Louis G. Welt, MD: The floor is now open for questions.
Douglas A. K. Black, MD: My question is addressed to Dr. Tyler and concerns the syndrome he delineated which is characterized by a convulsion with a considerable tonic, but negligible clonic component, which was liable to be followed by sudden death from a cardiac arrhythmia. Realizing the difficulties of studying such a syndrome, I would like to ask whether he knows of any electrolyte correlates of this syndrome.
H. Richard Tyler, MD: It's obviously very difficult to make clinical observations in situations like this. I became aware of this syndrome when I went to the record room of our hospital and looked up all the patients with kidney disease who had had convulsions. The first thing that interested me was that 25% of these patients had been considered terminal prior to their convulsive episode. The usual description of their