The fate of the inner nose: odor imagery in patients with olfactory loss.

Cerebral activations during olfactory mental imagery are fairly well investigated in healthy participants but little attention has been given to olfactory imagery in patients with olfactory loss. To explore whether olfactory loss leads to deficits in olfactory imagery, neural responses using functional magnetic resonance imaging (fMRI) and self-report measures were investigated in 16 participants with acquired olfactory loss and 19 control participants. Participants imagined both pleasant and unpleasant odors and their visual representations. Patients reported less vivid olfactory but not visual images than controls. Results from neuroimaging revealed that activation patterns differed between patients and controls. While the control group showed stronger activation in olfactory brain regions for unpleasant compared to pleasant odors, the patient group did not. Also, activation in critical areas for olfactory imagery was correlated with the duration of olfactory dysfunction, indicating that the longer the duration of dysfunction, the more the attentional resources were employed. This indicates that participants with olfactory loss have difficulties to perform olfactory imagery in the conventional way. Regular exposure to olfactory information may be necessary to maintain an olfactory imagery capacity.

Oxitropium bromide, a new anticholinergic drug, in a dose-response and placebo comparison in obstructive airway diseases.

12 patients with obstructive airway diseases took part in a double-blind study in which 0.02 and 0.2 mg of Ba 253 as metered aerosols were compared with a placebo. Both doses of Ba 253 elicited a significant fall of mean total airway resistance compared to the placebo, and this fall was still discernible even 8 h after inhalation. Under the higher dose, the maximum response was significantly greater and it occurred about 2 h after inhalation; the response was still significantly more pronounced 8 h after inhalation. There was no objective evidence of local or systemic side effects attributable to a vagus-blocking effect. In the light of published reports and our own experience, when Ba 253 is inhaled in the stated doses it appears to be equivalent to ipratropium bromide as regards potency, duration of action, tolerance and therapeutic safety margin.

[Alterations of systolic and electrocardiographic time intervals in normal patients by Ro 11-1781, a new calcium-antagonist (author's transl)]. / Die Beeinflussung systolischer und elektrokardiographischer Zeitintervalle herzgesunder Patienten durch den Kalziumantagonisten Ro 11-1781.

Five minutes following intravenous application of calcium antagonist Ro 11-1781 (1 mg/kg BDW) PQ duration increased significantly in 10 healthy volunteers without more severe atrioventricular conduction disturbances. Both, systolic and diastolic blood pressure decreased and heart rate increased significantly. Left ventricular ejection time (LVET) and the time from the beginning of QRS to the first sound (QS1) did not change in contrast to a significant decrease of the electromechanical systolic interval (QS2) and of the total pre-ejection-period (PEP). The decrease in PEP is explained by a decrease in isovolumic contraction time (IVCT). This can be regarded in connection with a decreased PEP/LVET-ratio, an expression of better heart performance. In spite of the negative inotropic effect of the calcium antagonist Ro 11-1781, our results point to an increase in left ventricular performance and in heart rate caused by an exaggerated sympathic reaction to a fall in blood pressure.

[Intravascular hemolysis following prosthetic heart valve replacement: influence of type and position of artificial valves (author's transl)]. / Hämolyseverhalten künstlicher Herzklappen in Abhängigkeit von verschiedenen Prothesentypen und -positionen.

The present study reports a comparison of the incidence and degree of intravascular hemolysis between patients with disc prosthesis (Björk-Shiley tilting or Lillehei-Kaster pivoting) and patients with Starr-Edwards ball valves (types 1260, 6120) in mitral and aortic position, examined 7 to 30 days and 2,5 to 71 months postoperatively. Malfunction or paraprosthetic valve regurgitation could be excluded. Estimation of serum haptoglobin and serum lactate dehydrogenase activity as the most sensitive parameters indicated clinically inapparent hemolysis in all 4 groups, especially in patients with Starr-Edwards ball valves in aortic position (type 1260).

Ca2+-specific fluorescence changes in N-dansylaminoethyl-labelled oncomodulin.

Rat oncomodulin (isoelectric point (pI) = 3.9) and homologous carp parvalbumin (pI = 3.95) was labelled at Cys-18 which is located in the AB loop, with the fluorescent reagent N-dansylaziridine. The fluorescence spectrum of the labelled parvalbumin was insensitive to both Mg2+ and Ca2+ binding. In contrast the dansyl fluorescence emission spectrum of labelled oncomodulin was quenched approximately 20% by Ca2+ in the presence of physiological concentrations of Mg2+. Approximately 90% of the Ca2+-induced fluorescence quenching was complete at a Ca2+/dansyl-S-aminoethyloncomodulin ratio of approximately 1. The labelled oncomodulin was insensitive to Mg2+ binding. The present study indicates that oncomodulin, unlike parvalbumin, undergoes a large Ca2+-specific perturbation that can be felt over the entire molecule. In addition this Ca2+-specific perturbation appears to be complete upon occupation of only one metal-binding site.

[Atypical vagal Wenckebach period in a high performance athlete]. / Vagal bedingte atypische Wenckebachsche Periodik bei einem Hochleistungssportler

A 27-year-old man, engaged in heavy physical training, exhibited sinusbradyarrhythmia with atrial abnormality and second degree av-block (atypical Wenckebach period). Since abnormal sinusrhythms was established with exercise and following parasympathetic blockade, this rhythm disorder was considered consequential exaggerated vagal tone. With the aid of His-bundle electrocardiography the block was localized in the av-node (AH).

[Treatment of the experimental chronic digitalisintoxication by hemoperfusion (author's transl)]. / Zur Therapie der experimentellen, chronischen Digitalisintoxikation durch Hämoperfusion.

In 5 adult dogs experimental chronic digitalis intoxication was produced by oral administration of different digitalis-types (digoxin, beta-methyl-, beta-acetyl-digoxin, digitoxin). 18 to 24 hours after the last application of digitalis, charcoal hemoperfusion was performed in Dipidolor-N2O-anesthesia and serum digitalis-concentrations in the arterial and venous lines of the hemoperfusion system were determined by RIA J125. The Ecg was registered continuously as a simple clinical parameter of cardiac digitalis intoxication. Initial multiple cardiac arrhythmias (AVII degree, SAII degree, tachycardia of the atrium) subsided in the dogs with digoxin, beta-methyl- and beta-acetyl-digoxin during hemocolperfusion within 130 to 160 min. The disturbances of rhythm persisted up to 200 min after onset of hemoperfusion in the dog intoxicated by digitoxin. The clearances of digoxin and derivatives (35.8--43.1 ml/min) are higher than the digitoxin clearance (17--23.2 ml/min) which is supposed to be the reason for cardiac detoxication in the digoxin-intoxicated dogs. Hemoperfusion using polymer coated charcoal appears to be effective for the elimination of digoxin leading to a marked improvement of cardiac arrhythmias. By contrast digitoxin induced cardiac arrhythmias are not influenced during hemoperfusion.

Results after resection of postinfarction left ventricular aneurysms.

Although left ventricular aneurysmectomy (LVA) is a common surgical procedure, the late functional and hemodynamic results have not been well defined. This presentation describes our results with LVA in 135 patients operated between 1969 and 1979. Associated procedures were performed in 57 (42%) including coronary bypass grafting in 50, valve replacement in 5, closure of ventricular septal defect in 2, or combinations of these in 3 patients. One hundred four of the 122 hospital survivors were followed from 2 to 107 months (mean = 37 months). There were 13 hospital deaths (9.6%), 12 late deaths (9.8%) and an actuarial 5-year survival rate of 77%. Clinical improvement of preoperative heart failure occurred in 82%, and of angina in 70%. Only 33 patients (30%) returned to normal work. Bicycle exercise testing in 70 patients showed normal working capacity in 41 (59%). Recatheterization in 49 patients showed no significant changes in left ventricular end-diastolic pressure or cardiac index, and a borderline reduction of the total ejection fraction. Ventricular arrhythmias were detected by long-term ECG in 70% of all patients after surgery. Of those with preoperative life-threatening arrhythmias, rhythm improvement was noted in 50%, but only 2 of 13 patients were free of arrhythmias after operation. This study demonstrates a greater frequency of postoperative symptomatic and functional improvement as compared to hemodynamic and ECG improvement. Ventricular tachyarrhythmias originating from post-infarct scars increased intra- and postoperative risk and aneurysmectomy alone is considered insufficient for treatment of these disturbances. Further electrophysiologic investigations are needed and additional surgical measures may be necessary to improve the subset of patients with life-threatening arrhythmias.