Sven Roland Kjellberg

The diagnosis of mitral insufficiency

Abstract When the clinical findings and the left-heart catheterization suggest a dominating mitral insufficiency we can perform an angiocardiography by injection of contrast medium through the needle into the left atrium in order to visualize the mitral valves. By this method it is possible to prove the diagnosis of a mitral insufficiency and avoid an exploratory cardiotomy.

Congenital Valvular Formations in the Urethra

It is evident that the congenital formation of valves within the urethra are relatively uncommon, but none the less, it is very important to know about them, as they are often directly dangerous to life especially in the case of newly born children. As a rule, these valves appear in the posterior part of the urethra, usually in close association with the colliculus. As their etiology is considered as being due to some disturbance during development, a short resume of the development of the urethra will be given here. At a very early stage in the development of the fetus, the entodermal cloaca is divided by the urorectal fold into a ventral urogenital duct and a dorsal anal duct, the rectum. The urogenital duct forms the common origin of the bladder, the urethra and the urogenital sinus. Into this open both of the primary urinary ducts, known as the Wolffian ducts. By degrees the inferior parts of the Wolffian ducts expand more and more until they form a part of the posterior wall of the urogenital duct (see Fig. I). At this stage of development the definite ureters will open directly into the urogenital duct. In the meantime, the partition between the openings of the ureters and those of the Wolffian ducts develops. This causes the openings of the ureters to project in a cephalic direction and those of the Wolffian ducts to project in a caudal direction. Gradually a slight constriction will be observed within the upper part of the urogenital duct which demarcates the border line between the bladder and the prospective urethra. Subsequently the origin of the bladder grows rapidly in size whilst the primary urethra remains narrow and short. The upper margin of the urethra lies against the above mentioned constriction whilst the lower edge lies at the opening of the Wolffian ducts. That part of the