Isolated tricuspid valve vegetations and steno-insufficiency in primary antiphospholipid syndrome.

Although cardiac valve disease is frequent in the antiphospholipid syndrome, isolated tricuspid valve pathology is uncommon and tricuspid valve steno-insufficiency with concomitant vegetations in association with primary antiphospholipid syndrome has very rarely been mentioned in the literature. We describe a 54-year-old Indian woman with newly-diagnosed antiphospholipid syndrome and isolated tricuspid valve disease, the nature of which was only discernible by transoesophageal echocardiography. This case report highlights the importance of being aware of antiphospholipid syndrome as the possible underlying diagnosis in isolated organic tricuspid valve disease and the need for transoesophageal echocardiography in such cases.

The mobilization of calcium and bicarbonate by raised concentrations of potassium in the haemolymph of the snail, Helix pomatia.

1. After the concentration of potassium in the haemolymph of Helix pomatia has been raised by the infusion of KCl, it falls approximately exponentially for a time and then tends to rise. The accompanying rise and fall of calcium concentration can be fitted to a simple mathematical model. 2. The mobilization of calcium is accompanied by the generation of bicarbonate in equivalent amounts, without much change in pH or Pco2. 3. There is probably an increased production or retention of carbon dioxide at this time, but the main cause of the changes in calcium and bicarbonate is not respiratory acidosis. 4. The concentration of potassium rises in snalis that have been infused with CaCl2. 5. The adverse responses visible in snails infused with KCl are largely prevented when CaCl2 is infused at the same time. 6. Homeostasis seems to involve the maintenance of a proper balance of calcium and potassium concentrations.