1. The surface properties of over 250 films of diplamitoyl lecithin (DPL) and Tween 20 on distilled water have been investigated using two different surface balances simultaneously, the Wilhelmy balance, popular in physiological studies, and the Du Nuoy ring method whose readings are independent of contact angle. 2. Using concentrations of DPL ranging from 0.08 to 1.90 microgram cm‐2 on a Langmuir trough where the pool area was cycled from 100 to 27.5% of maximum, the Wilhelmy balance registered virtually the same force per wetted perimeter as the ring method for both pure water and Tween 20, but appreciably lower values for DPL over the whole cycle. 3. The above differences can be explained on the basis of a significant (45‐70 degrees) contact angle, a surface property also demonstrated photographically and by direct measurement. 4. Contact angle was shown to vary with pool area, a relationship exhibiting hysteresis. 5. This study indicates that the Wilhelmy balance has been an unfortunate choice of instrument for studying DPL films whose surface tensions are appreciably higher than previously estimated.
Objective Two forms of recombinant growth hormone that accelerate the healing of skin graft donor sites in severely burned children were evaluated. Summary Background Data Growth hormone has been shown to reduce wound healing times in burned pediatric patients. Through genetic engineering, several different forms have been synthesized; however, not all are marketed currently. Two forms of growth hormone were used in these studies, Protropin (Genentech, Inc., San Francisco, GA), a commercially available product that possesses a N-terminal methionine residue not found in the second form Nutropin (Genentech, Inc., San Francisco, CA), which, as yet, is not commercially available. Through the use of recombinant human growth hormone, rapid wound healing may reduce the hypermetabolic period, the risk of infection, and accelerate the healing of donor sites used for grafting onto burned areas. The two structurally different forms of growth hormone were tested for their efficacy in healing donor sites in severely burned children. Methods Forty-six children, with a > 40% total body surface area and > 20% total body surface area full-thickness burn were entered in a double-bind, randomized study to receive rhGH within 8 days of injury. Twenty received (0.2 mg/kg/day) Nutropin or placebo by subcutaneous or intramuscular injection beginning on the morning of the initial excision. Eighteen patients who failed the entry criteria for receiving Nutropin received Protropin therapeutically (0.2 mg/kg/day). Donor sites were harvested at 0.006 to 0.010 inches in depth and dressed with Scarlet Red impregnated fine mesh gauze (Sherwood Medical, St. Louis, MO). The initial donor site healing time, in days, was reached when the gauze could be removed without any trauma to the healed site. Results Donor sites in patients receiving Nutropin (n = 20) or Protropin (n = 18) healed at 6.8 ± 1.5 and 6.0 ± 1.5 (mean ± SD) days, respectively, whereas those receiving placebo (n = 26) had a first donor site healing time of 8.5 ± 2.3 days. Both groups receiving rhGH showed a significant reduction in donor site healing time compared with placebo at p < 0.01. When subgroups were compared, no difference in healing times could be shown with regards to age or time of admission after injury.
A 70-year-old man was admitted with massive haematochezia. It was the first episode, and had not been associated with haematemesis, melaena or abdominal pain. He was diabetic and hypertensive, but well controlled on insulin injections and enalapril. He was alert, but pale. The blood pressure was 90/60 mmHg, the pulse was 100/min, and there was fresh blood on rectal examination. The haemoglobin value was 4.7g/dl. Resuscitation was started, and blood transfusion initiated. Gastroscopy revealed a small mucosal defect in the pylorus, with clot on the base, suggestive of Dieulafoy lesion.
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