Portosystemic shunt in Budd-Chiari syndrome: long-term survival and factors affecting shunt patency in 25 patients in Western countries

BACKGROUND: In Budd-Chiari syndrome (BCS) treated by portosystemic shunt, postoperative shunt thrombosis is associated with high morbidity and mortality rates. The aim of this study was to determine factors associated with shunt thrombosis. METHODS: From 1985 to 1991, 25 patients underwent portosystemic shunt for BCS. According to the patency of the shunt during the postoperative period and follow-up, patients were divided into two groups including 17 patients with patent shunt and 8 (32%) with shunt thrombosis. RESULTS: In patients with patent shunt, actuarial survival rate at 5 years was 87% versus 38% in patients with shunt thrombosis (p < 0.05). Duration of symptoms before operation was higher in patients with shunt thrombosis than in patients with patent shunt (315 +/- 483 vs 109 +/- 168 days, p < 0.05). In patients with patent shunt, extensive fibrosis or cirrhosis was observed in 3 of 17 (18%) versus in 5 of 8 (63%) of patients with shunt thrombosis (p < 0.05). Shunt thrombosis was observed in 3 of 3 patients (100%) with the combination of myeloproliferative disorder, duration of symptoms more than 100 days, and cirrhosis versus 0 of 6 (0%) patients without this combination (p < 0.05). CONCLUSIONS: In acute form of BCS (with short history of the disease and absence of extensive fibrosis or cirrhosis), early portal decompression is mandatory, with low risk of shunt thrombosis and good long-term results. In chronic form of BCS, the risk of shunt thrombosis is high and long-term results are bad; in these patients, orthotopic liver transplantation must be considered.     

FE3 EPR investigation of PLZT 1/65/35 and 8/65/35

X-band EPR spectra of PLZT 1/65/35 and PLZT 8/65/35 doped with 1% FE³⁺ were recorded at temperature range -175°C to 200°C. Three types of paramagnetic centers were found. Two of them are in strong axial and rhombic crystal field due to neighboring oxygen and lead vacancies. The other center has symmetry determined by polarization and oxygen octahedra tilt. EPR spectra of PLZT 8/65/35 are in agreement with its glassy behavior.     

Optimization of parameters of recirculating apparatus for obtaining liquid nitrogen using mixtures

Translated from Khimicheskoe i Neftyanoe Mashinostroenie, No. 12, pp. 20–23, December, 1993.     

From virtual worlds to the therapist's office

The increasing recognition of the importance of emotional state in both disease and health makes imperative the need for health care providers to evaluate the psychological status of patients. In primary care medical practice, between 30 and 60% of complaints prompting visits to the physician's office have a significant emotional component. In addition, rates of depressive illness are estimated to be as high as 20% in the general population. Prompt recognition of anxiety, depression, personality disorder, and psychosis is important for correct interpretation of historical and physical findings during examination and evaluation of patients. The establishment of a caring and trusting relationship is crucial so that patients can comfortably express concerns, and so that a discussion leading to an agreeable therapeutic plan can be decided upon. This process has traditionally taken place in the one-on-one format between the health care provider and patient. Many physicians and therapists are interested in exploring whether virtual reality can augment the therapeutic process, and thus improve diagnostic capabilities     

Fibrocystic disease of breast and pituitary-thyroid axis function

The aim this study was to report findings on the concentrations of mean triiodothyroxine (T3), thyroxin (T4), thyroid stimulating hormone (TSH) and prolactin (Prl) in patients with benign mastopathy and in control group. All of the examined subjects were clinically euthyroid. The mean T4 concentrations in women with mastopathy (78.25 +/- 15.27 ng/ml) were significantly lower than in control group 88.73 +/- 15.27). The mean TSH and PRL concentration in women with mastopathy were higher, but not significantly, than in control women. This results indicate, that benign mastopathy seems to be connected with thyroid functions.     

Effect of rotation on the structure of a convecting mushy layer

Summary Nonlinear natural convection in a mushy layer during solidification of a binary alloy is investigated under a high gravity environment where the rotation axis is inclined to the high gravity vector. Asymptotic and scaling analyses are applied to convective flow within the mushy layer and in vertical chimneys. The main result is that, for some particular moderate rotation range, vertical velocity in the chimneys decreases rapidly with increasing rotation rate and appears to have opposite signs across some rotation dependent vertical level.