1990年 · 第103卷第07期

CT-guided transcutaneous fine-needle aspiration biopsies were done in 350 patients. They involved the abdomen in 226 patients (liver 75, pancreatic and abdominal masses 51, kidney 96, adrenal gland 3, spleen 1), thorax 90, musculoskeletal system 32, and brain 2. The accuracy varied with different locations. The accuracy of liver biopsy was 94%, kidney 95.8%, pancreatic and abdominal masses 88.2%, thorax 90%, and musculoskeletal system 96.5%. The occurrence rate of complications was 2.3%. Pneumothorax occurred in 7 patients having thorax biopsy, and gastric perforation in one patient after abdominal biopsy. The proper selection of fine needles, the method and technique, the influential elements of the accuracy, and the application of CT-guided aspiration biopsy were detailed in this paper.

The random migration and chemotaxis of polymorphonuclear leukocytes (PMN) in agarose were studied in 21 patients with psoriasis and 10 healthy controls. Different concentrations of LTB4 were used as chemoattractants. The random migration and chemotaxis towards lower concentrations of LTB4 were enhanced and that towards higher concentrations of LTB4 reduced in psoriasis. The differences of body involvement, sex, and family history of psoriasis had no influence on PMN migration.

The immunolocalization of human neutrophil elastase (HNE) in the alveolar interstitium of 6 patients with emphysema was investigated by immunochemical electron microscopy. The results showed that HNE is localized in the azurophil granules of neutrophils, and extracellularly on the elastic fibers of alveolar interstitium and basement membranes of epithelium and endothelium. The damage of elastic fibers and basement membranes could be observed. The HNE level of the alveolar interstitium was obviously elevated and closely related to the severity of emphysematous lesions as shown by measuring the mean linear intercept (MLI) in 4 emphysematous lungs with chronic bronchitis (r=0.84). This suggests that HNE might play an important role in the pathogenesis of emphysema. Although enlarged airspace and increased MLI data were observed in 2 patients, one with asthma and the other, an elderly patient, without lung diseases, the HNE level of alveolar interstitium is much less than that of the other 4 chronic obstructive pulmonary disease patients. This implies that the mechanism of the the airspace enlargement occurring in the 2 patients may be different from that of others. These findings support the hypothesis of elastase-antielastase imbalance on the pathogenesis of pulmonary emphysema.

Cysts of Giardia lamblia from fresh stool specimens of a 13-year-old boy, who lived in suburban Beijing and had suffered from recurrent diarrheas for years, were concentrated, purified and suspended in physiological saline. Six suckling gerbils (Meriones unguiculatus) were each inoculated with 0.2 ml of this suspension which contained 20,000 cysts/ml. On day 8 after inoculation, the infected animals were sacrificed and trophozoites of G. lamblia which appeared numerous in the upper small intestines were isolated aseptically. The trophozoites were inoculated into modified TYI-S-33 medium and cultivated at 37 C. On day 14 of cultivation, the organism grew luxuriantly and formed a cellular monolayer on the inner wall of the culture tube. The organism replicated every 15±2 hours and the peak growth occurred 120 hours after seeding. No bacterial growth was detected by repeatedly transferring the culture onto blood agar plates and into beef broths. Several lots of the culture have been subjected to cryopreservation in liquid nitrogen and the viability of the thawed organism ranged from 50% to 80% 1-10 weeks after being cryopreserved. The thawed parasites grew well in subcultures. This axenic culture has been maintained for one year and 4 months, and more than 150 subcultures have been made.

This article presents 102 cases of recurrent parotitis in children with studies of clinical findings, sialographic manifestations, dynamic functions of the parotid gland examined with radionuclide, laboratory findings and follow-up studies of 28 cases with sialography. The following conclusions are reached: 1. Retrograde infection induced by the mumps virus and upper respiratory infection seem to play a major role in the etiology of recurrent parotitis. Familial abnormalities are potential factors. Incomplete immune functions of the children are factors related to the pathogenesis, and following growth and development of the immune system, this disease will undergo remission; 2. Sequential scintigraphy shows normal uptake and retarded excretion function of the parotid; 3. Long-term follow-up studies demonstrate that the patients are free from symptoms for many years, but the punctate dilatation in sialography may diminish, disappear, or be unchanged; and 4. If the disease is not cured in childhood, it may continue into adulthood and healing will take place eventually. Relationship with Sjogren's syndrome has not been revealed.

In an attempt to evaluate the significance of DNA-ploidy as an objective prognostic indicator of oral squamous cell carcinoma, a retrospective analysis of 70 paraffin-embedded specimens using flow cytometry was performed. Forty-one patients (58.6%) had aneuploid tumors and 29 patients (41.4%) had diploid DNA distribution patterns. There was a significant difference in 5-year disease-free survival rates between patients with aneuploid and diploid tumors. The difference in cervical metastatic rates between aneuploid and diploid group approximated statistical significance. No obvious correlation was observed between DNA indices and histologic grade, clinical stage or tumor size. It is concluded that patients with aneuploidy primary tumors have a significantly poorer prognosis and higher risk for regional metastases than those with diploid tumors.

Chromosomal fragile sites analyses were performed in peripheral lymphocytes of 37 patients with lymphoma and 16 patients with leukemia, and also of 50 healthy individuals as controls. The results were: 1) The rates of chromosomal aberration and frequency of expression of fragile sites in patients with lymphoma and leukemia were significantly higher than those of normal controls. 2) There was a statistical association between 21 of 44 fragile sites and specific cancer breakpoints in patients with lymphoma and this was also the case with 19 of 30 fragile sites and specific cancer breakpoints in patients with leukemia. 3) Concordance between fragile sites and location of oncogenes in the diseases was established. The possible important role of fragile sites in the pathogenesis of lymphoma and leukemia is discussed.

1,351 specimens resected surgically from 100 patients with gastric carcinoma were studied with PAP immunoperoxidase and ultrastructural method. The tumor cells were found positive for gastrin, serotonin, somatostatin and argyrophil particles in 19 patients. Among them the gastrin-secreting tumor cells consisted of 50% of the total in 4 cases, representing a separate new subtype, neuro-endocrine (NE) gastric carcinoma. Of the 100 cases, 16 (32%) contained NE cells among 50 undifferentiated type, while only 3 cases (6%) contained NE cells among the remaining 50 cases, the well-differentiated type. These results suggest that the appearance of NE tumor cells is closely correlated with the degree of differentiation of cancer, and confirms theoretically the heterogenicity of gastric carcinoma, and further supports the concept that exocrine and endocrine type gastric cancer cells are isogenous, i.e., from the endodermal stem cells.

Liver biopsies of 50 patients with chronic active hepatitis B were analysed immunohistochemically for HBcAg and HBsAg, and, by in situ hybridization, for hepatitis B virus (HBV) DNA. Double staining for manifesting HBV DNA and viral antigen simultaneously was also performed in some of them. The localization patterns of HBV DNA in hepatocytes could be classified into whole cytoplasmic, submembranous, nucleic and intermembranous types. The last type suggests that HBV DNA might be transmitted directly to the adjacent hepatocytes through the cell membranes. The double staining indicated that the majority of hepatocytes with high levels of HBV replication did not contain HBcAg of HBsAg. Conversely, most liver cells with strongly positive HBAg had low or negligible levels of viral replication. In addition, in a few cases HBV DNA could be found in the cytoplasm of bile ductule epithelia and sinusoidal endothelia.

Thirty-four pregnant women with hepatitis A and their neonates were investigated on serum anti-HAV IgM, ALT (GPT) and clinical manifestations (with 34 randomized controls) during the outbreak of viral hepatitis A in Shanghai. The result showed no evidence of maternal-infant transmission of hepatitis A, and no birth defect was found. Sufficient rest and proper diet for and close surveillance of the pregnant woman were suggested to ensure the well-being of mother and child. In addition, we found immune gamma-globulin given to the neonates born of mothers with hepatitis A may be beneficial to avoid horizontal transmission of hepatitis A.

111 patients with fresh dislocation of shoulder joint were treated with modified Putti-Platt procedure. Of these, 17 had recurrent anterior dislocation. 13 patients were followed up on the average for 25 years. According to Rowe criteria, 10 patients (76.9%) showed excellent results, 2 (15.4%) good, and (7.7%) fair. No recurrence and restriction of external rotation were found. Clinical experience and fetal investigation on congenital factors of recurrent shoulder dislocation were described.