Effective balloon-occluded retrograde transvenous obliteration of the superior mesenteric vein?inferior vena cava shunt in a patient with hepatic encephalopathy after living donor liver transplantation

Balloon-occluded retrograde transvenous obliteration (BRTO) has become a common and effective procedure for treating hepatic encephalopathy due to a portosystemic shunt related to cirrhosis of the liver. However, this method of treatment has rarely been reported in patients after liver transplantation. Here, we report the case of a 52-year-old patient who underwent living donor liver transplantation (LDLT) due to hepatitis C virus-infected hepatocellular carcinoma that was complicated with portal vein thrombosis and a large portosystemic shunt between the superior mesenteric vein (SMV) and inferior vena cava (IVC). The SMV-IVC shunt was not obliterated during LDLT because there was sufficient portal flow into the graft after reperfusion. However, the patient was postoperatively complicated with encephalopathy due to the portosystemic shunt. BRTO was performed and was demonstrated to have effectively managed the encephalopathy due to the SMV-IVC shunt, while preserving the hepatic function after LDLT

Experimental observations and modelling of radiation asymmetries during N2 seeding in LHD

N2 gas has been seeded in the Large Helical Device (LHD) to reduce the divertor heat load through enhanced radiation. Radiation is observed by two imaging bolometers, viewing the same poloidal cross-section from top and bottom ports, at a location which is 36°toroidally removed from the N2 gas puff nozzle located at the bottom of the machine. During N2 seeding, these measurements both confirm that additional radiation from the outboard side is coming exclusively from the top of the cross-section, indicating up/down asymmetry, which is also reproduced by modelling with EMC3-EIRENE using a half torus model. In addition, a toroidally localized, magnetic field direction-dependent radiation enhancement is observed with N2 seeding, but is not reproducible by the model