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This paper utilizes the Soviet Interview Project (SIP) and the 1990 U.S. census to identify and to track a sample of Soviet emigres. After examining basic descriptive statistics on income mobility, we specify and estimate earnings functions to examine the impact of a variety of explanatory factors on household earnings in the Soviet Union and in the United States. We find that while the household income of emigres from the Soviet Union increased, the degree of inequality increased significantly as did the share of this population experiencing poverty as defined by U.S. poverty norms.

Background Gastric outlet obstruction secondary to chronic duodenal ulceration is an indication for surgery as conservative management with balloon dilatation frequently fails. The standard operation is truncal vagotomy and a drainage procedure. However, development of minimally invasive surgery has revolutionized the surgical approach to this clinical problem. Methods Twelve male patients with pyloric stenosis secondary to duodenal ulceration underwent laparoscopic truncal vagotomy and gastrojejunostomy. The perioperative and long term outcome of this group of patients were analyzed. Results The median operating time was 210 (range 180 to 240) minutes. Median postoperative stay was 6 (range 4 to 41) days. Conversion to laparotomy was necessary in one patient. Delayed gastric emptying occurred in two patients but resolved on conservative measures. At a median postoperative followup of 6 (range 1 to 12) months all patients had a good symptomatic outcome (Visick grades I or II). Conclusions Laparoscopic truncal vagotomy and gastrojejunostomy is a feasible technique. Intermediate followup shows good symptomatic results when used for pyloric stenosis.

This paper analyses Russian city growth during the command and transition eras. Our main focus is on understanding the extent to which market forces are replacing command forces, and the resulting changes in Russian city growth patterns. We examine net migration rates for a sample of 171 medium and large cities for the period 1960 through 2002. We conclude that while the declining net migration rate was reversed during the first half of the 1990s, restrictions continued to matter during the early years of transition in the sense that net migration rates were lower in the restricted than in the unrestricted cities. This pattern seemingly came to an end in the late 1990s.

1David Geffen School of Medicine at UCLA and CURE Digestive Diseases Research Center, Los Angeles, CA, USA; 2Glasgow Royal Infirmary, Glasgow, UK; 3AstraZeneca RD 4Division of Gastroenterology, McGill University Health Center, Montreal, Canada; 5Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; 6Medizinische Klinik und Poliklinik II, University of Leipzig, Leipzig, Germany; 7Institute of Digestive Diseases, Chinese University of Hong Kong, Shatin, Hong Kong, China

Background: Endostasis for ulcer hemorrhage is of proven benefit. However, the best treatment for failed endostasis is uncertain. Further attempts at endostasis or surgery are associated with high mortality. The decision to procede to surgery is difficult when severe comorbidity is present. In high risk patients with failed endostasis there may be a role for cyanoacrylate glue injection. Aim: to evaluate cyanoacrylate glue injection in emergency endoscopy for ulcer bleeding when conventional methods of endostasis fail. Patients & methods: A retrospective study of 255 patients who underwent emergency endoscopy for bleeding gastric and duodenal ulcers between April 1996 and September 1999. Initial techniques for hemostasis included epinephrine 1:10,000 and heater probe application. Additional treatment with cyanoacrylate glue was performed in 20 patients (7.84%) in a further attempt to obtain hemostasis as surgical intervention was considered high risk. Results: Of the 20 patients, 12 were male, 8 were female and the median age was 68.5 years (range 33-97 years). There were 13 duodenal ulcers and 7 gastric ulcers. Prior to presentation, 17 patients (85%) were A.S.A. physical status scale ≤3. 15% (n=3) were hospitalised for other reasons prior to bleeding. Initial hemostasis was successful in 17 patients (85%), 3 patients proceeded directly to surgery, one died on day 4. One patient had an early re-bleed (within 24 hours of glue injection) and died 7 days after surgery. Delayed re-bleeding (>24 hours after glue injection) occurred in 3 patients (days 2,3,&9), one died 5 days after surgery, an active decision to withhold further treatment was made in the other 2 and both died. Therefore 5 deaths (25%) were related to bleeding. Four patients died of causes unrelated to further bleeding (days 3,4,7, & 9). Overall mortality was 45% (n=9), Discussion: When traditional methods of endoscopic hemostasis fails, patients usually require surgery. When surgery is considered very high risk cyanoacrylate glue is successful in obtaining initial hemostasis in 85% of patients where epinephrine and heater probe therapy have failed. Delayed re-bleeding after initial successful hemostasis was relatively uncommon (15%). The high mortality in these patients reflect their age and co-morbidity as only high risk patients for surgical intervention were treated with glue injection. Conclusion: Cyanoacrylate tissue glue may have a role to play in the endostasis of bleeding ulcers in conjunction with conventional methods of hemostasis.