[Long-term follow-up of the ulnar nerve repair: report of 42 cases]

A long term follow-up for 42 cases of ulnar nerve repair was reported in this article, and the reason of bad function were analysed. They are: 1. As long as the injured ulnar nerve was sutured perfectly and without delay, the result would be satisfying. 2. The follow-up examination of the repaired nerve showed all the paralysed intrinsic muscles would recover in certain extent. Abductor digiti quinti, adductor pollicis and flexor digiti quinti brevis usually restored easily. Among the intrinsic muscles the best result of the first dorsal interosseous and the first palmar interosseous muscles were obtained. The functional recovery of the second and third palmar interosseous muscles usually was poor. 3. After repairing of the injured ulnar nerve, recovery of the claw hand deformity usually takes long time, so the operative correction of the deformity should not be performed until 2.5 years.

[Cerebral infarction after resection of epidermoid carcinoma of buccal mucosa under general anesthesia--report of one case]

A 60 year-old hypertensive male was operated with resection of epidermoid carcinoma of buccal mucosa. He was expired postoperation complicated with left middle cerebral artery infarction. The cerebral infarction may be induced by acute hypotension, improper position during operation and underlying disease associated with old age. Prevention methods included preoperative evaluation, immediately injection vasopressor when acute hypotension occurred during anesthesia, and avoidance of improper position to compress vertebral or carotid artery which may leading to cerebral perfusion insufficiency.

Striated muscle tropomyosin-enriched microfilaments of developing muscles of chicken embryos

The striated muscle tropomyosin-enriched microfilaments were isolated from developing muscles in ovo by the previously described method with a monoclonal antibody against striated muscle isoforms of tropomyosin (Lin & Lin, 1986). Two-dimensional gel analysis of the isolated microfilaments from developing heart, thigh and breast muscles revealed the coexistence of non-muscle isoforms of tropomyosin and actin throughout all stages of embryogenesis. A small but significant amount of skeletal muscle isoforms (alpha, beta) of tropomyosins and their phosphorylated forms was detected in the microfilaments isolated from hearts of 6-15-day-old embryos. These skeletal isoforms of tropomyosins disappeared after this stage of embryogenesis. In addition, we also detected both embryonic and adult isoforms of troponin T in early developing hearts. In developing thigh and breast muscles, the presence of non-muscle tropomyosin isoforms 2, 3a and 3b in the isolated microfilaments was apparent. The contents of tropomyosin isoform 2 were decreased with development and this non-muscle isoform completely disappeared at the 15th day of embryogenesis. On the other hand, the non-muscle tropomyosin isoforms 3a and 3b were present throughout all stages of development. Double-label immunofluorescence microscopy with monoclonal CH1 (anti-striated muscle isoforms of tropomyosin) and CG beta 6 (anti-non-muscle isoforms of tropomyosin) on the isolated, glycerinated skeletal and cardiac muscle cells of 10-day-old or 13-day-old embryos confirmed the colocalization of muscle and non-muscle isoforms of tropomyosins within the same cells. These results suggest that different isoforms of actin and tropomyosin can assemble into a class of microfilaments (i.e. striated muscle tropomyosin-enriched microfilaments) in ovo, which may transform into the thin filaments of mature muscle cells.

Doppler ultrasonic diagnosis for deep venous thrombosis of lower limbs

Seventy-one patients with 80 lower limbs clinically suspected of deep venous thrombosis (DVT) were investigated by both Doppler ultrasound and venography. Sixty-seven lower limbs demonstrated by venography to have DVT, in 5 the thrombus was confined to the calf, and all were detected by the Doppler ultrasound. In 62 limbs thrombus extended into the popliteal and more proximal veins, the Doppler ultrasound detected 61 of them, a sensitivity of 98%. Venography showed a deep venous system without any evidence of thrombosis in 13, the Doppler findings were normal in all of the 13 lower limbs, a specificity of 100%. We found that the examination of the popliteal vein with patient in a semi-lateral prone position was important in detecting the presence of thrombosis in popliteal and more proximal vein.

Studies on peripheral T lymphocyte subsets in patients with autoimmune thyroid diseases

Peripheral T lymphocyte subsets in 60 cases of Graves' disease (GD) and 16 cases of Hashimoto's thyroiditis (HT) were determined by the use of OKT monoclonal antibodies (McAb). The results showed that in both diseases OKT3 cells (total T cells) and OKT8 cells (suppressor T cells, TS cells) were lower and the ratio of OKT4 cells (helper T cells, TH cells) OKT8 cells was much higher than those in normal controls. GD patients who were treated with antithyroid drugs (ATD) and whose serum T3, T4 recovered to normal, could be further divided into subgroups of high OKT4/OKT8 cell ratio and of normal ratio. The pathogenesis, treatment and relapse of autoimmune thyroid diseases (AITD) were discussed in this paper on the basis of the results.

Recognition and management of Budd-Chiari syndrome: report of one hundred cases

Budd-Chiari syndrome is an unusual form of portal hypertension caused by occlusion of the hepatic venous outflow, and it is often confused with portal hypertension caused by liver cirrhosis. Its prognosis is poor, and optimal therapy remains to be established. This is a report of 100 confirmed cases of this syndrome treated from December 1982 to March 1988 at two vascular centers in China. Sixty-two male and 38 female patients, 15 to 62 years of age (mean age, 32.6 years) were treated. Seventy-six patients had intractable ascites, 56 had esophageal varices, and 22 had upper gastrointestinal bleeding. There were 37 cases of membranous obstruction, 57 cases of occlusion of the inferior vena cava above the confluence of the hepatic veins, and 6 cases of occlusion of the hepatic veins. Eighty-one patients were operated on. Operative mortality rate was 8.6% (7/81). Follow-up from 2 to 66 months revealed that 58 of the patients operated on (72%) had good results, whereas 11 of 19 (58%) patients treated nonoperatively died within 2 months after admission. On the basis of these data we conclude that the operative procedure must be tailored to the cause and underlying pathologic characteristics. Mesoatrial shunting is the operation of choice for patients with occlusion of the retrohepatic inferior vena cava and hepatic veins, and inferior vena cava--atrial shunting is the operation of choice for patients with occlusion of the inferior vena cava and patency of the hepatic veins. Membranotomy is used for patients with inferior vena cava webbing, and mesocaval shunting is used for patients with intrahepatic venous occlusion only.(ABSTRACT TRUNCATED AT 250 WORDS)

[An immunohistochemical study of human atherosclerotic lesion]

Cellular composition of 31 cases of human atherosclerotic lesion was studied by immunohistochemical technique. Specimens were taken from the thoracic and abdominal aortas of necrosis. Four monoclonal antibodies were used to identify cell types. Monocytes/macrophages reacting with anti-Leu-M1 or anti-alpha-1-ACT were found in early lesions and some activated areas such as the peripheral region of bottom of atheromatous plagues of the advanced lesions. Some foamy cells also showed positive to alpha-1-ACT. In addition T lymphocytes reacting with anti-UCHL-1 were detected in the early lesions and some activated areas of advanced plaques, and both types of cells were more common in the early than in the advanced lesions. Other types of leukocytes were scanty in both early and advanced atheromatous lesions. In conclusion, the presence of a variable number of monocytes/macrophages and T lymphocytes in human atherosclerotic lesion may represent a cell-mediated immune response which may be very important in the initiation and progression of atherosclerotic lesion.

Blood meals of mosquito vectors of filariasis in Guizhou Province, China

The blood meals of mosquito vectors of W. bancrofti and B. malayi were determined by performing CIEP of the eluant of crushed mosquitoes in filter paper against rabbit anti-human, cow and pig sera. The mosquitoes were collected from houses, cowsheds and pigpens in two counties in Guizhou Province. It was shown that all three species fed on blood from humans, cows and pigs with different preference. While An sinensis fed more on cows, Cx. fatigans and An. lesteri fed on the hosts that were nearby, i.e., Cx. fatigans caught from households fed more on humans, and those collected from cowsheds or pigpens fed more on cows and pigs, respectively.

[Therapeutic effect of defibrase in chronic glomerulonephritis with chronic renal failure]

When chronic glomerulonephritis (CGN) proceeds to chronic renal failure (CRF), there are decline of fibrinolytic activity and deposition of fibrin in glomeruli with resulting thromboembolic lesions. 46 CGN patients with complicating CRF were thus treated with defibrase made from viper venom. Defibrase in a dose of 0.025 unit/kg dissolved in 250 ml 10% glucose was infused slowly once every 3 days in a total of 6 times. After the treatment, BUN and serum creatinine levels decreased, creatinine cleance improved and the clinical manifestations of uremia alleviated or disappeared. In some patients there were increase of hemoglobin concentration and decrease of urinary protein excretion. Hypertension was controlled in 17 out of 20 patients treated in combination with captopril. Level of plasma fibrinogen was significantly reduced after defibrase administration, but the reduction was not related to the therapeutic effect. Urinary output was increased in most of the patients, being related to the therapeutic effect. The authors are of the opinion that renal function may be improved in CGN patients after defibrase treatment due probably to elimination of fibrin deposition and resolution of thromboembolic lesions in glomeruli. However, a suitable dose has to be determined as there is no effective way to monitor the most dreaded complication of defibrase therapy bleeding.

A two-year study of acceptability, side effects, and effectiveness of Norplant and Norplant-2 implants in the People's Republic of China

A large scale, phased investigation of NORPLANT contraceptive systems was conducted in the People's Republic of China. The first phase comprehended 1,200 women in four cities. Expanded trials included 11,918 women at 12 major centers and at sub-centers by 31 May 1987. At that date 4,676 NORPLANT capsule subjects and 1,089 rod subjects had completed one year of use, 1,381 capsule acceptors had completed two years as had 197 rod users. Gross pregnancy rates were less than 0.1 per 100 for each implant type both at one and at two years. Continuation rates were 94 per 100 for each implant type at one year, and were 82.0 and 83.6 per 100 among users of NORPLANT capsule and rod implants, respectively, at two years. Disruption of menstrual function was the dominant reason for termination, but mean hemoglobin levels increased in each of the nine centers reporting values at admission and at one year. First year gross cumulative termination rates for medical reasons were 1.2 to 1.3 per 100, reaching 3.8 and 5.6 per 100 for capsule and rod implants, respectively, at two years. Microdose contraception with these levonorgestrel-releasing implants appears to be a highly acceptable and effective modality suitable for Chinese women. NORPLANT implants are now approved by the national drug regulatory agency for general use in China.

Granular mucosal lymphocytes in porcine small intestine

A subpopulation of purified, interepithelial lymphocytes from porcine small intestinal mucosa contained cytoplasmic granules. Toluidine blue staining revealed metachromatic granules in 13.64% (606/4,450) cells. The cells had scant organelles, a single large nucleus with obvious invagination of the nuclear membrane, and prominent chromatin. Each cell contained 1 to 10 cytoplasmic membrane-bound granules, 0.6 to 1.5 micron in diameter. These findings indicated that the granular mucosal lymphocytes are related morphologically to mucosal mast cells. The presence of serotonin in the granules, confirmed by the serotonin releasing test, provided functional evidence that granular mucosal lymphocytes are related to mucosal mast cells.

Cryopreservation of infective-stage larvae of Brugia malayi

Third-stage larvae of Brugia malayi (Guizhou, China strain), in RPMI-1640, 6% DMSO and 15% calf serum, frozen slowly in the vapor phase of liquid nitrogen prior to emersion in liquid nitrogen, remained viable for as long as as 321 days and were infective to Mongolian jirds. All DMSO should be removed from the freezing medium to restore larval activity after freezing.

Reconstruction of the thumb

Based on 25 years of experience (1960-1984) with 188 cases, six approaches to thumb reconstruction are categorized as follows: pollicization using the index finger; pollicization using a finger stump; free transplant of a toe to reconstruct the thumb; reconstruction of the thumb by bone grafting and free flap transfer from the great toe with the nail; reconstruction of the thumb by turning up the skin over the dorsum of the stump and lengthening with bone grafting, and reconstruction of the thumb with bone grafting and tubular skin grafting. A well-reconstructed thumb should be in proper position with good stability, have good sensation, be of proper length, and have a satisfactory aesthetic appearance. Proper selection of patients, based on the level of thumb loss, condition of other fingers, and age, occupation, and activities of the patient, is a key to successful reconstruction of the thumb. Care must be taken to avoid excessive interference with the original function of the donor site.

Antigenic characterization and ELISA detection of adult diarrhea rotaviruses

Recently, severe epidemics of diarrhea among both adults and children in China have been associated with an agent called adult diarrhea rotavirus (ADRV). We have studied ADRV from two areas of China (Jinzhou and Guangxi) and compared them with prototype group A, B, and C rotaviruses. The viral genomes were compared by electrophoresis of the RNA genome segments in polyacrylamide gels, and the antigenic relatedness of these viruses was examined by immune electron microscopic studies using virus preparations of either double- or single-capsid particles. Hyperimmune antisera (guinea pig and rabbit) to one strain of ADRV reacted with high titers with other strains of ADRV and with single-shelled capsids of a porcine group B rotavirus. The antisera to ADRV did not react with either group A or group C rotaviruses. Antisera to either bovine or porcine group B rotaviruses reacted with ADRV but not with the group A or group C viruses. Antisera to group A or group C virus reacted only with their respective homologous virus. These results and those of immunofluorescence studies place the human ADRV rotaviruses from China among the group B rotaviruses. We also report the development of an ELISA to detect ADRV; this ELISA should be useful for defining the epidemiology of these recently described rotaviruses.

[Nuclear ultrastructure and histocytologic features of thyroid papillary carcinoma]

Nuclear ultrastructure and histo-cytologic features of 5 cases of thyroid papillary carcinoma were studied. Three main ultrastructural features were: (1) the complex folds and invaginations of the nuclear envelope with formation of nuclear lobules and tiny bridges, (2) the intranuclear pseudoinclusions and (3) the abundant euchromatins. Under the light microscope, as mentioned above in (1), the findings were observed as the indentation of nuclear envelope and deep nuclear groove, (2) was shown as the intranuclear eosinophilic globular body and (3) as the ground-glass appearance of nucleus. The intranuclear eosinophilic globular bodies could be seen on the routine and frozen sections as well as smears. The intranuclear pseudoinclusions and eosinophilic globular bodies, were found in these 5 papillary carcinomas. At the same time, the ultrastructure and histologic features of the follicular cells were observed in 13 cases of colloid adenomas and 9 nodular goiters. None of the follicular cell nuclei showed the three features described above. The intranuclear pseudoinclusion or eosinophilic globular body was not found in any of the ultrathin and histologic sections. These results indicate that in the pathologic diagnosis of thyroid papillary carcinoma, the light microscope has more practical value than the electron microscope. Still does it, especially in the cytologic diagnosis of thyroid puncture before operation.

Intracranial alveolar echinococcosis in China: discussion of surgical treatment

Intracranial alveolar echinococcosis is an uncommon disease and difficult to treat. Three patients with central nervous system (CNS) involvement are reported, and the surgical treatment of the monomassive type is emphasized. The largest mass lesion reported, so far, in the literature (9.0 X 6.5 X 4.5 cm) was extirpated in one of our cases. Related problems are discussed in combination with the literature.

Working condylar movement and its effects on posterior occlusal morphology

The movement of the mesiolingual cusp of the maxillary left first molar was studied in the frontal and horizontal planes. The movement was studied while varying the top wall, rear wall, and incisal guidance on the articulator. It can be concluded that the top wall inclination may significantly influence movement of the mesisolingual cusp of the maxillary first molar during working mandibular movement, the rear wall inclination has less influence than top wall inclination on cusp movement during a working mandibular movement, and the working side condylar movement should be considered when evaluating or restoring the dentition.

Use of autogenous omentum for grafting electrical injury affecting the scalp and skull

A patient with high voltage electrical injury affecting the scalp and skull has been treated successfully using autogenous grafts of the greater omentum.

Dermorphin-like immunoreactivity in guinea pig and rat stomach

Dermorphin is an opioid peptide containing one D-amino acid isolated from amphibian skin. We examined the presence of dermorphin-like immunoreactivity (DMP-IR) in mammalian brain and tissues using an antiserum developed in our own laboratory which works at a dilution of 1:120,000 for Radioimmunoassay (RIA) and can detect 2.1 pg of dermorphin. We were unable to find DMP-IR in guinea pig, rat and toad brain and rat and toad spinal cord either extracted with methanol or with HCl. The guinea pig and rat stomach contained significant amounts of DMP-IR (228.9 pg/mg protein and 97.5 pg/mg protein respectively) when extracted with HCl but not with methanol. The DMP-IR we detected in the stomach is not dermorphin per se. A single peak of DMP-IR was found on Sephadex G-25 gel filtration. When re-chromatographed on reverse phase HPLC, this peak of DMP-IR gave rise to three peaks of DMP-IR.

Replantation of severed limbs--clinical analysis of 91 cases

From 1964 to 1980, 91 replantations of severed limbs were performed at Peking Ji Shui Tan Hospital, The People's Republic of China. Seventy of these replantations were successful, and 21 were failures, for a success rate of 77%. The highest success rate was in replantations at the wrist level, with the lowest success rate occurring for replantations at the proximal forearm. In clean-cut injuries, successful reattachment was achieved in 88%. Injuries resulting in twisting and tearing trauma inflicted by a revolving machine rendered the poorest outcome. No significant difference existed between the viability rates of replantations of complete or nearly complete severance. Causes of injury and failed replantations varied.