1993年 · 第106卷第05期

The author presented data obtained in Bangladesh, to elucidate the role of hypertension as a risk factor along with others such as smoking, cholesterol and diabetes mellitus as cofactors in ischaemic heart disease (IHD). There was a series of 100 cases with IHD admitted within 12 hours after the onset of chest pain observed in this study. They all were diagnosed as IHD for the first time. Of them, 94 were male and 6 female, with an age range of 25-77 years (mean 50.16±14 years). On grouping of IHD, 21 had angina pectoris and 79 acute myocardial infarction. 31% cases of IHD had hypertension. The blood pressure ranged between 168.54±24.85 and 106.29±16-80 mmHg. 74 out of the 100 cases with IHD were smokers. The mean value of serum cholesterol in this series was 6.48±1.66 mmol/L and that among 50 normal controls was 4.76±1.28 mmol/L (P<0.01). The serum triglyceride determinations between the 94 cases of IHD and 50 normal controls showed values with statistically significant difference. The author concluded in this study that, hypertension, smoking and hyperlipidemia are the most important risk factor of IHD in Bangladesh.

The surface phosphatidylinositol (PI)-linked proteins on membrane of paroxysmal nocturnal hemoglobinuria (PNH) erythrocytes (PNHE) was analysed by a flowcytometer (FACS 420). It was found that the loss of acetylcholinesterase (AchE) and decay accelerating factor (DAF), two PI-linked proteins, from cell membrane of PNHE was not synchronous. The hemolysis rates of DAF (-) and AchE (-) PNHE were much higher than that of mixed population in cobra-venom factor (CoF) lysis test. Intact PNHE remaining after CoF lysis had relatively lower immunofluorescent labeling rate of AchE on membrane in comparison with normal erythrocytes. It implied that this subpopulation, in spite of being insensitive to complement lysis, was still abnormal in terms of the amount of PI-linked protein on cell membrane. When these intact PNHE remaining after CoF lysis were incubated with activated polymorphonuclear leukocytes (PMN) for three hours, immunofluorescent labeling of AchE on PNHE was prominently decreased. This indicated that reactive oxidants released from activated PMN might injure PI-linked proteins.

The authors attempted to investigate the possibility of estimating modified LDL (acetylated LDL, oxidative LDL and glucosylated LDL) with peroxidized lipid in the native LDL from patients with familial hypercholesterolemia (FH). A group of 7 patients with FH were studied, with age ranging from 18 to 60 years. 10 ml of fasting blood were collected into siliconized syringes with 0.5 ml of 0.05 M ethylene diamine tetraacetic acid 2Na. LDL, LDL1 and LDL2 were separated by sequential ultracentrifugation. Total cholesterol (TC), triglycerides (TG) and phospholipids (PL) were estimated by enzymatic methods. Analyses of lipids in each LDL were done by thin layer chromatography (TCL). The modified LDL in native LDL of the FH patients was estimated by the authors' own method. The cholesterol concentration of LDL was 0.49±0.28 mmol/L in FH patients and 0.07±0.04 mmol/L in the healthy persons (P<0.001). The LDL1 cholesterol concentrations in the patients with FH and the normal controls were similar while that of the LDL2 was of significant difference (P<0.05). On the TLC plate, the detection of the spot X1 was considered an indicator of the existence of modified LDL. The percentages of spot X1 in LDL of FH patients were higher in all 3 fractions (LDL, LDL1, and LDL2), as compared to the corresponding percentages of spot X1 in the healthy controls. (P<0.001). Using the authors' own method, the molecular size were found in the order of LDL>LDL1>LDL2.

Serum TNF and IL-6 levels were measured in 48 patients with liver disease positive for anti-HCV only or concurrent HBV infection. High serum TNF levels were observed in patients with liver disease positive for anti-HCV and/or HBV infection (P<0.001). Serum TNF levels varied with the severity of liver disease. Serum TNF levels of anti-HCV positive patients with hepatic failure were higher than those with CAH (P<0.01). Serum TNF levels of patients infected with HCV or concurrent HBV were also significantly higher than those with HBV infection alone (P<0.001). However, no difference in serum IL-6 levels was observed in either group of patients. Serum TNF in the deceased patients with hepatic failure induced by HBV and HCV infection was higher than in those who survived (P<0.05), and it also seemed significantly different in patients with and without multiple organ failure (P<0.05). In vitro, HSS showed marked inhibitory activity on TNF production from PBM induced by endotoxin, but had no significant effect on the TNF cytotoxicity of L929 cells. It seems that high serum TNF level is an important mediator in the pathogenesis of liver necrosis and failure of microcirculation in HCV and/or HBV infection. These observations favor the attempt to treat hepatic failure with HSS or anti-TNF. Encouraging results were achieved using HSS in the treatment of subacute liver necrosis in our institute. Since HSS exerts growth factor-like activity in addition to inhibiting TNF production, further study of the mutual action of TNF and HSS may provide better understanding of liver necrosis and develop new immunomodulating therapeutic options.

Forty patients with hypertelorism seen in the past 16 years were reviewed retrospectively. Combined intra- and extracranial surgical approach was used for 37 severe and moderate cases and subcranial approach (U-osteotomy) for 3 moderate cases. Gratifying results were obtained in patients with different types of hypertelorism by a multidisciplinary team. Complications were also reviewed. Of the 37 cases of intra- and extracranial corrections, 1 died, 4 had cerebrospinal fluid leakage and 4 had keratitis. No seizure, cerebral edema, meningitis, blindness, and ptosis occurred in this series. The average age was 13 years and two months. Operating time averaged 6 hours and 50 minutes. Hypertelorism was mostly attributable to craniofacial cleft, craniosynostosis, frontoethmoidal meningoencephalocele, frontonasal fibrous dysplasia, and trauma. Satisfactory esthetic appearance was achieved in most of the cases.

Monoclonal antibody COC166-9 against ovarian carcinoma was conjugated with adriamycin or cisplatinum entraped in liposomes as immunochemical liposomes MLA and MLP respectively. MLA was shown to have the highest effect than adriamycin or other groups on SKOV3 (ovarian cancer cell line) growth inhibition. MLA was also used in target therapy on nude mice bearing human ovarian carcinoma by xenograft of SKOV3 cells. The observations of tumor volumes revealed that this target therapy other than the controls presents a significantly better result which gives a hopeful clue to ovarian carcinoma treatment.

Forty patients (25 cases of prostatic cancer and 15 cases of benign prostatic hyperplasia) were examined with radioimmunodetection (RAID) using antibody against r-Seminoprotein (r-Sm). The images of malignant tumor sites were revealed from the scan of single photon emission computerized tomography with the tracing of dual radionuclide and computer digital subtraction technique. Of the 25 patients with prostatic cancer tested, twenty-four were demonstrated in RAID with a positive rate of 96%. The ratio of taking in nuclide radioactivity between the tumor tissue and normal tissue (T/N) was 6.9 and the best showing time was the 96th hr from injection of radioactive antibody against r-Sm. The minimum diameter of the tumor detected in RAID was 0.5 cm. All of the 8 cases of metastatic prostatic cancer in pelvic or bone location were detected, with a rate of 100%. Of the 15 cases of benign prostatic hyperplasia, only one showed mild positive result. B-ultrasonography and CT showed a positive detective rate of 72.7% and 65%, respectively. Our results have indicated that RAID using131I-labeled antibody against r-Sm possesses more advantages in specificity, because RAID not only defines the involved sites, but also shows the sites of the original tumors, and the metastatic location as well as the relationship between them.

Combined extracranial and transcranial Doppler (TCD) instruments were used to study the hemodynamics of 20 patients with cerebral arteriovenous malformation (AVM) proved angiographically. It was discovered that the flow velocities in AVM-feeding arteries and their proximal arteries were increased; the increase of flow velocities in feeding arteries close to AVM was more remarkable than that in feeding-arteries proximal to extracranial internal carotid artery far from AVM; pulsating indexes of AVM-feeding arteries were decreased; increase of flow velocities in AVM-feeding arteries was related to the decrease of pulsating index; the flow velocities of nontapering feeding arteries were faster than those of tapering arteries; the greater the size of AVM, the faster the velocity in feeding artery; and the flow velocities and pulsating indexes of AVM-feeding arteries were gradually recovered to normal 3-5 weeks after resection of AVM. It is believed that increase of flow velocity in AVM-feeding artery is associated with distention and decreased resistance of flow in AVM-feeding artery. TCD combined with CT scans are helpful to the diagnosis of AVM. Combination of TCD and cerebral angiography (CAG) to evaluate comprehensively the preoperative hemodynamics of AVM and to monitor postoperative changes is helpful to detecting cerebral steal due to steal leakage in circle of Willis and preventing the hazardous postoperative complications caused by pressure breakthrough of normal perfusion.

The computed tomographic (CT) images of 52 patients of small peripheral lung nodule<3 cm proved pathologically were reviewed. Air bronchogram (AB) was found in 14 nodules on thin-section CT images, in which well or moderately differentiated small adenocarcinomas were only seen with lipidic growth. Squamous-cell, large-cell carcinomas and small benign lung nodules had no AB sign both on CT image and in pathologic specimens.

The effect of specific immune RNA (i-RNA) on the activity of natural killer (NK) cells in the peripheral blood of 27 newborn infants was studied by lactic dehydrogenase (LDH) release assay. Peripheral blood mononuclear cells (PBMC) were used as effector cells with K-562 tumour cells as target cells. The results showed that in the therapeutic group (n=17) the average activity of NK cells after therapy (24.13±4.62%) was 13.67±5.79% higher than before therapy (10.47±3.57%). In the control group (n=10) these were only 10.78±3.94% and 11.58±3.37%, the difference was not statistically significant (P>0.05). However, NK activity in the therapeutic group and control group was markedly different (P<0.01). The data indicate that specific i-RNA can enhance the activity of NK cells in the peripheral blood of newborn infants. Therefore, we believe that specific i-RNA may play an important role in defence against CMV infection. The mechanism of i-RNA augmenting NK cellular activity is also discussed.

The metabolism and transfer of tritium from pregnant mice to fetus after injection of tritiated water intraperitoneally was investigated in this paper. The study was composed of three experiments. 1. Pregnant mice were injected with tritium water on the first day of pregnancy, in order to obtain a transfer coefficient of tritium from pregnant mice to fetus through placenta. 2. Pregnant mice were injected with tritiated water on the first day of parturition to study the transfer of tritium via mother milk from nursing mice to the baby-animals. 3. Pregnant mice were injected with tritiated water in different periods of gestation. The results showed that tritiated water was uniformly distributed in all of the tissues measured, including placenta, fetal membrane and amniotic fluid in experiment 1. No effect of placentas on tritium transfer from pregnant mice to fetus was found. Concentration of tritium in the baby's tissues was evidently higher than that in the pregnant mice in experiments 2 and 3, and the transfer coefficient in experiments 2 and 3 was generally higher than that in experiment 1.

An improved technique for bloodless hepatic resection using in situ isolation and asanguinous hypothermic perfusion was described to deal with huge liver tumors involved in the liver hilum, the main hepatic veins and retrohepatic inferior vena cava. The original Fortner's technique was modified, including the choice of incision; semi-isolated perfusion of the liver portion preserved through the single portal vein; suprahepatic outlet of the perfusate and the shortening of the period of hepatic ischemia by reperfusion of hepatic artery prior to the repair or reconstruction of the portal vein. The initial successful experience of the technique applied to 2 pediatric cases with giant liver tumors was reported, and the indications, intraoperative and early postoperative courses were discussed.

Abstract of Chinese Medical Literature