Spinal space occupying lesions in thalassemia major

A 17 year old patient suffering from thalassemia, who had been dependent on transfusions since the age of three, showed an increasing incomplete sensory and motor transverse cord lesion below T-10. The causes were found to be multiple epidural erythropoietic foci, confirmed by myelography, CT, and biopsy. The lesions were located in the thoracic, lumbar, and sacral regions. Complete remission of the neurological symptoms was achieved by an immediate hypertransfusion regimen and subsequent local radiation therapy of the neuroaxis. Thirty-six cases of thalassemia and spinal space occupying lesions have been reported in the literature. The therapeutic results of these are presented and compared with our findings.     

Peut-on changer les comportements alimentaires ?

The naïve model of feeding behaviour determination, stating it stems from individual conscious will alone, is widespread but fallacious and roots many a failure in diets and public health campaigns.Feeding behaviour is determined at three levels: technico-economics, psychology, and sociology. Individual capacity of change, facing a whole system of affordances and habits, is limited. Changes are possible, but not when relying upon individual will alone. We list some realistic paths to foster and support change.     

星状神经节阻滞与颈横突局部注射疗法对颈源性头痛的疗效评价

目的:探讨星状神经节阻滞疗法和C2横突旁注射疗法对颈源性头痛的疗效.方法:颈源性头痛患者96例分别采用C2横突局部注射36例(A组)、星状神经节阻滞36例(B组)及单纯口服对乙酰氨基酚胶囊24例(C组).治疗前后采用McGill疼痛评分量表评定患者疼痛程度.结果:治疗3周后,A、B组疼痛评分差异无显著性意义,但均优于C组(P＜0.05).结论:C2横突旁局部注射与星状神经节阻滞疗法治疗作用相近,对颈源性头痛均有较好疗效.     

横突定位臂丛阻滞对臂丛感觉和运动神经分支的阻滞效果观察

目的评价三种横突入路臂丛阻滞对臂丛感觉和运动神经各分支的阻滞效果。方法200例需行肩部、上肢手术患者,分别在颈5（C5,78例）,颈6（C6,70例）,颈7（C7,52例）横突入路下进行臂丛阻滞。评价阻滞后30rain各感觉和运动神经阻滞效果,并记录并发症情况。结果三种横突入路对臂丛神经分支阻滞效果不同,C5入路对腋神经和C4神经阻滞率较C6、C7入路高（P〈0．05）,而C7入路对尺神经感觉和运动阻滞的完善程度较C6入路明显提高（P〈0．05）,均无严重并发症发生。结论三种横突入路臂丛阻滞对臂丛感觉和运动神经各分支的阻滞效果不同。     

小儿医源性睾丸回缩的防治（附5例报告）

报告５例因腹膜鞘状突未闭术后发生的睾丸回缩，分析其原因及提出处理措施。     

3-Dimensionale Messungen der Processus mastoidei zur Geschlechtsdiagnostik am Schädel

In sexing of skulls the mastoid process is considered to be an important sex trait because of its greater dimension in males. Quantitative studies of the volume of the process are limited to air cell system investigations. The objektive of the present study was to quantify mastoid processes and test the value for sex determination. The three-dimensional study of the mastoid processes was carried out on 72 human skulls of which 38 were females and 34 males. The surface of the processes, limited to the part which projects from the skull base, was scanned with an optical measurement system. The resulting data were used to reconstruct virtual processes on a personal computer. Volume, suface area and height of the 3-D images were measured. There was no significant difference between the left and right mastoid processes. All of the parameters showed significant differences between the sex groups (volume: male 833.31 mm³, female 647.88 mm³, P = 0.04118; surface area: male 339.51 mm², female 286.80 mm², P = 0.0383; height: male 8.93 mm, female 8.06 mm, P = 0.0039). But the female values for volume and surface area were scattered completely within the male range and the female and male values for the height were widely overlapping. In discriminant function analysis the accuracy was only 65.28%. The results verify the sexual dimorphism of the dimensions of the mastoid processes but because of the widely overlapping range of male and female values the results are not of use for determination by measurement.     

Beiträge zur forensischen Osteologie

Zusammenfassung An 105 Individuen, 61 männlichen und 44 weiblichen, wird die Behauptung eines Geschlechtsdimorphismus hinsichtlich der Höhe und Größe der Processus mastoidei statistisch nachgeprüft. Für die mediale und laterale Fortsatzhöhe lassen sich keine signifikanten Mittelwertsdifferenzen aufzeigen. Zudem ist die Varianz der Kollektive so groß, daß der Proc. mastoid. als Identifikationsmerkmal ausscheidet. Die gefundene Mittelwertsdifferenz der Größe der Fortsätze, hier durch die äußere Fläche ausgedrückt, läßt sich statistisch eindeutig sichern. Dies entspräche der Vorstellung einer Kausalbeziehung zwischen Ausbildung und Insertion der seitlichen Halsmuskulatur einerseits und Größe bzw. Volumen der Fortsätze andererseits.

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The human mastoid process as a criterion for identification?

Summary The supposition regarding sex-linked differences in height and surface area of the mastoid process was tested in 105 human skulls, 61 of which were male and 44 were female. There was no statistically significant difference noted in the mean values of the lateral and medial measurements of the processes from both sexes. Some significance, however, was noted in the measurement of the surface area. This may be associated with the insertion of stronger lateral neck-musculature, as is isually the case in males.

     

中国人胎儿睾丸下降的动态解剖学观察

通过观察101例正常发育的男性胎儿(胎龄12～33周)的睾丸及其相关结构,得到以下结果:1.提供了胎儿睾丸、附睾和引带的生长发育资料。2.发现所谓的阴囊韧带实际上并不存在,引带是一个间充质组织的柱锥体,客观上没有一个牵引睾丸下降的解剖结构。3.中国人胎儿睾丸下降的时间发生在孕21～25周之间,26周之后已全部下降完毕,比传统认为的第7～8个月有明显的提前。4.证实了睾丸一旦下降开始,很快通过腹股沟管,一般左侧比右侧有先下降的倾向。鉴于以上发现,作者认为有必要对传统概念进行修正。     

Spécificités de l’approche psychothérapique d’inspiration analytique à l’adolescence

The commitment of a teenager in an individual psychotherapeutic work often faces multiple obstacles, related to incompatibilities inherent to the process of adolescence, but that often reflect the ups and downs of the work of psychic separation or the vicissitudes of “subjectivation”. Therapeutic setting adjustments, made necessary by the psychic and relationship operating constraints of the concerned adolescents, have been proposed by psychoanalysts, intended to take into account the narcissistic vulnerability of their young patients, and also to put their own associative abilities at their disposal. Exciting contributions of several psychotherapists working with teenagers on these issues will be summarized and extended by the reflections of the author based on his own experience as a psychotherapist and that derived of different supervisory groups he facilitated for several years. Some designs may thus be summarized, illustrated and reformulated in the light of the clinic. In this perspective the issues inherent, to the objectives of the psychotherapeutic work at this age, to the levers that can be used, to the obstacles related, not only to the process of adolescence challenges, but also to parental positions, to the nature of the underlying psychopathological organization and to the counter-transferences reactions of therapists, will be re-examined. In order to better control the potential risks of such an encounter, and to increase profits for young patients, it turns finally essential to rethink the design, and to advocate the strong practitioners’ commitment.     

针刀疗法对第三腰椎横突综合征模型大鼠成纤维细胞增殖与凋亡的影响

目的：观察针刀疗法对L3横突综合征模型大鼠软组织中成纤维细胞增殖与凋亡的影响。方法：建立L3横突综合征大鼠模型。68只SD大鼠随机分为针刀组、封闭组、模型组、正常对照组,每组17只大鼠。第15天对相应组别进行针刀和封闭干预。于第21、30天时,每组各处死8只大鼠,取材后,行HE染色,及免疫组化和凋亡的检测,并计算成纤维细胞的增殖和凋亡指数。结果：第21天和第30天时,针刀干预组的增殖指数、凋亡指数与模型对照组相比较有非常显著的差异（P<0.01）;针刀干预组与封闭对照组在第21天时无显著差异（P＞0.05）,在第30天时有显著差异（P<0.05）。结论：针刀干预对L3横突综合征模型大鼠的组织修复有效,可能是通过调节成纤维细胞增殖与凋亡的平衡,从而防止了组织瘢痕挛缩的形成,印证了中医微观阴阳平衡理论。