During the 10-year period from 1 January 1975 to 31 December 1984, primary sclerosing cholangitis (PSC) was diagnosed in 45 patients. Twelve of the patients have died (26.7%), 10 of them of causes related to PSC. Inflammatory bowel disease was found in all patients; ulcerative colitis was found in 37, Crohn's disease in 6, and unclassified colitis in 2 patients. Of the patients alive, 27 were submitted to a follow-up study in 1985. At the follow-up examination no general progression of the liver disease, as measured on the basis of clinical examination and levels of transaminases, alkaline phosphatases, and bilirubin, was found. Cholangiographic evaluation in 24 patients showed that the stage of ductal changes progressed from mild to moderate in 3 patients; in the other patients the stage was not altered. Morphologic examination of liver biopsy specimens in patients with a benign clinical course usually showed portal inflammation, fibrosis, and minor signs of piecemeal necrosis, whereas widespread piecemeal necrosis was found in patients who deteriorated and died. The 50% survival since diagnosis of liver disease was calculated to be 17 years in patients with PSC and 50 years in a comparable group among the general population. The estimated survival curve in PSC was displaced to the left, indicating a reduced life expectancy of about 30 years.

Pressure recordings from the central systemic veins, the aorta, the left ventricle, as well as intratracheal pressure, have been obtained during simulated dives of domestic ducks. Upon submersion a conspicuous bradycardia gradually developed. The systemic arterial pressure did not change significantly during the profound bradycardia. There was a distinct increase in the central venous pressure and in the diastolic pressure of the left ventricle. The pressure increase surpassed a concomitant intratracheal pressure rise. The circulation time from the right atrium to the base of the aorta was prolonged four to five times during profound bradycardia. The data suggest that the stroke volume remains unchanged or decreases in spite of an increased filling pressure. The increased transit time through the lungs is suggestive of an increased resistance to flow in the pulmonary bed. The data also indicate an increased resistance to outflow from the larger systemic arteries. It is suggested that a marked change in the activity of the autonomic innervation to the myocardium takes place during submersion.

The low osmolar nonionic contrast medium Omnipaque was used in 5,339 consecutive coronary angiographies and serious complications were registered. Myocardial infarction occurred in 4 patients, of whom 2 died, and ventricular fibrillation in 1. Cerebral embolism occurred in 11 patients, all of whom survived. The results are compared with those of previous series of coronary angiography with high osmolar ionic media. It is concluded that use of the nonionic medium Omnipaque resulted in a significant reduction of the frequency of serious complications.