Automatic defibrillation in man: Is it feasible?

Twenty-eight patients who survived multiple arrhythmic cardiac arrest refractory to medical therapy underwent implantation of the automatic defibrillator without additional antiarrhythmic surgery. Lateral thoracotomy was used for implantation in 14 patients and the subxiphoid technique was used in 14. There was no operative mortality and surgical complications were minimal.The longest follow-up was 29 months and the average was 14 months. The implanted device correctly identified and reverted 50 episodes of spontaneous malignant ventricular tachyarrhytthmias in six hospitalized patients. After discharge, 20 episodes of automatic out-of-hospital resuscitations occurred in eight patients.Kaplan-Meier survival curves, based on the assumption that out-of-hospital defibrillations would otherwise have been lethal, indicated an expected 1 year mortality of 60 percent. Seven deaths were in fact observed in this period for an actual mortality rate of 30 percent. We conclude that automatic defibrillation is clearly feasible in man and appears to increase survival in selected high-risk patients.     

Adrenal myelolipomas: CT appearance with tiny amounts of fat and punctate calcification

Five cases of myelolipoma of the adrenal are presented which contained only tiny foci of fat along with areas of punctate calcification. This computed tomographic (CT) appearance is less common for this neoplasm and has only been described in three of 26 previously published CT cases of this adrenal tumor. The presence of even tiny amounts of fat in an adrenal mass should alert the radiologist to the probable diagnosis of myelolipoma. Small foci of calcification are also frequently associated.     

Incidence of stress ulcer formation associated with steroid therapy in various shock states

The use of pharmacologic doses of steroids early in the shock state, within the first hour when possible, for periods of less than forty-eight hours seems to reduce the incidence of gastric ulceration and hemorrhage in low flow states associated with septic, cardiogenic, and hemorrhagic shock.     

Zinc Requirements in Trauma and Inflammation

Delayed response in healing has been reported to be due to deficiencies in the trace mineral, zinc. Though trace elements are generally recognized as important in human nutrition, zinc is only recently receiving attention. The literature is scattered with many articles about zinc's use in trauma and inflammation. This paper is a review of some of the current knowledge of zinc and its use in trauma and inflammation.     

Release of immunoreactive somatostatin in the spinal dorsal horn of the cat

Antibody microprobes were used to investigate the possible release of immunoreactive somatostatin (irSS) within the lumbar spinal cord of anaesthetized cats. A basal release of irSS was detected in the region of the substantia gelatinosa of the dorsal horn. By comparison with in vitro standards the concentration of SS detected in this region was estimated at 10(-7) M. This release of irSS was not significantly altered by electrical stimulation of large myelinated primary afferent fibres but was increased when unmyelinated afferents were additionally stimulated. Release of irSS was also detected at the spinal cord surface. The results support a role for somatostatin in nociceptive transmission in the spinal cord.