A retrospective study was undertaken to identify recipients of blood from donors subsequently shown to be positive for hepatitis C virus using second-generation tests and polymerase chain reaction. The main aims were to determine the numbers of such recipients who were still alive and traceable, and to determine the risk of infection in this group. The feasibility and workload of this procedure, which is currently not practised in the U.K. or U.S.A., was also assessed. In the first six months of routine testing 42,697 donors were tested. Of 20 confirmed to be HCV-positive, 15 were regular donors. Eighty-three components were prepared from 63 anti-HCV positive previous donations from these donors. In all, nine recipients were found to be alive. All were positive for anti-HCV. We conclude that although this retrospective procedure is time-consuming and difficult, substantial numbers of infected recipients can be identified. The availability of treatment for chronic hepatitis C for such patients should encourage transfusion services to reassess current policies on the hepatitis C retrospective.

No abstract

The following account of a case of cardiac myxoma is offered because of the rarity of British descriptions'of this unusual condition.A woman, aged 29, was admitted to Aberdeen Royal Infirmary on April 17, 1944, as a case of breathlessness of unknown origin for investigation. She had been a waitress for eight years and had been in good health until a year prior to admission. Since then she had suffered from breathlessness on walking, rendering impossible any additional exercise such as climbing stairs. She had associated palpitation and occasional spells of dizziness when trying to hurry. No other symptoms were complained of, and the degree of disability had not increased since its onset.The patient was a healthy looking, well-coloured woman, afebrile, with a regular pulse varying between 68 and 92, and a blood pressure of 108/70. The apex beat of the heart was felt three and a half inches from the mid-line in the fifth left intercostal space. The mitral first sound was accentuated and followed by a high-pitched systolic murmur. The pulmonary second sound was also loud. No mitral diastolic murmur was heard, and none had been heard at the out-patient examination. The day after admission, however, a rough mitral presystolic murmur appeared and remained, the other cardiac findings being as before.Radiological examination showed definite enlargement of the left auricle, slight enlargement of the right auricle, doubtful enlargement of the right ventricle and none of the left. There were no signs of cardiac failure. Accordingly, but not without some misgivings, the condition was diagnosed as mitral stenosis, of rheumatic origin, and the patient was discharged on April 20, with advice to obtain lighter work.On June 20, she was re-admitted with heart failure. She had rested in bed for three weeks after her discharge and had then become a sedentary worker, with a four-hour day. She had felt very breathless at work, and had experienced severe attacks of breathlessness when walking home. After five days she was forced to go to bed, where she remained, more or less constantly breathless at rest, and suffering a steady epigastric pain. About a week before re-admission, she became still more breathless, with paroxysmal nocturnal dyspncea, following a prelude of vague lumbar and generalized pains, shivering, and feverishness.She was distressed, cyanosed, and orthopnceic. The blood pressure was 110/84, the temperature normal, the pulse 112, regular but weaker in volume. The apex beat was now four and a half inches from the mid-line in the fifth space, and on percussion the heart appeared to be enlarged three-quarters of an inch to the right of the sternum. A well-marked rough mitral presystolic murmur and a mitral systolic murmur were present. The superficial neck veins were engorged up to the level of the angle of the jaw, the liver was palpably enlarged and tender, and cedema was present over the sacrum and in the legs; moist sounds were heard at the bases of the lungs. X-ray examination including fluoroscopy of the heart, und...