Studies in the management of the contaminated wound. IX. Quantitation of the Evans blue dye content of open and primarily closed surgical wounds

The purpose of the present study was to quantitate the changes in the vascular permeability of open and primarily closed wounds after bacterial contamination. Alterations in vascular permeability in tissue were indicated by measuring the content of Evans blue dye in open and primarily closed wounds at different intervals after wounding and contamination. Evans blue dye forms a stable complex with circulating plasma albumin and extravasates through the walls of vessels as they become increasingly permeable.One hour after wounding, the tissue in the clean open wound exhibited a marked increase in dye content when compared with primarily closed wounds not subjected to bacterial contamination. The elevated dye content in the open wound persisted at least seventy-two hours after wounding. Contamination of the open wound with Staph aureus resulted in minimal changes in the content of dye when compared with open wounds not subjected to contamination. In contrast, topical application of Staph aureus to the surface of a wound undergoing primary closure elicited a marked increase in the Evans blue dye content of the primarily closed wound.It is postulated that the increase in Evans blue dye in the clean open wound is a reflection of extravasation into the wound of plasma proteins that form a serous exudate. This accumulation of blood proteins in the open wound may account for its resistance to infection by providing either local lymphatic blockades to bacterial invasion, wound drainage for removal of foreign bodies, antibacterial activity that renders the wound free of bacteria, or all of these factors.     

The effects of drugs on objective measures of thought disorder in schizophrenic patients

Results of studies using tests of thought disorder suggest the possibility of distinguishing three separate and possibly independent syndromes among schizophrenic patients.Process schizophrenics seem to be characterized by a relatively low I.Q., general psychomotor retardation, a slow reaction time, perceptual underconstancy, concreteness and distractibility. Many of these specific defects can be produced in normal people by the drug Sernyl, but not by other drugs studied. No known drug (such as the phenothiazines) has been shown to improve all these dysfunctions significantly in schizophrenic patients.Psychotic anxiety reaction is a label which might be used to describe the thinking disturbances found in many reactive schizophrenics. It consists of a tendency to produce unusual responses in a wide range of experimental situations, accompanied by an unusual degree of perceptual constancy. These behavioral abnormalities might be due to the disruptive effects of a very high level of anxiety, and might be alleviated by depressant drugs.Overinclusive Psychosis, characterizes a minority of hyperactive schizophrenics and some manic patients, who seem to use unusually broad and vaguely defined concepts in their thinking. LSD may induce this type of thinking in normal subjects, and it is possible that it may respond to phenothiazine medication.Paper presented at the meetings of the American College of Neuropsychopharmacology, December 10–11, 1970, San Juan, Puerto Rico, as part of a symposium, Behavioral Mechanisms of Drug Action in Schizophrenia, Solomon C. Goldberg, Chairman.     

The role of cell-fixed calcium in histamine release by compound 48/80.

1. Histamine release by compound 48/80 was substantially reduced in a time-dependent manner (maximum at 30 min) by pre-incubating mast cells in calcium-free medium at 37 degrees C but not at 2 degrees C. This effect was optimal at pH 7.0 to 7.5. 2. The re-introduction of calcium (0.1 to 3 mmol/l) restored histamine release to the control value; this effect was independent of temperature. 3. Strontium (1 to 30 mmol/l) partially reversed the effect of calcium deprivation but the same concentrations of barium and magnesium depressed histamine release even further. Magnesium (3 to 15 mmol/l) antagonized the effect of calcium replacement. 4. Results suggest that the level of cell-fixed calcium involved in compound 48/80-induced histamine release may be controlled by the combination of rapid passive influx and slow active efflux.     

Intraventricular fiberscopic observations in adult hydrocephalic patients

A flexible ventriculofiberscope was used to diagnose intraventricular pathological conditions in eight adult hydrocephalic patients. In each case the entire procedure was recorded on videotape for documentation, review, and teaching. Four representative cases are presented to illustrate the use and value of this technique.