骨间返动脉为蒂尺骨上段骨膜瓣移位的应用解剖

目的：为尺骨中上段和肱骨下段骨不连提供带血管蒂明膜瓣移位修复的解剖学基础，方法：在３６侧成人上肢标本上，观测了骨间返动脉的走行，分布和吻合，结果：骨间返动脉起始部距尺骨膺咀最突出点的长度为６．８９±１．１３ｃｍ，其动脉外径为１．３７±０．２９ｍｍ骨膜支外径为０．５４±０．２７ｍｍ，骨间返动脉母末支到肘后部与桡侧返动脉 ，桡别墅劝背侧支和中副动脉等构成吻合。结论：以骨间返动脉为蒂的尺骨上段骨膜瓣移闰     

以桡侧返或桡侧副血管为蒂的臂下外侧皮（骨膜）瓣的应用…

在５０侧成人支标本上，解剖观察了臂下外侧皮肤，肢骨下１／３段外侧半的血供，桡侧副动脉为主要营养血管，其背侧支经肱桡肌和桡侧腕伸肌之间，循肱骨外上髁嵴下行，沿余分支分布邻近皮肤，肌肉和肱骨下外侧骨膜，终支抵外上髁附近与桡侧返动脉升相吻合，墨染面积，皮肤１１．０ｃｍ×５．５ｃｍ，骨膜７ｃｍ×４ｃｍ设计臂下外侧皮（骨膜）瓣，以桡侧返血管为蒂逆行修复尺，桡骨中段骨下不连及皮肤缺损，以桡侧副血管蒂顺行修复肱     

带血管蒂上臂后侧筋膜瓣肘关节成形术的解剖和临床应用

目的：为肘关节成形术提供一个新的带血供的筋膜瓣供区。方法：通过解剖学观察,设计了以桡侧副动脉背侧支或尺侧上、下副动脉背侧分支为蒂的上臂后侧筋膜瓣,该筋膜瓣向肘关节内移位,包绕肱骨远端、尺骨切迹及桡骨小头。结果：临床应用６例,筋膜瓣面积６～８ｃｍ×１０～１２ｃｍ,血运良好,术后经１～４．５年,平均２年随访,肘关节功能明显改善。结论：带血管蒂的上臂后侧筋膜瓣转位适合于肘关节成形术,该手术可明显改善肘关节功能。     

以骨间后血管及其返支为蒂串连皮瓣设计的解剖学基础

目的 :为以骨间后血管及其返支为蒂串连皮瓣设计提供解剖学基础。方法 :在 40侧上肢标本上观测了骨间后动脉及其返支的来源、走行、分支、分布及吻合情况。结果 :前臂背侧下 2 / 3区的皮瓣由骨间后动脉供血 ,而上 1/ 3区由骨间后动脉返支 (或骨间返动脉 )供血。骨间后动脉起点外径 1.5mm ,管蒂长可达 15cm ,骨间后动脉返支起点外径 1.1mm ,血管蒂长 5cm。结论 :以骨间后动脉及其返支为蒂截取的串连皮瓣 ,向下可修复手部大面积组织缺损 ;向上可修复肘关节周围及臂下部大面积组织缺损     

骨间后动脉前臂逆行皮瓣的解剖学研究

目的:通过对骨间后动脉的解剖观测,为骨间后动脉逆行皮瓣的临床应用提供解剖学依据。方法:用30侧成人上肢标本,对骨间后动脉及其皮支、吻合支的起始、走行、分布进行解剖观测。结果:骨间后动脉发自骨间总动脉,穿过骨间膜上缘至前臂背侧,经旋后肌和拇长展肌之间在前臂深浅两层伸肌之间下行,沿途发出7~12条皮支营养前臂背侧的皮肤,其终末支(96.7%)在尺骨茎突近端(2.5±0.5)cm处与骨间前动脉的背侧支有弧形吻合支相连接。其皮支分布可达动脉主干两侧6cm范围,近侧达肘平面,远端至腕平面。结论:以骨间后动脉为蒂,可在前臂背侧设计大面积(10cm×8cm)逆行岛状皮瓣,用以修复手部皮肤组织缺损、瘢痕挛缩切除术后创面。     

前臂骨间背侧动脉逆行岛状皮瓣在手外科的应用

<正> 解剖发现前臂骨间背侧动脉的末端在腕上与骨间掌侧动脉背侧支之间有恒定的吻合支,以此吻合支为蒂,可设计前臂骨间背侧动脉逆行岛状皮瓣,修复手部软组织缺损。     

腓血管蒂比目鱼肌皮瓣逆行转位修复术的应用解剖

目的：为以腓血管为蒂比目鱼肌皮瓣逆行转位修复小腿中、下段组织缺损提供解剖学基础。方法：在３３侧经动脉灌注乳胶的下肢标本及６侧动脉铸型下肢标本上,解剖观测比目鱼肌形态,腓动脉比目鱼肌支的分布及腓动脉与胫前、后动脉之间的吻合。结果：腓动脉发出１～４条比目鱼肌支,外径２．０±０．５（１．０～３．８）ｍｍ,由其发出至皮肤的血管在比目鱼肌内或沿肌间隔穿行,穿出点在腓骨头下９．９±３．０ｃｍ,分布范围１６ｃｍ×９ｃｍ。腓动脉下端与胫前、后动脉间有丰富的吻合支和粗大的交通支,最近端交通支距内、外踝连线５．５±０．８（３．６～７．４）ｃｍ,外径１．２±０．３ｍｍ。结论：以腓血管为蒂可以形成比目鱼肌皮瓣;该瓣逆行转位可修复小腿中下段缺损,具有血供可靠、损伤小、操作简单的优点     

桡动脉和尺动脉皮支链皮瓣的应用解剖

目的为桡动脉和尺动脉皮支链皮瓣修复手部小范围软组织缺损提供解剖学资料。方法选用10侧新鲜上肢标本,6侧标本腋动脉灌注红色乳胶,解剖显示皮支;4侧标本腋动脉灌注红色铸型塑料,盐酸腐蚀,显示皮支。观察桡、尺动脉皮支的分布规律、分布范围和皮支链的链接方式。结果前臂中、下1/3段,桡、尺动脉皮支分别有5～7支和5～8支,各皮支分出升、降支,升、降支间吻合成完整的纵形皮支链,桡、尺动脉皮支链形成各自相对独立的血管供应区。结论以桡骨茎突、豌豆骨平面的桡、尺动脉远端皮支为蒂,可设计成不同形状的带蒂皮支链皮瓣,转位修复手部小范围的软组织缺损,不损伤前臂大血管甚至穿支血管。     

带血供肱骨下段内侧骨（膜）瓣移位术的应用解剖

目的：为带血供肱骨下段骨瓣移位术提供解剖学基础。方法：４０侧成人上肢标本，观测尺侧下副动脉、尺侧返动脉的起始、走行、分支分布、骨膜支和吻合。结果：尺侧下副动脉距髁间连线上３．７±１．７ｃｍ始于肱动脉，外径１．８±０．４ｍｍ，长１．８±０．７ｃｍ，骨膜支１～３支，外径０．８±０．４ｍｍ分布肱骨下段内侧半骨膜。尺侧返动脉前干外径１．１±０．２ｍｍ。尺侧上副动脉、尺侧下副动脉、尺侧返动脉在肱骨内上髁附近互相吻合。结论：利用上述血管吻合关系，设计带血供的肱骨（膜）瓣或骨皮瓣，可移位修复肱骨中上段、尺、桡骨中段骨折骨不连。临床应用已取得良好效果。     

肘下动脉穿支皮瓣的解剖学观察

目的为肘下动脉穿支皮瓣移位修复肘部软组织缺损提供解剖学基础。方法在30侧经动脉内灌注红色乳胶的成人上肢标本上观测肘下动脉的起源、走行、分支与分布,另在1侧新鲜标本上进行摹拟手术设计。结果肘下动脉在肱骨内、外上髁连线中点下方(3.98±0.86)cm处,自桡动脉(占50%)、桡侧返动脉(占40%)和肱动脉(占10%)起始后,斜向外下方走行,其轴线位于肘下动脉的起始处与桡骨背侧结节(Lister结节)的连线上。肘下动脉向远侧分布达15 cm,并与桡动脉的远侧穿支、桡侧返动脉的肘外侧部皮支相互吻合。肘下动脉外径0.8 mm。结论以肘下动脉为蒂设计皮瓣,局部转移可修复肘部各方的软组织缺损。     

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.