Effect of systemic treatment with cholesterol-lowering drugs on the skin barrier function in humans.

The intercellular lipids of stratum corneum are predominantly formed by cholesterol, ceramides and free fatty acids. Cholesterol synthesis is inhibited by statins, cholesterol-lowering drugs (lovastatin, pravastatin, simvastatin). The present study was undertaken to examine the effect of these drugs on skin barrier function. Knowledge about the effect on epidermis of systemic inhibition of cholesterol synthesis may improve our understanding of the skin barrier function. Seventeen statin-treated subjects were compared to controls. All were patch-tested with sodium lauryl sulphate (SLS), and the skin was evaluated after 24 h and after 7 days by measurement of transepidermal water loss (TEWL), erythema and visual scoring. After 24 h as well as after one week erythema was significantly less pronounced in the statin-treated group than in controls (p < 0.001). No significant differences in TEWL were found between the groups at any time. The results imply a decreased bioavailability of SLS in the statin-treated group, while no evidence for an altered permeability barrier to water was found.

Normal myocardial enzymes and normal echocardiographic findings during noninvasive transcutaneous pacing.

Noninvasive transcutaneous pacing was performed for 30 minutes in 10 healthy volunteers. The pace rate was from 85 to 115 min-1, and the threshold for pacing was from 38 to 70 mA, median 59 mA. Echocardiography before and during pacing showed no changes in left ventricular end-diastolic diameter, in fractional shortening nor in contraction pattern. Also, blood pressure remained unchanged. Blood samples for determination of myoglobin, creatine phosphokinase, creatine kinase MB and lactate dehydrogenase were drawn prior to pacing and 1,2,3,4,6,8 and 24 hours after pacing. The serum concentrations were the same before and after pacing for all enzymes and myoglobin. We conclude that non-invasive transcutaneous pacing for 30 minutes causes no muscular or myocardial injury and that the left ventricular function remains normal.

Transcutaneous pacing: experience with the Zoll noninvasive temporary pacemaker.

We investigated the effectiveness of noninvasive transcutaneous pacing in 35 patients. Pacing was achieved in 33 of 35 patients (94%). In 24 patients the indications were: acute sinoatrial block, atrioventricular block, or asystole with unconsciousness due to acute myocardial infarction in eight; sick sinus node syndrome in 12; and other indications in four patients. These patients were paced for 2 minutes to 14 hours; the median length of pacing was 15 minutes. The pacing thresholds varied from 30 to 110 mA; pacing was achieved in 22 patients without serious side effects. Nine patients needed sedation and six were unconscious; 12 later had a temporary or permanent transvenous pacemaker implanted. In 11 patients noninvasive transcutaneous pacing was performed prior to implantation of a permanent pacing catheter: in eight pacing was done just prior to catheter insertion, and in three the threshold was determined before a weekend on which the patient had to wait for implantation. Pacing thresholds were from 45 to 90 mA; the median was 55 mA. Seven of these eight patients felt chest pain. No serious side effects were seen. We conclude that transcutaneous pacing is effective and safe and can be used instead of inserting a transvenous catheter if this is impossible or until one can be inserted.

Effects of ouabain and hypoxia on the cardiac stimulation threshold in the dog (with special reference to changes in extra- and intracellular potassium concentrations).

The influence on the cardiac stimulation threshold of changes in the myocardial intra/extracellular potassium ratio induced with ouabain and hypoxia was investigated in 9 dogs with total atrioventricular block. In spite of significant elevations of extracellular potassium and reductions of intracellular potassium significant changes in stimulation threshold were not seen. It is suggested that different experimental conditions are responsible for the great variations in the results of previous studies of this subject.