Volume 104  ·   Issue 04  ·  1991

Percutaneous closure of ductus arteriosus (DA), preceded by a balloon exploration of the defect and a catheter scale examination of the foam plug, was performed on 47 patients aged from 6 to 54 years. The minimal internal diameter of DA varied from 3.7 to 11.6 mm. Successful occlusion was achieved in all the cases without major complications. Sustained improvement was observed in both clinical findings and laboratory parameters. No incidence of endocarditis, plug displacement or recanalization was noted during follow-up of 6 to 35 months. It revealed that ductal exploration with the balloon catheter is able to ascertain the actual occlusion diameter of the lesion and the catheter scale plug examination can ensure good matching between DA and the plug so that changing of plugs and ectopic embolisms can be avoided.

Hydrogen peroxide contrast hepatosonography (HPCH), a new technique, was developed for liver examination. On examination, 5-10 ml of 2-3% hydrogen peroxide was injected into the rectum through a dual-channel rubber tube. When hydrogen peroxide passed through the mucosa into the portal vein, the fast flowing contrast echoes were seen, and the liver parenchyma was covered by enhanced echoes. A total of 297 subjects were examined by HPCH with a successful contrast rate of 95.6%. In normal subjects, dense contrast echoes were visible throughout the liver. But in patients with hepatoma, hemangioma, cyst and abscess, contrast echo defects were noted. We conclude that HPCE is of great value in the differentiation of space-occupying lesions and measurement of portal circulation time and blood flow velocity in spite of its untoward reactions.

The ablative effect of argon laser delivered fibreoptically in vitro on 234 segments of atherosclerotic human aorta was studied. The variables such as energy density, type of atheroma and immersion media were included, and all irradiated specimens were subsequently submitted to histological examination and crater volumes in mm3 to micrometer measurements under light microscope. The results showed 1) a linear relationship between energy dose and crater volume in fibrous atheroma, 2) significantly greater damage or surrounding in the higher energy dose groups, 3) a lower dose response in calcified tissue than in fatty streaks or fibrous atheroma, and 4) immersion of tissue in blood during ablation resulted in a significantly greater dose response than immersion in plasma or saline, and the corresponding surrounding tissue damage was greatest when immersed in blood. Thus, argon laser is both effective and predictable in response during ablating of atheromatous tissue. The efficacy of the process is dependent on immersion medium, while the degree of surrounding tissue damage is dependent on energy dose.

Ferritin in 119 astrocytoma cases was studied by immunocytochemical PAP and immunogold silver staining (IGSS) methods. In 57% of the cases, ferritin was found in the cytoplasm of the tumor cells. The higher the differentiation of the tumor cells, the less ferritin they contained. Contrary to the reaction of glial fibrillary acidic protein (GFAP), the positive rate of ferritin in various types and grades of astrocytomas was inversely proportional to their degree of differentiation. Electron microscopic observation in 30 cases showed ferritin in the cell sap, cytocavity network, endoplasmic reticulum, Golgi apparatus and also in lysosomes. Some of the cases had extraordinary high level of ferritin in their blood serum.

Arachidonic acid metabolism via cyclooxygenase pathway in mouse resident peritoneal macrophages were stimulated by phorbol-12-myristate-13-acetate (PMA), calcimycin and exogenous arachidonic acid, respectively. Racemic, (-) and (+)-gossypol dose-dependently inhibited PMA or calcimycin-induced synthesis of prostacyclin, thromboxane A2 and prostaglandin F2 alpha, but failed to affect arachidonic acid-induced synthesis of prostaglandin. It is suggested that both (-)-gossypol and (+)-gossypol inhibit synthesis of prostaglandin at the level of arachidonic acid release, and the inhibition of prostaglandin synthesis by gossypol might not be the main mode of its antifertility action.

Patients whose routine MRI were negative but were clinically highly suspected of having intra-cranial or intra-spinal canal space-occupying lesions, and those whose routine MRI were positive but presented difficulties in defining the contour or the nature of the lesion, or difficulty in distinguishing the lesion from the surrounding edema were selected for Gd-DTPA enhancement. Altogether there were 80 cases, in which 51 had intracranial lesions and 29 intraspinal canal lesions. In each patient, Gd-DTPA 0.06-0.1 mmol/kg was injected intravenously 5 minutes before imaging (pituitary microadenoma images were taken immediately and 10 minutes after injection). No patient had contrast media reaction or complications. In cases with hemorrhage, hematoma, edema, cyst and arteriovenous malformation, no marked enhancement was observed after contrast media injection. When difficulty in differential diagnosis between these lesions and tumors occurs, injection of Gd-DTPA is very helpful. Gd-DTPA enhancement is of great benefit in diagnosis of intracranial or intraspinal canal tumors in four ways. 1) It reveals lesions which can not be demonstrated or can not be demonstrated clearly before enhancement, including iso-intensity lesions and small lesions which comprised 13.7% of our cases. 11 cases with equivocal diagnoses before enhancement obtained unequivocal diagnoses after enhancement. 2) It differentiates the tumor from edema more definitely. 3) It helps to distinguish the nature of lesions. 4) It shortens examination time when the T2 weighted image procedure is omitted.

Free radical generating substances, including fulvic acids, mycotoxins, Fe(II), etc attack chondrocytes, causing dedifferentiation. The dedifferentiated cells synthesize and secrete abnormal collagens rich in type I instead of the normal type II. These substances also directly attack collagens in the extracellular matrix. The abnormal collagens make the matrix change from hydroxyapatite crystallization inhibiting to promoting, and give crystals of low crystallinity, high aggregation and small size. This study leads to a new concept of the development of Kaschin-Beck's Disease (KBD).

We studied the diagnostic accuracy of magnetic resonance imaging (MRI) and the possibility of its substitution for myelography in 78 patients with lumbar canal stenosis and/or disc herniation, who had myelography and MRI examination. The diagnostic results of the two methods were compared respectively with those of operation, showing no statistical significance (coincidence rate 88.5% vs 92.3%, P greater than 0.05). We conclude that MRI could clearly reveal the pathological changes and anatomical relations of lumbar structures without invasive and radioactive damages, and that with the improvement of operative technique, better understanding of images, and reduction of cost, MRI is likely to replace myelography in the future.

A group of monoclonal antibodies against gastric cancer, pooled in equal proportions, was used to investigate their corresponding antigens (MG-Ags) in serum and body fluid of patients with gastrointestinal cancer and benign diseases using microsphere-ELISA method. The mean serum level (plus 3 standard deviations) in 59 normal subjects was arbitrarily set as the positive threshold value. The positive rate was found to be 68.8% (135/196) in sera of patients with gastric cancer, 70% (14/20) in colonic cancer, 72.2% (24/33) in rectal cancer, 43.8% (7/16) in esophageal cancer, 45.5% (5/11) in cholecystic cancer and 34.9% (15/43) in lung cancer, which, however, was not found in primary liver cancer, pancreatic cancer and ovarian cancer. In 214 patients with benign diseases, a false positive rate was 7.48%. In gastric juice and ascitic fluid of patients with gastric cancer, the positive rates were found to be 61.7% (27/44) and 83.3% (20/24) respectively. These antigens were also determined repeatedly in sera of patients with gastric cancer who had undergone gastrectomy. It was found that the level of MG-Ags in sera began to decrease at 8-10 days after operation. These results suggest that the determination of MG-Ags is useful in the diagnosis of gastrointestinal cancer and evaluation of the treatments.

Allergenicity of three plant abortifacient proteins, trichosanthin (TCS), α-momorcharin (α-MMC) and β-momorcharin (β-MMC) and the kinetics of IgE antibody response against these proteins were studied in C57BL/6N and BALB/cAn mice. These proteins were purified from Chinese medicinal herbs, characterized by biochemical and immunological procedures and found to be homogeneous by PAGE, SDS-PAGE and immunoelectrophoresis. The results obtained were summarized as follows: 1) different levels of IgE antibody responses against TCS, α-MMC and β-MMC were induced when they were injected i.p. as antigen adsorbed onto AI(OH)3 gel into BALB/cAn or C57BL/6N mice on day 0 and day 28; 2) the allergenicity of the proteins was in the order of β-MMC greater than α-MMC greater than TCS; 3) two injections of 10 micrograms or 50 micrograms of TCS or α-MMC given at 4 weeks interval without adjuvant elicited a low or undetectable PCA titer, while the same dose given weekly for 5 weeks resulted in high levels of IgE production; and 4) on the basis of PCA observations, no cross immunological reactivity among these three proteins was found, it seemed to support that TCS, α-MMC and β-MMC may be alternately used for inducing abortion.

Two cases of genital carcinoma were found after radiotherapy for carcinoma of the cervix. Vulval carcinoma occurred 30 years after radiation with initial symptoms of itching and whitish changes of the skin at the external genitalia. Adenocarcinoma of the endometrium occurred 9 years after radiation and diffused intra-abdominal metastasis was found surgically. The sites of second malignancies following irradiation for cervical carcinoma and the time interval between them were reviewed. The characteristics of the post-radiation vulval carcinoma and the endometrial carcinoma were discussed.