肘后切口肱三头肌两侧入路手术治疗肱骨髁上骨折

目的：探讨肘后切口肱三头肌两侧入路手术治疗儿童肱骨髁上骨折的疗效。方法：对46例手法复位失败的肱骨髁上骨折儿童患者均采用肘后切口肱三头肌两侧入路方法手术治疗,术后观察骨折愈合情况和肘关节功能。结果：46例手术均顺利,术后随访1—5a,骨折均愈合。按Cassebatum方法评价肘关节功能,46例患儿中优30例,良13例,可3例。结论：采用肘后切口肱三头肌两侧入路手术治疗儿童肱骨髁上骨折是对传统肱三头肌舌状瓣的改良,术野暴露充分,在基层医院有良好的实用价值。     

改良尺骨鹰嘴劈开、肱三头肌外缘入路，锁定钛板固定肱骨髁间粉碎性骨折

目的介绍改良尺骨鹰嘴劈开、肱三头肌外缘入路、复位、锁定钛板固定肱骨髁间粉碎性骨折。方法于尺骨鹰嘴后方将尺骨鹰嘴V形劈开并向后上翻转,自肱三头肌外缘向内牵开并显露肱骨下端,复位、锁定钛板固定肱骨髁间粉碎性骨折。结果改良尺骨鹰嘴劈开、肱三头肌外缘入路,复位、锁定钛板固定肱骨髁间粉碎性骨折28例,功能恢复良好。结论改良尺骨鹰嘴劈开、肱三头肌腱外缘入路,复位、锁定钛板固定肱骨髁间粉碎性骨折操作简便,疗效满意,并发症少,值得推广。     

肱三头肌-肘肌瓣入路治疗肱骨髁间骨折

目的设计一种肘关节后肱三头肌止点剥离、肘肌瓣入路,探讨其治疗肱骨髁间骨折的临床疗效。方法将肱三头肌止点连同尺骨骨膜从尺骨鹰嘴上自内侧向外侧剥离,保留附着在尺骨外侧肘后肌的止点,将整个肱三头肌-肘肌形成的组织瓣由尺侧向桡侧翻转,术后将肱三头肌在尺骨上的止点原位缝合。2005年11月至2006年6月,采用此入路治疗C型肱骨髁间骨折11例,骨折类型按AO分类C1型骨折3例,C2型3例,C3型5例,先将骨折复位后,分别采用钢板、拉力螺钉、克氏针内固定,采用Jupiter肘关节功能评分。结果该入路可取得良好的肘关节暴露,所有病例经过6至12月的随访,无一例出现切口皮肤坏死、深部感染、肱三头肌萎缩及尺神经损伤,1例出现克氏针松动。肘关节功能评价,优7例,良3例,中1例。结论肱三头肌．肘肌瓣入路是治疗肱骨髁间骨折的理想入路,可取得良好的肘关节和肱骨远端暴露,内固定安放方便,术后可早期功能锻炼。     

小儿肱骨髁上骨折的微创治疗

目的:探讨微创治疗小儿肱骨髁上骨折的临床疗效.方法:采用闭合复位、经皮克氏针内固定术治疗小儿完全移位肱骨髁上骨折44例.结果:44例患者均得到随访,肘关节活动恢复正常,无一例患者发生Volkmann肌挛缩及肘内翻.结论:闭合复位经皮克氏针内固定治疗小儿肱骨髁上骨折,手术简单,损伤小,并发症少,疗效好.     

肱三头肌-肘肌瓣人路治疗肱骨髁间骨折

目的 设计一种肘关节后肱三头肌止点剥离、肘肌瓣入路,探讨其治疗肱骨髁间骨折的临床疗效.方法 将肱三头肌止点连同尺骨骨膜从尺骨鹰嘴上自内侧向外侧剥离,保留附着在尺骨外侧肘后肌的止点,将整个肱三头肌-肘肌形成的组织瓣由尺侧向桡侧翻转,术后将肱三头肌在尺骨上的止七点原位缝合.2005年11月至2006年6月,采用此入路治疗C型肱骨髁间骨折11例,骨折类型按AO分类C1型骨折3例,C2型3例,C3型5例,先将骨折复位后,分别采用钢板、拉力螺钉、克氏针内固定,采用Jupiter肘关节功能评分.结果 该入路可取得良好的肘关节暴露,所有病例经过6至12月的随访,无一例出现切口皮肤坏死、深部感染、肱三头肌萎缩及尺神经损伤,1例出现克氏针松动.肘关节功能评价,优7例,良3例,中1例.结论 肱三头肌-肘肌瓣入路是治疗肱骨髁间骨折的理想入路,可取得良好的肘关节和肱骨远端暴露,内固定安放方便,术后可早期功能锻炼.     

可吸收棒治疗儿童肱骨髁上骨折35例报告

目的探讨可吸收棒内固定治疗儿童肱骨髁上骨折的手术方法及疗效。方法采用直径为1.5mm或2mm的超高分子聚-DL-乳酸(PDLLA)可吸收棒治疗儿童肱骨髁上骨折35例。经肘后正中"S"形切口,游离并保护好尺神经,肱三头肌舌形切开,显露骨折端。切开复位后2~3枚可吸收棒交叉固定,术中C臂X线机透视,并检查稳定性是否良好,术后行长臂石膏托外固定3周,3周后拆石膏进行肘关节屈伸功能锻炼,每1~2周复查X线片,观察骨折对位及愈合情况。结果本组35例得到全部随访,术后平均随访15个月(4~28个月),术后X线片示无骨折再移位,骨折全部愈合,无伤口感染,无骨化性肌炎及继发性尺神经损伤,发生肘内翻畸形1例;按Flynn肘关节评定标准,本组优27例、良6例、可2例,优良率为94.3%。结论 PDLLA可吸收棒内固定治疗儿童肱骨髁上骨折,固定牢靠,效果理想,不影响骨骺发育,避免了再次手术取内固定。     

儿童肱骨髁上屈曲型骨折的治疗

目的 探讨儿童肱骨髁上屈曲型骨折的治疗及效果评估。方法对14例儿童肱骨髁上屈曲型骨折,依据Gartland系统按骨折严重程度分类。Ⅰ型骨折行伸直型管型石膏固定;Ⅱ、Ⅲ型骨折行闭合复位经皮穿刺克氏针内固定术,如果经皮穿刺失败,则改行切开复位内固定术。结果1年后病人随访（时间14～36个月）。治疗效果,优7例,良4例,可3例,差0例;全部病人对恢复效果满意,无1例出现功能障碍。结论闭合复位和经皮穿刺内固定可以成功应用于Ⅱ型Ⅲ型肱骨髁上骨折。     

不切断肱三头肌入路治疗肱骨髁骨折

目的 为肱骨髁间骨折切开复位手术入路增加一种新术式。方法 对青壮年有移位新鲜肱骨髁间骨折采用肘后“Ｓ”形切口入路，不作传统的肱三头肌倒Ｖ字形切断，而是把与肱骨内、外髁骨折片相连的屈或伸肌健周组织适当松解，把骨折块连同肌附着一同拿出手术野，直视下复位固定。结果 自１９８１年至今收治１２例，经过平均６年零四个月随访，按北京积水潭医院门振武医师所定标准，优良率达１００％。结论 本法具有复位满意，固定牢靠     

支具固定下早期功能锻炼及中药熏洗治疗儿童伸直型肱骨髁上骨折的临床观察

目的 观察支具固定下早期功能锻炼及中药熏洗治疗儿童伸直型肱骨髁上骨折的临床效果与安全性.方法 对2008年8月~2010年8月在我院收治的儿童伸直型肱骨髁上骨折62例,随机分观察组和对照组,每组31例,对照组采用闭合复位克氏针内固定治疗,观察组采用手法复位支具外固定配合早期功能锻炼及中药熏洗,对2组的骨折再移位情况、骨折愈合时间、肘关节功能恢复情况及随访1年后肘内翻情况等方面进行比较.结果 观察组骨折再移位、肘内翻的发生率分别为16.1%、9.7%与对照组的12.9%、6.6%比较无明显差异,P>0.05;观察组临床愈合时间、肘关节功能恢复优良率分别6.3±0.9周、83.9%与对照组的7.2±1.1周、71.0%比较有显著性差异,P<0.05.结论 支具固定下早期功能锻炼及中药熏洗治疗儿童伸直型肱骨髁上骨折具有固定牢固,早期能进行功能锻炼及中药熏洗,安全系数大,可显著缩短骨折愈合时间,关节功能恢复好,骨折再移位、肘内翻的发生率低等优点,是该类骨折有效的治疗方式.     

闭合复位交叉克氏针治疗Garland III型儿童肱骨髁上骨折

目的:探讨闭合复位交叉克氏针固定治疗Garland III型儿童肱骨髁上骨折的疗效.方法:2002年5月～2009年8月,采用X线透视下闭合复位经皮交叉克氏针固定治疗Garland III型儿童肱骨髁上骨折56例,其中伸直型51例(尺偏型23例,桡偏型28例),屈曲型5例.按Flynn疗效评定标准评价其疗效.结果:56例患儿,55获随访,随访时间6个月～3 a,平均1.5 a.55例均骨折愈合,其中1例术后伤肢再次外伤,虽骨折愈合,但肘关节受限15°,不能完全伸直.无一例发生Valkmann肌缺血.疗效优35例,良11例,可7例,差2例,优良率83.64%.结论:闭合复位交叉克氏针固定治疗Garland III型儿童肱骨髁上骨折,能有效防止闭合复位外固定后骨折再移位,减少肘内翻畸形的发生.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

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.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

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.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'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.