From 1 January 1983 to 1 January 1989 123 cirrhotic patients with hepatocellular cancer (n = 122) or cholangiocarcinoma (n = 1) were screened using liver function tests, alpha-fetoprotein determination, ultrasonography with biopsy (and in selected cases computed tomography or nuclear magnetic resonance), laparoscopy and angiography, Child-Pugh classification and urea-nitrogen synthesis rate. Twenty-three patients were selected for surgical resection because the tumour was smaller than 5 cm, not centrally located and at least 1 cm away from main structures; there was no evidence of multicentricity or metastatic disease; and the Child-Pugh classification was A or B and the urea-nitrogen synthesis rate at least 6 g/day. Upper gastrointestinal endoscopy was used routinely to identify oesophageal varices which were present in 17 cases; ten patients with a history of variceal haemorrhage (43 per cent) had preoperative endoscopic sclerotherapy. In cases with recurrent haemorrhage, surgery was used to prevent intraoperative and postoperative bleeding. Tumour resection was carried out using controlled hypotension and hepatoduodenal ligament clamping. Twelve bisegmentectomies, ten segmentectomies and one atypical resection were performed. The operative mortality rate was 13 per cent with liver failure and sepsis as the causes of death. The 'recurrence rate' was 26 per cent and the late mortality rate for the whole group up to 1 January 1990 was 30 per cent; 13 patients were still alive. The 12-month survival rate was 77 per cent and after 5 years it was 49 per cent. Thus, surgical resection of small liver tumours is the treatment of choice in this selected group of patients.

estrogens are approximately the same. 4) When administered alone? these estrogens produce no significant change in either carbonic anhydrase titers or Gz 11 ratios of the endometrium. 5 ) The linear relationship with negative slope which is obtained between the logarithmic dose of the estrogens and the endometrial carbonic anhydrase content of the progesterone-treated Clauberg rabbit suggests the usefulness of the carbonic anhydrase method as an assay procedure for anti-progestational activity. 6 ) Comparison of the log-dose-response curves of progesterone with and without estradiol indicates that estrogen may depress reactivity of the endometrium to progesterone rather than neutralize or inactivate progesterone in the body.\Ye have recently isolated a heat stable erythropoietic factor, erythropoietin. and have shown it to be an acidic glycoprotein( 1). Because several workers have suggested that erythropoietin is not a protein (2,3,4) it was of interest to investigate the possibility that this glycoprotein subserves a carrier function. Since dialysis of erythropoietin does not reduce its activity( 5 ) , any 'carried factor' would be firmly bound. Therefore, erythropoietin was submitted to acid hydrolysis and the degradation products studied biologically and qualitatively by chromatography.Materials and methods. Purified erythropoietin was isolated from acidified, boiled plasma filtrates of anemic rabbits by DEAEcellulose ion-exchange chromatography as previously described (1 ) . It was dissolved in distilled water, 3 mg/ml. Five 1 ml aliquots were hydrolyzed in a water bath at 80' C for 1 hour with 5 ml H2S01 in final concentrations *Study supported by Contract with School of Aviation Medicine, U. S. Air Force, and from Eli L a y co. of 0.005 N, 0.01 N, 0.04 N, 0.08 N and 0.10 S respectively. A 1 ml aliquot brought to 5 ml with distilled water was carried through the procedure as a control. The hydrolysates were separately dialyzed in the cold against repeated changes of distilled water for 5 days. The dialysates, concentrated in vacuo, and protein dialysands were lyophilized and stored. Separations of 1 mg of the hydrolyzed protein were carried out on Whatman 3 MM paper a t 5 ma using veronal buffer pH 8.6, ionic strength 0.075. The strips were stained with bromphenol blue. Seven hour descending chromatograms of the dialysates in an ethyl acetate:pyridine:H20 (10:4:3) solvent system ( 6 ) were prepared. A mixture of neuraminic (sialic) acid, d-glucosamine, d-mannose, d-glucose, d-galactose and l-f ucose served as a reference material. After development and drying, the chromatograms were sprayed with aniline hydrogen phthalate reagent (7) and then heated at 110' C for 15 min. One half mg, in 0.9% NaCl, respectively of dialyzed 0.01 N hydrolysate of erythropoietin and in tact erythropoietin were injected subcutaneat JOHNS HOPKINS UNIVERSITY on June 9, 2015 ebm.sagepub.com Downloaded from

Pseudoaneurysm of a visceral artery is a rare, but life-threatening, complication of pancreatitis. Treatment options are operation and/or interventional catheter embolisation.

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