BUERGER'S DISEASE IN HONG KONG: A REVIEW OF 89 CASES

Background : A retrospective analysis of 103 case records from 1978 to 1996 with a provisional diagnosis of Buerger's disease was undertaken at the Department of Surgery, University of Hong Kong, Queen Mary Hospital. The aim of the study was to elucidate the clinical course and evaluate the results of surgical intervention of Buerger's disease in Hong Kong Chinese people. Methods : Fourteen patients were subsequently excluded from the study because of inability to fulfil our diagnostic criteria. Data on clinical presentation, investigations, indications and results of surgical intervention were reviewed. Sympathectomies and arterial reconstructions were performed on 42 and four patients, respectively, for critical ischaemia or rest pain. Outcome was analysed with respect to the rate of ulcer healing, pattern of recurrence and limb loss. Results : The patients were all young male heavy smokers with a mean age of 36.5 years. The majority of patients (80%) presented with ischaemic ulceration or gangrene. Vascular reconstruction was undertaken in four patients and satisfactory long-term results were obtained in three patients. Sympathectomy was able to relieve symptoms in 87% of operated patients and ischaemic ulceration healed in 2.6 (mean) ± 1.7 (SD) months after the operation. If the patient continued to smoke, surgical intervention did not exempt the patient from a relapse or amputation. Conclusion : Sympathectomy provides short-term pain relief and promotes ulcer healing in patients with Buerger's disease but carries no long-term benefit. Complete abstinence from smoking is the only means of arresting the progression of the disease.     

Mivacurium in infants and children

Mivacurium is the only available short-acting nondepolarizing muscle relaxant in clinical use. It is a bis-quaternary benzylisoquinolinium ester hydrolysed by plasma-cholinesterase into inactive compounds. The ED₅₀ and ED₉₅ in children are about 50 μg·kg^?1 and 90 μg·kg^?1 respectively. In infants, they have a tendency to be lower. A standard intubating dose of 0.25 mg·kg^?1 causes complete neuromuscular depression in 1.5–2 min, recovery to 5% in 6–10 min, and complete recovery in 15–20 min. The recent tendency is to use 0.3 mg·kg^?1 to obtain better intubating conditions with slight prolongation of effect. Since the recovery profile of mivacurium is independent of the dose and duration, it is most suitable for administration by continuous infusion. The infusion requirement in children is 10–16 μg·kg^?1 min^?1, which is about twice that of adults. Cutaneous flushes from histamine release are commonly seen with the larger doses of mivacurium; however, the associated hypotensive effects are minimal and counteracted by the tracheal intubation. The duration of action of mivacurium is prolonged in patients with cholinesterase deficiency. Mivacurium's neuromuscular effects can be satisfactorily antagonized by edrophonium or neostigmine.     

活血化瘀法治疗髌骨软骨软化症的探讨

本文从髌骨软骨软化症的病因病理出发，阐述了活血化瘀疗法治疗髌骨软骨软化症的作用及其原理，列举了活血化瘀法在该病治疗中的具体运用，同时强调了在辨证施治基础上活血化瘀的重要性。     

中草药红背丝绸不同成分对内皮素-1效应拮抗作用的研究

本文用中草药红背丝绸醇提物、乙酸乙脂提取物和单体ＣＡ－１２０１ 三种不同成分对ＥＴ－１ 在动物整体及离体水平生物学效应的拮抗作用进行了研究。结果发现：这三种成分对ＥＴ－１ 致小鼠进行死亡有保护作用，使得小鼠的死亡率及死亡数下降；并可拮抗ＥＴ－１ 致胸主动脉的缩血管效应，醇提物和乙酸乙脂提取物（１０－ ７母液）拮抗ＥＴ 缩血管效应分别为５７．２７％ 和５８．６１％ ；ＣＡ－１２０１ １０－ ８和１０－ ９ Ｍ 亦能拮抗ＥＴ－１ 的缩血管效应；醇提物和乙酸乙脂提取物口服及ＣＡ－１２０１ 静脉注射后能拮抗ＥＴ－１ 的升压作用，拮抗ＥＴ－１ 作用均呈现明显的剂量依赖性。提示中草药红背丝绸不同成分可拮抗ＥＴ－１ 的生物学效应。     

Hemorrhagic fever with renal syndrome virus infection in livers studied by in situ hybridization and immunohistochemistry

ＨｅｍｏｒｒｈａｇｉｃｆｅｖｅｒｗｉｔｈｒｅｎａｌｓｙｎｄｒｏｍｅｖｉｒｕｓｉｎｆｅｃｔｉｏｎｉｎｌｉｖｅｒｓｓｔｕｄｉｅｄｂｙｉｎｓｉｔｕｈｙｂｒｉｄｉｚａｔｉｏｎａｎｄｉｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｓｔｒｙＹａｎｇＳｈｏｕｊｉｎｇ（杨守京）；Ｌ...     

理气类中药对大鼠离体胃平滑肌条的作用

目的：观察理气类中药对大鼠离体胃平滑肌条运动的影响。方法：将肌条放置在灌流肌槽中，用生理记录仪记录肌条的收缩活动。结果：陈皮、枳实对胃各部位平滑肌条均为抑制效应，香附、薤白、木香、柿蒂、乌药对胃底肌条为兴奋效应，但对其他部位肌条则表现为兴奋或抑制不同的效应，沉香仅降低胃窦环行肌收缩波平均振幅，对其他肌条无影响。结论：理气类中药对大鼠离体胃平滑肌条既有兴奋作用，也有抑制作用。     

Rejuvenation in the early 20th century

Summary. The first theoretical reflections concerning the relation of hormone production with the ageing process stemmed from Charles Edouard Brown-Sequard (1817–1894). At the age of 72 years he experimented on himself with an injection of animal testicular extract.
The Viennese physiologist Eugen Steinach (1861–1944) gained world-wide acknowledgement for his theory of 'autoplastic' treatment of ageing. He deduced that after vasoligation, an increased incretory hormonal production would ensue following the cessation of the secretory output of the gonads. The first operation was performed in 1918 and resulted in a vasectomy boom over the next two decades.
The Russian Serge Voronoff (1866–1951), working in Paris, was one of the first to transplant testicular tissue from a monkey into a human reproductive gland in 1920. Five years later he had already performed this procedure on 300 patients and attracted patients from all over the world.
In America early efforts of human testicular transplantation were performed by Frank Lydston and V.D. Lespinasse. Steinach's vasoligation was taken over by many American doctors, e.g., Harry Benjamin and Charles H. Chetwood. Among the patients who underwent a rejuvenation operation according to Steinach's method were Sigmund Freud (1856–1939) and the Irish poet and Nobel Prize winner William Butler Yeats (1865–1939). Two caricatures from the German magazine Simplicissimus published in 1927, confirm that the rejuvenation operations were constantly in the limelight of the printed media. From 1935 onwards rejuvenation operations gradually lost their appeal due to the introduction of artificial androgens.