新生儿膈食管裂孔的应用解剖学

本文观察了50例新生儿的膈,食管孔均呈梭形矢状位,裂孔的高度92%位于第8～10胸椎前方。构成裂孔两侧缘的肌束主要来自右内侧膈脚,又根据肌束来源及位于裂孔两侧肌束情况,把食管裂孔分为五型。裂孔边缘和食管之间的间隙,以食管外侧间隙为形成食管裂孔疝的好发部位。同时,还观察到连结食管和膈之间的膈食管韧带有防止食管裂孔疝的作用。     

空肠和回肠微血管分布特点及其临床意义

目的:为小肠疾病的病机和手术治疗以及小肠移植提供微血管构筑的解剖基础。方法:对30例正常成人尸体小肠标本动脉红色乳胶灌注并解剖剥离,体视显微镜下观察入壁动脉形态并测量其管径;6例新鲜成人游离空回肠标本墨汁灌注,组织揭层透明铺片及组织切片,光镜下观察粘膜下层微动脉配布规律并测量毛细血管密度。结果:①空肠和回肠前后长入壁动脉入肌点位置和管径均不同;②入壁动脉终支-粘膜下动脉形成三级动脉网,并分别向肌层和粘膜层发出返支和分支,构成粘膜层和肌层动脉网。结论:入壁动脉是肠壁动脉主干,粘膜下动脉则是肠壁的血供枢纽。     

Barrett食管的临床病理研究

对3485例胃镜活检标本中的18例Barrett食管(BE)进行病理形态学、组织化学研究,并对其核仁形成区相关嗜银蛋白进行观察。认为先天性柱状上皮残留和后天刺激性柱状上皮化生可能分别为不同病例的病因。BE在胃镜活检中占0.52%,在食管炎活检中占13.3%。胃—食管返流引的化学刺激是炎症的主要原因,弯曲菌感染也可能是其原因。BE有胃底型、责门型和特化型三种组织学类型。在特化型中的肠上皮可是小肠型,也可是大肠型。本组2例见腺体增殖区扩大,6例有上皮异型增生。异型增生细胞AgNORs数量与食管腺癌相近,表明BE上皮受炎症刺激而出现异型增生,是食管腺癌发生的重要原因。     

食管壁内淋巴管的微细分布

用半薄切片光镜观察和超薄切片电镜观察 ,研究了家兔食管壁内淋巴管的微细分布及各层淋巴管的分布密度。结果显示 :食管粘膜层固有膜内有毛细淋巴管 ,粘膜下层存在有毛细淋巴管及淋巴管。肌束间见有淋巴管 ,但肌束内未见淋巴管 ,外膜存有淋巴管。本研究作了淋巴管的检出率 :粘膜层占 15 % ,粘膜下层占 2 4% ,肌层占 40 % ,外膜占 2 0 %。     

食管壁微动脉及毛细血管的观测

目的;观察食管壁内动脉血供及微血管构筑的基础性研究资料。方法：随机选取新鲜胎尸25具,墨汁灌注,组织切片;家兔5只,钙钴法碱性磷酸酶染色。光学显微镜下观测。结果;食管壁内各层均存在动脉网,粘膜下层动脉网丰富,分深浅两层;各层毛细血管特点各异,外膜层稀,肌层有肌束间血管网,粘膜下层呈丛状,粘膜层最丰富;食管各段毛细血管密度差异不大,但颈段前壁纵形肌、胸上段后壁粘膜层有相对毛细血管贫乏区。结论：食管的各段各层均存在动脉网,毛细血管密度差异不大,能有限代偿食管壁外供血动脉的阻断。     

食管颗粒细胞瘤一例

患者男,48岁。因左上腹无规律性疼痛不适伴嗳气2年余来院就医,于1997年4月28日行电子胃镜检查,无意中发现食管下段距门齿37ｃｍ处有1.0ｃｍ×0.5ｃｍ条形隆起肿物,遂取活检组织2块,病理诊断为食管颗粒细胞瘤。7月18日行超声胃镜复查,细探头20Ｈｚ示肿物位于粘膜下,中等细颗粒状回声,约0.50ｃｍ×0.25ｃｍ,肌层完整。随诊28个月,患者无明显不适。期间曾先后做电子胃镜复查3次,未见肿物增大。1999年11月3日再次复查,见肿物略有增大,应患者及其家属要求,行电子内窥镜肿物切除。至今已8个月余,患者恢复良好。病理检查:送检食管壁组织一块,呈不规…     

膈肌代食管手术可行性的动物解剖学研究

目的　研究猪膈肌的结构和动脉血供,探讨对猪行膈肌代食管手术实验的解剖学可行性并为其提供理论依据。 方法　杂种长白猪6头经动脉灌注明胶-氧化铅混悬液,CT扫描后将图像导入计算机行三维重建,并观察膈肌各条供血动脉的起源、走形、和分支;完整切取膈肌组织行X线摄片,观察各动脉在膈肌上分支、供血范围及相互的吻合;同时对膈肌进行大体解剖和测量。 结果　猪膈肌位置及结构与人类存在部分差异,其血供主要来自肌膈动脉、后肋间动脉、心包膈动脉及膈动脉,其主干和主要分支在重建图像上基本可显示,在X线图上可见其在膈肌上的分支丰富,相互吻合广泛。 结论　从猪膈肌的结构、动脉血供来看,具备作为带蒂组织瓣行食管替代的解剖可行性;而以膈动脉为血管蒂取组织瓣应为该手术最佳选择。     

人正常胃粘膜和慢性胃炎的扫描电镜观察

扫描电镜问世后,在医学生物学领域对物体细微结构的立体观察得到迅速发展,1962年开始应用于人和动物胃肠道粘膜的研究。关于慢性胃炎的研究工作,国内外报道较少。本文对正常和慢性浅表性胃炎、慢性萎缩性胃炎(CAG)的胃粘膜作扫描电镜观察,着重研究其基本形态特征,以加深对正常胃粘膜和这些疾患的认识。材料和方法经组织学检查未发现明显病变者的胃粘膜5例,慢性浅表性胃炎(包括轻、中、重度)25例及CAG12例。标本除3例为手术切除胃外,其余均为胃镜活检组织。胃镜取材尽可能在一处夹取两份材料,分别     

慢性萎缩性胃炎患者胃粘膜固有层平滑肌细胞组织化学、免疫组织化学及三维重组研究

现发现 ,在各种慢性胃炎的粘膜活检中可以观察到平滑肌细胞增多 ,有的增生很显著 ,同时也发现在胃癌的腺体周围平滑肌细胞往往增生很明显。我们结合临床和病理资料 ,采用组织化学、免疫组织化学及三维结构重组技术来研究慢性萎缩性胃炎 (ＧＡＧ)粘膜固有层中平滑肌细胞的形态特点及其病理意义。一、材料和方法标本选自白求恩医科大学附属第二临床医院 1997年 10月至 1998年 9月纤维胃镜钳取的胃粘膜组织和手术后胃标本 3 0 5 2例 ,慢性萎缩性胃炎 16 0例 ,女性 87例 ,略多于男性(73例 ) ,从中取ＣＡＧ胃活检标本 148例 ,发病年龄高峰为 5 1…     

气管隆嵴以下食管系膜的形态学特点

目的：为临床食管中下段肿瘤的微创切除提供气管隆嵴以下食管系膜形态的精细解剖。方法：大体解剖观 察成人尸体食管系膜及其包裹的结构；对胎儿尸体进行连续水平面取材后石蜡切片，Masson 染色确定食管系膜 的位置、形态及其和周围结构的关系；采用Mimics 19.0 软件对食管系膜进行三维重建。结果：在大体解剖和组 织学上均可观察到食管系膜结构。食管系膜除形成覆盖食管表面的浆膜，还包裹了食管周围的淋巴结、血管和神 经丛。Masson 染色显示气管隆嵴平面至膈肌食管裂孔平面之间，食管系膜的形态出现了逐渐的过渡，在第4~7 胸 椎水平食管系膜与胸主动脉外膜关系密切，第7 胸椎（T7）以下食管系膜与胸主动脉外膜相对独立。结论：气管 隆嵴以下食管系膜在T7 上下存在差异，该系膜与胸主动脉外膜关系的改变，能为食管中下段肿瘤切除时手术层 次的选择提供形态学依据。     

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.     

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 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.