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Univentricular heart is a complex cyanotic congenital heart malformation classically repaired during early childhood. Despite correction, a residual risk of infective endocarditis still persists and may be associated with a severe prognosis. We report the case of a 50 year-old woman with a known partially corrected univentricular heart in whom we diagnosed an infective endocarditis with a favorable evolution under antibiotics.

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The angioplasty of native coarcatations of the aorta remains a controversial treatment due to recurrences and the potential risk of aneurysm or of descending aorta dissection during catheterization. The interest of a systematic implantation of an endoprothesis is poorly documented. We report our experience in a small series of 3 patients aged from 7, 28 to 52 years at the moment of the angioplasty of their native aortic coarctation. In all the three cases it corresponded to a "membranous" type, localized a the level of the isthmus without hypoplasia of the aortic arch. All presented a refractory hypertension. One patient presented an intermittent claudication related to a low perfusion of lower limbs. The angioplasty was performed with BIB balloon, associated at the same time with the implantation of a Palmaz P308 stent in two cases and Genesis PG2910P in the last patient. The efficacy was immediate in all the 3 cases with stopping antihypertensive drugs at the very day of the procedure. The immediate results were complicated by a bilateral hematoma of the scarpa in a context of excessive anticoagulation in one patient requiring blood tranfusion. After a follow-up of one, 12 and 21 months, all the 3 patients are asymptomatic without any significant residual hypertension. The control scan of the infant confirmed the absence of re-coarctation. In conclusion, the angioplasty followed by systematic implantation of an endoprosthesis is a safe and effective technique for treating simple forms of native coarctations of the aortic isthmus. It can be proposed as a first line treatment for big infants and adults affected by localized types.

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A method has been developed that enables multiplex amplification and simultaneous typing of the loci D1S80 and amelogenin using discontinuous polyacrylamide gel electrophoresis and silver staining. The protocol is sensitive, simple, rapid, and relatively inexpensive. The results of the multiplex analysis of the D1S80 and amelogenin loci were comparable to those obtained when each locus was analyzed individually. A small validation study was undertaken to evaluate the forensic applicability of this multiplex system. The data demonstrate that DNA exposed to a variety of environmental insults yields reliable multiplex typing results.

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Hungarian population data for the loci LDLR, GYPA, HBGG, D7S8, Gc, HLA-DQA1, and D1S80 were generated. The genotype frequency distributions for the loci do not deviate from Hardy Weinberg expectations. Furthermore, there was little evidence for departures from expectations of independence between the loci. Using a test for homogeneity all the loci were similar between two Hungarian population samples and only the HLA-DQA1 locus was statistically different between Hungarians and US Caucasians. There generally would be little forensic differences, whether a Hungarian or a US Caucasian database was used, for estimating multiple locus profile frequencies for the seven PCR-based loci.

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This study investigated the relationships between mineral elements and Prader-Willi syndrome (PWS) and determined which minerals, if any, separated a group of PWS individuals (N = 19) from a non-PWS mentally retarded control group (N = 60). The PWS group had significantly raised hair magnesium levels and significantly lower hair silicon levels than controls. The PWS group was also elevated in hair calcium, magnesium, and copper in relation to laboratory standards, while their hair silicon, chromium, and lithium levels were deficient in relation to laboratory norms. Discriminant function analysis revealed that by using 16 hair minerals subjects could be correctly classified as PWS or non-PWS with 89.5% and 95.0% accuracy, respectively. It is concluded that continuing research is needed to study the relationship between mineral element patterns and PWS.

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This study investigated possible relationships of metal levels and metal combinations with children's visual-motor performance. Hair-metal concentrations of lead, arsenic, methylmercury, cadmium, and aluminum were determined in 69 randomly selected elementary age children. They were also administered the Bender Visual-Motor Gestalt Test. Parents of subjects were interviewed to control for confounding variables that might affect cognitive development. Regression data indicated that increases in aluminum and the interaction of aluminum with lead were significantly related to decreased visual-motor performance. Because metal levels and metal combinations previously thought harmless may be associated with visual-motor deficits, a continuing reexamination of metal poisoning concentrations is needed.

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This study investigated the relationships of metal levels and metal combinations to children's classroom behavior. Hair-metal concentrations of lead, arsenic, mercury, cadmium, and aluminum were determined in 80 randomly selected elementary-age children, who were also rated by their classroom teacher on the Walker Problem Behavior Identification Checklist (WPBIC). Parents were interviewed to control for confounding variables that may have affected behavioral development. Regression analysis indicated that the set of metals was significantly related to increased scores on four of the five WPBIC subscales and on the total scale, with lead being a major contributor to four of the six dependent measures. Metal combinations were significantly related to increased scores on the WPBIC subscales measuring acting-out, disturbed peer relations, and immaturity, and on the total scale. A continuing reexamination of metal poisoning concentrations is needed because metal levels and metal combinations previously thought harmless may be associated with nonadaptive classroom behavior.

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Transoesophageal left atrial pacing was used to reduce 102 episodes of ectopic atrial rhythms (79 common flutters and 23 ectopic tachycardias) in 83 patients (64 men, 19 women) aged 33 to 85 years (average 61 years). Overdrive pacing, at a faster rate than that of the spontaneous rhythm, was delivered via a bipolar pacing catheter introduced nasally and positioned behind the atrium under fluoroscopic and/or electrocardiographic control. Long pulse durations (up to 20 ms) were used to capture the atria with intensities of less than 20 mA for better tolerance. The overall results were: a) conversion to sinus rhythm in 60.8 p. 100 of cases (47 p. 100 directly and 13.8 p. 100 after transient atrial fibrillation), b) atrial fibrillation lasting over 24 hours in 7.8 p. 100 of cases, c) failure (31.4 p. 100) due to non-capture or intolerance (20.6 p. 100) or recurrence of the arrhythmia after transient atrial fibrillation (10.8 p. 100). Atrial flutter is more accessible to pacing than tachycardia (restoration of sinus rhythm in 63.3 p. 100 and 52.2 p. 100, respectively). Arrhythmias in the postoperative period of cardiac surgery, and isolated and recent arrhythmias were more easily converted. Prior antiarrhythmic therapy did not seem to improve results. Fifty per cent of failures of oesophageal pacing were converted to sinus rhythm by endocavitary pacing. These results show that atrial flutter or tachycardia may be successfully treated by oesophageal pacing in over 50 p. 100 of cases without having to use other forms of electrotherapy (endocavitary pacing or cardioversion).

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The effect of flécaïnide (new class I antiarrhythmic) on ventricular rhythm troubles was studied in 24 patients using Holter's method. The following results were obtained. For ventricular tachycardia, two cases of suppression, three cases of distinct reduction in the number and duration of attack and one failure were recorded. For single ventricular extrasystoles, doublets and triplets, nine very good results (80 to 100 per cent reduction of arrhythmia) and four 50 to 80 per cent reductions in ventricular prematurity were obtained. Results were uncertain in two patients as the disappearance of extra-systoles was not followed by relapse after termination of treatment. There were three failures. A twenty-fifth patient was treated with flécaïnide IV followed by oral administration with uncertain results. Undesirable effects are infrequent and are often characterized by sinusal bradycardia. Blurred vision and paraesthesia were encountered. The principal biological parameters remained unchanged.

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This study investigated possible relationships of lead and cadmium levels to childhood visual-perceptual development. Hair-metal concentrations of lead and cadmium were analyzed in 25 children who were having learning problems. They were also administered the Bender Visual-motor Gestalt Test. Lead and cadmium levels correlated significantly and negatively with age-deviations of Bender errors. A continuing reexamination of lead and cadmium levels is needed because levels previously thought harmless may be associated with decrements in childhood visual-perceptual development.

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