Volume 96  ·   Issue 06  ·  1983

Pancreatic abscess is a rare complication of pancreatic disease and the prognosis is poor as the diagnosis is obscure and uncertain, so the timing of surgical intervention ihS usually protracted. Five cases were seen during the past few years with 1 case dying of this complication. The experience is summarized in this paper.

It is clinically shown that the analgesic effect of electro-acupuncture anesthesia (EAA) for cranial operations is more effective than for other parts of the body. Among all cranial operations the analgesic effect of prefrontal craniotomy is best. Since 1975, 43 patients with pituitary adenoma operated on under EAA had good or excellent results in 41/43. In this series the patients' general conditions and mental status were similar. The OPeration was carried out as a small osteoplastic flap craniotomy in the right frontal region. All acupuncture points used were close to the sensory nerve branches around the operative field. According to the puncture locations the cases are divided into 2 groups. In Group A the points were very close to the nerves distributed in the frontal operative field including Zanzhu 攒竹, Yuyao 鱼腰, Ermen 耳门 and Shangguan 上关 In Group B point Chuanliao 颧鼹 was located near the infraorbital nerve with another point at the ipsilateral ear lobe as a coupling point, both were a little farther away from the operative field. The good and excellent results in Group A and B included all patients except l in each group (statistically insignificant). Although a few patients com- plained or groaned slightly, they could tolerate the entire operation. All points used in Groups A and B are close to sensory branches of trigeminal nerve and/or the analgesia is connected with changes of some neurochemical elements within the central nervous system (e.g. endorphine, 5HT). The authors' experience is that points close to sensory branches near the central nervous system have better EAA analgesic effect.

Selective renal and hepatic arterial embolization with gelfoam particles or liquid silicone rubber were done in 22 dogs. Gelfoam is one of the best material for arterial embolization, as it is readily available, easy to inject and much safer for hepatic arterial embolization, but the arteries obstructed may be recanalized within 2 weeks. It is useful to stop bleeding but in- sufficient for treating tumor. Liquid silicone rubber is a permanent embolic material and can obstruct very small blood vessels, but should be used with care.

Binocular near fogging has certain efficacy in prevention of youth myopia especially when the subject does excessive near work with visual stress. It also improves poor and normal vision. It is effective in decreasing youth myopia incidence as well as preventing new incidence. It can be used to treat low degree accommodative myopia, but is ineffective in myopia higher than -3.00 D. Its effect is similar to that of atropine but is safe and easy to use. Moreover, it does not interfere with students' studies. The course of treatment is indefinite, but we insist on constantly wearing the lenses in order to relax accommodation and lessen visual strain.

Tracer experiments with radioactive thyroid hormones and NaI demonstrate that, in mice, dexamethasone (DEXA) administration increases thyroid hormone deiodination and iodine urinary excretion but decreases thyroid iodine accumulation and thyroid hormone transfer to muscles. Propylthiouracil mainly inhibits thyroid iodine accumulation, whereas propranolol has little effect on thyroid hormone deiodination and thyroid iodine accumulation. In rats, DEXA increases the metabolic clearance rates of plasma 3',3,5-triiodothyronine (T3) and plasma iodide as well as renal iodide clearance rate. Plasma T3 is reduced not only by reduction in its formation from thyroxine, but also by elevation of its clearance rate, which results from the increase in deiodination and increase in urinary iodide excretion.

121 cases (153 eyes) of middle or late stage glaucoma in which intraocular pressure is controlled within normal range by surgery or miotics are treated with 4 Radix Salviae Miltiorrhizae preparations, 3 being compounds, given intramuscularly. The 4 medications improved vision in 43.7% of the eyes treated and most visual fields remained unchanged or improved in 87.5%. There were no statistically significant differences among the 5 medications. It is apparent that the traditional Chinese medicine therapy series showed better results than the control group. Follow up examination of 19 eyes showed that 14/19 retained long term therapeutic efficacy after treatment.

9 cases of atrial fibrillation from 3 generations of 1 family including 32 members are presented. The incidence is much higher than re- ported. One of our patients was only 10 years old, the youngest among those reported. The disease is considered, through clinical studies and chromosome examination an autosomal dominant hereditary disease, since familial sick sinus syndrome (SSS) is suggested and atrial fibrillation probably is merely one of its manifestations.

Continuous postoperative peritoneal lavage (CPPL) is a new, effective and energetic surgical therapy for severe general peritonitis (SGP) and recurrent attacks of severe diffuse adherent intestinal obstruction. Since 1958, the author has used this technic in clinical practice. To the best of the author's knowledge, the earliest use of this technic abroad was in 1968 and it was published in the literature in 1970, the author's work started 10 years earlier. CPPL is only used in peritonitis abroad while the author has used it also in recurrent adherent intestinal obstruction (including tuberculosis) with good results.

Vascularized skin grafts are being popularized in China. This paper shows the state of their use in a district hospitaL 53 vascularized free skin graft transplant operations were performed in 40 patients.

The authors propose an anterior approach for procurement of a vascularized fibular graft and believe it has the following merits: less trauma, less bleeding, good exposure and fast and safe procedure. The experience with 17 cases receiving the operation is reported, the procedure described and necessary precautions mentioned.