Internal pancreatic fistulas: pancreatic ascites and pleural effusions

Thirty-four patients seen over a 10-year period with internal pancreatic fistulas are reported. In 22 patients the fistula was into the peritoneal cavity and they presented with pancreatic ascits. In 7 patients the fistula tracked up through the mediastinum into a pleural cavity, and they presented with pancreatic pleural effusions. Five patients presented with both pancreatic ascites and pancreatic pleural effusions. Diagnosis was made by finding a markedly elevated amylase and protein content in the ascitic and pleural fluids. Serum amylase was usually, but not always, elevated. Over one half of the patients had no history of inflammatory pancreatic disease. Initial treatment was non-operative using nasogastric suction, diamox, atropine, and multiple paracenteses or thoracenteses. This was successful in 48% (12/25). If non-operative therapy failed, surgery was performed to drain or resect the internal fistula. Surgery was successful in 82% (14/17). The internal pancreatic fistula was successfully demontrated in most instances by preoperative, operative, or postmortem pancreatography, or by gross observation at the time of surgery.     

Active giant cell arteritis with cerebral involvement. Findings following four years of corticosteroid therapy

A patient had continued active giant cell arteritis proved on biopsy four years after the initial diagnosis of temporal arteritis. The patient had had erythrocyte sedimentation rates within the normal range and had been receiving corticosteroids without interruption for four years. Central nervous system symptoms occurred three and four years after the initial diagnosis.     

HLA types, blood groups, serum protein and red cell enzyme types among Samoans in New Zealand

101 Samoans living in New Zealand, of whom 77 had no known non-Samoan ancestry, have been typed for nine blood group systems, four serum protein and 23 red cell enzyme systems, for haemoglobin variants and antigens at the HLA A nad B loci. The frequencies of genes in these various systems suggest that Samoans fall partly into an island Melanesian-Micronesian pattern, and partly are unique. Their uniqueness is most distinctive for the HLA system.     

The resistance to infection of digestive sutures. Experimental study (author''s transl)

In the antimycin--resistant mutant anar-8 of the fission yeast Schizosaccharomyces pombe (Sch.p.) spontaneous mutants were isolated showing high resistance to the aminoglycoside antibiotic paromomycin. All mutants were resistant to the structurally related antibiotic neomycin. Tetrad analysis, mitotic segregation analysis, and mitotic haploidization revealed extrachromosomal, very likely mitochondrial inheritance. In contrast to the rapid segregation of mitochondrial markers in zygotic clones of Saccharomyces cerevisiae (S.c.) the heteroplasmic state of diploids proved to persist for at least 50 generations after zygote formation. Stationary cultures of the paromomycin-resistant mutants parr-106 and parr-112 contain up to 6% respiratory-deficient mutants, but no reversion to paromomycin-sensitivity was observed among 1700-1800 colonies tested. The ability of mutant anar-8 to produce spontaneously respiratory-deficient mutants could be separated from the antimycin-resistant phenotype of anar-8.     

Paroxysmal atrial tachycardia and frontal lobe tumor

We describe a patient who experienced repeated episodes of paroxysmal atrial tachycardia. He was found to have an epileptogenic focus within the right frontal lobe adjacent to a frontal lobe glioma. Subsequent to excision of the tumor, no further attacks have occurred.