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Selected AbstractsAtrial Morphology in Hearts with Congenitally Corrected Transposition of the Great Arteries: Implications for the InterventionistJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2002RAJNISH JUNEJA M.D. Atrial Morphology in Congenitally Corrected Transposition.Introduction: In view of the possible need for septal puncture to ablate left-sided lesions and the occasional difficulty in coronary sinus (CS) cannulation, we investigated relevant anatomic features in the right atrium of hearts with congenitally corrected transposition of the great arteries (ccTGA). Methods and Results: Nine hearts with ccTGA and an intact atrial septum and eight weight-matched normal hearts were examined by studying the "septal" aspect of the right atrium with reference to the oval fossa (OF). The anterior margin was arbitrarily measured as the shortest distance from the OF to the superior mitral/tricuspid annulus. The posterior margin was measured from the OF to the posterior-most edge of the right atrial "septal" surface. The total "septal" surface width was measured at the middle of the OF. The stretched OF dimensions and CS isthmus length were noted. Mann-Whitney test was used to compare absolute and indexed dimensions, i.e.. normalized to total width. The posterior margin in hearts with ccTGA was shorter than in controls (6.3 ± 2.4 mm vs 11 ± 1.9 mm, P < 0.001; normalized margin P = 0.09). The CS isthmus also was significantly shorter (5.3 ± 2.7 mm vs 11.4 ± 2.2 mm, P < 0.001). In two hearts with ccTGA, the CS opening into the right atrium was on the same side of the eustachian valve as the inferior caval vein. Conclusion: The shorter posterior "septal" margin in hearts with ccTGA may increase the risk of exiting the heart while performing septal puncture when pointing the needle posteriorly. The shorter CS isthmus and the abnormal location of the CS opening in some of these hearts are important when contemplating radiofrequency ablation in this area. [source] Leases: are they still not really real?LEGAL STUDIES, Issue 4 2000Michael Harwood This article seeks to show why, historically, the lease/tenancy were viewed as being peripheral to the scheme of land law, not perceived as part of ,real property It suggests that the continued classification today of leases/tenancies as personalty reflects an uncritical perpetuation of this perception, a failure to reappraise their legal status and function in the context of today law and social relations concerned with land. More generally, it touches on a possible need to reappraise many of the underlying, historically derived schemata and structures of today's property law. Finally, as the offer of a small step in the reappraisal of the place of lease/tenancies, it argues that today, in law, they can and should properly be classified (together with freeholds) as part of real property. [source] Hypophosphataemia causing profound cardiac failure after cardiac surgeryANAESTHESIA, Issue 12 2006R. M. Heames Summary We report the case of a patient who developed severe cardiac failure after cardiac surgery and required high-dose inotrope infusion. The patient was found to have significant hypophosphataemia and high insulin requirements immediately after surgery. On giving intravenous phosphate, there was a rapid decrease in inotrope requirement and improved glycaemic control. This occurrence raises questions about the cause of hypophosphataemia after cardiac surgery, the possible need for pre-operative plasma phosphate measurement and whether phosphate replacement should be part of the standard management of postoperative hypophosphataemia. [source] TUMOUR SIZE AS A PREDICTOR OF AXILLARY NODE METASTASES IN PATIENTS WITH BREAST CANCERANZ JOURNAL OF SURGERY, Issue 11 2006Sharon Laura Background: The ability to predict the behaviour of breast cancer from its dimensions allows the clinician to inform a woman about the absolute benefits of adjuvant therapies or further surgery to control her disease. Tumour size and grade are independent predictors of nodal disease. This study aims to generate a tool, using Australian data, allowing surgeons to calculate the probability of axillary lymph node involvement in a preoperative setting. Methods: The histological reports of patients with breast cancer treated in 1995 in New South Wales were examined and tumour size, grade and nodal status recorded. Univariate and multivariate analyses identified predictors of node positivity and, using linear regression analysis, a simple formula to predict nodal involvement was derived. Results: In a 6-month period, 754 women had non-metastatic, unifocal breast cancer treated with surgery and complete axillary dissection and 283 (37.5%) had positive nodes. Tumour size remained an independent predictor of node positivity and the probability (%), y, of nodal involvement may be predicted by the formula y = 1.5 × tumour size (mm) + 7, r = 0.939 and P = 0.001. Conclusions: This paper shows the need to assess the axilla in every patient because even patients with small tumours (0,5 mm) have the possibility of axillary involvement (7,14.5%). Use of this simple formula allows clinicians and patients to make informed decisions about the possible need for a full axillary dissection to reduce the chance of understaging and potentially undertreating a woman's breast cancer. [source] Detecting Interaction Between Random Region and Fixed Age Effects in Disease MappingBIOMETRICS, Issue 1 2001C. B. Dean Summary. The purpose of this article is to draw attention to the possible need for inclusion of interaction effects between regions and age groups in mapping studies. We propose a simple model for including such an interaction in order to develop a test for its significance. The assumption of an absence of such interaction effects is a helpful simplifying one. The measure of relative risk related to a particular region becomes easily and neatly summarized. Indeed, such a test seems warranted because it is anticipated that the simple model, which ignores such interaction, as is in common use, may at times be adequate. The test proposed is a score test and hence only requires fitting the simpler model. We illustrate our approaches using mortality data from British Columbia, Canada, over the 5-year period 1985,1989. For this data, the interaction effect between age groups and regions is quite large and significant. [source] | ||||||||||