These multiple alterations may be primary or secondary events but, nonetheless, add importantly to the morbidity and mortality of the patients.

Izzy added importantly, cupping her hands to her mouth.

"They 'ad to sign for that 'un." He looked at their faces and added importantly, "'Tes from Lunnon!"

"I'll come pretty soon," said Mary Jane, and then she added importantly, "I have something I want to do first."