Volume 95 · Issue 09 · 1982

From the experience in a series of 50 cases of cardiac myxoma it is realized that echo-cardiography is the best nontraumatic diagnostic method, once the diagnosis is made tumor removal should be done immediately without delay and follow-up examination of patients is of paramount importance in detecting any tumor recurrence.

During 4 recent years (1977-1980), 29 cases (7.5%) of acute lymphoid leukemia, 14 (3.6%) of chronic lymphocytic leukemia and 15 (3.9%) of bone marrow involvement (BMI) are observed in a total 382 cases of advanced non-Hodgkin's lymphomas (NHL). The male incidence is 4.8 times that of the female. Most cases of leukemia or BMI develop within 3 months after NHL diagnosis. The mortality rates at 2 years after discovery of acute leukemia, BMI and chronic leukemia are 82%, 53% and 36% respectively. Examination of bone marrow smears before treatment reveals marked or moderate hyperplasia with predominance of lymphoblasts in acute leukemia, moderate hyperplasia with predominance of small lymphocytes in chronic leukemia and normoplasia or hyperplasia of different stages of the lymphocyte series in BMI. Typical changes occur in the peripheral blood in leukemia cases, while the BMI blood picture is essentially normal. The morphologic features of neoplastic cells in chronic leukemia are rather uniform, while in acute leukemia they vary a great deaL In 23 cases of acute leukemia in our series, 6 types (undifferentiated, immunoblastic, macrolymphoblastic, microlymphoblastic, prolymphocytic and convoluted cell) are differentiated, the macrolymphoblastic being encountered most frequently. BMI neoplastic cells also varied in morphology, but consist chiefly of small lymphocytes, plasmacytoid lymphocytes or prolymphocytes. The relationship between lymphomas and leukemias as well as the nomenclature and types of acute lymphoid leukemia developing in NHL cases and their clinical significance are discussed.

Male Wistar rats are injected intraperitoneally with 40 µCi 131I or 132I. They are maintained on normal diet for 20 months, then killed for pathologic examination of the thyroid glands. The dose absorbed by the thyroid gland is about 7×102 rads for each animal in the 132I group and 2.8×104 rads for each animal in the 131I group. The former shows predominantly carcinogenic effect with a 93.7% tumor incidence of which malignant neoplasms account for 31.2%, while the latter manifests chiefly cell destruction and development of adenoma with a 62.5% benign tumor incidence and no malignancies. In the controls, the benign tumor incidence is 3.8%. The difference of the effects between the 131I and 132I groups is attributed to radioactive nature diversity and dose distribution of the two nuclides. This can be elucidated by differences in dose rate effects by Rossi's dual radiation action theory. 132I carcinogenic effect should be taken into account in establishing radioiodine protection standards.

The micro-enzyme-linked-immunosorbent assay technic in kala azar diagnosis is described and possible factors influencing the assay are discussed. 20 kala azar cases examined before treatment had a 100% positive rate. 23 kala azar cases in another series examined 1 month to 3 years after treatment still showed positive results in about five sixths. False positive reactions were recorded in some tuberculosis or leprosy patients, especially the latter.

Diethylcarbamazine medicated salt is highly effective in wiping out filariasis. The authors find that membrane filtration in mass screening for blood microfilaria is more sensitive than thick blood smear. However, the amount of blood taken for both methods is not significantly different and thick blood smear is still a practical alternative method even when microfilarial rates are rather low.

With slight modification of the candle jar method described by Trager and Jensen, Plasmodium falciparum has been successfully cultivated in vitro with fresh rabbit serum instead of human serum. Each 50 ml Erlenmeyer flask containing 5 ml culture was incubated in a candle desiccator at 35.5-37 C. 15 ml rabbit serum was added to 100 ml RPMI 1640 medium with sodium bicarbonate. In the culture both infected and uninfected red cells were 5%. The culture has been maintained alive for more than 500 days and the infection rate was over 20%. Cultivation was also conducted in plastic dishes (3.5 cm in diameter) containing 1.5 ml of the culture, but using human serum instead of rabbit serum for comparison. The growth rate showed no significant difference. The results suggest be used with advantage for continuous culture that rabbit serum may instead of human serum of the malaria parasite.

42 normal Chinese are examined for plasma amino acid (AA) concentrations under controlled conditions. All are metropolitan residents. The normal plasma AA concentration values are given with the exception of serine and threonine. Further study of normal Chinese AA patterns and changes after AA infusion is of great significance.

Blood gas analysis is reported in diagnosis of 100 cases of cough and asthma. PaO2 and AaDO2 are considered valuable in judging the degree of lung damage.

Selective and superselective hepatic arteriography is valuable in diagnosing primary hepatic carcinoma. Tumor vessels, tumor stain, vessel stretching displacement, vascular encasement, arteriovenous shunt, pool or lake-like collection of contrast medium and tumor emboli formation occurring during arterial phase and irregular mottling during parenchymal phase are characteristic manifestations. Among them, tumor vessels and tumor stain are the 2 pathognomonic signs. After evaluating the correlation of the arteriographic features, isotope scan, clinical data and pathologic findings, it is obvious that arteriography is superior to isotope scan in establishing a correct diagnosis. It can facilitate treatment when the catheter is retained for drip chemotherapy.

This paper reports 41 cases of bone and joint X-ray changes in hepatolenticular degeneration. The cases were proved clinically (ophthalmologic and laboratory) and their X-ray bone and joint changes were divided into 5 groups: no abnormal findings, osteoporosis, osteomalacia (rickets), special changes and miscellaneous. Special changes include marginal bone fragments, angulation of carpal bones, squaring of metacarpal heads and calcification of the joint capsule or tendon insertion. The mechanism causing the bone changes in hepatolenticular degeneration is also discussed.