Volume 96  ·   Issue 05  ·  1983

A case of fully developed idiopathic pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy) is reported. The main clinical manifestations are: skin thickening, especially over the face and cheeks, where the skin is drawn into thick folds; acral enlargement and gross clubbing of the fingers and toes; profuse sweating of the hands and feet and subperiosteal proliferation of long bone diaphysis shown in X-rays. Tufting of the distal phalanges and abnormalities of the sella turcica are not seen. It is important to recognize and distinguish the syndrome from pulmonary hypertrophic osteoarthropathy, thyroid acropathy, acromegaly and hypertrophic osteoarthropathy.

A rare case of ulcerative keratitis caused by a Collectotrichum dematium strain is reported. By light microscope the conidia are smooth-walled falcate form and the setae are stiffly erect and smooth-walled. But by electronmicroscope, the conidia show much irregular pitting, the setae are rough surfaced and spinas numerous. Clinical observation and animal inoculation confirm that it is opportunistic in humans and rabbits.

Clinical and ECG findings in 9 cases of magnesium deficiency are presented. Five of the 9 had biliary tract disease (this was because the study was made in those with biliary disease), the other 4 had intestinal tuberculosiis, bacillary dysentary, pulmonary emphysema with infection and acute myocardial infarction. Clinically, gastrointestinal symptoms predominate. Serum magnesium values range from 1.16 to 3.0 mEq/L in 8 and 24-hour urinary magnesium values 1.1-3.6 mEq in 5. Both determinations are made by atomic absorption spectroscopy. ECG change4s are limited to the T waves. Attempts are made to categorize the T wave changes into increases in amplitude, "spinous" appearance, or both high and broad at the base; double peaked or "cloven"; and flat or inverted. Serum potassium, sodium, chlorides and ca.lcium changes have no relation to the ECG changes. When the mentioned T wave changes appear, magnesium deficiency is suspected.

A clinical study was undertaken to ascertain the significance of a probably newly discovered physical sign of tenderness at ileocecal point in diagnosis of tuberculous peritonitis (TP). It is a point at the junction of the inner and middle thirds of the right umbilico-iliac line joining the umbilicus and the anterior superior iliac spine. Based on the study of 41 patients and an equal number of nontuberculous disorder served as controls, the rate of tendernesis at this point in TP is 85.4%, statistically significant in comparison with the controls or any other 5 points including McBurney's point in the TP group. The author suggests that the tenderness at this point may be valuable as a diagnostic clue for the detection of both early and atypical TP.

13 cases of human esophageal squamous cell carcinoma are studied by electron microscopy. 10 male and 3 female patients' smaples are taken from resected pathologic esophageal specimens. The ultrastructural features of the esophageal squamous cell carcinoma are differentiated into Grades I, II and III.

A genetic factor is found in late stage schistoisomiasis japonica, a greater number of blood group A patients being found.

A case of gastric leiomyoblastoma aSSOCiated with multiple pulmonary chondrohamartomas is reported with a review of the literature. Diagnosis is confirmed by thoracic operation, suggesting that gastric leiomyoblastoma patients with chest film shadows should not be diagnosed arbitrarily as metastatic tumors. The possibitity of chondrohamartoma should be considered and exploratory thoracotomy performed. Prognosis is good in most cases (80%).

The authors introduce a new, convenient and precise method for localizing multiple metallic intraocular foreign bodies. It has the advantages of less superimposition of bony shadows of extraorbital foreign bodies avoiding difficulty in correlating each multiple foreign body on frontal and lateral view films. This method has been proved accurate by simulation of orbital multiple foreign body localization and clinical application. It is a new way of solving the problem of localizing multiple metallic intra-ocular foreign bodies which are not able or hard to locate by other means. It can not locate some foreign bodies of lower density casting indistinct shadows.

Slitlamp biomicroscopy and photomicrography show the conjunctival plexus, anterior ciliary arteries, emissary veins and episcleral plexus. Their morphologic characteristics, aqueous vein distribution, superficial and deep aqueous vein classification and examination methods are preliminarily described. Dilation and microaneurysm formation are valuable diagnostic signs in hypertension.

The epidemiologic complexity of influenza in 1977 was not known before. This paper describes influenza surveillance from 1977 to February 1978 in Shanghai through the establishment of influenza monitoring stations, isolation and antigenic analysis of influenza virus strains and serologic investigations. When the number of cases with upper respiratory tract infection and high fever recorded at the monitoring stations exceeded the critical level of the weekly nonepidemic period peak of the early months of 1977 it was predicted from antigenic and serologic studies that the influenza B and H3N2 viruses being antigenically similar to A/Beijing/75 would not cause a pandemic. After the new H3N2 variant A/Shanghai/56/77 appeared, the weekly incidence again exceeded the critical level in June. Taking into consideration the results of antigenic analysis and the antibody level in the population, an epidemic was predicted. This virus strain was isolated from a sporadic case l month before the epidemic. This is favourable for obtaining a vaccine strain in time and for taking preventive measures. The influenza A (H1N1) epidemic was chiefly limited to young people. The epidemic curve may persist above the critical level and show no significant peak. From January to February 1978, 2 subtypes (H1N1 and H3N2) were found to occur together for the first time in Shanghai. Problems in surveillance and prediction of influenza epidemics are discussed.