1988年 · 第101卷第10期

The measurement of salivary cortisol (F) was accomplished by using tritium labeled F. Comparison between saliva cortisol concentrations in matched samples collected with or without stimulation of citric acid indicated that salivary cortisol concentration is independent of salivary flow rate. In 104 normal subjects, average salivary cortisol value was 3.15 ng/ml with no significant sex difference. The ratio of saliva cortisol to plasma cortisol was 3.0%. The comparative circadian variations in saliva and plasma cortisol levels were examined and samples collected every 4 hours throughout a 24-hour cycle. The result indicated that the levels of salivary cortisol parallelled those of plasma cortisol. After ACTH stimulation the cortisol response of 6 control subjects was greater in the saliva than in the plasma. 90 minutes after intramuscular ACTH injection the cortisol level was 4.8-fold the basal in saliva, compared with l.8-fold in plasma. After eight hour ACTH tn-traavenous infusion the cortisol level increased by 8.6 fold in the saliva, compared with 3.4-fold in the plasma. Cortisol level suppression was also more pronounced in the saliva (90%) than in the plasma (85%) after 0.75 mg dexamethasons administration. In 13 control subjects the average salivary cortisol level of 6 measurements throughout a 24-hour cycle was l.36 ng/ml, whereas in 12 cases of Cushing's syndrome this reached 9.1 ng/ml and in 2 cases of Addison's disease it was only 0.14 and 0.52 ng/ml. In 105 pregnant women total serum cortisol concentration was markedly increased, but salivary cortisol level was within the normal range of nonpregnant women.

Electrophysiological study has shown that intra-venous flecainide acetate, a newly synthesized Ic type sodium channel blocker, can significantly prolong the AH, HV intervals and QRS time in dogs, and the SCL, CSNRT, SACT as well as the ERP of ventricles. Intravenous flecainide has been proved very effective in controlling spointaneous and inducing ventricular tachyarrhythmias in ischemic dogs. The antiarrhythmic actions, when compared with lidocaine, appear more potent and prolonged in time. In dogs receiving flecainide infusion, ventricular fibrillation could not be induced but with lidocaine such anti-fibrillatory action can not be observed.

We studied the chronotoxicity of parathion, an organophosphorus pesticide. A toxicity rhythm was found in mice with a peak mortality at 20:00 and a bottom mortality at 08:00, according to different exposure schedules during day and night. The circadian rhythm of activity of cholinesterase in blood and brain changed in a shifted and reverse way after the administration of the pesticide to mice. Treated by repeated poisoning and induction of liver microsomal enzymes, the toxicity of parathion disappeared, suggesting that its chronotoxicity might result from factors concerning temporal organization rather than metabolism. In this paper, fundamental concepts of chronotoxicology are introduced, and mechanisms of the toxicity rhythm are analysed and discussed.

Four hundred and ten amblyopic children with visual acuity of less than or equal to 0.5, who had been cured by occlusion therapy, were studied for stereopsis with major amblyoscope. 81.4% of them obtained stereopsis. Ocular alignment was closely related to the success rate of the establishment of stereopsis, while severity of amblyopia did not influence the development of binocular function. The percentage of stereopsis was increased with age. The occlusion therapy had no dismal effect on the development of stereopsis in children by over 3 years old. It was suggested that the critical period of stereopsis in human being may be at or before 3 years of age and the sensitive period may last until 12 years of age. We conclude that occlusion therapy is still worth recommending for amblyopia.

Since the division of the lobes and segments of the lung on CT scan is limited to its relations with the structures of the pulmonary hilum and the interlober fissures, we attempted to put the division on the anatomical basis of segmental structures. The topographicul relationship of the segmental bronchi and the relevant arteries and veins was studied meticulously. The segmental bronchi and the vessels on the serial CT images were determined by the three-dimensional reconstruction. Together with interlobar fissures, the lobes and segments of the lung on the images were delineated for diagnostic localization of lung diseases.

Antitachycardia pacemaker is one of the new developments in pacing technique. It can be used to control paroxysmal supraventricular tachycardia (PSVT) due to circus movement. The pacer emits pulses according to the preset program to terminate the tachycardia. Clinical experiences in six patients are reported. All are men, aged 23-61. Five had atrioventricular re-entrant tachycardia and the other one had atrioventricular nodal re-entrant tachycardia. PASAR 4171 was used in five patients and Intertach 262-12 in one. Atrial electrode was used in five while ventricular electrode in the other one due to intermittent paroxysmal atrioventricular block. The results are satisfactory. Before implantation they all had very frequent episodes of PSVT that could not be effectively controlled by antiarrhythmia drugs. In an average follow-up period of 11 months after implantation, none of the patients had sustained PSVT and needed antiarrhythmia drugs except one who had occasional atrial fibrillation and amiodaronc was used. Clinical application of antitachycardia pacemaker was discussed.

As malignant pleural effusion following drainage tend to recur, multiple chemotherapeutic or immuno-therapeutic agents had been investigated to control it. We studied and compared 30 patients with malignant pleural effusions, half on intrapleural mitomycin-C (a relatively cheap cytotoxic drug) and half on intrapleural corynebacterium parvum. We were unable to reproduce the claimed superiority in efficacy of the latter as reported elsewhere. The patients' characteristics, method of study and analysis of results were briefly discussed.

The craniofacial resection with a newly designed H-shaped incision was done in two patients with extensive malignant meningioma. The results suggest that the H-shaped incision allows an excellent exposure and is especially suitable for the craniofacial resection of extensive tumors involving the base of the anterior cranial fossa, nasal cavities, paranasal sinuses, and the orbits.

It has been proved by the immunohistochemical technique avidin-biotin-peroxidase complex (ABC) that immunostaining for keratin and vimentin is valuable in diagnosing nasopharyngeal carcinoma (NPC). By immunostaining of keratin, epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), 38 cases of NPC were investigated. It was found that as a marker of NPC, keratin is better than EMA and CEA. Besides, the diagnostic value of ABC immunostaining technique and immunogold-silver staining (IGSS) technique was compared. The result indicates that the latter is more practical, economical and sensitive than the former.

Seven cases of pityrosporum folliculitis are reported. The typical lesions were pruritic erythematous follicular papules and follicular pustules, 2 to 4 mm in diameter, located mainly on the upper trunk. Histopathologic sections showed PAS positive spherical to oval single budding yeast cells in dilated follicles. The follicular wall was ruptured in 1 sample, follicular epithelia were disrupted and yeast cells were seen in the sebaceous glands in 2 samples, and there was cellular infiltration in the sebaceous glands and around the dermic capillaries in all Samples.