OVERHEATING IN BED AS AN IMPORTANT FACTOR IN MANY COMMON DERMATOSES

Background. Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. Methods. In order to test the hypothesis, 12 “clean-skinned” subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. Results. All the subjects were too hot by 3 to 4°C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the “heat-sink” area. Conclusions. The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. “Lifestyle” modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive.     

Aortopulmonary window with patent ductus arteriosus and interrupted aortic arch: A case report

Indian Journal of Thoracic and Cardiovascular Surgery -     

Staple penetration and staple histological response for attaching an epimysial electrode onto the abdominal surface of the diaphragm using a laparoscopic approach

Background: Laparoscopic stapling was found to be a viable option for attaching epimysial electrodes onto the abdominal surface of the diaphragm. Stapling was preferable to suturing due to its simplicity and speed. Methods: Of the two staplers tested in this study, the Ethicon Endopath was preferred over the Autosuture Endo Hernia because the staples did not penetrate the diaphragm when an electrode tab thickness greater than 0.75 mm was used. Results: The thickness of the electrode tab was an important factor in determining staple penetration but large variation in penetration depth indicated that other factors may also play a role. An electrode tab thickness of 1.0–1.25 mm was suggested to minimize the risk of diaphragm perforation. Conclusions: The histological reaction to staples implanted up to 14 months was unremarkable, reflecting the safety of laparoscopic staples for permanently anchoring electrodes on the diaphragm. Received: 2 April 1996/Accepted: 12 June 1996     

Gender differences in the effect of age on adrenergic neurotransmission in the heart.

In male rats, there is an age-associated decline in the capacity of cardiac sympathetic nerves to release norepinephrine. To investigate whether this phenomenon also occurs in female rats, we examined adrenergic neurochemical transmission in the hearts of female and male Fischer 344 rats. Rats aged 6, 12, and 24 months were employed. Hearts with the right cardiac sympathetic nerve intact were isolated and perfused with Krebs-Ringer solution. Stimulations were performed following the administration of cocaine or metanephrine separately and in combination or following the combination of cocaine, metanephrine, and yohimbine. Cocaine (1 microM) was used to block uptake 1, metanephrine (1 x 10(-5) M) to block uptake 2, and yohimbine (3 microM) to block alpha 2 receptor presynaptically. The nerve was stimulated with frequencies of 2, 6, and 12 Hz, and norepinephrine amount in the effluent was determined by high performance liquid chromatography/electrochemical detection methods. Neither norepinephrine release nor the effects of yohimbine, cocaine, or metanephrine were found to be affected in older female rats (24 month). This suggests that age-related changes in adrenergic neurochemical transmission in the heart of female rats differ from those seen in older male rats.     

Arsphenamine jaundice and the recognition of instrument-borne virus infection.

Soon after its introduction in 1910, intravenous arsphenamine treatment for syphilis was found to be complicated by jaundice. The underlying cause, unsterile syringes and needles, was eventually recognised in the early 1940s, mainly through the efforts of British Army investigators. The infection most often transmitted was probably hepatitis B virus (HBV), but the high mortality in a few of the outbreaks of arsphenamine jaundice suggests that variants of HBV, or other hepatitis viruses, were sometimes involved. Fifty years later, at a time when there are estimated to be over three hundred million carriers of HBV in the world and probably at least as many hepatitis C virus carriers, and when the World Health Organisation estimates that there have been 17 million infections with human immunodeficiency virus, the lessons learnt around 1945 about the need to use sterile instruments and needles for all injections and venepunctures remain highly pertinent.     

Effects of short-duration transients on cardiac rhythm

Cardiac stimulation thresholds of short-duration large-amplitude electrical transients were studied. An isolated rabbit heart model was used and transients were applied directly to the heart through electrodes of 1 mm² and 1 cm² surface area. A variety of oscillatory waveforms and pulse configurations were studied and indicated that, for transients shorter than 100 μs, stimulation thresholds approach a constant charge-transfer density of 3·4 μC cm⁻².