Disseminated neonatal herpes simplex virus infection with necrotizing encephalitis--an autopsy case

An autopsy case of disseminated HSV type 2 infection occurring in a neonate at 32 weeks' gestation, delivered by cesarean section after premature rupture of membrane of 7 days duration, is presented. Herpes simplex virus type 2 was isolated from the vesicular skin lesion. The mother and patient had specific antibody to type 2 herpes simplex virus. Patient's parents had denied any herpetic orolabial or genital lesion during or before this pregnancy. Cultures from the cervical and vaginal swabs of the mother were negative for HSV. Postmortem examination showed hepatic necrosis, skin vesicle, devastating necrotizing inflammation of the brain, chorioretinitis and interstitial pneumonitis.     

A statewide preventive health care program for the aged

Because of the rising percentage of elderly in the population and the cost of health care expenditures, interest has increased in preventive health care services for the aging. Although the effectiveness of such programs is still being discussed by policy makers, the number of preventive health programs for the elderly is increasing. One of the oldest and largest preventive health programs for the elderly in the United States, the California Preventive Health Care for the Aging Program (PHCAP) is analyzed. The typical PHCAP participant was white, female, between 70 and 79 years of age, and living in an urban area. More than half (59 percent) of the PHCAP participants had some kind of private medical insurance in addition to Medicare coverage. Seventy-seven percent of the participants had seen a physician within the previous year. The most frequently reported chronic conditions were arthritis (31 percent), hypertension (24 percent), cardiovascular problems (13 percent), and vision and hearing problems (18 and 11 percent). Twenty-seven percent of the population were hypertensive; 7 percent of these had moderate to severe hypertension. Eighty percent of the participants were identified as having at least one problem; 40 percent were referred to a physician. Frequently, public health programs need to be evaluated without the benefit of a controlled trial design. This analysis of a statewide preventive health care program for the aging, PHCAP, shows the program's effectiveness in detecting a large number of health problems and making extensive referrals to other health professionals, particularly physicians. These findings should be useful to health practitioners and policy makers developing similar statewide programs for the elderly.     

Partial mastectomy with axillary lymph node dissection and radiotherapy as a new treatment modality of breast cancer (I).

This is the first preliminary report among two consecutive papers. Partial mastectomy(PM), axillary lymph node dissection(AD) and radiotherapy (RT) were performed on seventeen operable breast cancer patients who had been admitted from April 1991 to March 1992 to the department of surgery, Yongdong Severance Hospital for improved cosmetic appearance and better survival rate. Of seventeen patients, 47% were T1 lesion and 76% were stage I and II. Extensive intraductal component(EIC) within or around the tumor was also analyzed. Twenty nine per cent of the patients were EIC positive. The mean number of axillary lymph nodes was 21.5 after PM with AD and 20.5 after mastectomy. For radiotherapy, 4,500 rad was delivered to the breast parenchyma and 1,600 rad of boost to the primary tumor site using the electron beam method after surgery. All patients have since been living well without any local recurrence and were satisfied with breast preservation for the one-year follow-up period. We concluded that the PM, AD and RT can be another surgical treatment modality of breast cancer. A longer follow-up data will be followed on the second paper.     

竹黄颗粒剂Ⅱ号对应激小鼠皮肤肥大细胞影响的实验研究

目的：阐明竹黄颗粒剂Ⅱ号治疗现的作用机制。方法：应用形态学方法观察竹黄Ⅱ号对应激小鼠皮肤肥大细胞的影响。结果：束缚应激诱导小鼠皮肤肥大细胞脱颗粒，竹黄Ⅱ号抑制了此效应。结论：提示竹黄颗粒剂Ⅱ号可抑制心理应激诱导的皮肤肥大细胞脱颗粒，可能是其治疗银屑病的疗效机制之一。     

益肾通淋汤对尿石病人尿中草酸钙结晶的影响

本文就益肾通淋汤对尿结石病人尿中的草酸钙结晶的影响进行了随机对照观察。结果:实验组尿中出现草酸钙结晶、大晶体、结晶聚体的例数比对照组少(P<0.01)。提示益肾通淋汤有抑制尿石病人尿中草酸钙结晶的析出、增大和聚集的作用,以及可能有预防尿结石的形成和复发的作用。     

Pancreatoblastoma--histopathological and ultrastructural analysis of two cases.

Pancreatoblastoma has been described in children and characterized by unique histologic features and excellent clinical course. Ultrastructural and immunohistochemical studies of pancreatoblastoma reveal either exocrine alone or both endocrine and exocrine differentiation. We present two cases of pancreatoblastoma in children in which immunohistochemical and ultrastructural examination failed to demonstrate features of either enzyme or hormone production and which became worse in clinical course. We assume that pancreatoblastomas are tumors which differentiate more toward acinar or ductal elements than toward islet cell.     

Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism.

BACKGROUND: This study investigated the utility of the alveolar - arterial oxygen pressure difference (AaDO (2)) in predicting the short-term prognosis of acute pulmonary embolism (PE). METHODS AND RESULTS: This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation - perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO(2) cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO(2) between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO(2) had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO(2) was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO(2) was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. CONCLUSION: The AaDO(2) measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO(2) >or=53 mmHg).     

益肾通淋汤防治草酸钙肾结石的实验研究

本文观察了益肾通淋汤对大鼠实验性草酸钙结石的防治实验。结果表明,实验组在草酸钙晶体数和聚体数、肾小管扩张数,肾钙含量等方面均少于对照组(P<0.05或P<0.01);同时观察了实验大鼠肾脏的一般组织学改变,可见对照组肾小管上皮细胞浊肿变性,甚至细胞崩解、细胞碎片,胞核和刷状堟PAS阳性物质脱落于管腔内,有的与结石晶体粘附,肾小管明显扩张,而实验组未见明显的组织学损害。因而认为益肾通淋汤可能是通过抑制草酸钙结晶的析出和聚集,改善肾组织细胞的代谢和功能,减少细胞器脱落成为结石核心和基质物质以及加速尿液排泄,促进微结石排出的途径而起到防治尿结石作用的。     

Motor neuron disease and optic neuropathy after acute exposure to a methanol-containing solvent mixture.

A 34-years-old floor-layer developed optic neuropathy and motor neuron disease after being accidentally exposed to a solvent mixture containing methanol and other substances. Optic neuropathy is a complication of methanol poisoning, but the onset of a motor neuron disorder resembling amyotrophic lateral sclerosis after the exposure to these substances has not been previously described. The temporal onset of the clinical symptoms, biological plausibility, young age of the patient and absence of neurological disorders in the family history raises suspicion of a possible causative relationship.