemia, the problem of cholelithiasis is becoming more frequent.

Adolescent↗
PubMed1990

Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem.

From our experience with chronic schizophrenic patients treated for acute intra-abdominal surgical disease, we present seven examples of this unique clinical condition. In all seven cases the decision to operate was preceded by considerable delay, owing to misleading medical history, patient behavior, and the lack of definitive signs of peritonitis. The intra-operative findings were unexpected, and in all cases the disease had reached an advanced stage. As chronic schizophrenic patients have a distorted perception of pain and seldom demonstrate a clinical picture commensurate with the disease, we advocate that a higher index of suspicion be assigned to these patients than to the average acutely ill patient.

Abdomen, Acute↗
PubMed1989

[Torsion of the appendix in a child].

Torsion of the vermiform appendix is a rare condition that simulates acute appendicitis. An 8-year-old girl with symptoms suggestive of acute appendicitis is reported. At operation the appendix was found to be twisted 72 degrees and was resected.

Acute Disease↗
PubMed1986

Placental glycogen accumulation and maternal-fetal metabolic responses in hyperglycaemic non-diabetic rats.

The effect of maternal hyperglycaemia on glycogen and triglyceride accumulation in the feto-placental unit of non-diabetic rats was studied. Hyperglycaemia was induced by continuous infusion of a 400 g/l glucose solution at the rate of 2-4 g/hr/kg, from day 18.5-20.5 of gestation. Hyperglycaemic mothers were hyperinsulinaemic; their fetuses were hyperglycaemic but their insulin levels were comparable with those of control pregnant rats (infused with a 50 g/l glucose solution at the same rate). Fetal pancreas insulin content in the hyperglycaemic fetuses was pronouncedly reduced. The hyperglycaemia produced an approximately 2-fold increase in placental glycogen content in association with increased activities of placental glycogen synthase and phosphorylase. Maternal serum triglycerides fell concomitant with the hyperglycaemia. Placental triglyceride content of hyperglycaemic rats did not change significantly, whereas up to a 2-fold increase in maternal and fetal liver triglyceride concentration was observed. There was no change in fetal and placental weight. Since we have shown previously an increase in both placental glycogen and triglycerides in diabetic rats with hyperglycaemia, concomitant with elevation of plasma triglycerides and free fatty acids, the present experiments demonstrate that these 2 factors causing placental glycogen and triglyceride accumulation can be dissociated. On the other hand, maternal and fetal liver triglycerides accumulate in the hyperglycaemic rats probably as a result of local de vovo lipogenesis.

Animals↗
PubMed1984

Serum lactic dehydrogenase: a tumor marker of ovarian dysgerminoma in a female pseudohermaphrodite.

A case of a female pseudohermaphrodite who presented with a large ovarian dysgerminoma is reported. Preoperatively, markedly elevated levels of serum lactic dehydrogenase (LDH) were noted. After complete excision of the tumor, serum levels of LDH returned to normal levels. Only five other cases of dysgerminoma with elevated serum LDH have been reported. In each case, as in the present one, LDH levels were significantly higher than in any other ovarian tumor. LDH can be considered as an enzymatic tumor marker of ovarian dysgerminoma, for diagnosis, prognosis, and surveillance.

Adult↗
PubMed1983

Increased lithogenicity of the bile after jejunoileal bypass in the rat.

Increased formation of biliary calculi is a complication of jejunoileal bypass (JIB) in man. We investigated the biliary lipid composition and bile flow rate in the rat 42 days after a JIB or sham operation. In the bile of the bypassed rats, the percentage cholesterol saturation and the concentration of phospholipids were significantly increased, while the concentration of bile acids and the lithogenic index (bile acids + phospholipids/cholesterol) were markedly decreased. The concentrations of cholesterol in the bile and in the liver were unchanged. These results suggest an increase in lithogenicity of the bile with decreased bile flow after JIB in the rat.

Animals↗
PubMed1982

Exercise in rats with liver injury induced by carbon tetrachloride or bile duct obstruction. Blood cholic acid and liver histology.

UNLABELLED: Tolerance of exercise in rats with liver injury was evaluated by the response of plasma cholylglycine (CG) and by liver histology in two experiments with CCl4 hepatocellular damage and in two other experiments with cholestatic liver injury induced by obstruction of the common bile duct. (1) Rats swimming daily for 1 h while exposed to five successive doses of CCl4 and studied at rest, had a trend (P less than 0.06) to higher CG and a higher plasma SGPT (P less than 0.05) than sedentary CCl4 rats. (2) In rats recovering from four successive doses of CCl4 there were no differences between CG curves before, during, and after exercise, except at 48 h of recovery when exercise elevated CG (P less than 0.05). (3) Sixteen days after ligation of the bile duct CG was high but not affected by exercise, 45 days after ligation exercise resulted in further increase of CG (P less than 0.05). (4) When ligation of the bile duct lasted only 24 h, exercise prior to release of the obstruction did not affect CG. Exercise 8 h and 27 h after release of ligation resulted in an increase in CG (P less than 0.05). Return to pre-exercise CG occurred 30 min after exercise. CONCLUSION: CG was a useful indicator of liver injury showing a positive correlation with the CCl4 dose and a negative correlation with recovery from CCl4. Exercise had only mildly adverse effect in hepatotoxic and cholestatic liver injury. CG appeared to respond more sensitively to exercise after release of bile duct obstruction than in CCl4 hepatocellular injury.

Alanine Transaminase↗
PubMed1982

Nitrogen sparing effects and mechanisms of branched-chain amino acids in the injured rat.

A series of experiments in a rat injury model were designed to elucidate the role and mechanisms of branched-chain amino acids in the post-injury catabolism. Our results suggest that: 1. Nutritional support can maintain nitrogen equilibrium in the early post-operative state. 2. Branched chain amino acids exert a nitrogen sparing effect and thus prevent or minimise post-operative catabolism. 3. Increasing the amount of infused branched chain amino acids results in nitrogen retention. 4. A balanced amino-acid mixture containing 45 per cent branched chain amino acids seems to be optimal for nutritional support in the post-injury state.

Journal Article↗
PubMed1982

The effect of parenteral and enteral nutrition on portal and systemic immunoreactivities of gastrin, glucagon and vasoactive intestinal polypeptide (VIP).

To compare the effect of parenteral with enteral nutrition on gastroentero-pancreatic hormones, hypercaloric and hypocaloric nutrient preparations, commonly used clinically, were administered to rats either through cannulae in the jugular vein or gastrostomies. Control rats were fed orally ad libitum. Portal and aortic plasma was collected for radioimmunoassay with antibodies to C-terminal regions of gastrin and glucagon and to N-terminal-to-central regions of glucagon and VIP. Levels of all immunoreactivities were significantly lower in aortic than portal plasma. Apparent clearance of glucagon and gastrin by liver or lung both was enhanced by administration of the hypercaloric nutrient intravenously. Only intragastric hypercaloric nutrition maintained levels of VIP immunoreactivity close to those of control rats. Intragastric administration of either preparation appeared to maintain adequate levels of gastrin. Differences in the levels of glucagon immunoreactivities may be related to the stimulatory effects of metabolites in the lower gut and pancreas.

Animals↗
PubMed1982

Juvenile leg ulceration in beta-thalassemia major and intermedia.

A series of 12 patients with beta-thalassemia who developed juvenile leg ulcers is described. The trophic skin changes and leg ulcers occurred after the age of 15 years. Usually the ulcer occurred after trauma over the predisposed medial aspect of the leg. In four out of seven females, the trophic changes deteriorated during or following pregnancy. The development of trophic changes and subsequent leg ulcers is not related to the severity of the anemia or to the patients' transfusion requirements, but may be related to high fetal hemoglobin concentration. The ulcers are slow to heal and tend to recur. Multiple skin-grafting operations are required in order to achieve satisfactory coverage of the ulcers. Since tissue hypoxia may be the underlying pathophysiology, the use of topical hyperbaric oxygen chamber may be beneficial in the treatment of thalassemic leg ulcers.

Adolescent↗
PubMed1982

Total parenteral nutrition in a pregnant insulin-requiring diabetic.

A 28-year-old class F diabetic woman whose pregnancy was complicated by gastroparesis, hemorrhagic gastritis, narcotic addiction, intrauterine fetal growth retardation, and severe preeclampsia was supported with total parenteral nutrition (TPN) from the 27th to the 29th week or pregnancy. During this period there was adequate control of serum glucose, a positive nitrogen balance, and a normal amino acid profile. Unfortunately, a rapid deterioration in renal function and hypertensive disease occurred, requiring cesarean section at the 29th gestational week. TPN was continued for an additional 30 days postoperatively until the gastritis resolved and adequate oral nutrition could be reestablished. Wound healing was satisfactory.

Acute Kidney Injury↗
PubMed1982

Blood-brain barrier derangement in uremic encephalopathy.

A disturbance of cerebral neurotransmitters and an accumulation of octopamine, a putative false neurotransmitter, have been found in patients with uremic encephalopathy who manifest disorientation, somnolence, asterixis, and coma--symptoms also seen in portal systemic encephalopathy (PSE). Altered plasma concentrations of the neutral amino acids (NAAs) and increased blood-brain NAA transport may play a role in PSE, and in the present study plasma amino acid concentrations and blood-brain barrier NAA transport were investigated in rats with acute and chronic uremia. Acute uremia was produced by unilateral nephrectomy and occlusion of the renal artery of the remaining kidney for 70 minutes; the animals were studied 24 hours later. Chronic uremia was produced by unilateral nephrectomy and 70% to 80% devascularization of the remaining kidney; these animals were studied 2 weeks later. Brain uptake was studied with the technique of Oldendorf, and blood and brain amino acids (AAs) were measured. The blood urea nitrogen (BUN) level in rats with acute uremia increased to 108 mg/dl, in rats with chronic uremic 54 mg/dl, and in sham-operated rats 22 mg/dl. In both uremic groups there was a decrease in plasma branched-chain AAs. In the brain these AA levels were normal, while levels of phenylalanine, tyrosine, and histidine were increased in uremic rats.

Amino Acids↗