1990年 · 第103卷第06期

A case of cerebral aspergillosis is reported, the presenting symptom was numbness of right face, which worsened after one year. CT-scan showed two enhanced low-density patches in the anterior and basal parts of right temporal lobe. During operation, an abscess in the deep part of right temporal lobe was revealed. The patient gradually felt amaurosis and oculomotor palsy of right eye. About six months later, she died from intracranial hypertension. Biopsy, as well as autopsy findings suggested fungal infection, and was identified as Aspergillus nidulans, which has probably never been reported in the literature.

An EDAP LT-01 lithotripter was used to treat 245 patients with functioning gallbladders containing one to three radiolucent stones of less than 20 mm in diameter. Ursodeoxycholic acid was administrated as adjuvant litholytic therapy. The gallbladder stones disintegrated in 98.8% of patients and disappeared completely in 21.2% within 1 month after lithotripsy, in 26.5% within 2 months, in 33.9, 40, 46.5, 48.6 and 53.9% within 3, 4, 6, 9, and 12 months, respectively. Adverse effects after lithotripsy were dull abdominal pain (49.4%), biliary colic (13.1%), jaundice (1.2%), and pancreatitis (0.4%). Extracorporeal shock wave lithotripsy combined with litholytic therapy is a non-invasive, painless, safe, and effective treatment in selected patients. Patients with solitary radiolucent stone less than 20 mm in diameter are considered candidates for extracorporeal shock wave lithotripsy (ESWL). The key to success of ESWL lies in the strict selection of patients, careful monitoring throughout the lithotriptic procedure, and enough litholytic therapy. The disadvantages of this method include strict selection of patients and high costs, poor curative effect, and recurrence of stones (11.4% of patients).

Liver specimens from the Shanghai Ma ducks congenitally infected with duck hepatitis B virus (DHBV) were examined by immunohistochemical technique and electron microscopy. All the 12 serum DHBV positive ducks showed varying degrees of positive straining in hepatocytes. In 8 of the 12 ducks, DHBV antigen was discovered in the cytoplasm of biliary epithelial cells. Conventional electron microscopy revealed two kinds of virus particles in the biliary epithelial cells: 1. the incomplete virus, 40-50 nm in diameter and spherical in shape with an outer membrane, located mainly in the dilated cisternae of rough endoplasmic reticulum of the cells in large amounts; 2. the complete virions, 55-60 nm in diameter, were spherical with an outer membrane and located mainly in the cytoplasmic vesicles in small amount. We believe the particles found in the biliary epithelial cells in this study were DHBV particles. It is most likely that the infection and replication of DHBV not only take place in the liver cells but also in the biliary epithelial cells.

Biopsy and autopsy specimens of liver tissues of two series of patients, one of adults and the other children suffering from hepatitis B virus (HBV) infection were used to evaluate hepatitis delta virus antigen (HDAg) by direct immunoperoxidase staining method. The results showed that four HDAg positive cases were found among 30 cases of HBV infected adult patients (13.3%), and 6 were found in 44 cases in the children series (13.6%). Therefore, we are convinced that hepatitis delta virus (HDV) superinfection does exist in Guangzhou area. The superinfection rates in adults and children are almost identical.

A new strain of Hantaan virus (HTNV), GH716, was isolated from the peritoneal exudate cells (PEC) of a patient with severe hemorrhagic fever with renal syndrome (HFRS). The isolate was propagated in Vero E6 cells. At each passage the virus-infected cells were examined for HTNV with immunofluorescence technique using monoclonal antibodies (McAb) 25-1 and 84-1 against HTNV. From passage 5 on, fluorescent intensity tended to stabilize at (+++) and infectivity titer reached 105 TCID50/ml. Using 14 McAb to 76-118 and BI strains of HTNV, we found that strain GH716 was antigenically similar to strain 76-118 (Apodemus type) and different from strain R22 (Rattus type), suggesting that GH716 may fall into the Apodemus type of HTNV. This is the first isolation of an HTNV from human PEC collected on the tenth day of illness. The successful isolation of strain GH716 may provide an alternative source of obtaining HTNV during the later stages of HFRS.

The use of intravenous tetrandrine on paroxysmal supraventricular tachycardia (PSVT) in 32 episodes of 27 cases were studied. The single blind test was done by injecting normal saline as placebo for self-control. Ambulatory ECG was recorded continuously. The dose of tetrandrine ranged from 0.12 to 0.21 g. The success rates of conversion of the placebo and tetrandrine were 3.1% and 83.9% respectively, being statistically significant (P less than 0.001). The efficacy of tetrandrine was comparable to that of verapamil (85%). In 4 cases of WPW syndrome one was converted by the placebo, the other 3 by tetrandrine. Those who did not respond to tetrandrine were mostly suffering from organic heart disease and were supposed to have automatic atrial tachycardia. The time needed for conversion ranged from immediacy after intravenous injection to 20 minutes, with an average of 4.6 minutes. The ECG changes of the termination of PSVT were similar to that of verapamil and can be explained as the effect of slow channel antagonists. Tetrandrine may be an alternative to verapamil in the treatment of PSVT.

905 diagnostic contrast echocardiographic studies (DCE) were performed on 223 children. Carbon dioxide microbubble was used as contrast agent in various age groups, especially in newborns and infants because of its safety in application, stable contrast effect, and peripheral vein injection. Two-dimensional echocardiography (2-DCE), a useful tool in diagnosis of left to right shunt lesions reduced false negative diagnoses for ventricular septal defects and eliminated false positive diagnosis for atrial septal defects and patent ductus arteriosus. The accuracy of diagnosis in this series was 97%. The results of this series showed that 2-DCE is also valuable in the diagnosis of congenital heart disease with right to left shunts, and can be used to evaluate shunt levels and determine the obstructive sites on the right side of the heart.

This article reports the efficacy and safety of treatment with Somatonorm in 9 children with idiopathic growth hormone (GH) deficiency in China. The growth velocity increased from 2.6±0.2 cm/year before treatment to 10.7±0.5 cm/year at the end of 1-year treatment. The increment of human growth hormone (hGH) level and area under the response curve above the baseline level were larger after one injection of Somatonorm at the dose of 0.1 IU/kg sc than that of 0.17 IU/kg im. Increments of delayed bone age were not significant. There was no correlation between the increase of height growth velocities and the serum Somatomedin-C (SMC) levels during hGH therapy (r=-0.055). Blood sugar levels and blood alkaline phosphatase concentrations increased significantly after therapy. There were no significant side effects. Serum T4 levels of 3 patients dropped below normal after treatment. Serum anti-hGH antibody appeared at 3-12 month in 2 patients, but it did not attenuate the growth velocity.

Lymphocytes from regional lymph nodes of patients with ovarian carcinoma were immortalized by fusing them with a nonsecreting cell line of murine myeloma (Sp2/0-Ag14). The fusion rate was 0-87.5%. By early cloning and recloning, a hybrid cell line, named HMD4, was established. It has stably secreted human IgG for more than 15 months. Chromosome analysis showed the characteristics of human-mouse hybridoma. The cells of HMD4 were injected into the abdominal cavities of nude mice and 2-3 weeks later large quantities of ascites were obtained. Human IgG of lambda light chain was detected and purified from the ascites. The specificity of HMD4 human McAb was tested by ABC or PAP immunoperoxidase stainings of paraffin-embedded tissue sections, cryostat sections, cell smears of various tissues and different cancer cell lines. 60.5% (26/43) of epithelial ovarian cancers was positive, while nonepithelial ovarian cancers, most cancers from other organs and almost all nonmalignant and normal tissues were negative. The molecular weight of the antigen recognized by HMD4 was 55 KDa determined by Western blotting. The problems of maintaining the IgG secreting function of human-mouse hybridoma and its screening were also discussed.

An immunohistochemical analysis using a series of mono- and polyclonal antibodies against myoglobin, desmin, vimentin, actin, NSE, S-100 protein and keratin was done on alveolar rhabdomyosarcoma (3 cases), embryonal (3) and pleomorphic rhabdomyosarcoma of the orbit (1). All tumors were stained by monoclonal antibodies to desmin and vimentin, whereas 6 of the 7 cases were stained by myoglobin. The results indicate that desmin and vimentin are highly sensitive immunohistochemical markers for the diagnosis of rhabdomyosarcoma, especially in poorly differentiated ones.

Clinical, experimental and electronmicroscopic observations, and computer-enhanced images were made on 5 patients with tinea favosa resistant to griseofulvin. The pathologic fungus was identified as the Mongolian variant of Trichophyton schoenleini. The results of physical examinations, routine tests of blood, urine and stool, liver and immunologic function examinations were normal in all of the 5 patients. Under scanning electron microscopy, the surface of the spore showed pineapple-like form, the cluster of the acrogenous spores presented flower shape, and the antler-like hyphae appeared twisted in the culture. They were observed by transmission electron microscope and the images were processed by microcomputer. It was found that the cell walls of the fungi consisted of 8 layers, among which the inner layer was loose and contained cytoplasm. It was also found that all structures within the cytoplasm possessed a 1-3 layer intact envelope and there was chromatin in the nucleus. These may be contributing factors in the development of resistance to griseofulvin. This multiple-layered thick cell wall may act as a barrier responsible for the impermeability of the cell of fungi to griseofulvin.