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A new algorithm for the diagnosis of celiac disease

Cellular & Molecular Immunology 2011年第2期8卷 146-149页

作者： Orit Rozenberg Aaron Lerner Avi Pacht Maya Grinberg Dina Reginashvili Clara Henig Mira Barak Central Laboratory of Haifa and Western galilee Clalit Health Services and Pediatric GastroenterologyHaifaIsrael Nutrition Unit Carmel Medical CenterHaifaIsrael Technion-Israel Institute of Technology HaifaIsrael

Celiac disease(CD)affects at least 1%of the Western population but remains largely *** our laboratory,we utilize a novel algorithm to diagnose pediatric CD that offers both high sensitivity and high specificity for diagnosis in an outpatient *** aim of the present study was to challenge this algorithm and to test its performance in children and adults suspected of having *** a three-assay algorithm,screening with the most sensitive tissue transglutaminase(tTG)complexed with deamidated gliadin peptide neoepitope immunoglobulin A(IgA)1IgG assay and confirming with the two specific tTG IgA and tTG IgA1IgG assays,we examined the serological results from 112 children aged 0–17 years old and 60 adults in comparison to their respective biopsy *** algorithm performance was calculated by statistical *** use of the new algorithm enabled us to diagnose CD with 98%sensitivity,93%specificity and 95%accuracy in the pediatric group and 94%sensitivity,92%specificity and 93%accuracy in the total population *** false-negative cases in the adult group were attributed to previous adherence to a gluten-free diet,and the single false-negative result in a young child became a true positive after 6 *** have also monitored three celiac patients before and after diagnosis and found that the algorithm may be suitable for disease *** newly proposed three-assay algorithm for celiac detection is very reliable in both children and *** to the high performance of this assay,the further need for confirmatory intestinal biopsies will be reassessed.

关键词： celiac disease diagnosis intestinal histopathology sensitivity specificity tissue transglutaminase

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Inflammatory bowel disease patient profiles are related to specific information needs: A nationwide survey

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World Journal of Gastroenterology 2019年第30期25卷 4246-4260页

作者： Saleh Daher Tawfik Khoury Ariel Benson John R Walker Oded Hammerman Ron Kedem Timna Naftali Rami Eliakim Ofer Ben-Bassat Charles N Bernstein Eran Israeli Institute of Gastroenterology and Liver Diseases Hadassah-Hebrew University Medical CenterJerusalem 91120Israel Department of Gastroenterology Galilee Medical CenterFaculty of Medicine in the GalileeBar-Ilan UniversityNahariya 22100Israel IBD Clinical and Research Centre University of ManitobaWinnipegMB R3E3P4Canada Research Branch IDF Medical CorpsTel-HashomerRamat Gan 52630Israel Institute of Gastroenterology Meir Medical CenterKfar-saba 4428164Israel Sackler School of Medicine Tel-Aviv UniversityTel-Aviv 6997801Israel Institute of Gastroenterology Sheba Medical CenterRamat-Gan 52630Israel Institute of Gastroenterology Rabin Medical CenterPetach-Tikva 49100Israel

BACKGROUND Inflammatory bowel diseases(IBD) is a heterogenous, lifelong disease, with an unpredictable and potentially progressive course, that may impose negative psychosocial impact on *** informed patients with chronic illness have improved adherence and outcomes, previous research showed that the majority of IBD patients receive insufficient information regarding their *** large heterogeneity of IBD and the wide range of information topics makes a one-size fits all knowledge resource overwhelming and *** hypothesized that different patient profiles may have different and specific information needs, the identification of which will allow building personalized computer-based information resources in the *** To evaluate the scope of disease-related knowledge among IBD patients and determine whether different patient profiles drive unique information *** We conducted a nationwide survey addressing hospital-based IBD clinics.A Total of 571 patients completed a 28-item questionnaire, rating the amount of information received at time of diagnosis and the importance of information, as perceived by participants, for a newly diagnosed patient, and for the participants themselves, at current *** performed an exploratory factor analysis of the crude responses aiming to create a number of representative knowledge domains(factors), and analyzed the responses of a set of 15 real-life patient profiles generated by the study *** Participants gave low ratings for the amount of information received at disease onset(averaging 0.9/5) and high ratings for importance, both for the newly diagnosed patients(mean 4.2/5) and for the participants themselves at current time(mean 3.5/5).Factor analysis grouped responses into six *** responses of selected profiles, compared with the rest of the participants, yielded significant associations(defined as a difference in rating of >0.5 points with a P < 0.05).Patients w

关键词： Inflammatory bowel diseases Information needs Patient education Knowledge resources Patient profiles

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The Use of Cortical Bone Wedges from the Mandibular Ramus “Wedge Technique”: For 3-Dimensional Bone Augmentation of the Atrophic Ridges. Technique Presentation and Report of Case Series

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Open Journal of Stomatology 2018年第6期8卷 217-239页

作者： Fares Kablan Department of Oral and Maxillofacial Surgery The Galilee Medical Center Nahariya Israel

Purpose: Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges. However if large bone grafts are needed to augment multiple edentulous atrophic segments, extraoral donor sites may be mandatory. The aim of this report is to introduce the Fares Wedge Technique, as a new bone augmentation method that can augment multiple edentulous ridges with intraoral cortical bone grafts. Methods: This report includes patients with moderate to severe ridge atrophy in different regions of the both jaws who were treated over 6-years period (2009-215) with wedge Technique (WT). Patients received panorex immediately after the surgery, and they were examined clinically and radiographically (periapical) every 2 weeks. At 4 months, computed tomography was performed to evaluate the bone gain. Reentry was performed after 4 to 5 months to evaluate the new bone volume and quality and to insert implants. At this stage specimens for histologic examination were also obtained. Results: 39 augmentation sites in 22 patients (15 women, 7 men: mean age 47 years) were followed 12 to 52 months. The healing process was uneventful, with minimal morbidity. The success rate was 95%, and the bone gain average was 3 - 6 mm vertically and 3 - 9 mm horizontally. In two patients the graft was partially exposed and treated with shaving and rounding the exposed wedges, but the augmentations were saved. In one case the majority of the bone graft was lost. At 38 sites the patients had successfully received 114 implants. Conclusions: wedge technique can augment multiple segments of atrophic ridges with small amount of autogenic graft. The bone volume that achieved was satisfying, especially that the majority of the augmented areas were at posterior mandibular defects.

关键词： Bone Augmentation Autogenic Bone Grafts Allogenic Bone Substitute Donor Site Space Maintenance

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Characteristics of common solid liver lesions and recommendations for diagnostic workup

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World Journal of Gastroenterology 2009年第26期15卷 3217-3227页

作者： Nimer Assy Gattas Nasser Agness Djibre Zaza Beniashvili Saad Elias Jamal Zidan Liver Unit Ziv Medical Center Faculty of Medicine Technion Institute of Technology Department of Medicine Western Galilee Hospital Department of Medicine Ziv Medical Center Institute of Oncology Ziv Medical Center

Due to the widespread clinical use of imaging modalities such as ultrasonography,computed tomography and magnetic resonance imaging (MRI),previously unsuspected liver masses are increasingly being found in asymptomatic *** review discusses the various characteristics of the most common solid liver lesions and recommends a practical approach for diagnostic *** diagnoses include hepatocellular carcinoma (the most likely;a solid liver lesion in a cirrhotic liver) and hemangioma (generally presenting as a mass in a non-cirrhotic liver).Focal nodular hyperplasia and hepatic adenoma should be ruled out in young *** 70% of cases,MRI with gadolinium differentiates between these *** needle core biopsy or aspiration,or both,might be required in doubtful *** uncertainty persists as to the nature of the lesion,surgical resection is *** the patient is known to have a primary malignancy and the lesion was found at tumor staging or follow up,histology is required only when the nature of the liver lesion is doubtful.

关键词： Liver mass Hepatic nodule Tumor Lesion Cirrhosis Hepatocellular carcinoma Magnetic resonance imaging Ultrasonography Computed tomography Fineneedle aspiration Biopsy

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Gender Effects on Acute Heart Failure

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International Journal of Clinical Medicine 2011年第3期2卷 254-259页

作者： Arnon Blum Rizak Sirchan Lital Keinan-Boker Department of Medicine Baruch-Padeh Poria Medical Center Lower Galilee Israel

Background: Congestive heart failure is the leading cause of hospitalization in the elderly. Little is known about gender effect on baseline characteristics and in-hospital outcome in patients admitted with acute heart failure. Our purpose was to study the gender effect on in-hospital mortality in acute heart failure patients. Methods and Results: A prospective study [143 patients, 67 men (73.9 ± 13.8 years old) and 76 women (77.8 ± 10.1 years old) (p = 0.059)] followed in-hospital outcome of patients with acute heart failure admitted to the hospital. Clinical parameters included body mass index (BMI), ankle brachial index (ABI), left ventricular ejection fraction (LVEF), re-admissions within 1 year, and in-hospital mortality. The gender effects that were studied included height, BMI, smoking, coronary artery disease, LVEF and mortality: in total, 9 (6.3%) patients died, of them 8 (10.5%) women and 1 (1.5%) man. Women were shorter (p < 0.001), had a higher BMI (p = 0.053), reported less frequently on current smoking (p < 0.001), had lower prevalence of coronary artery disease (p = 0.016), had a better LVEF (p = 0.02), but still, had a higher mortality rate (p = 0.026). The only variables independently affecting in-hospital mortality in women were height and recurrent admissions. When we tested for the effect of height and recurrent admissions on mortality only among females by a multivariate analysis height inversely and independently affected in-hospital mortality (p = 0.024), as well as recurrent admissions (p = 0.031). Conclusions: In-hospital mortality was significantly higher in women compared with men admitted with acute heart failure. Among females, the only independent variables that affected mortality were low stature and recurrent admissions.

关键词： Gender Heart Failure In Hospital Death

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Constitutive expression of feedback-insensitive cystathionine γ-synthase increases methionine levels in soybean leaves and seeds

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Journal of Integrative Agriculture 2018年第1期17卷 54-62页

作者： YU Yang HOU Wen-sheng Yael Hacham SUN Shi WU Cun-xiang Ifat Matityahu SONG Shi-kui Rachel Amir HAN Tian-fu Key Laboratory of Soybean Biology (Beijing) Ministry of Agriculture/Institute of Crop Sciences Chinese Academy of Agricultural Sciences Beijing 100081 P.R.China Laboratory of Plant Science Migal Galilee Technology Center Kiryat Shmona 12100 Israel TeI-Hai College Upper Galilee 11016 Israel

Soybean （Glycine max （L.） Merr.） is a major crop that provides plant-origin protein and oil for humans and livestock. Al- though the soybean vegetative tissues and seeds provide a major source of high-quality protein, they suffer from low con- centration of an essential sulfur-containing amino acid, methionine, which significantly limits their nutritional quality. The level of methionine is mainly controlled by the first unique enzyme of methionine synthesis, cystathione y-synthase （CGS）. Aiming to elevate methionine level in vegetative tissues and seeds, we constitutively over-expressed a feedback-insensitive Arabidopsis CGS （AtD-CGS） in soybean cultivars, Zigongdongdou （ZD） and Jilinxiaoli 1 （JX）. The levels of soluble methionine increased remarkably in leaves of transgenic soybeans compared to wild-type plants （6.6- and 7.3-fold in two transgenic ZD lines, and 3.7-fold in one transgenic JX line）. Furthermore, the total methionine contents were significantly increased in seeds of the transgenic ZD lines （1.5- to 4.8-fold increase） and the transgenic JX lines （1.3- to 2.3-fold increase） than in the wild type. The protein contents of the transgenic soybean seeds were significantly elevated compared to the wild type, suggesting that the scarcity of methionine in soybeans may limit protein accumulation in soybean seeds. The increased protein content did not alter the profile of major storage proteins in the seeds. Generally, this study provides a promising strategy to increase the levels of methionine and protein in soybean through the breeding programs.

关键词： soybean (Glycine max (L.) Merr.) constitutive expression cystathionine y-synthase (CGS) methionine contentstorage protein

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Echo is the preferred modality for hemodynamic monitoring in the cardiac intensive care unit

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World Journal of Cardiovascular Diseases 2012年第3期2卷 165-167页

作者： Hillel A. Steiner Yonatan Hasin Division of Cardiovascular Medicine Boruch Padeh Medical Center Lower Galilee Israel

The PAC has enabled major advances in understanding cardiac hemodynamics and pathophysiology. However its clinical utility is limited by data interpretation and serious complications. Echocardiography provides a useful alternative for hemodynamic assessment as well as identification of important concomitant findings. The combination of echocardiography with insertion of a central venous pressure catheter may be the optimal combination for hemodynamic monitoring.

关键词： Hemodynamics Pulmonary Artery Catheter Echocardiography

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Effects of alkaline-electrolyzed and hydrogen-rich water,in a high-fat-diet nonalcoholic fatty liver disease mouse model

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World Journal of Gastroenterology 2018年第45期24卷 5095-5108页

作者： Karen Jackson Noa Dressler Rotem S Ben-Shushan Ari Meerson Tyler W LeBaron Snait Tamir Laboratory of Human Health and Nutrition Sciences MIGAL-Galilee Research InstituteKyriat Shmona 11016Israel Tel Hai College Upper Galilee 12110Israel center of Experimental Medicine Institute for Heart ResearchSlovak Academy of SciencesBratislava 84005Slovakia Molecular Hydrogen Institute UT 48101United States

AIM To identify the effect of hydrogen-rich water(HRW) and electrolyzed-alkaline water(EAW) on high-fat-induced non-alcoholic fatty acid disease in *** Mice were divided into four groups:(1) Regular diet(RD)/regular water(RW);(2) high-fat diet(HFD)/RW;(3) RD/EAW; and(4) HFD/EAW. Weight and body composition were measured. After twelve weeks, animals were sacrificed, and livers were processed for histology and reverse-transcriptase polymerase chain reaction. A similar experiment was performed using HRW to determine the influence and importance of molecular hydrogen(H2) in EAW. Finally, we compared the response of hepatocytes isolated from mice drinking HRW or RW to palmitate *** EAW had several properties important to the study:(1) pH = 11;(2) oxidation-reduction potential of-495 mV; and(3) H2 = 0.2 mg/L. However, in contrast to other studies, there were no differences between the groups drinking EAW or RW in either the RD or HFD groups. We hypothesized that the null result was due to low H2 concentrations. Therefore, we evaluated the effects of RW and low and high HRW concentrations(L-HRW = 0.3 mg H2/L and H-HRW = 0.8 mg H2/L, respectively) in mice fed an HFD. Compared to RW and L-HRW, H-HRW resulted in a lower increase in fat mass(46% vs 61%), an increase in lean body mass(42% vs 28%), and a decrease in hepatic lipid accumulation(P < 0.01). Lastly, exposure of hepatocytes isolated from mice drinking H-HRW to palmitate overload demonstrated a protective effect from H2 by reducing hepatocyte lipid accumulation in comparison to mice drinking regular *** H2 is the therapeutic agent in electrolyzed-alkaline water and attenuates HFD-induced nonalcoholic fatty liver disease in mice.

关键词： Hydrogen-rich-water Nonalcoholic fatty liver disease Alkaline water Metabolic syndrome Molecular hydrogen High-fat diet

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A Model of Hormonal and Environmental Involvement in Growth and Sex Differentiation in European Eel (Anguilla Anguilla)

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Advances in Biological Chemistry 2016年第4期6卷 141-145页

作者： Gad Degani galilee Technological center School of Science and Technology Tel-Hai Academic College Upper Galilee Israel

Growth in vertebrates is a complex interaction involving the development of cells, tissues and organs. Hormones regulating growth during maturation are involved mainly in the interaction between the somatic axis and the reproduction of brain-pituitary axes. Based on the results of hormone and gene transcriptions, the secretion and treatment controlling both the somatic axis and the gonadotropic axis were affected, directly or indirectly, by the environment parameter through hormones that were studied in my laboratory. A model was proposed for sex differentiation and gonadal development correlating to the growth of European eel (Anguilla anguilla). A high growth variation is affected by the environment. At a low density of eels, the gonadotropin-releasing hormone (GnRH) affected the secretion follicle stimulation hormone (FSH) in the pituitary, steroidogenesis and aromatase (CYP19) synthesis, and the 17β-estradiol (E2) from 11-ketotestosterone (Kt-11) causing ovary development. The ovary secretion E2 affecting the ade-nylate cyclase-activating polypeptide (PACAP), growth hormone (GH) and the insulin-like growth factor (IGF) stimulated rapid growth in females. On the other hand, a high density of eels caused the pituitary gland to secrete FSH at a lower level, and CYP19 was not synthesized in the gonads. The secretion of Kt-11 affected differentiation to testis, which inhibits the somatic axis in reducing growth rate.

关键词： Hormones Environmental Sex Differentiation Anguilla anguilla

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Olive oil consumption and non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2009年第15期15卷 1809-1815页

作者： Nimer Assy Faris Nassar Gattas Nasser Maria Grosovski Liver Unit Ziv Medical CenterSafedIsrael Faculty of Medicine Technion Institute Department of Medicine Western Galilee Hospital Department of Biotechnology Ort-Braude College

The clinical implications of non-alcoholic fatty liver diseases(NAFLD)derive from their potential to progress to fibrosis and *** dietary fat intake,excessive intake of soft drinks,insulin resistance and increased oxidative stress results in increased free fatty acid delivery to the liver and increased hepatic triglyceride(TG)*** olive oil-rich diet decreases accumulation of TGs in the liver,improves postprandial TGs,glucose and glucagonlike peptide-1 responses in insulin-resistant subjects, and upregulates glucose transporter-2 expression in the *** principal mechanisms include:decreased nuclear factor-kappaB activation,decreased lowdensity lipoprotein oxidation,and improved insulin resistance by reduced production of inflammatory cytokines(tumor necrosis factor,interleukin-6)and improvement of jun N-terminal kinase-mediated phosphorylation of insulin receptor *** beneficial effect of the Mediterranean diet is derived from monounsaturated fatty acids,mainly from olive *** this review,we describe the dietary sources of the monounsaturated fatty acids,the composition of olive oil,dietary fats and their relationship to insulin resistance and postprandial lipid and glucose responses in non-alcoholic steatohepatitis,clinical and experimental studies that assess the relationship between olive oil and NAFLD,and the mechanism by which olive oil ameliorates fatty liver,and we discuss future perspectives.

关键词： Liver steatosis Fatty liver Olive oil Fatty acids Monounsaturated Non-alcoholic steatohepatitis Lipids Oleic acid Non-alcoholic fatty liver disease

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