["Slowing" right bundle-branch block in reciprocating tachycardia from a latent right lateral Kent bundle].

The authors report the case of a 56 year old man with paroxysmal reciprocating tachycardia. The participation of a right lateral Kent bundle, latent in sinus rhythm and with retrograde atrioventricular conduction during tachycardia was proved by : 1) the slowing of the tachycardia rhythm and lengthening of the ventriculo-atrial conduction time by 50 ms during right bundle branch block ; 2) atrial mapping during tachycardia showing right lateral atrial pre excitation ; 3) the spontaneous termination of some attacks after a blocked Hisian depolarisation. Analysis of the mechanisms of spontaneous termination of tachycardia showed a block in the accessory pathway in 80% of cases, leading to the successful use of Amiodarone.

Evidence for the lack of classical secretory phospholipase A2 in guinea-pig pancreas.

Several lipolytic enzymes from guinea-pig pancreas have been determined in a soluble extract and in a purified zymogen granule fractions. The positional specificity of phospholipolytic enzymes was detected using phospholipids bearing various radioactive labels. It is shown that guinea-pig pancreatic extracts are able to release both fatty acids from phosphatidylcholine, but with more efficiency towards the fatty acid occupying the 1-position of sn-glycerol.

[Clinical, haemodynamic and biochemical effects of angiotensin-converting enzyme inhibition in chronic refractory cardiac failure (author's transl)].

Twenty patients with chronic congestive heart failure resistant to conventional treatment with digitalis, diuretics and vasodilators received captopril, an oral inhibitor of the angiotensin-converting enzyme, in daily doses of 200 mg and were followed up for 2 months or more. At 2 months, there was a significant reduction in functional symptoms (NYHA classification), bodyweight and left ventricular filling pressure, with an equally significant rise in cardiac output and sodium urinary excretion. There was no fall in systemic blood pressure, nor tachycardia.

[Surgical revascularization of infarcted myocardial areas. Its effects on left ventricular function].

The results of twelve patients undergoing revascularisation procedures of infarcted myocardial territory alone were analysed quantitatively by planimetry in the right anterior oblique projection. Patients operated in the acute phase of myocardial infarction (2 cases) were distinguished from those with preinfarction syndromes (8 patients) and those with postinfarction angina (2 patients). Two posterior wall and ten anterior wall revascularisations were carried out by single bypass grafts (8) and double bypass grafts (2) with no operative deaths.

Purification of two lipases with high phospholipase A1 activity from guinea-pig pancreas.

1. Two cationic lipases (Ia and Ib) were purified from homogenates of fresh guinea-pig pancreas by ion-exchange chromatography on DEAE-Sepharose and CM-Sepharose (twice for the latter) followed by gel filtration on Sephadex G-100. 2.

Studies on the substrate specificity of a carboxyl ester hydrolase from human pancreatic juice. I. Action on carboxyl esters, glycerides and phospholipids.

Purified carboxyl ester hydrolase (carboxylic-ester hydrolase, EC 3.1.1.

Echocardiographic diagnosis of mobile left ventricular tumour.

Echocardiography detected a mobile left ventricular tumour. The tracing showed a cluster of echoes in the left ventricular outflow tract corresponding to the location of the tumour as confirmed by cineangiograms. At operation, a thrombus was discovered, attached to a chorda tendineae.

[Comparison of the effects of phentolamine and trinitrine in the treatment of left ventricular failure during the acute phase of myocardial infarct].

Two groups of 10 patients with left ventricular failure during the acute phase of myocardial infarction were studied. One group were given phentolamine, the other trinitrin. The infusion rate was regulated so that the heart rate was not increased by more than 10 beats per minute, and to obtain a pulmonary arterial diastolic pressure less than 18 mmHg with a mean systemic arterial pressure remaining greater than or equal to 80 mmHg.

[Stenosis of the trunk of the left coronary artery. Contribution of coronary arteriography and hemodynamic correlations. Apropos of 34 cases].

From a study of 34 cases, the authors have tried to define the characteristic features of this very specialised type of coronary artery disease. From the clinical standpoint, if the common combination of uncontrolled angina and a past history of myocardial infarction are taken as representative, the basal ECG can in no way differentiate the diagnosis; on the other hand tests on the bicycle ergometer appear to have a good indicative value. Coronary arteriography shows the sharply isolated character of the stenosis of the trunk which is part of the picture of diffuse coronary disease, and the frequency (2 cases out of 3) of total coronary occlusion.

[Vasodilator treatment of left ventricular insufficiency in the acute stage of myocardial infarction].

The haemodynamic effects of two vasodilators (phentolamine and nitroprusside) have been studied in 11 patients who developed acute left ventricular failure during the acute phase of a myocardial infarction. The dose was adjusted to the highest level failing to cause tachycardia (phentolamine: 0.19 to 0.

[Oral contraceptives and myocardial infarct].

In the light of four proven cases of myocardial infarction in patients under treatment with hormonal contraceptives, the authors point out: the sudden 'inaugural' appearance of the infarction during a therapeutic course; the appearances of the lesions on coronary arteriography; on 2 occasions a lacunar form on the proximal segment of a main coronary trunk, in one case lesions more redolent of atheroma, and in one case a completely normal vascular tree. These appearances had not changed at follow-up arteriography; the existance in 3 cases of multiple associated risk factors, especially of a mixed type of hyperlipoproteinaemia associated with tobacco consumption. The current relative frequency of coronary episodes in patients with multiple risk factors would seem to point towards caution in prescribing hormonal contraceptive treatment, especially for females of over 35 years of age.