TREATMENT OF PALMOPLANTER HYPERHIDROSIS BY IONTOPHORESIS

Twenty-seven patients with idiopathic palmoplanter hyperhidrosis were treated with Iontotherapy over a one year period. In twenty-four cases there was a good response but maintenance therapy was required every 3-4 weeks.KEY WORDS: Iontophoresis, Palmoplanter hyperhidrosis     

Age Related Development of Angiotensin Converting Enzyme in Testes and Epididymis of Rat

Altersabhängige Entwicklung von Angiotensin-Converting-Enzym (ACE) in den Hoden und Nebenhoden der Ratte
ACE wurde in den Hoden und in verschiedenen Bereichen des Nebenhodens der Ratte unterschiedlichen Alters untersucht. Die ACE-Aktivität erreichte ihren Gipfel, wenn die Tubuli seminiferi die Spermatozoenproduktion des Erwachsenenstadiums aufwiesen; sie pendelte sich auf dieser Höhe danach ein. Die Spitzenkonzentration im Nebenhoden wurde später beobachtet als im Hoden. Der Konzentrationsgrad im Nebenhoden war proportional zum Grad der Spermatozoenreifung und zur Fertilität; die höchste ACE-Aktivität im Nebenhoden fand sich im Kopfbereich.     

Prazosin modulates rapid eye movement sleep deprivation-induced changes in body temperature in rats

Prolonged rapid eye movement sleep deprivation (REMSD) causes hypothermia and death; however, the effect of deprivation within 24 h and its mechanism(s) of action were unknown. Based on existing reports we argued that REMSD should, at least initially, induce hyperthermia and the death upon prolonged deprivation could be due to persistent hypothermia. We proposed that noradrenaline (NA), which modulates body temperature and is increased upon REMSD, may be involved in REMSD- associated body temperature changes. Adult male Wistar rats were REM sleep deprived for 6–9 days by the classical flower pot method; suitable free moving, large platform and recovery controls were carried out. The rectal temperature (Trec) was recorded every minute for 1 h, or once daily, or before and after i.p. injection of prazosin, an alpha-1 adrenergic antagonist. The Trec was indeed elevated within 24 h of REMSD which decreased steadily, despite continuation of deprivation. Prazosin injection into the deprived rats reduced the Trec within 30 min, and the duration of effect was comparable to its pharmacological half life. The findings have been explained on the basis of REMSD-induced elevated NA level, which has opposite actions on the peripheral and the central nervous systems. We propose that REMSD-associated immediate increase in Trec is due to increased Na-K ATPase as well as metabolic activities and peripheral vasoconstriction. However, upon prolonged deprivation, probably the persistent effect of NA on the central thermoregulatory sites induced sustained hypothermia, which if remained uncontrolled, results in death. Thus, our findings suggest that peripheral prazosin injection in REMSD would not bring the body temperature to normal, rather might become counterproductive.     

Androgen Dependence of Testicular and Epididymal Angiotensin Converting Enzyme

Treatment with cadmium chloride (CdCl2) and cyproterone acetate (CA) depressed angiotensin converting enzyme (ACE) activity significantly in testes and epididymal regions of the adult rats compared to the corresponding untreated controls. Exogenous testosterone to CA-treated rats significantly increased the enzyme activity both in the testes and epididymis, the effect in the latter being very significant comparable to CA-treated and untreated controls. Testosterone failed to induce ACE activity in the testes and caput epididymis of 30 day-old immature rats, but the enzyme activity was detected in corpus and cauda epididymis. Our findings indicate that ACE activity in the testicular complex is possibly linked with androgen and is concerned with spermatogenesis and sperm maturation.     

Congenital Segmental Absence of Intestinal Musculature

Intestinal obstruction due to congentital segmental absence of intestinal musculature in a neonate has been described. This report represents the fifth known case of this abnormality. The defective segment of the bowel was deficient in its muscle coat and consisted only of mucosa, submucosa and serous coats. Exact etiology of the condition is not known but it is presumed that discontinuous myogenesis may be due to some genetic or development defect. it is almost impossible to arrive at a preoperative diagnosis. Diagnosis can only be made with certainty at operation by transillumination of the bowel wall and its microscopic examination. Treatment consists of resection of the defective segment of intestine with end to end anastomosis of the normal bowel.     

Endogenous ouabain-like compounds in locus coeruleus modulate rapid eye movement sleep in rats

Although the detailed mechanism of spontaneous generation and regulation of rapid eye movement sleep (REMS) is yet unknown, it has been reported that noradrenergic REM-OFF neurons in the locus coeruleus (LC) cease firing during REMS and, if they are kept active, REMS is significantly reduced. On the other hand, the activity as well as expression of Na-K ATPase has been shown to increase in the LC following REMS deprivation. Ouabain is a specific inhibitor of Na-K ATPase, and endogenous ouabain-like compounds are present in the brain. These findings led us to propose that a decrease in the level of ouabain-like compounds spontaneously available in and around the LC would stimulate and increase the REM-OFF neuronal activities in this region and thus would reduce REMS. To test this hypothesis, we generated anti-ouabain antibodies and then microinjected it bilaterally into the LC in freely moving chronically prepared rats and recorded electrophysiological signals for evaluation of sleep−wakefulness states; suitable control experiments were also conducted. Injection of anti-ouabain antibodies into the LC, but not into adjacent brain areas, significantly reduced percent REMS (mean ± SEM) from 7.12 (±0.74) to 3.63 (±0.65). The decrease in REMS was due to reduction in the mean frequency of REMS episode, which is likely due to increased excitation of the LC REM-OFF neurons. Control microinjections of normal IgG did not elicit this effect. These results support our hypothesis that interactions of naturally available endogenous ouabain-like compounds with the Na-K ATPase in the LC modulate spontaneous REMS.     

Successful selection of patients with intractable extratemporal epilepsy using non-invasive investigations

PURPOSE: Patients with intractable epilepsy, operated for extratemporal epileptogenic foci, have often been found to have poorer surgical outcome compared with those with temporal lobe foci. The objective of this study is to assess the surgical outcome in patients with extratemporal foci, operated at the All India Institute of Medical Sciences (AIIMS), New Delhi. METHODS: Patients of intractable epilepsy with extratemporal foci on detailed investigation constituted the study group. They were evaluated by the 'Comprehensive Epilepsy Care Team' at the AIIMS with detailed clinical assessment, interictal EEGs, video-EEG studies, magnetic resonance imaging (MRI) with special sequences tailored for evaluation of the temporal lobes and for cortical dysplasias and single photon emission computerised tomography (SPECT) studies. Intraoperative electrocorticography was obtained in some patients. Outcome was assessed on follow-up, and graded according to Modified Engel's Grading System. RESULTS: Twenty-five patients (18 males, 7 females) with a mean age of 19.7 years (age range 7-45 years) were operated and assessed during the study period, for surgical outcome with a mean follow-up of 16.8 months (range 3 months to 6.5 years). Twenty patients (87%) were found to have a good outcome (Modified Engel's grades I and II), while three had poor outcome, one died and one was lost to follow-up. CONCLUSION: We found a good seizure outcome in patients who underwent resection of extratemporal epileptogenic foci, one of the reasons being presence of a lesion in all patients. Careful patient selection even with non-invasive investigations can aid in obtaining a good outcome in this group of patients.