[Comparison of postmortem heart and femoral vein blood ethanol concentrations]

Alcohol abuse is a major cause of medical and social problems and ethanol analysis is the most frequently performed assay in forensic toxicology laboratories. Femoral vein blood is the choice specimen, but occasionally there is no access to it. The aim of this study is the comparison of ethanol concentration between heart blood and femoral venous blood. Ethanol concentrations were determined in femoral vein blood and heart blood obtained from 50 forensic necropsies that the time of death was less than 24h. The specimens were stored in duplicate state at 4°C within filled, dark and closed containers with preservative and analyzed by headspace gas chromatography in Forensic Toxicology Laboratory of Tehran's Legal Medicine Organization with a precision coefficient of variation 5%-7%. The limit of detection was /1 mg/dl and the limit of quantification was 10 mg/dl. The mean concentration of ethanol in heart blood was 131.88 +/- 93.46 mg/dl and in femoral vein blood was 135.96 +/- 95.47 mg/dl. The heart blood/femoral blood ethanol concentration ratio was 0.958 +/- .18 and regression correlation coefficient was 0.98. When considered specimens with concentrate 100 mg/dl was 0.943. There was no considerable difference between femoral vein blood and heart blood alcohol concentration if the death was happened before 24h and sampling and storage be correct and appropriate

Electromechanical effects of urea on the isolated rat heart

Langendorff-perfused isolated hearts and left ventricle papillary muscles from 3-month old albino rats of both sexes were studied before and after a 30-min treatment with 17 mM urea added to the medium, a of urea were produced by an increase in tonicity, the study was repeated using 17 mM sucrose. Mechanical studies on the papillary muscles showed that isometric force development and its first time derivative decreased after washing out urea from the bath (F=9.73 ñ 1.02 g/mm2 to 7.47 ñ 0.72 and dF/dt=66.8 ñ 6.43 to 56.7 ñ 4.60 g (mm2)-1 s-1, respectively; P<0.05). Inotropic responses to isoproterenol and increased extracellular calcium after urea treatment reached values similar to those obtained before urea treatment. Thus, the effect of isoproterenol and calcium was stronger than that obtained before urea treatment. In Langendorff-perfused hearts, the spontaneous heart rate did not change after urea or sucrose treatment. Urea promoted a decrease in the left ventricle isovolumetric systolic pressure (39.7 ñ 4.05 to 26.1 ñ 2.69 mmHg, P<0.05) and a reduction of total QRS amplitude. In both papillary muscles and isovolumetric perfused hearts, contractile responses resulting from changes in extracellular sodium concentration were reduced after urea treatment. The increased osmolarity due to sucrose did not produce any changes in electromechanical activities. Although 17 mM, which reduces isometric force and isovolumic pressure development and modifies the ECG, is well below the concentration required to modify protein conformation in vitro, the present results suggest that its action could be explained by an effect at the sarcolemmal level

Angiocardiografia com tecnécio-99m na avaliaçäo do pseudo-aneurisma do ventrículo esquerdo / Angiocardiography with technetium-99m in the evaluation of left ventricular pseudoaneurysm

O falso aneurisma do ventrículo esquerdo, ao contrário do verdadeiro, tem evoluçäo frequente para ruptura e morte do paciente, podendo ter o prognóstico alterado desde que o diagnóstico e tratamento cirúrgico sejam efetuados oportunamente. Dentre as técnicas cardiovasculares de avaliaçäo näo invasiva, a angiocardiografia com tecnécio-99m - seja em "primeira passagem" ou sincronizada com o eletrocardiograma - vem sendo cada vez mais utilizada. Assim, foram revistos, retrospectivamente, 283 exames obtidos até seis meses após um enfarto do miocárdio dentre 1.564 exames rotineiramente realizados em 2 hospitais que dispöem de cardiologia nuclear. Identificaram-se 3 pacientes com pseudo-aneurisma do ventrículo esquerdo confirmado por ecocardiograma bidimensional e cateterismo cardíaco. Os achados típicos da cintigrafia incluiam: 1. formaçäo de uma câmara cardíaca extra; 2. enchimento tardio em relaçäo ao ventrículo esquerdo; 3. orifício de entrada estreito; e 4. expansäo paradoxal sistólica. A ausência de músculo cardíaco nas paredes do pseudo-aneurisma foi observado em 2 casos também submetidos à cintigrafia miocárdica com tálio-201. Nossos dados mostram que a angiocardiografia com radionucídos é um método näo invasivo útil e de grande importância clínica para o diagnóstico do pseudo-aneurisma, podendo ser recomendado alternativamente ou associado ao ecocardiograma

Banda anômala: uma análise crítica da anatomia e embriologia de seus elementos / Anomalous band: a critical analysis of the anatomy and embryology of its elements

Elabora-se um "modelo teórico-da banda anômala de ventrículo direito", tendo por base a anatomia normal dos elementos constituintes do Ostium bulbi. Questiona-se a possibilidade de uma hipertrofia destes elementos, provocando uma estenose intraventricular direita, responsável pelos gradientes intracavitários de pressäo encontrados nesta doença. Faz-se mençäo aos aspectos embriológicos e aventam a possibilidade desta malformaçäo ser decorrente do acúmulo de geléia cardíaca e do manto mioepicárdico entre o ventrículo primitivo e o "Bulbus cordis". Comenta-se de modo suscinto, a vasta sinonímia usada, bem como sua incidência e concluem que o termo Estenose do "Ostium bulbi" é o mais abrangente e específico