Prostaglandins and the antiarrhythmic effect of preconditioning in the isolated rat heart.

Our study evaluated the relationship between the endogenous production of prostacyclin and the antiarrhythmic effect of ischemic preconditioning against ischemic and reperfusion-induced tachyarrhythmia. Langendorff perfused rat hearts underwent 30 min regional ischemia with reperfusion. Preconditioning was induced by a single episode of 5 min ischemia and 15 min reperfusion.

An undocumented effect of lidocaine revealed by computerized electrocardiography.

The influence of an intravenous push of lidocaine 1 mg/kg followed by 2 mg/min infusion on total QRS amplitude and R-to-S duration in leads V2-V4 of the electrocardiogram was studied in 11 patients who were hospitalized in the coronary care unit. A computerized system sampled the amplitude and timing of peak R and S waves of 1100 QRS complexes of leads V2-V4, starting two minutes before the first push of lidocaine. Curves of amplitude and R-to-S duration versus time were obtained in all patients.

Unstable anginal syndrome and pulmonary oedema due to thyrotoxicosis.

We report on a 40 year old woman who presented with typical unstable angina pectoris associated with pulmonary oedema, due to poorly controlled hyperthyroidism. No cardiac abnormality was detected by echo-Doppler and nuclear ventriculography. Coronary angiography demonstrated normal coronary arteries.

The influence of pH on the intravenous delivery of lidocaine solutions.

In order to evaluate the surface tension lowering effect of lidocaine 0.4% on a 5% glucose solution, drop size has been measured in intravenous sets of 60 drops per ml. The relationship between the number of drops per ml and the pH of the solution was sigmoidal, from 63 drops/ml at pH5 to 95 drops/ml at pH 10.

Influence of ethanol on the delivery of intravenous nitroglycerin solutions.

In order to evaluate the surface tension lowering effect of ethanol in intravenous nitroglycerin solutions of varying concentrations, drop size was measured in intravenous transfusion sets that should deliver 60 drops/ml. Ethanol 5% solutions led to a significant decrease in drop volume and a concomitant increase in the number of drops per unit volume, up to 79 drops/ml were observed. The surface tension lowering effect may account for decreases of up to 25% in delivered nitroglycerin when drop counting infusion pumps are used, and may be a factor in the development of apparent tolerance to intravenous nitroglycerin.

Laetrile intoxication and hepatic necrosis: a possible association.

A 65-year-old woman with cirrhosis and hepatoma lapsed into deep coma, hypotension, and acidosis after ingestion of 3 gm of Laetrile, a cyanogenetic glucoside. After initial treatment, the patient regained consciousness, but massive hepatic damage led to her death. We suggested a possible relationship between Laetrile poisoning and massive hepatic necrosis.

Hyperkalemic left bundle branch block and hyporeninemic hypoaldosteronism (hyperkalemic left bundle branch block).

A 70-year-old woman was admitted to the intensive coronary care unit with suspected myocardial infarction. During the follow-up period, the patient twice developed left bundle branch block, which was shown to be related to high serum potassium levels secondary to hyporeninemic hypoaldosteronism and moderate renal failure.

Neurocirculatory asthenia and mitral valve prolapse--two unrelated entities?

Patients with neurocirculatory asthenia share common symptoms with patients having evidence of mitral valve prolapse. A link between these two conditions has been suggested but never documented. We have evaluated the prevalence of mitral valve prolapse among 42 young soldiers suffering from the neurocirculatory asthenia syndrome, using auscultation and echocardiography to detect the mitral abnormality.