Complete atrioventricular block, retrograde atrial activation and intra-atrial block

A case of complete atrioventricular block, retrograde atrial activation, and intra-atrial block was reported. Inhomogeneous inhibition of the atrioventricular junction and the so-called summation of impulses may both act together to make retrograde conduction possible when third-degree atrioventricular block was present. In lead 2, P waves were dome-shaped, and in lead V1, P waves were biphasic; narrow and peaked P waves intermittently appeared, denoting third-degree intra-atrial block. The peaked P waves signified that the right atrium was activated while the left atrium was not depolarized.

Survival analysis of T-28 hip arthroplasty with clinical implications

Seventeen years after its introduction, the T-28 and its successor (the TR-28) have proved to be a successful arthroplasty system, with very low long-term socket and femoral loosening rates, especially in older patients. The 10-year revision rate for aseptic loosening of the socket is only 2 per cent. This form of conventional cemented total hip replacement has provided pain relief and improved function in many individuals who have exhausted nonoperative treatment alternatives. Although there are still unsolved long-term problems for the young active patients, cemented hip arthroplasty continues to play an important role in joint replacement, and remains the treatment of choice in older and relatively inactive patients.

Tomography in a juvenile Tillaux fracture

Juvenile Tillaux fractures are Salter-Harris Type III physeal fractures involving the lateral weight-bearing surface of the distal tibia. A recent case demonstrates the usefulness of tomography as an adjunct to routine radiographs as a more accurate means of diagnosing the amount and direction of fracture displacement, a critical factor when treatment decisions are made.

Articular sporotrichosis

Sporotrichosis is a fungal disease caused by Sporothrix schenckii, which is seen worldwide. Infection usually involves cutaneous and subcutaneous tissues. Articular involvement is rare. A 29-year-old man with ankle sporotrichosis is reported to demonstrate the differential diagnosis and treatment.

Epitope diversity of angiotensin II analysed with monoclonal antibodies

The antigenic heterogeneity of angiotensin II (AII) was studied with monoclonal antibodies. Twelve antibodies were produced and characterized. Association constants for AII varied from 1.2 X 10(8) to 1.1 X 10(10) M-1. The fine specificity of the Mab was studied by immunoenzymoassay using solid-phase AII. Using AII analogues in binding inhibition experiments, three groups of specificity could be characterized: (1) five antibodies reacted only with peptides in which phenylalanine is the carboxy terminal aminoacid; for two of these antibodies, tyrosine4 is closely associated with the binding site, since iodine labelling suppresses reactivity; (2) two antibodies also required phenylalanine in position 8, but, in addition, reacted with AI, a decapeptide in which phenylalanine is not terminal; (3) five antibodies reacted with analogues in which phenylalanine had been substituted for another amino acid. In addition, studies in which binding of a biotinylated Mab to solid-phase AII was analysed in the presence of various unlabelled Mab suggest further antigenic heterogeneity of AII.

Network security considerations in BLN

In a heterogeneous computer network, resources on each node are protected by the local security mechanism. Network services allow local resources to be accessed remotely from other nodes. Without appropriate network security measures, each node is vulnerable to attack from the network. This paper analyzes the heterogeneous Bell Labs Network (BLN) environment and lists the potential network security risks. By assessing the risks, counter-measures are proposed for minimizing potential exposure. These counter-measures are part of a global network security mechanism being implemented for BLN.

[Clinical effects in 1136 cases of Beijing silicon rubber IUD and its effect on the endometrium]

Beijing Silicon Rubber IUD was designed by Xuan Wu Hospital and Beijing Silicon Rubber Manufacturing Research Institute in 1980. Animal experiments of the silicon rubber were done, and toxic effect studied before clinical use. 1136 cases were reported at the end of 12 months by 6 hospitals in Beijing. The followup rate was 93.75%. Life table of 12 months showed the cumulative continuation rate of the IUD was 82.45%, pregnancy rate 4.5%, expulsion rate 8.49%, removal for medical cause 3.9%, and removal for personal reasons 0.64%. Among the side effects, menstrual irregularity was 5.03%, blood discharge 6.35%, dysmenorrhea 11.95%, backache 31.1%, and leucorrhea 18.12%. Menstrual blood loss was measured in 30 cases before and after 1, 2, 3 months of insertion. The mean blood loss before insertion was 51.96 ml (51.71 +or- 15.95), while 1 month after insertion it was 62.9 ml (70.59 +or- 26.81), 2 months after insertion 71 ml, and 3 months after insertion 75 ml. The morphological endometrial change as compared with that by induced stainless steel ring is not much heavier especially in regard to glandular and stromal changes. The endometrial cytologic count of white cells of the IUD group (34 cases) in comparison with that of the control group (36 cases) was about twice as much in number. As Moyer reported, the endometrial cell count of IUD cases was about 6-10 times that of control cases. The authors consider that the cellular reaction of this IUD is not much greater than that of other types of IUDs.

Congenital intracardiac band: a rare cause of nonrheumatic combined aortic and mitral regurgitation

A patient had a congenital intracardiac band lying across the aortic valve that caused combined aortic and mitral valvular regurgitation. The band was excised, and the damaged aortic valve was replaced with a prosthesis. The case illustrates that not all congenital intracardiac bands are completely asymptomatic and not all bivalvular incompetence is rheumatic in origin.

Secundum atrial septal defect in the adult: repair using cardiopulmonary bypass in 133 patients

Images