Volume N4  ·   Issue 05  ·  1978

110 workers of a storage battery plant with relatively high lead dust exposure were investigated. Different parameters indicating lead exposure were used. Diagnostic lead excretion tests were carried out in 11 cases of suspected lead poisoning. Urinary lead, delta aminolevulinic acid and coproporphyrin may be used as early diagnostic indicators with normal limits of 0.08 mg/l, 6 mg/l and 150 μg/l. Hair lead may be used as an indicator of lead absorption. Blood ALA-dehydrase is highly sensitive to the effect of lead but is not suitable as a diagnostic indicator, it may be used in monitoring environmental lead pollution. Hemoglobin and basophilic stippling cell count are not specific to lead effect. In cases suspected of lead poisoning, diagnostic lead excretion, test is valuable to confirm the diagnosis.

75 cases of old myocardial infarction, were followed up at the coronary heart clinic. 21 showed regional, cardiac bulge on X-rays and diagnosed ventricular aneurysm, an incidence of 28.0%. The clinical diagnostic criteria of ventricular aneurysm included systolic heave of the apical, impulse, sustained ST elevation in certain ECG leads, regional cardiac bulge on cardiac X-rays and regional paradoxic impulse of left ventricular electrokymography. 17 of 21 ventricular aneurysms were at the apex and anterior wall. The X-ray locations of ventricular aneurysm coincided with the sites of ECG myocardial infarction. 9 cases were accompanied by papillary muscle insufficiency and 1 by ventricular septal perforation.

The use of medical tannin as a burn escharotic has long been abandoned because of its liver toxicity. However, the application of various Chinese herbs which have been used for a long time in this country, in local management of burns, though containing tannin, did not seem to have toxic effects, local or systemic. In the present study, a toxicity comparison was made between, the tannins from 7 different Chinese medicinal herbs and the conventional medical tannin. It was fouud that hydrolysable tannins, including medical tannin from Galla chinensis 五倍子, were far more toxic than those of the condensed type. It is hoped that this study can provide grounds for the selection of escharotic herbs suitable for early local use in extensive burns.

Long term follow-up of 73 patients with arteriovenous malformation of the brain, surviving various surgical operations, revealed that 40 had recovered without noticeable defects, 13 had mild degrees of neurological deficits, 10 needed care by others and 19 died. Among the operative procedures performed, complete or subtotal lesion, resection gave the best long term result, whereas feeding artery ligation, simple evacuation of hematoma, biopsy and cranial decompression were less satisfactory. In cases with intracerebral hematoma, although the operative procedure was easier to perform, neurological, functional recovery was less satisfactory than in those without hematoma.

170 cases of acute perforation of peptic ulcer were treated with combined traditional Chinese and western medicine. Of these, 137 (80.6%) underwent nonoperative treatment and 33 (19.4%) immediate surgery. The treatment of 120 patients in the nonoperative group was successful a success rate of 87.6%. The remaining 17 cases failed to respond and were transferred for operation, a transfer rate of 12.4%. The overall mortality was 2.9% and morbidity 1.8%. The therapeutic results for this series were better compared with the series reported 3 years ago. Due expansion of the scope of nonoperative therapy and appropriate application of emergency surgery were emphasized in rational selection of indications. Oral administration and local application of traditional herbal medicine were considered essential in prevention of complications. Electroacupuncture and efficient decompression, proved effective in promoting resolution of peritonitis secondary to peptic ulcer perforation.

229 cases of granulomatous disease of the large intestine secondary to schistosome infestation were studied. All the cases were characterized by mucosal hyperplasia, pseudopolyposis, ulceration, thickening of the intestinal wall and bowel stenosis coupled with involvement of the mesentery. Diffuse involvement of the large intestine and a history of symptoms of 10 years' duration were common. The rectum and sigmoid colon were most frequently affected. Tumefaction was seen in 54 cases. Complications included schistosomiasis dwarfism, intestinal fistulae or free perforation, perianal fistulae, intussusception, massive intestinal, hemorrhage and urinary troubles. Roentgenologically, the condition was classified into ulcerative colitis type, localized narrowing type and polypoid and extraneous type; and pathologically, into mucosal hypertrophy type, transmural type, extraneous type and mixed type. Pseudopolyposis, ulceration and ectopically proliferating glands were thought to be conditions predisposing to malignant transformation. Complete excision in the precancerous state is considered helpful to the control of carcinoma.

Jaundice, the most common symptom with periampullary tumors is often mistakenly believed to be their early clinical, manifestation. Actually only about 20% of carcinoma of ampulla of Vater patients and 15% of cancer of pancreatic head patients complain of jaundice as their first subjective symptom. Jaundice is clinically manifested only when the intrabiliary pressure exceeds the hepatic secretory pressure and before its appearance the biliary tract has already considerably dilated. Thus it is possible to diagnose periampullary tumors in the prejaundice stage by finding an enlarged gallbladder or screening with ultrasound for biliary tract dilation.

This article reports the discovery of a new type of pathogenic lung fluke which the authors designated as Paragonimus westermani ichunensis. Despite its gross resemblance to Paragonimus westermani, it has the following characteristic features permitting its differentiation, not only from P. westermani, but also from P. westermani var. szechuanensis [Paragonimus westermani (Szechuan variety, Chung and T'sao, 1962)]: a. the oral sucker is greater than the acetabulum; b. the cuticular spines are of mixed-growth pattern; c. the ova are smaller than those of P. westermani and their opercula are much flattened; d. the second generation rediae are smaller in size than those of P. westermani; e. the number of microcercous cercariae present in each second generation redia is only about 13 as aganist 20 or so in P. westermani; f. the average size of the metacercariae is markedly smaller than that of P. westermani found in Liaoning province, but is considerably bigger than that of P. westermani in Fukien; g. the first and second intermediate hosts are Semisulcospira amurensis and Cambaroides schrenckii as well as C. dauricus respectively, whereas the first and second intermediate hosts of P. westermani in other parts of China other than the 3 north-eastern, provinces are 4 species of melania snails and 8 Potamon species of fresh water crabs. Albeit the natural and experimental final hosts of this new lung fluke are the same as those of P. westermani, the clinical manifestations are quite different in many respects from those caused by P. westermani.