A minicomputer approach to consultation-liaison data basing: Pedagog-Admin-CLINFO

Minicomputer systems have been designed for researchers who have no prior computer experience and, therefore, require no computer training, that is, programming knowledge. Such systems allow immediate access to the data, their retrieval, reduction, and analysis, and the retention of direct control over the data base by the researcher. In addition, CLINFO offers a wide range of calculations and statistical procedures. The three-dimensional, time-oriented data-base format of CLINFO allows for a longitudinal study of a particular variable, and its repeated measure over time in the same patient. This system has been adapted for use in the consultation-liaison setting to provide pedagogic, research, and administrative functions from a field-tested data base.     

Rheumatoid arthritis and schizophrenia: Are they mutually exclusive?

The relationship between schizophrenia and rheumatoid arthritis has been explored in a number of studies. It has been claimed that the two disorders are mutually exclusive. Review of the literature indicates that the two conditions seldom coexist. The underlying mechanisms responsible for the infrequent coexistence of schizophrenia and rheumatoid arthritis are far from clear. However, various hypotheses have been proposed to explain the negative correlation between the two diseases.     

Operative treatment of chronic recurrent pancreatitis

Six patients with recurrent chronic pancreatitis are described. In each case, with one exception, the patients had severe pain with a good medical regimen and abstinence from alcohol. All were treated with ablation of the celiac ganglia, vagotomy, and either a gastric drainage procedure (four patients) or antrectomy and gastrojejunostomy (two patients). In five of the six cases, relief of abdominal pain was achieved during a follow-up period of one month to two years. In two cases, detailed studies of serum and urine amylase and serum lipase values were carried out preoperatively while the patients were on a good medical regimen and again postoperatively. These indicated elevated levels of both enzymes preoperatively with a fall to normal levels postoperatively. There were no deaths in this series and only one serious complication.     

Fatal outcome in a child with pseudomembranous colitis.

The clinical and histologic changes occurring with antibiotic-associated pseudomembranous colitis are usually reversible with discontinuation of the causative medication. The spectrum of disease patterns ranges from a benign form to a very fulminant and occasionally fatal one. This report describes a child with a severe form of the disease. Despite recognition and sigmoidoscopic confirmation of this syndrome and cessation of antibiotics, his course continued to deteriorate. Sepsis, leukocytosis, refractory diarrhea, and abdominal distension led to exploratory laparotomy. A proctocolectomy was performed for necrosis of the entire colon; however, the patient died of sepsis.     

Management of a high-risk intestinal anastomosis

An experimental model was utilized to evaluate and compare the function of an exteriorized intestinal anastomosis and an intraperitoneal anastomosis in sixteen animals. No anastomotic leakage occurred and no difference was noted in the microscopic appearance, function, and strength of the anastomoses at seven days. Return of the exteriorized anastomosis to the peritoneal cavity did not result in significant late complications. This technic was then utilized in managing thirty animals with obstructed colons. Sixty-seven per cent of these animals had healing of exteriorized anastomosis; those anastomoses which leaked (33 per cent) were converted to colostomies. No intraperitoneal contamination resulted from leakage of an exteriorized anastomosis.     

Electrophoretic patterns of gamma-glutamyltransferase activity eluted from liver tissue.

Up to three zones of gamma-glutamyltransferase activity were present in 89 samples of human serum after agarose-gel electrophoresis at pH 8.6. Their mobilities relative to albumin were zero, 0.3--0.5, and 0.7--0.9. Incubation of human liver tissue in serum increased the activity of the zones with zero and 0.7--0.9 mobilities, and transiently, of the zone of intermediate mobility. More prolonged incubation caused the intermediate zone to decline, and produced new zones of mobility greater than that of albumin which were not seen in native sera. The mobility of partially-purified liver gamma-glutamyltransferase incubated in serum or protein-free solutions was 0.7--0.8. The intermediate zone was not produced when liver tissue was incubated in protein-free solutions, nor with the purified enzyme in serum or protein-free solutions. The possible relevance of these observations to the electrophoretic patterns of gamma-glutamyltransferase in pathological sera is discussed.     

Ectopic atrial rhythms in the primate

P-wave polarity was studied in small primates during electrical stimulation of both atria. Negative P-waves in Leads II, III, and aV_F were obtained during stimulation of the lower right atrium near the inferior vena cava, the lower anterior left atrium near the inferior pulmonary vein, and the infero-posterior left atrium. The P-R interval was affected inconsistently. These studies confirm findings originally observed in the canine and human heart, and call for caution in making the diagnosis of “coronary rhythm” and “left atrial rhythm.” The term “ectopic atrial rhythm” seems preferable.