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1.
髋臼上方置钉骨盆外固定的应用解剖   总被引:1,自引:0,他引:1  
目的:为髋臼上方置钉进行骨盆外固定手术提供应用解剖学参考资料.方法:对20例40侧尸体骨盆的髂前下棘区域进行观察测量,获取髂前下棘与股动脉、股神经、股外侧皮神经、旋髂深动脉等毗邻血管神经的距离.对髋臼上置钉的钉道进行测量,获取钉道的长度、宽度,钉道与髋臼边缘及坐骨大切迹的距离等.所得数据按性别分组进行统计学处理.结果:髂前下棘为股直肌起始部,表面为髂肌覆盖,缝匠肌由外上至内下斜行越过髂前下棘外下方.男性股动脉位于髂前下棘内侧(27.54±3.53)mm,女性为(27.15±0.81)mm;男性股神经位于髂前下棘内侧(17.61±3.47)mm,女性为(19.26±4.21)mm.男性股外侧皮神经位于髂前下棘外侧(23.24±5.33)mm,女性为(17.82±3.26)mm;男性旋髂深动脉位于髂前下棘上方(16.26±1.77)mm,女性为(14.06±2.16)mm.男性髋臼上钉道长度为(147.76±7.39)mm,女性为(142.75±6.36)mm;男性钉道位于髋臼上方(25.10±4.43)mm,女性为(19.35±3.54)mm;男性钉道位于坐骨大切迹上方(25.01±3.61)mm,女性为(21.34±3.17)mm.结论:髋臼上方置钉骨盆外固定手术,应选取在腹股沟韧带外侧1/4下方约1 cm处作一平行切口,采用纵形钝性劈开髂肌的方式,以套筒保护下在髂前下棘处置入固定钉,避免损伤周围组织.由髂前下棘到髂后上棘间的钉道为一完整连续的骨性钉道,可为骨盆外固定提供足够的钉道长度和固定强度.  相似文献   

2.
经皮逆行髋臼前柱螺钉的应用解剖与临床   总被引:2,自引:0,他引:2  
目的 应用优化计算机辅助解剖测量技术,为经皮逆行髋臼前柱螺钉内固定术提供解剖学基础.方法 取骨盆CT数据40份,进行精确的三维重建得到骨盆模型.首先为使用单螺钉的内固定方法设计特定的最优化目标函数,并在约束条件下自动计算其最佳经皮逆行螺钉位置.统计分析测量结果,并设计解剖测量参考体系.结果 经皮逆行髋臼前柱螺钉的入钉点在耻骨上支耻骨结节与髂耻隆起中点处的闭孔嵴上,出钉点在髂前上下棘之间切迹与坐骨大切迹连线中点上方,其连线即为髋臼前柱纵轴.该线与弓状线接近平行,其进针方向与出钉点-髂前下棘连线为(42.84±2.61)°,与出钉点-髂结节连线为(31.96±2.58)°.螺钉骨内段长度为(101.12±7.28)mm.结论 优化计算机辅助解剖测量是一种非常有效的测量技术,克服了传统手工实物解剖测量的很多缺点,便于设计解剖测量参考体系和制定临床手术方案.经皮逆行髋臼螺钉技术可用于髋臼前柱骨折的临床治疗.  相似文献   

3.
目的 探究髋臼上区域螺钉的进钉位置、角度以及安全范围。 方法 收集男女骨盆CT数据各50例,利用Mimics软件重建髋臼上置钉区域三维模型(髂前下棘至髂后上棘方向)。同一横断面上,通道狭窄处中点连线方向确定为螺钉方向,沿该方向每2.5 mm为一层,逐层测量安全范围相关指标。在1/2高度层面放置中心钉,测量中心钉进钉点与髂前下棘的位置关系及螺钉方向,在水平面和矢状面上移动钉尖,测量安全倾角范围。 结果 髋臼上骨通道存在前、后两狭窄点,不同层面其宽度不同,从下至上,前狭窄由窄变宽再变窄,后狭窄逐层增宽。螺钉通道中间层较宽,上下层较窄;中心通道宽度90%的男、女性分别大于7 mm和6 mm;进钉约50 mm至前狭窄,70 mm至坐骨大切迹顶上方,100 mm至后狭窄,全程长约130 mm;螺钉为内倾、头倾方向,与矢状面和横断面的夹角均约为30°;97%的进钉点位于髂前下棘中心外侧,其中外下方占71%。 结论 髋臼上螺钉的进钉点主要位于髂前下棘外方,内倾、头倾方向,与矢状面和横断面的夹角均约为30°。  相似文献   

4.
髋臼前柱螺钉内固定的最优化计算机辅助测量   总被引:1,自引:0,他引:1  
目的:研究专门的最优化计算机辅助解剖测量技术,为髋臼前柱拉力螺钉内固定提供解剖学基础。方法:取骨盆CT数据40份,进行精确的三维重建得到80个半骨盆模型。根据临床手术需要,对螺钉到骨边界的加权距离进行动态采样作为最优化目标函数,在约束条件下自动迭代修改螺钉两个端点位置,达到最佳位置,并设计新的解剖测量参考体系。结果:髋臼前柱拉力螺钉的入钉点在髂前上、下棘之间切迹与坐骨大切迹连线中点上方(15.72±2.71) mm处;其进针方向与入钉点-髂前下棘连线呈(42.84±2.61)°,与入钉点-髂结节连线呈(31.96±2.58)°;螺钉骨内段长度为(101.12±7.2)mm。结论:最优化计算机辅助解剖测量是一种非常有效的新测量技术,方便设计新的解剖测量参考体系和临床手术方案。  相似文献   

5.
髋臼后柱拉力螺钉内固定的应用解剖学   总被引:11,自引:1,他引:10  
目的:为髋臼后柱拉力螺钉内固定提供解剖学基础。方法:取半骨盆标本30个,采用截面法将一斯氏针由髋臼后柱最小截面的圆心打入,该斯氏针在髂翼内侧穿出点(即拉力螺钉的人钉点)为P。测量其在髋臼后柱骨皮质内的长度。作一参考线AB,其中A为骶髂关节最前缘,B为髂前下棘的基底,并经过P点作AB的垂线PC。将髂前上下棘间切迹命名为D点,作直线PD,并测量其距离。斯氏针与PD的夹角为α,斯氏钊与髂翼内侧的夹角为β。结果:PC为AB的中垂线,P点距AB的距离PC为(6.1±1.9)mm,PD平行于AB,PD距离为(2.5±2.6)mm,斯氏针与PD或AB的夹角仅为89.5°±3.2°,斯氏针与髂翼内侧的夹角β为24.1°±1.7°,髋臼后柱骨皮质内斯氏针长度(即拉力螺钉的长度)为(131.2±8.9)mm。最小截面位于髋臼切迹上方15.0mm处,位于髋臼中部,该截面平均直径(即拉力螺钉最大直径)为(12.8±2.1)mm。结论:髋臼后柱拉力螺钉内固定是可行的。  相似文献   

6.
髋臼前柱拉力螺钉内固定的定量解剖学研究   总被引:7,自引:1,他引:6  
目的 :为髋臼前柱拉力螺钉内固定提供解剖学基础。方法 :取半骨盆标本 3 0个 ,自髋臼切迹至髋臼上缘作系列截骨面 ,用一斯氏针由最小截面的圆心逆行打入 ,在髂骨后外侧穿出点为P。将该截面下方的系列截面解剖复位 ,再将斯氏针顺行打出 ,测量其在髋臼前柱骨皮质内的长度。作一参考线AB ,其中A为髂前上、下棘间的切迹 ,B为坐骨大切迹 ,并作AB的中垂线CD。结果 :P位于AB的中垂线上 ,P点距AB的距离为 (15 .3± 4.7)mm ,斯氏针与AB的夹角为 (90 .1± 4.7)° ,与CD的夹角为 (2 5 .3± 3 .9)° ,髋臼前柱骨皮质内斯氏针长度为 (82 .0± 7.9)mm。最小截面位于髋臼切迹上方 15 .0mm处 ,该截面平均直径为 :(5 .2± 1.9)mm。结论 :髋臼前柱拉力螺钉的入钉点在髂前上下棘之间切迹与坐骨大切迹连线中点上方 (15 .3± 4.7)mm处 ,其进针方向与该线呈 (90 .1± 4.7)° ,与该线中垂线呈 (2 5 .3± 3 .9)° ,该拉力螺钉直径为 (5 .2± 1.9)mm ,长度为 (82 .0± 7.9)mm。  相似文献   

7.
优化髋臼后柱螺钉内固定的计算机辅助设计   总被引:1,自引:1,他引:0  
目的研究专门的最优化计算机辅助解剖测量技术,为髋臼后柱拉力螺钉内固定提供解剖学基础。方法取骨盆CT数据40份,进行精确的三维重建得到80个半骨盆模型。根据临床手术需要,对螺钉到骨边界的加权距离进行动态采样作为最优化目标函数,在约束条件下自动迭代修改螺钉2个端点位置,达到最佳位置。对测量结果进行统计分析,并设计新的解剖测量参考体系。结果髋臼后柱拉力螺钉的入钉点在骶髂关节最前缘与髂前上下棘之间切迹连线的上方(18.90±1.19)mm处,垂足点在骶髂关节最前缘与髂前上下棘之间切迹连线上的比例位置为2:3;其进针方向与入钉点-髂前上下棘之间切迹连线呈(85.99±2.04)°,进针方向与入钉点-垂足点连线的夹角呈(37.54±1.55)°;螺钉骨内段长度为(133.07±3.22)mm。结论最优化计算机辅助解剖测量是一种非常有效的新测量技术,克服了传统手工实物解剖测量的缺点,并且方便设计新的解剖测量参考体系和临床手术方案,有利于提高临床工作质量和效率。  相似文献   

8.
目的 为髋臼前柱骨折后入路置入拉力螺钉固定提供解剖学基础。 方法 (1)50侧(男32,女18)成人髋骨标本,观测前柱纵轴走向,将纵轴穿出髂骨翼外面的点定为进钉点。用直径3.5 mm导针经进钉点沿纵轴置入,经耻骨结节下方穿出。测量导针与矢状面夹角α及与冠状面夹角β,纵轴长度,导针易穿出骨皮质的薄弱区及穿出点与耻骨结节的距离,对测量数据行统计学处理。(2)34侧尸体标本解剖,观测进针点毗邻,模拟置钉,经X线、CT扫描验证结果。 结果 进钉点位于髂结节和坐骨结节连线与髂前上棘和坐骨大切迹顶点连线的交点,出钉点于耻骨结节下方,男(6.62±2.79)mm,女(11.71±1.66)mm, α(50.62±3.55)°,β男(22.32±3.66)°,女(19.57±2.07)°;纵轴长,男(108.64±5.49)mm,女(100.92±6.25)mm。以上数据除角α外男女间均有显著性差异。验证结果及临床应用疗效满意。 结论 髋臼前、后柱均骨折时,在后入路复位固定后柱的同时,经该方法置入拉力螺钉固定前柱安全、简捷。  相似文献   

9.
背景:切开复位钢板置入内固定治疗髋臼前柱骨折时,螺钉穿入关节面的情况时有发生,为预防该并发症,对前柱钢板技术髋臼区安全置钉的定量解剖学测量非常有必要。目的:为前柱钢板髋臼区安全置钉提供解剖学依据。方法:利用Mimics软件对40例男性、40例女性骨盆CT进行三维重建,使用软件的切割工具制作前柱髋臼系列断面。使用软件测量工具,对各断面上不同进钉点的安全进钉方向及长度进行测量。将数据输入SPSS13.0软件进行统计学分析。结果与结论:髋臼前后缘、前缘到髂耻隆起的距离,分别为男性(56.63±2.05)mm,(12.30±1.51)mm;女性(49.07±5.07)mm,(16.93±1.74)mm;髋臼后缘到髂耻隆起的距离为男性(45.46±3.44)mm,女性(33.72±6.85)mm。螺钉在矢状面与髂骨板的夹角为男性(72.17±0.93)°,女性(81.05±0.92)°。B、C和D各断面,斜冠状面上螺钉与髂骨板的最大夹角分别为男性(53.88±3.01)°,(43.22±1.86)°,(54.60±2.97)°;女性(49.54±1.81)°,(39.10±1.22)°,(47.91±2.23)°。提示利用三维模型测量前柱髋臼区解剖特点,对于前柱骨折钢板置入内固定过程中避免螺钉进入关节有重要的指导意义。  相似文献   

10.
目的:为导向器引导经皮逆行拉力螺钉固定髋臼后柱骨折的可行性提供应用解剖学基础.方法:收集29例正常成人骨盆的螺旋CT扫描数据,重建骨盆三维模型.找出髂前上棘和髂后上棘的骨性最突出点,分别为(A)和(B),经AB的中点(M)做一垂直于AB的平面(α).在髋臼后柱的α截面上置入虚拟三维圆柱体.测量其最大直径(d),以及置入点(C)到坐骨结节远端(D)的距离CD.比较d、CD在男女之间及左右两侧间的差异.结果:共获得58个半骨盆,男26个,女32个.虚拟三维圆柱体置入成功率为87.9%,其中男性为96.2%,女性为81.3%.虚拟三维圆柱体的平均最大直径为(11.44±3.20)mm,且男女间的差异有统计学意义(t=4.55,P<0.001).CD为(19.10±5.10)mm.结论:沿髂前上棘和髂后上棘最突点连线的中垂线置入拉力螺钉固定髋臼后柱是可行的,该方法更适用于男性,可作为研发导向器的应用解剖学依据.  相似文献   

11.
Renal dysplasia and asplenia in two sibs   总被引:2,自引:0,他引:2  
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.  相似文献   

12.
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.  相似文献   

13.
About 1900, modern food selection and processing caused widespread 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 panhypovitaminosis B, i.e., a mixture of substrate beriberi and substrate pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse 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 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.  相似文献   

14.
15.
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.  相似文献   

16.
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.  相似文献   

17.
Newton H 《Medical history》2011,55(2):153-182
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.  相似文献   

18.
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.  相似文献   

19.
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.  相似文献   

20.
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.  相似文献   

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