apata's remaining contentions do not require extended treatment. It is clear that Unterweser's action in filing its limitation complaint in the District Court in Tampa was, so far as Zapata was concerned, solely a defensive measure made necessary as a response to Zapata's breach of the forum clause of the contract. When the six-month statutory period for filing an action to limit its liability had almost run without the District Court's having ruled on Unterweser's initial motion to dismiss or stay Zapata's action pursuant to the forum clause, Unterweser had no other prudent alternative but to protect itself by filing for limitation of its liability.^[20]Its action in so doing was a direct consequence

20

*20of Zapata's failure to abide by the forum clause of the towage contract. There is no basis on which to conclude that this purely necessary defensive action by Unterweser should preclude it from relying on the forum clause it bargained for.

Question 1

Please explain the mechanism of the mycotic aneurysm in infective

endocarditis.

Question 2

Why are the right valves more commonly affected in infective

endocarditis when the microbes enter through the IV route, for example

with IV drug users?1374

Question 3

You have said that in IV drug users the microbes go directly to the right

ventricle, thus causing endocarditis in the right heart. But in dental

procedures the microbes also go through the veins to the right heart first,

so why are the left heart valves more commonly affected?

Question 4

What causes splenomegaly in infective endocarditis?

Question 5

We know that Janeway lesions appear with infective endocarditis, but is

there any other disease that can cause it?

Question 6

Why are deep-sea divers considered a 'high-risk' group if they have an

atrial septal defect (ASD)?

Question 7

Is it prognostically beneficial to start treatment of impending cor

pulmonale in a case of chronic obstructive pulmonary disease (COPD)

with no symptoms of failing heart but with investigational evidence

(electrocardiogram and chest X-rays)?1384

Question 8

What would be the ideal investigation for a suspected pulmonary

embolism according to the protocol in a UK hospital?

Question 9

Can the apical pulsation in right ventricular enlargement be

hyperdynamic?

Question10

Please explain concentric and eccentric left ventricular hypertrophy.

When the hypertrophied ventricle dilates and the wall thins out, is it still

called a hypertrophied ventricle?