1987年 · 第100卷第05期

In 49 noninsulin dependent diabetes mellitus (NIDDM) patients (33 males, 16 females) the concentration decreased of insulin receptor on erythrocytes and normal levels of fasting plasma insulin as compared with the control groups, suggesting that hyperinsulinemia may not be the sole cause for receptor defects in NIDDM. Comparison of insulin receptors between obese and nonobese-NIDDM patients indicated that such defects were more severe in obese NIDDM patients than those in nonobese ones. A slight but signifciant increase of plasma hCH and cortisol was found in NIDDM, but it is unlikely that the decrease of insulin receptors in NIDDM is caused by the slightly increased antagonistic hormones. The factors leading to insulin receptor defects in NIDDM are discussed.

Rats were bled and maintained at a mean arterial pressure of 40 mm Hg for 4 hours. Liver, lung and renal cortex were assayed for adenylate cyclase, cAMP dependent phosphodiesterase and catechola mines. Results showed that following 4 hours of hypoperfusion, adenylate cyclase activity was altered differently in different tissues. In lung tissue NaF-stimulated adenylate cyclase activity decreased from 2,019 picomoles/mg/10 min in the control group to 1,237, while that of the renal cortex increased from 2,990 picomoles/mg/10 min to 5,622. But there was no difference in liver tissue. Responsiveness of the adenylate cyclase system to epinephrine stimulation was also depressed in lung tissue.

This is a pathologic analysis of 150 cases of pituitary adenomas treated surgically. According to the clinical manifestations and laboratory findings they were divided into 5 groups: 1. those with acromegaly, 77 cases; 2. those with amenorrhea and galactorrhea, 44 cases; 3. those with Cushing's syndrome, 13 cases; 4. those with hypothyroidism, 1 case; and 5. those with no specific endocrine symptoms, 15 cases. Gross and microscopic analysis of the pituitary adenomas was made together with the clinical findings. Under electron microscope, pituitary adenomas were classified into GH, PRL, ACTH, TSH cell adenomas, and polyfunctional adenomas.

Serum C-reactive protein (CRP), mucin (Mu) and transferrin (Tf) levels were measured in 63 cases of leukemia. CRP and Mu levels were obviously higher in 33 cases with concomitant infections than in those without, while the Tf levels in leukemia with infection were significantly lower than in those without infection. The CRP level rapidly increased in patients with concomitant infections and promptly decreased after control of inflammation. Therefore, it is a useful index for detecting infection and judging the effect of treatment. Changes in Mu and Tf levels correlate well with the severity of infection. Clinically, the dynamic CRP, Mu and Tf changes aid the diagnosis of infection complicating leukemia.

Fifty-one cases of coronary heart disease (CHD), 44 males and 7 females, aged 39-78 years, were studied. 13 cases were angina (group A), 29, myocardial infarction (group B) and 9, ventricular aneurysm or acute expansion of the zone of infarction (group C), with ECGs and UCGs done in alt. 16 cases were angiographically studied. Wall motion abnormalities were found in 4 cases in group A, 27 in group B and 9 in group C. 5.18% of the segments had abnormal waH motion in group A, 31.6% in group B and 63.77% in group C. There was an inverse relationship between left ventricular wall motion index (LVWMI) and ejection fraction (EF) (y=81.3520-1.1601x, r=-0.78) and the difference in LVWMI among the three groups was significant (p<0.01). The study suggests that persistent wall motion abnormality in angina pectoris indicates severe coronary artery disease, while normal waLl motion in old myocardial infarction is a sign of better prognosis. LV wall motion can help determine further examinations or treatment in CHD. The LV function can be assessed indirectly by LVWMI.

The amount and distribution of antral G cells and the gastrin contents of the gastric mucosa, gastric juice and serum are studied in 18 patients with atropbic gastritis. Significant abatement of G cells was found and was directly proportional to the degree of antral mucosa atrophy, but the cytoplasmic fluoresence of G cells was brighter, indicating higher gastrin content. This may account for the lack of difference in serum gastrin levels between patients with atrophic gastritis and controls. Most G cells were situated between antral glandular cells and had narrow necks in contact with the lumen, but a few were adjacent to antral gland basement membrane. It is postrtlated that they may have paracrine function and that gastric juice gastrin may come directly from G cells, because gastric juice gastrin content is higher than that in the serum.

In this paper 4 cases of bullous retinal detachment are reported with a review of 37 cases in the literature. Characteristic clinical features and fluorescin angiography findings are presented. Fluorescin angiography is quite useful in detecting retinal pigment epithelium detachment and in differentiating it from thegmatogenous retinal detachment and secondary retinal detachment of other causes.

Five hybridomas producing monoclonal antibodies (McAbs) against adenoviruses were obtained. One of them was group specific, 2 specific for adenovirus type 3 (Adeno-3), and 2 specific for Adeno-7. Tests showed that the McAb possessed extremely high specificity. We tried to examine adenovirus antigens in clinical smears of 37 cases. Results were satisfactory. McAb may be used in the diagnosis of specific types of adenovirus infection.

Of 25 cases of proliferative cystitis, 20 are associated with tumors, 7 of which are papillomas. 6 cases are transitional cell carcinoma, malignant changes of the Brunn's nests arc found in 4. 2 cases are adenomas of intestinal type. 2 cases are adeno-carcinomas, found among 9 cases of intestinal type mucoid metaplasia. Of these, 1 has developed from colonic type glands and the other from in testinal type anaplastic adenoma. 3 cases were mixed type. It is suggested that atypical proliferation of Von Brunn's nest cells and glandular lesion should be looked for before diagnosis of proliferative cystitis precancerous change is made. Proliferative cystitis clinical symtoms and signs are similar to those of bladder tumors, and differential diagnosis must be done histopathologically. Follow-up of cases of proliferative cystitis with biopsy is beneficial to early diagnosis, prevention and treatment of tumors of the bladder.

This paper reports 21 cases of large intra-cranial aneurysms (7 intracavernous carotid aneurysm, 5 MCA aneurysm, 3 supraclinoid ICA aneurysm, 3 ACoA aneurysm, 1 each of carotid ophthalmic aneurysm, ACA aneurysm and PCA ancurysm). 18 cases received surgical treatment: acute or chronic occlusion with or without EIAB was performed in 7 cases, neck clipping with excision of the aneurysm in 5, neck clipping only in 2, excision of ancurysm with end-to-end anastomosis of the MCA in 1, trapping with excision of aneurysm in 1, and opening of the aneurysm with removal of thrombus and packing with copper wire and gelfoam in 2. No operative death occurred. 2 cases developed hemiplegia due to acute occlusion of ICA after operation. 16 cases were cured. Follow-up (one month to 2 years) of 14 cases revealed that 1 of 2 untreated patients died, and 1 remained the same as before. 11 of the 12 surgically treated were in excellent or good condition. The incidence, diagnosis, differential diagnosis and treatment of this disease are discussed.