The first paper I ever published was probably my best, "Visualisation and measurement of the main bronchi by tomography as an objective indicator of thoracic situs in congenital heart disease." Partridge JB, Scott 0, Deverall PB, Macartney FJ. Circulation 1976;51:188-196. Of course, the idea for it was not mine, it was of Fergus Macartney. He was a brilliant chap, IQ stratospheric, student to consultant in four years. Wouldn't be allowed today. It wedded me to congenital heart disease. The paper itself provided a link between the morphologists' appreciation of atrial and thoracic situs and a practical way of assessing it in life. It helped make sense of the isomerisms. It contained the case below, one of bilateral tracheal bronchi in right isomerism. Conveniently, there was a tomogram of an ordinary case in our series that I could show for comparison, and a physiologist who was studying prostacyclins and the ductus in newborn pigs donated a set of lungs for the bronchogram! The original has long faded and all I have is this scan of the reprint, but it is probably a unique image.
All these years later I now see that I said "trachea" in the legend of fig 11c, instead of "carina"!
Also in this paper was a pair of identical twins, female and in their early thirties. One had presented to us with and ASD and when she had her tomograms she clearly had left isomerism. Although she regarded herself as mildly symptomatic, compared to her sister she was much less energetic. Her sister kindly consented to tomography and was in situs solitus. Presumably the fault in side recognition is not a chromosomal problem. One of these days I will explore the literature on identical twins and see if another pair in the same situation has been discovered.