1983年 · 第96卷第01期

This paper records observations on the prevalence of human ocular sparganosis causing blindness on Hainan Island, South China. Its etiologic agent, epidemiology and particularly, for the first time, the demonstration of thermotropism as a very important factor in the pathogenesis are described. Besides, treatment, prevention control measures and a brief historical review of the disease in China are also presented.

The morphology of 48 cardiac myxomas obtained from 45 cases is studied by light and electron microscopy. Among them 41 are located in the left atria, 5 in the right atria and 1 each in the left ventricle and right ventricle. Except for 1 case having 3 myxomas and another with recurrent myxoma after excision of the first, patients had only 1 tumor. Myxomal cells are either scattered or in cord-like arrangement. Glands are seen in 3 myxomas. In 41 myxomas, many vessels are surrounded by myxomal cells. The glands and perivascular myxomal cells are directly connected to or in transit to the cord-like myxomal cells. Myxoma pedicles are separated from the heart wall by a layer of elastic fibers. The pulmonary emboli of myxomatous tissue arising from a well differentiated myxoma show evidence of local implantation.

This paper reports 471 snake venom poisoning cases. With the exception of 2 deaths, the others were all cured by trypsin injection and none had sequelae. The course for trivial, moderate and grave cases averaged 2.8 days, in dangerous cases it was 23.5 days and the total average was 3.1 days. When a case develops symptoms of systemic poisoning, treatment with combined traditional Chinese medicine and western medicine is used. Trypsin injection is simple, has quick and broad spectrum efficacy,short treatment course and few and mild side effects. The authors recommend it. It is advisable to give phenergan, chlorpheniramine or other antianaphylaxis drugs before trypsin.

Analysis of 34 cases of nasopharyngeal well differentiated adenocarcinoma (WDAC) of the nasopharynx in a large series of nasopharyngeal carcinoma (NPC) collected by the authors in Guangdong province over the past 20 years enhances knowledges of the histopathologic characteristics, biologic behaviour, differential diagnosis, and histogenetic origins of the disease. These 34 WDAC cases may be classified into 2 pathologic patterns: salivary gland (14) and general pattern (20). The salivary gland pattern tumor cells most probably arise from the minor seromucinous glands of the nasopharynx, having the same special histopathologic features of real salivary gland carcinomas. The general pattern cases seem to arise from either the columnar epithelium or minor nasopharyngeal glands as their configurations are identical with adenocarcinomas of the glandular or columnar epithelium elsewhere. The similarities between WDACs of salivary gland pattern and general pattern are: The age-range (36-66), mean age (46.14) and exophytic primary growth (11 of the 14) of salivary gland pattern WDAC are similar to those (rang 34-68, mean age 47.25 and 16 of the 20) of the general pattern. However, the sex ratio of the former (M:F=1:1) differed markedly from that of the latter (M:F=4:1). The frequency of lymph node metastasis in the salivary gland pattern (21%) is less than in the general pattern (50%). The average duration of symptoms prior to admission in salivary gland pattern WDAC patients (14.8 months) is significantly longer than in the general pattern (3.8 months). Patients in the former group seem to survive longer than in the latter.

Cholinesterase activity in 2,205 intact adult Ancylostoma duodenale and 1,494 Necator americanus collected from artificially infected puppies was determined by estimating the pH change. The results demonstrate that the cholinesterase activity of N americanus was much higher than A duodenale. There was a significant interspecific difference in the average cholinesterase activity values between these 2 species of human hookworm.

93 different types of carries were studied to determine the probability of carriership. The methods of calculating pedigree probability, likelihood ratio and final probability (FP) are described. FP is 1 in 31 obligate carriers, 0.9015-0.9999 in 7 probable carriers and 70.5-0.9999 in 7 of 55 possible carriers. The authors believe that carrier detection is paramount in genetic counselling.

This is a report of 2,530 cases of hospitalized pediatric arrhythmia patients. There were 793 ectopic arrhythmias with conductrive disturbances accounting for 23.7% of all 3,351 electro-cardiograms made during the same period, indicating that arrhythmia is common in hospitalized children. The common types of pediatric arrhythmia are A-V block, premature beats of ventricular and supraventricular origin, incomplete right bundle branch block and paroxysmal supraventricular tachycardia The common causes of pediatric arrhythmia are infectious toxic myocarditis, theumatic fever, theumatic heart disease and digitalis intoxication, indicating a close correlation between infection and the development of pediatric arrhythmia. So management of infectious diseases plays an important role in the prevention and treatment of the disease. The prognosis is generally good with a death rate of only about 1%. Arrhythmias disappear following control of the primary disease.

19 cases of Tourette syndrome are reported. The clinical features including initial symptoms, distribution of abnormal movements, vocal phenomena, mental condition, neurologic examinations, EEG, and laboratory examinations are described. Haloperidol is again proved in our series to be the most effective drug in the syndrome. In 1 severe, obstinate case resistant to haloperidol, combined haloperidol with nitrazepam yielded most satisfactory results. Clonidine and imipramine have also been tried with some effect. The theraDeutic effect of haloperidol and the high homovanillic acid level in the cerebrospinal fluid in this series support the hypothesis of dopaminergic hyperactivity in the syndrome.

Since May 1972, the authors have used the saphenous vein as autograft for reconstruction of wrist blood circulation in treating 15 cases of electrically burned upper limbs with wrist vascular injuries. Using this method in 11 limbs, necrosis was avoided. Pathologic study was done after early stage treatment of the injured arteries. Also observed pathologically were the arteries of the limbs amputated after conservative treatment. These studies suggest a pathologic concept of the damage induced by electric current passing through the upper limbs, revealing the mechanism of t.he injury and providing a basis for early vascular reconstruction to prevent necrosis.

Channel and collateral sensation may occur spontaneously with cerebral diseases. When these sensations are symptoms of intracranial disease, they manifest as epilepsy. This based not only upon the clinical features but also upon the effect of dilantin on the fit. The author names this sort of symptomatic seizure epilepsy of channel sensory attack type.