Neuropathologic effects of intrathecal water

In attempting to control the pain of disseminated carcinoma, a variety of agents has been injected intrathecally. This report deals with the neuropathologic changes in spinal roots and spinal cord of four patients into whose lumbar sacs 100 to 285 ml of distilled water was infused. Survival following the procedure ranged from 9 to 50 days. In most severely affected case (285 ml instilled 50 days prior to death) the abnormalities were: (1) severe breakdown of axons and myelin sheaths of the lower cauda equina and to a lesser extent of other roots at levels as high as the eighth cervical segment, (2) severe central chromatolysis of anterior horn cells in lumbo-sacral spinal cord with milder degrees of change in the thoracic and lower cervical spinal cord, and (3) striking vacuolar change and axonal swelling, primarily in the lateral columns ascending as high as the lower cervical spinal cord. A second case (140 ml instilled 24 days prior to death) showed similar but milder changes. The remaining cases (100 ml instilled 34 days prior to death: 100 and 200 ml instilled 27 and 9 days prior to death) showed no changes referable to intrathecal water. Infusion of distilled water intrathecally is capable of producing distinctive lesions of spinal root and cord.

Myelination inhibiting and neuroelectric blocking factors in experimental allergic encephalomyelitis

Sensitization of Lewis rats with whole central nervous system tissue or with purified myelin induced both experimental allergic encephalomyelitis (EAE) and a serum factor which inhibited myelin formation in vitro. Sensitization with the encephalitogenic factor, myelin basic protein, induced EAE, but not the myelination inhibition factor. Sensitization with cerebroside induced neither EAE nor myelination inhibition factor. The serums from control animals without EAE as well as from animals sensitized with all of the above antigens blocked evoked electrical responses in vitro.

Vagotomy for gastric ulcer

Out of a series of 75 patients who were treated by vagotomy and drainage for gastric ulcer 66 have been followed up for one to seven years (average three-and-a-half years). Four recurrent gastric ulcers occurred among the 33 cases of ulcer of the lesser curve or body with no antral or duodenal lesion (type I). Among the 42 patients with an antral ulcer or an associated active or healed pyloric or duodenal lesion (type II or III) there was only one recurrence. The recurrence rate for men was 5% and for women 12%. One patient died two years after operation from cancer which may have originated in the stomach. The clinical results in patients without recurrences were generally satisfactory.Vagotomy, preferably selective, with drainage is a satisfactory operation in gastric ulcers of types II and III. For ulcers of type I, gastrectomy is to be preferred except in selected cases.