Consecutive versus separate sessions of endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) for symptomatic choledocholithiasis.

Background: Common bile duct (CBD) stones are a potentially life-threatening medical condition. Patients with proven CBD stones should undergo stone extraction. The aim of this study was to evaluate whether performing endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) for symptomatic CBD stones in a single session reduces complications related to postponing treatment due to separate EUS and ERCP sessions, and to assess the safety in both options.

[Thiopurine-induced hyperammonaemic encephalopathy in a patient with Crohn's disease].

Thiopurine drugs, azathioprine (Imuran) and 6-mercaptopurine (6-MP), are immunomodulators that have been shown to be effective at inducing and maintaining remission in inflammatory bowel disease. Although usually well-tolerated, the occurrence of side effects, typically myelotoxicity and hepatotoxicity, is a major drawback. The side effects can be classified as dose-dependent and independent.

Nonspecific esophageal motility disorders may be an early stage of a specific disorder, particularly achalasia.

The clinical significance of nonspecific esophageal motility disorder (NEMD) is unclear. Our aim was to investigate the natural history of NEMD. All manometries performed at Meir Hospital from 1997 to 2004 and diagnosed as NEMD were reviewed.

[ERCP for benign disease in the elderly: a good prognosis].

Background: biliary disease in the elderly (over 80) are common and can be a diagnostic and therapeutic challenge.

Methods: medical records of patients age 80 and older who underwent endoscopic retrograde cholangiopancreatography (ERCP) for benign biliary disease from January 2000 to April 2005 were studied retrospectively.

Results: 100 patients of whom data was obtainable underwent 133 procedures.

Fasting hypoglycemia in solitary fibrous tumor of the peritoneum: a diagnostic clue for an emergent situation.

Solitary fibrous tumors are rare fibrous tumors found in various anatomic sites. Extrathoracic neoplasms are often symptomatic at presentation, with paraneoplastic hypoglycemia being reported as one of the associated clinical features of such slow-growing tumors. As hypoglycemia can be an emergent clinical situation, we describe a patient with a giant abdominal tumor who presented with a symptomatic hypoglycemia, which might be regarded as a diagnostic clue.

Cyclosporin for severe ulcerative colitis.

Background: About one-third of patients with severe ulcerative colitis do not respond to conventional therapy and require urgent colectomy. It was recently shown that cyclosporin is effective in some of these patients.

Objectives: To review the current experience of six hospitals in central Israel that used cyclosporin in patients with severe ulcerative colitis.

Retroperitoneal perforation during endoscopic sphincterotomy: imaging findings.

Background: Endoscopic retrograde cholangiopancreatography with sphincterotomy has become an important technique in the diagnosis and treatment of biliary and pancreatic diseases. Serious complications, although rare, may occur, and their early recognition and treatment are of the utmost importance. We encountered several such cases.

Expression of bcl-2 in autoimmune and Helicobacter pylori-associated atrophic gastritis.

Chronic atrophic gastritis can be induced either by H. pylori or by an autoimmune process. The protein product of bcl-2, which is a protooncogene, blocks apoptosis.

Methotrexate in chronic active Crohn's disease: a double-blind, randomized, Israeli multicenter trial.

Background: At present only one large controlled study has indicated that parenteral methotrexate may be effective in chronic active Crohn's disease (CD).

Aim: To evaluate the effectiveness of oral methotrexate in chronic steroid-dependent CD.

Patients: Patients with active CD, who have received steroids and/or immunosuppressives for at least 4 months during the preceding 12 months and with a current Harvey-Bradshaw index of > or = 7 were studied.

Cerebral venous thrombosis and chronic active hepatitis as part of the antiphospholipid syndrome.

A case of antiphospholipid syndrome, presenting as sinus vein thrombosis together with chronic active hepatitis, is reported in a 35-year-old woman.

Methotrexate in chronic active ulcerative colitis: a double-blind, randomized, Israeli multicenter trial.

Background & Aims: Uncontrolled studies have suggested that methotrexate may be effective in patients with active ulcerative colitis. The aim of this study was to evaluate the effectiveness of oral methotrexate in chronic steroid-dependent ulcerative colitis in a randomized, double-blind multicenter trial.

Methods: Patients with active ulcerative colitis who have received steroids and/or immunosuppressives for at least 4 months during the preceding 12 months with a current Mayo Clinic score of > or = 7 were included in the study.

Two point analysis 15-minute 14C-urea breath test for diagnosing Helicobacter pylori infection.

The value of a two point analysis (double sample) 14C-urea breath test in diagnosing Helicobacter pylori (HP) infection in patients with suspected acid peptic disease has been studied and compared to histology and to a rapid agar plate urease test in 76 patients. Using the histological finding of HP as the gold standard, the 14C-breath test was positive in 59 of the 61 histologically confirmed infected patients and in 3 of the 15 noninfected ones, giving a sensitivity of 97% and specificity of 80%. In 12 patients, a smaller dose of 3 mu Ci 14C-urea was used.

Effect of chlorpromazine (CPZ) on cholecystokinin-induced gallbladder contraction: the role of calcium.

Smooth muscle contraction is initiated by a rise in intracellular calcium, which binds to calmodulin resulting in myosin phosphorylation. CPZ impairs smooth muscle contraction by either interfering with calcium influx at low concentrations (less than 1.25 x 10(-5) M) or inactivating calcium-calmodulin at higher levels.

The effects of prosthetic gallstones on gallbladder function and bile composition.

Diminished gallbladder emptying has been implicated in the pathogenesis of gallstone formation. This study assessed the effect of the physical presence of inert, prosthetic gallstones on gallbladder contractility, histopathology, and bile composition. Three glass beads, each 3 mm in diameter, were implanted in the guinea pig gallbladder.

Direct determination of the contractility of the guinea pig gallbladder: a new in vivo model.

In vivo methods to study gallbladder contractility either equate gallbladder emptying with contraction or have relied on changes in gallbladder intravesicular pressure to reflect active transmural tension. We therefore devised an animal model in which the contractile force of the intact gallbladder is measured directly while the blood and neural supply remains uncompromised. Under general anesthesia one pole of the guinea pig gallbladder is anchored to the sternum and the other connected to a force displacement transducer.

Abnormal gallbladder emptying in a subgroup of patients with gallstones.

Gallbladder stasis has been implicated in gallstone formation. Gallbladder filling and emptying were quantitated by computer-assisted cholescintigraphy in 41 normal subjects versus 26 patients with gallstones. Gallbladder contraction was induced by low-dose (1.