1983年 · 第96卷第04期

The authors report 16 cases of hand reconstruction including 1 case of bilateral hand reconstruction after total loss of both hands performed from October 1978 to December 1982. During this period much technical progress was made from bilatelral to unilateral toe donation. Brief discussions are given to the operative indications, materials utilized for reconstruction, the general operative procedure, and the proposed classification for hand reconstruction; and the merits and disadvantages of unilateral and bilateral toe donation are compared and evaluated.

A 10 year (1970-1979) survey of 615 cases of primary liver cancer and comparison of the data of 1970-1974 and 1975-1979 demonstrate that alpha fetoprotein (AFP) mass screening with advances in the technic of early diagnosis, have increased the discovery rate of subclinical hepatocellular carcinoma (HCC) and small HCC to 16.0% and 11.2%, this results in an increased resection in the series (20.1%) and definite improvement in ultimate outcome. 5-year survival rate increased from 2.5% to 12.3% and resection rate from 16.3% to 39.1%. Some new findings on the development of early HCC are presented. Unicentric HCC development is observed in 68.3% of small HCC. Concepts of early diagnosis have changed to combined AFP and SGPT analysis. Instead of nuclide imaging, angiography (positivity rate 80.0%) and B scan ultrasonography (positivity 50.0%) provide valuable information for small HCC localization. Some surgical principles have to be revised concerning the management of small HCC, including local tumor resection in the right lobe in patients with cirrhosis and reoperation in solitary recurrence or metastasis after initial radical resection. More aggressive use of cryosurgery, laser, hepatic artery ligation and infusion either alone or combined are emphasized in patients with compensated liver function. Prognostic factors and future prospects are also discussed.

Keshan disease is a kind of endemic myocardial disease which affects the local agricultural population widely. Severe deterioration of myocardium, multiple focal necrosis and myocardial scar formation are the basic manifestations which result in myogenic dilation of both ventricles. The lesions in the other visceral organs are due to systemic congestion, anoxia and thromboembolic phenomenon. During the past 25 years, the morphogenesis of the myocardial lesion, pathogenesis of subendocardial necrosis and differential diagnosis of Keshan disease and other primary cardiomyopathies have been studied. This paper mainly introduces the pathologic features of Keshan disease and also covers some recent progress in experimental models and electromicroscopic studies.

The serum zinc and copper levels before and after moderate severity operative trauma are investigated in 18 patients. Serum zinc concentration was markedly decreased 6 hr after operation but gradually returned to near normal without exogenous zinc supply. Serum copper concentration increased after operation. The possible mechanism and importance of these changes are discussed briefly.

The distribution and incidence of hemorrhagic fever with renal syndrome in China was reported. There is a tendency of increase in the incidence of the disease in the whole country in recent years. The factors influencing the disease incidence are rodent density of the affected areas and the size of area of the rice paddy fields. Deratization is proved to be an effective measure in the control of hemorrhagic fever with renal syndrome.

Phenithionate is a new aryl derivative of amoscanate in which the phenylisoithiocyanate (-NCS) group is replaced by thioncarbamate and is a new, structurally different antischistosomal compound. On clinical trial in the treatment of 463 cases of schistosomiasis japonica, its toxicity to the liver and central nervous system is much lower than that of amoscanate, while its marked chemotherapeutic activity against Schistosoma japonica is maintained. In other words, the toxicity and chemotherapeutic activity of amoscanate can be dissociated by suitable structural modification. Phenithionate is recommended for further large scale clinical trial in the disease.

Three cases of choroid plexus papilloma at the cerebellopontine angle are reported in this article, the tumor blood supply was mainly from the anteroinferior cerebellar artery. There is a relationship between the course of the artery and the tumor shape. This may aid the diagnosis. The author was not able to find a report of this arterial connection in the literature available.

In vivo continuous observations made separately on 41 female and 19 male worms of Ancylostoma caninum reveal that the average volume of blood sucked by each female or male worm from infected dogs was 43.1 (±39.6) and 12.9 μl/24 hr. There was always further bleeding from the mucosal laceration at the site of attachment while the worm was sucking actively. Separate observations made on 35 lacerations induced by female and 14 by male worms of A caninum reveal that the blood lost averages 46.1 (±39.1) and 15.8 μl/24 hr/laceration for female and male worms. The volume of blood loss through two routes correlates closely, the coefficient being 0.618. As only about 42% of the worm population actively suck at a given time, it seems logical to adjust these 2 sets of figures with a coefficient 42%. Observations are made on 37 female and 13 male worms of A caninum to ascertain the quantity of blood lost from the wound when the worm moves on to a new site, the values obtained are l.5 and 0.3 μl/24 hr/worm for female and male worms. A considerable amount of blood is also lost through "extensive intestinal hemorrhage" which occurs occasionally. In general, the amount of blood lost through bleeding external to the worm is greater than that lost through the hookworm. Preliminary studies on A duodenale and A ceylanicum supplement the impressions gained on A caninum.

A new Strain of cryptococcus neoformans Var Shanghaiensis 8012 is reported. In its parasitic state, the special features are bacilli, needle, gourd, round, oval and shuttle forms and blastospores appear simultaneously. It produces a very thick capsule in the tissues and is pathogenic to humans and animals. Observations of 10 cultures, and 4 physiologic determinations and animal tests through 3 generations of this new strain confirmed that the mentioned features are all stable.

This paper deals with the clinical application of ear tissues preserved in the Wuhan Medical College Type I Ear Bank, including homograft of tympano-ossicular chain and tympanic membrane. The results of 15 operations performed with these allografts were encouraging.