Liver transplantation for metastatic hemangiopericytoma associated with hypoglycemia

We report a case of successful liver transplantation in a young man with metastatic hemangiopericytoma confined to the liver. He had a primary retroperitoneal hemangiopericytoma removed in 1982 and was diagnosed as having liver metastases 8 years later. Subsequently, he developed hypoglycemia, which did not respond to chemotherapy. Hepatectomy and transplantation resolved his hypoglycemic attacks. He remained well and symptom free for 4 years. Liver transplantation can provide effective palliation and should be considered in carefully selected patients with localized metastatic cancer.     

Predictors of physical function among the oldest old: a comparison of three outcome variables in a 24-year follow-up

This study has measured physical function in a nationally representative sample of persons aged 77 to 98 (N = 508) in 1992. Three measures of function are used: activities of daily living (ADL), an index of mobility, and performance tests. These are used as outcomes and analyzed in relation to variables gathered in a survey in 1968. Variables from 1968 include education, mobility, smoking, and an index of circulation problems. All four variables predict some limitations in physical function in old age. However, there are different patterns of predictors found for the three outcome measures. All three outcomes are associated with age, education, and previous circulation problems. ADL limitations are also associated with poor previous mobility and smoking; mobility limitations are also associated with sex and smoking; performance limitations are also associated with sex.     

Prognosis in schizophrenia. Prognostic predictors and outcome

Eighty-eight of 92 first-admission schizophrenics from 1963, an incidence by first admission cohort, were followed up in 1974 and 1975. Epidemiologically the sample was more comparable to lower European rates and expectancy rather than to higher American figures. Prior to follow-up, factors said to predict outcome were scored. This prognostic information was complete for 79 cases. Outcome was measured on a variety of criteria. The patients fell into a "poor prognosis" group based on the prognostic indicators, which were of little value in predicting prognosis within this group. However, patients who received extensive service during the follow-up period had poorer outcomes. Outcome was better than in most earlier studies of schizophrenia, but similar to that in some other recent studies of first-admission patients; also, the use of phenothiazines, short-term hospitalization, and community services may play a part. The failure of prognostic indicators to predict more than about 25% of the outcome variance for this group of "poor prognosis" patients supports the viewpoint that "good" and "poor" prognosis schizophrenia are two different entities.