Which factors predict the results of pituitary surgery in acromegaly?

1988 ◽  
Vol 117 (4) ◽  
pp. 491-496 ◽  
Author(s):  
W. J. G. Oyen ◽  
G. F. F. M. Pieters ◽  
E. Meijer ◽  
J. v. Laarhoven ◽  
A. G. H. Smals ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Predictive Factors ◽  
Pituitary Surgery ◽  
Sex Distribution ◽  
Normal Range ◽  
Somatomedin C ◽  
Group A ◽  
Operation Group ◽  
Group B ◽  
Suprasellar Extension

Abstract. Thirty-one patients with acromegaly who underwent pituitary surgery were investigated for possible predictive factors of the surgical outcome. The patients were divided into two groups: those whose GH levels normalized (<5 μg/l) after operation, group A (N = 18), and those whose GH levels remained elevated, group B (N = 13). There were no differences in age, sex distribution and sellar volume between both groups. There was a tendency to a higher incidence of suprasellar extension of the pituitary tumor in group B (P < 0.10). The basal GH levels in group A (38 ± 5 μg/l) before operation were significantly lower than in group B (100 ± 22 μg/l, P < 0.002). Somatomedin C levels after the operation were significantly lower in group A than in group B (P < 0.05) and were more often in the normal range (P < 0.05). No differences were found in the occurrence of paradoxical GH responses to TRH and/or to GnRH between the groups and neither were there any differences in GH responses to GHRH and to bromocriptine between the groups. The sensitivity to SRIH tended to be higher in group A. After operation, the paradoxical GH response to TRH disappeared in 7 out of 10 patients and to GnRH in 2 out of 5 patients of group A, whereas in group B this anomaly persisted in all 9 after TRH and all 3 patients after GnRH. Hypopituitarism developed in only 5 out of the 31 patients. We conclude that the basal GH level is a factor that to a large extent may predict the effect of pituitary surgery in acromegaly. However, despite normalization of the basal GH level, paradoxical responses to TRH and or GnRH persist in a minority of the cured patients, indicating the presence of remnants of the pituitary adenoma.

Effects of Mechanical Stimulation on MMP-2 and TIMP-2 Expression of Scleral Fibroblasts after Posterior Sclera Reinforcement

2014 ◽  
Vol 490-491 ◽  
pp. 867-871
Author(s):  
Guo Hui Wang ◽  
Wei Yi Chen
Keyword(s):  
Mechanical Stimulation ◽  
Sine Wave ◽  
Posterior Pole ◽  
Cyclic Stretch ◽  
Elisa Method ◽  
Band Group ◽  
Group A ◽  
Operation Group ◽  
Group B

To understand the effect of mechanical stimulation on posterior sclera reinforcement (PSR), the rabbit scleral fibroblasts after PSR were subjected to stretch in vitro and MMP-2 and TIMP-2 expression of scleral fibroblasts were evaluated. Three-week-old rabbits were monocularly performed by eyelid suturation randomly to prepare experimental myopia eye. After 60 days, the experimental myopia eyes were treated by PSR. After 6 months, the posterior pole scleral fibroblasts (normal sclera - group A, sclera after operation - group B and fusion region of sclera and reinforcing band group C) were isolated and cultured in vitro. The cells were subjected to cyclic stretch regimens (sine wave, 3% and 6% elongation amplitude, 0.1Hz, 48h duration) by FX-4000 Tension System. The MMP-2 and TIMP-2 expression of scleral fibroblasts were evaluated by ELISA method. The results show that after cyclic stretch to the scleral fibroblasts of the normal sclera and the sclera after operation, the MMP-2 expression was significantly reduced and the TIMP-2 expression was significantly increased, the MMP-2 and TIMP-2 expression of the scleral fibroblasts of the fusion region after operation was no changed. It was indicated that the mechanical stimulation could regulate the MMP-2 and TIMP-2 expression of scleral fibroblasts and play an important role in the process of treating high myopia with PSR surgery.

A CLINICO-COMPARATIVE STUDY ON THE EFFECT OF LASHUNA SIDDHA TAILPANA POORVAK VAMANA KARMA AND NITYA VIRECHANA BY GOMUTRA HARITAKI IN THE MANAGEMENT OF HYPOTHYROIDISM

2021 ◽  
Vol 12 (4) ◽  
pp. 49-55
Author(s):  
Sheetal R Tokle
Keyword(s):  
Comparative Study ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
End Of Treatment ◽  
Group A ◽  
Insignificant Difference ◽  
Randomized Control ◽  
Drug Dependent ◽  
Group B ◽  
Stimulating Hormone

Hypothyroidism is a condition in which thyroid gland doesn’t produce enough thyroid hormone. This is more prevalent among women. Management through levothyroxine is safe & may bring the value of Thyroid stimulating hormone and thyroxine to normal range but the increased dosage and continuous medication are cost expensive and make the patient into drug dependent till the end of mortal life. So, better, therapy is needed for the society through the heritage of Ayurveda especially with Shodhana therapy. Aim of Clinico-comparative study was to evaluate and compare the efficacy of Lashuna siddha Tailpana Poorvak Vamana Karma and Nityavirechana by Gomutra Haritaki in the management of Hypothyroidism. Study was conducted at Govt. Akhandanada Ayurvedic hospital, Ahmedabad, Gujarat. This study was Open labelled parallel randomized control trial. 15 patients were treated with Lashuna siddha Tailpana Poorvak Vamana Karma in group A. 15 patients was treated with Nitya Virechana by Gomutra Haritaki in group B. Washout period was 14 days. Triiodothyronine and thyroxine were compared at the end of treatment by paired t-test and Mann Whitney-U test. Lashuna siddha Tailpana Poorvak Vamana Karma was more beneficial than Nitya Virechana by Gomutra Haritaki. Insignificant difference was found on subjective and objective parameters (Weight gain, Basal metabolic rate, Serum triiodothyronine) but significance difference found on objective parameters (Thyroid stimulating hormone, Serum thyroxine).

Copper and Iron Status in Myelodysplastic Syndromes.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4593-4593
Author(s):  
Zoi Saouli ◽  
Zisis Kontoninas ◽  
Fotios Girtovitis ◽  
Georgia Kaiafa ◽  
George Ntaios ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Iron Overload ◽  
Copper Deficiency ◽  
Iron Status ◽  
Mean Value ◽  
Normal Range ◽  
Flame Atomic Absorption ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Introduction: Copper is an essential mineral found in many tissues. It is involved in iron incorporation into hemoglobin, hemolytic syndromes, while copper deficiency provokes iron overload and induces dysplastic changes to erythrocytes. On the other hand, there are references that iron overload can result in mild copper deficiency. There seems to be equivocal relationship between these two elements. Aim: The aim of this study is to determine copper and iron status in myelodysplastic patients and to investigate if copper deficiency correlates with the type of myelodysplastic syndrome. Materials and methods: We studied 52 patients with myelodysplastic syndrome, 29 men and 23 women(mean age 67,05± years). No other simultaneous disease was confirmed which could contribute to copper disorders. Patients were categorized in two groups. Group A, composed of 21 patients frequently transfused(approximately once monthly), suffering from RAEB, RAEB-t AND CMML. Group B included 31 patients, who either didn’t often need transfusion, or responded to erythropoietin, suffering from RA and RARS. Copper, iron and ferritin levels measurments were performed. Copper was measured by flame atomic absorption spectrometry (normal range: 0,8–1,3mg/l). Results: Nine patients of group A revealed copper deficiency(mean value 0,66±0,06mg/L). Mean copper value was 0,8±0,11mg/L for that group. All of them had elevated iron levels (average:602,23±160,46μg/dl) and high ferritin levels(average:1769±693,85ng/ml) All group B patients were found to have normal copper levels(Mean value was 1,15±0,09), indicating a statistically significant difference compared to group A patients(p<0,0001). Iron and ferritin levels were within normal range(average105,22±28,63 and 82,9±28,42 respectively) Conclusions: Copper levels, in multitransfused patients with poor prognosis myelodysplastic syndrome and iron overload, are significantly lower than in oligotransfused ones with good prognosis who consequently present normal iron burden.

scholarly journals Changes in Semen, Hormonal profile and Testicular Morphology of West African Dwarf Goat Bucks treated with Danazol

2020 ◽  
Vol 8 (12) ◽  
pp. 2570-2573
Author(s):  
Lukman Oladimeji Raji ◽  
Mohammed Babashani ◽  
Ganiyu Jimoh Akorede ◽  
Aishat O Olatunji ◽  
Fatima Sanusi ◽  
...  
Keyword(s):  
West African ◽  
Normal Range ◽  
Hormonal Profile ◽  
West African Dwarf ◽  
West African Dwarf Goat ◽  
Semen Characteristics ◽  
Testicular Morphology ◽  
Group A ◽  
Mass Activity ◽  
Group B

This study was carried out to investigate the changes in semen characteristics, hormonal profile and testicular morphometry of West African Dwarf (WAD) goat bucks treated with danazol. For this purpose, eighteen matured WAD bucks average of about two years were randomly divided into groups A, B and C comprising of six bucks per group. Group A was the control while B and C bucks were given danazol at a dose rate of 20mg/kg body weight orally daily for four weeks. The group B bucks’ testes were harvested thereafter for gross and histo-morphometric studies while those of group C were left intact but danazol treatment was withdrawn for four more weeks. The bucks’ semen samples (collected by electro-ejaculation) and hormonal samples (taken via the jugular vein) were analyzed. The semen characteristics studied included color, volume, mass activity, motility, percentage normal live-dead ratio, morphology and concentration; while the hormones studied included testosterone, follicle stimulating hormone and luteinizing hormone. Results show that there were significant decreases in semen characteristics of group B and C bucks compared with those of group A in the first four weeks. The semen characteristics of the group C bucks were reversed to normal range (similar to those of group A bucks) two weeks after danazol treatment was withdrawn. Similar results were observed with the hormonal studies. In conclusion, danazol caused a reversed reduction in sperm cells characteristics suggesting its possible use as a contraceptive in WAD goat bucks.

scholarly journals The Impact of Complex Preoperative Preparation of Patients with Aortic Heart Diseases on the Level of Postoperative Anemia

2020 ◽  
pp. 37-42
Author(s):  
B. M. Gumeniuk ◽  
V. V. Popov ◽  
A. K. Logutov ◽  
E. V. Aksenov
Keyword(s):  
Surgical Treatment ◽  
Serum Iron ◽  
Heart Diseases ◽  
Heart Defects ◽  
Intervention Group ◽  
Artificial Circulation ◽  
Normal Range ◽  
Group A ◽  
Group B ◽  
The Impact

In patients undergoing surgical treatment of aortic heart defects under artificial circulation, pre-operative correction of serum iron levels, and application of blood-saving techniques during surgery reduce the level of postoperative anemia. The aim. To investigate the combined influence of preoperative correction of serum iron levels and blood-saving techniques in the early postoperative anemia in the surgical treatment of aortic heart defects under artificial circulation. Material and methods. This study involves 133 patients with acquired aortic heart diseases undergoing surgical treatment under artificial circulation and aims at identifying the combined effect of preoperative correction of serum iron (III) hydroxide levels and blood-saving techniques on the level of postoperative anemia. The levels of iron, transport enzymes, blood corpuscles, Hb and Ht were investigated. All the patients were divided into 3 groups. Group A (control group) included 52 patients in whom iron levels were within the normal range and donated blood components were used during the intervention. Group B (study group) included 43 patients in whom iron levels were within the normal range and blood-saving techniques were used during the intervention. Group C (adjustment group) included 38 patients with low iron levels and anemia, which was interpreted as anemia of chronic disease (ACD). Preoperative correction of serum iron levels and intraoperative blood-saving techniques were applied in this group. Results. For the purpose of perioperative anemia correction, transfusion of 539.8 ± 9.1 ml (p¤0.05) of packed red blood cells and 582.4 ± 77.2 ml (p¤0.05) of fresh frozen plasma was given in Group A patients. In the Group B, the use of blood-saving techniques during the intervention allowed us to obtain good clinical effect without perioperative transfusion of blood products. It was established that in Group C preoperative correction of serum iron enabled to achieve 5.6 times higher level of serum iron (p¤0.05), 2 times higher transferrin saturation, and 7.3 times higher ferritin activity (p¤0.05), as well as increase preoperative Hb level by 9.5 % and decrease postoperative anemia by 8.7 %. Conclusions. Correction of low baseline serum iron in patients with chronic anemia (ACD) provides 5.6 times increase in preoperative serum iron (SI) (p¤0.05), increases hemoglobin by 9.5% (p¤0.05), and reduces the level of postoperative anemia in patients undergoing surgical treatment of aortic heart defects under artificial circulation with the use of blood-saving techniques and without the use of donor blood and Cell Saver.

Hyperemia prior to acute brain swelling during rewarming of patients who have been treated with moderate hypothermia for severe head injuries

2003 ◽  
Vol 98 (4) ◽  
pp. 793-799 ◽  
Author(s):  
Koji Iida ◽  
Kaoru Kurisu ◽  
Kazunori Arita ◽  
Minako Ohtani
Keyword(s):  
Head Injuries ◽  
Mean Flow ◽  
Brain Swelling ◽  
Normal Range ◽  
Content Type ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Flow Velocity ◽  
Fine Print

Object. The goal of this study was to elucidate the optimal time for rewarming of patients who have been treated with hypothermia for severe head injury. Methods. Eleven patients with severe head injuries who had been treated by hypothermia underwent transcranial Doppler (TCD) ultrasonography examinations. The patients were divided into two groups: Group A consisted of three patients in whom acute brain swelling occurred during the rewarming period and Group B was composed of eight patients who displayed no significant intracranial hypertension during or after hypothermia therapy. In all patients, the mean flow velocity of the middle cerebral artery (FVMCA) recorded transcranially and the mean flow velocity of the internal carotid artery (FVICA), recorded high in the neck, were monitored at 24-hour intervals after the patient was admitted to the hospital. In Group A, the FVMCA was normal at 48 hours (maintenance state of hypothermia) in each patient, and abnormal increases and peak values (> 100 cm/second) occurred from 96 to 144 hours postinjury (rewarming period). The FVICA, which was monitored concurrently also varied as the FVMCA increased. The pulsatility indices in the arteries decreased at the time of the peak FVMCA. The enhanced FVMCA was consistent with hyperemia because of the low FVMCA/FVICA ratios (< 3). Two patients in whom jugular venous oxygen saturation was monitored were found to have high values (> 80%), representing hyperemia. All intracranial pressures (ICPs) that lay within the normal range at 48 hours postinjury elevated acutely after the peak FVMCA. In Group B, both FVMCA and FVICA values were normal at 48 hours postinjury and remained stable throughout the rewarming period. Values of ICP were also maintained within the normal range until the patients were weaned from hypothermia therapy. Conclusions. Hyperemia, detectable by TCD ultrasonography, may serve as an index in the prediction of acute brain swelling, and rewarming should be terminated when such a hemodynamic phenomenon is observed.

scholarly journals Predictive Factors for Postoperative Severe Hypocalcaemia after Parathyroidectomy for Primary Hyperparathyroidism

2012 ◽  
Vol 78 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Nicola Crea ◽  
Giacomo Pata ◽  
Claudio Casella ◽  
Carlo Cappelli ◽  
Bruno Salerni
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Predictive Factors ◽  
Clinical Symptoms ◽  
Several Variables ◽  
Group A ◽  
Group B ◽  
Intraoperative Parathyroid Hormone ◽  
Severe Hypocalcaemia ◽  
Postoperative Hypocalcaemia

Hypocalcaemia is a complication of parathyroidectomy. We retrospectively analyzed data on patients who underwent parathyroidectomy for primary hyperparathyroidism (pHPT) to identify predictive factors for severe postoperative hypocalcaemia. Since 2004 we performed 87 parathyroidectomies for pHPT. We divided the patients into two groups: subjects who presented with postoperative hypocalcaemia (group B) or otherwise (group A). We looked for a correlation between several variables and the incidence of postoperative hypocalcaemia. The median calcemia in group B (19 patients) was 6.9 mg/dL on the first postoperative day and 7.6 mg/dL on the third day. We observed hypocalcemia related clinical symptoms in every patient. In all 19 cases the reduction of intraoperative parathyroid hormone above 85 per cent after parathyroidectomy was related to the development of severe postoperative hypocalcaemia ( P = 0.042). We found that the reduction of intraoperative parathyroid hormone over 85 per cent after parathyroidectomy can be considered a reliable predictive factor of postoperative hypocalcaemia after parathyroidectomy for primary hyperparathyroidism.

LT4-monopreparation versus LT4- LT3-compound preparation in the treatment of diffuse endemic goitre

1986 ◽  
Vol 113 (2) ◽  
pp. 242-248 ◽  
Author(s):  
H. Bongers ◽  
L. A. Hotze ◽  
R. Schmitz ◽  
K. Joseph
Keyword(s):  
Thyroid Volume ◽  
Serum Levels ◽  
Double Blind Study ◽  
Endemic Goitre ◽  
Weak Correlation ◽  
Normal Range ◽  
Double Blind ◽  
Blood Samples ◽  
Group A ◽  
Group B

Abstract. Fifty-four patients with diffuse non-toxic goitre were observed before and under therapy either with 125 μg LT4 (group A) or 75 μg LT4 + 15 μg LT3 (group B) in a prospective double blind study, using 1-, 3- and 6-months controls. Changes in goitre size have been estimated by ultrasonic scanning. Both treatment forms provided a significant reduction of goitre size, even after 1 month of therapy: a 20%-decrease in group A and 16% in group B. The 6-month reduction was about 30% in group A and 27% in group B. Between the 2 groups there were no differences in the reduction of volume. The suppression of the TSH-response to TRH was identical in both groups, too. In group A there was a predominant increase of the TT4-and FT4-serum levels, both reaching the hyperthyroid range. In group B there was a predominant increase of the TT3- and FT3-serum levels and a slight increase of the FT4-levels. The TT3- and FT3-serum levels also exceeded the upper normal range. As the blood samples were drawn about 2 h after medication, acute hormone resorption influenced these data. In the 3-month controls only there was a significant correlation between the reduction of the thyroid volume and the suppression of TSH-release. In the 6-month controls we found a weak correlation of the reduction of volume and the decrease of the pertechnetate uptake value. No correlation was found between the relative changes of FT3- and FT4-serum levels and the reduction of goitre size. There were no indications of possible side effects in group A or B during treatment. So this study showed the compared treatment forms to be equivalent in the therapy of diffuse non-toxic goitre, both yielding excellent results.

Gastric Diffuse Large B-Cell Lymphoma: Analyses of Prognostic Factors and Value of Pretreatment FDG-PET Scan.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3703-3703
Author(s):  
Dai Chihara ◽  
Yasuhiro Oki ◽  
Shouji Ine ◽  
Hiroshi Onoda ◽  
Harumi Kato ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Pet Scan ◽  
Stage I ◽  
Normal Range ◽  
Limited Disease ◽  
Group A ◽  
Group B ◽  
Lower Limit Of Normal

Abstract Abstract 3703 Poster Board III-639 Background Up to 40% of patients with DLBCL present with extranodal involvement of lymphoma, among which stomach is a common site. Patients with gastric DLBCL are generally treated with chemotherapy with or without radiotherapy similar to other DLBCL, but the disease may carry specific biological features. We herein present our experience with gastric DLBCL, and attempted to identify potential prognostic factors. Furthermore, the value of pretreatment PET scan was analyzed in this population, since CT scan is generally not sensitive in detecting gastrointestinal lesions. Methods We reviewed patients with gastric DLBCL treated with CHOP or R-CHOP based therapy in Aichi Cancer Center Hospital from 1995 to 2008. Multiple characteristics were evaluated for their prognostic values for complete response rate (CRR), overall survival (OS) and progression free survival (PFS). We also calculated the sensitivity of PET scan in detection of gastric involvement of lymphoma. Results Seventy-five patients with gastric DLBCL were identified and analyzed. The median age of patients was 66 (range 21-87). Thirty-five patients (47%) had Lugano stage I or II1, defined here as limited disease. International prognostic index (IPI) was low in 39 patients (52%), low-intermediate in 17 (23%), high-intermediate in 7 (9%) and high in 12 (16%). The CRR after initial treatment was 83%, and 5-year overall survival (OS) rate was 72% (median follow up duration was 32months). In 35 patients with limited disease, 25 patients (71%) underwent three courses of CHOP or R-CHOP followed by involved field radiation. Eight patients (23%) underwent gastrectomy (curative intent [n=6], control of bleeding [n=1] or obstruction [n=1],) followed by CHOP or R-CHOP. Two of those with limited disease (avoided radiation due to large primary lesion [n=2]) and all with advanced stage (Lugano II2 or IV; n=40) were treated with 6 to 8 cycles of CHOP with or without rituximab. Multivariate analysis with logistic regression model for CRR revealed that rituximab (odds ratio [OR] 0.1, p=0.007), Hb>12.0g/dl (OR 0.11, p=0.004) were independently associated with higher CRR. Multivariate analysis with Cox proportional hazard model for OS revealed that treatment without rituximab (hazard ratio [HR] 3.27, p=0.027), Hb<12.0g/dl (HR 4.06, p=0.006), and serum albumin level < lower limit of normal range (HR 3.43, p=0.023) were independently associated with shorter OS. An analysis for PFS revealed that treatment without rituximab (HR 2.73, p=0.03), advanced stage (HR 3.36, p=0.006), Hb<12.0g/dl (HR 3.61, p=0.004), and serum albumin level < lower limit of normal range (HR 2.96, p=0.021) were independently associated with shorter PFS. In the initial work up of patients with newly diagnosed DLBCL in general, upper gastrointestinal endoscopy has been a part of staging studies in our institution. PET scan was introduced as a part of pretreatment staging studies in 2003. Gastric lymphoma was diagnosed by gastroscopy performed for screening purposes or digestive symptoms (i.e. DLBCL was diagnosed by biopsy of gastric tumor, group A) in 52 patients (69%), by gastroscopy performed as a part of staging evaluations for proven lymphoma by biopsies of other site in 17 patients (23%, group B) and the diagnostic process was not well documented in 6 (8%). Twenty-two patients in group A underwent pretreatment PET scans, among which five did not show any abnormalities (sensitivity 77%). All these 5 had small stage I disease originally detected by screening gastroscopy. Eleven patients in group B underwent pretreatment PET scan, which all showed gastric lesions (sensitivity: 100%). Conclusions We showed the survival benefit of rituximab in gastric DLBCL. Furthermore, hemoglobin and albumin levels were determined to be potential prognostic factors in these patients. While PET scan seems reasonably sensitive to detect gastric involvement of lymphoma as a part of staging evaluation, small stage I gastric DLBCL can be missed by PET scan. Larger scale studies are needed to validate the prognostic factors identified here, and more data is needed to determine the value of pretreatment PET scan in this patient group. Disclosures: No relevant conflicts of interest to declare.

Predictive Factors for Treatment Failure after Peritoneovenous Shunt for Hepatic Ascites

2017 ◽  
Vol 83 (11) ◽  
pp. 1289-1293
Author(s):  
Hiroya Iida ◽  
Tsukasa Aihara ◽  
Shinichi Ikuta ◽  
Naoki Yamanaka
Keyword(s):  
Predictive Factors ◽  
Independent Predictor ◽  
Laboratory Data ◽  
Refractory Ascites ◽  
Peritoneovenous Shunt ◽  
Venous Tumor Thrombus ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Death Group

Peritoneovenous shunt (PVS) is used to treat refractory ascites. Here, we identify predictive factors for inhospital death after PVS placement. Thirty-five patients with refractory ascites related to liver cirrhosis and/or hepatocellular carcinoma (HCC) who underwent PVS placement between February 2005 and February 2013 were included in the study. Group A comprised 13 patients for whom the PVS placement outcome was inhospital death. Group B comprised 22 patients who were discharged after PVS placement without complications. Patient background and laboratory data were analyzed to identify risk factors for inhospital death. HCC prevalence in Groups A and B was 92 and 55 per cent, respectively (P = 0.02) and that of portal venous tumor thrombus (PVTT) was 54 and 9 per cent, respectively (P = 0.003). The mean des-γ-carboxy prothrombin (DCP) level in both groups was 15,553 ± 49,330 and 787 ± 2600 mAU/mL, respectively (P = 0.009). Multivariate analysis revealed that the presence of PVTT was the only independent predictor of inhospital death (P = 0.007). The presence of PVTT, HCC, and elevated des-γ-carboxy prothrombin levels are predictors of inhospital death after PVS placement. Therefore, PVS should not be used to treat refractory ascites in patients with these predictors, particularly with PVTT.

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