Volume 101  ·   Issue 07  ·  1988

We studied the synovial plica syndrome of the knee in 58 cases (69 joints) for a better understanding of its anatomical structure, diagnosis and treatment. Synovial plicae of the knee were normally seen in adults: suprapatellar plica in 94%, medial patellar plica 39%, and infrapatellar plica 100%. Despite the least percentage of normal existence, the medial patellar plica was most commonly involved due to its encroachment between the patella and the medial condyle of the femur. We found that pneumoarthrography is of value as an aid of preliminary diagnosis and that arthroscopy or open surgery would be able to give satisfactory results.

With RNA-DNA dot blot technique, the expression of c-myc and N-ras oncogenes in human hepatocellular carcinoma was found to be higher than in tie non-cancerous liver tissue adjacent to the carcinoma (p<0.01). The expression of both oncogenes was high in the fetal liver and gradually decreased with age during development, indicating a probable co-operation of c-myc and N-ras. Immunocytochemical analysis showed changes in protein products of c-myc hepatocellular carcinoma and its non-cancerous tissue were similar to those in mRNA expression. The same was true for the fetal liver during its development. A comparable study was also made on the expression of c-myc and N-ras oncogenes in limited samples of human pancreatic adenocarcinoma and its noncancerous tissue. The results are inconclusive, and further studies are needed.

A new system of reverse passive hemagglutination (RPHA) for fecal occult blood (FOB) is presented in this study. The results showed that the RPHA-Z method established in this laboratory was efficient in FOB test as the Japan-made RPHA-J. The FOB positive rates of the specimens from patients with colon cancer, rectal cancer and polyp were 92.3%, 100% and 100%, respectively. RPHA-Z was simple and high in specificity and sensitivity as compared with other methods. It is suggested that RPHA-Z be used as one of the screening methods for early bowel cancer.

In detecting HBsAg by RIA, when Mc-anti-HBe(b) is coated on the well and radiolabled, some HBsAg positive sera show high values but other remain negative. This indicates a new binding site on HBsAg in some sera. The antigenicity of this new binding site is not as strong as that of the "b" determinant on HBsAg and shows cross reactivity with Mc-anti HBe(b), but not with Mc-anti HBe(a).

From November 1983 to December 1986, adrenal medullary imaging was carried out in 208 cases of clinically suspected pheochromocytoma by using I-131-mIBG. The sensitivity was 88.4% and the specificity 98.5%. The negative predictive accuracy was 94.5% and the positive one 96.7%. We conclude that pheochromocytomas either intraadrenal or extraadrenal can be localized correctly by I-1331-mIBG adrenal medullary imaging even neuroendocrinal tumors such as neuroblastoma.

Prepapillary arterial loop, a congenital vascular anomaly, was first reported by Liebrich in 1871. The abnormal vessels were once considered prepapillary and preretinal arterial loops, the former seems to be more appropriate since they are located over the optic disc.

24 biopsies of the oral mucosa in 24 cases of oral submucous fibrosis were studied for epithelial and subepithelial connective tissue changes. Of the 24 biopsies, epithelium in 13 was judged to be atrophic compared with the controls. Normal thickness of the epithelium was observed in 1, and hyperplastic epithelium in 9. The atrophic epithelium had in most cases lost its rete pegs. Epithelium showed para- or hyperparakeratosis in 17 cases, ortho or hyperorthokeratosis in 4, and unkeratinization in 3. Intracellular edema was seen in 15 cases. In only 1 case were all biopsies showing slight epithelial atypia. Subepithelial connective tissue changes were mainly hyalinization of the collagen fibers which appeared as a smooth sheet without discernible separate bundles. The blood vessels were dilated in 20 cases, and narrowed in 3.

Serum calcitonin (CT) concentrations were studied in 235 age- and sex-matched normal Chinese (13-88 years old; 115 males, 120 females) by Eiken RIA kit (Eiken Chemical Co, Ltd, Japan). The subjects were divided into 7 age groups. The range of content tested was 31.8 to 220.6 ng/L. There was no significant sex-related difference in CT mean values in any of the 7 age groups (p>0.05). Statistical analysis showed that CT concentration was influenced significantly by age. Mean CT values were much higher before 30 years old and after 70. There was a significant increase in serum CT in those over 70, which has seldom been reported. The authors believe that the increased CT values in those over 70 are caused by calcium stress, just as in pregnant women and growing children.

We studied 1400 cases of CNS cysticercosis. 1064 were males and 336 females, with 62.6% aged 31-45 years. According to the classification standard of our country, we divided the cases into epileptic type, 561 cases; subarachnoid type, 126 cases; cerebral parenchymal type, 184 cases; intraventricular type, 102 cases; mixed type, 419 cases; and asymptomatic type, 5 cases. Epilepsy was the most common symptom. Meningitis or adhesive arachnoiditis was the most catastrophic complication of neuro-cysticercosis. Other less common manifestations were stroke, encephalitis, headache without hydrocephalus, cerebral parenchymal inflammation and isolated large cyst, which may mimic intracranial tumors and present a great diagnostic challenge. Virtually, CT scan is the most useful test in diagnosing neuro-cysticercosis. Clinical improvement was attained in 64.4% of the cases, suggesting that praziquantel is effective in the treatment of neurocysticercosis.