Newer aspects of antiarrhythmic drug development: Introduction

Although cardiac arrhythmias remain a serious clinical problem in many patients with heart disease, the exact role of antiarrhythmic drug therapy is currently under intense evaluation. Within the last several years it has become clear that there are significant risks as well as potential benefits associated with existing agents. Ongoing studies in large patient populations should help determine the benefit/risk ratio of traditional therapy. Regardless of the outcome of these trials, current electrophysiological dogma will have to be re-evaluated and newer concepts evolve for drug development to make further progress. The goal of this symposium is to exchange information among basic and clinical investigators so as to facilitate the emergence of novel electrophysiological concepts that will form the basis for future generations of antiarrhythmic drugs.     

Characteristics of the sequelae to frostbite of the extremities

At the burn centre in Donetsk, from 1979 to 1988, 236 sufferers with a III-IV degree frostbite of the extremities were treated. Operated on were 189 patients, who underwent necrectomy, amputation of the extremity and different types of skin plasty. Of these patients, 49.8% were recognized as invalids. After 1-10 years, all the patients after a III-IV degree frostbite of the extremities make complaints, require different types of treatment, 38.9%--the operative one. For timely and qualitative rehabilitation of this category of the sufferers, their prophylactic medical examination is necessary.     

Correction of the position of the limbus in open reduction of congenital hip dislocation in children

On the basis of their clinical experience in the treatment of 146 patients with congenital dislocation of the hip the authors have evaluated the state of the limb in this pathologic condition. Various changes in the limb's form have been observed depending on the expression of the hip dislocation and on the patient's age. The instruments for incisions and for correcting the limb's position have been worked out. The fixation of the limb in the functionally correct position is carried out by stitching its fragments and fixing the strained threads in the greater trochanter area. The correction of the limb's position allows the subsequent correct development of the acetabular roof.     

Results of the use of a graft with a monocusp in radical correction of Fallot's tetrad

The article deals with the results of complex study of the effect of pulmonary insufficiency on intracardiac hemodynamics and function of the heart in the immediate and late-term periods after radical correction of Fallot's tetralogy. Answers are also given to questions concerning the expediency of the use and functional adequacy of a xeno-pericardial monocusp in the closure mechanism of the pulmonary artery valve. The study showed that massive pulmonary regurgitation has a negative effect on the functional condition of the right ventricle in late-term postoperative periods. Convincing data were obtained which allow a graft with a monocusp of a bull's pericardium to be recommended for further clinical use to prevent insufficiency of the pulmonary artery valve after radical correction of Fallot's tetralogy.     

Mercury exposure of different origins among dentists and dental nurses

Mercury exposure was studied among dental personnel with the use of urinary mercury excretion rates and questionnaires. The study covered 314 dentists and dental nurses employed in public clinics and private practices in Stockholm. The obtained urinary mercury excretion rates were analyzed by stepwise regression for assigning them to different origins, such as environmental factors, number of amalgam surfaces, chewing of gum, kind of employment and profession, age, sex, amalgam handling time, and use of amalgam capsules. On the average the occupational contribution to the total urinary mercury excretion rate was small and of the same order as the contribution from their own amalgam fillings (approximately 2 micrograms of mercury/24 h). There were, however, individuals showing excretion rates close to the levels at which effects on the central nervous system and the kidneys have been reported.     

Influence of the menstrual cycle on skin-prick test reactions to histamine, morphine and allergen

The purpose of this study was to examine the possible influence of the phases of the menstrual cycle on dermal reactivity to skin-prick testing. We studied 15 atopic, menstruating women with seasonal rhinoconjunctivitis and/or asthma, with known sensitivity to olive and parietaria (mean age 25.2 years) and 15 non-atomic, healthy, female controls (mean age 24.7 years). Skin-prick tests with histamine, morphine, and in the atopic group with parietaria/and/or olive, were repeated three times during the same menstrual cycle, corresponding to bleeding (day 1–4), midcycle (day 12–16) and the late progesterone phase (day 24–28). None of the patients had received oral antihistamines or exogenous hormones for at least 1 month prior to testing. Results indicate a significant increase in weal-and-flare size to histamine, morphine, and parietaria on days 12–16 of the cycle, corresponding to ovulation and peak oestrogen levels. This was observed in both atopic and non-atopic women. Differences in skin reactivity to histamine and morphine between the groups were not significant. Therefore, in women, the phase of the menstrual cycle is another factor that may influence skin-test results.