Volume 92  ·   Issue 04  ·  1979

37 cases of Hexachloroparaxylol (HPX)-induced hemolysis were investigated. The cut-standing features were: According to the time of onset, clinical picture, laboratory data and prognosis, HPX-induced hemolysis can be classified into early-onset and late-onset types. Early diagnosis is imperative. Sufficient blood should be transfused to tide the patient over the hemolytic crisis. Hemoglobin electrophoresis revealed that all cases of early-onset type were hemoglobin H disease while most cases of late-onset type were either β-thalassemia or unstable hemoglobinopathy. To prevent hemolysis, the diagnostic clues of mild forms of thalassemia were reviewed, e.g. abnormal morphology of the red blood corpuscles on routine blood smear, inclusion body formation of red blood corpuscles and isopropinol test. Hemoglobin electrophoresis is diagnostic.

From June 1970 to September 1975, 94 cases of displaced fracture of the lateral condyle of the humerus were treated by closed reduction and short splint fixation by combined traditional Chinese and western method. Of the 94 cases, 68 were boys and 26 girls, the youngest was 2 years old and the oldest 15. 87% were 3-8 years old. 44 cases involved the left lateral condyle and 50 the right lateral condyle. Anterior displacement occurred in 22 cases and posterior displacement in 72. Rotational displacement was less than 90° in 10 cases and more than 90° in 84. On reduction, the anteriorly displaced type should be first changed into posteriorly displaced one by pressing the distal bone fragment backward. The posteriorly displaced type was treated by 2 methods. X-ray films taken immediately after reduction showed satisfactory apposition in 55 cases, lateral displacement in 33 and mild oblique displacement in 6. Roentgenograms made 3-4 weeks after short splint fixation revealed that all cases except one in which the patient discontinued treatment were in apposition and obtained clinical union within 4 weeks. 54 cases were followed up for 3 months to 5 years, averaging 2.6 years. X-ray findings showed osscous union in 53 cases. Among them, 12 had the appearance of excessive long capitulum, especially among the laterally or obliquely displaced cases. 3 cases had concave "fish fin" deformity between capitulum and trochlea. No secondary displacement occurred in the 51 follow-up cases.

22 patients with cerebral hemorrhage due to hypertension were treated surgically from December 1974 to June 1976. Of the patients in this series, 6 died, the mortality rate being 27.3%. Most of the remaining 16 cases achieved some degree of functional recovery of the paralyzed limbs when they were discharged. Of the 15 patients who were followed up for 2 years, 2 died of pneumonia 3 months after discharge and 1 died of status epilepticus. 12 patients survived over 2 years, 7 of them had sequelae in the form of functional disturbances of the affected limbs and 5 recovered almost completely and were able to do light work. The indications for operation, pre- and postoperative care and factors affecting the operative results are also discussed in detail.

A case of complete left bundle branch block with second degree atrio-ventricular block of Mobitz type II (bilateral bundle branch block, confirmed by his bundle electrogram, is reported. It eventually progressed to complete atrio-ventricular block and was treated with an implantable demand pacemaker with good result. A series of ECGs with interpretations is presented.

405 cases of female urinary fistula treated surgically with an analysis of the etiology, time of onset, relation to age of primiparity, size, shape and classification are reported. Of these, 338 (83.46%) were cured, 42 (10.37%) improved, and 25 (6.17%) unimproved. Improvements on the preoperative diagnostic procedure, operative technique, postoperative care and factors influencing the success of surgical management are discussed. Suggestions for postoperative anti-infection care and use of traditional Chinese drugs are made.

From November 1973 to October 1975, 53 cases of migraine, one of the commonest neurologic disorders, were treated with Radix Puerariae (RP) 葛根 tablets, a traditional Chinese herb medicine, with an overall effective rate of 83% without side effects. Previous pharmacologic studies have shown that the herb can cause an increase in cerebral blood flow, a decrease in cerebrovascular resistance and relieve hypertensive headaches.

In cases of complete absence of the thumb or severance through the 1st metacarpal associated with partial defects of the fingers, the thumb may be reconstructed by means of transplanting one of the defected fingers according to the conditions of the injury. The thumb thus reconstructed has a suitable length and an acceptable appearance as well as a good sensation and a certain amount of movement. The operative technique of pollicization using the 2nd metacarpal and the stump of the index, middle and ring fingers is discussed in detail in this article with case reports and diagrams of the operative technique.

Ehrlich ascites tumor (EAT) cells developed into drug resistant sublines (DR) after treatment with antitumor agents (Vinblastine VBL, actinomycin D - AD, and 5-flurouracil - 5-Fu) for several months, but became sensitive again (RS) when the drugs were stopped for 4 months or more. The cell electrophoretic mobilities of the three DR sublines were significantly different from that of the drug sensitive line (DS). The cell surface charge densities of RS of VBL and 5-Fu were also different from those of the respective DR sublines. However, the charge density of the RS of AD remained the same as that of its DR subline. This phenomenon had previously been seen in the subline of EAT treated with sarcolysine (Ku and Liu, 1965). In a later stage of the development of DR of VBL, tumor cells invaded into adipose tissue along the uterus of tumor bearing mice. Invasion persisted for 40-50 generations when tumor cells were already resistant to VBL, but vanished gradually.