Comparative Investigation of the Antiarrhythmic Effect of Propafenone (Rytmonorm) and Lidocaine in Patients with Ventricular Arrhythmias during Acute Myocardial Infarction

ABSTRACT Propafenone, a new class I antiarrhythmic drug, given as a bolus injection followed by oral medication, or lidocaine were given to 20 consecutive patients admitted with chest pain suggesting acute myocardial infarction and showing high grades, i.e. multiform, pairs or R-on-T premature ventricular complexes or short runs of ventricular tachycardia. Before institution of therapy the mean number (±1 SD) of premature ventricular contractions (PVCs) per hour was 169±123 in the lidocaine group and 324±440 in the propafenone group. During the next 24 hours lidocaine reduced the numbers of PVCs by 73% and propafenone by 75%. The mean number (±1 SD) of 5-minute periods with high grade PVCs was 4.3±2.9 in the lidocaine group and 5.8±4.5 in the propafenone group. During therapy this number was equally reduced in both groups to 2.4. One patient in the lidocaine group developed ventricular fibrillation and three patients in the propafenone group were excluded because of increasing numbers of PVCs. One patient in the propafenone group showed a torsade-de-pointes ventricular tachycardia.     

Socio-economic versus obstetric risk factors for drug addiction in offspring

Two possible risk factors for drug addiction were weighed against each other: (1) perinatal factors associated with obstetric medication at time of birth; and (2) factors associated with familial socio-economic conditions at time of birth. The subjects comprised 200 amphetamine addicts and 200 opiate addicts born in Stockholm 1945–1966. In a matched case control study, addicts were compared to their siblings with regard to possible obstetric risk factors by means of conditional logistic regression controlling for socio-economic level and civil status. Administration of opiates, barbiturates and nitrous oxide to mothers during labour was associated with drug addiction in offspring, hence confirming results from earlier studies. In a cohort study the risk associated with birth at a given hospital and familial socio-economic level was analysed by means of loglinear analysis using 7100 controls from the general population. For amphetamine addicts, a low socio-economic level at time of birth might be of importance for the infant subsequently becoming an addict. This could not be demonstrated for the opiate addicts. An uneven distribution of births among the hospitals, most pronounced for the amphetamine addicts, is in agreement with the hypothesis that obstetric practices may be risk factors for adult drug addiction.     

QRS Amplitudes,QTc Intervals and ECG Abnormalities in Pheochromocytoma Patients before,during and after Treatment

ABSTRACT QRS amplitudes (S₁ + R₅), Minnesota Code ECG abnormalities and QT_c intervals were analyzed in ECGs from 31 pheochromocytoma patients on admission to hospital, after 17±7.2 (SD) days of preoperative phenoxybenzamine therapy in a dosage of 148± 45.0 (SD) mg/day and after a mean postoperative follow-up of 6 years. QRS voltage decreased significantly from 3.37± 1.48 on admission, to 2.26±0.69 mV at postoperative follow-up (p<0.001). The prevalence of total Minnesota Code changes increased or was unchanged on the different occasions. Severe to moderate changes, however, became less prevalent, while mild changes increased. The QT_c interval was 0.44±0.04 s on admission and 0.41±0.02 s at follow-up (p<0.01). No significant differences were observed during treatment with phenoxybenzamine. Pathological ECGs are common findings in patients with pheochromocytoma and significant improvements occur after surgery. Significant effects of phenoxybenzamine therapy were only found in patients with sustained hypertension.     

EGF-receptors in human normal and pathological thyroid tissue

Expression of the epidermal growth factor receptor (EGFR) was studied in cryosections from human thyroid tissues. Normal tissue (4 cases), nodular goitre (12), toxic goitre (9), adenoma (9), follicular carcinoma (1), papillary carcinoma (7) and poorly differentiated carcinoma (1) were used for immunohistochemistry. Northern blot analysis was performed in two nodular goitres, three adenomas, two papillary carcinomas, one follicular carcinoma and the adjacent normal tissue in five cases as well as in two cell lines from anaplastic carcinomas. Epidermal growth factor receptor immunoreactivity was detected in all tissues examined. The amount of EGFR mRNA did not differ between normal and abnormal tissues. However, the EGFR staining was weaker in normal thyroid tissue compared to the adjacent neoplastic areas suggesting an upregulation at the posttranslational level in the latter. A strong staining was also seen in hyperfunctioning thyroid glands. The EGFR location was mainly basal or basolateral in all thyroid tissues with normal histology and in toxic diffuse goitre. Pericellular and sometimes cytoplasmatic staining was seen in neoplastic tissues. In nodular goitre the staining was both basal, lateral and apical and varied in intensity. Our data suggest that a non-polarized location of EGFR probably indicates a loss of the normal epithelial cell polarity and could be interpreted as an early sign of dedifferentiation. Furthermore, a role for the EGFR is proposed, not only in the development of thyroid neoplasias but also in goitre formation.     

Phagocytosis following Translocation of the Neutrophil b-Cytochrome from the Specific Granule to the Plasma Membrane is Associated with an Increased Leakage of Reactive Oxygen Species

The effect of neutrophil b-cytochrome translocation on the respiratory burst activation generated during phagocytosis of yeast particles was investigated. Secretion of neutrophil specific granules was induced by the calcium ionophore ionomycin prior to phagocytosis. The secretory process is associated with a translocation from the specific granules to the plasma membrane of the respiratory burst b-cytochrome. Respiratory burst activity was measured as release of hydrogen peroxide in the absence of azide (extracellular leakage) and in the presence of azide (total production). The subcellular localization of the b-cytochrome was found to affect the extracellular release of hydrogen peroxide in that a plasma membrane localization was associated with a significantly increased release during phagocytosis. It should be pointed out, however, that most of the hydrogen peroxide, both in control and in ionomycin-treated cells, is produced intracellularly, probably in the phagosomes.     

Decrease in vascular ‘reactivity’ to noradrenaline after prolonged exposure to ouabain

Hippocampal slices were labelled with [^H]glutamate. Evoked release, which was calcium-dependent and inhibited by tetrodotoxin, could be reduced concentration-dependently by L-PIA. The effect of L-PIA was blocked by 10 µM 8-phenyltheophylline. The results indicate that there are adenosine receptors modulating the efflux of glutamate in field stimulated hippocampal slices.     

Transcatheter Closure of Patent Foramen Ovale (PFO) in Patients with Paradoxical Embolism: Procedural and Follow‐Up Results after Implantation of the Amplatzer®‐Occluder Device

Background: Prevalence of patent foramen ovale (PFO) with detectable right‐to‐left shunt is higher in young adults with transient ischemic attack (TIA) and stroke compared to the general population. So far, published series included different occluder systems, various indications and regimens of postprocedural anticoagulation. In our experience, occluder systems may be associated with an increased prevalence of thrombus formation, which has also reported by other groups. The aim of the present study was to evaluate the follow‐up results after implantation of the Amplatzer® occluder in patients with PFO using a consistent anticoagulation regimen. Methods and Results: One‐hundred and fourteen patients with PFO (60 men; age: 47 ± 13 years) and ≥1 thromboembolic event were included. Other causes for embolism were excluded. PFO‐closure was successful in all patients. All patients were treated with aspirin (100 mg/day) and clopidogrel (75 mg/day) for 6 months. TEE was repeated at a mean of 10.3 months. Mean clinical follow‐up period was 18 ± 9 months. After a mean of 10 months, no patient had either a significant residual shunt nor a suspected thrombus formation on the occluder. During follow‐up, 5 patients suffered from neurological events (1 stroke, 2 TIAs, 2 epileptic seizures), though complete closure of the PFO was documented by TEE. One patient suffered from bleeding complications (upper GI‐bleeding). Conclusion: Percutaneous closure of PFO in symptomatic patients by Amplatzer® occluder represents an effective therapy with a low incidence of peri‐interventional complications and recurrent thromboembolism. Thrombus formations on the occluder system were not detected in this cohort. (J Interven Cardiol 2011;24:85–91)     

Interaction between chlorhexidine digluconate and sodium monofluorophosphate in vitro

Abstract — The aim of the present study was to investigate the compatibility of chlorhexidine digluconate and sodium monofluorophosphate since these agents are potential ingredients in future products in preventive dentistry. Varying combinations of chlorhexidine digluconate and sodium monofluorophosphate in water, covering the possible ranges of clinically relevant concentrations of both compounds, were made, incubated for 24 h and observed for precipitation of insoluble salts. The mixtures were analyzed for presence of free chlorhexidine and monofluorophosphate after incubation. The results showed that chlorhexidine digluconate and sodium monofluorophosphate are not compatible in clinically relevant concentrations. A chlorhexidine- monofluorophosphate salt of low solubility in water is presumably formed.