1983年 · 第96卷第03期

Any thumb defect with exposure of the deep structures deserves proper repair with a flap. The authors describe 2 types of dorsalis indicis flap which can be satisfactorily used for any defects of the thumb and the first web space. This flap is superior to any previous flaps ever used for thumb repair because of the ease of transferance and high success rate. 6 successful cases are presented to add to the limited number of cases accumulated in the world literature during the past 3 years. Key technical points of flap dissection are elaborated by the authors and the importance of inclusion of 1 artery, 2 veins and l nerve is also stressed for good results.

This paper reports the results of superior mesenteric vein-inferior vena cava silk taffeta shunt, disconnection of portoazygos and splenectomy in 50 cases of portal hypertension. 45 are due to portal or postnecrotic hepatitis liver cirrhosis and 5 schistosomiasis. Of the 24 emergency operations performed for acute bleeding, 22 are due to ruptured esophageal varices and 2 48 hr rebleeding after splenectomy. The surgery stops the bleeding in all cases. One dies of pulmonary infection and another of hepatic failure. The overall operative mortality for both elective and emergency shunt is 4%. 39 patients are followed up for 1-6 years without rebleeding. They lead normal lives. The authors' impression is: the triplex operation is a good, comprehensive means of portal decompression and the clinical use of silk taffeta for the venous inter-position "H" graft recommended. The operative technic and points to be noted are presented and discussed.

The pancreatic tissue and common bile duct of 97 surgical specimens of carcinomas of the pancreatic head and ampullary region are studied histologically and histochemically. Pancreatic duct hyperpilasia (epithelial) is divided into 3 types: simple hyperplasia, papillary hyperplasia (local and diffuse) and atypical hyperplasia. All types of ductal epithelial hyperplasia, especially papillary and atypical hyperplasia of the medium duct are much more frequently seen in the pancreatic tissue adjacent to pancreatic head carcinoma than in ampulla of Vater or common bile duct carcinoma Mucin histochemical examination revealed similar tinctorial characteristics in pancreatic ductal hyperplasia (papillary and atypical) and ductal carcinoma. Epithelial cells adjoining ampulla of Vater and common bile duct carcinoma also display varying degrees of hyperplasia and the same mucin histochemistry picture as their malignant counterparts. Transition from papillary and atypical hyperplasia of the medium and large pancreatic ducts to pancreatic ductal carcinoma and from bile duct epithelium hyperplasia to common bile duct and ampulla of Vater carcinoma are detected in most cases of this series. The results suggest that most of the ampulla of Vater carcinomas probably arise from the common bile duct terminal portion and the papillary and/or atypical hyperplasia of the large and medium pancreatic duct seems to be a precancerous state of pancreatic ductal carcinoma.

Inplantation of silicon intraoicular lenses in 50 cataract eyes is reported. Of the 50 eyes, 42 were implanted immediately after extraction, while 8 were implanted in a second operation. 44 of the 50 blind eyes showed some degrees of recovery of vision: 14(31.8%) over 0.5, 13 (29.6%) 0.4-0.3, 14 (31.8%) 0.2-0.1 and 3 (6.8%) below 0.1. 6 were failures due to corneal edema.

The SPAIF technic has been used for rapid detection of salmonellae in foodstuffs. Parallel testing with SPAIF, conventional immunolfluoresence technic (CIF) and routine culture isolation was carried out on 2,250 samples of 10 food categories showing SPAIF superiority over CIF on the following grounds. Stained smears easier to read, postenriched culture unnecessary, higher sensitivity and specificity, easier to perform. The SPAIF has a much higher salmonella detection rate than routine culture. A total of 17,310 samples of 3 main kinds of food are SPAIF screened showing that SPAIF can be easily applied in regional or district bacteriologic laboratories.

This paper reports 715 cases of primary cutaneous amyloidosis, among which are 33 rare poikiloderma-like cutaneous amyloidosis and 71 new seborrheic dermatitis-like cutaneous amyloidosis. The characteristics of early lesions and the regularity of their occurrence and development are noted. The types described in the literature may only be different developmental stages of the ordinary type. The newly demonstrated 4-5 paralell yellowish band-like lesions over the lower back need further study. There are protein abnormalities and blood lipids, especially triglycerides are increased. The neutral fat in the amyloid deposits is proved by histochemical staining. The increase in triglycerides and skin specimen fatty acid content is shown by infrared spectrophotometry and neutral fat thin layer chromatography. These suggest that metabolic disturbance of lipids and proteins may have something to do with the pathogenesis of the disease. Family history shows autosomal dominant inheritance with higher but incomplete penetrance in the ordinary type and autosomal recessive inheritance in the PCA type.

Cardiovascular diseases have become one of the major health problems in China in recent years. Stastistics from 4 urban Beijing districts showed that the mortality rate of heart diseases increased from 71/100,000 in 1958 to 141/100,000 in 1979 and that of the cerebrovascular diseases from 107/100,000 to 152/100,000. Cardiovascular diseases accounted for 52.6% of all deaths in Beijing in 1979. Cardiovascular epidemiology and community control programs for management and prevention of major cardiovascular diseases are making steady progress in our country. Further development of international exchange and collaboration in cardiovascular epidemiology will be emphasized in the coming years.

This paper describes the ultrastruotural surface configurations of 5 cases with bone and joint tumors and tumorous conditions, observed by scanning electron microscopy (SEM). The study of pleomorphism of malignant bone tumor cells and their surface ultrastructures shows that there is increased cell surface activity to meet heightened malignancy metabolism. Osteoid osteoma and pigmented villonodular synovitis have no malignant tendencies, according to their surface ultrastructure. SEM iS valuable in investigating tumor cell surface ultrastructure and the intercellular substances and in differentiating malignant bone and joint tumors from benign ones and tumorous conditions.

This paper describes the results of the use of acupuncture needle sphenoidal electrodes in 2,000 cases. In 155 suspected cases of psychomotor epilepsy sphenoidal electrodes, as compared with scalp electrodes can raise the positive incidence by 30.33%. In 765 suspected cases of generalized epilepsy they can raise the positive incidence by only 15.16% but are helpful in immediate differentiation between primary and secondary generalized seizures. In 851 cases of nonparoxysmal diseases they are useful in depicting the organic nature of the disease or in giving more precise localization of the lesion. Our 18 year experience shows that acupuncture needle sphenoidal electrodes are simple, safe, reliable and good for routine EEG use. Four illustrative cases were appended.

Pentagastrin stimulated gastric secretory tests (PSGST) were performed in 31 normal subjects and 569 patients with various gastro- duodenal diseas.es The mean basal acid output (BAO) and peak acid output (PAO) were higher in patients wi.th duodenal ulcer and[ combined ulcers, lower in patients with chronic atrophic gastritis and gastric carcinoma as compared with normal;s. The PSGST results in patients with chronic superficial gastritis and gastric ulcer were similar to those in normal subjects. Pa- tients with stomal ulcer had a higher PAO than those without stomal ulcer. The clinical value and significance of the test are discussed.