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I'd start by going over the plug wires real good. Look at them closely for condensation and arcing. Then inspect the coil wire and under the distributor cap. I've seen ignition wires go bad under the rubber boots where its very hard to detect anything that's gone wrong. An ohmmeter is real handy here.
Next, inspect the Idle Air Control Valve. There is a good writeup in the FAQ's about the IAC.
If you're sure all the above is OK then its not outside the realm of (275K) possibility that a new head gasket is what's needed.
Whatever you do, don't give up.
Good luck.
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