Volume 96  ·   Issue 02  ·  1983

97 cases of pancreatic head and ampullary region carcinoma, including 43 pancreatic head carcinomas, 48 ampulla of Vater carcinomas and 6 of intrapancreatic common bile duct carcinomas, are studied clinicopathologically. Despite the similarity in clinical manifestations, each kind of cancer retains its own morphologic characteristic of gross and microiscopic appearance and mode of invasion and metastasis. In studying the relationship of the intrapancreatic common bile duct to the 3 kinds of cancer in this region, a method of total sampling of the excised specimen was used, revealing a high incidence of cancerous invasion of the common bile duct. Carcinomas of the pancreatic head, whether large or small, advanced or early, usually attacked the common bile duct in a form of annular intramural infiltration associated with varying degrees of desmoplastic reaction, leading to common bile duct scirrhous stenosis. On the other hand, ampulla of Vater carcinoma was either a primary papillopolypoid mass growing into the duct lumen or a localized duct tumor with concurrent intraluminal papillopolypoid growth, never causing scirrhous stenosis. Necrosis and sloughing of the tumor mass may ameliorate any clinical jaundice. Common bile duct carcinoma, originating from the bile duct epithelium, usually appear as a papular or polypoid tumor in the early stage; with increasing size, the common bile duct becomes stenosed and finally totally obstructed.

This article deals with studies in late autumn 1981 of the infection of wild adult Tupaia belangeri yunalis (a species of tree shrew caught in autumn in Yunnan province) with human rotavirus. 12 tupaias are infected in the first passage, 3 in the second passage and 3 in the third passage, 12/12, 2/3 and 2/3 of the tupaias develop diarrhea during the 3 passages. Electron microscopic observation shows that 12/12, 3/3 and 2/3 of the tupaias excrete rota-virus during the passages. Three tupaias died during the first passage and show mucosal necrosis and lymphocyte infiltration in sections of different intestinal parts. Immune electron microscopically, anti-rotavirus antibody is assayed in sera of 2 infected tupaias, in both of which titer rises greater than 4 folds in the convalescent phase serum as compared with the pre-infection serum. These results indicate that the adult tupaia is probably susceptible to human rota-virus.

The 30 years' experience in studies of microflora disturbances and their attempted adjustments was summed up. In order to observe the antagonistic action of the indigenous bacteria against the invading pathogens, a series of in vitro tests are made. In vivo studies are carried out in house rats for demonstrating ecologic manifestations of normal bacterial flora. Clinical studies are undertaken in dysentery and diarrheas. The results obtained are tabulated and described. Flora disturbances are corrected by adjustment of nutrition, disturbed micro-flora etc. The authors conclude that being aware of the existence of intestinal flora disturbance is very important to make proper diagnosis as well as to prescribe proper treatment and prevention in accordance with the microbial flora changes as the guiding principle.

A case of Legionnaires' disease is reported with a brief discussion of the clinical manifestations and treatment.

A method for the simultaneous determination of matrine and oxymatrine in the same biologic material and the metabolic fate of the latter are described. There is wide variation between the distribution and excretion of oxymatrine administered to rats by different routes. After IM oxymatrine injection, the parent drug concentration is high in the tissues, bile and urine However, when oxymatrine is given orally, matrine concentration is higher than that of oxymatrine. This indicates that oxymatrine may be converted to matrine in the GI tract. After absorption, matrine is distributed to the tissues and excreted in the urine. After IV injection, oxymatrine rapidly disappears from plasma It can be suited to a 2-compartment open modeL Experimental results show that matrine is probably the pharmacologically active substance in the treatment of asthma.

Intrauterine contraceptive device (IUD) insertion at cesarean section was performed on 150 cases in this hospital from April 1981 to April 1982. A new suture fixation method is used and described. The expulsion rate is 0.7% (1 case) in 150 cases 42 days after insertion and 3.1% (4 cases) in 130 cases during the 3rd month with a 2.3% pregnancy rate. These expulsion rates are encouraging.

This is the first report on a mermithid nematode pathogenic to Anopheles gigas baileyi in Tibet, China as far as we know, this is also the first time that An gigas baileyi has been incriminated as a host for the mermithid nematode. The nematode infection and infected larvae mortality rates are as high as 94.9% and 88.5% respectively.

Four cases of multiple atrial parasystole with 2-3 atrial ecitopic pacemakers are presented with the ECGs. Three are ischemic heart disease with complete AV block, recognized as supranodal in nature according to James' criteria. The remaining case is acute inferior wall myocardial infarction with paroxysmal auricular fibrillation. Careful observation of the ECGs show 3 varieties of A waves, A1 wave of right atrial type, A2 wave of left atrial type as well as retrograde A3 wave of coronary sinus type. Double parasystoles, atrial fusion beats and exit block are also shown. Detailed measurements show the rate of each ectopic pacemaker and mutual interference of the sinus pacemaker and ectoipic pacemaker forming reversed coupling. These findings further support James' hypothesis on the intra-atrial conduction system.

This is a report of 350 cases of trophoblastic tumors treated with 5-Fluorouracil (5 FU) from 1965 to 1975. Large dosage 5FU (25-30 mg/kg) single agent, given in slow infusions over 6-8 hours proves to be at least as effective as, if not more so than the other chemotherapeutic agents currently used in gestational trophoblastic disease. Complete remission is obtained in 84.9% of malignant moles and 59.3% of choriocarcinomas with 5FU as a primary therapeutic agent. Patients with satisfactory immediate 5FU response also have good long-term results. Death from recurrences occurred in only 2.8%. Toxic reactions such as depression of hemopoietic function, hepatic toxicity, stomatitis, etc are milder than with MTX, 6MP or KSM. Only gastrointestinal tract reactions are more frequent and occasional pseudomembranous colitis occurs when the diarrhea is treated improperly. Two deaths occur due to 5FU toxicity, a 0.57% toxic mortality.

Plasma factor VIII related antigen (VIIIR:Ag) is determined in 54 cases of various kinds of primary glomerular diseases and compared with the plasma fibrinogen, fibrin(ogen) degradation products and some renal function tests. The results show that VIIIR:Ag is elevated in nephrotic syndrome (Group 1), chronic glomerulonephritis (Group 2) and chronic renal failure (Group 3), especially in Groups 1 and 3. In addition, the VIIIR:Ag level has evident positive correlation with the 24-hour urine protein in Group 1 and with blood urea nitrogen in Group 3. It is demonstrated that the VIIIR:Ag level can not only be regarded as an inWortant objective index of the hypercoagulation state in renal diseases, but also reflects to some extent the severity of glomerular damage. Continuous observations of its change are instrumental in assessing the effectiveneSs of therapy and prognosis. It deserves further research.