术前膝内外翻畸形程度对全膝关节置换术后疗效的影响研究

目的 探讨术前膝内外翻畸形程度对全膝关节置换术（TKA）后疗效的影响。方法 回顾性分析2016年3月至2020年6月因膝关节骨关节炎于武汉大学人民医院行初次全膝关节置换术的患者174例（178膝）。依据术前患肢髋膝踝角度分为A组（膝内翻≤10°）、B组（10°＜膝内翻≤20°）、C组（膝外翻≤10°）、D组（10°＜膝外翻≤20°）。其中,男27例,女147例;年龄65 ～ 88岁,平均（72.8±6.2）岁。记录术前及术后1周术侧HKA角,术前1周及术后末次随访时的HSS、ROM、AKS评分、VAS评分、AOFAS评分。对以上指标进行组间比较及相关性分析。结果 174例患者均获得随访,随访15 ～ 66个月,平均（42.0±16.0）个月。各组术后1周时HKA角均较术前明显改善（P＜0.05）;末次随访时各组患者的HSS评分、ROM评分、AKS功能和活动评分、AOFAS评分均较术前明显提高（P＜0.05）;VAS评分均较术前明显下降（P＜0.05）。不同程度内/外翻的术前各项指标、术后HKA及优良率、AOFAS评分比较,内/外翻程度越严重,结果越差（P＜0.05）;术后HSS评分、ROM、AKS功能及活动评分、VAS评分比较,差异均无统计学意义（P＞0.05）。膝内翻患者的术前HKA角与术前HSS评分、ROM、AKS活动及功能评分、VAS评分、AOFAS评分、术后AOFAS评分正相关（P＜0.05）,与术后HSS评分、ROM、AKS活动及功能评分、VAS评分无相关（P＞0.05）。膝外翻患者的术前HKA角与术前HSS评分、ROM、AKS活动及功能评分、AOFAS评分、术后AOFAS评分负相关（P＜0.05）,与术后HSS评分、ROM、AKS活动及功能评分、VAS评分、术前VAS评分无相关（P＞0.05）。结论 从中期随访来看,患者术前膝内、外翻畸形的严重程度对术后HKA对线优良率、术后踝关节功能、术前膝关节功能有显著影响,而对术后膝关节功能无显著影响。     

基于足负重位CT影像应用Mimics软件测量拇外翻相关指标

目的 探讨基于足负重位CT图像应用Mimics软件测量拇外翻相关角度的准确性及可靠性。方法 前瞻性选择昆明医科大学第一附属医院2016年7月—2017年3月收治的30例(36足)拇外翻患者,应用Mimics软件对患者足负重位CT图像行拇外翻3D重建。应用Mimics软件拟合区域功能自动分析计算生成近节趾骨轴线和第一、二跖骨轴线,并重建第一跖骨远端实际关节面,通过近节趾骨与第一跖骨3D模型进行修正;采用以上解剖学参数实现对拇外翻角(HVA)、跖骨间角(IMA)、跖骨远端关节面夹角(DMAA)的精确测量。由4名测量者分别使用上述计算机辅助CT建模测量法与常规X线测量法对30例拇外翻患者进行测量,比较各组观察指标测量结果的统计学差异,并行Bland-Altman分析一致性。结果 4名测量者采用常规X线法和CT建模重建法测量结果的ICC值分别为0.89和0.91,可靠性优。传统X线测量法测量患者HVA、IMA分别为29.10°±10.04°、13.98°±4.38°,CT建模法测量患者HVA、IMA分别为30.02°±10.62°、13.83°±4.29°,差异均无统计学意义(P值均＞0.05);传统X线测量法测量患者DMAA为12.57°±3.96°,CT建模法测量患者DMAA为16.21°±3.65°,差异有统计学意义(P＜0.01);Bland-Altman结果显示对于HVA、IMA角的两种测量方法一致性较好,DMAA的测量结果一致性较差。结论 基于足部模拟负重CT图像应用Mimics软件测量拇外翻HVA、IMA、DMAA可以精准生成上述3个角的边线,进而实现角度的精确测量;重建第一跖骨远端关节面,使DMAA测量的准确度和可靠性明显优于常规X线测量法。该方法是一种可行、可靠并且精准的测量方法,为拇外翻精准化、个体化治疗提供了可靠的基础。     

微创接骨板内固定治疗Sanders Ⅱ型跟骨关节内骨折的三维有限元分析及临床疗效评估

目的 通过三维有限元分析评价跟骨微创锁定接骨板的稳定性,并评价采用跟骨微创锁定接骨板治疗Sanders Ⅱ型跟骨关节内骨折的临床疗效。方法 建立三种微创锁定接骨板固定Sanders Ⅱ型跟骨关节内骨折的三维有限元模型,模拟加载700 N应力后进行三维有限元分析,评价微创锁定接骨板的生物力学稳定性。自2020年1月至2021年5月,珠海市第五人民医院共收治26例Sanders Ⅱ型跟骨关节内骨折患者,其中男17例,女9例,平均年龄（43.3±8.2）岁（21 ～ 61岁）。所有患者择期行经跗骨窦切口有限切开复位跟骨微创锁定接骨板内固定。术后定期随访复查摄片,测量Böhler角及Gissane角,同时采用美国骨科足踝外科协会（AOFAS）踝关节与后足评分及视觉模拟量表评分（VAS）评估治疗效果,并记录相关并发症。结果 三维有限元分析结果显示内植物的最大应力值均低于其屈服强度,三种固定方式的骨块最大移位值均位于载距突。临床研究中2例患者失随访,其余24例患者获平均14.5个月（12 ～ 18个月）随访。除1例患者出现伤口延迟愈合外,余未见软组织并发症。术后3个月复查摄片明确骨折端愈合。术后末次随访时摄片Böhler角从术前10.9°±5.3°增加至术后末次随访时31.3°±2.3°（P＜0.05）,而Gissane角从术前108.3°±24.2°改善至术后末次随访时113.3°±5.5°（P＞0.05）。末次随访时AOFAS踝关节与后足评分平均为（88.9±6.6）分（76 ～ 100分）,VAS平均（1.0±0.9）分（0 ～ 3分）。除1例患者复查CT见关节面复位欠佳外,余患者未见骨不连、畸形愈合、固定失效、创伤性关节炎等并发症。结论 采用跟骨微创锁定接骨板固定治疗Sanders Ⅱ型跟骨关节内骨折具有创伤小、术后并发症少、固定稳定性可靠等优势,是一种安全、有效的治疗技术。     

特色微镰刀微创治疗拇外翻畸形临床观察

目的探究特色微镰刀微创治疗拇外翻畸形的临床疗效。方法选取江门市蓬江区中西医结合医院骨科2014年1月到2017年1月收治的拇外翻畸形患者80例,按照随机数字表法将患者随机分为观察组和对照组,各40例。对照组患者给予常规手术截骨治疗,观察组患者给予特色微镰刀微创治疗。所有患者术后完成6个月随访,比较2组患者手术前后AOFAS踝-后足评分系统(AOFAS)评分,拇外翻角(HVA),第l、2跖骨间角(IMA1~2),近侧关节固定角(PASA),第4、5跖骨间角(IM 4~5),第5跖骨外翻角,胫侧籽骨位置(TSP)的差异,并于术后6个月门诊随访时对患者临床疗效和胼胝疼痛进行评估。结果经不同术式治疗后,2组患者AOFAS均明显高于治疗前,且观察组明显高于对照组,2组患者HVA、IMA1~2、IMA4~5以及第5跖骨外翻角均明显低于手术前,且观察组明显低于对照组,组间比较差异均有统计学意义(P0.05);2组患者手术前后PASA组间比较,差异均无统计学意义(P0.05)。观察组患者治疗优良率(100%)明显高于对照组(90.00%),差异有统计学意义(χ2=4.21,P=0.04)。2组患者VSA评分均明显低于治疗前,且观察组患者VAS评分(0.44±0.12)分明显低于对照组的(0.95±0.18)分,差异有统计学意义(t=14.91,P=0.000)。结论特色微镰刀微创治疗与传统截骨治疗相比临床疗效更显著,能有效纠正患者拇外翻畸形,缓解患者胼胝疼痛。     

关节镜下内侧支持带重叠缝合联合外侧松解治疗青少年创伤性髌骨脱位的临床研究

目的 探讨膝关节镜下内侧支持带重叠缝合联合外侧支持带松解治疗伴有撕脱性骨折的创伤性髌骨脱位的临床疗效。方法 回顾性分析2018年5月至2021年5月秦皇岛市第一医院诊治的30例青少年初次创伤性髌骨脱位合并髌骨内侧缘撕脱性骨折的患者,均在关节镜下采用内侧支持带重叠缝合联合外侧支持带松解方法治疗。评估膝关节优良率,术后6个月及1年的Kujala髌股关节评分、Lysholm膝关节评分、IKDC膝关节评分的改善情况,记录术前、术后6个月、术后1年的膝关节活动度、髌骨倾斜角、髌骨适合角及髌骨外移率。结果 ①30例患者术后均恢复良好,髌骨位置解剖复位,术后平均随访时间为12.1个月（10 ～ 18个月）,均无复发性脱位或半脱位发生;②膝关节优良率、Kujala髌股关节评分、Lysholm评分、IKDC评分分别由术前的3.3%、（45.3±2.2）分、（36.8±2.5）分、（53.5±4.9）分提高至术后1年的93.3%、（92.9±2.2）分、（94.8±3.5）分、（98.3±5.0）分,差异均具有统计学意义（P＜0.05）;③膝关节活动度由术前的（25.3±4.5）°提高至术后1年的（125.4±3.2）°,髌骨倾斜角、髌骨适合角及髌骨外移率分别由术前的（12.5±1.8）°、（19.2±1.9）°、（18.5±2.3）%降至术后1年的（5.6±0.7）°、（6.8±1.0）°、（6.9±0.8）%,差异均具有统计学意义（P＜0.05）。结论 膝关节镜下内侧支持带重叠缝合联合外侧支持带松解治疗伴有撕脱性骨折的创伤性髌骨脱位安全有效,可获得稳定的髌骨运动轨迹,术后中短期随访影像学指标和临床功能评分满意。     

重建板矫形内固定治疗拇外翻临床研究

目的探讨重建板矫形内固定治疗拇外翻的临床疗效。方法 2008年10月~2011年4月采用重建板矫形内固定术治疗拇外翻患者25例,共48足。临床症状采用美国足与踝关节协会1994年制定的AOFAS评分系统,影像学采用2006年2月中华骨科学会足踝外科学组制定的拇趾外翻的分型标准,术前与术后进行对比。结果术后与术前相比,HVA平均矫正17.3±1.2°,IMA平均矫正3.5±1.2°。AOFAS评分平均增加55.6±3.7分。结论重建板矫形内固定治疗拇外翻是一种较为理想的方法。     

斜外侧腰椎融合术联合Smith-Petersen截骨治疗伴矢状面失衡成人退行性脊柱侧凸疗效观察

目的 观察斜外侧腰椎椎间融合术（oblique lumbar interbody fusion, OLIF）联合Smith-Petersen截骨（SPO截骨）对成人退行性脊柱侧凸矢状面失衡矫形效果,并与单纯后路矫形融合手术进行比较。方法 回顾性分析2014年11月至2019年10月华中科技大学同济医学院附属同济医院收治的64例成人退行性脊柱侧凸患者资料,根据手术方式分为OLIF联合SPO组（33例）和单纯后路矫形组（31例）。记录患者的手术时间、术中出血量及术后住院时间;评估术前、术后3个月、术后1年及末次随访的腰痛和腿痛的疼痛视觉模拟评分（visual analogue scale, VAS）、Oswestry功能障碍指数（Oswestry disability index, ODI）;脊柱全长X线评估脊柱侧凸冠状面Cobb角、腰椎前凸角（lumbar lordosis, LL）、骨盆倾斜角（pelvic tilt, PT）、骨盆入射角（pelvic incidence, PI）与腰椎前凸角（LL）差值（PI-LL）、矢状面平衡（sagittal vertical axis, SVA）等情况,并观察随访期内固定相关并发症,包括近端交界性后凸（proximal junctional kyphosis, PJK）、近端交界区失败（proximal junctional failure, PJF）、内固定失败等。结果 所有患者随访24 ～ 51个月,平均（34.38±8.6）个月。OLIF联合SPO组术中出血量及术后平均住院时间低于单纯后路矫形组（P＜0.05）,而平均手术时间高于单纯后路矫形组（P<0.001）。两组患者术后腰、腿痛VAS评分及ODI评分较术前有显著下降（P＜0.05）,两组间比较差异无统计学意义（P＞0.05）;冠状面参数比较,两组患者术后随访冠状面Cobb角均较术前明显下降,同时OLIF联合SPO组术后及末次随访Cobb角小于单纯后路矫形组（术后1周6.8°±4.5° vs 12.3°±7.3°,末次随访9.1°±7.3° vs 15.2°±11.7°,P＜0.05）。矢状面参数比较,两组术后及末次随访PT、LL、PI-LL及SVA均较术前明显改善（P＜0.05）,而OLIF联合SPO组末次随访LL大于单纯后路矫形组（34.3°±6.4° vs 29.6°±8.9°）,PI-LL小于单纯后路矫形组（16.4°±5.3° vs 21.9°±11.2°）,差异具有统计学意义（P＜0.05）。OLIF联合SPO组PJK、PJF及内固定失败等内固定相关并发症发生率低于单纯后路矫形组（18.2% vs 25.8%）,但差异无统计学意义（P=0.461）。结论 OLIF联合Smith-Petersen截骨治疗成人退变性脊柱侧凸安全、有效,其能够提供坚强的前柱支撑,有效地恢复腰椎前凸,纠正矢状面失衡,并且还有助于减少术中出血,促进术后康复。     

新型多用途跟骨髓内微创稳定系统在跟骨Sanders Ⅲ型骨折中的应用

目的 探讨新型多用途跟骨髓内微创稳定系统在跟骨SandersⅢ型骨折中的治疗应用。方法 自2020年12月至2022年1月,对12例跟骨SandersⅢ型骨折患者应用新型多用途跟骨髓内微创稳定系统进行治疗,患者均为男性,平均年龄44.1岁（26 ～ 60岁）,根据美国矫形足踝协会（AOFAS）后足评分标准进行功能和疗效评估。结果 随访时间6 ～ 13个月,平均10.6个月,12例跟骨SandersⅢ型骨折手术治疗后骨折愈合（8.00±2.08）周。所有患者均未出现跟骨内固定术后复位丢失,无内固定意外发生。末次随访的后足AOFAS评分,本组12例评分均为优（90 ～ 100分）,平均（92.88±3.33）分。结论 新型多用途跟骨髓内微创稳定系统在治疗SandersⅢ型骨折中表现优异,微创操作,安全性高,低的软组织皮肤伤口并发症,内固定框架结构稳定,有效防止跟骨复位的丢失,骨折康复迅速,是一种理想的内固定器材,较好地解决了受外科医生影响的预后因素。     

指掌骨接骨板治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折的临床体会

目的 探索切开复位指掌骨接骨板内固定术治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折的临床疗效。方法 回顾性收集中部战区总医院骨科2019年9月至2021年5月收治的44例不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折患者为研究对象,实施切开复位指掌骨接骨板内固定手术,所纳入患者行Mayo肘关节评分、上肢功能评定表（DASH）评分、视觉模拟评分（VAS）,测量手术切口长度,记录术后并发症。结果 随访12 ～ 32个月（平均18.5个月）,在末次随访时,所有桡骨头均骨性愈合。Mayo肘关节评分平均为（88.9±0.6）分,优良率97.7%（43/44）;上肢功能评定表（DASH）评分平均（7.3±0.7）分;视觉模拟评分（VAS）平均（1.6±0.1）分;三种评分较术前均有显著改善。术后切口长度为（5.6±0.1）cm。术后1例患者出现肘关节僵硬,其余未见明显术后并发症。结论 通过指掌骨接骨板内固定治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折,术后患者肘关节功能恢复良好,切口小,术后并发症少,临床上推荐应用。     

胫骨髁外翻截骨术治疗创伤性膝关节炎的早期临床疗效分析

目的 探讨胫骨髁外翻截骨术（TCVO）治疗陈旧性内侧胫骨平台骨折并发创伤性膝关节炎（TKOA）的早期临床疗效。方法 回顾性分析2016年6月至2021年6月于苏州市立医院关节外科接受TCVO手术治疗陈旧性内侧胫骨平台骨折并发TKOA的18例患者的术前及术后相关临床资料,所有患膝均为陈旧性内侧胫骨平台骨折保守治疗后畸形愈合并发膝内翻TKOA。患者发生胫骨平台骨折至TCVO手术治疗的时间为49 ～ 171个月,平均（111.1±33.8）个月;患膝内翻角度为6.81° ～ 14.49°,平均10.95°±2.62°;关节线会聚角（JLCA）为3.58° ～ 8.12°,平均5.95°±1.42°。所有患者于术前及术后3个月拍摄站立位双下肢全长X线片、膝关节正侧位X线片并测量患膝内翻角度、胫骨近端内侧角（MPTA）、JLCA、胫骨平台后倾角（PTS）,评估术前、术后下肢力线以及膝关节对合状态的变化情况。依据术前及术后3、12个月的患膝关节活动度（ROM）、疼痛视觉模拟评分（VAS）、西安大略与麦克马斯特大学（WOMAC）骨关节炎指数、膝关节损伤与骨关节炎评分（KOOS）评估早期临床疗效。结果 18例患者均获得随访,随访时间为14 ～ 65个月,平均随访（27.4±14.4）个月。术后3个月时,患膝内翻角、JLCA均较术前显著降低,差异均具有统计学意义（P＜0.05）;MPTA与术前相比有显著提升,差异有统计学意义（P＜0.05）;PTS与术前相比差异无统计学意义（P＞0.05）。术后3、12个月时,患膝关节ROM、VAS、WOMAC、KOOS评分均较术前有显著好转,差异均具有统计学意义（P＜0.05）。结论 采用TCVO治疗陈旧性内侧胫骨平台骨折并发TKOA可以取得良好的早期临床疗效,有效矫正膝关节内翻畸形,缓解膝关节疼痛及改善膝关节功能。     

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.     

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.     

'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.     

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.