Fetal heterotaxy with tricuspid atresia, pulmonary atresia, and isomerism of the right atrial appendages at 22 weeks.

We report the accurate prenatal diagnosis at 22 weeks gestation of right atrial isomerism in association with tricuspid atresia. Several distinctive sonographic features of isomerism of the right atrial appendages were present in this fetus: complex cardiac abnormality, ventriculoarterial discordance, juxtaposition of the aorta and the inferior vena cava to the right side, pulmonary atresia, and anomalous pulmonary venous return to the morphological right atrium. Tricuspid atresia, which is an extremely rare lesion within heterotaxy spectrum disorders, was present. Postnatal investigations confirmed all prenatally diagnosed abnormalities, with additional findings of pulmonary atresia with discontinuous pulmonary arteries and bilateral arterial ducts, asplenia, and bilateral eparterial bronchi. To our knowledge, tricuspid atresia in the setting of isomerism of the right atrial appendages has not previously been diagnosed or reported prenatally. Because of the complexity of cardiac lesions that may be present in cases of atrial isomerism, these disorders should be considered even if sonographic findings are uncommon or atypical

3. Manorialism

Parallel to the military and political system called feudalism, and acting as the foundation, was an economic system known as manorialism. The two systems were distinct and could exist without each other, but they were often linked by the fact that a vassal generally be received as a fief, the lordship of one or more small, self-sufficient farming villages called manors. Although the typical manor never existed, and although the manorial system was not found in southern Europe and in the Celtic countries, the general features of this system as it prevailed in the feudal Europe of the eleventh century can be broadly sketched. [excerpt

6. Ian T. Ramsey

In view of the requirement of verifiability that is demanded by certain philosophical schools, there seems little justification for what are conventionally recognized as theological statements. Certainly no one man has yet succeeded, except perhaps to his own satisfaction, in expressing religious notions in such language and in verifying by such a method that universal consent is gained for the validity of his system. If the charm of empirical verification is not invoked, then for some minds there is little reason to say anything. Obviously, given such rigid requirements for securing a sympathetic audience, theological discussion may find itself standing tongue-tied in the wings while logic and empiricism dominate the stage. But faced with the possibility of the eventual demise of theology, an effort is made to translate religious experience into intellectual terms which are acceptable to these critics. [excerpt

2. An Agricultural Revolution

While capitalism was making rapid strides toward dominating English industry, changes were taking place in agriculture which made it more efficient and productive, and which prepared it to be fitted eventually into the industrial capitalistic pattern. Actually, changes in the direction had been occurring in English agriculture since the revival of trade discussed in earlier chapters. [excerpt

5. The Search for Meaning

It is possible to draw certain parallels between the West\u27s present predicament and similar periods of radical change and the dislocation of values, and so to suggest that this sort of thing has happened before, that man has always come our of such situations and landed on his feet, that history is basically cyclical, and that there is no need to be unduly alarmed about our contemporary situation. While it is possible to make a very convincing case for this argument, there are three major factors which are new today. Thanks to our past territorial expansion and new techniques of communication, there is no area of the Western World whose ideas and institutions have been unchanged, Today\u27s changes are immediately carried to all parts of the world. Thus there are no longer any isolated areas to which people can go to escape change and its consequences. Also, thanks to the same means no classes in society are immune from these changes. Whereas in earlier centuries such changes affected only minority groups and limited areas, now they affect all groups and all areas. And further, as we have already noted, this combination of factors, plus the size of our institutions and their competition with one another, have served to increase the rate of change. These three new factors have helped to make our contemporary crisis both more widespread and penetrating than the others which Western Civilization has experienced. [excerpt

3. Soren Kierkegaard and Karl Barth

Soren Kierkegaard (1813-1855) seldom left his native city, Copenhagen, and, except for two brief visits to Berlin, never left Denmark. The externals of his life were rather ordinary for the son of a wealthy hosier. He always employed at least one servant and dressed in the best of fashion, but his death found him with the last of his income in his pocket. He was a lonely man seeking only one or two intimate friends, passing the daily pleasantries with everyone, but warding off with his masterful use of irony most of those who tried to befriend him. When he asked for and received the ridicule of a local scandal journal, his slightly twisted frame — he had an injury of the spine — became his trade mark because of the journal\u27s cartoons. [excerpt

7. Jerusalem: St. Augustine

Perhaps no individual after Paul exercised an influence on t he history of Christianity comparable to that of Augustine (354- 430). Beyond a doubt the greatest of the Latin Church fathers, he lived during the years when the formative period of the Christian Church was drawing to its close. By the time of his death, the polity, the doctrine, and many of the practices which the Western Church was to carry into the Middle Ages were already clearly recognizable, if not finally set. It was the contribution of Augustine, during the last half of a long and eventful life, to sharpen, expound, and expand upon so many different aspects of the Christian faith and in such a convincing (though sometimes inconsistent) way that there was no significant restatement of Roman Catholic doctrine for more than eight hundred years after his death. When the early Protestants of the sixteenth century wished to return to what they held to be true Christianity, they did so through Augustine. [excerpt

8. The Gothic Cathedral

The Gothic cathedral, like the Summa of Aquinas, the University of Paris, and the Christendom of Innocent III, stands as one of the major expressions of the spirit of the High Middle Ages. The word Gothic, coined by the Renaissance as a term of disparagement, has come recently to have more favorable and appreciative connotations. Such a reevaluation may be due not only to the better perspective that a longer period of time offers us, but also to a deeper understanding of the cultural role of artistic and spiritual symbolism. The artistic expression of the Middle Ages found its supreme embodiment in the architecture of the Gothic cathedral. [excerpt

7. The Making of France as a National State

The west Frankish kingdom of Charles the Bald, which he had received in 843 as his portion of his grandfather\u27s great empire, is geographically the genesis of modern France. In the century of disorder and confusion following the partition of Charlemagne\u27s realm into three kingdoms, government fell into the hands of powerful vassals. From the first, therefore, great lords in France exercised the functions of independent rulers. In 987 they chose one of the weaker of their number, Hugh Capet (987-996), to be king. He and his successors faced two great problems in establishing nationhood in France: how to recover and unite the territories by wrestling control of the land from the great barons; and how to create and develop an effective central government. [excerpt

1. International Anarchy (1900-1918)

It is probable that most people, if asked to list the characteristics of the Western World in this century, would place at or near the top of their list something about international rivalries. Curiously enough, a similar poll conducted in Europe and North America in 1900 would likely have given equal prominence to the idea that the world had entered a period of increasing international amity. [excerpt