915MHz与2450MHz微波在活体与离体猪肝实验中温度曲线与消融范围的比较

目的比较水冷915MHz和2450MHz微波在活体与离体猪肝实验中温度曲线和消融区的差异。方法使用915和2450MHz微波消融和热监测系统,共获得58个消融区和180个温度数据。输出设置为915MHz50W,70W和2450MHz50W,70W,并设置时间为600S。每个温度点的温度曲线在天线旁开5、10、15mm处,对消融区的宽径和长径进行测量。结果在活体与离体实验中,除旁开5mm,915MHz水冷微波其余点的峰值温度[活体50w10mm：（59＋4．26）℃;70W10mm：（67±9．01）℃]均高于2450MHz微波[活体50w10mm：（54±4．09）℃;70w10mm：（57±6．13）℃]（P〈0．05）。在相同条件下,离体肝脏的消融区宽径和长径[活体50w宽径：（3．13±0．76）cm;长径（4．95±0．87）cm]均显着大于2450MHz微波[活体50w宽径：（2．34±0．49）cm;长径（3．43±0．96）cm]（P〈0．05）。结论在离体和活体的肝脏实验中,915MHz水冷微波比2450MHz可以形成更大的消融区和达到更高的温度。     

几种常见物理消融方法的动物实验研究

目的探讨射频、微波、高频介导的热治疗(HITT)、激光等4种消融方法固化的凝固范围。方法对离体猪肝在不同条件下应用4种消融方法进行固化,观察并记录剖面状况和凝固范围。将12只猪分成4组,亦采用4种消融方法,使用离体实验所用的相同条件固化在体猪肝,观察并记录剖面状况及凝固范围。结果在体猪肝实验中射频组,电极针开放至3cm及5cm,消融时间分别为5.5、10min时,凝固范围分别是2.12cm×1.83 cm×2.07cm、2.59cm×2.19cm×2.19cm及4.57 cm×2.58cm×2.61 cm及4.64cm×2.70cm×2.76cm。微波组,微波功率为80 W,消融时间分别是3、5、6、10 min时,凝固范围分别是2.53 cm×1.84 cm×1.23 cm、2.74cm×2.08cm×1.62cm、2.85cm×2.09cm×1.59cm及3.38cm×3.34cm×1.77cm。HITT组,消融时间分别是5及10min,消融温度为85℃时凝固范围分别是2.53 cm×1.70cm×0.90cm及3.03cm×2.07cm×1.53cm。激光组,采用单针凝固及4针耦合凝固,凝固范围在功率为2.0、2.5、10,0、12.0 W时分别是0.95cm×1.05cm×0.85cm,1.05cm×1.10cm×0.90cm及2.45cm×1.45cm×1.95cm,2.55cm×1.55cm×2.05cm。离体猪肝实验中,4种方法的凝固范围均比相对应条件下在体猪肝的凝固范围有不同程度的增大。结论通过对离体与在体猪肝的4种物理消融方法的实验研究,表明射频、微波及HITT凝固范围较大,其中射频消融效果更稳定,激光消融凝固范围较小,为临床治疗时物理消融方法的选择提供了技术参数。     

几种常见物理消融方法的动物实验研究

目的 探讨射频、微波、高频介导的热治疗(HITT)、激光等4种消融方法固化的凝固范围.方法 对离体猪肝在不同条件下应用4种消融方法进行固化,观察并记录剖面状况和凝固范围.将12只猪分成4组,亦采用4种消融方法,使用离体实验所用的相同条件固化在体猪肝,观察并记录剖面状况及凝固范围.结果 在体猪肝实验中射频组,电极针开放至3cm及5cm,消融时间分别为5.5、10 min时,凝固范围分别是2.12 cm×1.83 cm×2.07 cm、2.59 cm×2.19 cm×2.19 cm及4.57 cm×2.58 cm×2.61 cm及4.64 cm×2.70 cm×2.76 cm.微波组,微波功率为80W,消融时间分别是3、5、6、10 min时,凝固范围分别是2.53 cm×1.84 cm ×1.23 cm、2.74 cm×2.08 cm×1.62 cm、2.85 cm×2.09 cm×1.59 cm及3.38 cm×3.34 cm×1.77 cm.HITT组,消融时间分别是5及10 min,消融温度为85℃时凝固范围分别是2.53 cm×1.70 cm×0.90 cm及3.03 cm×2.07 cm×1.53 cm.激光组,采用单针凝固及4针耦合凝固,凝固范围在功率为2.0、2.5、10,0、12.0 W时分别是0.95 cm×1.05 cm×0.85 cm,1.05 cm×1.10cm×0.90 cm及2.45cm×1.45 cm×1.95 cm,2.55 cm×1.55cm×2.05 cm.离体猪肝实验中,4种方法的凝固范围均比相对应条件下在体猪肝的凝固范围有不同程度的增大.结论 通过对离体与在体猪肝的4种物理消融方法的实验研究,表明射频、微波及HITT凝固范围较大,其中射频消融效果更稳定,激光消融凝固范围较小,为临床治疗时物理消融方法的选择提供了技术参数.     

股骨近端髓腔三维解剖测量

目的测量国人股骨近端髓腔形态,探讨适合国人的股骨近端髓内钉设计方案。方法选取120侧(男性55侧,女性65侧)正常成人单侧股骨近端CT扫描数据,利用Mimics图像分析软件对股骨近端的髓腔内径及髓腔开大指数行三维解剖测量,研究其与身高、年龄之相关性,及性别差异,并与国内外数据进行综合比较。结果以小粗隆中点为参考点(T),男、女性组髓腔内径分别为:T+20(44.79±5.42)mm和(39.79±4.96)mm;T+10(34.00±3.64)mm和(32.06±3.29)mm;T(26.93±3.71)mm和(24.18±3.31)mm;T-20((18.65±2.96)mm和(18.21±2.60)mm;峡部(10.40±1.45)mm和(10.15±1.05)mm。男女组T+20、T+10、T处比较存在显著性差异(P0.001);T-20、峡部处两组间比较无显著性差异(P0.05)。身高与各组间数据存在正相关关系,存在统计学意义(P0.05),与干骺端髓腔开大指数呈负相关,存在统计学意义(P0.05);偏相关分析年龄与髓腔内径参数间存在正相关关系,存在统计学意义(P0.05),而与各组髓腔开大指数间无明显相关性。结论东西方人、男女性之间股骨近端髓腔内径存在显著性差异,在治疗粗隆间骨折时需要充分评估其股骨近端内径,选用合适的内固定器械。     

股骨颈径相参数测量及其在股骨颈置钉选择中的意义

目的了解华中地区成人股骨颈解剖特点以指导临床髋部骨折的治疗。方法测量34具股骨标本、150幅成人正常髋关节计算机断层扫描图像和774幅成人正常骨盆X线图像,获取股骨颈平均最小前后径和最小上下径,结合股骨近端髓内钉和联合交锁加压髓内钉的双螺钉外间距,Gamma钉和股骨近端防旋髓内钉的拉力螺钉直径,初步探讨股骨颈解剖学特点在髋部骨折治疗中的意义。结果股骨标本股骨颈平均最小前后径为(24.08±2.24)mm,平均最小上下径为(30.61±2.77)mm。计算机断层扫描图像股骨颈平均最小前后径为(24.70±2.89)mm,平均最小上下径为(30.56±3.76)mm。X线图像股骨颈平均最小上下径为(35.73±3.98)mm。21位同时行计算机断层扫描与X线照射的成人的计算机断层扫描图像股骨颈平均最小上下径D左=(30.40±3.30)mm,D右=(30.61±3.84)mm;X线图像股骨颈平均最小上下径d左=(36.17±4.93)mm,d右=(36.43±5.12)mm,X线相对计算机断层扫描有放大作用,放大率为19%(0.01)。股骨近端髓内钉的双螺钉外间距为22mm,联合交锁加压髓内钉的双螺钉外间距为15.25mm,Gamma钉和股骨近端防旋髓内钉的拉力螺钉直径为10.5mm。结论对股骨颈直径细小的某些身材矮小的女性股骨转子间骨折患者,建议选择股骨颈单钉置入内固定器材。     

433MHz微波消融天线的设计与实验研究

目的针对915 MHz和2450 MHz微波在肝脏消融中穿透深度低及消融范围受限的问题,提出使用433 MHz微波用于恶性肝肿瘤的消融治疗,通过探索性研究和设计433 MHz频率的微波消融天线,探讨433 MHz微波消融系统对肝组织的消融效果。方法采用缝隙长度分别为18 mm、15 mm和15mm,缝隙间距为10 mm的尺寸设计天线。实时采集消融区域中4个不同旁开距离点的温度,并通过分析有效消融区域的横纵径数据,对所设计的微波天线进行有效评估。结果 433 MHz微波消融天线能形成类葫芦形的消融区域,不仅能有效扩大消融体积,而且能缩短最大横径形成的时间。结论 433 MHz微波消融天线有望应用于恶性肝肿瘤的微波热疗,为研究新频率段的适形微波消融方法提供重要参考。     

注射不同液体对微波消融温度场的离体实验研究

研究不同注射液体、注射量对于微波消融温度场的影响。在加热功率60 W、加热时间10 min的情况下,利用新型注射型微波天线进行消融离体肝脏的实验研究,并且于加热过程中分别注射生理盐水和无水乙醇液体,注射量依次为0、10、20 mL。根据测温针采集的温度数据,利用Matlab计算消融区域的范围(高于60℃区域)。通过对离体肝脏的消融面积、体积、横径和纵径的测量和统计,发现注射两种液体均可有效增大消融范围,与无液体注射相比面积增大率的范围在29.1%~72.0%之间,体积增加率在45.2%~141.8%之间;当注射液体体积由10 mL增加到20 mL时,生理盐水组的面积增加率为8.8%,无水乙醇组的面积增加率为28.8%。因此,联合液体注射可以扩大微波消融范围,并且随着注射体积的增加,消融范围扩大;微波联合无水乙醇的注射效果要略好于生理盐水。     

短波容性加温治疗仪体模内热场分布的研究

目的:研究3MHz短波容性加温治疗时非均匀体模内热场分布之规律。为临床治疗提供定量依据。方法:自制400mm×220mm×220mm肌肉等效均质体模及220mm×220mm×220mm之非均质体模。在体模内有效加温容积内垂直和水平放置100mm×25mm的猪骨各1根;并放置100mm×5.6mm的硅胶导管1根,12mm×0.7mm的订书针1根作为金属材料。用抗干扰热电偶型数字化实时测温仪进行实时动态同步测温。加热仪采用3MHz肿瘤射频热治疗仪。结果:3MHz短波容性(射频)加温治疗之治疗深度可达200mm。其电势分布表现在一是发散得很开。二是有边缘聚集效应。在体模中心水平平面,有效加热范围为60%。非均匀体模内不同介质周围有不同的温升规律。结论:(1)在使用合适的耦合水袋时,中心温度比表面温度晚约4min达到设定温度,而水袋温度平均每4min上升1℃。因此,可通过降低表面水袋1℃的办法使得中心温度与表面温度在控温时保持一致;(2)恒温后10min,金属旁2.5mm处的温度比体模中心的温度可高出约3℃;(3)导管旁和骨旁的温度实际升温与中心升温基本一致。因此,在加热区域有骨或引流管时,射频热疗是安全的;(4)反射波的调节能力对热场分布有决定性作用。     

成人股骨骨髓腔影像解剖学及临床意义

目的 :为研制新型股骨髓内固定器提供解剖学依据。方法 :将 60支成人股骨干燥标本 ,拍摄标准的X线正侧位片 ,观察髓腔的形态 ,测量皮质骨的厚度 ,髓腔的横状径 ,矢状径 ,髓腔的轴线在不同节段与皮质骨内侧缘的切线形成的夹角等。结果 :正位片示髓腔呈“哑铃状” ,自上而下 ,横状径由大 (2 0 .0±0 .3 )mm变小 (11.1± 2 .4)mm ,再由小 (11.1± 2 .4)mm变最大 (3 2 .6± 5 .2 )mm。狭窄段横状径的直方图呈正态分布 ,均数为 (10 .7± 2 .0 )mm。侧位片示髓腔中上段的轴线与中下段的轴线所形成夹角为 (172 .2±2 .2 )° ,其夹角顶端距小转子下缘的实际长度为 (12 .8± 3 .0 )cm。结论 :①髓内钉不适合股骨中下段骨折的髓内固定。②组合式分叉防旋转的髓内钉适合股骨中下段的解剖学特点和力学要求。③顺行击钉 10～ 15cm处时 ,忌用暴力 ,减慢进入速度。     

先天性髋关节发育不良股骨近端髓腔内径曲线形态

目的测量并分析国内先天性髋关节发育不良(developmental dysplasia of the hip,DDH)患者股骨近端形态参数与髓腔内径曲线,为DDH股骨柄设计提供参考依据。方法进行股骨三维重建后,测量并比较分析30名正常人(30髋,男21名,女9名,平均年龄29.4岁)和64名DDH患者(74髋,男12名,女52名,平均年龄45.3岁)股骨近端形态参数和多个高度上髓腔内外径、前后径,建立不同人群的髓腔内径曲线并进行比较分析。结果 DDH患者与正常人群相比,前倾角(26.39°±14.74°vs 15.68°±7.95°)显著较大(P=0.001),颈干角(125.65°±5.73°vs 129.19°±5.80°)、峡部高度[(99.14±14.62) mm vs (110.13±11.73) mm]、髓腔开大指数[(3.63±0.77) vs (4.45±0.79)]、股骨头直径[(44.01±5.75)mm vs (47.26±3.94)mm]和偏心距[(31.80±3.82)mm vs (36.42±4.84)mm]则显著较小(P0.05)。结合测量所得的髓腔前后径、内外径与所拟合的内径曲线,DDH近端髓腔呈现的特点为内外径变狭窄、前后径向前偏移。在不同分型DDH中,股骨的变形程度随着分型增大愈发严重,CroweⅣ型DDH患者与其他分型间的股骨髓腔形态存在较大差异。结论 DDH患者的平均股骨近端曲线与正常人群存在较大差异,且DDH的不同分型间也存在形态差异。研究结果有助于定量了解DDH患者的股骨近端形态特征,为设计适用于DDH患者的新型股骨柄提供参考依据。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.