Volume 99  ·   Issue 06  ·  1986

1,119 inpatients (cancer group) suffering from gastric cancer (507), cancer of the colon and rectum (297), breast cancer (315), and 400 patients with cerebral hemorrhage (control group) treated from January 1958 to June 1983 were studied epidemio-logically for their previous appendectomy rates. In the cancer group, 98(8.76%) had undergone appendectomy (APP) three years before; whereas in the control group, 14(3.50%) had had APP (P<0.001). As compared with the control group, APP had been performed in 48 (9.47%) of 507 gastric cancer cases (P<0.001), in 21 (7.07%) of 279 cancer cases of the colon and rectum (P<0.05) and in 29(9.21%) of 315 breast cancer cases (P<0.01). As to sex distribution, 46 (9.82%) of 438 male cancer cases had had APP, while in the controls, 8 (4.47%) of 179 cases (P<0.05) had had APP; in the 681 female cancer cases, 55 (8.08%) had undergone APP, while in the controls, 6 (2.71%) in 221 cases (P<0.01) had had APP. The appendectomy rates were higher in various age groups of cancer group than in the controls, but only in the 50-59 age group was the difference statistically significant (P<0.05). In this paper, the morphological studies on the immune structure of the rabbit and human appendices during the past ten years are reviewed.

A new heterograft for myringoplasty is described. It is the proplast of catgut suture manufacturing. Histologic and biochemical studies, animal experiments and clinical application proved it to be an invaluable graft in ear surgery. In a trial on 56 patients (60 ears) with perforation of the drumhead, its overall take rate was 93.3%.

The chromosomes of MT-1, an adult T-leukemic cell line, were studied, using the Brdu high resolution technique. A particular chromosome region was found in the second cycle metaphases. The frequency of MT-1 cell with early duplication region (EDR) was about 6%. Five marker chromosomes (M1-M5) were found, 2 of them, M1 and M4, were identified by the high resolution G-banding technique. M1 was iso-2q and M4 10p-. EDR was located on the long arm (10ql1-10q25.1) of M4. The mechanism of EDR formation and its relationship with fragile site and HTLV are discussed.

Between August 1971 and August 1985, 16 adult patients with pyogenic infection of intervertebral discs were treated. The lumbar spine was involved in 94.1% of the patients and the thoracic spine in one. More than one intervertebral disc was involved in 1 patient. The chief symptom was backache, but one week later all patients with the disease in the lumbar region complained of pains in the hip, groin, thigh, lower abdomen or buttock. Tenderness was felt over the affected spinous process in all patients. The earliest radiological change was narrowing of the affected intervertebral disc space, which was followed by progressive sclerosis of the subchondrol bone with an increase in density of the adjacent margins of the vertebral bodies on either side of the affected disc and subperiosteal new bone formation. In addition, there was no paravertebral abscess, whereas the blood sedimentation rate was obviously elevated. All but two patients were treated with antibiotics in association with bedrest. One month after treatment, the patients were permitted to walk with lumbar protection. Follow-up for 11 months after discharge showed that prognosis is excellent.

This paper reports the pathologic morphology of chronic renal failure in a case of epidemic hemorrhagic fever (EHF). Clinically, the case progressed through the typical symptoms and physical signs of EHF with fever, hypotension and oliguria. The serological tests for EHF (IgG) were positive on the 15th and 40th days after onset, with titer of 1:320 and 1:5,120 confirming the diagnosis. The pathological changes showed many fibrosed glomeruli without hyalinization and proliferation of capsular and tubular epithelial cells. The epithelial cells of the proximal convoluted tubules showed cytoplasmic hyalinization. The fibrous tissue of the tubular walls and renal stroma were proliferated. The renal stroma was infiltrated with numerous monocytes, plasma cells and eosinophils, with prominent deposition of hemosiderin. Electron micros copic examination showed viruslike particles within the cisternae of the endoplasmic reticulum. On the basis of the clinical history and morphologic characteristics, this case was assumed to be acute EHF stage of chronic renal injury. Uremia was temporarily alleviated by repeated hemodialyses, lengthening the duration of disease which turned into a chronic condition. Inhibition of proliferation of renal fibrous tissue during treatment of chronic renal dysfunction in EHF may be a significant favourable indicator for the prognosis.

Eight cases of acute traumatic diaphragmatic hernia (ATDH) were caused by penetrating injury in 2 and blunt trauma in 6. Among the latter group, 4 sustained pelvic fractures, 3 fractures of the lower extremities and only 2 had multiple rib fractures. This denotes that crush injury to the lower abdomen may lead to an abrupt increase of intraabdominal pressure and cause ATDH. We suggest that in patients with chest symptoms after extensive crush trauma below the umbilicus, ATDH should be highly suspected and that routine plain chest X-ray is indicated for ATDH diagnosis.

Thirty-five normal esophageal mucosae were observed by TEM for ultrastructural features of the epithelium.

A female young worker, single, aged 20 years, had an attack of systemic lupus erythematosus evolving rapidly into lupus encephalopathy manifested by psycho-neurologic disorders. The clinical features were typical with fever, arthralgia, proteinuria, oliguria, heart enlargement, pleural effusion and abnormal liver function (Zntt 40 u, GPT 75 u), hypcrgammaglobulincmia, hypopro-teinemia with A/G inversed. Anti-DNA Ab positive. Typical facial butterfly erythema was seen. At the last stage of the disease course, auditory and depressive hallucination with nervous disorders following soon appeared and finally the patient died on March 15, 1984 in deep coma. Autopsy performed 48 hours post-mortem, revealed typical wire-loop in the GBM, early stage Libman-Sack syndrome, bleeding due to duodenal ulcer, wedge shape lesion in the left kidney, upper lobe of the right lung, and on the orbital surface of the frontal lobe of the brain, bronchial muco-membrane damage and a large amount of filamentous fungi were seen in the lesions in the brain, kidney, and lung. These pathologic findings confirmed aspergillar septicemia undiscovered during life as the final cause of death.