Idiopathic Right Ventricular Outflow Tract Tachycardia: A Clinical Approach

Right ventricular outflow tract (RVOT) tachycardia is the most common form of idiopathic ventricular tachycardia (VT). Phenotypically, RVOT tachycardia segregates into two predominant forms, one characterized by repetitive monomorphic nonsustainnd VT and the other by paroxysmal exercise induced sustained VT. There is an increasing body of evidence to support the concept that both forms of tachycardia reflect disparate clinical manifestations of an identical cellular mechanism (i.e., cAMP-mediated triggered activity), which is identified clinically by the tachycardia's sensitivity to adenosine. The clinical characteristics, natural history, and approaches to therapy of RVOT tachycardia are delineated herein.     

The Effects of Water Soluble Contrast Agents on the Respiratory Tract

The water soluble contrast agents Gastrografin^R (Sodium diatrizoate and meglumine diatrizoate, Schering, Berlin), Iopamiro 300 R (Iopamidol, Schering, Berlin), and Dionosil Aqueous^R (propyliodone BP, Glaxo, England) were instilled into the tracheobronchial tree of rats in doses of either 0.1 ml and 0.25 ml. Rats being used as controls, underwent sham operations with the instillation of air instead of contrast agent. In all, 85 rats were used. All rats that had not already died from the effects of contrast agent were sacrificed 30 minutes after instillation. The relative effects of the contrast agents were measured by comparing: 1. survival time; 2. radiographic effects of the contrast agents on the lungs and; 3. pathological changes as estimated by post mortem lung section andmicroscopy. The least toxic agent was the one with the lowest osmotic activity, namely Aqueous Dionosil. It is therefore recommended that Aqueous Dionosil be used in preference to Gastrografin or Iopamidol for studies of the oesophagus whenever there is a danger of aspiration of contrast agent into the tracheobronchial tree.     

UNEQUAL LEG LENGTH: AN ACCURATE METHOD OF DETECTION AND SOME CLINICAL RESULTS

SUMMARY A simple, accurate X-ray method of assessing leg length discrepanciesis described. By comparison, assessment by iliac crest palpationand type-measurement has proved less reliable. The possibleclinical results of failure to correct discrepancies of over10 mm. accurately, and at an early stage, are indicated. ^*Paper read at the Annual Meeting of the British Associationof Physical Medicine and Rheumatology, London, April 1972.     

DAPSONE INDUCED PERIPHERAL NEUROPATHY

Summary.— A further case of peripheral neuropathy has occurred in the course of dapsone therapy. It was predominantly motor in type, but a sensory element was present. It recovered completely after dapsone withdrawal. Electromyography and nerve conduction studies showed the neuropathy to be axonal in type.     

THE REGROWTH OF RIGHT ATRIAL NORADRENERGIC NERVES AFTER 6-HYDROXYDOPAMINE IN GENETICALLY DIABETIC MICE: EFFECTS OF INSULIN TREATMENT

1 This study examined the rate of repletion of right atrial noradrenaline levels after a single dose (100 mg/kg i.p.) of 6-hydroxydopamine (6-OH Da) in diabetic and non-diabetic mice of the C57 BL/KS db/db strain. 2 In mice which received no 6-OH Da there was no significant difference, in endogenous noradrenaline levels, between diabetic and non-diabetic animals. The depletion of noradrenaline 24 h after 6-OHDa was slightly more profound in the diabetic mice than in non-diabetic controls. Thereafter the rate of repletion of noradrenaline was more rapid in the diabetic group. 3 The normal noradrenaline content was reinstated in diabetic mice between 7 and 10 days after 6-OHDa. In the non-diabetic group levels similar to those found in untreated mice were not reinstated until 14 days after 6-OHDa. 4 Ten days after 6-OHDa right atria from diabetic mice were markedly more responsive to stimulation of the intramural noradrenergic nerves than were preparations from non-diabetic mice. 5 A group of diabetic mice was treated with insulin (10 m Units/g daily) for 6 weeks. The right atria from these animals, examined 10 days after 6-OHDa, were similar in their responses to noradrenergic nerve stimulation to the preparations from the non-diabetic mice. 6 All these groups of atria gave similar responses to exogenous noradrenaline. These findings indicate that regrowth of noradrenergic terminals after 6-OHDa was more rapid in diabetic mice than in either insulin-treated diabetic mice or non-diabetic mice.