Anorexia nervosa in children: a follow-up study

Thirty children seen between 1954 and 1970 with the diagnosis of anorexia nervosa were contacted between five and twenty years after initial treatment. Patients outcomes in terms of education, weight in adulthood, medical problems, marriage, psychiatric treatment, and recurrence of anorexia were surveyed. Results corroborate those of earlier studies suggesting that adjustment in adulthood is related to personality type.     

The role of small bowel follow-through examination in the diagnosis of coeliac disease

A retrospective study of 105 barium follow-through examinations on 102 patients suspected of having malabsorption syndrome has been carried out to assess the usefulness of this technique in the diagnosis of coeliac disease. Comparison with histological and biochemical data has been made. Of the 34 examinations on 31 patients with a proven diagnosis of coeliac disease, 30 examinations showed both abnormal X-ray and biopsy findings, two examinations showed normal X-ray appearance but abnormal jejunal biopsy and two showed normal jejunal histology but abnormal X-ray findings. There were two cases with sensitivity, non-invasive nature, ease and cheapness of the technique, barium follow-through examination is suggested as the initial investigation in patients suspected of coeliac disease.     

Mechanism of production of intestinal secretion by negative luminal pressure

The relationships between luminal hydrostatic pressure and fluid transport by dog jejunum in vivo studied as a sheet in the Wells clamp were compared with quantitative predictions from a model proposed for the mechanism of the secretion produced by elevated venous pressure. According to the model, the secretion produced by increasing venous pressure and the secretion produced by negative luminal pressure are both passive filtrates contingent on a transepithelial pressure of a few centimeters of H2O. We consider that the agreement between the observed and predicted responses to luminal pressure provides strong support for the model. In particular, a) the observations displayed a predicted gross asymmetry in rates of fluid transfer with isotonic fluids depending on whether the luminal pressure was positive or negative; b) the observed magnitude of the negative luminal pressure required for the onset of secretion agreed with predictions; and c) the secretion contained significant amounts of protein at about 25% of the plasma concentration.     

Persistence of thromboxane A2-like material and platelet release-inducing activity in plasma

During the incubation of arachidonic acid with platelet-rich plasma, a persistent activity appeared that caused the release of [14C]5-hydroxytryptamine from indomethacin-treated platelets. By the time-course of its appearance and disappearance, this release-inducing activity could be dissociated from prostaglandin endoperoxides and associated with thromboxane A2-like material. This material persists in plasma because of its continued production and increased stability.     

Relationship between internal calcium and outward current in mammalian ventricular muscle; a mechanism for the control of the action potential duration?

In sheep and calf ventricular bundles, increasing the internal calcium by increasing the frequency of voltage-clamping to plateau range potentials increased the time-independent outward current. This effect was more marked with higher [Ca]o, and was reduced if the Ca current blockers Verapamil or D 600 were used. 2. If the internal Ca was increased by the addition of cyanide and reduction of external sodium the outward current was also increased. The frequency-dependent increase in outward current also occurred in this Na-poor (12 mM) solution. 3. Tension measurement on the ventricular bundles showed that a Na-free solution with cyanide did not cause a contracture. On changing from Tyrode to a Na-free solution containing cyanide, and on changing back to Tyrode there was a potentiation of the twitch. 4. In Na-poor solution with cyanide, although no contracture was found, ECa was less positive, suggesting that under these circumstances Ca accumulates at the inner side of the membrane, but not around the myofibrils. 5. The prolongation of the action potential in Cl-free solution is frequency-dependent. A greater prolongation is seen at lower frequencies suggesting that Cl current is relatively more important for repolarization at lower frequencies of stimulation. 6. It is suggested that calcium at the inner side of the membrane sets the level of the background outward current. A feed-back mechanism on this basis is proposed for the control of the action potential duration. Various factors that could influence this basic mechanism are discussed.     

Analysis of a large pedigree with elliptocytosis, multiple lipomatosis, and biological false-positive serological test for syphilis

Elliptocytosis, multiple lipomatosis, and biological false-postive serological test for syphilis (BFPSTS) were found in a single individual. One hundred eighty relatives were tested for the three diseases: 74 were typed for seven blood group antigens, and 58 were typed for four electrophoretic enzyme markers. Likelihood analysis of the pedigree data confirmed independent dominant inheritance for elliptocytosis and lipomatosis. BFPSTS appears dominant, but the analysis was inconclusive. No linkages were found between any disease gene and any marker gene. Two female pedigree members with BFPSTS developed systemic lupus erythematosus, a finding in agreement with the previously described association. The analysis did not lead to any conclusions about the causal relationship between the two traits.     

Cardiopulmonary effects of intermittent mandatory ventilation

IMV is a combination of spontaneous and mechanical ventilation. For numerous reasons, IMV is potentially more advantageous than conventional techniques. By maintaining spontaneous breathing, mechanical augmentation can be titrated to adjust alveolar minute ventilation levels to normal, thereby decreasing the incidence of respiratory alkalemia. There are major differences between the cardiopulmonary effects of IMV and conventional mechanical ventilation. Spontaneous inspiration decreases Ppl and results in better distribution of inspired gas, a better V/Q, and less physiological dead space. In addition, transmural filling pressures, venous return, and cardiac output are more normal than during conventional mechanical ventilation. Maintenance of spontaneous ventilation lowers mean Paw and pulmonary vascular resistance. If venous admixture occurs, it can be minimized by titrating PEEP. Thus, more effective therapy for hypoxemia is possible. If spontaneous breathing is to persist and be efective, work-of-breathing must be minimized. This can be accomplished best when a continuous flow of gas provides optimal CPAP to maintain FRC and to minimize the effects of decreased compliance without depressing cardiac function.