Volume 96  ·   Issue 10  ·  1983

The medial collateral ligament injury of elbow joint may be produced by valgus stress with the arm in extension and abduction or in extension, abduction and slight backward inclination. The injury presents definite clinical features. If injury is severe, the abnormal passive valgus movement of elbow joint is at least 30 degrees. Operative technic for repairing the ruptured medial collateral ligament is introduced. From the operative findings of traumatic pathologic changes, the rapid recovery of normal function in 10 cases after operation and simplicity of the operative technic, surgical repair is recommended in severe injury of the medial collateral ligament.

96 clinically healthy aged individuals are tested for parameters including lymphocyte count, lymphocyte transformation test (LTT), total rosette-forming cells (T-RFC), active rosette-forming cells (A-RFC), auto-rosette-forming cells (Auto-RFC), stable rosette-forming cells (S-RFC), erythrocyte-antibody-complement rosette forming cells (EAC-RFC), serum IgG, IgA, IgM, C3, CH50, RF, ANF and PHA skin test. It is found that the percentage and mean value of LTI, mean value of active-RFC, positive incidence and flare dimension of PHA skin test were all lower in the aged than in blood donorS (as controls), while the mean values of serum IgG, IgA, IgM are higher. Serum CH50 level was higher and serum C3 level lower. Although the positivities of serum RF and ANF were higher in the elderly this was not statistically significant.

Based upon Goldsmith's experience and our animal experiments, we designed a microsurgical procedure for treating ischemic cerebrovascular disease by transplanting free omentum to the brain surface. From August 1980 to March 1981 15 patients are treated this way satisfactorily.

Based on the experience in treating 67 burn patients, we propose the following contraindications to extensive escharectomy: hemorrhagic diathesis calls for postponement of escharectomy until the cause is, found and treated; multiple system organ failure due to low flow state requires escharectomy postponement for a few days and energetic treatment to correct this complication; serious burn infections have a focus of invading infection which should be found and totally removed during escharectomy, but if the focus of infection causing the septicemia is, not identified, one should not take it for granted that extensive escharectomy will be of much help as the surgery may be fatal; uncorrected electrolyte and acid-base imbalance contraindicate extensive escharectomy; very extensive and deep burns with the patient seriously ill call for prolonging the interval between operations unless there is an infectious focus necessitating immediate removal.

After pointing out why calculating a survival rate by traditional method often leads to a misleading result, this paper suggests a new set of formulae for estimating a rate product and its variance and performing significance test with numerical examples. The theoretical bases are discussed in detail.

Extensive skin and soft tissue defect accompanied by damage and/or absence of blood vessels in the local and adjacent regions is a formidable problem which often cannot be effectively solved by conventional means as skin tube transfer, crossed skin flap or free skin grafting. An original operative procedure designed by our group and applied successfully to repair a massive left leg defect with extensive scarring measuring 30×12.5 cm and extending deep into the periosteum is presented in this paper. The left anterior tibial vessels and great saphenous vein were also badly damaged. A free latissimus dorsi skin flap is excised and transplanted onto the defect, while the right leg is flexed so the ankle crosses over and lies just behind the upper end of the left leg forming a 60° angle between the 2 legs. A pedicle skin flap is mobilized from the right ankle region and sutured to the left leg wound margin to form the "floor" of the skin bridge. The right anterior tibial artery and its continuation, the dorsal pedal artery, the continuation of the great saphenous vein, and the dorsal pedal vein were mobilized and severed. They are anastomosed end-to-end respectively with the thoracodorsal artery and vein of the free latissimus dorsi skin flape. Finally, the free latissimus dorsi skin flap is sutured to the right ankle skin incision edge to form the "surface" of the skin bridge. The vascular pedicle of the free latissimus dorsi skin flap is made to span the crossed legs, serving as a skin bridge through which flows the temporary blood supply to the free skin flap. After vascular training to promote new circulation formation, the skin bridge is severed 6 weeks postoperatively. The free skin flap survives The success of this procedure makes possible the plastic reconstructive repair in patients with large area skin and compound tissue defects, broadening the range of reconstructive surgery and the operative indications for large area skin and compound tissue loss.

Since the majority of glucagonomas are malignant, early diagnosis and prompt surgical excision are imperative. Clinicians should be alerted to the cardinal symptoms of this rare disease.

84 specimens are obtained from patients with gastric carcinoma and tested for ABO(H) blood group antigens. The results show that these antigens are partially or completely lost in about 75% of the specimens. ABO(H) blood group antigens are 1 of the 2 major cellular histocompatibility antigens involved in transplantation immunobiology, histoincompatibility causing transplant rejection. The authors consider that during cellular anaplasia, cells lose or undifferentiate histocompatibility antigens of ABO erythrocyte system, this may be a carcinoma cell biologic characteristic and cancer cell metastasis may be related to undifferentiation of cellular histocompatibility antigen, a new view on the mechanism of carcinoma metastasis.

It has been shown by many investigators that hematoporphyrin derivative (HpD) when infused intravenously is perferentially retained by malignant cells. Clinical trials both for the detection and treatment of malignant tumors have been carried out. If localized HpD is activated by visible light, particularly 625-630 nm in the wave length of the spectrum red region cytotoxic singlet oxygen is elicited. Since 1981 a study group on HpD-photoradiation therapy (HpD-PRT) has been set up in the Cancer Institute, Chinese Academy of Medical Sciences (CAMS), Beijing. PRT technic and procedure used in this group are essentially the same as first described by Dougherty and his associates, except that all the medical facilities including the HpD and laser system used are China made. 47 patients with cancers treated by PRT are presented with promising short-term results.