1984年 · 第97卷第06期

The maturity of twins is not the same, even in monozygote twins. In the management of high risk twin pregnancies, double sacs amniocentesis becomes mandatory. Under B-scan ultrasonography, the placenta as well as the double sacs are located. Amniocentesis is done for each sac, with injection of indigo carmine into the first sac for identification. Four cases of twin pregnancies were tapped with success. The amniotic fluid (AF) analytical results were listed. The neonates were examined for possible ill effect caused by the dye to the blood system, but there were none.

539 diabetic patients selceted randomly were studied. Normal fundus was found in 544 eyes (50.4%), non-proliferative fundus, 405 eyes (37.50%) and proliferative, 75 eyes (6.96%). There were 42 eyes with vision of less than 0.05. Twenty six cases of primary glaucouma (51 eyes) and 10 cases (11 eyes) with hemorrhagic glaucoma were found. In China, the clinical features of diabetic retinopathy are comparatively mild, but in this study the incidence of blindness due to diabetes is about 4% and that of primary glaucoma in diabetic patients is 6.49%. The close relationship between them should be born in mind when one considers the problem of prevention and treatment of blindness.

108 permanent human teeth with white or brown spots were prepared and observed by transmitted, polarized light microscopes and microradiography. 60 teeth with similar lesions were observed by scanning electron microscope. The observations showed clearly that the carious changes took place at certain points on the enamel surface. They then penetrated deeper into the enamel by dissolution of the prisms. The cores of the prisms were the first parts to be destroyed, resulting in destruction of the Retzius lines. The pathologic process spread along these lines as the lesions enlarged.

This paper reports 12 cases of neurological complication following different vaccinations. The central or the peripheral nervous system was invovled. The clinical course was acute or chronic with remissions and relapses. Change of the immune status following inoculation was thought to be responsible. The clinical manifestations were compatible with the clinical picture of acute encephalomyelitis, Guillain-Barre syndrome and multiple sclerosis, being in favor of the idea that different inflammatory demyelinating diseases are associated with one and the same pathogenesis. The chronic course of neurological manifestation points to the possibility that inoculation is one of the inciting factors of multiple sclerosis.

Since 1963, we have been engaged in studies on percutaneous absorption of pesticides in vivo, and an in vitro percutaneous absorption model was established in 1980. Using the skin from the same animal, we carried out a comparative study On percutaneous absorption of chemicals in vivo and in vitro. It was found that the model can be used for evaluation of percuitaneous absorption in vivo, and has the advantages of rapidity, simplicity and sensitivity. Factors affecting percutaneous absorption, including dosage and solubility of the pesticides used, skin barrier properties, and external conditions (temperature, humidity and skin surface covering, were observed). Protective measures are discussed and emphasized. As to the efficacy of protection, cotton wears were considered better than polyester, and surgical gloves Preferable to cotton gloves.

Medical education in China has a long history. This paper describes its development according to three distinct periods: the ancient period, the modern period and the contemporay period.

A case of primary ovarian pregnancy with intrauterine device (IUD) in situ is presented. It is of particular interest that this pregnancy terminated very early; at the 15th day of the menstrual cycle. Wedge resection of the ovary aids in differentiating between ovarian pregnancy and rupture of corpus luteum. Because the IUD is widely used in this country, it is important to be alert for this entity.

Chronic lymphocytic thyroiditis and lymphocyte infiltration were studied in 2,053 cases of endemic goiter. Only 7 cases of chronic lymphocytic thyroiditis and 3 of focal thyroiditis showed diffused enlargement of thyroid. Among 2,053 cases, 150 had thyroiditis (7.3%), of whom 137 (7.1%) were accompanied by nodular goiters. If focal thyroiditis was excluded, the incidence rate of chronic lymphocytic thyroiditis would be 2.39%. The increased incidence of Hashimoto's disease was considered to he due to the decreased incidence of endemic goiter and the neglect of chronic lymphocytic thyroiditis accompanied by nodular goiters. Thyroiditis occurs in the surrounding tissues of the nodule, and it is why the changes in thyroiditis were overlooked in excised nodules.

Serial duplication without concurrent aberration in other chromosomes is extremely rare in human chromosomal pathology. Such a case is reported in this paper. The propositus, a 7-year-old boy with mental retardation, cranio-facial asymmetry and minor dysmorphism, is found to have a partial serial duplication of the short arm of chromosome 3. Using high-resolution chromosome banding, the karyotype is ascertained as 46,XY, dir dup (3) (pter p2.5::p25→p21.3::p25→qter). His parents are phenotypically and karyotypically normal. The origin of such pure duplication and its significance in studies of clinico-karyotypical correlation and human gene mapping are discussed.

Analysis of the pathoanatomical characteristics of late cases of thoracolumbar fracture-dislocation complicated by paraplegia indicates that the bony compressing structure over the anterior aspect of the vertebral canal is the main obstacle to continual recovery. We divised a new ,technique, subtotal cricumferential decompression, by which the lateral, posterior and anterior aspects of the vertebral canal can be approached, and a complete decompression can be accomplished in one stage. We treated 86 patients in this way. Of these, 64 were followed up for 2 years or more including 55 with incomplete paraplegia. The effective rate was 86%. No effect was observed in 7 patients with complete paraplegia caused by transection of the spinal cord. With wide range decompression, injury was minimal, disturbance to the stability of the vertebral column was least, and the operative results were good.