昏迷病人的脑电图监测

目的：探讨昏迷病人的脑电图监测应用价值。方法：对78例昏迷病人的脑电图监测记录结果及临床预后进行回顾性分析。结果：慢波型昏迷：61例(78％)死亡7例，B昏迷：1例(1％)预后良好，α-昏迷：2例(3％)均死亡，三相波：5例(6％)死亡3例，周期复合波4例(5％)死亡3例，平坦波：5例(6％)死亡3例，植物状态2例。结论：脑电图监测对昏迷病人的预后评估有一定意义。     

动态脑电图加刺激对昏迷病人预后的临床观察

目的：探讨脑电图(EEG)及其反应性对昏迷病人预后评估的应用价值。方法：利用EEG加刺激(疼痛、呼唤)对58例昏迷病人进行24h连续监测，观察脑波的动态变化。结果：纺锤波昏迷和可变化的慢波(0、8)昏迷对刺激反应相对敏感，预后较好。无反应的慢波型(θ、δ或单一慢波)昏迷和8波昏迷，预后较差；α波、平坦波、暴发-抑制波型昏迷，对刺激无反应，死亡率为100％。周期性放电型昏迷，即使能存活下来，也留有严重的后遗症。24hEEG监测加上对刺激反应的观察对脑死亡的诊断价值明显优于常规EEG检查。结论：利用EEG加刺激的方法，对昏迷的病人进行监测，可提高对预后及脑死亡的正确判断率。     

动态脑电图在昏迷病人中的应用

目的：探讨动态脑电图监测对昏迷病人的应用价值。方法：对107例昏迷患者采用多次动态脑电图监测，分析脑电图改变与临床结局的关系。结果：平坦波型昏迷死亡率较高(94．7％)，慢波型昏迷死亡率较低(30．3％)，且预后较好。结论：对昏迷病人实施动态脑电图监测，可提高对预后评估及脑死亡的正确判断率。     

头颅术后继发癫痫的脑电图分析

目的：了解头颅术后继发性癫痫的脑电图改变特点与手术的关系。方法：对头颅手术后癫痫发作的27例病人的脑电图及临床进行分析。结果：正常脑电图3例，异常24例，异常率89％(局限性异常22例，广泛性异常2例)，局限性异常中，一侧性慢波异常6例，区域性慢波异常14例，痫样放电2例。广泛性异常中，中度异常1侧，重度异常l例。结论：头颅术后继发性癫痫的脑电图局限性异常占总异常的92％，而痫样放电仅占4％，局限性慢波与痫样放电的出现与术前病灶、手术部位、术后继发性病灶的部位有关。     

脑电图在昏迷病人中的应用及愈后分析

目的：探讨脑电图（EEG）在昏迷病人中的应用及与愈后的关系。方法：对80例昏迷病人的EEG及愈后进行分析研究。结果：80例昏迷病人中：其中α波昏迷1例治愈；β波昏迷2例中，1例治愈（50％），1例死亡；θ波昏迷30例中18例治愈，好转7例（83．3％），未愈5例；δ波昏迷27例中16例治愈，好转5例（77．8％），未愈6例；睡眠-纺锤波4例中3例治愈，1例好转（100％）；电静息16中1例好转（0．06％），15例死亡。结论：EEG可直接反映昏迷病人的脑功能状态，其愈后的严重程度依次为电静息〉δ波昏迷〉θ波昏迷〉睡眠-纺锤波昏迷。对愈后判断有重要价值。     

昏迷病人的脑电图表现及与预后的关系

目的 :探讨昏迷病人的脑电图表现和预后之间的关系。方法 :对 16 9例昏迷病人的脑电图进行回顾性分析 ,并将其与临床结局作对照。结果 :脑电图慢波型昏迷 12 0例中死亡 2 3例 (19 1% ) ;α昏迷型 11例中死亡 9例 (81 8% ) ;β昏迷型 3例和纺锤昏迷型 2例均存活 ;发作波型昏迷 13例中死亡 2例 (15 3% ) ;平坦波型昏迷 2 0例中死亡 17例 (85 % )。结论 :脑电图可作为判断昏迷病人临床预后的参考指标 ,平坦波昏迷和α波昏迷者大多死亡。β昏迷和纺锤昏迷则预后良好。     

意识障碍和脑死亡脑电图（续）

（上接年2011年第4期250页）病及脑脂质沉着症也可出现GRST。（四）广泛性周期性三相波（GFFW）三相尖波呈周期性再现,分布广泛且以两额为主。许多有意识障碍的代谢性脑病病人均发现有广泛性周期性三相波。有人观察了8例脑电图出现GPTW的病人,有肝昏迷（2例）﹑肾衰及尿毒症（2例）﹑糖尿病酮症酸中毒（1例）及Laennecs肝硬变（1例）﹑呼吸机能不全所致缺氧性脑病（2例）,其中有6例记录到GPTW,10天后死亡,提示广泛性周期性三相波常见于不可逆的代谢性脑病病人。     

颅脑术后继发癫痫的脑电图表现

目的：了解颅脑术后继发性癫痫的脑电图改变特点及其与手术的关系。方法：对因颅脑手术后癫痫发作的54例病人的脑电图及临床资料进行回顾性分析。结果：常规脑电图正常范围6例,异常48例（其中局限性异常44例,广泛性异常4例）,异常率89％。局限性异常中,一侧性慢波异常13例,区域性慢波异常29例,区域性波基础上痫样放电2例。广泛性异常中,轻度异常2例,中度异常1例,重度异常1例。结论：颅脑术后继发笥癫痫的脑电图局限性异常占总异常的92％,而局限性痫样放电仅占4％。局限性慢波与痫样放电的出现与术前病灶、手术部位、术后继发性病灶的部位有关。     

脑电图监测对小儿意识障碍的诊断价值

目的：探讨脑电图（EEG）对意识障碍患儿临床诊断及预后的价值。方法：对52例意识障碍患儿进行EEG描记,同时进行感觉刺激观察EEG的反应并与临床转归进行比较。结果：52例患儿EEG全部异常。其中α-昏迷型1例,呈弥漫性8～11Hz中高波幅α频率波;β-昏迷型1例,呈弥漫性13～20Hz低中波幅β波,外界刺激无反应;θ-昏迷型18例,呈弥漫性20～280μV的θ波;争昏迷型16例,呈弥漫性高波幅δ波;伴有癎样放电者6例,在慢波背景上不同区域出现癎样发作波;纺锤波昏迷2例,为20～150μV的纺锤波,以中央、顶区为主;低电压倾向8例,呈低波幅慢活动。临床结局：临床痊愈38例,遗留后遗症11例,死亡3例。结论：EEG描记可以了解昏迷病人脑功能受损情况,为诊断和评估预后提供参考依据。     

昏迷病人动态脑电图的临床应用

目的 动态脑电图检测对昏迷病人的应用价值.方法 对107例昏迷患者采用多次动态脑电图检测.分析脑电图改变与临床结局的关系.结果 平坦波昏迷死亡率较高(94.7%),慢波型昏迷死亡率较低(30.3%),且预后较好.结论 对昏迷病人实施动态脑电图监测,可提高对预后评估及脑死亡的正确判断率.     

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.