Ultrastructural changes of synaptic glomeruli following intrathecal injection of distilled water to rats.

We attempted to identify synaptic glomeruli in the spinal substantia gelatinosa of rats by injecting distilled water into the subarachnoid space. The altered synaptic glomeruli were visualized when injecting 1.0 ml of distilled water, though the incidence of degenerative synaptic glomeruli was rare in the case of an injection of 0.5 ml or less. We assume that when the distilled water is injected, there is a sudden change in homeostatic balance in cerebrospinal fluid, following inhibition of nerve impulses in the dorsal root and the altered synaptic glomeruli. Ultrastructurally, the injection of distilled water led to a preferential degeneration of synaptic glomeruli derived from the C-fibers.

Methods for mitigating soft-tissue injury after subcutaneous injection of water soluble contrast media.

RATIONALE AND OBJECTIVES: Water soluble contrast media may cause tissue injury by extravasation during intravenous injection during various radiologic examinations. The authors attempted to find out what kind of management could mitigate tissue injury when extravasation of water soluble contrast media occurs. METHODS: Sodium and meglumine ioxithalamate was injected subcutaneously into 240 hind feet of 120 rats that were divided into six groups according to the methods of experimental management. Experimental managements included the following: no further management (control), injection of distilled water, injection of normal saline, injection of hydrocortisone, hot water application, and cold water application. Gross morphologic changes in each group were compared with those in the control group. RESULTS: Only the saline injection group showed statistically significant decrease of tissue injury compared with the control group. CONCLUSIONS: Saline injection lessens the degree of soft-tissue injury at contrast media extravasation sites in rats.

Scald accidents during water aerosol inhalation in infants.

A study of 193 infants admitted for burns over a 4-year period revealed 11 infants (5.7 per cent) had sustained scalds during the process of water aerosol inhalation. The water aerosol inhalation therapy was prescribed for respiratory tract infection and carried out at home using either an electric kettle or a saucepan. It appears that infants are prone to this type of injury because of the difficulty of keeping them still during therapy and their inquisitiveness to explore their surroundings. The resulting scalds added to the morbidity of those children already suffering from respiratory tract infections. These accidents can easily be prevented by the alternative use of a humidifier.

Magnesium in atherosclerotic cardiovascular disease and sudden death.

Magnesium ions are important for maintaining the functional and structural integrity of the myocardium. Epidemiologic studies suggest that myocardial hypomagnecytia can predispose to sudden cardiac death and that hard water protective factor preventing heart attack could be magnesium. Recent studies show that infarcted portion of the myocardium has lowered magnesium content as compared to noninfarcted segment. Magnesium deficiency sensitises the myocardium to the toxic effect of various drugs, hypoxia etc. and magnesium administration is protective. The metabolic, biochemical and electrophysiologic effects of magnesium appear to be significant in treatment of myocardial ischaemia. Magnesium is a metal-coenzyme and activates adenosine-triphosphatase which may be inhibited by nonglucose fuels like lactate and free fatty acids. Magnesium deficiency may be responsible for the chronic electrical instability of the myocardium predisposing to sudden cardiac death. The acute precipitating stress dependent trigger which lie in the brain may also be related to magnesium. In addition to fast Na and Ca channels there could be a Mg-carrying transport system maintaining the electrical activity of the myocardium. There is sufficient evidence to suggest the use of magnesium salts against ischaemic heart disease and sudden cardiac death. Magnesium is cardioprotective and influences action potential duration, membrane potential and perhaps maintains the fast response. The therapeutic and prophylactic value of magnesium needs further assessment.

Effect of some enzyme inducers, fluids, and methionine-thiosulfate on induced acute aflatoxicosis in goats.

Groups of four 6- to 12-month-old male goats were injected intraruminally with a lethal dose (3 mg/kg of body weight) of aflatoxin B1 (AFB1). Drugs were administered parenterally before (pretreatment) or beginning 8 hours after goats were doses with AFB1. These drugs were phenobarbital (PB), phenylbutazone (PBZ), piperonyl butoxide (PRO), benzoflavones, water, and 5% glucose solution (D5W). Most groups given the drugs after AFB1 was administered also were given intraperitoneal injections of methionine-sodium thiosulfate (MET-TS) solution. Clinical signs of toxicosis, serum aspartate aminotransferase activities, serum bilirubin concentrations, duration of illness, mortality, and gross and microscopic pathologic findings taken together indicated that toxicosis was increased with MET-TS + PB therapy, PBZ pretreatment, PBZ therapy, benzoflavone pretreatment, benzoflavone therapy, MET-TS + benzoflavone therapy, and MET-tS + water therapy. Toxicosis was not altered appreciably by MET-TS + PBO therapy. Beneficial effects (less severe toxicosis) were produced by PB pretreatment; these effects were prolonged maintenance of strength, vigor, and appetite and (in 1 goat that recovered) absence of pathologic changes or serum bilirubin increase. Therapy with MET-TS + D5W (but not MET-TS alone) also lengthened maintenance of strength, vigor, and appetite, but did not prevent pathologic changes. The beneficial effect of MET-TS therapy reported in a previous study (AFB2 dosage of 4 mg/kg) was not observed with the 3 mg/kg lethal dose. In conclusion, therapy for acute aflatoxicosis with inducers of hepatic microsomal enzymes is ineffective (PBO) or contraindicated (PB, PBZ, benzoflavones). Therapy with D5W may be a useful adjunct to other therapeutic drugs, but multiple intraperitoneal injections of D5W may decrease survival time because of stress.

Mast cell tumor destruction by deionized water.

In a controlled study, malignant murine P815 mastocytoma cells exposed in vitro to distilled and deionized water died as a result of progressive swelling, degranulation, and membrane rupture. A 90% mean cell death occurred when cells obtained directly from culture were exposed to deionized water for 2 minutes. Of 6 cryopreserved malignant murine cell lines, which included Cloudman S91 melanoma, CMT-93 rectum carcinoma, MMT-06052 mammary carcinoma, and S-180 Sarcoma, only P815 mastocytoma and YAC-1 lymphoma were significantly (P less than 0.05) affected by hypotonic shock; Cloudman S91 melanoma cells were the most resistant. Mastocytoma cells were selectively killed by hypotonic solution, and lymphoma cells were also killed by isotonic saline solution. Local mast cell tumor (MCT) recurrence and percentage survival were evaluated in 12 cats (21 MCT) and 54 dogs (85 MCT) subjected to surgery alone or local infiltration of deionized water as an adjunct to surgery. Of all 16 incompletely excised MCT in cats, there was no local recurrence following injection. Four mast cell tumors (2 cats) regressed after being injected in situ. In dogs with clinical stage-I MCT, local recurrence was detected in 50% (5/10), but with injection after incomplete excision, local MCT recurrence was significantly (P less than 0.05) less (6.6%, 1/15). Percentage recurrence was significantly (P less than 0.05) less and survival significantly greater when incompletely excised grade-II MCT were injected. Mean follow-up period after surgery in cats and dogs was 35 and 23.4 months, respectively.

Caustic ingestions. Pathophysiology, diagnosis, and treatment.

More than 5,000 caustic ingestions are estimated to occur each year. Liquid lye is associated with the greatest morbidity. Endoscopy is the only method for evaluating the extent of the injury; clinical signs and symptoms (e.g., vomiting, dysphagia, abdominal pain, oral burns, leukocytosis) are not reliable. In less severe burns (involving only mucosal irritation or ulceration), current therapy with antibiotics and steroids results in a very favorable prognosis. Circumferential or very deep burns have a much poorer outcome, with a greatly increased risk of stricture formation and/or perforation. The risk of developing esophageal carcinoma may be 1,000 times greater for individuals who have had a lye burn than in the general population. It cannot be overemphasized that prevention is still the key to decreasing this morbidity.

[Hemolysis in not the cause of the TUR-syndrome. The use of non-hemolytic solutions does not prevent its occurrence (author's transl)]. / Hämolyse ist nicht Ursache des TUR-Syndromes. Die Verwendung nichthämolysierender Spüllösungen kann es nicht verhindern

The TUR-syndrome has an acute and a delayed toxic modality. It occurs during the resection of large prostatic glands with long operative times and by perforation of the prostatic capsule. The TUR-syndrome is not caused by hemolysis by but disturbances of the serum electrolytes.

Foot soaks for callosities and fissures.

A study to assess the effect of soap soaks and plain water soaks on the dry anaesthetic sole of 15 leprosy patients bearing multiple fissures and callouses is reported. A callous scraper devised by us was found effective. It is recommended that a hypotonic keratolytic solution such as toilet soap or plain water be used for soaking which has the effect of softening the keratin. It may be better to use soap solution for this purpose.

[Liver resection by water jet].

Major problem in resecting liver parenchyma is how to control the bleeding. Recently, resection of the liver by water jet has been reported. So, experimental and clinical studies were performed to investigate the usefulness of the water jet equipment. Ten pigs weighing around 17kg were used. The optimal pressure to resect the porcine liver was 7 to 15kg/cm2. By 4 weeks the cut surface was covered with fibrous capsule. Portal angiography showed no abnormality in the resected area. The water jet was also used in 30 human operations. The optimal pressure was 12 to 18kg/cm2 for non cirrhotic liver and 15 to 20kg/cm2 for cirrhotic liver. The surface immediately after jet cutting was more smooth than that of CUSA and histologically there was slight bleeding and necrosis. The volume of blood loss during dissection was not different between water jet group and CUSA group. No significant changes were found in the laboratory data. These results suggest that water jet is as useful as CUSA for cutting the liver parenchyma.