1987年 · 第100卷第01期

There are reports on cases in which macroglo-bulinemia developed into myeloma and leukemia, but no report on cases with myelofibrosis. Such a case is described in this paper.

146 patients with bone fluorosis were collected from endemic areas (100 from Yangyuan county of Hebei province and 46 from Beijing suburbs). X-rays of the chest, spinal column, pelvis, elbow, forearm, knee joint and leg bones were taken in every case. The drinking water fluorine content was also determined. All patients were followed up once a year for 3 years. Our investigation reveals that in different areas with similar drinking water fluorine content, X-ray findings of bone fluorosis were significancy different. Some cases presented mainly rarefaction whereas others had mainly malacia. For further research into this problem, we observed the principal X-ray changes of bone fluorosis and its pathologic basis.

The histologic and ultrastructural features of an extrarenal juxtaglomerular cell tumor arising in the distal phalanx of the left thumb in a 53-year-old woman are described. So far as we know, this is the first case of benign extrarenal juxtaglomerular cell tumor with postoperative diagnosis by histologic examination of the surgical specimen. The identity of the tumor was confirmed by ultrastructural features, there were many renin granules and trapezoid crystalloids in the cytoplasm of the tumor cells. The previous 24 cases reported in the literature are reviewed.

A case of 45,X/46,XY Turner syndrome is reported. Analysis of the phenotype-karyotype relationship seems to indicate that the patient's phenotype was not determined by the peripheral lymphocyte karyotype but by the karyotype of each tissue involved.

In the management of ankle joint fractures, reduction and fixation of the lateral malleolus should be emphasized. The lateral maUeolus should have anatomical reduction and fixation should be reliable. Fibular integrity is essential in stabilizing the ankle joint. Routine section of the fibula may result in separation of the inferior tibiofibular joint, ankle instability and talus displacement. Eventually this leads to traumatic arthritis. So special attention should be paid to fibular resection, even partial removal of the fibula for transplantation should be carried out carefully.

By radio-immunoassay, normal serum ferritin (SF) values in our study range from 12-260 ng/ml with a median value of 86 ng/ml in males and 11-250 ng/ml with a 55.5 ng/ml median in females. SF is significantly higher in males than in females (P<0.005). However, the normal leukocyte ferritin (WBCF) values are similar in both sexes, 1.1-9.0 ng/106 cells in males and l.0-8.4 ng/106 cells in females. SF as well as WBCF were very high in untreated adult acute leukemia and relapses occurred. SF correlated with the WBCF. The SF and WBCF correlated well with the percentage of blast cells in the blood and bone marrow of patients with ANLL. Most of the patients with more than one year of remission had stable SF and WBCF within normal range. Patients with higher levels of SF and WBCF in complete remission show a tendency to relapse more easily than patients with normal levels. When the disease is complicated by infections, hepatic damage, or during chemotherapy, SF level can in crease; but the WBCF does not change markedly. Our data indicate that changing SF and WBCF can be good predictors of therapeutic response and prognosis, but WBCF is more reliable.

The balloon method was used to form a space-occupying lesion corresponding to 3.5% volume of the cranial cavity to model mechanical compression effects of hypertensive hematoma in the internal capsule-basal ganglia region. 31 dogs were used in the investigation. Of these 25 were used for symptomatological and neuropathological studies during brain compression at the time ranging from 6 to 168 hours. The pathological findings were as follows: within 6 hours characteristic changes of vasogenic brain edema with petechial hemorrhage; 9 to 48 hours, degeneration and necrosis of the neural tissue; and 72 to 168 hours, disintegration and liquefaction of the focal cerebral tissue. Intracranial pressure was monitored in 6 dogs; it ascended suddenly to a peak of 84 mmHg during brain compression. Our experimental results showed that the favorable time for surgical management of hypertensive intracerebral hematoma was within 6 hours after onset.