Results and hemodynamic changes after interposition mesocaval shunt

Forty-seven patients have been treated by interposition mesocaval shunting for portal hypertension and variceal bleeding between December 1973 and March 1980. The average age was 55 years. The underlying diseases were alcoholic cirrhosis in 26 patients (56%), macronodular cirrhosis in 11 patients (23%), and other causes in 10 patients (21%). Thirty-five operations (75%) were performed on an emergency basis for patients who continued to bleed after failure of conservative management. In these patients, the early mortality rate was 43%. Overall survival, rebleeding, and postshunt encephalopathy rates are correlated with the preoperative Child's classification. These figures are similar to those reported for end-to-side portocaval shunts. The improvement in postshunt encephalopathy rates as reported by Drapanas is not borne out by our results. Postshunt angiography was performed in 31 patients and shunt patency was confirmed in 28 (90%). In 26 patients, selective studies to determine portal flow patterns were carried out, and in only three patients was there any evidence of hepatopedal flow. In each of these patients, some kinking of the shunt was noted. Mesocaval shunting is a reasonable alternative to end-to-side portocaval shunts and is associated with similar rates of patency, rebleeding, mortality, and late postoperative encephalopathy. A well-constructed, patent mesocaval shunt totally diverts portal flow.     

A novel founder MSH2 deletion in Ethiopian Jews is mainly associated with early-onset colorectal cancer

Familial Cancer - Lynch syndrome is an inherited cancer predisposition syndrome caused by germline defects in any of the mismatch repair (MMR) genes. Diagnosis of carriers makes precision...     

Identification of possible cigarette smoke constituents responsible for muscle catabolism

The age-related loss of muscle mass and strength also known as sarcopenia is significantly influenced by life style factors such as physical inactivity and impaired nutrition. Cigarette smoking is another life style habit that has been shown to be associated with sarcopenia and to affect skeletal muscle. Even today, smoking?is still prevalent worldwide and is probably the most significant source of toxic chemicals exposure to humans. Cigarette smoke (CS) is a complex aerosol consisting of thousands of various constituents including reactive oxygen and nitrogen free radicals, toxic aldehydes and more. Previous epidemiological studies have identified tobacco smoking as a risk factor for sarcopenia. Clinical, in vivo and in vitro studies have revealed CS-induced skeletal muscle damage due to impaired muscle metabolism, increased inflammation and oxidative stress, over-expression of atrophy related genes and activation of various intracellular signaling pathways. This review aims to discuss and identify the components of CS that may promote catabolism of skeletal muscle.     

Evidence-based roads to the promotion of health in old age

The increase in life expectancy, along with the accompanying ongoing increase in the proportion and absolute numbers of nonagenarians and centenarians have set forth the curiosity regarding the question of the quality of health in very old age. Studies on that issue have pointed to the fact that the very old people are actually healthier than originally predicted on the basis of the earlier studies on aging. Current efforts are thus invested in elucidating the possible basis of health in the very old people, as well as better understanding of potential causes of frailty and common diseases in old age. This review recounts on the various aspects underlying evidence-based recommendations for healthy life in old age. We focus on the genetic and non-genetic bases of aging and longevity, and the various directions towards the promotion of health, both via avoiding, or eliminating risk factors and deleterious effects, as well as conducting healthy lifestyle — in terms of proper nutrition and physical exercise. Next, we touch upon preventive medicine, particularly as related to vaccination, with a note also on the need for a reasonable use of medications. In addition, we report about the developing area of regenerative medicine and its potential in relation to the prevention of damage and possible strategies towards tissue repair in cases of age-related degenerative processes.     

The consistency and uncertainty in examiners' definitions of pass/fail performance on OSCE (objective structured clinical examination) stations

The Medical Council of Canada has made use of examiners' pass/fail classifications of candidates' behaviors in objective structured clinical examination (OSCE) stations in defining cutting scores for these stations. This process assumes that there is consistency in the judgments of examiners employed in the same stations at different testing sites and in the cutting scores derived from these judgments. These assumptions were tested using the results of the fall 1993 administration of part 2 of the Medical Council of Canada's Evaluating Examination to 744 candidates. The results of this study provided evidence of the consistency of the pass/fail and cutting score definitions for the stations used across examiners.     

西藏那曲冬虫夏草无形型的研究

目的 :分离鉴定西藏那曲冬虫夏草无性型真菌。方法 :采用子囊孢子、织、僵虫、体液分离的方法从巴青、索县、比如 3县分离冬虫夏草无性型菌株。结果 :采用 4种方法获得了性状特证与中国被毛孢相同的无性型菌株。结论 :中国被毛孢是西藏那曲冬虫夏草的无性型。