[Budd-Chiari syndrome and Vaquez disease: apropos of a case. Results of medical and surgical treatment of Budd-Chiari syndrome]. / Syndrome de Budd-Chiari et maladie de Vaquez: à propos d'un cas. Revue des résultats des traitements médicaux et chirurgicaux du syndrome de Budd-Chiari.

A case is reported of polycythaemia vera associated with Budd-Chiari syndrome. Anticoagulant treatment produced a favorable outcome. A review of the literature prompts the conclusion that in the context of polycythaemia vera surgery does not produce better results than a purely medical approach. We therefore feel that in the type of patient we report, anticoagulation should be maintained for as long as possible.

CSF bicarbonate regulation in respiratory acidosis and alkalosis.

CSF bicarbonate regulation was studied in respiratory acidosis and alkalosis of 4h duration in antsthetized dogs. PCO2, pH, HCO3, ammonia, and lactate in CSF and arterial and safittal sinus bloof were measured when equal volumes of saline or acetazolamide (8 mg) were injected into lateral cerebral ventricles. The brain CO2 dissociation curve was determined at the end of all experiments. CSF and arterial bicarbonate increased 11.8 and 5.9 meg/l, respectively, in acidosis. Acetazolamide limited the rise in CSF bicarbonate to 4.2 meg/l, and prevented the CSF bicarbonate increase associated with hyperammonemia. During alkalosis CSF bicarbonate fell 6.5 meg/l and CSF lactate increased almost 2 meg/l while arterial bicarbonate fell 5.7 meg/l and lactate remained unchanged. Thus plasma bicarbonate changes account for some of the CSF unchanged. Thus plasma bicarbonate changes account for some of the CSF bicarbonate alterations in respiratory acid-base-disturbances. In acidosis additional CSF bicarbonate is formed by the choroid plexus and glial cells on the inner and outer surfaces of the brain--a reaction catalyzed by the locally present carbonic anhydrase. In alkalosis the greater fall in CSF bicarbonate than blood is due to selective brain and CSF lactic acidosis.