岩静脉的解剖学特征及临床意义

目的：为临床桥脑小脑角区的手术提供岩静脉的应用解剖学资料。方法：经甲醛固定的成人头部标本２６例,手术显微镜下解剖观察岩静脉形态、行径及其与三叉神经的毗邻关系。结果：①岩静脉有１～３支,长度２．９±２．０ｍｍ,外径２．３±１．０ｍｍ;②岩静脉位于三叉神经根背外方者占９２．５％;岩静脉与神经根的最短距离５．０±３．８ｍｍ,最长距离７．１±４．１ｍｍ;静脉对神经根有压迫的占１５．４％;③岩静脉距横窦与乙状窦交角处的距离为３１．１±５．２ｍｍ。结论：岩静脉与三叉神经根关系密切,可压迫三叉神经根引起三叉神经痛。     

垂体与鞍隔孔的显微解剖及临床意义

目的：为开展经鼻蝶窦垂体瘤切除术及功能性鼻窦内窥镜手术提供垂体窝区的解剖学基础。方法：对５０个头部标本的鞍区正常垂体以及鞍隔孔的显微解剖观测。结果：①正常垂体的形状主要有扁圆形、球形及三角形三种，其前后径为１０．１±１．６ｍｍ，左右径为１４．３±２．０ｍｍ，上下径为６．５±１．４ｍｍ；②鞍隔孔的形状主要有圆形及椭圆形两种，其孔径：圆形直径为７．０±１．９ｍｍ；椭圆形左右径为９．５±１．８ｍｍ，前后径为７．２±１．４ｍｍ。结论：垂体与颈内动脉间的关系及鞍隔孔的大小对临床实际工作具有直接的指导意义。     

登革热患者血液中病毒滴度的动态观察

１９８６年海南岛Ⅱ型登革病毒流行时，对７例患者发病当天至第５天，定时取血观察血液中的病毒滴度变化情况。实验结果表明，病毒血症高峰期是在起病２天内（Ｌｏｇ１０ＴＣＩＤ５０／０．０２５ｍｌ为４．４４～≥８．５０，平均为７．３１）；病毒血症至少维持３天（Ｌｏｇ１０ＴＣＩＤ５０／０．０２５ｍｌ为２．００～８．３３，平均为４．７５）；第４天多数可（５／７）检出病毒（Ｌｏｇ１０ＴＣＩＤ５０／０．０２５ｍｌ为２．００～３．２３，平均为２．５０）；第５天病毒血症全部消失。提示，临床标本的采集时机，以及合理使用蚊帐，防止蚊子叮咬，对病原学诊断和控制登革热具有实际意义。     

硬脑膜静脉池的形态学研究

观察了２５０例成人硬脑膜标本，结果如下：１、硬脑膜静脉池，按其所在部位，分为４类：①下大静脉池；②小脑静脉池；③枕静脉池，④顶静脉池。２．将下矢状窦和大脑大静脉后汇合的膨大处，命名为下大静脉池，其形状多种多样，矢状径平均为１５ｍｍ，垂直径平均为１２ｍｍ，３．下大静脉池，可分为两种类型。Ｉ型为双管型，占８７．６％，ＩＩ型为三管型，占９．６％，此外，下矢状窦中途注入上矢状窦者，占２．８％，４．在下大静     

骨骼常用牵引部位观测与骨牵引锥钉研制及临床应用

目的：为研制和应用骨牵引锥钉，对成人四肢骨常用牵引部位行解剖学观测。方法：随机选择成人四肢骨标本，包括１００根尺骨、股骨、胫骨及１００个跟骨。观测其大体结构，测量其矢状径和额状径为：尺骨鹰嘴冠突部３１．７±２．３ｍｍ和２１．０±２．３ｍｍ，股骨粗隆最凸部３４．５±２．９ｍｍ和５４．４±３．８ｍｍ，股骨髁上２ｃｍ处２０．１±２．５２ｍｍ和４３．０±２．７ｍｍ，胫骨结节最凸处４１．４±３．５ｍｍ和３５．９±３．６ｍｍ，跟骨距下、后缘各２ｃｍ处额状径２６．２±２．３ｍｍ。结果：研制出长６２ｍｍ、５２ｍｍ和４２ｍｍ三种规格的骨牵引锥钉。临床应用证明其简单易行，效果可靠，未出现神经血管损伤及骨被拉豁等并发症。结论：研制及应用骨牵引锥钉，观测成人四肢骨常用骨牵引部位的解剖是必要的     

趾主要血管神经断层的解剖观察

目的：为拇指再造提供解剖学依据。方法：用３０例（男１９,女１１）成人趾作组织切片,取近、远侧横纹及二者中点处的横断层切片,对趾跖固有动脉和神经的位置、管径进行观测。结果：趾跖腓侧固有动脉和神经,Ｉ断层腓侧动脉 ３、４区出现率为 ９２．３１±４．９５％,Ⅱ、Ⅲ断层位于 ４、５区内者占 ８６．５４±6．３４％。Ⅰ、Ⅱ、Ⅲ断层腓侧神经 ４、５区出现率为 ９７．４５±２． ８８％,它们纵径平均值分别大于 １．０８ ｍｍ和 １． ６３ ｍｍ。趾跖胫侧固有动脉和神经在 ８、９区内者均高于 ９２％以上,其纵径平均值分别大于 ０． ６８ ｍｍ和 １． ６７ ｍｍ。结论：排侧动脉截面积均大于胫侧,腓侧可被视为优势动脉。神经与同名动脉基本位于同一区内。     

慢性皮肤癣菌病患者外周血T淋巴细胞亚群的研究

为了解慢性皮肤癣菌病患者细胞免疫功能的异常，我们对３０例慢性皮肤癣菌病患者进行了外周血Ｔ淋巴细胞及其亚群的测定。慢性皮肤癣菌病患者３０例，年龄２６－７３岁，病期４月～２０年，其中体／股癣患者１５例，手／足癣患者１５例。皮损真菌学检查均为阳性。受试者近半年均未服用过激素及免疫抑制剂，末发现其它与免疫有关的疾病。慢性皮肤癣菌病组ＣＤ３、ＣＤ４、ＣＤ８．ＣＤ４／ＣＤ８值分别为：５５．３±８，３１；３１．９７±７．０１；２３．８３±５．２１；１．３６±０．３５。正常对照组分别为５２．１±９．５；４０．５…     

手术中对喉返神经定位的应用解剖

目的：为甲状腺手术中对喉返神经的定位和保护提供解剖学基础。方法：在５０具（１００侧）成人标本上，对术中喉返神经易损伤部位进行定位观测。结果：①甲状腺下极区，喉返神经位于气管食管沟内，在气管与颈总动脉之间的浅面平面深度，左侧为１０．４±２．０ｎ１ｍ，右侧为１２．０±２．０ｍｍ；②环甲关节区，喉返神经入喉处距甲壮软骨下角尖为８．２±６ｍｍ，距喉结突出点水平相交点为３３．３±４．３ｍｍ；③腺体侧叶后侧区，９５％的喉返神经在甲状腺外侧韧带后方经过，５％穿甲状腺外侧韧带；④甲状腺下动脉弓形弯曲恒定存在，其最高点至神经与该动脉交叉点的距离为１４．６±４．４ｍｍ。结论：上述喉返神经定位观测结果，是术中防止神经损伤的应用解剖学基础。     

鼻内窥镜下泪囊鼻腔造口术的应用解剖

目的：为鼻内窥镜下泪囊鼻腔造口术提供解剖学基础。方法：在３０侧成人头部正中矢状剖面标本上，观测了泪囊的形态、毗邻、在鼻腔外侧壁上的投影及泪囊窝内侧壁骨质厚度。以鼻小柱基部为基准，鼻腔底为平面，对泪囊进行了定位。结果：泪囊的长度为１３．３±２．２ｍｍ，内侧壁宽为６．０±１．１ｍｍ，横径为４．９±０．９ｍｍ，容积为０．３３±０．０７ｍｌ。从鼻小柱基部至泪囊下部和顶部的距离分别为３２．８±３．７ｍｍ和４３．４±４．３ｍｍ，两者与鼻腔底的夹角分别为４７．５°±３．６°和６５．６°±５．１°。结论：提出了泪囊鼻腔造口术时内窥镜进入深度和角度的安全范围，造口位置的选择及手术并发症的预防     

成人左肺下叶支气管CT显示的应用解剖

目的：为左肺下叶支气管的ＣＴ显示提供应用解剖学基础。方法：用３０具成人标本的支气管树及其中的１３例ＣＴ影像进行观测。结果：叶支气管内径５．０±０．６ｍｍ。段支气管内径２．４～３．１ｍｍ。Ｂ６、Ｂ７、Ｂ８、Ｂ９和Ｂ１０的夹角分别为８６．４°±５．４°、１８．１°±１．３°、１９．０°±２．２°、１７．０°±３．１°和２１．５°±３．１°。结论：本研究可为左肺下叶支气管的ＣＴ诊断增加一个以数据为依据确定管腔狭窄或管壁增厚的方法，并可为调整段支气管与ＣＴ层面间的夹角以提高其ＣＴ显示率提供倾斜角度     

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 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.     

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.     

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.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

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.