小骨窗经外侧裂入路显微手术治疗高血压基底节区脑出血

目的探讨小骨窗经外侧裂显微手术治疗高血压性基底节区脑出血疗效。方法选择我院2013年12月至2015年2月30例出血量在30~60 m L的基底节区出血患者,对其手术过程及疗效进行回顾,总结小骨窗经外侧裂显微手术的方法及技巧,对比分析了传统手术优缺点。结果患者术后24 h复查CT颅内血肿清除90%以上,1例出现颞叶脑梗塞,无再次出血及死亡病例。患者术后意识恢复良好,通过早期康复治疗,肢体功能、语言功能均不同程度好转。结论小骨窗经侧裂显微镜下清除基底节区中等量血肿具有创伤小、止血彻底、功能保护好等明显优点,可在神经外科手术中推广应用。     

小骨窗开颅经外侧裂与经颞叶入路显微外科治疗高血压基底节区脑出血效果对比分析

目的 探讨经外侧裂入路和经颞叶入路小骨窗显微手术治疗高血压基底节区脑出血的临床效果.方法 选择82例高血压基底节区脑出血患者,其中男性54例,女性28例;年龄38～74岁,平均年龄58.5岁.按照随机数字表法分为外侧裂组和颞叶组,每组41例.两组均接受小骨窗显微手术治疗,外侧裂组经外侧裂入路,颞叶组经颞叶皮质入路.比较...     

高血压脑出血经外侧裂入路手术探讨

目的 探讨高血压脑出血经外侧裂手术入路方式.方法 研究我院31例高血压脑出血患者病历.结果 所有病例均经侧裂入路,术后即刻复查,消除率达80%以上者占83.9%.结论 经侧裂入路清除高血压脑出血,可有效提高血肿清除率及降低血肿复发.     

显微手术治疗高血压性脑出血的临床体会

目的探讨小骨窗开路经颞叶颞叶皮质显微外科清除血肿的手术方法,提高对高血压脑出血的治疗水平。方法回顾性分析我科自2007年3月至2010年3月基底节区高血压性脑出血患者大骨瓣开颅减压以及采用经颞叶皮质入路以显微外科手术治疗126例,总结其手术方法,比较其入路与其他手术入路的优缺点,探讨手术技巧。结果 126例患者中完全清除血肿90例、大部分清除血肿15例,再出血5例、存活105例、死亡21例。根据日常生活活动能力评分（activities of daily living,ADL）分级,手术后随访3个月,105例生存者预后达I级者6例,Ⅱ级43例,Ⅲ级18例,Ⅳ级26例,Ⅴ级13例。结论显微手术治疗基底节区脑出血,手术创伤小,时间短,止血可靠,安全有效。手术脑组织损伤小,可缩短昏迷时间,减少并发症,可提高患者生存率和生存质量。     

小骨窗显微镜下手术治疗高血压基底节区出血

目的探讨小骨窗显微镜下手术治疗老年人高血压基底节区出血的疗效。方法回顾性分析了58例老年人高血压基底节区出血的临床表现、小骨窗显微镜下手术过程及预后。结果清除血肿量均达75%以上;术后48h意识状态好转45例,无改善13例;6例72h再次出血,3例死亡。术后6个月随访(按ADL分级法):I级18例,II级23例,III级11例,IV级3例。结论小骨窗显微镜下手术创伤小、清除血肿充分,对于老年高血压脑出血患者比较实用。手术中的微创是高血压脑出血手术成功的关键。     

侧裂入路手术治疗基底节区血肿

目的：评估经侧裂入路手术治疗基底节区血肿的临床疗效。方法：60例基底节区血肿均采用经侧裂入路手术治疗。结果：死亡9例，死亡率15．0％。其余51例预后按ADL日常生活能力分级方法进行测评，1级5例，2级8例，3级18例，4级12例，5级8例。结论：经侧裂入路治疗基底节区血肿疗效安全、可靠，具有易于暴露血肿、脑损伤轻微的优点。     

两种手术方法治疗高血压基底节区血肿的疗效分析

目的探讨高血压基底节区血肿两种手术方法的疗效,寻求最佳治疗方法。方法总结以往手术治疗的高血压基底节区血肿,对比小骨窗经外侧裂显微外科（显微手术组：64例）和传统开颅手术（传统手术组：59例）患者的死亡率和生存质量,评价两种方法的治疗结果。结果两组死亡率分别为21.9%（14/64）和22.0%（13/59）,P〉0.05;随访六个月,两组患者恢复的GOS评分分别为：显微手术组,GOS恢复分级Ⅴ＋Ⅳ、Ⅲ、Ⅱ、Ⅰ分别为22、25、3、14例;传统手术组,GOS恢复分级Ⅴ＋Ⅳ、Ⅲ、Ⅱ、Ⅰ分别为13、31、2、13例;两组GOS评分比较Ⅰ、Ⅱ级无显著差别（P〉0.05）,而Ⅴ＋Ⅳ、Ⅲ级则差别显著（P〈0.05）。结论小骨窗经外侧裂治疗高血压基底节区血肿能够明显提高存活者的生存质量。     

经脑沟裂入路治疗高血压基底核脑出血

目的 探讨经外侧裂及脑沟回裂入路治疗基底核区脑出血对减少术后并发症、改善预后的作用。方法 利用尸头研究外侧裂以及额、颞叶部分脑沟的解剖,并回顾性分析经外侧裂入路手术治疗的14例、经脑沟回裂入路手术治疗的21例和经脑回皮层手术治疗的38例基底核区脑出血患者的临床资料。统计学分析明确3种方法是否具有可比性,并对比研究3种治疗方法的治疗效果。结果 经脑外侧裂组与经脑沟回裂组预后差异无统计学意义（P＞0.05）,两组与经颞叶皮层手术组比较差异均有统计学意义（P值均＜0.05）,经外侧裂与经脑沟回裂入路较经脑回皮层入路血肿清除率高、术后恢复好、术后出现失语及癫痫可能性低。结论 利用脑沟裂自然间隙入路治疗高血压基底核出血是切实可行的,且经外侧裂与经脑沟回裂入路手术优于经脑回皮质入路,该入路对正常脑组织损伤小、治疗效果好,对基底核出血可考虑首选。     

经外侧裂岛叶入路显微手术治疗高血压基底节区脑出血

目的:探讨经外侧裂岛叶入路显微手术治疗高血压基底节区脑出血的手术要点和疗效.方法:对38例高血压基底节区脑出血患者采用经外侧裂岛叶入路显微手术治疗,术后6个月根据GOS评分评定疗效.结果:38例均顺利手术,术后32例清醒,1例持续昏迷,5例死亡.存活的33例随访3～8个月,平均5个月.根据GOS评分,恢复良好9例,中残18例,重残5例,植物生存1例.结论:经外侧裂岛叶入路显微手术是治疗高血压基底节区脑出血较理想的方法,具有对脑组织损伤小、易发现出血点、神经功能恢复好等优点.     

神经内镜下经外侧裂入路血肿清除术治疗高血压脑出血的临床疗效和预后分析

目的探讨神经内镜下经外侧裂入路血肿清除术对高血压脑出血(HICH)患者神经功能、炎症因子和预后的影响。方法回顾性分析我院收治的80例HICH患者的临床资料,根据是否采用神经内镜辅助分为A组和B组。A组38例患者给予经外侧裂入路血肿清除术,B组42例患者给予神经内镜下经外侧裂入路血肿清除术。比较2组患者的神经功能、手术指标、炎症因子和预后。结果 B组术中出血量少于A组,血肿清除率高于A组,手术时间短于A组,差异均有统计学意义(P 0.05)。2组术后1 d白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)及C反应蛋白(CRP)水平均较术前升高(P 0.05),但B组低于A组(P 0.05)。2组术后1 d神经元特异性烯醇化酶(NSE)、神经营养因子(NF)、S100B蛋白水平及神经功能缺损程度评分(NDS)较术前均降低(P 0.05),且B组低于A组(P 0.05)。B组预后良好率高于A组(P 0.05),2组病死率比较差异无统计学意义(P 0.05)。结论神经内镜下经外侧裂入路血肿清除术治疗HICH患者,手术效果好,术后机体炎性应激反应较小,可有效减轻患者神经功能损伤,患者预后佳。     

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.     

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.     

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.     

'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.     

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.     

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.     

The case for allele‐specific recognition by the TCR

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.     

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.