7,595 research outputs found

    Gastrointestinal complications of hepatic transplantation

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    In this series of 150 orthotopic hepatic transplants, clinically significant gastrointestinal hemorrhage occurred in 34 patients (23%). Five patients (15%) survived this complication. Enteric perforations occurred in 20 patients following 198 biliary-enteric procedures. Only one patient survived. Enteric perforations unrelated to biliary procedures fared only slightly better with one survivor among eight perforations. These results clearly do not warrant complacency. Modifications advocated are an aggressive diagnostic approach and early reoperation with establishment of extensive peritoneal drainage where necessary

    Liver Resection for Hepatic Adenoma

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    Between 1970 and 1978, eight hepatic adenomas were resected. Four of the eight patients took oral contraceptive pills before the hepatic adenoma was identified; one patient was male. Four patients had evidence of bleeding at the time of presentation. The original histologic diagnosis in the first five patients was malignant hepatoma. There has been no known recurrence of tumor and all patients are well. The use of oral contraceptives in these patients has been prohibited. Formal anatomic resection is recommended for hepatic adenoma when this procedure can be done without mortality or serious morbidity; however, in the future, less drastic treatments, such as occlusion of the hepatic arterial circulation to the tumor or discontinuation of oral contraceptives, may prove as effective as tumor resection. © 1979, American Medical Association. All rights reserved

    Kidney transplantation. Modern trends in kidney transplantation.

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    Trends in renal transplantation stem from recognition of the virtues and drawbacks of this kind of treatment and from a better appreciation of the interrelationship between transplantation and dialysis

    An Optical Study of Two VY Sculptoris-Type Cataclysmic Binary Stars: V704 And and RX J2338+431

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    We report observations of the known cataclysmic variable star (CV) V704 And, and also confirm that the optical counterpart of the ROSAT Galactic Plane Survey source RX J2338+431 is a heretofore-neglected CV. Photometric and spectroscopic observations from MDM Observatory show both systems to be novalike variables that exhibit dips of 4-5 magnitudes from their mean brightnesses, establishing them as members of the VY~Scl subclass. From high-state emission-line radial velocities, we determine orbital periods of 0.151424(3) d (3.63 hr) for V704 And and 0.130400(1) d (3.13 hr) for RX J2338+431. In V704 And, we find that the H-alpha emission-line measures cluster into distinct regions on a plot of equivalent width versus full width at half-maximum, which evidently correspond to high, intermediate, and low photometric states. This allows us to assign spectra to photometric states when contemporaneous photometry is not available, an apparently novel method that may be useful in studies of other novalikes. Our low-state spectra of RX J2338+431 show features of an M-type secondary star, from which we estimate a distance of 890 +- 200 pc, in good agreement with the Gaia DR2 parallax.Comment: Accepted for Astronomical Journa

    0-Ď€\pi quantum transition in a carbon nanotube Josephson junction: universal phase dependence and orbital degeneracy

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    We investigate experimentally the supercurrent in a clean carbon nanotube quantum dot, close to orbital degeneracy, connected to superconducting leads in a regime of strong competition between local electronic correlations and superconducting proximity effect. For an odd occupancy of the dot and intermediate coupling to the reservoir, the Kondo effect can develop in the normal state and screen the local magnetic moment of the dot. This leads to singlet-doublet transitions that strongly affect the Josephson effect in a single-level quantum dot: the sign of the supercurrent changes from positive to negative (0 to π\pi-junction). In the regime of strongest competition between the Kondo effect and proximity effect, meaning that the Kondo temperature equals the superconducting gap, the magnetic state of the dot undergoes a first order quantum transition induced by the superconducting phase difference across the junction. This is revealed experimentally by anharmonic current-phase relations. In addition, the very specific electronic configuration of clean carbon nanotubes, with two nearly orbitally degenerated states, leads to different physics depending whether only one or both quasi-degenerate upper levels of the dots participate to transport, which is determined by their occupancy and relative widths. When the transport of Cooper pairs takes place through only one of these levels, we find that the phase diagram of the phase-dependent 0-π\pi transition is a universal characteristic of a discontinuous level-crossing quantum transition at zero temperature. In the case were two levels participate to transport, the nanotube Josephson current exhibits a continuous 0-π\pi transition, independent of the superconducting phase, revealing a different physical mechanism of the transition.Comment: 14 pages, 12 figure

    Thoracic duct drainage in organ transplantation: Will it permit better immunosuppression?

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    It is possible that thoracic-duct drainage, a major but neglected immunosuppressive adjunct, can have an important impact on organ transplantation. If thoracic-duct drainage is started at the time of transplantation, the practicality of its use in cadaveric cases is greatly enhanced. With kidney transplantation, the penalty of not having pretreatment for the first organ is compensanted by the automatic presence of pretreatment if rejection is not controlled and retransplantation becomes necessary. The advantage of adding thoracic-duct drainage to conventional immunosuppression may greatly enhance the expectations for the transplantation of extrarenal organs, such as the liver, pancreas, heart, and lung. There is evidence that pretreatment with thoracic-duct drainage of patients with cytotoxic antibodies may permit successful renal transplantation under these otherwise essentially hopeless conditions. Exploration of the neglected but potentially valuable tool of thoracic-duct drainage seems to the authors to be highly justified in other centers

    Liver Transplantation for Budd-Chiari Syndrome

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    Orthotopic liver transplantation was accomplished in a 22-year-old woman dying of the Budd-Chiari syndrome. She is well and has normal liver function 16 months postoperatively. In view of the good early result, it will be appropriate to consider liver replacement for this disease in further well-selected cases. © 1976, American Medical Association. All rights reserved

    Manipulating the magnetic state of a carbon nanotube Josephson junction using the superconducting phase

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    The magnetic state of a quantum dot attached to superconducting leads is experimentally shown to be controlled by the superconducting phase difference across the dot. This is done by probing the relation between the Josephson current and the superconducting phase difference of a carbon nanotube junction whose Kondo energy and superconducting gap are of comparable size. It exhibits distinctively anharmonic behavior, revealing a phase mediated singlet to doublet transition. We obtain an excellent quantitative agreement with numerically exact quantum Monte Carlo calculations. This provides strong support that we indeed observed the finite temperature signatures of the phase controlled zero temperature level-crossing transition originating from strong local electronic correlations.Comment: 5 pages, 4 figures + supp. material
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