Volume 93  ·   Issue 08  ·  1980

The authors consider removal of pulmonary hydatid cyst intact without needle aspiration (Barrett's technique) to be an ideal operation both for eradication of the disease and for maximal preservation of functionary lung tissues. This technique, however, has not been much used because of the risk of contamination following rupture of the cyst. This series of 167 cases had no mortality. Among 106 patients operated on before June 1975 who were followed up for 2-18 years (average 5.5 years), there were 2 recurrences in 35 cases with ruptured cyst, a recurrence rate of 5.7%. This is only a little higher than the recurrence rate of 3.7% in our needle aspiration series of 136 cases in the same period. Of significance, however, is the failure rate of 30.2% in the 106 cases operated on before June 1975 and the failure rate of 9.8% in the 61 cases operated on after that date.

Ochronosis is caused by an inherited metabolic defect resulting in the absence of the enzyme homogentisic acid oxidase. Large quantities of homogentisic acid are excreted in the patient's urine to produce alkaptonuria. Excessive homogentisic acid is present in the blood and chronic deposition of the black pigment appears between the second and third decade in the soft tissue. The clinical course of a 24-year-old male with ochronosis is described and previous reports of such uncommon disorder are reviewed.

379 cases comprising 367 intrathoracic and 12 so-called "liver-roof" hydatid cysts were seen from 1957 to 1975. A total of 347 cases were operated on with a mortality of 0.9% and 255 cases were operated on after 1968 with no death. 323 patients were followed up for 3-20 years, 13 of them died. All these 13 deaths but 1 (the cause of death was unknown) were not related to intrathoracic hydatidosis. 11 (3.4%) of the 323 cases had recurrence. Of the 32 cases which refused to be operated upon 6 died of hydatidosis. Of the remaining 26 cases, 5 were lost to follow-up and 21 survived. 9 of the latter showed no cysts.

23 adults and 5 children with acute nonlymphocytic leukemia (ANLL) were given a traditional Sino-Western HOAP regimen for remission induction. The complete remission (CR) rate for the group was 82.1%, being higher for acute granulocytic leukemia, acute promyelocytic leukemia and erythroleukemia and somewhat lower for acute myelomonocytic and acute monocytic leukemia. During the induction regimen, supportive therapy with traditional Chinese medicine, blood transfusions, antibiotics and levimasole were important.

Through February 1964 to December 1974, 60 cases of septicemia due to gram-negative bacilli were treated in the First Hospital of Zhejiang Medical College. 61 strains of organisms were isolated from blood, 40 (65.6%) belonging to Escherichia coli, 9 (14.8%) Paracolon bacillus, 5 (8.2%) undifferentiated colon bacilli, 4 (6.6%) Pseudomonas aeruginosa, 1 (1.6%) Klebsiella pneumoniae, and Proteus and undifferentiated gram-negative bacillus were also isolated each in one (1.6%). Escherichia coli were mainly isolated from urine, ascitic fluid, sputum and pus. Most strains (over 50%) were sensitive to antimicrobials. Among the 60 cases (excluding 12 of self discharge) 21 were cured and 27 died, a mortality rate of 56.2% (27/48). The clinical manifestations were also discussed.

The counterimmunoelectrophoresis (CIEP) technic is a rapid and accurate immunodiagnostic test for detecting paragonimiasis. 57 cases of paragonimiasis were examined by this method and all showed positive reactions. For comparison, their sera were also examined by agar gel diffusion (AGD) test. It was noted that the number of positive reactions obtained by AGD was 63% that by CIEP. The average CIEP titer was 13 times higher than the AGD. Only 1 (0.4%) of the 275 controls showed a false positive reaction by CIEP and no false positive was obtained by AGD. Follow-up observations on 34 cases were made after treatment. It was found that the majority of the cases (29/34, 85.3%) had negative CIEP reactions at 6 months or a little more after treatment.

A simple method of culturing amniotic fluid cells for detection of fetal chromosome abnormalities and genetic diseases is presented. 26 cases were studied by this method with a 92% success rate.

A quantitative histologic method of pancreatic islet measurement is used in the analysis of hypoglycemic cases in order to find a basis for differentiating islet hyperplasia from insulinoma. Analysis of the results of measuring 20 normal control patients, 11 insulinoma patients and 6 hypoglycemic but exploration negative patients reveals that islet hyperplasia in the distal pancreas resected during exploration of hypoglycemic patients is an important criteria for differential diagnosis of islet hyperplasia from insulinoma. The methods of calculation and analysis are described and several aspects of quantitative analysis and differential diagnosis between islet hyperplasia and insulinoma are discussed.

Large scale control of malayan filariasis has been achieved in China by carrying out mass surveys and total population treatment mainly with diethylcarbamazine (DEC) or DEC medicated salt reducing the microfilaria rate to minimum levels. But surveillance and campaigns must be continued for at least 10 years. We have little experience in exterminating the Anopheles sinensis vector. The density of this species of vector is still fairly high here so further investigation and studies should be made in order to find a method of controlling it. This is our major task today.

Both cases studied presented with typical hairy cells and splenomegaly, establishing hairy cell leukemia (HCL) diagnosis. When white cell count is high, hairy cell percentage is also high. Case 1 with unique leukocytosis, unimproved by splenectomy and prednisone plus vincristine, showed improvement on leukerancyclophosphamide therapy. Hairy cells are probably lymphocyte-monocyte hybrids, but both of our cases conform to B lymphocyte. Pseudosinuses in the spleen are helpful to HCL diagnosis. Ribosome lamellar complexes and tartarate resistant acid phosphatase reaction are also helpful to the diagnosis but neither is HCL specific.