Atrioventricular junctional parasystole with ventricular fusion beats due to complicating Wolff-Parkinson-White syndrome.

We present a case of atrioventricular (AV) junctional parasystole manifesting with ventricular fusion beats due to the presence of an accessory AV conduction pathway. Ventricular fusion beats are usually impossible in AV junctional parasystole. In the reported case the ventricular fusion occurs because the ectopic AV junctional impulse is conducted through the His bundle, whereas the sinus impulse is conducted to the ventricles through the Kent bundle.

Normal haematological reference values in the adult black population of the Witwatersrand.

Normal haematological reference values for healthy adult blacks residing on the Witwatersrand are given. The haemoglobin concentration was 13.95 +/- 0.8 g/dl for women and 15.82 +/- 1.05 g/dl for men. Leucocyte counts were lower than those found in whites, being 5.60 +/- 1.51 X 10(9)/l for both sexes. Platelet counts were 280 +/- 59.4 X 10(9)/l for men and 317 +/- 64.0 X 10(9)/l for women. The differential counts and other parameters are given in the text.

Sarcoid dactylitis in black South African patients.

Six black South Africans with sarcoid dactylitis are described. By the term sarcoid dactylitis we mean sarcoid involvement of the bone and soft tissue of the fingers. Three of the six patients developed dactylitis during the course of chronic sarcoid. These patients had multisystem disease. In all three patients dactylitis developed after the diagnosis of sarcoid was established. However, in the other three patients dactylitis was the presenting feature of sarcoidosis, and none of these patients had evidence of chronic fibrotic sarcoid elsewhere. This finding is at variance with the observation that bony sarcoid is always a feature of chronic, poor prognosis, fibrotic sarcoid of all organ systems; these patients may form a sub-group with bony involvement and good prognosis. The significance, however, of this latter localized presentation of sarcoid is that clinically and histologically it is easily confused with tuberculoid leprosy and has been misdiagnosed.

Myocardial infarction in an intensive care unit for blacks. A review over 6 years.

Ischaemic heart disease seems to be on the increase in South African Blacks, and medical staff should be more conscious of this. Fifty-four Black patients with acute myocardial infarction are presented and their complications and management while in an intensive care unit reviewed. Epidemiological aspects of ischaemic heart disease in South Africa are discussed.

Cushing's syndrome and pregnancy: a case report.

The literature on Cushing's syndrome associated with pregnancy is reviewed, and a case of this rare association is reported. The patient had an adrenal adenoma. Investigations and interpretation of stimulation and suppression tests are discussed. Cortisol metabolism in normal pregnancy is referred to.

Malignant hepatoma with disappearance of alpha-fetoproteinaemia after hemihepatectomy: a case report.

A 62-year-old Black man was found to have a malignant hepatoma localized to the right lobe of the liver but multicentric in origin. Alpha-fetoprotein (AFP) was found to be present in the serum, but, after a right hemi-hepatectomy, it was no longer detectable. The implications are discussed.

Perforated duodenal ulcer in Black patients.

Sixteen cases of perforated duodenal ulcer in Black patients admitted to Tembisa Hospital during a 1-year period are reviewed. They constitute 0,4% of all surgical admissions. Duodenal ulcer has been considered a rare disease in South African Blacks, but we believe that the incidence is increasing in Black urban populations. The literature is reviewed and possible aetiological factors are discussed.