内窥镜辅助颞下锁孔入路的应用解剖

目的 :为颞下锁孔入路提供解剖学基础。方法 :2 1例福尔马林固定尸体头部标本上进行入路相关解剖结构观察和测量 ,在 9例新鲜标本上模拟内窥镜辅助颞下锁孔入路手术 ,记录入路的显露范围及可利用的操作空间 ,尝试增加显露和操作空间的方法。结果 :圆孔、卵圆孔、棘孔、三叉神经压迹、弓状隆起、岩大神经裂孔到颞下颌关节处颧弓上缘和中线的距离分别为 :(4 5 .2± 3 .3 )mm和 (2 0 .1± 2 .3 )mm、(3 2 .6± 2 .1)mm和 (2 3 .7± 1.2 )mm、(2 8.9± 1.1)mm和 (3 1.2± 3 .1)mm、(4 0 .1± 1.2 )mm和 (15 .6±2 .7)mm、(2 5 .0± 2 .7)mm和 (3 3 .8± 0 .9)mm、(2 6.7± 2 .3 )mm和 (2 9.6± 0 .8)mm ,Kawase三角各边长度 :耳蜗至岩大神经与下颌神经交点 (18.6± 1.6)mm、耳蜗至三叉神经孔 (19.6± 1.5 )mm、三叉神经孔至岩大神经与下颌神经交点 (16.2± 0 .8)mm ;Day菱形区各边长度 :三叉神经孔至岩大神经与下颌神经交点(16.2± 0 .8)mm、弓状隆起至三叉神经孔 (2 1.7± 2 .5 )mm、岩大神经与下颌神经交点至膝状神经结 (7.2± 1.3 )mm、膝状神经结至弓状隆起 (12 .5± 2 .1)mm ;颞下锁孔入路最大控制范围前至视交叉 ,后到脑干腹外侧乳头体至中下斜坡的区域。结论 :颞下锁孔入路是治疗鞍上区和岩斜区病变     

用于分析面形态与颞下颌关节生物力学关系的三维有限元模型的建立

目的为研究(牙合)面形态变化对颞下颌关节应力影响的规律,建立包括下颌牙列(牙合)面形态及双侧髁突的三维有限元模型.方法尸头1具,平行于眶耳平面作CT扫描,获取下颌骨几何参数;取石膏模型,以三维扫描仪对牙列(牙合)面扫描(精度0.5mm);将石膏模型参数与CT参数换算到同一坐标系下,在髁突上方设均厚类关节盘,关节盘顶及下颌角作约束设计,经划分网格生成有限元模型.结果建立了包括双侧髁突、类关节盘及下颌牙列在内的用于分析咬合与颞下颌关节关系的三维有限元模型.结论采用本方法可建立研究(牙合)面形态与颞下颌关节应力关系的三维有限元模型.     

下颌骨骨折机理的解剖学研究

目的:为下颌骨骨折机理的研究提供解剖学依据。方法:10例新鲜颅面标本进行解剖,对咀嚼肌、位进行观察,把下颌骨横断截开,测量各个解剖区全厚骨质厚度。结果:下颌骨各部分骨质厚度:颏部正中(12.4±0.7)mm、颏孔区(10.6±1.1)mm、磨牙区(14.1±0.9)mm、下颌角(6.8±0.5)mm、下颌孔前区(10.1±1.0)mm、下颌孔后区(6.2±0.5)mm。下颌第3磨牙阻生时,骨质变薄。牙缺失时,骨质吸收牙槽突降低。咀嚼肌在下颌骨两侧呈镜面影像,附着于下颌骨的不同部位。牙尖交错位和下颌后退接触位时上下牙列接触,髁状突与颞骨关节面无间隙,下颌姿势位时使上下牙列及髁状突与颞骨关节面之间均有间隙。结论:(1)颏部正中、下颌体部、下颌角、髁突颈部为下颌骨解剖薄弱区域,下骨全厚骨质厚度和骨折无相关性;(2)下颌第3磨牙阻生、缺失牙、颏孔和尖牙窝使下颌骨变薄弱;(3)咀嚼肌的收缩和位的不同可以改变下颌骨骨折的发生部位;(4)下颌骨薄弱区、咀嚼肌和位共同影响下颌骨骨折的发生。     

磨牙与下颌管、上颌窦的位置关系及临床意义

目的:为牙种植术等临床口腔外科提供解剖学基础.方法:选取新鲜及成人全牙上、下颌骨标本和全牙志愿者,观察下牙槽神经、血管的关系和上颌窦下壁的凸起结构,测量磨牙牙根至下颌管、上颌窦的距离和牙槽窝的深度.结果:下颌管内的下牙槽血管位于下牙槽神经上方,下颌第1磨牙、第2磨牙、第3磨牙牙根至下颌管上壁的距离分别为(3.22±1.40)mm、(2.96±1.54)mm、(3.64±1.72)mm.上颌窦下壁有凸起的骨隔和黏膜隔,上颌第1磨牙、第2磨牙、第3磨牙牙根至上颌窦下壁的距离分别为(2.02±0.91)mm、(2.06±1.04)mm、(3.74±1.73)mm.下颌磨牙的牙槽窝深度均大于上颌磨牙相应的牙槽窝.结论:磨牙牙根至下颌管、上颌窦的距离和牙槽窝的深度对选择适宜长度的牙种植体,避免牙种植体损伤下牙槽神经和误入上颌窦等具有重要意义.     

骨性Ⅲ类儿童前牵引后颞下颌关节改变的相关性分析

背景：前牵引治疗能有效改变儿童骨性Ⅲ类错(牙合)患者的颅颌面结构关系,同时也改变了颞下颌关节结构。但是关于前牵引颞下颌关节改变和颅颌面变化的相关性,尚无确切研究结果。目的：分析儿童骨性Ⅲ类错(牙合)患者前牵引矫治前后牙颌面改变与颞下颌关节改变的相关性,探讨前牵引矫治对儿童颞下颌关节的影响。方法：上颌前方牵引矫治儿童骨性Ⅲ类错(牙合)29例,男16例,女13例,年龄8-11岁,对前牵引矫治前后牙颌面和颞下颌关节的改变进行头影测量分析、坐标系统定位测量分析,数据分析采用配对t检验和Mann-Whitney检验及Pearson相关性分析。结果与结论：前牵引治疗前后骨骼矢状方向发生明显改变,颞下颌关节窝和髁状突在X轴改变明显,在Y轴改变不明显,颞下颌关节后间隙明显减小;相关性分析发现,颞下颌关节与牙颌面结构改变之间存在中等相关关系。结果表明,前牵引矫治后,牙颌面与颞下颌关节结构均有明显改变,且颞下颌关节骨改建与牙颌面改变之间存在中等相关关系,但没有密切相关关系。     

颞下经下颌入路相关骨性结构解剖及其临床意义

目的研究与颞下经下颌入路相关的骨性结构解剖,为扩大手术暴露提供解剖学参考。方法选用成人尸头10例(20侧),经模拟手术后去除软组织,显露相关骨性结构,进行观察和测量。结果颧弓是暴露中颅底和颞下窝的关键,颧弓长度和下颌关节窝宽度分别为32.9±2.6mm和15.5±1.3mm;下颌孔位于下颌升支内侧面中央略偏后上方,下颌升支的斜行截骨安全且可以获得最佳的纵向暴露;颞下窝,翼腭窝和咽旁间隙骨性结构复杂,腔隙众多且互为交通;茎突是重要的解剖标志,其根部至颈静脉孔后缘仅2.95±0.25mm。结论颞下经下颌入路暴露充分,掌握相关骨性解剖对手术治疗侧颅底区沟通性肿瘤具有重要意义。     

下颌前牙牙槽窝底距下颌骨下缘高度的观测

目的 观测国人的下颌前牙牙槽窝底到下颌骨下缘垂直距离的数据。方法 取100具成人下颌骨,由前牙唇侧壁测量其牙槽窝底到下颌骨下缘的垂直距离。结果 中切牙牙槽窝底到下颌骨下缘的垂直距离平均为(26.19±5.64)mm:侧切牙牙槽窝底到下颌骨下缘的垂直距离平均为(23.95±6.08)mm,尖牙牙槽窝底到下颌骨下缘的垂直距离平均为(20.58±5.26)mm。结论该数据为解剖学增添资料,也为颏部的表面划线提供应有的数据。     

深覆及过大超与颞下颌关节紊乱综合征

颞下颌关节紊乱综合征是口腔科的一种常见和多发疾病,多年来,国内外学者们对此疾病的病因进行了大量的研究,发现咬合的异常与疾病的发生和发展密切相关,咬合异常有多种形式,其中深覆(牙合)及过度超合与颞下颌关节紊乱征之间的关系日益受到人们的重视.深覆(牙合)合是一种常见的上下颌牙弓垂直关系异常,一般指在正中合位时上前牙冠覆盖下前牙唇面超过1/3以上者,深覆(牙合)常伴有过度超合,重度深覆(牙合)限制前后牙齿及牙槽高度的生长,形成异常的(牙合)曲线进而导致下颌运动障碍,影响咀嚼功能,深覆(牙合)者的咀嚼效率(84.07%)明显低于正常者(97.95%);有学者发现重度深覆(牙合)患者出现颞下颌关节紊乱综合征的几率为70%～82.8%.1 深覆(牙合)对颞下颌关节结构的影响颞下颌关节的骨性结构主要由颞骨的关节窝和下颌骨的髁状突构成,这两者之间有关节盘,深覆(牙合)者的髁状突及关节窝形态与正常(牙合)者是否有差     

经鼻内镜翼腭窝区手术相关的显微解剖学研究

目的:为经鼻内镜翼腭窝区手术提供显微解剖学基础。方法:选用30例(60侧)成人头颅湿标本,对翼腭窝区进行显微解剖观测,并模拟鼻内镜手术入路,观测翼腭窝区穿行结构及毗邻关系。结果:①翼腭窝内有上颌动脉、上颌神经及其分支,以及翼腭神经节等重要结构;②由蝶腭孔至前鼻棘的距离为(52.99±4.95)mm;③上颌神经出圆孔处至前鼻棘的距离为(62.90±3.81)mm;④翼管神经至前鼻棘的距离为(58.83±3.91)mm。结论:熟悉翼腭窝区穿行结构位置及毗邻关系,对经鼻内镜翼腭窝区手术的开展具指导意义。     

阻塞性睡眠呼吸暂停低通气综合征的解剖学基础

目的 :为阻塞性睡眠呼吸暂停低通气综合征的诊断、手术治疗提供解剖学参考资料。方法 :选用经福尔马林固定的成尸头颈部正中矢状切面 (30例 ) 6 0侧咽标本 ,用游标卡尺测量咽腔相关解剖结构。结果 :腭帆后缘中点的厚度为 (1.2± 0 .6 )mm ,下鼻道底至腭垂尖的高度为 (31.7± 5 .9)mm ,腭垂根部的前后径、左右径、上下径分别为(6 .1± 1.5 )mm、(5 .2± 2 .2 )mm、(7.5± 2 .0 )mm ,腭垂两侧腭帆根部的厚度为 (11.3± 1.8)mm ,舌根、腭垂尖、会厌尖分别至咽后壁之间的直线距离分别为 (16 .7± 4 .8)mm、(10 .6± 4 .9)mm、(12 .7± 4 .2 )mm。结论 :咽腔的异常结构在引发阻塞性睡眠呼吸暂停低通气综合征的过程中具有重要的意义     

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.     

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.     

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.     

'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.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

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.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.