[CT diagnosis of primary cerebral lymphoma--report of 2 cases]

CT findings of 2 patients with primary cerebral lymphoma were presented with a literature review of the CT manifestations of primary cerebral lymphoma. On the plain CT scan, most of lymphomas were either hyper- or isodense, well demarcated, and had variable surrounding edema. The tumors were mostly situated in the deep structures of brain: the basal ganglia, corpus callosum, periventricular white matter and vermis of cerebellum. On the postcontrast CT scan, cerebral lymphomas showed a homogeneous contrast enhancement. Ring enhancement, occasionally gyral enhancement also may be seen. On the CT scan, primary cerebral lymphomas were usually misdiagnosed as glioma, meningioma, metastases and abscess. The difference between lymphoma and the above lesions was discussed.

[The causes responsible for recurrence of pituitary adenomas and an evaluation of reoperation effects]

Four hundred and twenty one cases of transfrontal removal of pituitary adenomas were presented. Of these 23 had recurrence of tumor which was confirmed by reoperation and histopathological examination. The rate of recurrence decreased while the patients' age increased. Incomplete removal of the tumor tissue was one of the most important causes of recurrence. Invasiveness was another important cause. Most of the tumors in this series were large and had pathologically proven invasiveness. At the reoperations, there were evidences of worse invasiveness, especially the infiltration of adenomas into the capsules and adjacent structures. There was a case of Nelson's syndrome, suggesting the endocrine causes of recurrence. Apparent adhesion and topographic disorders were found during reoperation, improvement of visual impairment decreased obviously, and the mortality rate increased; therefore, the reoperations should be decided with great deliberation.

[Computed tomography in the diagnosis of intracranial trigeminal neuroma]

CT scans of 12 cases of intracranial trigeminal neuroma were presented. Three of the neuromas were located in petrous apex-middle cranial fossa, two in posterior cranial fossa, and 7 in both the middle and posterior cranial fossae. The tumors appeared hypo- and isodense on the plain CT scan. After contrast infusion, all tumors were well circumscribed with marked enhancement, which was homogeneous, inhomogeneous or circular. None of the trigeminal neuroma had surrounding brain edema. Of 12 cases, 10 showed change of cranial bones, which included dilatation of Meckle's cave and destructions of petrous apex, clivus and the bottom of middle cranial fossa. The tumor in one case extended to paranasopharyngeal space from the bottom of middle cranial fossa, Various features of trigeminal neuroma on CT were reviewed. Also presented were the author's experiences in differentiating intracranial trigeminal neuroma from meningiom, from pituitary adenoma spreading to parasella and glioma adjacent to cranial bottom in middle cranial fossa, and from acoustic neuroma, meningioma, cholesteatoma in cerebellopontine angle.

[Diagnosis value of lateral pharyngeal roentgenography in snoring disease]

In this paper, X-ray findings of the lateral pharynx before uvulopalatopharyngoplasty in 14 cases of snoring disease were studied. The results are as follows. There is less than 5 mm in anterior-posterior airway of pharyngeal cavity (13 cases), and 8 mm (1 case), in diameter. Minimum 2 mm, average 4.4 mm. There is less than 25 mm length of uvula (7 cases), 28-35 mm (7 cases). Minimum 22 mm, average length is 27.9 mm. Shape of uvula is thick and long (12 cases), thick and short 1 case, thin and long 1 case. The etiology, abnormal X-ray finding and X-ray examination of the lateral pharynx, etc. in snoring disease have been discussed.

[Effects of ipratropium bromide (IPB) and its combination with salbutamol sulfate (SAS) in acute asthmatic attack]

34 patients with acute asthmatic attack were studied in double-blind, randomized and crossover manner. Each of them was treated with following two protocols during two sequential days: 0.5 mg of ipratropium bromide (IPB), followed by 5 mg of salbutamol sulfate (SAS) 75 minutes later; or 5 mg of SAS, followed by another dose 35 minutes late. The drugs were delivered via a jet nebulizer. The effects and side-effects of the treatment were evaluated immediately before the first inhalation and at peak of bronchodilatation (60-75 minutes after IPB or 20-35 minutes after SAS). Compared with inhaled SAS, IPB produced considerable improvement in central airway parameters such as forced expiratory volume in one second (FEV1) peak expiratory flow (PEF) and respiratory resistance (Rrs) (P greater than 0.05), but less improvement in peripheral airway parameters such as forced vital capacity (FVC) and maximal mid-expiratory flow (MMEF) (P less than 0.01). The sequential inhaled SAS after IPB improved all five parameters (P less than 0.01), but the repeated dose of SAS increased only MMEF (P less than 0.01). Compared with double-dose SAS, the sequential treatment with IPB and SAS 1 ed to considerable improvement in FVC and MMEF (P greater than 0.05), but greater improvement in FEV1, PEF and Rrs (P less than 0.01). Heart (rate and tremor scores after two doses of SAS increased significantly (P less than 0.01). It is concluded that IPB alone is less effective than beta-adrenoceptor agonist, but its combination with SAS would be an effective and safe treatment in acute asthmatic attack.

[Pneumococcal pneumonia: a report of 100 cases]

This paper reports 100 cases of etiologically proved pneumococcal pneumonia. It is shown that Gram's stain smear and culture of sputum are still useful in the diagnosis of the disease but are easily influenced by antibiotics. Whereas coagglutination, a newly developed procedure in detecting pneumococcal capsular antigens, is relatively independent to antibiotic therapy. Moreover, it is rapid, convenient and sensitive. Both Gram's stain smear and coagglutination may confirm early diagnosis and are valuable in the initial treatment of the disease. If unhospitalized patients with acute pneumonia are checked routinely with these methods and samples are collected before administration of antibiotics, etiological diagnosis of pneumococcal pneumonia will be confirmed in more cases. The data from 100 cases of pneumococcal pneumonia demonstrates that pneumococcal pneumonia remains the most common type of community-acquired pneumonias in this country. Its clinical manifestations have not changed greatly since 1950s but the age of the afflicted tents to be greater especially in those with underlying diseases. There are two common types of roentgenographic manifestations, i.e., lobar consolidation and bronchopneumonia, the former is still overwhelming in those under sixty and the later is more frequently seen in those over sixty. Penicillin G showed good clinical effects in treating pneumococcal pneumonia and all the 57 strains tested were sensitive in vitro. Therefore, penicillin G is still the drug of first choice in treating pneumococcal pneumonia.