[High malignant B-cell non-Hodgkin lymphoma of the heart: intravital diagnosis by transesophageal echocardiography controlled biopsy]. / Hochmalignes B-Zell-Non-Hodgkin-Lymphom des Herzens: intravitale Diagnose durch transösophageale Echokardiographie-gesteuerte Biopsie.

We report about a 66-year old patient with Non-Q-wave infarction in coronary artery two-vessel disease. During an echo- and transesophageal multiplane echocardiography preoperatively before a coronary artery bypass surgery a right atrium septal tumor of unknown form was discovered. The computerized axial tomography (CAT) and nuclear magnetic resonance (NMR) scans did not demonstrate extracardiac pathologic findings. A transesophageal echocardiography-guided biopsy of the right atrial septum over the vena femoralis and the right atrium enabled intra vitam a very early diagnosis of high malignant B-cell Non-Hodgkin-lymphoma without the need for thoracotomy. The diagnosis was confirmed histopathologically and immunohistochemically and early treatment with cytostatic therapy could begin. To our knowledge the transesophageal echocardiography-guided biopsy has never been described in the worldwide literature.

Influence of the beta-1 selective blocker, metoprolol, on the development of pulmonary edema in tocolytic therapy.

Research on one group of nine anesthetized dogs pretreated with alpha-naphthyl-thiourea showed that doses of the beta-sympathicomimetic fenoterol such as those normally administered in clinical tocolysis (2 micrograms/kg per minute) lead to significant fluid displacement to the extravascular space of the lung in the sense of a preclinical interstitial edema. In a second group (N = 9) with the same pretreatment the addition of the beta-1 selective blocker, metoprolol (1.5 micrograms/kg per minute) served to antagonize the hemodynamic changes and possibly the increase of pulmonary capillary permeability induced by the beta-mimetic. Fluid displacement into the interstitium of the lung was prevented by metoprolol. These observations corroborate the hypothesis that pulmonary edema occurring during tocolytic therapy is largely a result of the use of beta-mimetics. In addition to its cardioprotective effect, the administration of the beta-1 selective blocker, metoprolol, may reduce the risk of the development of pulmonary edema in beta-sympathicomimetic therapy for premature labor.

A comparative study with various anesthetics in mice (pentobarbitone, ketamine-xylazine, carfentanyl-etomidate).

The following three regimens of anesthesia in mice were compared: (1) Ketamine 100 mg--xylazine 5 mg/kg b.wt. i.m., (2) pentobarbitone 50 mg/kg b.wt. i.p., and (3) carfentanyl 0.003 mg--etomidate 15 mg/kg b.wt. i.m. For these dosage rates the respiratory variables, i.e., respiratory rate, paO2, paCO2, pHa, BEa, HCO-3a, and the circulatory parameters, i.e., heart rate, mean arterial pressure and hematocrit, were determined during the conscious state, during surgical anesthesia, and at waking time. With ketamine and xylazine, the respiration was moderately decreased whereas the cardiovascular system was strongly depressed. Pentobarbitone induced a high respiratory depression but a lesser degree of circulatory depression. Analgesia was inadequate. Although there was a moderate respiratory and circulatory depression during anesthesia with carfentanyl and etomidate the drug-induced excitation and muscle spasms do not recommend this anesthetic combination for mice. Of these three methods, the combination of ketamine and xylazine is considered the most reliable for anesthesia of mice.

[Investigations in animal experiments into the influence of the beta-1-selective blocking agent metoprolol on the cardiovascular and metabolic side effects of the tocolytic fenoterol]. / Der Einfluss des Beta-1-selektiven Blockers Metoprolol auf die kardiovaskulären und die metabolischen Nebenwirkungen des Tokolytikums Fenoterol im Tierexperiment.

The influence of the highly selective beta-1-adrenergic blocker Metoprolol on cardiovascular and metabolic side effects of the beta-mimetic Fenoterol, used for labour inhibition, was investigated in anesthetized mongrel dogs. In a dosage of 1.5 microgram/kg BW/min Metoprolol antagonized the positive inotropic and chronotropic cardiac effects of Fenoterol (0.06 microgram/kg BW/min) thus compensating the impaired energetic balance of the myocardium. As expected, there was no influence on the beta-mimetic mediated metabolic alterations. Taking into account its pharmacologic actions, the additional application of Metoprolol in labour inhibition with beta-mimetics seems to be advantageous. On account of the proven results a reduction of the more or less considerable missensations and a cardioprotective effect may be expected.

[Liquid shifts in the lung under fenoterol and verapamil. Experimental study on the origin of pulmonary oedema under tocolysis. III (author's transl)]. / Flüssigkeitsverschiebungen in der Lunge unter Fenoterol und Verapamil. Experimentelle Studie zur Entstehung des Lungenödems unter Tokolyse. III.

The question of the causal relationship between tocolysis and pulmonary edema has been unresolved up till now. Eight mongrel dogs were given infusions of Fenoterol (0.06 mcg/kg/min) and later of Fenoterol (0.06 mcg/kg/min) and Verapamil (2 mcg/kg/min). In the case of infusion of Fenoterol alone measurements by the thermo-dye-technique showed massive shifts of lung fluids from the intravascular to the extravascular space corresponding to interstitial edema. The addition of Verapamil induced no further changes. The intrapulmonary haemodynamical overload by increased cardiac output and pulmonary arterial pressure which we measured after infusion of Fenoterol must be regarded as the main cause of the shifts in fluid volumes. They seem to be amplyfied by central nervous-, metabolic- and localized toxical effects of the betamimetic drug. A direct cardiac cause as well as serious changes in electrolytes and colloidosmotic pressure could be excluded.