1988年 · 第101卷第05期

The world's first test tube baby was born in England in July 1978, almost ten years ago. In recent years, the number of test tube babies has increased rapidly from 3 000 in 1986 to 6 000 in 1987. Successful cases of in vitro fertilization and embryo transfer (IVF & ET) in Taiwan and Hong Kong have been reported. The technique of gamete intrafallopian transfer (GIFT) was first described by Asch et al in 1984. We started the IVF & ET research program in late 1984 and worked out our own protocols in the beginning of 1987. There are now two cases of clinical pregnancy following IVF & ET and two following GIFT. The first IVF & ET baby was delivered on March 10, 1988 and the second is expected to be born by the end of May. The first GIFT patient aborted in her third month of pregnancy and the second one was delivered of a full-term baby on March 18, 1988.

Co-Cr-Mo alloy pearl-surfaced hip prostheses were employed to implant into 33 dogs and 44 patients (49 hips). The mongrel dogs were randomly divided into 2 groups for biomechanical test (21) and histomorphological study (12). Each group was sub-divided into 6 groups according to the specimens tuken at 0.5, 1, 2, 4, 6, 8 months, respectively. The specimens were evaluated by scanning electron microscopy, polarized microscopy, fluorescent labelling, isotopic scanning, microradiography, stereomicroscopy, histological study and biomechanical test. From September 1983 to March 1986, 44 patients (49 hips) had cementless total hip endoprostheses. They had no loosening appearance either in clinical examination or in radiography. We conclude that ingrowth fixation of the pearl-surfaced hip prosthesis is an attractive alternative to the use of acrylic cement and is free from any local or general complications usually caused by cement technique.

Visuospatial perceptual tests were administered to 57 patients with Parkinson's disease (PD). 50 normal subjects served as controls. Of the controls only 7 female subjects made mistakes in the tests, they were older and essentially illiterate. Thirty-eight patients (25 males and 13 females) with PD made significantly more mistakes than the 7 female controls. The patients' mean age was 10 years younger and their mean duration of school attendance was 7.8 years. The visuoperceptual deficits seem not to be a feature of global mental deterioration. Four patients' illnesses had lasted less than 1 year. Three of them showed frank visuospatial deficits. It is conceivable that the visuospatial performance abnormalities found in PD are mainly due to basal ganglia (BG) damage. Visuoperceptual impairment was present only in tests requiring mental processing of information derived from a two dimensional picture into three-dimensional concepts. BG is probably involved in mental processing of visuospatial images.

The acute hemodynamic effect of oral nifcdipine 20 mg in 15 patients with severe congestive heart failure (CHF) and sequential changes of plasma catecholamines in 10 of 15 patients was investigated. Nifedipinc improved the hemodynamic status in most severe CHF patients with the decrease of mean arterial pressure, systemic vascular resistance, pulmonary vascular resistance and pulmonary artery end-diastolic pressure, and the increase of cardiac output, cardiac index, stroke volume and stroke work index. After administration of nifedipine, heart rate did not change, while plasma norepinephrine and double product of HR and systolic blood pressure decreased. The mechanism of improvement of CHF by nifedipine is mainly due to the reduction of afterload. It seems that nifedipine can be safely used in most severe CHF patients.

We designed a colon-intussuscepting technique for artificial anus after Miles' operation. After excision of tumors, the distal end of the resected colon was sutured intussusceptively for a certain length to form an incomplete obstructed ring as an artificial perineal anus. From May 1981 to March 1986, 302 patients received this operation, followed by manometric determination and barium enema. Of the 121 patients who had been operated upon, 111 survived with 2- and 3-year survival rates of 91.73% (111/121) and 74.60% (47/63) respectively. Function of the artificial anus was excellent in 80% of the patients 3 months after operation. This simple technique may bring about satisfactory results inmost patients with rectal cancer.

Acupuncture points in the phsiologic system exist neither in a static nor stationary state. Rather,they have dynamic potential by which they are capable of converting between different functional phases. In a state of optimal health, all acupuncture points should remain iii an inactive stage of latent phase. If the human body sustains physical injuries coming exogenously and/or suffers from diseases occurring endogenously, some of the points will turn from an inactive latent to an active functional stage of the passive phase. Passive acupuncture points can be physically detected by simply pressing a finger tip on the body surface with an appropriate force. An increased number of acupuncture points existing in the passive phase indicate less stability of the physiologic system. Instability of the physiologic system reflects a diminishing capability of our body to maintain the homeostatic state. Therefore, it is reasonable to assume that passive acupuncture point scan be used as a physical as well as a physiologic indicator of the level of homeostasis.

273 cases of mucinous ovarian tumors and 221 cases of serous ovarian tumors were reviewed. After excluding those of benign tumors, the remaining 48 and 44 cases were divided into three groups: bordeline malignancy, local malignancy and carcinoma. The results of clinicopathologic analysis revealed that the borderline malignancy and local malignancy lesions were similar in clinical behaviors but different in benignancy and malignancy in pathology. They appeared to be malignant clinically, but were so indolent that they had much less extraovarian spread and more favorable prognosis than carcinomas. The concept of borderline tumors must include two groups of tumors. One is the benign tumors bordering malignancy named the "borderline malignancy" and the other is the malignant tumors bordering benignancy named "the local malignancy". The tumors of borderline malignancy and local malignancy are in the nature of one category of lesions in the borderline zone between benign and malignant varieties. The histologic criteria for borderline malignancy, local malignancy and carcinoma were summed up by experience. The unquestionable malignancy criteria were indicated and the significance of stromal invasion for diagnosis of carcinoma was discussed.

Mutagenicity and teratogenicity of chlorpromazine and scopolamine with indicators of chromosomal aberration, sister chromatid exchange (SCE) and teratogenesis test of gestation in mice are presented in this paper. Chlorpromazine and scopolamine were divided into five (0.25, 0.5, 1.0, 1.5 and 2 μg/ml) and six (0.5, 1.0, 2.0, 5.0, 10 and 20 μg/ml) dosage groups respectively. Each was added directly to peripheral lymphocyte cultures of 10 healthy adults. Cultures treated with saline and mitomycin served as normal and positive controls. The chromosomal aberration and SCE were simultaneously studied. The frequency of chromosomal aberration and SCE in the chlorpromazine groups were markedly higher than these of the normal controls (p<0.01 or p<0.05). Those of the scopolamine groups were also significantly higher. The results showed that chlorpromazine damages DNA. Usual clinical doses of scopolamine do not damage DNA, but large doses do. Using 1/50 and 1/10 0f the LD50 dose (i.e., 1.8 and 9.2 μg of chlorpromazine or 4.6 and 59 μg of scopolamine per gram of body weight), their terato-genicity was tested in mice. Saline and cod-liver oil treated mice were used as normal and positive controls respectively. The incidences of malformed fetuses were 38.5% and 42.7% with chlorpromazine or 3.8% and 8.2% with scopolamine, while those in nomal and positive controls were 0 and 28.6% respectively. The results showed that the teratogenic effect of chlorpromazine in mice was greater than that of scopolamine.

Plasmids and biological characteristics of Shigela-strains isolated in Shanghai were studied for comparison with those of strains isolated in Tokyo from travellers back from various areas of South East Asia. Invasive ability was confirmed to be related to 140 or 120 mega dalton (M) plasmids. Thirty to 70 M plasmids were found to be conjugative R plasmids. Incidences of ampicillin, trimethoprim and mercury resistant strains (R plasmids) were higher in Shanghai strains than in South East Asian strains. A variety of small plasmids were detected in all strains. In S flexneri strains, 2.0 and 2.6 M plasmids were found to be common in the strains from both areas, and in Sonnei strains, 3.4 M col El plasmids were common. The plasmid patterns formed by the small plasmid combinations were not always specific for species or serotype. But at least these small plasmid DNA patterns could be used to trace epidemic strains.