Serum IgE levels in giardiasis

Raised levels of serum immunoglobulin E are found in many parasitic diseases. In order to determine the influence of Giardia lamblia on IgE levels of clinically symptomatic patients, a controlled study was performed. There was no difference between the serum IgE values from Brazilian patients with giardiasis and those from normal Brazilian controls, although in both groups there were many individuals with values higher than the normal range reported from the northern hemisphere.

Sarcoid of the cauda equina. Case report

An unusual case of sarcoid involving the cauda equina, resulting in progressive paraparesis, is presented. There was no evidence of sarcoid involvement outside the nervous system, and the diagnosis was established through thoracolumbar exploration. The patient was treated with steroids postoperatively, and had a moderate recovery of neurological function.

Penetration of brain abscess by systemically administered antibiotics

✓ In six consecutive patients treated with systemic antibiotics for brain abscess, chloramphenicol, methicillin, and penicillin were found capable of penetrating the abscess in therapeutic concentration. Nafcillin, a fourth antibiotic tested, failed to penetrate. While on antibiotics, all six patients continued to deteriorate neurologically until needle aspiration of the abscess was carried out, after which recovery began promptly. Organisms were found in the pus despite the presence of therapeutically effective antibiotic levels, and despite the fact that the organisms were sensitive, in vitro, to the antibiotics used. These observations confirm that antibiotics alone are insufficient and that surgical evacuation of the abscess is essential. The need for local instillation of antibiotics directly into abscesses is questionable since penetration following systemic administration of three antibiotics tested was adequate when blood levels were high. It is suggested that the instillation of penicillin or its derivatives be avoided in view of their potential epileptogenicity as well as the questionable value of this method.

Carotid-cavernous fistula: a controlled embolus technique for occlusion of fistula with preservation of carotid blood flow. Technical note

✓ A case is described in which a carotid-cavernous fistula was eliminated successfully with preservation of the carotid circulation by a small ball-shaped muscle embolus introduced via an arteriotomy in the cervical carotid. The intent is to lodge the embolus in the fistula without occluding the carotid siphon. A long thread is attached to the embolus to permit its withdrawal if its position in the siphon proves unsatisfactory. Neither the intracranial nor cervical carotid artery is ligated.

Alleviation of Pain by Hypothalamic Stimulation in the Monkey

This study is concerned with stimulation of various subcortical loci as a means of attenuating the aversive properties of concurrent painful stimuli applied peripherally. The medial forebrain bundle (situated in lateral hypothalamus) of the monkey was found to yield consistent self-stimulation behavior. Stimulation of this positively reinforcing locus during delivery of painful shock to the ankle resulted in an attenuation by approximately one-third of the pain response. Other loci tested in limbic system produced little or no diminution in pain. Although the mechanism of this phenomenon is not clear, it is suggested that human trials may be warranted if further animal studies confirm the present observation.