1985年 · 第98卷第03期

From April 1964 to December 1978, 1,684 patients with primary breast cancer were admitted to our hospital. 260 of them had unilateral breast cancer of Stage n according to p-TNM classification of UICC. The size of the primary tumors was equal to or less than 5 cm in diameter. The axillary lymph nodes were involved pathologically in all patients. The 260 patients had a radical mastectomy with or without adjuvant radiotherapy. Their results were reviewed retrospectively. The survival rates, incidence of local recurrence and distant metastases were compared between the patients with and those without postoperative radiotherapy. The 3-, 5-, and 10-year survival rates were 67.9%, 52.8% and 40.5% in the group with radiotherapy, and 61.0%, 49.6% and 28.9% in the group without radiotherapy respectively (p>0.05). The incidence of local recurrence and regional metastases was 22.6% in the first group and 32.1% in the second group; the recurrence rate of the ipsilateral supraclavicular lymph nodes was 1.4% and 15.2% respectively (p<0.005). The rates of distant metastasis of the groups were nearly the same. The results suggest that radiotherapy after operation may reduce the rate of local recurrence, particularly that of ipsilateral supraclavicular lymph nodes, and increase the 10-year survival rate of radical mastectomy.

This paper reports an investigation of endemic chronic arsenism due to drinking deep artesian well water in a plant in Kuitun Area, Xinjiang Uighur Autonomous Region. The 0.6 mg/L arsenic concentration of this water was 15 times the maximal permissible concentration. In the plant, endemic chronic arsenism morbidity rate was 44.6%. The clinical features and histopathologic changes of this disease are described. The authors believe that areas of hyperpigmentation mixed with whitish depigmented spots are typical arsenic dyspigmentation, and that the spotted keratosis and corn-like keratosis palmaris et plantaris are typical arsenic keratosis although there are no standardly recognized specific diagnostic pathologic changes. These characteristic changes may aid in diagnosis.

To compare the effects of various porta-systemic shunts on the liver, experiments were done in 66 dogs which were divided into 8 groups: end-to-side portacaval shunt 7 dogs, side-to-side portacaval shunt with a big stoma (1.5 cm) 7 and a small stoma (1.0 cm) 13, side-to-side mesocaval shunt with a big stoma (1.5 cm) 9 and a small stoma (1.0 cm) 13, end-to-side splenorenal shunt 5, selective distal splenorenal 7, and simple laparotomy 5 used as controls. The determination of hepatic blood flow index, liver function test and histologic examination of the liver revealed that the extent of liver damage was closely related to the amount of portal blood diversion and the site of the anastomotic stoma. The small stoma side-to-side mesocaval and splenorenal shunts induced mild liver damage, whereas the end-to-side and big stoma side-to-side portacaval and big stoma side-to-side mesocaval shunts caused rather severe hepatic damage. Hence, the procedure of choice should be considered with great care in clinical practice.

Material for this report was obtained from a 1,000,000-person prospective epidemiologic study started in 1959 by the American Cancer Society and ended in 1970. The lung cancer death rate of cigarette smokers who ate fruit or drank fruit juice 5 to 7 days a week was lower than that of cigarette smokers who ate fruit or drank fruit juice 0-2 days a week. Consumption of green salad and vitamin pills showed little or no relationship to lung cancer death rates.

Preoperative symptoms of primary low malignancy tracheobronchial tumor (bronchial adenoma) consist mainly of repeated obstructive pneumonitis, hemoptysis and progressive dyspnea. Most patients were misdiagnosed as having pneumonia, atelectasis, bronchitis or lung cancer. Tomography and fiberoptic bronchoscopy proved to be very helpful in early diagnosis of this condition. In 19 patients, 21 operations were done, including transtracheal tumor resection (9), lobectomy (9), pneumonectomy (2) and exploration (1). Two patients were reoperated upon after recurrence, and 1 died during the second operation. 52.6% of patients were histophathologically diagnosed as having cylindroma. All 19 patients except one were alive after follow-up for 4 months to 17 years. 3 patients with distant metastases were alive, one for over 5 years since lung metastasis was discovered. Terminologically, it is suggested to classify carcinoid, cylindroma and mucoepidermoid tumors under primary low-malignancy tracheobronchial tumors, and to reserve the term bronchial adenoma for the true benign tumor only.

Quantitating T lymphocytes and IgA-, IgM-, IgG producing cells was performed in gastric carcinoma tissue and mucosa adjacent to carcinoma and three cm from carcinoma in biopsies of 48 patients. T lymphocytes were identified by ANAE stain. Antibody-producing cells were stained by immunocytochemical methods. T lymphocytes and IgG-producing cells per mm2 were significantly increased both in gastric carcinoma tissue and the mucosa adjacent to it. T lymphocytes concentrated around the tumor cells, some of which were degenerating or necrotic. The percentage of T lymphocytes in gastric carcinoma tissue was 53.0%, and that in normal gastric mucosa was 12.5%. The percentage of IgA-producing cells was decreased in cancer tissue and gastric mucosa affected by atrophic gastritis and benign ulcers.

A most sensitive method was developed for the detection of Epstein-Barr (EB) virus in throat washings. Cryopreserved preparations of fetal cord blood lymphocytes, from samples already found to be optimally sensitive to virus-induced transformation in vitro, were exposed to concentrates prepared from throat washings by ultracentrifugation; the cells were then cultured for 8 weeks to observe the incidence of EB virus-induced transformation to lymphoblastoid cell lines. By this method, oropharyngeal shedding of EB virus was monitored in a prospective study involving 30 healthy adults (all but one of Caucasian origin) with serologic evidence of previous EB virus infection. Of these individuals, 6 shed virus on every occasion of testing within 15 months, 13 on most occasions, and 9 on less than half the occasions, while only 2 never gave evidence of virus shedding. This work indicates that the extent of EB virus shedding in healthy seropositive individuals is much greater than what previous reports have suggested, and raises the possibility that EB virus may actually persist in vivo via chronic, usually low-grade, replication in a permissive cell type in the oropharynx.

This article deals with the relationship of the clinical types of hepatitis B with HLA-A and B loci and refers to the definite rule between them. The result of HLA-A genotype distribution among these groups had a marked significance (X2>3.84) such as increased Ag frequency in chronic active hepatitis group in comparison with healthy controls. The HLA-A3 and A28 were also closely associated with chronic active hepatitis. The HLA-A28 and B13 loci were higher in acute hepatitis group than the healthy controls. In the carriers, the chronic persistent hepatitis and the posthepatitis cirrhosis groups, the difference was not statistically significant (X2<3.84).

In this study the sera from a patient with macro-globulinemia were collected, IgM purified by salting out and gel filtrating with Sephadex G-200, and the heavy and light chain isolated by chemical-reduction. Antibodies to the μ chain were prepared by rabbit inocualtion. The immunodiffusion test showed that the μ chain combined with antibodies to human IgM, but not with Kappa and Lambda antibodies. The U chain antibodies were used clinically to detect anti-HBc-IgM, and the results obtained were similar to those of imported products.