阴茎皮肤和包皮动脉的应用解剖

目的：为带蒂阴茎皮瓣修复尿道下裂提供解剖学基础。方法：对３０例成年男性阴茎的动脉分布进行解剖观察。结果：阴茎背浅动脉的一级分支集中在阴茎的近、中１／３段内，其再分支呈扇形分布于阴茎皮肤和包皮。阴茎背浅动脉的分支首先进入包皮外板，经包皮内外板交界处，返折进入内板。阴茎背浅动脉有三种配布类型：①单支分布型（３０％）；②对称分布型（４０％）；③非对称分布型（３０％）。阴茎背动脉在距阴茎冠状沟０．５～１．５ｃｍ范围内发出穿支至包皮内板。结论：用阴茎远侧皮肤和包皮作纵行带蒂岛状皮瓣具有可行性。     

毫米波辐照对小鼠EMT6乳腺癌细胞增殖活性的影响

作者用频率３６．１１ＧＨｚ，功率密度分别为１，３，５，７ｍＷ／ｃｍ＾２的毫米波辐照培养的小鼠ＥＭＴ６乳腺癌细胞，观察对其增生活性的影响。结果发现，５或７ｍＷ／ｃｍ＾２功率密度照射１５ｍｉｎ后，细胞增殖数目少于对照组，照射３０ｍｉｎ后，细胞的克隆形成数目少于对照组及１，３ｍＷ／ｃｍ＾２照射组。７ｍＷ／ｃｍ＾２照射后２４ｈ时，细胞的ＡｇＮＯＲ颗粒数虽多于对照组和其他照射组，但颗粒体积缩小。照射组细胞超     

阴茎龟头恶性淋巴瘤一例

阴茎龟头恶性淋巴瘤一例王淑华，周小鸽患者男，３５岁。４个月前因发现阴茎龟头２个黄豆大赘生物前来我院就诊，经抗炎处理无效，肿块迅速增大并溃烂、流脓。近一周来有畏塞发热不适，于１９９０年８月１日以阴茎癌收入院。查体：阴茎龟头肿块７ｃｍ×６ｃｍ×５ｃｍ，灰...     

膀胱直肠间隙异位前列腺伴部分上皮重度不典型增生一例

患者男 ,13岁。因Ｂ超发现一直径约 7ｃｍ的盆腔肿瘤 ,伴阴囊、阴茎、双下肢及右上肢淋巴管瘤和慢性淋巴性水肿复发于 1999年 2月 1日入院。体检 :阴囊高度肿胀 ,12ｃｍ×12ｃｍ× 10ｃｍ ,局部皮肤呈象皮样变。双下肢、右前臂和阴茎上可见多数边界清楚的淋巴管血管瘤。直肠指诊可触及一直肠前壁肿物 ,无痛。ＣＴ示 :肿物位于膀胱直肠间隙 ,7.0ｃｍ× 6 .3ｃｍ ,边界清 ,软组织密度不均匀 ,前面边缘直下有两处囊性变 (图 1) ;可见前列腺位置正常 ,距肿物 2 .1ｃｍ。患儿曾患下腹部、右大腿、阴囊、阴茎包皮先天性局限性淋巴管瘤伴慢性淋巴性…     

阴茎恶性黑色素瘤1例

患者男 ,85岁。因“阴茎癌术后 2年复发”入院。体检 :一般情况尚可。阴茎腹侧见一 4ｃｍ× 3ｃｍ× 3ｃｍ大小肿块 ,灰褐色 ,质硬 ,界清 ,局部有压痛。全身浅表淋巴结无肿大 ,其它部位的皮肤及心、肝、脾、肺、肾、脑均未见异常。病人曾在院外活检诊断为“阴茎鳞癌”。此次入我院行阴茎根治术。病理检查　眼观 :全部切除阴茎 ,10ｃｍ× 3ｃｍ× 3ｃｍ ,距断端 2ｃｍ处见一黑褐色菜花状肿块 ,4ｃｍ× 3ｃｍ× 3ｃｍ ,肿块表面可见溃疡。切面灰褐色 ,无包膜 ,界限不清 ,深部侵入阴茎海绵体。镜检 :肿瘤细胞呈弥漫、巢状排列 ,细胞异形性明显 …     

46,X,t（Y;Y）伴先天性尿道下裂隐睾一例

４６，Ｘ，ｔ（Ｙ；Ｙ）伴先天性尿道下裂隐睾一例卢洁患儿男，７岁。因生后发现尿道外口位置异常，蹲式排尿就诊。检查：智力正常，身高１００ｃｍ，体重１７ｋｇ。男性外阴，阴茎短、小，明显下弯，包皮腹侧对裂，堆积于阴茎背侧呈头巾状。尿道外口位于阴茎阴囊文界处。...     

前锯肌下部肌皮瓣移植的应用解剖

目的：为前锯肌下部肌皮瓣移植提供解剖学基础。方法：在２５具（５０侧）成人尸体标本上，对前锯肌下部的形态、血供和神经支配进行了应用解剖学观测。结果：前锯肌下部的血供主要来自胸背动脉的前锯肌支，外径１．３±０．２ｍｍ，伴行静脉外径１．５±０．２ｍｍ，长４．９±１．１ｃｍ；由胸长神经支配，其横径为１．７±０．４ｍｍ，神经干长７．７±１．４ｃｍ。结论：以胸背血管及前锯肌支为血管蒂和胸长神经为蒂可切取前锯肌下部１２．０ｃｍ×９．０ｃｍ的肌皮瓣，修复较大创面或重建肌动力     

小腿前外侧群肌瓣的应用解剖

目的：为小腿下１／３的骨髓炎和其它创伤性修复提供满意的肌瓣。材料和方法：用３０具成人的尸体,采用连续层次解剖法,调查了小腿前群和外侧群各肌,用游标卡尺测量有关的数据。结果;转动胫骨前肌、拇长伸肌、趾长伸肌、腓骨长肌、腓骨短肌和第３腓骨肌瓣能覆盖胫骨前内侧下１／３的面积分别为８．７ｃｍ＾２、１２．４ｃｍ＾２、１２．７ｃｍ＾２１３．６ｃｍ＾２、１９．０ｃｍ＾２、１６．７ｃｍ＾２。结论：除胫骨前肌和腓骨     

成人和大鼠阴茎包皮及包皮系带内降钙素基因相关肽免疫阳性神经末梢的分布及来源

目的探讨人和大鼠阴茎包皮和包皮系带内降钙素基因相关肽（CGRP）免疫阳性神经末梢的分布和起源。方法采用免疫组织化学法观察成人阴茎包皮和包皮系带内CGRP免疫阳性神经末梢的分布，通过荧光金（FG）逆行标记和CGRP免疫荧光标记相结合法研究大鼠包皮系带内CGRP免疫阳性神经末梢的起源。结果成人阴茎包皮及包皮系带内均有CGRP免疫阳性神经末梢存在，主要位于表皮基底层和棘细胞层内，呈树枝状或念珠状分布，大多成束走行。阴茎系带处CGRP免疫阳性神经末梢的分布密度明显大于阴茎包皮处。大鼠的阴茎包皮和包皮系带内也有类似的CGRP免疫阳性神经末梢分布，结合FG逆行标记法研究发现，神经末梢起源于第6腰髓对应的背根神经节（L6-DRG）和第1骶髓对应的背根神经节（S1-DRG）的神经元。CGRP免疫荧光标记细胞大多为中小型，呈深绿色，沿神经束成行排列或散在分布。FG／CGRP双标阳性细胞均为中小型，其数量占FG逆标阳性细胞总数的二分之一。结论人和大鼠阴茎包皮及包皮系带内存在着大量的CGRP免疫阳性神经末梢；大鼠实验表明，这些末梢来源于L6-DRG和S1-DRG，提示CGRP可能参与阴茎包皮及包皮系带感觉信息的传递。     

腰大肌横断面积与腰椎间盘突出症的关系

目的：测量腰大肌械断面积，探讨其与腰椎间盘突出的关系。方法：随机选择１４０例腰椎间盘突出症和７２例正常对照组，在Ｌ４～５和Ｌ５～Ｓ１间隙水平测量双侧腰大肌横断面积。结果：（１）正常腰大肌横断面积（Ｌ４～５：男１５．０３ｃｍ＾２，女８．６０ｃｍ＾２；Ｌ５～Ｓ１：男１４．４２ｃｍ＾２，女８．３９ｃｍ＾２）；男性较女性明显增大但双侧腰大肌横断面积，腰椎间盘突出症较正常对照组减小。结论：双侧腰大肌不对称及     

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.