1989年 · 第102卷第12期

The authors report the first case of parrot breeder's lung in China and the study of its immunology, respiratory physiology, as well as pathology. The main characteristics of this disease are progressive dyspnea after contacting parrots, patchy or reticular shadows in the lower lung fields on chest X-ray, the presence of alveolitis, companied by pulmonary interstitial fibrosis as demonstrated in lung biopsy, restrictive or mixed ventilation disorders with reduction of diffusing capacity and lung compliance. The results of specific ring precipitation test and counter immunoelectrophoresis were helpful in diagnosis. The importance of early diagnosis and treatment is also discussed.

A case of hyaline membrane disease was treated successfully with pulmonary surfactant (PS) isolated from human amniotic fluid. Dosage was 150 mg phospholipid/kg. The exogenous surfactant was instilled into the airway via a tracheal cannula. Clinical symptoms, PO2 and FiO2 improved evidently 24 hours after administration. L/S ratio and phosphatidylglycerol recovered gradually in aspirates. Lung X-ray film manifested "white lung" before instillation of surfactant and showed a striking improvement 3 days after treatment. The duration of mechanical ventilation was 6 days. During the period of recovery complications of patent ductus arteriosus and bacterial pneumonia developed. However, the patient recovered completely and was discharged 32 days after admission.

100 pieces of renal tissue from 4 patients with renal artery stenosis were studied histologically. Juxtaglomerular cells were found not only in the region close to the glomerulus but also in the proximal 2/3 of the afferent arteriole of the glomerulus, but not in the interlobular arterioles. In the cytoplasm of juxtaglomerular cells, three kinds of granules were found: crystalline granules (immature), the round or ovoid granules (mature), and the lobulated granules (fusion). Renin was synthesized in the rough endoplasmic reticulum and packaged in the Golgi complex. Electron microscopic findings suggested that the secretory microvesicles were produced on the surface of Golgi complex. They fused to form primary crystalline granules, which were enlarged by renin supplied by transportation vesicles and finally formed typical crystalline granules. The mature renin granules (round or ovoid) moved toward the periphery of the cytoplasma. Their limiting membranes on the side toward the basement membrane disintegrated and formed microvesicular bodies passing through the periplasm, and the basement membrane and were discharged into the interstitial matrix.

The xanthine oxidase catalysed release of superoxide free radicals (O2-) from endogenous hypoxanthine was determined in homogenates of synovium obtained from three groups of patients, those undergoing primary or revision total hip replacement (THR) for osteoarthritis and those undergoing arthroscopy of the knee for semilunar disc injuries. The concentrations of hypoxanthine in homogenates obtained during THR were found to be significantly higher than those in the group with semilunar disc injuries. The results suggest that there is a greater predisposition to free radical release and tissue damage in Osteoarthritis.

Using the left sciatic nerves of 44 rats we studied neurotropism in nerve regeneration. The proximal and distal cut ends of the nerves were separately introduced into the ends of a specially designed silastic Y- or cross-shaped tube. Either the distal stump or a cut end of the Achilles tendon was inserted into the other ends of the tube, or was left empty. The distance between the tissue ends, nerve-to-nerve or nerve-to-tendon, was 4 mm. Four weeks later, neurofibers sprung out from the proximal stump and grew towards the distal nerve end instead of the tendon end or the vacant channel of the tube. This finding suggests that neurotropic factors may influence the direction of growth of the newly formed neurofibers. This paper discusses the mechanism of neurotropism, the effect of the distance between the cut ends of the nerve, and the choice of the silastic material.

Plasma aminogram changes were lerospectively studied in 95 patients with external enteric fistula and intraabdominal infection who were under total parenteral nutrition (TPN) therapy with anfuming 14s. Plasma amino acids and albumin were determined before the administration of TPN, weekly and at the end of the therapy or 2 to 5 days before death of patients. In patients with sepsis and starvation, the aminogram showed remarkably Jow total free amino acids before TPN therapy. In survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in the dead increased rapidly to a significantly high peak at the terminal stage. In both survivors and deceased, phenylalaninc level remaIned high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acid preparation for the starved, septic patients should be high in BCAA and arginine but low in phenylalaninc; the administration of inappropriate exogenous amino acids in metabolically decompensated septic patients may bring about more harm than benefit; and in septic patients the persistently elevated level of plasma phenylalanine and proline along with decrease of arginine is a useful prognostic sign.

100 patients with W-P-W syndrome who had repeated attacks of supraventricular tachycardia (200-300 beats per minute) associated with syncope and hypotension were treated surgically. Most of them were refractory to medical treatment. Electrophysiological studies were done before operation and the anomalous conduction pathyways (ACPs) were confirmed and localized by epicardial mapping during the operation. Among the 100 patients, 44 were of type B, 29 type A and 27 type A+B. The right ACPs were excised and the left ACPs were injected with alcohoL Four patients died after operation. 96 patients were followed up for an average of 24 months; 38 (90.5%) of 42 type B patients, 23 (82.1%) of 28 type A patients, and 17 (65.4%) of 26 type A+B patients were cured.

Anti-nuclear antibodies (ANA) combined with anti-cytoplasmic antibodies (ACA) in 0.6% (n=43) of 7 121 consecutive patients referred for ANA screening were observed. Homogeneous/cytoplasmic was the most frequently combined ANA/ACA pattern among 6 different indirect immunofluorescent (IF) combinations. Distribution of diseases was similar in patients with ANA/ACA and those controls with ANA alone. However, the ANA/ACA results were often transitory, especially in systemic lupus erythromatosus (SLE). The appearance of transitory ANA/ACA combinations on serial ANA testing may be useful as a serologic marker for SLE.

The possibility of using the bioluminescent (BL) technique to substitute the traditional viability count of colony forming units (CFU) of BCG vaccine was investigated. The results showed there is a significant dose-dependent correlation between the concentration of standard adenosine triphosphate (ATP) and ATP BL value. The ultrasonic-chloroform method designed by us yielded the best results. The correlation coefficient values (r) of BL of the liquid and lyophilized vaccine were found to be 0.8 155 and 0.8 484 respectively (P<0.05). The coefficient of variation (CV) between the BL value of different lots of ATP obtained was 3.2-4.4%, much lower than that of CFU (CV=10.4-11.2%). The presence of bacterial clumps within the vaccine had great influence on the bacterial ATP value and on the CFU viability count. 2.8 fg of ATP was found in each CFU formed in the vaccine with clumps, while it was only 0.94 fg in the vaccine without clumps, indicating the superiority of the BL method. The BL method has shown a high sensitivity, good reproducibility and simplicity in handling with quick results and high accuracy. Therefore, we consider that the BL method can he used to substitute the CFU method.