枕动脉的临床解剖学

在44例成人头颅材料上对枕动脉走行分三段调查.第一段位于颈动脉三角内.长2.9±0.4cm,分出脑膜支、肌支;第二段位于胸锁乳突肌和头夹肌深面,长5.8±0.5cm,分出乳突支、耳支、降支、颅后支,第三段是枕动脉浅出点至上横线的头皮支.长11.7±1.3cm,一般分为Ⅱ主支型(占75%).枕动脉起始部外径3.1±0.2mm;浅出点(A点)外径2.8±0.4mm;头皮支的B点外径2.1±0.2mm、C点1.7±0.4mm、D点2.0±0.3mm 、E点1.6±0.4mm.对头皮支的分型分布提出了体表定位方法.结合临床颅内、外动脉吻合术和动脉逆行插管术的应用进行了讨论.     

旋股外侧动脉升支阔筋膜张肌支髂骨瓣的解剖学研究及临床意义

目的 :探讨带旋股外侧动脉升支阔筋膜张肌支髂骨瓣的解剖及应用要点。方法 :在 2 5侧经动脉灌注红色乳胶的成人下肢标本上 ,重点观测旋股外侧动脉升支阔筋膜张肌支的走行、分支、发出点和外径等。结果 :旋股外侧动脉升支的阔筋膜张肌支上行支发出点距髂前上棘平面 7.1± 2 .3cm ,外径 1.2± 0 .8mm ,该支又分出 2～ 3支外径在 0 .3mm～ 0 .5mm的小分支从阔筋膜张肌后份进入肌质 ,上行至肌起始处达髂骨 ;其下行支发出点距髂前上棘平面 7.9± 1.8cm ,外径 1.3± 0 .8mm。结论 :旋股外侧动脉升支阔筋膜张肌支髂骨瓣具有手术可行性和实际应用价值     

股骨中段骨膜瓣移植的应用解剖

在45例成人下肢标本上,解剖了股中间肌近端血管及其骨膜支的来源、分布.结果表明,近端的肌动脉来自施股外侧动脉的占57.8%;股深动脉的占28.90%;股动脉的占13.3%.股动脉长1.6±0.7cm,外径2.2±0.7mm.88.9%的骨膜支发自肌动脉,行经股中间肌与股内侧肌之间的间隙,达股骨中段前份.骨膜支长3.6±1.1cm、外径1.5±0.4mm.临床应用12例成功证实,以肌动脉为蒂可截取较大面积的骨膜瓣,是顺行或逆行修复股骨近、远端骨折骨不连的新供区.     

正中神经返支和掌皮支血供的显微解剖

目的为修复正中神经返支提供带血管蒂神经桥接的有关数据和掌皮支血供的解剖学资料。方法用体视学方法研究了40侧灌注红色乳胶液的返支和掌皮支的营养血管。观察返支营养血管的来源、长度、外径和进入神经干的方式;观察掌皮支营养血管的来源和进入神经的方式。结果返支营养动脉主要发自掌浅弓凹侧筋膜支(称之来源动脉)。来源动脉起点至“零点”距离(11.62±2.30)mm,外径(0.95±0.10)mm,长度(10.12±1.30)mm。营养动脉主干长度(2.84±0.10)mm,外径(0.42±0.15)mm。营养动脉从返支主干近侧1/3段直入式进入神经者占86.5%;从返支中、远侧段伴入式进入神经者占14.5%;掌皮支营养动脉主要发自尺动脉(占52.5%)和桡动脉(占37.5%),以直式、伴入式和肌支式进入神经。结论返支营养动脉可作为血管蒂神经移植的受体血管。     

肩胛上血管肩峰支肩胛冈骨瓣移位术的应用解剖

目的为锁骨肩峰端骨不连修复提供新的手术方法.方法在40侧成人尸体标本上,解剖观测肩胛上血管肩峰支的走行、分支及分布;1侧标本上摹拟手术设计.结果肩峰支自肩胛上动脉发出后,向外走行于斜方肌、冈上肌之间,穿斜方肌在肩峰处的附着点达肩峰,并与胸肩峰动脉的肩峰支吻合构成肩峰动脉网.其长度为4.6±1.1cm,外径1.7±0.4mm.其主要分支肩胛冈支外径0.8±0.1mm,长度2.0±0.5cm.结论可以肩峰支为蒂设计切取肩胛冈骨瓣移位修复锁骨肩峰端骨不连.     

眼球直肌的应用解剖学

目的 :为眼球直肌联结术提供解剖学依据。方法 :对 30具甲醛固定的成人尸头和 4具新鲜尸头眼直肌动脉进行了显微解剖学观测。结果 :眼直肌的动脉主干可分为单干、双干和三干三种类型 ,上、下、外直肌动脉多为单干型 ,分别占 53.3%、91.7%、68.3%。上、下、外直肌动脉干的长度分别为5.7± 1.4 mm、8.2± 1.8mm、5.9± 1.9mm。上、下直肌动脉入肌点距肌止点距离分别为 2 8.1± 4 .0 mm、19.2± 3.6mm。将各直肌分为前、中、后三段 :上直肌入肌动脉共有 2 81支 ,其中在肌的后 1/ 3段入肌者2 52支 ( 89.7% )、中段 2 3支 ( 8.2 % )、前段 6支( 2 .1% ) ;外直肌入肌动脉有 398支 ,在肌后 1/ 3段入肌者 2 76支 ( 69.3% )、中段 10 2支 ( 2 5.6% )、前段2 0支 ( 5.0 % ) ;下直肌入肌动脉共有 34 3支 ,在肌中1/ 3段入肌者 170支 ( 4 9.6% ) ;后段 167支 ( 4 8.7% ) ;前段 6支 ( 1.7% )。下直肌动脉干入肌前分支最多 ,各直肌内小动脉走行与肌束平行。结论 :行眼球直肌联结术时 ,应注意保护肌动脉     

带腓肠外侧皮神经及其营养血管筋膜皮瓣的应用解剖

<正> 为带腓肠外侧皮神经及其营养血管筋膜皮瓣的临床应用提供解剖学基础.在32侧成人下肢标本上,对腓肠外侧皮神经及其营养血管进行解剖观测.结果:腓肠外侧皮神经在腓骨头平面上方(7.l±2.4)cm处起于腓总神经,横径为(2.6±1.0)mm,沿腘窝及小腿后外侧面下行,腓骨头平面的横径为(3.0±0.9)mm,发出1-3个终支,分布于小腿后外侧上半或上2/3的皮肤.其营养动脉主要为:①腓肠外侧皮动脉;起自腘动脉外侧壁,在排骨头平面上方(5.0±1.5)cm处浅出,外径为(0.9±0.3)mm,穿出前长度为(3.11.2)cm,伴腓肠外侧皮神经及其主要分支下行;②肌间隔筋膜皮支:起自胫后动脉(占54.5%)和腓动脉(占45.5%),向后外行,自小腿三头肌与腓骨长、短肌之间的肌间隔穿出,穿出点分别在腓骨头平面下方(9.2±3.8)cm和(15.8±3.8)cm,外径为(0.7±0.3)mm和(0.9±0.4)mm,穿出前长度分别为(3.6±1.1)cm和(3.6±1.4)cm.该营养动脉除在腓肠外侧皮神经主干及其分支旁或其内呈相互吻合,形成纵行的动脉丛(网)外,沿途还发出分支至周围的筋膜皮肤,并借吻合支     

以胫前返血管为蒂腓骨上段移植的应用解剖

目的:为胫前返血管蒂腓骨瓣的设计提供解剖学基础。方法:30侧经动脉红色乳胶灌注的成人下肢标本,解剖观测胫前返动脉的起始、走行、分支及分布。结果:胫前返动脉始于胫前动脉,起始点距腓骨头尖下(4.5±0.7)cm(3.0～6.0cm),动脉主干长(0.5±0.2)cm(0.2～1.2cm),外径(2.0±0.4)mm(1.3～3.0mm),伴行静脉2条,外径为(2.1±0.5)mm(1.5～3.0mm)和(2.6±0.4)mm(1.7～3.2mm)。胫前返动脉腓骨头支1～2支,外径(1.7±1.3)mm(0.6～2.1mm),分布于腓骨头的前内侧面骨膜,并与其它来源的腓骨上段骨膜支构成动脉网。腓骨头支起始点至胫前返动脉起始点长度为(1.0±0.4)cm(0.3～1.8cm),其中长度≥1.0cm者占46.7%。腓骨头支起始点以远1.5cm处的胫前返动脉外径为(1.4±0.5)mm(0.8～2.1mm)。结论:胫前返血管蒂腓骨瓣的的设计具有可行性,为临床带血管腓骨上段移植提供一种新的可供选择的血管蒂。     

隐神经营养血管远端蒂皮瓣的应用解剖

目的:为隐神经营养血管皮瓣设计提供解剖学依据。方法:灌注红色乳胶成人下肢标本30侧,解剖观测大隐静脉隐神经营养血管及其吻合关系。结果:小腿内侧下1/3段有胫后动脉肌间隙支2～3支,外径(1.1±0.3)mm;骨皮穿支1～2支,外径(1.0±0.3)mm;内踝前动脉踝前内侧穿支外径(0.6～0.8)mm;胫前动脉踝上穿支外径(0.8±0.3)mm。上述穿支吻合构成前、中、后3条纵向的血管丛以及骨膜、深筋膜和神经浅静脉3个层面的血管丛。结论:小腿内侧下1/3段有明显的多源性供血,皮肤、筋膜、骨膜、大隐静脉和隐神经等的营养血管同源,可以设计以胫后动脉肌间隙支为蒂的小腿内侧隐神经营养血管远端蒂皮瓣。     

子宫动脉上行支的解剖学研究及临床意义

目的:为设计保留子宫动脉上行支及卵巢支的子宫剥除术式提供解剖学依据。方法:随机收集108例新鲜离体子宫连带一侧或双侧附件标本,解剖观测子宫动脉上行支及其各分支的起点外径、位置和分布走行;观察上行支主干与宫壁肌层间紧密度。结果:子宫动脉上行支主干左为(2.81±0.57)mm,右为(2 86±0.56)mm;卵巢支左为(2.00±0.50)mm,右为(1.74±0.51)mm;输卵管支左为(1.33±0.40)mm,右为(1.23±0.43)mm;宫底支左为(1.66±0.39)mm,有为(1.63±0.41)mm。在宫角部上行支的分支分布类型有3型Ⅰ型占58％,Ⅱ型占34％,Ⅲ型占8％;卵巢支分支部位在圆韧带附着子宫角下缘后方至下方3cm之间;上行支主干与宫颈峡部接触较为紧密且呈较大幅度迂曲状,向上行走后逐渐平直且与子宫壁间渐为疏松,至卵巢支分支处大约有0.5 cm。结论:子宫动脉上行支及卵巢支管经较粗,且与子宫外壁保持一定间距,经临床实践,在保留卵巢的子宫切除手术中可完整保留,且不必连带子宫肌层。     

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.