1984年 · 第97卷第04期

With computer analysis we processed the power spectrum, transfer function, coherence function, impulse response and amplitude histogram of spontaneous and evoked electroencephalograms of 54 subjects in 1981. By the same method, we processed electroencephalograms of 52 patients with epilepsy, another 52 patients with cerebral concussion, and 100 normal subjects. Eight indexes were chosen to evaluate their brain function. Consequently, the positive rate was increased by 25% as compared with conventional electro encephalogram analysis. The severer the damage of the brain function, the more the appearance of positive indexes. This serves as an effective criterion for evaluating the extent of the brain damage. The method has a high repeatability and is feasible for clinical use.

Complete avulsion amputation of the thumb or degloving amputation of a finger is characterized by pulling out of the extensor and flexor tendons from the musculotendinous junction and torn off digital arteries, veins and nerves at variable distances from the amputation site. To treat this condition, routine replantation is hardly successful, and the functional results are poor even the thumb and finger survive. This type of injury was formerly considered to be a contraindication to replantation. Since 1978, we have treated 13 avulsively amputated thumbs and one degloved ring finger with replantation of primary tendon transfer and cross anastomoses of arteries, veins, and nerves. All but one thumb survived; follow-up fOr 5 months to 3 years and 5 months showed good restoration of sensation,two-point discrimination sensation (range 6-12 mm), and satisfactory motor function.

100 pathologically proved cases of bronchogenic carcinoma were evaluated with regard to the superior features of CT scans in comparison with conventional chest radiographs. The results were: 42% CT superior to chest films with additional information, 54% CT parallel and 4% CT inferior to chest films. CT scans are particularly useful in detecting masses in such regions, as the lung apex, paravertebral region, azygoesophageal recess, intermediate bronchus, and the posterior sulcus of the lower thorax. CT also can determine tumor invasion of the pleura and demonstrate the enlargement of mediastinal and hilar lymph nodes. All these are conducive to predicting the resectability of affected segments or lobes. Limitations and appropriate application of CT scans as well as the improvement of conventional X-ray examination are discussed.

In this paper, micro-in-macro gelatin-encapsulated activated charocal (MMAC), a double gelatin-coated activated charcoal, is recommended as an effective adsorbent for clinical hemoperfusion (HP). In vitro studies show that the clearance and adsorption values for a variety of substances are as good as those with uncoated or collodion-coated activated coconut charcoal. Blood compatibility is excellent and particulate release minimal. Clinical conditions for which MMAC HP has been tried include acute drug overdose, poisoning, chronic uremia and schizophrenia. Experience suggests that MMAC HP is effective and safe in the treatment of intoxications. It is also a useful adjunct to hemodialysis in the treatment of uremia. As for schizophrenia, further study is needed. The shortcomings of MMAC are also discussed.

We used a self-designed instrument to evaluate thyroid function. With this instrument the R-p time intervals were measured from the onset of R wave on ECG to the onset of the pulse wave taken from electrodes placed on the forehead. This interval was related to myocardial contractility and could be changed by circulating thyroid hormones. The range of R-p time interval in 50 normal subjects was 121-144 msec (132±5.8). In 47 cases of hyperthyroidism, this time interval was shortened to 98-119 msec (108.5±5.6) and in 18 cases of hypothyroidism, it was prolonged to 144-179 msec (160±8.7). There was an exponential correlation between R-p time intervals and the concentrations of serum T3, T4. This method could be used as a screening test, for estimating the thyroid functional status and as an index to guide medication during the course of treatment of hyper- and hypothyroidism.

The frequency of sister chromatid exchanges and chromosomal aberrations of peripheral lymphocytes (i.e., subploid, hyperploid, tetraploid, breakage, fragmentation) were studied in 20 cases of hydatidiform mole, 23 cases of invasive mole, 22 cases of choriocarcinoma, and 20 normal controls. The sister chromatid exchange frequency was 5.74±0.69 per metaphase in normal women, and 6.84±1.56 in hydatidiform mole, 11.49±2.24 in invasive mole, and 11.37±1.90 in choriocarcinoma. The frequency of chromosomal aberrations was highest in choriocarcinoma, and lowest in normal controls, with hydatidiform mole and invasive mole second and third. Statistically significant differences were found in these 2 indices in the 4 groups.

71 cases of hypoparathyroidism are reported. Of these, 36 were idiopathic hypoparathyroidism, 11 pseudohypoparathyroidism and 24 post-thyroidectomy hypoparathyroidism. Tetany (90%), convulsions (50.7%), extrapyramidal symptom (11%) and mental changes (16.9%) including irritability, anxiety, fear, depression, hallucination and confusion were noted.

There is still no specific method for the early diagnosis of ovarian carcinoma. It has been suggested that serum lactic dehydrogenase (SLDH) levels may help in diagnosing and following up the patients with this disease. Between 1979 and 1981, SLDH levels of 18 patients with malignant ovarian tumors and 9 with benign tumors were examined before and after surgery and chemotherapy. A control group of 62 blood donors and employees, was also examined. The normal mean value for the control group was 157.29±24.94 IU/100 ml. 11 of the 18 patients with malignant ovarian tumors, had elevated SLDH levels before treatment, which decreased when the tumor was resected or after chemotherapy and radiotherapy. In 11 of 15 patients with primary ovarian carcinoma, SLDH levels were high before treatment. Patients with benign tumors had normal levels of SLDH. SLDH determination seems valuable in the diagnosis, treatment and follow-up study as well as differential diagnosis of ovarian carcinoma.

A clinical analysis of 18 infants with necrotizing enterocolitis disclosed that nosocomial staphylococcal infection is an important factor in the development of necrotizing enterocolitis in this unit. Mature infants with clinical necrotizing enterocolitis are usually complicated by other conditions probably due to alteration of the blood flow to the bowel or bowel motility. Two of the 3 full-term infants who had profound intrapartum asphyxia had Hirschsprung's disease. Early recognition, and management of necrotizing enterocolitis in low birth weight infants may bring about favourable outcomes.

The levels of Factor B (B), properdin (P) and the third complement component (C3) in serial serum samples obtained from 36 hospitalized patients with epidemic hemorrhagic fever (EHF) were measured by single radial immuno-diffusion. These proteins of the alternative activating pathway of C were activated and their circulating levels reduced. Good correlations were observed between the B, P and C3 levels in patient sera. The alternative C pathway was activated in these patients. The number of the positive cases and positive sera was increased with severity of illness, strongly suggesting the correlation of activation of this pathway with the disease condition. In addition, activation of the classical C pathway in the same patients was again observed through determination of activation of the first complement component (CI) by assessing the ratio of the subunit Clr to subunit Cls (the Clr:Cls ratio) according to a method previously described. Some discrepancies were found in activation between the 2 pathways. A variety of biologically active peptides produced during enormous activation of the C system via the alternative and classical pathways may contribute to a number of serious consequences in EHF, including increased vascular permeability, hypotension, shock, hemorrhage and renal damage.