Penetrating stab wounds of the chest: experience with 200 consecutive cases

The incidence of penetrating wounds of the chest is rising rapidly. Opinions continue to differ on their management. Our experience with 200 consecutive cases of stab wounds of the chest between 1972 and 1975 were reviewed. There were 176 males and 24 females. The average age was 31 years; about two-thirds of the patients were under 30. About 74% presented with hemothorax or hemopneumothorax; 21 presented with pneumothorax. Eleven per cent had associated intra-abdominal injuries. Seventy-nine per cent were successfully treated with tube thoracostomy. About 15% underwent thoracotomy, with three deaths (mortality, 10%); the mortality for cardiac wounds was 16%; overall mortality was 1.5%. The overall complication rate was 5.5%, most occurring in patients with cardiac wounds and associated intra-abdominal injuries. The average period of hospitalization was 6.5 days. Treatment was individualized. Indications for each course of therapy are discussed.     

Anticonvulsant activity and inhibition of cellular respiratory activity by substituted imidazolocarbamides

Several 1-(1-aryl-2-mercaptoacetylimidazole)-3-alkylcarbamides were synthesized and characterized by their sharp melting points, elemental analyses, and IR spectra. These substituted imidazolocarbamides possessed anticonvulsant activity, which was reflected by the 20-80% protection observed with these compounds against pentylenetetrazol-induced convulsions in mice. These substituted imidazolocarbamides selectively inhibited the in vitro oxidation of nicotinamide adenine dinucleotide (NAD)-dependent oxidations of pyruvate, alpha-ketoglutarate, beta-hydroxybutyrate, and NADH by rat brain homogenates. However, NAD-independent oxidation of succinate was not affected. The anticonvulsant activity possessed by 1-(1-aryl-2-mercaptoacetylimidazole)-3-alkylcarbamides had no relationship to their ability to inhibit cellular respiratory activity.     

Equilibration of pancratic digestive enzymes across zymogen granule membranes

Zymogen granules isolated from the rat pancreas released digestive enzyms in response to lowering the enzyme concentration of the medium in which the granules were suspended, and reabsorbed enzyme when the enzyme concentration of the medium was increased. The evidence suggests that the distribution of digestive enzyme between zymogen granule and medium is the result of an equilibrium process. This equilibrium is apparently expressed across the granule membrane since the disruption of the membrane barrier eliminated the delay in establishing new equilibrium between the bound and free enzyme. The release of enzyme was continuous (equilibration did not occur) when the suspending medium was continuously filtered, thereby maintaining a constant state of disequilibrium between intragranular enzyme and enzyme in the medium. The data suggest the following: (1) that digestive enzyme passes through the intact granule membrane bidirectionally, and (2) that there is a free cytoplasmic pool of digestive enzyme in intact cells which is in equilibrium with the enzyme content of the zymogen granule.     

Termination of abnormal intrauterine pregnancies with intramuscular administration of dihomo 15 methyl prostaglandin F 2alpha

A synthetic compound, 2a, 2b dihomo 15 (S) 15 methyl prostaglandin F 2 alpha methyl ester given 8-hourly by intramuscular injection was used to terminate pregnancies in 72 patients with a missed abortion, intrauterine fetal death, molar or anencephalic pregnancies. Treatment was successful in all cases. A 4 mg dose of loperamide given orally at 15 to 30 minutes before the injection of prostaglandin analogue prevented diarrhoea as a side effect.