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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 113-118页

作者： Johad Khoury Yaniv Zohar Naim Shehadeh Tarek Saadi Internal medicine B Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology Liver Unit Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology Department of Pathology Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology Meyer Children's Hospital of Haifa Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology Institute of Diabetes Endocrinology and Metabolism Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology Department of Gastroenterology Rambam Health Care Campus and Rappaport Faculty of Medicine Technion-Israel Institute of Technology

Background: Glycogenic hepatopathy(GH) is a disorder associated with uncontrolled diabetes mellitus,most commonly type 1, expressed as right upper quadrant abdominal pain, hepatomegaly and increased liver enzymes. The diagnosis may be difficult, because laboratory and imaging tests are not pathognomonic. Although GH may be suggested based on clinical presentation and imaging studies, the gold standard for diagnosis is a liver biopsy, showing a significant accumulation of glycogen within the hepatocytes. GH may be diagnosed also after elevated liver enzymes in routine blood tests. GH usually regresses after tight glycemic control. Progression to end-stage liver disease has never been reported. This review aims to increase the awareness to this disease, to suggest a pathway for investigation that may reduce the use of unnecessary tests, especially invasive *** sources: A Pub Med database search(up to July 1, 2017) was done with the words "glycogenic hepatopathy", "hepatic glycogenosis", "liver glycogenosis" and "diabetes mellitus-associated glycogen storage hepatopathy". Articles in which diabetes mellitus-associated liver glycogen accumulation was described were included in this ***: A total of 47 articles were found, describing 126 patients with GH. Hepatocellular disturbance was more profound than cholestatic disturbance. No synthetic failure was ***: GH may be diagnosed conservatively, based on corroborating medical history, physical examination, laboratory tests, imaging studies and response to treatment, even without liver biopsy. In case of doubt about the diagnosis or lack of clinical response to treatment, a liver biopsy may be *** is no role for noninvasive tests like fibroscan or fibrotest for the diagnosis of GH or for differentiation of this situation from nonalcoholic fatty liver disease.

关键词： Glycogenic hepatopathy Diabetes mellitus Hepatic glycogenosis Mauriac syndrome

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Capsule endoscopy: Improving transit time and image view

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World Journal of Gastroenterology 2005年第37期11卷 5863-5866页

作者： Zvi Fireman D Paz Y Kopelman Department of Gastroenterology Hillel Yaffe Hadera and Bruce Rappaport Faculty of Medicine Technion Haifa Israel

AIM： To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa. METHODS： Ninety-five patients underwent capsule endoscopy （CE） by easily swallowing the capsule. They were divided into three study groups according to the preparation used： group A （n = 26） by polyethylene glycol （PEG） liter or with sodium phosphate （SP） 12 h prior to the CE study; group B （n = 29） by erythromycin 1 h prior to the CE study; and group C （n = 40） without any preparation. Visualization ranged from good to satisfactory to poor. RESULTS： The gastric emptying time in the group prepared with erythromycin was shorter but without statistical significance and the small bowel transit time was unaffected. In elderly subjects prepared by PEG or SP, the gastric emptying time was significantly longer （163.7 rain, P = 0.05）. The transit times of the three sub-groups were not affected by gender or pathology. The grade of cleaning of the entire study group was 3.27±1.1. The erythromycin group presented significantly the worst quality of images （P = 0.05） compared to the other sub-groups. Age, gender, and pathology had no effect on the quality of the cleaning of the small bowel in the sub-groups. One （1.05%） case had no natural excretion. CONCLUSION： Erythromycin markedly reduces gastric emptying time, but has a negative effect on the quality of the image in the small bowel. The preparation of elderly subjects with PEG or SP has a negative effect on the small bowel transit time.

关键词： Capsule endoscopy Gastric emptying time Small bowel transit time View Erythromycin Polyethylene glycol

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Impact of rotavirus vaccine implementation on Israeli children:a comparison between pre-and post-vaccination era

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World Journal of Pediatrics 2022年第6期18卷 417-425页

作者： Hussein Zaitoon Shaden Hanna Ellen Bamberger Department of Pediatrics Bnai Zion Medical CenterThe Ruth and Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of Technology47 Golomb St.31048HaifaIsrael The Ruth and Bruce rappaport faculty of medicine Technion-Israel Institute of TechnologyHaifaIsrael

Background Worldwide rotavirus vaccination has resulted in a substantial decrease in rotavirus-induced severe gastroenteritis and related hospitalizations among ***,the characterization of patients warranting hospitalization needs to be further *** purpose of the study is to compare the clinical and laboratory features of children hospitalized with acute rotavirus infection before and after the introduction of routine *** This is a retrospective observational *** were pediatric patients who presented to the Bnai Zion Medical Center pediatric emergency department and were diagnosed with rotavirus acute gastroenteritis between 2017 and *** During the pre-vaccination period(2007–2009),114 infants and young children(median age:14 months,range:1–72 months;59 male,55 female)were hospitalized for rotavirus-induced acute gastroenteritis with a rate of 11.71 positive rotavirus tests per 1000 emergency room *** the post-vaccination period(2012–2019),168 infants and young children(median age:17 months,range:0–84 months;90 male,78 female)were hospitalized with a rate of 4.18 positive rotavirus tests per 1000 emergency room *** were no statistical differences between the two groups in gender,breast-feeding rates and sibling(s).The proportion of cases with moderate-to-severe dehydration was higher in the post-vaccination children than in the pre-vaccination *** Rates of rotavirus-attributed acute gastroenteritis hospitalizations declined from the pre-to the post-vaccination *** rates of dehydration were found in the post-vaccination *** surveillance is warranted to better understand the implications of the vaccine.

关键词： Acute gastroenteritis Booster dose Hospitalization Rotavirus Vaccination

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Importance of 3-D image reconstruction of spectraldomain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema

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International Journal of Ophthalmology(English edition) 2013年第6期6卷 836-843页

作者： Avinoam Ophir Rana Hanna Michael R.Martinez Division of Ophthalmology Hillel-Yaffe Medical Center The Ruth and Bruce rappaport faculty of medicine theTechnion

AIM:To present the outcome of modified grid laser photocoagulation(GLP)in diffuse diabetic macular edema(DDME)in eyes without extrafoveal and/or vitreofoveal ***:Inclusion criteria for the retrospective study were DDME eyes of patients with typeⅡdiabetes mellitus that had≥4 months of follow-up following *** one eye per patient was *** 3-D spectral-domain optical coherence tomography(3-D SDOCT),eyes that had either extrafoveal or vitreofoveal traction,or had been previously treated by an intravitreal medication(s)were *** DDME eyes were divided into 4 groups:A)"Classic"DDME that involved the central macula;B)edema did not involve the macular center;C)eyes associated with central epiretinal membrane(ERM);D)DDME that was associated with macular capillary dropout≥2 disc-diameter(DD).RESULTS:GLP outcome in 35 DDME eyes after 4-24(mean,13.1±6.9)months was as follows:Group A)18eyes with"classic"*** one or 2(mean,1.2)GLP treatments,best-corrected visual acuity(BCVA)improved by 1-2 Snellen lines in 44.4%(8/18)of eyes,and worsened by 1 line in 11.1%(2/18).Central macular thickness(CMT)improved by 7%-49%(mean,26.6%)in77.8%(14/18)of *** of CMT worsening(n=4)were commonly explainable,predominantly(n=3)associated with emergence of extrafoveal traction,5-9months *** B)GLP(s)in DDME that did not involve the macular center(n=6)resulted in improved BCVA by 1-2 lines in 2 ***,the central macula became involved in the edema process after the GLP in 3(50%)eyes,associated with an emergence of extrafoveal traction in one of these eyes 4months following the *** C)GLP failed in all 5eyes associated with central *** D)GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout≥***:Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s)during mid-term follow-up,unless complicated pre-GLP or post-GLP by vltreoretinal interfa

关键词： extrafoveal traction vitreofoveal traction grid laser macular edema non-center-involved macular edema epiretinal membrane Evi membrane macular capillary dropout 3-D spectral-domain optical coherence tomography

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Hydrodynamics based transfection in normal and fibrotic rats

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World Journal of Gastroenterology 2006年第38期12卷 6149-6155页

作者： Rita Yeikilis Shunit Gal Natalia Kopeiko Melia Paizi Mark Pines Filip Braet Gadi Spira Department of Anatomy and Cell Biology The Bruce Rappaport Faculty of Medicine Rappaport Family Institute for Research in the Medical Sciences Technion Haifa 31096 Israel Department of Experimental Surgery The Bruce Rappaport Faculty of Medicine Rappaport Family Institute for Research in the Medical Sciences Technion Haifa 31096 Israel Institute of Animal Sciences Agricultural Research Organization the Volcani Center Bet Dagan 50250 Israel Australian Key Centre for Microscopy and Microanalysis The University of Sydney Sydney NSW 2006 Australia

AIM： Hydrodynamics based transfection （HBT）, the injection of a large volume of naked plasmid DNA in a short time is a relatively simple, efficient and safe method for in vivo transfection of liver cells. Though used for quite some time, the mechanism of gene transfection has not yet been elucidated. METHODS： A lucJferase encoding plasmid was injected using the hydrodynamics based procedure into normal and thioacetamide-induced fibrotic Sprague Dawley rats. Scanning and transmission electron microscopy images were taken. The consequence of a dual injection of Ringer solution and luciferase pDNA was followed. Halofuginone, an anti collagen type I inhibitor was used to reduce ECM load in fibrotic rats prior to the hydrodynamic injection. RESULTS： Large endothelial gaps formed as soon as 10＇ following hydrodynamic injection; these gradually returned to normal 10 d post injection. Hydrodynamic administration of Ringer 10 or 30 m prior to moderate injection of plasmid did not result in efficient transfection suggesting that endothelial gaps by themselves are not sufficient for gene expression. Gene transfection following hydrodynamic injection in thioacetamide induced fibrotic rats was diminished coinciding with the level of fibrosis. Halofuginone, a specific collagen type I inhibitor, alleviated this effect. CONCLUSION： The hydrodynamic pressure formed following HBT results in the formation of large endothelial gaps. These gaps, though important in the transfer of DNA molecules from the blood to the space of Disse are not enough to provide the appropriate conditions for hepatocyte transfection. Hydrodynamics based injection is applicable in fibrotic rats provided that ECM load is reduced.

关键词： Gene transfection Fibrosis In vivo transfection Fibrotic Hepatic Endothelial lining Endothelium Sinusoidal Fenestrae Space of disse Extracellular matrix

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Advanced paternal age and reproductive outcome

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Asian Journal of Andrology 2012年第1期14卷 69-76,176页

作者： Zofnat Wiener-Megnazi Ron Auslender Martha Dirnfeld Fertility and iVF Unit Department of Obstetrics and Gynecology Carmel Medical Center the Bruce Rappaport Faculty of Medicine Technion Haifa 34362 Israel

Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspectsare clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome.

关键词： ART outcomes fertility male aging paternal age reproductive outcome

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Hepatotoxicity of anti-inflammatory and analgesic drugs:ultrastructural aspects

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Acta Pharmacologica Sinica 2006年第3期27卷 259-272页

作者： Irena MANOV Helen MOTANIS Idan FRUMIN Theodore C IANCU Pediatric Research and Electron Microscopy Unit.Ruth and Baruch rappaport faculty of medicine Technion-Israel Institute of TechnologyHaifa Israel

With the increasing incidence of drug-induced liver disease,attempts are beingmade to better understand the mechanisms behind these frequently life-endan-gering *** and anti-inflammatory drugs are a major group ex-hibiting *** review research relating to these reactions,focusingon ultrastructural findings,which may contribute to the comprehension and pos-sible avoidance of drug-induced liver *** also present some originalobservations on clinical material and cultured cells exposed to acetaminophenalone or in combination with the antioxidant N-acetylcysteine or the P-glycopro-tein inhibitor verapamil.

关键词： non-steroidal anti-inflammatory agents drug toxicity liver aspirin acetaminophen cultured cells electron microscopy apoptosis P-glycoprotein acetylcysteine

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Diagnostic approach to patients with cholestatic jaundice

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World Journal of Gastroenterology 1999年第3期5卷 252-262页

作者： Assy N Jacob G Spira G Edoute Y Liver Disease Unit and Department of Internal medicine C Rambam Medical Center Haifa and Department of Anatomy the Bruce Rappaport Faculty of Medicine Technion-Israel Institute of Technology Haifa Israel

Conjugated hyperbilirubinemia due to any form of hepatobiliary disease is essentially the result of impairment in bile formation and/or bile flow, a condition known as cholestasis[1,2].

关键词： AIDS cell US ERCP GGT Diagnostic approach to patients with cholestatic jaundice PBC TPN

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Standards of admission capillary blood glucose levels in cesarean born neonates

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World Journal of Pediatrics 2017年第5期13卷 433-438页

作者： Tatiana Smolkin Irena Ulanovsky Pnina Carasso Imad R.Makhoul Department of Neonatology Ruth Rappaport Children’s HospitalHaifa IsraelRambam Health Care CampusHaifaIsrael The Ruth&Bruce rappaport faculty of medicine.Technion—Israel Institute of Technology HaifaIsrael.

Background:Neonatal hypoglycemia (NH) and cutoffs remain *** center screens all cesareandelivered (CD) neonates for *** sought to define standards of admission capillary blood glucose levels (ACBGLs) in CD neonates who were at the lowest risk for ***:Of 4947 neonates,519 met all 14 inclusion *** highly-selected neonates were apparently the healthiest,least-stressed,earliest to be admitted to nursery and at lowest-risk for *** each CD,cord blood gases and glucose were determined and each infant was screened for blood glucose at nursery ***:Sampling age was 41.6±15.3 minutes,a mean ACBGL of 52.3±10.7 mg/dL,and percentiles as follows:1st percentile,29.2;3rd,33.6;5th,35.0;10th,39.0;25th,46.0;50th,51.0;75th,58.0;90th,67.0;95th,71.0;97th,73.0,and 99th,*** rose significantly with increasing gestational age (P=0.004),increasing cord blood glucose (P<0.001),decreasing cord blood pH (P<0.001) and decreasing sampling age (P=4).027).Conclusions:Setting uniform ACBGL cutoffs for NH definition is unachievable due to the enormous heterogeneity among ***,we provide group-based ACBGL standards in CD *** propose setting ACBGL cutoffs for use in CD neonates:1) hypoglycemia:ACBGL <5th percentile (<35 mg/dL);and 2) interventional hypoglycemia:ACBGL <1st percentile (<30 mg/dL).

关键词： capillary blood cesarean delivery glucose hypoglycemia newborn infant

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Effects of fibroblast transplantation into the internal pallidum on levodopa-induced dyskinesias in parkinsonian non-human primates

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Neuroscience Bulletin 2015年第6期31卷 705-713页

作者： Arun Singh Claire A.Gutekunst Subramaniam Uthayathas John P.M.Finberg Klaus Mewes Robert E. Gross Stella M.Papa Yair Feld Neuropharmacology and Neurologic Diseases Yerkes National Primate Research Center Department of Neurosurgery Emory University School of Medicine Molecular Pharmacology Department Rappaport Faculty of Medicine Department of Neurology Emory University School of Medicine Gene Grafts Ltd

Recent studies have shown that fibroblast transplantation can modify the activity of basal ganglia networks in models of Parkinson＇s disease. To determine its effects on parkinsonian motor symptoms, we performed autologous dermal fibroblast transplantation into the internal pallidum （GPi） in two parkinsonian rhesus monkeys with stable levodopa- induced dyskinesias （LIDs）. Levodopa responses were assessed every week after transplantation for three months. A reduction of between 58% and 64% in total LIDs on the contralateral side was observed in both animals. No clear LID changes were observed on the ipsilateral side. These effects lasted the entire 3-month period in one monkey, but declined after 6-8 weeks in the other. The antiparkinsonian effects of levodopa did not diminish, The results of this pilot study indicate that fibroblast transplantation into the GPi may have beneficial effects on LIDs and warrant further investigation for potential therapeutic use.

关键词： globus pallidum autologous levodopa antiparkinsonian monkeys

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