Volume 95  ·   Issue 08  ·  1982

Ribosome-lamella complex has been more commonly found in hairy cell leukemia. However, it can also be seen in a variety of other conditions. Brunning and Parkins first reported a case of Waldenström's macroglobulinemia with this kind of inclusion in 1975. An additional case is herewith described. Our findings further support the opinion that the appearance of ribosome-lamella complex is of no diagnostic specificity.

A case of sinistral family used to writing with his right hand is presented. He was suddenly found unable to articulate or write. There was transient left hemiparesis. Speech comprehension was normal. Language was disturbed with dysarthric speech and impaired handwriting. He could not express his thoughts correctly in full sentences. His drawing and paper cutting ability also deteriorated but improved as his speech improved. The hypothesis is that speaking and writing are mediated by the same cortical region, which is also involved in the initiation and guidance of dexterous manual movements.

The hemodynamic and selected humoral responses to endotoxemia are assessed in dogs anesthetized with pentobarbital. Measurements include systemic and pulmonary arterial pressures (SAP, PAP), right and left atrial pressures (RAP, LAP), heart rate (HR), and stroke volume (SV). Blood samples are collected for plasma noradrenaline (NA), acetylcholinesterase (AchE) activity, cyclic adenosine monophosphate (cAMP) and cyclic guanosinc monophosphate (cGMP). Cardiac output (CO), total systemic peripheral resistance (TSPR) and total pulmonary vascular resistance (TPVR) are calculated from standard equations. After a short control period, 5 or 7 mg/kg wt E coli endotoxin was given as an intravenous bolus. Although the survival time of shocked animals varies, the SAP response pattern is essentially the same in all shocked dogs; however, the CO and TSPR response patterns are quite different in different animals, which may be ascribed mainly to individual responsiveness. The hemodynamic response patterns could be divided into 3 categories, i.e. high out-put-low resistance (HoLr), low output-high resistance (LoHr) and low output-low resistance (LoLr). The majority of shocked animals begin and terminate with LoLr. Furthermore, HoLr seems to be the most effective form of compensation, LoHr less effective and LoLr least effective. The alterations in humoral factors suggest that different hemodynamic patterns may be attributed to the adrenergic and cholinergic activity changes and increased cholinergic activity plays a part in the pathogenesis of shock, particularly in LoLr response.

31 insulin-dependent diabetes mellitus (IDD) and 50 insulin-independent diabetes mellitus (IID) patients were tested for HLA-A, B and DR antigens. 128 and 105 healthy unrelated Chinese served as, A, B and DR antigens controls. The frequency of DR3 antigen was 54.84% among IDD patients as compared with 13.33% in the controls (RR=7.89, corrected p=4.14×l0-5). The A9 antigen frequency in IDD patients was also significantly increased (RR=4.15, corrected p=0.0124). The frequencies of Bw54 antigen in both IDD and IID patients were also increased, but the differences were not statistically significant. The distribution of HLA-A, B and DR antigens in the IID group was not significantly different from that in the controls.

Cyclic adenosine monophosphate (cAMP) content of CSF in 94 cases of nervous system inflammatory diseases is measured. Statistically significant increases are found in tuberculous meningitis, encephalitis, cerebral arachnoiditis and cysticercosis cerebralis showing the most prominent increase, varying in accordance with the severity and progress of the disease. The mechanism of increase in CSF cAMP is briefly discussed in relation to the literature and the possible clinical application of CSF vAMP content measurement.

A case of incontinentia pigmenti with incipient cataract is reported. A review of the literature indicates that about 1/3 of the cases have ocular manifestations. The pathogenesis, clinical features and ocular signs are described briefly.

168 members of 29 families with hemophilia A were studied for detecting and discriminating the carriers. Factor Ⅷ related coagulant activity (Ⅷ:c), related antigen (Ⅷ:Ag) and ristocetin cofactor (ⅧR:RCoF), and factor Ⅸ coagulant activity (Ⅸ:C) were used as laboratory parameters, and different methods for discrimination were described. The results showed that Ⅷ:C/Ⅷ:Ag ratio was the best discriminator regardless of methods of discriminant analysis and efficacy of discrimination was better in carriers of severe hemophilia than in carriers of mild case.

40 adults with fourth ventricle tumor admitted from January 1972 to January 1978 are reported. Among them 29 were totally resected, 11 subtotally resected and 16 received postoperative irradiation. Three totally resected cases died shortly after operation of acute brain stem edema, an operative mortality of 7.5%. The remaining 37 survived and were followed up for 2 to 8 years. 10 cases died of tumor relapse. Of the 29 totally resected cases, 21 are still alive. The author discusses prognostic factors and clinical experience in treating fourth ventricle tumors. Ventriculogram characteristics are also described.

Clinical results of extra-intracranial arterial bypass (EIAB) for cerebral ischemic stroke are assessed in 278 patients. 223 had marked improvement and 19 fully recovered without any neurologic residue. The percentage of improvement is 87% (242/278) and mortality 1.7%. Angiography demonstrates graft patency in 61 of 80 patients. 3 year study of 41 patients suggests that EIAB protects against further clinical cerebrovascular diseases. The authors believe that in patients even with moderate or severe complete stroke, EIAB should be tried. About 76% had been ill more than 6 months before surgery.

In a series of 735 diabetics, a search for ocular signs other than diabetic retinopathy to help diabetes diagnosis suggests that reduced corneal sensitivity, somewhat high intraocular pressure and heightened dark adaptation threshold without significant cause all may indicate diabetes mellitus.