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Duplication of an atrio-ventricular valve is a rare anomaly. In most instances the double, or even triple, atrio-ventricular orifice is on the left sidethe so-called "double mitral valve" (Hartmann, 1937; Wimsatt and Lewis, 1948;Schraft and Lisa, 1950;Prior, 1953; Wigle, 1957;Pachaly and Schultz, 1962;Edwards et al., 1965). Only exceptional cases of "double tricuspid valve" have been described (Sinapius, 1954;Pachaly and Schultz, 1962;Neufeld et al., 1960;Edwards et al., 1965). Another is reported here and a second is briefly reported.Case Reports Case 1. This 11-month-old boy had been deeply cyanosed from birth and was subject to frequent cyanotic attacks. On examination he was an underdeveloped child with central cyanosis and slight clubbing. A coarse systolic thrill was felt over the praecordium, associated with a grade 5/6 pansystolic murmur, with its maximum intensity in the mitral and tricuspid areas. There was also an early diastolic triple rhythm; the second sound was single.The electrocardiogram showed gross right atrial and ventricular hypertrophy patterns, with right axis deviation. The chest x-ray film showed an extremely large, globular heart with ischemic lung fields. The blood count showed no polycythemia or other abnormality.The electrocardiographic picture was thought to exclude tricuspid atresia or Ebstein's disease. Pulmonary atresia, with an intact ventricular septum and tricuspid incompetence, seemed the most likely diagnosis. The patient's condition was very poor, with daily cyanotic attacks, and the possibility of surgical relief was considered. Angiocardiography was, therefore, performed. The catheter entered the right atrium which was shown to be enormously dilated, occupying more than half the cardiac silhouette, and then passed to the left atrium and ventricle; it could not be manipulated into the right ventricle. An injection of opaque medium into the left ventricle showed an intact ventricular septum, mild 94:mitral incompetence (probably produced by the presence of the catheter), and a small atrial septal defect, possibly a foramen ovale. A Brock procedure for pulmonary valve dilatation was performed (G. Rabago) and an atretic or near atretic valve was opened to give an outlet to the right ventricular outflow tract. The immediate result was good, with relief of cyanosis, but the child died suddenly 24 hours later with cardiac arrest.Necropsy was limited to the heart. It weighed 110 g. Externally there was a very large right atrium but the ventricles and great vessels appeared normal. The right atrial wall was hypertrophied, and there was a small ostium secundum septal defect. The tricuspid valve, from its atrial aspect ( Figure A) presented two orifices, one anterior and the other lateral, with its medial half occupied by a rigid diaphragmatic septal cusp. Between the two orifices there was a fibrous band from the middle of the septal cusp to the lateral border of the fibrous annulus. The anterior orifice was roughly triangular, about 1-5 cm. across; its anterior edge had a normal...

The work concerns the monitoring of the technical condition of metro trains. For this purpose, a vibration monitoring system installed in buildings in the vicinity of the underground is used. Based on measured vibrations buildings, the identification of technical condition in metro trains is conducted. The results of measurements from the system are also used to assess the impact of vibrations on people staying in buildings through the WODL ratio. Exceeding the assumed levels of the WODL ratio is the basis for repairing trains by turning wheels. Statistical analysis of the data was implemented and trends for particular time periods of measurements were shown. With the entered monitoring system and the introduced WODL index thresholds, it is possible to better plan the costs associated with the repair and replacement of wheels of rolling stock, where there are large values of radial runout. According to the introduced monitoring procedure, the number of complaints from residents decreased and the comfort of their lives improved.

Correctly indicated non-operative management or surgery changes the natural history of these pathologies. The aim of treatment is to resolve pain in adolescence, as it risks becoming chronic and disabling by adulthood.