Reversible hepatic injury induced by long-term vitamin A ingestion.
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Alkaline Phosphatase↗
Biomedical subjects
Y Ilan
Publications and source records attributed to Y Ilan.
Resistance of hepatitis delta virus replication to interferon-alpha treatment in transfected human cells.
Interferon-alpha (IFN-alpha) is known to inhibit both DNA and RNA viruses, including hepatitis B virus (HBV). In humans the antiviral effect, if any, of IFN-alpha on hepatitis delta virus (HDV) is complicated by the fact that HDV is spread only to patients already infected with HBV. An in vitro model system was used to assay for an antiviral effect of IFN-alpha on HDV genome replication. Hep G2 cells were transfected with a plasmid containing a trimer of HDV and treated with IFN (20 or 100 units/mL) starting 1-7 days after transfection. RNA extracted from treated and nontreated cells was assayed by both slot blot and Northern analyses. The IFN-alpha treatment as expected increased the 2'-5' oligo A synthetase RNA activity, but it did not affect HDV genome replication. Thus, in the absence of HBV, it appears that HDV is resistant to IFN-alpha.
2',5'-Oligoadenylate Synthetase↗
Glomerulonephritis associated with acute HAV infection.
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Acute Disease↗
Prolonged sleep-deprivation induced disturbed liver functions serum lipid levels, and hyperphosphatemia.
Sixty-four healthy young male volunteers were kept awake from 76 to 80 h. Blood tests conducted at the start and conclusion of the continuous sleep deprivation revealed an increase of 170% in mean SGOT, 58.5% in mean SGPT and 37.5% in mean plasma phosphorus levels. Triglyceride levels decreased by 16%, while HDL levels increased by 18% and the apoB/apoA ratio decreased by 12%. Morning plasma cortisol showed a significant increase during the experiment while evening cortisol showed a significant decrease. Morning T3 levels increased from the first to second day and decreased on the third day. There were no significant changes in other plasma electrolyte levels.
Adult↗
Mixed connective tissue disease presenting as a left sided pleural effusion.
Mixed connective tissue disease (MCTD) usually occurs in women aged 13-50 years. Pleural effusion is rarely the presenting feature of this disease. The case is reported here of a male patient with MCTD who presented at the age of 79 years with a left sided pleural effusion.
Aged↗
Primary biliary cirrhosis in Israel.
Primary biliary cirrhosis (PBC) is a relatively rare autoimmune disorder leading to the destruction of the interlobular biliary epithelium, which has not been reported in the Middle East. We studied 30 patients with PBC who had been referred to the Liver Unit at the Hadassah Medical Center in Jerusalem. The diagnosis was established by conventional criteria in 28 female and 2 male patients. Twenty-two patients were of Ashkenazic origin and 8 of Sephardic background. Mean serum alkaline phosphatase activity at the time of diagnosis was 911 IU/l gamma-glutamyl transpeptidase 677 u/l, cholesterol 73 mmol/l, albumin 3.2 g/l, bilirubin 72 mmol/l, and prothrombin time was 65%. All patients had positive antimitochondrial and M2 antibodies, and the mean IgM level was 684 mg/dl. The diagnosis was confirmed by liver biopsy in 27 of 30 patients. To the best of our knowledge this represents the first report of primary biliary cirrhosis in the Jewish population in Israel. This retrospective survey raises the question whether the disease is indeed rare in Israel or, alternatively is underdiagnosed.
Academic Medical Centers↗
Pyrexia of unknown origin as the only manifestation of colorectal carcinoma.
Patients with colon cancer rarely present with pyrexia of unknown origin (PUO) without other manifestations or symptoms. The present paper reports a patient who presented with a 6-month history of fever. The patient was found to suffer from well-differentiated adenocarcinoma of the sigmoid colon. A few days after sigmoidectomy the fever subsided and the patient recovered. Investigation of the large bowel should always form part of the evaluation in patients with pyrexia of unknown origin.
Adenocarcinoma↗
Quality of sleep in the medical department.
The quality of sleep in 134 patients admitted to two medical departments and an intensive coronary care unit was studied by comparing pre- and post-admission sleeping scores. Four aspects of sleep have been evaluated: duration of sleep; number of awakenings; personal assessment of quality of sleep; and the need for using sleeping pills. Results were expressed in scores ranging from 1 (worst) to 4 (best). A significant reduction in the mean quality of sleep for the entire group was found for all scores employed (P < 0.01-P < 0.001). Of the 134 patients, 51% had a reduction in post-admission total sleep score (23 +/- 3%, mean +/- SE); 31% had no change or mixed trends in the various scores, with a change in total sleep score not exceeding 3 +/- 3%; and 18% had an improved total sleep score (16 +/- 2%). Of the individual scores, a deterioration was found in the following order of frequency: number of awakenings (37%); personal assessment of quality of sleep (32%); duration of sleep (31%); and the need for using sleeping pills (26%). Of the reasons specified for impaired quality of sleep, the most important were noise made by other patients or by the medical staff (47%), and the patient's own disease (30%). Significant differences in the quality of sleep between the two medical departments located in different hospitals have been encountered (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Schönlein-Henoch syndrome in adults and children.
Sixty-one patients (15 adults and 46 children) with Schönlein-Henoch syndrome (SHS) were seen at the Hadassah University Hospital over the last 20 years. The presentation, clinical course, and prognosis of these patients were studied. The disease course was generally similar in children and adults, except for the epidemiological background and the pattern of skin and joint involvement. In these nonselected patients, the disease was self-limited, and progressive renal failure was not found. The long-term prognosis was excellent for both adults and children.
Adolescent↗
Undetectable caeruloplasmin values in a patient with autoimmune chronic active hepatitis.
Caeruloplasmin is an alpha 2 protein produced in the liver that is responsible for transporting copper in the blood. Caeruloplasmin values are usually high in patients with chronic liver diseases, including chronic active hepatitis: low values, however, are characteristic of Wilson's disease. The case of a 17 year old woman with very low caeruloplasmin values and chronic active hepatitis of the lupoid type is described. Steroid treatment resulted in an increase in the caeruloplasmin concentration and clinical improvement.
Adolescent↗
Etiology, treatment, and prognosis of large pericardial effusions. A study of 34 patients.
During the last 20 years, only a few studies have been published concerning large pericardial effusion. We recently reviewed 34 patients who presented with large pericardial effusion not associated with trauma. Our analysis revealed that half of the patients (52 percent) had pericardial effusion of unknown origin. Four patients had postmyocardial infarction pericardial effusion, three had associated malignant neoplasms, three suffered from collagen diseases, and two had infectious agents. Uremia and irradiation accounted for a single case each. Twenty-seven (79 percent) of the patients underwent pericardiocentesis and two (5.8 percent) had a pericardial window operation. The overall prognosis of the patients was excellent.
Adult↗
Acute pericarditis: etiology, treatment and prognosis. A study of 115 patients.
One hundred and 15 hospitalized patients with acute pericarditis were analyzed retrospectively for their etiology, management and long-term prognosis. It was found that most of the patients had either idiopathic or viral etiologies (60%), collagen disease (16.4%) or malignancy (6.9%). Most of the patients were treated with non-steroidal anti-inflammatory drugs (NSAID). Twenty-six patients (22%) required corticosteroids following NSAID treatment failure. Only one patient underwent pericardiocentesis for tuberculous pericarditis. The long-term prognosis was good, although 21.9% of the patients suffered from recurrent episodes of pericarditis. It is concluded that in hospitalized patients with pericarditis, an extensive workup may not reveal the major etiologies, and the disease may be more complicated than previously thought.
Acute Disease↗
Elevated creatine phosphokinase and creatine phosphokinase-MB in acute laryngitis.
Elevated creatine phosphokinase (684 mU/ml) and creatine phosphokinase-MB (3.5%, 23.9 mU/ml) were observed in a 66 year old female with acute laryngitis. The patient had received L-thyroxine because of hypothyroidism for 10 years and her T3 and TSH levels were normal. Acute myocardial infarction was denied by repeated EKG findings. The mechanisms of the enzyme abnormality were discussed.
Aged↗
Subacute cutaneous lupus associated with Hashimoto's thyroiditis.
Subacute cutaneous lupus erythematosus is a widespread, non-scarring, photosensitive form of histologically specific cutaneous LE. These patients frequently have mild systemic illness marked by musculoskeletal complaints and characteristic serologic abnormalities. Hashimoto's thyroiditis coexists with other diseases of presumed autoimmune nature, including systemic lupus erythematosus. The association between subacute lupus and Hashimoto's disease has not been described. We describe here a patient with Hashimoto's thyroiditis and Sjögren's syndrome who developed subacute cutaneous lupus two years later.
Aged↗
Intravenous verapamil for tachyarrhythmia in Duchenne's muscular dystrophy.
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Adolescent↗
Postpartum Budd-Chiari syndrome with prolonged hypercoagulability state.
Budd-Chiari syndrome after pregnancy is an extremely rare disease. Reported here is a case of postpartum Budd-Chiari syndrome with unusual features of prolonged hypercoagulability state. The disease occurred 2 weeks after delivery and despite massive anticoagulation treatment the patient developed severe hepatic vein occlusion, renal vein thrombosis, inferior vena cava thrombosis, and femoral artery thrombosis.
Adult↗
Prolonged course of a cutaneous T-cell lymphoma with late systemic involvement.
The clinical course of cutaneous T-cell lymphomas is known to be extremely variable. The disease may be present for up to 50 years, although it has a median survival of four to ten years. Clinical manifestations may range from cutaneous involvement alone to widespread systemic involvement. Described here is a patient with an unusually prolonged course of a cutaneous T-cell lymphoma with systemic involvement which reappeared ten and 18 years after the initial presentation. The patient developed Sjögren's syndrome, bone marrow and peripheral nerve involvement late in the course of her disease.
Adult↗
Vasculitis and cryoglobulinemia associated with persisting cholestatic hepatitis A virus infection.
Extrahepatic manifestations are rarely found in hepatitis A viral (HAV) infection. Only a single case of HAV infection associated with cutaneous vasculitis and cryoglobulinemia has been reported. Described here is a patient with a persisting cholestatic type of HAV infection who developed cutaneous vasculitis and cryoglobulinemia during the third month of her illness. Analysis of the cryoglobulins revealed IgM anti-HAV antibodies.
Adult↗