Three dimensional body surface maps provide more information on the gee-spatial distribution of cardiac elactrieal activity. It is hypo thesised that this information could facilitate the diagnosis of acute MI in early cases where standard methods are equivocal. To date these techniques have been confined to the laboratory and have yet to find clinical application. An important first step is the assessment of their diagnostic value among patients with established MI.All 82 consecutive patients admitted to the RVH cardiac unit with first presentation ofchastpaln suggestive of MI were mapped at 24 hours using a Corazonix BSM-32 predieter which measured QRS and STT iso-lntegrals using 32 leads. Of the 82 patients, 57 (69.5%) had an initial diagnostic ECG with subsequent confirmatory enzyme elevation. A further 25 (30.5%) presented with nondiagnostic ECG f'mdings. Fifteen of this group had an MI as confirmed by an increase in cardiac enzymes. For comparative purposes, 54 consols were recruited and mapped, all with normal ECG and no IHD risk factors. A series of discriminant function analyses were performed to assess sensitivity and specificity. Using a subset of the 32 QRS and the 32 STT iso-integralmeasurements, selected by a stepwise forward algorithm, a sensitivity of 94.7% (54/57) and a specificity of 90.7% (49/54) was obtained. When all measurements were analysed together, better results were obtained: sensitivity 10070 (57]57) and specificity 96.3 (42/ 54). In further multivariate analysis, map topography differed significantly (p<< 0.01) between males and females. Separating the data according to sex and using all QRS and sTr iso-integral measurements, 100% specificity and sensitivity resulted. Despite these findings, each of the derived discriminam functions had difficulty in classifying the 25 cases belonging to the possible MI group. The best results obtainable were: a sensitivity of 60% and a specificity of 60%. This suggests that further analysis is required to identify the topography of these patients. MYOGLOBULIN RELEASE AS AN INDICATOR OF REPERFUSION FOLLOWING THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTIONF. Lavin, M. Keane, A. Forde, P, Shah, F. Gannon, K. Daly. Department of Cardiology, University College Hospital, Galway. National Diagnostics Unit, University College, Galway.Myoglobulin (ME) coneentratien time curves were studied as an index of successful reperfusion in acute myocardial infarctien and compared to standard non-invasive indices of reperfusiontime to peak CPK, rapid-ST segment normalization, reperfusion arrhythmias. 18 patients with clinical and electrocardiographic evidence of acute myocardial infarction were studied, of which 12 received thrombulytic therapy. Six patients who received thrombolysis showed signs of early reperfusion -Group A, six patients did not reperfuse -Group B, six did not get thrombolysis -Group C. Group A were shown subsequently angiographically to have patent infarct related arteries. Blood samples were obtained on admission (O hrs.), hourly up to8 hrs. and 8 ho...
No abstract
Ten years ago, in September, 1966, an International Theological Congress was convened in Rome to study the theology of the Second Vatican Council. On the occasion of the Congress, Pope Paul addressed a letter to the participants and also delivered to them a significant discourse in the course of a concluding Audience. In both of these texts, Pope Paul developed an analysis of the role of the theologian in the Church which is still as relevant as it was ten years ago.In his letter, the Pope began by discussing the limits which divine revelation and the unity of the faith imposes upon the freedom of theologians. He then went on:But once these limits are recognised -and they are required by the very dignity of the Word of God, which of its nature is one and is everlasting -there remains an immense field of research where, as the Vatican Council put it, 'it is recognised that all the faithful, clerical and lay, possess a lawful freedom of inquiry and of thought, and the freedom to express their minds humbly and courageously about those matters in which they enjoy competence'. (Gaudium et Spes, 62). It is precisely this lawful freedom which is the basis of progress in theology 1 Freedom is indeed a condition of all genuine progress in theology. But it is not in itself necessarily a guarantee of theological progress. It would be idle to deny that the new freedom given to Catholic theologians in the past ten years has been sometimes abused. Things have been written and said which have been quite simply a disgrace to Catholic theology. It often seems that much of the best work in theology is still being done by men formed in the older tradition and now themselves no longer young. The best fruits of freedom have, in many respects, still to be reaped.The freedom which the Council sought to restore to all the members of the Church, and in particular to theologians, is a freedom in faith, a freedom to serve the believing community in the unity of charity which marks the body of Christ. This freedom calls for a greater sense of responsibility than ever on the part of all members of the Church. As freedom increased, the sense of personal responsibility was required to grow in keeping with it. As control by Church authority over the thinking and practice of Catholics diminished, the taking over by members of the Church, each in their own place and sphere, of personal responsibility for the purity of Catholic teaching and the fidelity of religious observance ought to have increased. When, for example, Church authority ceased to enforce the old regulations about prior 1.
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