1988年 · 第101卷第06期

A series of laboratory diagnostic tests for lysosomal storage diseases (LSD), including screening test, specific enzyme assays, and 35SO4 incorporation test were set up. This paper reports 7 pregnancies at risk for various lysosomal storage diseases prenatally diagnosed by amniocentesis in the second trimester. In pregnancies at risk for Tay-Sachs disease, mucolipidosis III and Niemann-Pick disease, the prenatal diagnosis was made by enzyme assay of culture damniotic fluid cells. The 3 pregnancies at risk for mucopolysaccharidosis were diagnosed by the 35SO4 incorporation test. According to our experience, enzyme assay of cultured amniotic fluid cells is reliable and accurate in the prenatal diagnosis of LSD.

This paper reports computerized tomography (CT) findings in 21 cases of tuberculous meningitis, normal in 5 and abnormal in 16. The cases with abnormal CT findings were hydrocephalus, tuberculoma, exudation in basal cisterns, brain edema and cerebral infarction. The incidence of hydrocephalus increased with the duration and severity of illness. The locations of tuberculomas corresponded with patients' clinical pictures. The study also indicated that patients wih normal or slighly changed scans had good prognosis, but patients with severe hydrocephalus and exudation in basal cisterns had poor prognosis in spite of active medical treatment. CT has been proved valuable in diagnosis and treatment of tuberculous meningitis.

62 patients with proven gastric adenocarcinoma were studied by CT scanning using air contrast (AC) technique, gastrografin contrast (GC) technique or both. The true thickness of the gastric wall was obtained by AC technique which is effective to demonstrate extragastric extension of neoplasm, to evaluate the depth of cancer invasion, and to detect metastasis if any. We conclude that AC technique is superior to GC in selecting therapeutic regimens for gastric carcinoma and evaluating the prognosis.

After one successful fusion of murine spleen cells, immunized with hepatitis B virus (HBV) particles bearing polymerized human scrum ablumin receptors (PHSA-R) with myeloma cells (SP2/0), a stable hybrid cell line secreting monoclonal antibody (McAb) was established. The McAb, specific for PreS2 antigen of HBV, can inhibit PHSA-R activity on HBV, and may probably be antibody against PHSA-R of PreS2. With this McAb, we developed a reversed passive hemagglutination assay (RPHA) and ELISA for detection of PreS2 antigen. The hemagglutination titers of monoclonal anti-PreS2 sensitized sheep red blood cells were closely related with those of PHSA cells. The average hemaggutination titer of PreS2 antigen was higher in HBeAg positive sera than that in HBeAg negative sera, though PreS2antigen could be sometimes detected in HBeAg negative and even in anti-HBe positive sera. In HBeAg positive sera, titers of PreS2 antigen were correlated with those of HBsAg, but not paralleled with those ofHBeAg. It is suggested that PreS2 and HBeAg could not be substituted for each other. The significance ofPreS2 in relation to HBV DNA replication and its diagnostic value still need further study.

Two hundred pathologic specimens of gastric mucosa with various degrees of intestinal type lesions (including simple intestinal metaplasia, mild, mode-rate, and severe intestinal type dysplasia and gastric carcinoma) were submitted to morphometric analysis by an automatic image analysis system (Quantimet 900). Three indices and 7 geometric parameters were measured. The three indices are index of structure atypism (ISA), index of gland form (IGF), and index of nuclei-gland ratio (ING). The geometric parameters of cell nuclei include area, perimeter, size, 1engthbreadth, axis ratio and contour. The results showed that, except 2 parameters (axis ratio and contour),all increased in pace with the increase of atypism degrees in various type gastric mucosal lesions, so they could be used as the objective diagnostic criteria. Anassessment model was established for discriminating various types of lesions. The coincidence rate between model assessment and original histopathologic diagnosis was 85.7%. So morphometric analysis may provide a possibility for standardization of the pathologic diagnosis and grading of gastric precancerous lesions.

107 cases of hepatic encephalopathy (HE) treated during 1977-1986 were analyzed. The commonest precipitating cause was upper gastrointestinal hemorrhage. Blood ammonia was elevated in 79.1% with no correlation between its levels and HE severity. The blood levels of branched chain amino acids (BCAA) were markedly reduced, with elevation of aromatic amino acid (AAA) levels and drop in the BCAA/AAA ratio down to 1.31. The overall survival rate was 22.4%. The chance of survival for such patients is inversely proportional to the degrees of liver damage and HE. BCAA infusion yielded the highest survival rate, and seems to be worthy of further trial.

The prevalence of congenital heart disease (CHD) at high altitude was determined by surveying 1116 children at 4 study sites, ranging from sea level to 4 300 M. Children were screened by physical examination, and echocardiogram and electrocardiogram were done on those suspected of having CHD. A high prevalence of patent ductus arteriosus (PDA) and atrial septal defect (ASD) was found at high altitude sites and the effect of altitude was progressive. At 4 300 M, a combined prevalence of 5.2% was found. PDA is thought to result from failure of low atmospheric pO2 to constrict ductal muscle. We speculate that the persistence of high pulmonary vascular resistance and right heart pressure inhibits early closure of the patent foramen ovale (PFO) and that the flap becomes incompetent with growth, resulting in ASD. The high prevalence of ASD/PFO in tetralogy of Fallot may be analogous and related to high right ventricular pressure present from birth.

This paper reports the study on correlation between coronary angiographic findings and type A behavior in 100 cases of coronary heart disease. The results showed that among 83 type A behavior cases, 81 had abnormal angiographic findings, including 72 with 50% or more stenosis in the affected vessels. All cases having 3 or more vessels involved belonged to type A behavior. In 8 of 17 non-type A behavior cases, angiographic findings were normal. Coronary vessel lesions in non-type A behavior cases were milder than in type A behavior cases.

Pedicled omental transposition was done in 70 patients aged 14-60 years. The anatomical patterns of the omental arteries were observed as to the incomplete anterior omental arcade and the vascular connections between the middle left or right omental arteries. Accordingly, different methods were used for tailoring and lengthening of the omentum according to the patterns. We described 5 patterns of the omental arteries and the corresponding lengthening methods.

Local application of 0.03% camptothecine cream and 0.03% camptothecine in DMSO ethanol in 92 cases of psoriasis vulgaris showed a statistically significant therapeutic effect in comparison with topical 1% hydrocortisone cream. Mouse vaginal epitheliumin estrogenic phase and mouse tail scale epidermis were used as experimental models to study the therapeutic mechanism of the drug. It was found that camptothecine not only could inhibit the mitosis of epithelial cells, but also alter the process of epidermal keratinization. With these pharmacologic activities it is thought to probably play a role in correcting the essential pathologic process of psoriasis. In addition to promoting the formation of a granular layer, use of the drug led to appearance of Langerhan's cells in mouse tail scale epidermis, suggesting that these cells may involve in the process of epidermal Keratinization.