1988年 · 第101卷第11期

A case of human Angiostrongyliasis cantonensis from Guangdong in August 1984 was reported. A clinical study was carried out in detail. The patient, a 13-year-old boy, was admitted to the hospital be cause of severe headache, mild fever, malaise, anorexia, diplopia, slight central left facial paralysis and slight bilateral papilledema. The change of CSF suggested eosinophilic meningitis. An alive larva of Angiostrongylus cantonensis was identified in CSF. Medical history revealed that the patient had frequent contact with the snail, Achatina fulica, which had been heavily infected by a cantonensis in the village he lived. During hospitalization, the patient was treated with dexamethasone, hetrazan, levamisol and successive spinal taps. It was difficult to estimate the efficacy of the treatments. However, the patient improved progressively. He had recovered before discharge and was followed up for more than two years and was found quite well.

A total of 1 312 kindergarten children in Beijing city were surveyed for acute respiratory infections (ARI) during a one-year period. The average number of ARI episodes was 3.1/child-year and the pneumonia incidence in children under 5 years of age was 59.2/1 000 child.year. The viral infection distribution was analysed. Influenza viruses played an important role in ARI epidemics in these children while respiratory syncytial virus was the major agent in acute lower respiratory infections.

Two male siblings and one female from two unrelated families were affected by late infantile metachromatic leukodystrophy (MLD) with similar clinical manifestations. Arylsulfatase A (ASA) activities in dialyzed urines and in leukocytes were deter mined. Urinary ASA activities of patients at a pH optimum of 5.0 were below the lower limit of the normals, but increased when assays were carried out at pH 5.6, while it fell in normals or non-MLD patients with a rise in pH. Leukocyte ASA activities in a proband were also below the lower limit of normal controls. Urinary ASA activities of 3 of 4 parents were normal. Leukocyte ASA activities in all of the parents were intermediate between those of the pro bands and those of normal controls. Urinary ASA determination might be used as a screening test for MLD patients but not reliable for heterozygote detection. The confirmation of the diagnosis should rely upon leukocyte or fibroblastic ASA determination.

The angiographic findings in 377 of 520 patients with intracranial aneurysm were studied in connection with the incidence, size, shape and location. The incidence of intracranial hemorrhage and the occurrence, location and degree of vasospasm following intracranial bleeding are discussed.

We studied the efficacy of electronic visual aid in 55 patients with severe low vision mainly due to optic atrophy, primary retinitis pigmentosa, and macular degeneration. 76% of the patients had a vision of 0.1 or worse, and 42% had severe impairment of the visual field. With closed-circuit television (CCTV), 52 patients (95%) were able to read. The prime advantage of CCTV lies in its adjustable high power of magnification. Hence it is suitable for patients with severely damaged visual functions that cannot be improved with conventional optical aids. CCTV is also useful in educational programs for the visually impaired. Its disadvantages lie in its cost and cumbersomeness.

Excessive hemodilution (HD) cardiopulmonary bypass (CPB) is advantageous in improving tissue blood flow due to changes in blood theological properties, lessening blood damage, and relieving homologous blood syndrome.. Excessive HD, however, also reduces the oxygen capacity of blood, and increases the volume of extracellular fluid and the interstitial pressure, which may cause deterioration of respiratory function and myocardial contractility in the immediate postoperative period. To prevent or eliminate such complications and to reverse excessive HD in the later period of CPB, we used 2-HD and ultrafiltration (UF) with hollow-fiber hemofilter in 8 mongrel dogs. Another 5 mongrel dogs were used as controls. The mean CPB duration was 77 mniutes and the mean UF duration 36 minutes. In case of a negative pressure of 300-500 mmHg and a blood flow rate of 300-500 ml/min, the output of UF amounted to 1 793.8±198.3 ml, and the fluid balance thus was +392.1±174.2 ml. The fluid balance of the controls, however, was +2693.6±222.4 ml (p<0.001). The hemoglobin after the first HD was 9.25±1.07 g/dl, a mild HD. The hematocrit and hemoglobin before UF (i.e., after 2nd-HD) amounted to 12.00±1.05% and 4.30±0.44 g/dl, an excessive HD, whereas after UF the variables in creased to 24.00±2.79% and 8.38±0.93 g/dl, respectively (p<0.01). Each UF could meanly remove BUN 123.22±16.30 mg, Cr 38.51±10.66 mg. K+ 7.51±1.45 mEq, and Na+ 251.28±31.27 mEg. But, the concentrations of K+ , Na+, BUN and Cr and the osmolarity of blood were similar before CPB, before and after UF (p>0.05). The hemoglobin and total protein of each filtrate were zero. We conclude that UF and 2-HD may be a relatively simple, safe and effective method for removing extracellular fluid and preveting the complications of respiratory func-function deterioration and myocardial contractility during CPB of excessive HD. This method is worth recommending for clinical use.

We studied hemorheologic alterations in acute pancreatitis in 28 dogs to find out that during the early stage of induction of acute necrotizing pancreatitis, all the hemorheologic parameters were significantly elevated, and continued to increase at the rest intervals but no difference between the acute interstitial pancreatitis and control groups. We suggest that increased blood viscosity and tendency of erythrocytes to aggregate with rouleaux formation are the causes of microcirculatory thrombosis in pancreas. They may be th key factors in the pathogenesis of pancreatic necrosis in acute necrotizing pancreatitis.

Superior oblique myokymia, a rare entity, is characterized by short episodes of pendular oscillopsia for several seconds in one eye, with unknown etiology and pathogenesis. We encountered two cases of this kind, in one of which the amplitude and frequency of the abnormal eye movement were re corded with electronnystagmugraph (ENG) as the objective criteria for diagnosis. So far as we know the ENG recording of abnormal eye movements b.as not been mentioned in the Chinese literature.

Radiologic and pathologic manifestations of 30 peripheral pulmonary masses around l.5-3 cm in diameter were compared to the pathologic basis of vacuole sign and small node sign on tomogram. Statistics of 100 conventional X-ray tomograms of peripheral pulmonary masses about l-3 cm in diameter suggested that the vacuole sign and small node sign, more common in early peripheral lung cancer than in tuberculoma, are valuable for differentiating early peripheral lung cancer from tuberculoma.

This report presents the results of endoscopic hemostasis for GI bleeding using high alkylester of α-cyanacrylate (V-I Gel). Experiments on dogs confirmed obvious hemostasis of submucosal arterioles in acute artifical ulcers. When the gel was sprayed on the ulcer, the surface showed a crowded fibrin-network structure under electronic scanning microscope. The spraying greatly reduced blood coagulation time and clot retraction. The same phenomena were observed in clinical tests on 32 patients. The hemostatic rate per treatment was 84.4% in the 32 cases of upper GI bleeding from various causes. Follow-up of 16 cases (average 26.1 months) showed rebleeding in one case. The advantages of this tissue adhesive spraying are: there are no side effects, the applications can be repeated, costs are low, and the result is satisfactory.