Cyanotic "ostium secundum" atrial septal defect without pulmonary hypertension.

This patient presented with central cyanosis. A clinical diagnosis of atrial septal defect with possible Eisenmenger syndrome was made. The correct diagnosis was made at catheterization.

Chemoprophylaxis with erythromycin stearate or amoxycillin in patients with chronic bronchitis--effects on cellular and humoral immune functions.

Twenty-six patients aged between 27 and 71 years with chronic bronchitis were divided into a control group of 6 and two groups of 10 patients each who received either erythromycin stearate or amoxycillin 1500 mg/d for 2 weeks and 1000 mg/d for 12 weeks thereafter. Immunological function tests were performed before starting chemotherapy and thereafter at 2 weeks and 14 weeks. Clinical evaluations and lung function tests showed no significant changes in any of the groups during the study period. In the control group no changes in cellular and humoral immune functions were noted. In the group receiving amoxycillin decreased responses of lymphocytes to the mitogen phytohaemagglutinin were observed after 14 days. In the erythromycin-treated group, increased polymorphonuclear leucocyte (PMNL) motility and mitogen-induced transformation were observed at 14 days but these increases were not statistically significant. In this group the markedly depressed PMNL migration found in 3 individuals before treatment improved considerably. These results indicate that chemotherapy and chemoprophylaxis with either amoxycillin or erythromycin stearate do not compromise the host immunodefences.

Ventricular septal defect due to blunt chest trauma. A case report.

Blunt chest trauma may cause cardiac trauma, this possibility often being overlooked. Various anatomical structures may be affected. A case of ventricular septal defect due to blunt chest trauma is described and the relevant literature is reviewed.

A job well done--a short history of Dr James Moroka.

James Moroka was one of the first Black South Africans and definitely the first Tswana national to obtain a medical degree. After graduating from Edinburgh University he practised for 58 years as a general practitioner in Thaba 'Nchu. He also played a leading role in the sociopolitical history of his people.

Electrocardiographic and biochemical studies on marathon runners.

The electrocardiographic findings and certain biochemical observations in 48 male runners before and after participation in the Comrades Marathon race are presented. In 21 of the 48 runners electrocardiographic changes consistent with early ischaemic heart disease could be demonstrated before the race. In 2 runners who had normal tracings before the race, abnormalities could be shown after the race. The total serum creatine kinase activity was markedly elevated after the race in the majority of the 23 runners in whom this was measured. In 11 of these subjects, the Marsh-Bender (MB) fraction could be demonstrated after the race. It is concluded that an elevated MB fraction is probably not a reliable index of myocardial damage after strenuous exercise.

[Smokers on Bloemfontein schools: profile and standpoint]. / Rokers in Bloemfonteinse skole: profiele en standpunte.

Primary prevention is now the first priority of research on smoking. A study was made of 1 505 children of 12 high schools situated in a conservative Afrikaans-speaking community in an attempt to determine the characteristics of the smoking and non-smoking groups. Of the total group 16% were smokers. The male/female ratio was 3:1. The mean age at which smoking commenced was 15,5 years. A positive relationship was found between the smoking habits of the smokers and those of their parents and best friends. The majority of pupils think that smoking is addictive. In addition, they believe that it is unhealthy and leads to poor sporting achievements. The great majority of smokers and non-smokers agree that non-smokers do better at school. Fathers of both smokers and non-smokers do not favour the habit. Ninety per cent of the boys and 83% of the girls started smoking between 12 and 18 years of age. The critical age for a preventive programme is thus 11 years.

Evaluation of serum levels during prolonged combination therapy with phenytoin and phenobarbitone.

When phenobarbitone was added to the treatment regimen of epileptic patients who received phenytoin only, the serum levels of phenytoin increased significantly within 6 weeks. Eleven weeks after the introduction of phenobarbitone, phenytoin levels had returned to those existing before phenobarbitone therapy. In view of possible complex pharmacokinetic interactions which might occur when phenobarbitone is added to a regimen of phenytoin, or vice versa, frequent measurement of serum drug levels appears to be indicated for up to 10 weeks after effecting a change in treatment. During this period a constant change in serum levels could be expected, resulting either in toxicity or lack of efficacy.

[Cycling, fitness and the prevention of ischemic heart disease]. / Fietsry, Fiksheid en die voorkoming van iskemiese hartsiekts.

A short review of the prevalence of ischaemic heart disease in South African Whites is given, and primary prevention, which entails an alteration in life style, is emphasised. The role of increased physical activity in primary prevention is discussed. Any programme to increase the fitness status of a population based on activities that must be performed outside the daily routine, willhave limited impact. The possible role of cycling is discussed and it is shown that ordinary cycling to work probably causes sufficient stimulation of the cardiovascular system to produce an acceptable standard of physical fitness.