INTRAVENOUS PULSE METHYL PREDNISOLONE IN THE SUCCESSFUL TREATMENT OF SEVERE SARCOID POLYNEUROPATHY WITH PULMONARY INVOLVEMENT

Abstract: :Severe widespread sarcoid polyneuropathy with associated pulmonary involvement was treated successfully in a 26 year old man using 'pulse' methyl prednisolone. After he had failed to respond clinically to a two months course of high-dose oral prednisolone, a regimen of intravenous methyl prednisolone 1 g once a week for eight weeks was instituted, along with 10 mg prednisolone orally daily. Neurological improvement began after the third dose with complete remission achieved after the eighth week. More than 12 months after cessation of treatment he remains in good health with no clinical or laboratory evidence of sarcoidosis.     

右室双出口伴左位型大血管错位、肺动脉狭窄和主动脉瓣下室间隔缺损的修复

本文报告1例右室双出口伴左位型大血管错位、肺动脉狭窄和主动脉瓣下室间隔缺损、房间隔缺损患儿,成功地利用心内隧道、心外通道进行了纠治手术。作者结合文献,讨论这类可纠治的少见病变的病理解剖、诊断、手术和术后结果等问题。     

SUBACUTE HEART RUPTURE AND HEMOPERICARDIUM FOLLOWING ACUTE MYOCARDIAL INFARCTION: REPORT OF SUCCESSFUL TREATMENT AND TEN YEAR FOLLOW-UP

Hemopericardium complicating acute myocardial infarction generally has a poor prognosis. Two cases of this complication, one due to subacute rupture of the free left ventricular wall, are reported. Both patients are still alive and well ten years after urgent surgical intervention. Good long-term results are possible in this condition if diagnosis and surgical intervention are not delayed.     

HYPOTHALAMIC-PITUITARY FUNCTION FOLLOWING SUCCESSFUL TREATMENT OF INTRACRANIAL TUMOURS

Hypothalamic-pituitary function was examined in seventeen patients treated in the past for extrasellar intracranial tumours. All patients had received a course of external cranial irradiation. Biochemical abnormalities of endocrine function were present in almost all of the patients. In particular, the growth hormone response to insulin induced hypoglycaemic stress was impaired in eleven out of fifteen patients. Preliminary data from a group of seven patients with intracranial tumours prior to radiotherapy are also presented. The possibility that cranial irradiation causes hypothalamic-pituitary dysfunction is discussed. The results suggest that endocrine assessment should be considered in patients who have been treated for intracranial tumours, even in the absence of direct pituitary involvement.     

肺螨症的临床观察及其治疗的研究

调查与粮食和中药材密切接触者363人,其中65例肺螨症患者痰螨检查阳性。具有咳嗽、痰多、痰中带血、胸闷、胸痛、气急、乏力、低热等临床症状。胸片示肺门特征性结节状阴影。患者血清特异性抗体阳性,嗜酸粒细胞增高。所有患者均采用甲硝达唑治疗3个疗程,治疗量为0.2g每日3次,或0.4g每日2次,疗程7d,每疗程间隔7～10d,治后痰螨阴转率达94.4％,多数患者临床症状的X线胸片有明显改善,嗜酸粒细胞降至正常范围,提示对肺螨症有明显的疗效。     

SUCCESSFUL TREATMENT OF ACUTE DAPSONE INTOXICATION USING CHARCOAL HEMOPERFUSION

Abstract: A 22 year old female was admitted to hospital two hours after ingesting 4 g of dapsone. Over the next 15 h she developed progressive hemolysis and methemoglobinemia. Charcoal hemoper-fusion and sequential dialysis were performed because of the serious risk of fatality following such a massive dose of dapsone. Charcoal hemoperfusion led to rapid clearing of dapsone from the circulation. This resulted in clinical improvement and controlled the progression of hemolysis and methemoglobinemia.     

SUCCESSFUL TREATMENT OF RAYNAUD'S SYNDROME WITH ILOPROST, A CHEMICALLY STABLE PROSTACYCLIN ANALOGUE

Twelve female patients with severe secondary Raynaud's phenomenonwere treated in a randomized order with both placebo and Iloprostinfusions. Infusions were for 5 hours on 3 consecutive daysand lloprost was administered at variable dosage from 1.0 to3.0 ng/kg/min. A 6-week follow-up period was used between thetwo sets of infusions. A significant number of patients reportedlloprost had improved Raynaud's symptomatology compared withplacebo and this effect lasted for up to 6 weeks. The numberof attacks of Raynaud's as recorded by patients in diary bookswas similarly reduced after lloprost. Digital and nail-bed bloodflows measured by laser-Doppler methods were increased for upto 6 weeks after lloprost, but not after placebo infusions.lloprost may be a useful therapeutic agent in the treatmentof severe secondary Raynaud's syndrome. KEY WORDS: Scleroderma, Raynaud's phenomenon, Vasodilation     

完全性肺静脉异位引流的外科治疗

１９８０年至１９９２年期间，手术矫治完全性肺静脉异位引流５例（男２例，女３例），年龄５～１３岁。其中心上型４例（Ⅰａ型２例、Ⅰｂ型２例），心内型１例。术后全部成活。本文重点讨论右侧径路进行左房和肺静脉总干吻合法和Ⅱｂ型的手术方法。     

SUCCESSFUL TREATMENT OF ACUTE PROMYELOCYTIC LEUKAEMIA WITH ALL-TRANS-RETINOIC-ACID DURING LATE PREGNANCY

We describe a patient with acute promyelocytic leukaemia (PML) diagnosed in the third trimester of pregnancy who presented with coagulopathy and prolonged bleeding time. Treatment with all-trans-retinoic-acid (ATRA) resulted in rapid normalization of the coagulopathy and complete remission of PML within 2 weeks. Induced labour resulted in an uneventful vaginal delivery without major blood loss with no signs of neonatal ATRA-induced embryopathy. ATRA therapy for PML during late pregnancy was effective in reversing the maternal bleeding tendency and inducing a complete remission of the PML without evidence of teratogenicity. Careful monitoring of bleeding time is important, even after normalization of clotting parameters and thrombocyte count, for determining the moment of induction of labour.