Prospective trial of the six hour rule in stab wounds of the chest

Stab wounds of the chest may be associated with a spectrum of injuries ranging from the lethal to the insignificant. The management of asymptomatic patients with stab wounds of the chest is controversial. The results of previous reports have asserted that asymptomatic patients with stab wounds of the chest do not have delayed complications develop if roentgenograms of the chest taken six hours after the injury are normal. This "rule" has not been validated. A three year, prospective study of patients with stab wounds of the chest was done. Patients were excluded from the study if they had symptoms on arrival, evidence of physiologic derangement caused by intrathoracic injury, wounds near the subclavian vessels or precordial wounds. Patients with lower thoracic stab wounds were evaluated by diagnostic peritoneal lavage. If findings from lavage were negative, the patients were included in the study. One hundred and five patients met the criteria for inclusion in the study group. All of the patients were hospitalized and examined serially. All had roentgenograms of the chest performed at admission, at six hours and at 24 hours. Four patients had a pneumothorax or hemothorax develop between the time of admission and six hours of hospitalization. In the remaining 101 patients, none had a pneumothorax or hemothorax between six and 24 hours. No patient asymptomatic on admission had a tension pneumothorax develop later. No patient had delayed evidence of abdominal injury. An asymptomatic patient with a stab wound of the chest that is not precordial, not in proximity to the subclavian artery and not suspected of diaphragmatic penetration should be serially examined and have a follow-up roentgenogram of the chest at six hours. If the patient remains asymptomatic and the six hour film is normal, delayed complications are rarely, if ever, encountered and the patient does not require further studies or hospitalization. The six hour rule for stab wounds of the chest is valid.

Adult tuberculous meningitis. An immunological study

In adult tuberculous meningitis (10), delayed skin hypersensitivity to DNCB was significantly impaired, whereas to tuberculin not altered. Lymphocyte migration (LMI) index was lower in comparison with pulmonary tuberculosis (20) and healthy adults (20). Lower LMI index was statistically not significant than pulmonary tuberculosis. Serum IgG and IgM levels were higher than in healthy adults. In comparison with pulmonary tuberculosis, only IgM levels were raised. We conclude that in adult tuberculous meningitis, cell mediated immune response is impaired and non-specific antibody response is increased than pulmonary tuberculosis and healthy adults.

Is the 'rejection reaction' inducing ability in sporophytic self-incompatible systems restricted only to pollen and tapetum?

The present investigation describes the stigmatic rejection response, induced by anther or pollen at developmental stages ranging from anther primordia to mature pollen, as well as in other floral and vegetative tissues. This has been studied in a sporophytic self-incompatible system, Brassica campestris (Brassicaceae). The implications of these observations have been discussed.

Changes in composition and enzyme activities of mitochondrial and post-mitochondrial fractions of tissues of rats given mustard oil diet with carnitine and/or fish oil

The effects of short-term feeding of a 20% mustard oil (containing 47% erucic acid) diet with 0.1% carnitine and/or fish oil on the activity of enzymes of lipid metabolism in mitochondrial and post-mitochondrial fractions of heart, liver, and skeletal muscles of rats were determined to study the reversal of erucic acid-induced lipidosis. Histopathological changes were also studied. The inclusion of fish oil or fish oil plus carnitine in a mustard oil diet, especially the latter, eliminated the histopathologically detectable lipidosis in heart and skeletal muscles. The reason for this appears to be the increased activity of lipase and phospholipase in tissue homogenates and of cholesterol ester hydrolase in the post-mitochondrial fraction; and also an increase in mitochondrial succinate dehydrogenase which may increase the utilization of the liberated fatty acids. The results suggest that the erucic acid-induced lipidosis is prevented or eliminated by increased lipolysis and oxidation of fatty acids when such a diet is supplemented with carnitine and/or fish oil.