1987年 · 第100卷第03期

Four cases with documented intra-Hisian block associated with unusual etiologies are reported. They occurred in rheumatoid arthritis, cysticercosis cellulosae, Behcet's disease and aorto-arteritis.

Dimethyl-l-curine dimethochloride was obtained by methylating the l-curine which was isolated from plants belonging to Genesia Cyclea widely distributed in Hainan Island, South China. It is a non-depolarizing post neuromuscular junctional blocker acting upon N2 receptor. Its chemical structural formula, physical properties, pharmacological actions and acute or chronic toxicities have been thoroughly studied. Its biological activities varied a great deal in different experimental animals but their clinical potency is uniform. Its activity is 51.8% as those of d-tubocurarine. Clinically, 1,449 cases, male and female, aged and young, were studied. Among them 422 were employed for endotracheal intubation, 468 for muscular relaxation and 559 for both. Operation varied, including intracraneal, intra-abdominal and open heart surgery. Different kinds of anesthetics and adjuvants were used in association. I.V. dosage of 0.4-0.5 mg/kg or more was enough for intubation while 0.2-0.3 mg/kg for relaxation. Average duration of action was 30-40 minutes, but could be prolonged after heavy doses. Side effects were limited only to mild hypotension and temporal face freshness, while cardiovascular disturbances were very insignificant.

Intercellular junctions in the alveolar epithelium and in the capillary endothelium in the lungs of 4 sheep with oxygen intoxication and 3 control sheep are studied by freeze-fracture. Under electron microscope, it was found that there was no significant difference between the number of strands, both in the epithelium and in the endothelium, in the oxygen intoxication group and the control group. However, the incidences of discontinuity, irregularity and free-ended strands were higher in the oxygen intoxicated group than in the control. The differences of most of these features were highly significant (p<0.005). In addition, in the oxygen intoxicated group some epithelial junctions showed that the meshes of the network were extended significantly. These phenomena may indicate destruction or degeneration of the junctional elements and may partly explain the route of fluid leakage and the occurrence of pulmonary edema induced by breathing pure oxygen.

Hemilaryngectomy has been expanded aggressively in recent years, so that the resultant defect has been described as three/quarters, seven/eighths, 90%, near-total or subtotal laryngectomy. In some of the author's cases, resection has been extended to involve one pyriform sinus and/or the base of the tongue. Reconstruction after these radical extended resections, especially those including the tongue base are very difficult. This paper presents the author's experience in 67 patients who underwent adjacent cervical skin flap reconstruction after subtotal and extended subtotal laryngectomy. The surgical indications, types of surgical procedures used and reconstructive technics are outlined. The author concludes that cervical skin reconstruction is effective for restoration of laryngeal function after subtotal and extended subtotal laryngectomy.

The mechanism of action of 3,6 bis(2-piperidinoethoxy) acridine trihydrochloride (CL 246,738) in the potentiation of natural killer (NK) cells was investigated. Orally administered CL 246,738 consistently produced enhancement of NK cell activity in mice. Using anti-asialo GM-1 (ASGM-1) antibody as an NK cell marker, it was determined that the compound increased the number of ASGM-1 positive cells in mice as indicated by immunofluorescence staining. The compound at concentrations of 0.02-0.2 μg/ml also induced NK cell activity in vitro. This effect was dependent upon the presence of macrophages and was inhibited by anti-IFN (alpha+beta), but not anti-IFN (beta) antibody. Taken together, it is postulated that the compound functions by stimulating macrophages to release IFN (alpha) which subsequently activates NK cells. As an effective stimulator of IFN and NK cells, CL 246,738 may prove clinically useful in the immunotherapy of certain types of malignancy.

Cytogenetic studies of a human lung adenocarcinoma cell line, AGZY83-a were carried out by chromosome banding. The cell chromosomes varied from 53 to 69 and the modal number was 68. Most of the cells had 47-50 normal chromosomes and 17-20 structurally abnormal chromosomes. The basic chromosomal constitution was almost the same in most cells. In addition 17 consistent marker chromosomes were found. A light staining region differing from the homogeneous staining region (HSR) in staining properly was found in a marker chromosome. The implications of the chromosomal abnormalities of this cell line are discussed.

We set up the first radial immuno-diffusion assay for Apoprotein A1(ApoA1) in China and compared the lipoprotein and ApoA1 levels among Non-insulin-dependent diabetics, coronary heart disease patients (CHD) and Weight/Age matched controls. Compared to the controls, diabetics and CHD patients had significantly higher triglycerides levels (TG), lower high density lipoprotein-cholesterol (HDL-C) levels, lower ratios of HDL-C to LDL-C (low density lipoprotein-cholesterol) and lower ApoA1 levels. These suggested that the abnormalities of ApoA1 and lipoproteins in diabetics may be related to the higher frequency of CAD in diabetics. Our data show that ApoA1 levels in Chinese controls and NIDDM patients are higher than in American controls and NIDDM patients, and CHD frequency is lower in Chinese than in Americans. This may be related to the higher ApoA1 levels in Chinese.

Cerebrospinal fluid ferritin (CSF.F) levels are higher in patients with central nervous system leukemia (CNL) or suspected CNL, as compared with nonleukemic patients. Our data shows that changes in CSF.F levels are more marked than any other CSF routine test parameters in CNL and correlate well with the disease progress. CSF.F examination may help in early diagnosis of CNL. CNL is the origin of leukemic relapSe, so it is very important to prevent and treat CNL in time.

To examine the relative importance of serum thyroxine (T4), free thyroxine (fT4) and triiodothyronine (T3) in monitoring adequate T4 dose in patients on T4-replacement therapy, the effect of T4 dose on total T4, fT4 and T3, basal thyroid stimulating hormone (TSH) and TSH-response to thyrotropin releasing hormone (TRH) were investigated in 33 patients taking T4 doses of 50-200μg/day. The T4-treated patients had highly elevated mean T4 (total and free) and lower basal TSH levels compared to the mean values in normal subjects. But serum T3 was not significantly different. The patients on T4 doses greater than 150μg/day frequently had more suppressed TSH response to TRH than those on T4 doses less than 150µg/day. Total T4 and fT4, but not serum T3 levels, cerrelated significantly with T4 dosage. Changes in T4 dosage led to concomitant changes in total T4 and fT4 and inverse changes in TSH-response to TRH. The study also revealed a high incidence (33%) of elevated serum fT4 (hyperthyroxinemia) during therapy. The hyperthyroxinemic group was characterised by clevated serum T4 (total and free), T3 and T4 dose, and suppressed TSH-response to TRH compared to the T4-treated group with normal serum T4 levels. These findings may be indicative of excessive T4 treatment in these patients and suggest serum T4 may be more useful than T3 in monitoring T4 dosage in T4-replacement therapy. The discrepancy between normal serum T4 levels and TSH-response to TRH may reflect heterogeneity in returning normal function of the pituitary-thyroid axis. Clearly, measurement of TSH or TRH test can not be used alone in assessing thyroid status in these patients, particularly when serum T4 is in normal range.

This article reports the cyclic AMP and cyclic GMP content of psoriatic epidermis and dermis and compares them with those of normal human skin. Cyclic AMP content of involved and uninvolved epidermis of psoriatic patients were found to be significantly decreased by 41% and 46% respectively (DNA data basis) as compared with normal human skin. But cyclic AMP content of psoriatic dermis was increased by 103% (wet weight), as compared to uninvolved and normal human dermis. Cyclic GMP content of psoriatic epidermis was significantly increased by 124% and 150% (wet weight) as com pared with uninvolved and normal human epidermis. These changes may play an important role in causing psoriatic lesions.