A marked centrolobular

steatosis was noted in CD154KO mice, with neither visible lobular inflammation nor signs of hepatocyte damage, as assessed by morphological examination, (Fig. 1A). The absence of hepatocyte damage was also shown by serum liver enzyme measurements (Fig. 1B). Furthermore, there were no signs of apoptosis as assessed by caspase-3 immunostaining (Supporting Fig. 1) and terminal deoxynucleotidyl transferase–mediated dUTP nick-end labeling (data not shown). Features were evocative of simple steatosis41 and confirmed by oil red O staining of frozen tissue sections (data not shown) and liver TG measurements (Fig. 1C). These GDC-0068 concentration results identified CD154 as a novel factor interfering with fat processing in the liver. Plasma TG and TG-containing lipoproteins (VLDL) were decreased in CD154KO mice fed an olive oil–rich diet (Fig. 2A and Supporting Table 1). There was a modest and not significant reduction in WT mice, consistent with the absence of increased plasma VLDL-TG following

diets enriched in unsaturated fats.42 We next studied the in vivo plasma TG production rate after VLDL clearance inhibition by Triton WR 1339. As shown in Fig. 2B, CD154KO mice exhibited significantly lower rates of hepatic TG secretion compared with WT mice. These results suggest that the reduced plasma VLDL concentrations in CD154KO mice resulted from an impaired hepatic export of TG-rich lipoproteins. apoB100, a key structural component of VLDL is primarily expressed in the mammalian liver and is essential to VLDL secretion.7, 43 Both WT and CD154KO mice displayed increased liver apoB100 messenger RNA (mRNA) levels when fed see more an olive oil–rich diet with no significant difference between either mouse strain (Fig. 3A). However, apoB100 protein expression was reduced in CD154KO mice compared with WT mice following the olive oil–rich diet (Fig. 3B). mRNA and protein expression of microsomal triglyceride transfer protein (MTTP), which is required for VLDL

assembly and secretion, were not modified for both mouse strains fed the olive oil-rich Ixazomib in vivo diet (Fig. 3C,D). Because steatosis may result from alterations in uptake, synthesis, storage, and/or oxidation of fatty acids in liver, we studied genes involved in these pathways (Table 1). There was no modification of the fatty acid transporters FABP1 and SLC27A1 expression. However, the lipogenic genes ACC, FAS, and SCD-1 were significantly up-regulated in CD154KO mouse livers for animals fed an olive oil–rich diet. The expression of these latter genes relies on the activation of transcription factors such as SREBP-1c. SREBP-1c was indeed activated in the livers of CD154KO mice receiving olive oil (Fig. 3E). SREBP-1c mRNA was also up-regulated, most likely through self-activation of its promoter20 (Fig. 3F). The hepatocyte major lipid droplet-associated protein, ADFP, was up-regulated by the fat diet in both mouse strains.

Microarray analysis revealed that there was little impact on the transcriptome of inoculated leaves compared with controls,

with only 0.22% of genes that were differentially regulated. However, several interesting genes, including a NAC domain–containing protein, an elicitor-responsive protein, involved in ubiquitination, and a glycosyl transferase gene, two transcription factors (TFs) and two unknown genes were up-regulated more than five-fold. Genes for metabolic and cellular components, TFs and defence signalling, such as the mitogen-activated protein kinase cascade, were also significantly induced after Xoo infection. This study provides a genome-wide view Regorafenib research buy of the initial reaction of rice (Y73) to Xoo infection and elucidates some of the genes that may play an important role in disease resistance. “
“A sensitive antiserum is needed for

the detection of Apple stem pitting virus (ASPV), one of the most important latent viruses that infect fruit trees. We have studied many properties of coat protein, such as the antigenic index, α-helix, β-sheet, β-turn, coil structure, hydrophilicity, find more surface probability and flexibility and analysis with several software algorithms. Based on the rules for locating the antigenic epitopes in the regions including β-turns and coil structures with the high hydrophilicity and surface probability, the predicted epitopes were located in the region of amino acid positions 4–18, 100–114, 400–414, respectively. Two linear synthetic peptides (CRGYEEGSRPNQRVLP and CTGGKIGPKPVLSIRK) were prepared and conjugated with carrier protein. The antisera, designated 1468 and 1469, were obtained by immunizing

rabbits. The antibody produced a strong immuno-reaction with the expression product of the ASPV coat protein gene in Escherichia coli. By testing ten apple samples, ASPV could be detected by Protein A Sandwich ELISA using antiserum 1468, but only some positive samples could be detected with antiserum 1469. To our knowledge, this is the first report of the preparation of antiserum to a pome fruit Megestrol Acetate virus using the antigenic epitopes method. “
“Apple chlorotic leaf spot virus (ACLSV), Apple stem pitting virus (ASPV), Apple stem grooving virus (ASGV) and Apple mosaic virus are economically important viruses infecting fruit tree species worldwide. To evaluate the occurrence of these pome fruit viruses in Latvia, a large-scale survey was carried out in 2007. Collected samples were tested for infection by DAS ELISA and multiplex RT-PCR. The accuracy of the detection of the viruses in multiplex RT-PCR was confirmed by sequencing amplified PCR fragments. The results showed a wide occurrence of viruses in apple and pear commercial orchards established from non-tested planting material.

Innate immune responses in IL28B minor patients may have adapted to a different equilibrium compared with that in IL28B major patients. Our data will advance both understanding of the pathogenesis of HCV resistance and the development of new antiviral therapy targeted toward the innate immune system. Additional Supporting Information may be found find more in the online version of this article. “
“Cellular and plasma lipid levels are tightly controlled by complex gene regulatory mechanisms. Elevated plasma lipid content, or hyperlipidemia, is a significant risk factor for cardiovascular morbidity and mortality. MicroRNAs (miRNAs) are posttranscriptional regulators of

gene expression and have emerged as important modulators of lipid homeostasis, but the extent of their Stem Cell Compound Library purchase role has not been systematically investigated. In this study we performed high-throughput small RNA sequencing and detected ≈150 miRNAs in mouse liver.

We then employed an unbiased, in silico strategy to identify miRNA regulatory hubs in lipid metabolism, and miR-27b was identified as the strongest such hub in human and mouse liver. In addition, hepatic miR-27b levels were determined to be sensitive to plasma hyperlipidemia, as evidenced by its ≈3-fold up-regulation in the liver of mice on a high-fat diet (42% calories from fat). Further, we showed in a human hepatocyte cell line (Huh7) that miR-27b regulates the expression (messenger RNA [mRNA] and protein) of several key lipid-metabolism genes, including Angptl3 and Gpam. Finally, we demonstrated that hepatic miR-27b and its target genes are inversely altered in a mouse model of dyslipidemia and atherosclerosis. Conclusion: miR-27b

is responsive to lipid levels and controls multiple genes critical to dyslipidemia. (HEPATOLOGY 2013) Cellular and plasma lipid levels are tightly controlled by complex feed-back and feed-forward mechanisms, which regulate the expression and activity of key metabolic genes1 at both the transcriptional and posttranscriptional levels.2, 3 Dysregulation of lipid metabolism can lead to Levetiracetam hyperlipidemia, a major risk factor for cardiovascular disease.4 Several key processes for regulating cellular and systemic lipid levels have been identified5; however, posttranscriptional mechanisms remain less well characterized. MicroRNAs (miRNAs) are short (≈22 nucleotides) noncoding RNAs that regulate gene expression at the posttranscriptional level.6, 7 They serve as stable plasma biomarkers for various disorders,8 are important factors in the pathogenesis of several diseases,9, 10 and are promising targets of novel therapeutic strategies.11, 12 In regard to lipid metabolic control, miRNAs have recently been found to modulate cholesterol homeostasis.13 In vivo inhibition of a liver-specific miRNA, miR-122, significantly lowers plasma cholesterol levels in both mice and nonhuman primates.

Finally, we used the CAC score as an outcome variable to predict future coronary artery disease in individuals with NAFLD. The suggested relationship between CAC score and coronary artery disease is rational because the CAC score reflects the actual presence and severity of atherosclerosis, whereas risk factors, risk scores, and biomarkers reflects only likelihood of coronary artery disease.38 Some limitations of our study merit comment. First, the cross-sectional design makes it difficult

to determine causal or temporal relationships between NAFLD PLX3397 datasheet and the development of subclinical coronary atherosclerosis. Second, hepatic ultrasonography was used to diagnose NAFLD, and this technique cannot identify fatty infiltration below 30%52 and have intra- VX809 and interobsever variability in making a diagnosis. The advantages of ultrasonography,

however, include its safety, low cost, repeatability, satisfied sensitivity, and specificity.53 Based on these characteristics, ultrasonography is the first-line imaging technique for both clinical practice and epidemiological studies.54 Third, VAT data were not available to all study subjects. Although they are likely representative of the whole study population, the anthropometric and laboratory data of subjects with VAT data may have differed in some way from subjects without VAT data. Fourth, we did not have data on fasting insulin and did not have information on insulin resistance for our cohort due to retrospective design. In addition, FER this study was conducted at health screening centers, which introduces the possibility of selection process. In this largest study conducted to date, patients with NAFLD are at high risk for coronary atherosclerosis

regardless of classical cardiovascular risk factors, especially visceral adiposity. Detection of NAFLD should signal the existence of an increased coronary artery disease risk independent of visceral adiposity. Additional Supporting Information may be found in the online version of this article. “
“With the advent of induced pluripotent stem cell (iPSC) technology, it is now feasible to generate iPSCs with a defined genotype or disease state. When coupled with direct differentiation to a defined lineage, such as hepatic endoderm (HE), iPSCs would revolutionize the way we study human liver biology and generate efficient “off the shelf” models of human liver disease. Here, we show the “proof of concept” that iPSC lines representing both male and female sexes and two ethnic origins can be differentiated to HE at efficiencies of between 70%–90%, using a method mimicking physiological relevant condition. The iPSC-derived HE exhibited hepatic morphology and expressed the hepatic markers albumin and E-cadherin, as assessed by immunohistochemistry.

The time constant, τ, was extrapolated from the data to be approximately 50 seconds. In the frequency domain, this translated to a bandwidth of 0.003 Hz. Therefore, following Nyquist criterion (sampling at least twice the bandwidth of the original signal), the minimal sampling in the active mode to avoid aliasing in the reconstruction of temperature is 0.006 Hz or 166 seconds.[18] To ensure accurate temperature reconstruction in the

active mode, the monitor was programmed to sample every 60 seconds for 5 minutes, before returning to the idle mode. this website The subjective reporting of compliance by the participants in this study served as the control to compare the results of the objective data recorded by the compliance monitor. A Pearson correlation

coefficient was employed to evaluate the relationship between objective and subjective elapsed times. Means and standard deviations of objective and subjective elapsed times were determined along with the percent nightly usage of the test appliance by each participant over the period of time in which he/she was in possession of the appliance. Finally, the percentage of participants reporting various adverse effects while wearing the MRD was examined. By using appropriate sampling rates at transition periods (insertion/removal), usage time can be determined without the need for calibrating

GDC0199 monitors for absolute temperature accuracy. Mathematica Software (Wolfram Research, Champaign, IL) was used to filter the temperature data based on slopes and time constant to extract the objective insertion and removal times (Fig 4A). Filtering the data in this manner is more robust against false positives than filtering Interleukin-3 receptor by a temperature threshold (Fig 4B). Objective usage times by each participant were compared to the times indicated in their treatment journals (Fig 4C). The correlation between subjective times as recorded by the participants and objective times as recorded by the monitor was 0.9985 (Fig 5). The mean objective wearing time, as detected by the compliance monitor, was 6.6 ± 1.6 hours/night. The mean subjective wearing time, as recorded by the participants, was 6.5 ± 1.5 hours/night (Fig 6). The mean usage of the MRD by participants in this study was 68.7%, with a range of 24% to 100% (Fig 7). Table 1 shows the percentage of participants reporting adverse effects while wearing the MRD. Modern processors operate at the lowest power by remaining in a deep sleep mode as long as possible. Awakening a processor to take a data point draws a fixed amount of charge from its power source. In the case of an intraoral monitor, the power source is a battery, which can only carry a certain amount of charge.

Results:  Among the 277 patients, the overall accuracy of EUS and MDCT for T staging was 74.7% and 76.9%, respectively. Among the 141 patients with visualized primary

lesions on MDCT, the overall accuracy of EUS and MDCT Alvelestat mw for T staging was 61.7% and 63.8%, respectively. The overall accuracy for N staging was 66% and 62.8%, respectively. The performance of EUS and MDCT for large lesions and lesions at the cardia and angle had significantly lower accuracy than that of other groups. For EUS, the early gastric cancer lesions with ulcerative changes had significantly lower accuracy than those without ulcerative changes. Conclusions:  For the preoperative assessment of individual T and N staging in patients with gastric cancer, the accuracy of MDCT was close to that of EUS. Both EUS and MDCT are useful complementary modalities for the locoregional staging of gastric cancer. “
“Background and Aim:  Hepatocellular carcinoma (HCC) tends to metastasize to extrahepatic organs. Stomach involvement has been seldom reported and has always been considered as direct invasion. This study aims to propose a possible existing pathway for the hematogenous metastasis of HCC to the stomach. Methods:  Only seven cases with stomach involvement were found from 8267 HCC patients registered at our hospital between 2000 and 2007. Their laboratory data, the findings of computed

tomography and upper endoscopy, therapeutic procedures, such selleck kinase inhibitor as esophageal variceal banding ligation (EVL), and transhepatic arterial embolization (TAE) were further studied.

Results:  All seven patients were male. Liver cirrhosis was found in six patients (6/7 = 85.7%), HCC with portal vein thrombosis (PVT) in six patients (6/7 = 85.7%), splenomegaly in five patients (5/7 = 71.4%) and esophageal varices in five patients (5/7 = 71.4%). Six patients underwent TAE and one patient underwent EVL before the development of HCC in the stomach. Four patients had HCC at the cardia, one patient at the anterior wall of the high body and two patients at the greater curvature of the high body, far away from the original HCC. Morin Hydrate Six patients eventually developed distant metastasis. HCC with gastric metastasis developed 53–126 days after TAE in five patients and 74 days after EVL in one patient. Conclusions:  When cirrhotic patients with portal hypertension have HCC with PVT, a hematogenous pathway can exist for gastric metastasis of tumor thrombi involving hepatofugal flow to the stomach after TAE or EVL apart from the major pathway of direct invasion. “
“Idiopathic portal hypertension (IPH) is a rare cause of intrahepatic portal hypertension. Data on natural history and prognosis of IPH are limited. We sought to describe the complications and long-tem outcome of IPH by retrospectively studying 69 biopsy-proven cases of IPH. Mean duration of follow-up was 6.7 ± 4.6 years. All patients had evidence of portal hypertension (PH) at diagnosis, and 42% were symptomatic.

The mean diameter of the third ventricle was 4.0 mm (SD 1.7 mm), when

measured with MRI, and 4.4 mm (SD 1.7 mm), when measured Temozolomide with TCS. The 95% limits of agreement of the Bland-Altman Plot were 2.93 mm (95% CI 2.08 to 3.78 mm) and −2.23 mm (95%CI −3.08 to −1.38 mm). Pearson correlation coefficient was .71 (P < .0001). TCS may appear suitable as screening examination for the extent of brain atrophy at a single-point study, but at least in the early stages of the disease, TCS is not useful to monitor disease progression. J Neuroimaging 2010;20:53-57. "
“NF2 is an autosomal dominant disorder with neuroectodermal dysplasia. Most patients present with characteristic clinical tumors during or beyond the adolescent age group. The diagnosis is mainly clinical. Vasculopathy is rarely associated with NF2. Vascular complication as the presenting symptom in NF-2

is unknown. We report a case of a 2-year-old child with no prior family history of neurofibromatosis presenting with ataxia and brain-stem stroke. “
“Contrast neurotoxicity (CN) following exposure to iodinated contrast is uncommon, and usually presents as cortical blindness due to bilateral occipital lobe involvement. Unilateral cortical dysfunction due to CN could mimic an acute stroke and has been rarely described. We report the case of an 89-year-old female who developed a transient dense/complete left homonymous-hemianopsia and left-sided Bioactive Compound Library screening tactile extinction after undergoing a right internal carotid (ICA) artery rotational angiogram with a standard high-volume iodinated contrast injection for 3D visualization a 6×4-mm right posterior

communicating artery aneurysm with a fetal posterior Farnesyltransferase cerebral artery (PCA) incorporated in the neck. This was associated with transient fullness and loss of gray-white matter differentiation in the right occipital and parietal lobes. The potential mechanism of CN in our case was the injection of a high volume of contrast in the ICA for the rotational angiogram. The presence of a right fetal PCA possibly allowed the contrast to reach the right occipital lobe. CN manifesting as an acute focal neurologic syndrome should be considered in the setting of recent iodinated contrast exposure. “
“The hallmark radiological finding in metastatic brain disease is multiple enhancing lesions. We report a case of metastatic lung cancer to the brain with a lack of contrast enhancement. We believe that this unusual finding is due to inadvertent “treatment” of the metastases with the antiangiogenic agent bevacizumab (Avastin). “
“We present a case of a symptomatic venous aneurysm that developed in the drainage network of a deep-seated basal ganglia and thalamic arteriovenous malformation. The venous aneurysm was treated selectively with platinum coils using a venous approach. “
“Ganglioneuromas are uncommon, benign, and highly differentiated tumors arising from sympathetic ganglia.

2). Manometry is the most sensitive and accurate technique to diagnose esophageal motility disorders.5,13 While the technique has been available for over 30 years, recent advances in technology have substantially improved its recording power and fidelity. Standard manometry relies on a perfused assembly with 8 ICG-001 in vivo or 16 recording points. However, high-resolution manometry

(HRM) has been developed with up to 36 recording points. This enables pressure measurements of 1 cm or less apart along the entire esophagus, thus providing more detailed mapping of esophageal motor function, including the upper and lower esophageal sphincters.5,13–15 A further advancement in manometry has been the invention of the topographical (or contour, or color) plot, which has largely replaced the traditional line plot (Fig. 3).16,17 The main advantage is more rapid interpretation of results, as it is easier for the human eye to recognize colors rather than lines. The combination of HRM with topography, termed high-resolution esophageal pressure topography,18 allows more precise measurement of esophageal pressures, and has been shown to have superior diagnostic sensitivity for achalasia compared with limited conventional manometry (72% vs 56%).17 However, despite the improved sensitivity of HRM compared with conventional

manometry, http://www.selleckchem.com/products/mitomycin-c.html convincing additional benefit in terms of patient Resveratrol outcome remains to be demonstrated. Overall, manometry, whether it be in the conventional or high-resolution form, remains the most important tool in assessing esophageal motility. It is highly sensitive in detecting pressure changes, correlates reasonably well with bolus transit, and remains the gold-standard test in diagnosing conditions such as achalasia and esophageal spasm.

Scintigraphy is an often forgotten and somewhat superseded test for assessing dysphagia. The main role for the radionuclide transit test is as a screening test to detect an esophageal transit problem. It involves the ingestion of a liquid or solid bolus labeled with a radionuclide such as 99mTc-DTPA, and the radionuclide movement recorded by a gamma camera, capable of measuring esophageal bolus transit time and clearance.19–22 Even though it is reported to have high sensitivity and specificity in detecting esophageal motor abnormalities,20 scintigraphy has a number of disadvantages, including handling of radioactive material and radiation exposure, poor anatomical definition compared with barium swallow, and a lack of well-defined diagnostic criteria. Hence, this technique is rarely used in clinical practice. Until recently, the only method to measure bolus transit in the esophagus was by fluoroscopy or scintigraphy. However, these are unsuitable for routine and repeated use due to exposure to ionizing radiation.

As shown in Fig. 5A, treatment of PLC5 cells with AR42 had no effect on Csn5 expression (input), but led to a concentration-dependent increase in the association of topoIIα with CK2α and Csn5 (right panel), which is noteworthy in that physical interaction with Csn5 is reported to be a prerequisite

for the degradation of its target proteins.27 This increase in the amount of CK2α associated with the Csn5-topoIIα complex paralleled the increase in total cellular CK2α levels in AR42-treated cells. Moreover, the ectopic expression of Csn5 dose-dependently mimicked SAHA HDAC price the suppressive effect of HDAC inhibitors on topoIIα expression (Fig. 5B), whereas siRNA-mediated knockdown of Csn5 protected against the drug-induced down-regulation of topoIIα in AR42- and MS-275-treated PLC5 cells (Fig. 5C). These results are consistent with the putative role of Csn5 in HDAC inhibitor-mediated topoIIα degradation. The Csn complex facilitates the proteasomal degradation of target proteins by functioning as a docking platform for recruitment of the target’s specific kinase and E3 ligase.29 Consequently, we

sought to identify the E3 ligase that targets topoIIα in the Csn5 complex. Csn5 is known to maintain the stability of a number of the F-box proteins of the Skp1-Cul1-F-box-protein family, including Skp2, Fbw7, Fbx4, and Fbx7, as the silencing of Csn5 led to the down-regulation of these F-box proteins.30 Thus, using these Csn5-interacting F-box proteins as candidates for the topoIIα-targeted E3 ligase, we assessed the concentration-dependent effects of AR42 on GSI-IX order the binding of these F-box proteins to topoIIα. The E3 ligase Bmi1 was also assessed in light of a recent report that Bmi1 controlled topoIIα degradation in response to glucose

starvation.31 PLC5 cells exhibited robust expression of Skp2, Fbw7, and Bmi1, but had low abundance of Fbx4 and Fbx7 (Fig. 6A, input). Coimmunoprecipitation revealed a concentration-dependent increase in the binding of Fbw7 to topoIIα Demeclocycline by AR42 (right panel). This AR42-induced association was highly selective because the other F-box proteins were undetectable or present in extremely low levels, relative to Fbw7, in the complex formation with topoIIα. The functional role of Fbw7 as the topoIIα-targeted E3 ligase was further supported by the protective effect of shRNA-mediated knockdown of Fbw7 on AR42- and MS-275-mediated topoIIα ablation (Fig. 6B). Above, we showed that, in addition to Csn5, CK2α also associated with topoIIα in response to AR42 (Fig. 5A). Thus, we hypothesized that phosphorylation of topoIIα by CK2 facilitated the association of topoIIα with the Csn5-Fbw7 complex in AR42-treated cells. Results in support of this hypothesis are shown in Fig. 6C, where the CK2 inhibitor DMAT abrogated the interaction of topoIIα with Csn5 and Fbw7.

SBP was associated with hepatic encephalopathy (HE) in 93(57.7%), Raf inhibitor Variceal bleed (VB) in 16(9.9%), septic shock in 60(37.2%) requiring ventilator support in 47(29.2%) with median hospital stay of 7(range 4-14) days with a high mortality (n=43, 26.7%); predominantly due to sepsis (83.7%), Variceal bleed (11.7%). The predictors

of poor survival were presence of HE, Child-C status, MELD >24, persistence of SBP on D3 and D7, low ascitic fluid glucose <92mg/dl%, culture positivity for ascitic fluid (p<0.05). Reduction in ascitic fluid neutrophil count by 13% on D3, was the only predictor associated with improved survival (p<0.05). Conclusions:- The clinical presentation, advanced liver disease, low ascitic fluid glucose with culture positivity at the baseline and the neutrophil count reduction but not the base line ascitic fluid TLC or reduction at 48hr predict the resolution of SBP and overall outcome. The response tap at 48 hr showing neutrophil ICG-001 cost count reduction by 13% is associated with better outcome Disclosures: The following people have nothing to disclose: Ashok K. Choudhury, Ankur Jindal, Chandan K. Kedarisetty, Tanmay S. Vyas, Ajeet S. Bhadoria, Shiv K. Sarin Purpose : To analyze the impact of TIPS with covered stents on survival of patients with

“severe” portal hypertension compared to a control group treated medically. To assess complications associated with implantation of the TIPS. Material and methods : 344 consecutive patients were hospitalized for decompensated cirrhosis (Child-Pugh B 60% / C 40%) from 01/2008 to 12/2012. Covered stent was implanted in 98 patients for refractory ascites or recurrent gastrointestinal

bleeding. Assessment of median survival (MS) with and without TIPS, MS according to Child-Pugh score and after matching 1:1 (n=130) for age, Child-Pugh score, MELD score, presence of hepatocellular carcinoma HCC, to a control group having a first decompensation. Results :TIPS implantation was successful in 100% of rates. The mean portosystemic pressure gradient decreased from 18.5±4.5 mmHg to 5.8±2.6 mmHg. MS of patients with TIPS (n=98) was 29.4 months [22-38.6] vs. 12.9 months [10.2-18.3] without TIPS (n=246), p=0.0015 ; MS of child-pugh B patients with TIPS (n=69) was 38.6 months [29.4-48.7] vs. 19.1 months [14.1-35.3] without TIPS (n=137), p=0.0183; DNA Synthesis inhibitor MS of child-pugh C patients with TIPS (n=29) was 17.4 months [10.1-25.3] vs. 8 months [6.2-11.2] without TIPS (n=109), p=0.22. TIPS was a prognostic variable associated with survival in univariate analysis (p=0.015). HCC, alcoholic hepatitis were more frequent in patients without TIPS (respectively 31% vs. 8%, p <.0001, 17% vs. 10%, p=0.05). After matching 1:1 for age (61 ±10), Child-Pugh score (B 66%, C 34%), MELD score (17.0±4.2) and presence of HCC (9%), esophageal varices grade 2 or 3 (p=0.003), refractory ascites (p=0.01), an increase in the portosystemic gradient (p=0.