ABSTRACT
A 35-year-old Brazilian woman (gravida 4, para 2) was delivered of a severely anaemic child whose cord red blood cells had a strongly positive direct antiglobulin test and who required two exchange transfusions within 24 h of birth. Because of the emergency of the situation and the lack of a local immunohaematology reference laboratory, the phenotype of the mother and the specificity of the relevant antibody could not be determined. Hence, compatible blood was not immediately available and the infant had to be given repeated exchange transfusions with incompatible group 0 Rh-negative blood. The infant is now healthy and thriving. The mother's red cells were subsequently found to lack all the antigens of the Rh system, and her serum reacted with all red cell samples except those of two unrelated Rh(null) individuals. Her serum gave high titres (i.e. 1,024-4,096) by the indirect antiglobulin test against red cells of normal Rh phenotype, as well as against cells with partially deleted Rh phenotypes (titres = 128-512 with -D-/-D- and .D./.D. samples, respectively), and was extremely active in antibody-dependent cell-mediated cytotoxicity and monocyte monolayer assays against red cells of normal Rh phenotypes.
Subject(s)
Erythroblastosis, Fetal/immunology , Rh-Hr Blood-Group System , Adult , Anemia/etiology , Blood Transfusion , Female , Fetal Blood/chemistry , Humans , Infant, Newborn , Pedigree , PregnancyABSTRACT
PURPOSE: To evaluate the predictive value of mitral valve components in percutaneous balloon mitral valvuloplasty (PBMV). METHODS: 53 patients undergoing PBMV were submitted to an echocardiographic analysis of mitral valve in order to note mobility, thickness, calcification of leaflets and subvalvar apparatus (SV). Mitral valve area (VA) before and after PBMV was obtained using continuous wave Doppler. Patients were divided in group 1 (VA enhance inferior to 50%) and 2 (VA enhance equal or superior to 50%) and subgroups A (VA post PBMV inferior to 1.5 sqcm) and B (VA post PBMV equal or superior to 1.5 sqcm). Correlations between the score of each component of mitral valve and the results were established. RESULTS: Concerning to the total score, there was no significant difference between the groups and subgroups. Differences were significant when SV was analysed separately (p less than or equal to 0.001). VA average in patients with SV compromising grade 3 (1.28 +/- 0.26 sqcm) was inferior to those with grade 1 or 2 (p less than or equal to 0.001). CONCLUSION: SV has a higher predictive value in the success of PBMV.
Subject(s)
Catheterization , Echocardiography, Doppler , Mitral Valve Stenosis/therapy , Adolescent , Adult , Aged , Cardiac Catheterization , Female , Humans , Male , Middle Aged , Mitral Valve Stenosis/diagnostic imagingSubject(s)
Echocardiography, Doppler , Fetal Heart/physiology , Adolescent , Adult , Female , Gestational Age , Heart Defects, Congenital/diagnosis , Heart Rate, Fetal , Humans , Maternal Age , Middle Aged , PregnancyABSTRACT
Using the Dürrer electrode needle to record the intramural electrogram and a standard peripheral electrocardiogram (ECG) lead as reference, the authors studied the action of 9 different drugs in the conduction system of dogs. The authors concluded that diphenylhydantoin and lignocaine would be useful in dysrhythmias related to increased excitability and perhaps increased automatism. Ajmaline and quinidine may be some of some interest in dysrhythmias due to conduction disturbances; and, finally, ajmaline, diphenylhydantoin, di-isopyramide and quinidine may be useful in dysrhythmias due to focal re-entry.
