Ahaustral colonic segment following trauma: a possible sign of seromuscular tear.

Although traumatic seromuscular tears of the colon are often managed conservatively, it is pertinent to detect the tear since it poses a risk for acute or delayed perforation. Unfortunately, clinical findings are inadequate for detecting and monitoring this lesion. Therefore, this complication has not been recognized prior to laporatomy. We have noted that an ahaustral colonic segment following trauma may be a potential marker for seromuscular tear.

Micro-flowcell conductometric sweat analysis for cystic fibrosis diagnosis.

This paper describes a device specifically designed to facilitate neonatal sweat testing. The components are sized appropriately for attachment to the limbs of newborns. Iontophoretic electrodes, with pilocarpine gel inserts, are latched into small holders attached by straps to the limb. The holder at the anodic site remains in place to receive and align the sensor cell, which uses a conical collecting surface to channel the sweat directly and anaerobically from the sweat ducts to the continuous flow-through conductivity cell within its body. A crib-side analysis unit incorporates an iontophoretic power supply and displays a continuous readout of sweat electrical conductivity. The average conductivity during a specific time interval and the initial sweating rate are automatically displayed. The method, which simplifies sweat tests, is currently being assessed in three neonatal clinical trials to test its ability to reduce test failures in the newborn due to insufficient sweat.

Laboratory diagnosis of cystic fibrosis.

The demonstration of abnormally high concentrations of electrolytes in eccrine sweat is still the only practical laboratory procedure available for diagnosis of cystic fibrosis. Properly performed, the sweat test is very reliable, but there are many published reports that all of the methods in current use frequently generate incorrect diagnoses. Analysis of potential for error in sweat test methods shows that of the three essential phases involved, stimulation, collection, and analysis, the major cause of intrinsic inaccuracy occurs in the collection process. In this case the problem is due to condensate formation, which leads to the subsequent analysis of nonrepresentative sweat. Human error is also an important cause of false results and is a direct function of the number of critical manual operations involved in the technic. This review provides a critical examination of sweat test methods, identifying problem areas and suggesting ways to improve procedures in the interests of clinically reliable laboratory data in support of diagnosis.

New approach to cystic fibrosis diagnosis by use of an improved sweat-induction/collection system and osmometry.

A comprehensive equipment system is described that induces, collects, and analyzes sweat as a diagnostic procedure for cystic fibrosis. The safety and convenience of the iontophoretic induction phase have been improved by specially designed circuitry and electrodes. The problem of potentially serious error as a result of condensation within sweat-collection cups has been eliminated by use of a thermostatically controlled heated cup. The osmolality of the collected sweat is measured with a vapor-pressure osmometer. Data are presented to support the validity of osmolality as an alternative to electrolyte assay or electrical conductivity measurement and normal and abnormal ranges are provided. The complete system was tested in a pediatric hospital and data are presented to illustrate the relative advantages of the system with respect to safety, convenience, diagnostic reliability, and decreased potential for human error.