His Bundle Recordings Using Epicardial Pacing Wires: A New Technique

His bundle electrograms were recorded from the epicardial surface of the heart of nine dogs using temporary pacing electrodes. Simultaneous His bundle activity was recorded by the standard endocardial catheter technique. There was a close correlation between the AH times (r = 0.93) and HV times (r = 0.96) using both techniques. This new technique for studying His bundle activity is simple, requires no additional dissection during the performance of open heart surgery, and should be of value in diagnosing conduction system disturbances occurring in the perioperative period.     

Peptides from multiple regions of the lectin domain of P-selectin inhibiting neutrophil adhesion

The selectins are a family of three structurally related glycoproteins that are integral components of leukocyte adhesion to the vascular endothelium. Their involvement in the recruitment and extravasation of neutrophils is critical in mounting an inflammatory reaction. The carbohydrate nature of the selectin ligands suggests that the binding regions of the selectins are contained within the lectin-like domains of the selectins. The synthesis and evaluation for inhibition of selectin binding of overlapping peptides of the lectin and adjacent EGF-like domains of P-selectin have been used to identify small peptides that completely inhibit P-selectin-dependent neutrophil adhesion. These peptides span a region of more than 100 amino acids and may define the carbohydrate recognition domain of P-selectin.     

Community receptivity to a countermeasure designed to reward sober drivers

This paper describes the components and results of a one-yearpilot program in Sudbury, Ontario, Canada, The program incorporatedthe enforcement and education strategies of traditional drinking-drivingcountermeasures, but focussed the intervention on sober drivenstopped at police roadside spot-checks through a social marketingstrategy. Drivers who were randomly stopped for this one yearperiod and had not been drinking were rewarded with an incentiveitem (a plastic licence-folder) by a police officer at the spot-check,to reinforce their compliance with the law. A concurrent mediacampaign with the theme of ‘Thanks for Being a Sober Driver’was also implemented in an attempt to further reinforce thenon-risk behaviour of sober driving. A telephone survey was conducted of a random sample of peopleliving in the municipality to determine community receptivityto this new countermeasure. Respondents overwhelmingly indicatedsupport for the program, felt it was a good idea to thank andacknowledge sober drivers and endorsed the development of asimilar program approach in other communities. Key informantsfrom the police department involved with this program furthersupported this position.     

PERFORATION OF THE BOWEL DURING BARIUM ENEMA REDUCTION OF INTUSSUSCEPTION IN INFANTS

Two cases of extravasation of barium into the peritoneum following the reduction of an intussusception by barium enema are described. Some of the causes and consequences of this unusual complication are discussed.     

Streptococcus mutans in plaque and saliva and the development of caries

Abstract— Plaque samples from 10 different tooth surfaces of 10 schoolchildren with Varied Caries experience (DFS 10-33) were collected five times during 2.5 years. The samples were examined with an immunofluorescent technique for identification and enemeration of Sreptococcus mutans scrotypes C/e/f and d/g. At each sampling occasion the children were scored for caries. A Stimulated saliva sample was also collected and the number of S. mutans per ml salva was determined. The salva level of S. Mutans was Shown to reflect the prevalence and proportion of this microorganism on theselected surfaces. Five surfaces carried S. nutans at each sampling. Four of these surfaces showed progressive caries. S. mutans infection was also found to precede the development of incipient caries on four surfaces. Eighty percent of the surfaces that stayed sound were only transiently carrriers of S. mutans in mainly very low numbers. Serotype c/e/f dominated in prevalence and proportion on the surfaces with a history of caries during the study.     

DISPOSITION OF PROPOFOL IN PATIENTS UNDERGOING SURGERY: A Comparison in Men and Women

The disposition kinetics of propofoi have been determined in12 patients (six female) receiving propof of 2.5 mg kg^–1for induction of anaesthesia, which was maintained with 67%nitrous oxide in oxygen and 1–1.5% halothane. Peripheralblood samples were collected at selected times up to 8 h afterthe injection of the drug, and whole blood propofoi concentrationsdetermined by HPL C with fluorescence detection. Drug concentration–timedata were analysed by the non-linear regression program EL SFIT.This showed the data to be describable by a tri-exponentialequation, corresponding to a three-compartment model. Therewere no differences in the derived kinetic indices for the maleand female patients, with the exception of a greater Vd^ss: Vratio in the males. The terminal half-life in the male patientswas 262 min (SEM 44), and in the female patients 309min(60).Vd^ss was 329 litre (67) and 313 litre (69) in male and femalepatients, respectively. The clearance in both groups was 1.8litre min^–1. Seven out of 12 patients showed significantsecondary peaks in blood propofoi concentration associated withrecovery from anaesthesia.     

Myocardial involvement in systemic lupus erythematosus detected by magnetic resonance imaging

Myocardial involvement in systemic lupus erythematosus is commonlyfound at autopsy but seldom recognized clinically or by routinecardiological investigations. As the magnetic resonance relaxationparameter, Tl, is altered by changes in tissue cellularity,we carried out magnetic resonance imaging in 10 patients withsystemic lupus erythematosus. Five had active systemic lupuserythematosus when assessed using the lupus activity criteriacount. The mean ( ±SD) Tl was 319 ±12 in normal volunteersand 321 ± 10 in a second control group with hypertrophiccardiomyopathy. In the group with systemic lupus erythematosus,there was a higher mean value of 336 ms/vith a wider scatterof individual results (SD±22 ms). In the subgroup ofpatients with active disease, Tl was significantly higher (349± 24) than in either of the two control groups. In addition, there was an inverse correlation between serumcomplement and myocardial Tl in patients with systemic lupuserythematosus. Myocardial abnormalities in systemic lupus erythematosuswere demonstrated by magnetic resonance imaging even where othernon-invasive cardiac investigations were negative. We concludethat Tl calculated from magnetic resonance imaging is oftenabnormal in systemic lupus erythematosus and probably indicatesmyocardial involvement.     

The effects of recent food, alcohol, and tobacco intake and the temporal scheduling of testing on cardiovascular activity at rest and during psychological stress

Participants in cardiovascular psychophysiological studies receive various instructions regarding restraints on alcohol, food, and tobacco intake prior to testing. Further, although the hour of testing is frequently a concern, little attention is paid to month of the year. In the present study, we examined cardiovascular activity at rest and in response to a laboratory stress task in 1,272 men in terms of these variables. Alcohol consumption among alcohol users and food intake within 4 hr of testing were associated with higher baseline diastolic blood pressure (BP) but lower baseline heart rate (HR). Tobacco use in smokers within 1 hr of testing was associated with elevated baseline BP and HR. Hour of testing was related to baseline HR, whereas month of the year was associated with baseline BP. In contrast to these baseline effects, cardiovascular reactions to the laboratory stress task were largely immune to these contextual influences.