James F. Connell

The clinical evaluation of a new anti-inflammatory agent: A preliminary report

Abstract 1. 1. G-27202, a metabolic derivative of phenyl-butazone, has potent anti-inflammatory properties. 2. 2. This agent has not demonstrated any toxic effects during short term therapy on the dosage schedule outlined. 3. 3. The use of anti-inflammatory agents may play a definite ancillary role in reducing inflammation due to surgical intervention. 4. 4. Further studies on the basic activity of this agent in the role of a host modifier in clinical trials are in progress.

Bacillus subtilis protease in the digestion of burn eschar.

The activity of a Bacillus subtilis protease on burn eschar was studied. The protease is a broad‐spectrum proteolytic enzyme active between pH 5.4 and 7.8. The enzyme digests denatured necrotic human skin but is practically inactive toward nOlmal viable skin. In the course of its digestive activity, it breaks down burn eschar to acid‐soluble peptides and amino acids; the latter predominating in comparison with the activity of some other enzymes. About 40 per cent of burn eschar is broken down in 24 hours. By applying fresh enzyme and extending the time to 48 to 72 hours, 60 per cent of the eschar may be broken down. The residue is left in a condition which is easily removed. The release of the enzyme from a fatty base is satisfactory.

Evaluation of present day concepts in the treatment of the severely burned patient

We will attempt in this paper to present a summary of our experience with 233 severefy burned patients. This discussion wiI1 be fimited to the more criticaf topics of mortality, infection and focal wound therapy carried out under the aegis of the Department of Surgery, St. Vincent’s Hospital, New York City, during the past five years, with the support of the United States Army, Department of Medical Research and Devefopment. Our main criteria for progress in the status of the burn patient in the first forty-eight hours have been the hourly observation of urinary output from an indweffing catheter correlated with frequent observations of the hematocrit and vita1 function.

Use of thermography for evaluation of sympathetic blocks

Summary A method for evaluating the effect of sympathetic blocks using thermographic equipment is described. The technical criteria of the procedure must be followed accurately to obtain reliable results The relative complexity of the methed may somewhat limit its use for routine cases, but thermography has proved to be a valuable adjunct in the evaluation of complicated or obscure conditions.

A clinical evaluation of oxyphenbutazone in surgical inflammatory lesions

Abstract Oxyphenbutazone proved to be an effective, rapid-acting, anti-inflammatory agent in 245 patients studied. Although a metabolite of phenylbutazone, it has not demonstrated any of the side reactions of the parent compound in these short courses of therapy. Oxyphenbutazone, combined with an appropriate antibiotic, exerts a potent bactericidal effect on local wound organisms. In all instances of wound inflammation associated with infection, an antibiotic must be given concomitantly with oxyphenbutazone. Oxyphenbutazone given preoperatively, reduces wound edema and local myositic reaction so that narcotic requirements are markedly reduced and early mobilization is facilitated. Oxyphenbutazone is at present limited to oral use. The parent phenylbutazone compound may be temporarily substituted for parenteral use. An excellent ancillary tool is hereby added to our surgical armamentarium.