Volume 96  ·   Issue 07  ·  1983

A case of late choriocarcinoma with pelvic arterio-venous fistula was treated successfully with preservation of fertility. Therapeutic measures included combined chemotherapy and conservative surgery with ligation of the uterine artery involved and eradication of the pelvic carcinomatous focus. Two successful pregnancies ensued after the treatment. Criteria for conservative therapy and mechanism of complications of pregnancy following successful treatment of trophoblastic tumors are briefly discussed. The patient is still living and well.

The results of barium-air hypotonic double contrast examination of normal intestines in 50 persons are reported. An outstanding advantage of this technic is, it demonstrates the mucosal folds very clearly.

This paper describes a case of heart amyloidosis accompanied by chronic pericarditis and calcification within the amyloid, detailing the histopathologic changes.

Porphyria is easily misdiagnosed, the paper presents 2 cases, 1 is typical porphyria cutanea tarda, previously misdiagnosed and the other a mixed type hepatoerythropoietic porphyria which may not have been reported in the literature before. Problems of porphyria diagnosis, classification and treatment are discussed.

In this experiment, 5 methods are used in an attempt to produce "dry socket", but in only Group 5 was the method successful. Three treatments commonly used clinically are tested in the experimental "dry socket". The treatment used in Group 8 achieved the best results in promoting healing both macro- and microscopically, as compared with Group 7 (the "dry socket" control group). The "dry socket" paste (used in Group 10) markedly delayed the healing process and the wound treated with 3To hydrogen peroxide healed at the same rate as in the control group. Some other problems, as the criteria of animal model "dry socket, animal selection, experimental procedures and treatment of "dry socket" are discusesd.

The methods of determination of blood neuraminidase, T-antigen and T-antibody are described. The results of determinations in 38 cases of septicemia and 7 infantile necrotizing enterocolitis reported and the order of appearance of blood neuraminidase, T-antigen and T-antibody, the influence of blood transfusion on T-antigen positive cases and the pathogenesis of infantile necrotizing enterocolitis are discussed.

12 polycythemia vera (PV) patients treated with iv drip harringtonine in 14 treatment courses all achieved complete remissions (CR) in a median 60 days. 4 relapsed, 2 of these retreated with harringtonine alone again achieved CR. The harringtonine median total dose is 98 mg. Follow up shows that harringtonine is a safe reliable new PV therapy, comparing favorably with the other PV treatments. It has not caused acute leukemia sequelae as some other anti-PV drugs.

The diagnostic and therapeutic experiences of 13 reoperated cases of insulinoma and islet hyperplasia are reported. Among a total 82 cases, 13 (15.9%) were reoperated upon, but this rate was as low as 6.1% in the hands of the authors. The causes for reoperation are: failure to find the tumor in the first operation 6 cases; mistaking lymphnode for tumor on frozen section 2; missing 1 of multiple tumors 1; new insulinomas developed many years after removal of the first tumor 1; no tumor was found at reoperation in 3, 2 of whom were identified as islet hyperplasia, while the reason for hypoglycemia in the other case was unexplained. Analysis shows that in 8 of these 13 cases, reoperation could have been avoided had the first operation been managed properly. Measures to prevent unnecessary reoperation are directed toward tumor localization before exploration using such technics as selective abdominal arteriography, percutaneous transhepatic or intraoperative portal blood sampling for insulin assay. However, thorough examination of the entire pancreas during operation remains the fundamental and key measure to finding insulinoma.

This paper reports a case of refractory amebic liver abscess resistant to treatment and reviews the literature briefly. The causes of difficult cure were multiple. First, thickened pus cavity wall prevented drug penetration resulting in insufficient drug concentration to kill the ameba, so the disease persisted. Immune deficiency and drug resistance were also considered. Direct emetine injection into the pus cavity is recommended.

From a review of 60 cases of tarsometatarsal dislocations or fracture dislocations, the authors realize that careful X-ray analysis can detect incomplete dislocation. X-rays with the foot in 60° eversion help in diagnosing dorsal displacement of the first or second metatarsal base. For exploring vessels in cases complicated by circulatory embarrassment, the dorsalis pedis artery must be explored first from the dorsal foot wound in compound injuries, while the posterior tibial vessels must be first explored in closed injuries. Internal fixation with Kirschner wire is insufficient to counteract the tension exerted by muscular pull. Percutaneous suture with stain- less steel wire provides sufficient force for good reduction. Following tarsometatarsal joint arthrodesis, care must be taken to mould the cast so that immobilization ensures good foot alignment preventing deformity.