排斥性导向分子a抑制剂6FNⅢ对大鼠大脑皮质神经元缺血再灌注后自噬的作用

目的 探讨排斥性导向分子a(RGMa)特异性抑制剂6FNⅢ对大鼠大脑皮质神经元缺血再灌注引发的自噬及对神经功能恢复的影响。 方法 雄性成年SD大鼠立体定位侧脑室注射不同浓度6FNⅢ后建立大脑中动脉闭塞（MCAO）/再灌注模型,Western blotting检测RGMa下游分子脑衰反应调节蛋白-2（CRMP-2）蛋白表达水平,确定最佳6FNⅢ干预浓度。将72只雄性成年SD大鼠随机分成4组：假手术组（sham）、脑缺血再灌注组（I/R）、生理盐水干预组（I/R+NS）、6FNⅢ干预组（I/R+6FNⅢ）,每组18只。缺血2h再灌注后24h,采用神经功能缺损评分评估各组大鼠神经功能恢复情况;Western blotting检测自噬相关蛋白LC3Ⅱ/Ⅰ水平;免疫荧光双标检测LC3在神经元内的表达情况;透射电子显微镜观察自噬体的形成情况。 结果 根据各浓度6FNⅢ干预组CRMP-2表达,确定中浓度（0.5 g/L）为本实验的最适浓度。缺血再灌注后24h,I/R组较sham组神经功能评分降低(P＜0.05)、自噬相关蛋白LC3Ⅱ/Ⅰ水平升高(P＜0.05)、自噬体形成增多;I/R+6FNⅢ组较I/R组神经功能评分增高(P＜0.05)、自噬相关蛋白LC3Ⅱ/Ⅰ水平降低(P＜0.05)、自噬体形成减少;而I/R+NS组与I/R组以上各项均无统计学意义(P＞0.05)。 结论 RGMa特异性抑制剂6FNⅡ可在缺血再灌注急性期抑制自噬发生,促进神经功能恢复。     

缺血后适应对大鼠局灶性脑缺血再灌注所致自噬的抑制作用

目的:探讨缺血后适应对大鼠局灶性脑缺血再灌注所致自噬的影响。方法:取健康雄性SD大鼠30只,随机分为假手术(sham)组、缺血再灌注(I/R)组、缺血后适应(IPC)组,每组各10只。Sham组仅单纯暴露右侧颈总、颈内和颈外动脉;I/R组采用Longa改良线栓法制备大鼠右侧大脑中动脉缺血2 h、再灌注24 h模型;IPC组大鼠缺血2 h后,同侧颈总动脉再通10 s/闭塞10 s,循环5次,然后全面恢复血流再灌注24 h。采用透射电镜观察脑细胞自噬情况;Western blot法测定各组大鼠脑组织中哺乳动物雷帕霉素靶蛋白(m TOR)、磷酸化m TOR(pm TOR)和微管相关蛋白轻链3(LC3)-Ⅱ的蛋白表达水平;TTC法检测脑梗死面积;干湿称重法测定脑组织含水量;HE染色观察脑组织病理学变化。结果:IPC组m TOR、p-m TOR均显著高于I/R组(P0.05),LC3-Ⅱ显著低于I/R组(P0.01)。IPC组脑梗死面积、脑组织含水量均显著低于I/R组(P0.01)。HE染色显示,IPC组神经元变性、坏死较I/R组明显减轻。透射电镜显示IPC组神经元损伤程度明显减轻,自噬泡明显减少。结论:IPC通过减少细胞内自噬而减轻脑缺血再灌注损伤,可能与增强m TOR作用有关。     

白藜芦醇通过Sirtuins 1通路促进自噬减轻大鼠脑缺血/再灌注损伤

目的观察白藜芦醇(Res)在大鼠局灶性脑缺血/再灌注(I/R)损伤中脑保护作用与自噬的关系。方法随机将大鼠分成假手术组(S组)、脑缺血/再灌注模型组(I/R组)、低和高剂量(15和40 mg/kg)Res处理组(R1和R2组),其中将R2组另设2个亚组:R2+3-甲基腺嘌呤(3-MA)组和R2+Sirt1抑制剂Sirtinol组。线栓法构建大鼠I/R模型。缺血2 h,再灌注24 h后,用尼氏染色观察皮质区的组织学形态;用2,3,5-氯化三苯基四氮唑(TTC)染色法检测脑组织的梗死体积;用real-time QPCR和Western blot检测脑组织中Sirt1和LC3的mRNA和蛋白表达。结果与S组相比,I/R组大鼠可见明显的脑梗死灶,显微镜下见病理损伤改变,自噬相关蛋白LC3Ⅱ/LC3Ⅰ、Sirt1表达均有上升。Res预处理后,能明显减轻I/R大鼠皮质区的病理损伤,减少脑梗死体积(P0.01),显著增加I/R大鼠脑组织中LC3Ⅱ/LC3Ⅰ和Sirt1的表达(P0.01);而Sirt1抑制剂及3-MA能削弱Res的作用。结论 Res减轻大鼠局灶性脑缺血/再灌注损伤的脑保护作用可能与Res通过提高Sirt1的表达进而促进自噬来完成的。     

sCR1-SCR15-18蛋白减轻补体介导的大鼠脑缺血/再灌注损伤

目的: 探讨补体在大鼠大脑缺血/再灌注(ischemia-reperfusion,I/R)损伤中的作用及重组人可溶性补体受体Ⅰ型SCR15-18蛋白(sCR1-SCR15-18)的保护作用。方法: 75只雄性SD大鼠,随机分为假手术组、I/R组和sCR1 -SCR15-18保护组。采用线栓法建立大鼠大脑中动脉闭塞模型(middle cerebral artery occlusion MCAO),缺血2 h,再灌注24 h后,进行神经功能学评分,测定脑梗死体积、大脑皮质髓过氧化物酶(myeloperoxidase,MPO)活性,观察大脑皮质区补体C3b沉积和病理改变。结果: 缺血/再灌注24 h后,sCR1-SCR15-18保护组神经功能学评分,脑梗死体积及脑皮质MPO活性明显低于I/R组(P<0.05);sCR1 -SCR15-18保护组缺血脑组织补体C3b沉积明显减少,病理损伤减轻。结论: 补体在脑I/R损伤中起一定作用,sCR1-SCR15-18蛋白对大鼠I/R损伤脑具有保护作用。     

针刺通过PI3K-Ⅲ/Beclin-1通路抑制脑缺血-再灌注损伤大鼠的细胞凋亡

目的:利用大脑中动脉闭塞/再灌注(MCAO/R)法制备大鼠脑缺血再灌注损伤(CIRI)模型，研究针刺对CIRI模型大鼠脑组织中Ⅲ型磷脂酰肌醇-3-羟激酶(PI3K-Ⅲ)/Beclin-1通路的影响。方法:利用MCAO/R方法制备SD大鼠CIRI模型，分别给予针刺和(或)自噬抑制剂3-甲基腺嘌呤(3-MA)进行治疗。利用采用Garcia评分法检测大鼠神经功能，TTC染色法检测大鼠脑梗死面积，Western Blot法检测海马组织PI3K-Ⅲ、Beclin-1和B淋巴细胞瘤-2基因(Bcl-2)蛋白的表达水平，TUNEL法检测细胞凋亡。结果:MCAO/R手术后大鼠神经功能评分降低(P<0.01),TTC染色观察到脑梗死，同时海马区PI3K-Ⅲ、Beclin-1和Bcl-2表达显著下调(P<0.01),脑皮质细胞凋亡增多(P<0.01)。针刺治疗不但提高了大鼠神经功能评分(P<0.01),并且减少了脑梗死面积(P<0.01);同时显著上调了海马组织中PI3K-Ⅲ、Beclin-1和Bcl-2表达(P<0.01),并减少了脑细胞凋亡(P<0.01)。3...     

黄芪甲苷对脑缺血/再灌注损伤大鼠细胞自噬的影响

目的:探讨黄芪甲苷对脑缺血/再灌注损伤大鼠细胞自噬的影响。方法:选取清洁级雄性SD大鼠70只随机分为假手术组、脑缺血/再灌注组、溶剂对照组、黄芪甲苷组、黄芪甲苷+自噬抑制剂组、自噬抑制剂组和自噬激活剂组。采用线栓法建立大鼠局灶性脑缺血/再灌注损伤模型。观察大鼠神经缺损症状,根据Zea Longa评分标准挑选模型成功的大鼠;采用TTC染色法检测大鼠脑梗死体积;尼氏染色观察大鼠神经细胞形态学变化;透射电子显微镜观察细胞自噬现象;Western blot检测beclin-1和LC3-Ⅱ蛋白表达量的变化。结果:假手术组无神经缺损症状,未出现脑梗死灶,尼氏体丰富、染色均匀。与假手术组相比,脑缺血/再灌注组出现明显的脑梗死灶,神经细胞坏死增多,尼氏体数量减少、着色较浅,透射电镜下可见典型的自噬体,自噬标志蛋白beclin-1和LC3-Ⅱ表达增加(P 0. 05)。与脑缺血/再灌注组相比,黄芪甲苷组和自噬激活剂组可明显减小脑梗死体积,神经细胞有不同程度的恢复,尼氏体稍增多,自噬体数量、beclin-1和LC3-Ⅱ表达量均增加(P 0. 05);自噬抑制剂组脑梗死体积增大,神经细胞坏死严重,尼氏体减少,着色变浅,自噬体数量、beclin-1和LC3-Ⅱ表达量均减少(P 0. 05);溶剂对照组无明显变化。与黄芪甲苷组比较,黄芪甲苷+自噬抑制剂组和自噬抑制剂组脑梗死体积增加,神经细胞坏死增多,尼氏体数量减少,自噬体数量、beclin-1和LC3-Ⅱ表达量降低(P 0. 05)。结论:黄芪甲苷可通过激活自噬而减轻脑缺血/再灌注损伤,从而发挥神经保护作用。     

半胱氨酸蛋白酶抑制剂C对脑缺血再灌注大鼠脑皮质中热休克蛋白70、微管相关蛋白轻链3蛋白表达和神经元超微结构的影响

目的应用不同浓度的半胱氨酸蛋白酶抑制剂C(Cys C)干预脑缺血再灌注大鼠,检测热休克蛋白70(HSP70)和微管相关蛋白轻链3(LC3)蛋白的表达,观察其对神经元超微结构的影响。方法成年雄性SD大鼠60只,随机分成5组:假手术组(sham)、缺血再灌注组(IR),Cys C低浓度组(Cys C1)、Cys C中浓度组(Cys C2)、Cys C高浓度组(Cys C3),每组12只。采用线栓法制备脑缺血再灌注损伤模型,缺血2 h再灌注24 h后进行改良神经功能损伤严重程度评分(m NSS)。Western blotting半定量检测损伤中心脑皮质组织中HSP70、LC3-Ⅱ/LC3-Ⅰ蛋白表达;免疫组织化学法检测HSP70、LC3的阳性细胞个数;免疫荧光双标记法检测皮质神经元自噬相关蛋白LC3和神经元核抗原(Neu N)共染的阳性细胞平均吸光度值;透射电子显微镜下观察神经元超微结构的变化。结果与IR组相比,Cys C1、Cys C2组m NSS评分明显减少(P0. 05),HSP70的表达较IR组明显升高(P0. 01);而Cys C3组m NSS评分升高,与IR组差别无显著性(P0. 05); Cys C3组HSP70的表达明显降低(P0. 01); Cys C各浓度组LC3-Ⅱ/LC3-Ⅰ的表达有不同程度的升高(P0. 01); LC3和Neu N共染阳性细胞平均吸光度逐渐增强(P0. 05);透射电子显微镜结果显示,Cys C1、Cys C2组神经细胞的超微结构有所改善,而Cys C3组脑皮质神经细胞损伤较重。结论 Cys C可能在一定浓度范围内对缺血再灌注损伤神经细胞有保护作用。浓度过高则导致神经细胞自噬性死亡。     

重组人生长停滞特异性蛋白6预处理对大鼠局灶性脑缺血再灌注PI3K/AKT的影响

目的研究生长停滞特异性蛋白6(Gas 6)对Wistar大鼠局灶性脑缺血再灌注损伤的影响,探讨其与PI3K/Akt通路的关系。方法线栓法制作大鼠局灶性脑缺血再灌注模型,将大鼠随机分成4组:假手术组(Sham组)、缺血再灌注组(I/R组)、Gas6预处理组(Gas6组)、Gas6预处理联合PI3K抑制剂Wortmannin组(Gas6+W组)。按Zea-Longa 5分制法测定各组神经功能评分,干湿重法测定脑组织含水量、TTC染色测定脑梗死面积、Western-blot法检测脑组织p-Akt的蛋白表达。结果 I/R组较Sham组神经功能缺损、脑含水量和梗死区均增加,p-Akt表达上调;Gas6组较I/R组,神经功能缺血损伤、脑含水量和梗死面积显著减少,p-Akt表达进一步上调;而给与PI3K抑制剂后,Gas6+W组与Gas6组比较,神经功能缺损、脑含水量和梗死面积显著增加,p-Akt的表达显著下调。结论 Gas6对于大鼠脑缺血再灌注损伤具有保护作用,可能与激活PI3K/Akt信号通路相关。     

羟基红花黄素A对脑缺血再灌注后缺血半暗带自噬活性的调节作用

目的:探讨脑缺血再灌注后羟基红花黄素A(hydroxysafflor yellow A,HYSA)对缺血半暗带自噬活性的调控机制。方法:构建雄性SD大鼠脑缺血90 min再灌注模型,分为假手术组、脑缺血再灌注(cerebral ischmia/reperfusion,I/R)组、I/R+HSYA组和假手术+HSYA组,分别在再灌注后6 h、1 d、3 d和7 d对大鼠进行改良神经功能缺损评分(modified neurological severity score,m NSS),同时检测缺血半暗带的自噬活性、凋亡及干扰素β(IFN-β)表达。结果:与假手术组比较,I/R组缺血半暗带在6 h~7 d内可见LC3-Ⅱ蛋白表达增高及SQSTM1/P62蛋白降解,提示自噬激活;与I/R组比较,I/R+HSYA组的自噬活性在1 d和3 d时明显升高(P0.05),7 d时则明显降低(P0.05)。同时,I/R组的IFN-β表达较假手术组在6 h时升高(P0.05),1 d和3 d时降低(P0.05),7 d时恢复正常;而I/R+HSYA组的IFN-β表达在1 d和3 d时明显高于假手术组和I/R组(P0.05),并且3 d时的细胞凋亡少于I/R组,m NSS评分自4 d起明显低于I/R组(P0.05)。结论:HSYA可动态调节缺血半暗带的自噬活性和IFN-β表达,从而改善脑缺血再灌注损伤。     

磷酸肌酸减少大鼠缺血再灌注心肌细胞凋亡及自噬泡的数量

目的 研究磷酸肌酸减少大鼠缺血再灌注心肌细胞凋亡及白噬的能力.方法 雄性SD大鼠24只,体质量200 ～ 250 g,随机均分为假手术(sham)组、缺血/再灌注(ischemia-reperfusion,I/R)组和磷酸肌酸钠(phosphocreatine,CP)干预组.其中CP组按4 mg/kg磷酸肌酸钠剂量于再灌注前经右股静脉注射.用TUNEL法检测心肌细胞凋亡;电子显微镜观察心肌细胞自噬泡的发生和线粒体的形态学改变;Western blot检测微管相关蛋白1轻链3-Ⅱ(LC3-Ⅱ)蛋白的表达.结果 I/R组与sham组相比,线粒体超微结构损伤加重,自噬泡数量增多(P＜0.01),心肌细胞凋亡率明显增加(P＜0.01);CP干预组可减轻I/R组线粒体超微结构损伤,自噬泡数量减少(P＜0.05),降低心肌细胞凋亡率(P ＜0.05);LC3-Ⅱ作为评价自噬强度的指标,I/R组与sham组相比,LC3-Ⅱ蛋白的表达明显上调(P＜0.01);而CP与I/R组相比,该蛋白表达明显下调(P＜0.05).结论 磷酸肌酸通过减少大鼠缺血再灌注心肌细胞凋亡及自噬泡的数量,从而减轻心肌缺血再灌注损伤.     

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.