Volume 93  ·   Issue 03  ·  1980

10,978 administrations of epidural block were performed during 1962-1977 and the major complications and related factors are evaluated and analyzed. Toxic reactions (0.56%) occurred more frequently in portal hypertension cases undergoing shunt operations and are believed to be related to impaired liver function. Intermittent injections of small fractional doses of sodium pentothal controlled these toxic manifestations effectively without sequelae. Respiratory depression (0.24%) occurred most frequently during cervical upper-thoracic epidural blocks. One patient developed cardiac arrest following administration of adjuvant drugs which enhanced respiratory depression due to high epidural block, this patient was successfully resuscitated. Puncture paresthesia (1.13%) was also encountered most frequently during cervical upper-thoracic punctures. The incidence of postoperative neurologic complications in this group of patients was 18.5%. The dura was perforated in 0.61% of the patients. This low incidence of dura puncture was probably due to the blunt-pointed needle used and strict adherence to the proper puncture procedure. Not a single case of total subarachnoid block occurred.

100 cases of breast cancer treated preoperatively with colchicine (extracted from the Chinese herb Iphigenia indica A. Grey 山慈菇) preparations are studied and compared with 100 other cases treated without preoperative chemotherapy as control. Tissue changes were classified as slight, moderate or severe depending on the extent of irreversible change. In the colchicine treated group slight, moderate and severe irreversible changes were observed in 28, 51 and 21 cases and in the control group in 55, 39 and 6 cases. Mitotic figures less than 5, 5-10 and more than 10 per 20 high power fields were seen in 68, 31 and 1 cases of the colchicine group and in 55, 28 and 17 of the control group. Vascular changes were observed in 27 and calcification in 20 of the colchicine group and in the control group the corresponding figures were 15 and 9. Colchicine compound and colchicine-amide caused varying degrees of damage to breast cancer tissue, but did not cause complete disappearance. The degree of damage more or less parallels the therapeutic effects. Colchicine preparations effect changes in breast adenofibromas and desmoid tumors by contraction of fibrous tissue elements which may be the mechanism causing breast cancer softening and regression.

Colchicine-amide, extracted from the Chinese medicinal herb Iphigenia indica A. Grey 山慈菇 has varying degrees of antitumor effect against mice S180, S37, hepatoma (solid form), SAK, lymphosarcoma and rat W256 tumors. Compared with colchicine at optimal dose the effect of colchicine-amide is more pronounced and toxicity is less. Its mitotic action is similar to that of colchicine. Colchicine-amide causes serious tumor cell degeneration including cytoplasmic swelling, vacuolization, karyopyknosis, karyorrhexis, karyolysis and liquefying necrosis of S180 tumor tissue. The absorption, distribution, excretion and transformation of 14C-colchicine-amide in normal and S180 bearing mice are studied.

Cantharidin is an agent isolated from Mylabris phalerata Pall 斑蝥 Given in a dose of 1.25-2 mg intraperitoneally or orally it exhibited an inhibitory action on reticulo-cell sarcoma and ascites hepatoma in mice inoculated with 2 million tumor cells. Intraperitoncal injections of 0.4-1.0 mg/kg of this drug showed no marked influence on the concomitant ijw munity and GVH (graft versus host) reaction in 'nice. Intragastric or intraperitoneal injection of 3H_cantharidin led to a high level of radioac- tivity in the bile, kidney, liver, stomach and tumor cells of ascitic hepatoma-bearing mice; within 24 hours after administration radioactivi- ty excreted in the urine and feces was about 580/o. In patients with liver carcinoma canthari- din also had some palliative therapeutic effect.

17 cases of toxic polyneuropathy due to chronic allyl chloride intoxication are reported. An experimental neuropathologic study reveals peripheral nerve degeneration of both axons and myelin sheaths which may well explain the clinical and electrodiagnostic findings of chronic allyl chloride poisoning. The neuropathologic features in rabbits show that allyl chloride is a neurotoxic agent and especially damages the peTipheral nervous system resulting in a dying-back pattern of axonal degeneration similar to that of toxic neuropathy due to acrylamide, n-hexane, methyl n-butyl ketone (MBK), or triorthocresol phosphate (TOCP) intoxication. The fact that toxic polyneuropathy relapses in some patients who return to the same work after apparent recovery indicates the importance of prevention. It is evidently essential for the factory concerned to carry out effective preventive measures to lower the concentration of allyl chloride in the air of the workshop below the proposed maximum allowable concentration-1 mg/m3 in order to prevent chronic intoxication among workers.

This paper presents a method for the determination of DNA polymerase activity by modified Mitsunbu and Robinson's procedure in detail. 16 healthy blood donors and 38 cases of hepatitis B were used for this investigation. Results show that serum DNA polymerase activities in the 16 healthy blood donors was 18.1±7.4 cpm (average±SE), in 11 of the patients who were both HBsAg an HBeAg positive was 384.2+158.0, in 5 patients with anti-HBe positive was 9.0±6.8 and in 22 patients with both HBeAg and anti-HBe negative was 91.0±33.0. The clinical significance of DNA polymerase as well as the correlations of reverse passive hemagglutination activities and titers and the presence of anti-HBe are discussed. The authors are against using serum with polymerase above 50 cpm and positive HBsAg in preparing hepatitis B vaccine because viral transmission might occur.

A study on cellulose acetate electrophoresis of cerebrospinal fluid (CSF) proteins is reported. Two methods are used for concentration, acetone precipitation and sephadex dialysis with slight modifications. They are both considered to be clinically valuable, but the former is simpler and more practical. The normal values of 135 persons are presented.