颈静脉孔的应用解剖学研究

目的 :研究颈静脉孔的形态结构及毗邻关系 ,为临床手术提供解剖学依据。方法 :在 32个颅底标本观察颈静脉孔的形态、在 1 0个完整头颅标本上观察颈静脉孔内穿梭结构间关系 ,并测量其的长度、宽度及其到颞骨岩骨嵴、前庭小管外口、内耳门下后缘、后半规管弓峰的距离。结果 :颈静脉孔位于岩枕交界处 ,形态不规则 ,可有 1～ 3个孔 ,其中 1孔占 75 % ,2孔 2 1 9% ;Ⅸ～Ⅹ间均有纤维分隔 ;岩下窦穿颈静脉孔时 90 %位于Ⅸ～Ⅹ神经间 ,1 0 %位于Ⅹ～Ⅺ神经间 ,其 95 %汇入颈静脉球、4 5 %分支同时汇入颈静脉 ,测量结果均值依次为 1 5 4 5、9 0 8、1 3 79、9 5 1、4 77、5 2 1mm ,其中颈静脉孔长度、宽度及其到前庭小管外口、后半规管下缘弓峰的距离有统计学差异 (P <0 .0 5 )。结论 :颈静脉孔是颅底一个明显的标志性结构 ,与毗邻的各个重要结构有着一定的解剖关系 ,颈静脉孔内结构变异较大 ,右侧颈静脉孔较对侧大 ,高颈静脉球以右侧多见。     

侧颅底神经血管的应用解剖学——颞下窝径路的外科解剖学研究

目的：通过对侧颅底区神经血管的临床应用解剖学观察,为术中保全脑神经和重要血管提供解剖学基础。方法：对２１侧成人尸头按ＦｉｓｃｈＡ、Ｂ型颞下窝手术进路进行解剖,观察颈静脉球区域神经血管解剖关系;观察颈内动脉及毗邻的解剖关系。结果：颈静脉球可分为隆起型（占６６．７％）和低平型（占３３．３％）。岩下窦开口部位有三种类型。Ⅸ脑神经多位于颈静脉球的前内侧,Ⅹ、Ⅺ脑神经多位于其内侧。Ⅺ脑神经与岩下窦末端关系密切,可分三种类型。颈内动脉水平段距鼓膜张肌平均为２．２ｍｍ,距脑膜中动脉和下颌神经分别平均为６．８ｍｍ和６．９ｍｍ。结论：避免手术损伤后脑神经的关键是充分暴露,辨认清楚后明视下操作。鼓膜张肌、脑膜中动脉、下颌神经是预测和辨认颈内动脉水平的良好标志。     

颈静脉孔的应用解剖学

目的：为与颈静脉孔相关的影像诊断和临床治疗提供解剖学资料。方法：从颅底内、外面,对80具成年颅骨的颈静脉孔进行观测;并对20具成人尸头进行解剖,观察该区域神经血管解剖关系。结果：①62.3%右侧颈静脉孔较左侧大,15.9%左侧较大,21.8%两侧大小一致;②14.38%的颈静脉孔有骨桥,85.62%无骨桥;③颈静脉孔内、外侧缘距正中矢状面两侧的平均距离颅外均较颅内大：颅外分别为26.11mm和33.41mm,颅内分别为22.29mm和27.52mm。④XI脑神经多沿颈静脉孔前上缘,X、XI脑神经沿内侧缘出颅,两者被纤维索（占87.5%）或骨桥（占12.5%)隔开。⑤IX脑神经多经颈静脉孔外口前上缘向前下越过颈内动脉表面;IX脑神经经颈内静脉深面（占57.5%）或其浅面（42.5%)行向后下。结论：右侧颈静脉孔通常较左侧大,左右不对称;影像学观测该区域血管、神经应选择恰当的层面。     

颈静脉孔的显微外科解剖学研究

目的:为颈静脉孔区病变的手术提供显微外科解剖学基础。方法:在手术显微镜下对２０例福尔马林固定的成人头颈部标本和１０例成人颅骨标本的颈静脉孔区进行显微解剖和观测。结果:静脉孔分成三部,即神经部、岩部、乙状部,岩部为接收岩下窦、舌下神经管静脉、岩斜裂静脉和椎静脉丛分支的静脉窦;乙状部接收乙状窦血流;神经部由位于结缔组织鞘中的舌咽、迷走、副神经所组成。颈静脉孔长(１３．４±１．１)ｍｍ,颈静脉孔乙状部宽(９．１±１．９)ｍｍ,颈静脉孔的乙状部高(７．３±２．２)ｍｍ,颈静脉孔的内、外口相距(１２．７±１．５)ｍｍ。颈静脉球具有下述特点:(１)静脉壁相当薄,不及乙状窦及颈内静脉壁一半的厚度 ;(２)连接多处的引流静脉;(３)完全位于骨质中且位置变异较大;(４)邻近重要结构等。高位颈静脉球出现率为１５%。结论:熟悉颈静脉孔区的显微解剖有利于手术中保护重要的神经和血管。     

颈静脉孔区的薄层断面解剖学研究

目的：进一步明确颈静脉孔区的断面形态和各结构的解剖关系，为影像诊断和手术治疗提供解剖学依据。方法：成人尸体头颈部标本7例，制成0．5～1．0mm厚的水平位和冠状位火棉胶切片。结果：①颈静脉孔入口处分舌咽道和迷走道两部分，但颈静脉孔腔内未见骨桥或纤维桥将其分部。②岩下窦最多见于注入颈静脉球的下部。③髁导静脉多汇入乙状窦与颈内静脉移行处。④舌下神经管静脉丛充满舌下神经管，出管后与岩下窦汇合注入颈静脉球或颈内静脉。舌下神经沿舌下神经管的前下壁走行。⑤颈静脉球与面神经垂直段关系密切。结论：火棉胶薄切片很好地显示了颈静脉孔区的正常解剖结构及其毗邻关系，对该区的影像诊断和手术治疗有重要的参考价值。     

颞下经下颌入路显露侧颅底区的应用解剖学研究

目的研究颞下经下颌入路应用解剖,为术中保护重要结构提供解剖学参考。方法选用成人尸头10例(20侧),摹拟手术入路,解剖观察、测量相关结构,探求入路涉及的骨、肌肉和神经血管间的解剖关系。结果影响该入路暴露的主要结构包括面神经、腮腺、颧弓和下颌升支。颞下窝和翼腭窝血管神经丰富,茎突及其筋膜将咽旁间隙分为咽旁前和咽旁后间隙,后者容纳颈内静脉、颈内动脉和Ⅸ、Ⅹ、Ⅺ及Ⅻ对脑神经。结论颞下经下颌入路暴露充分,熟悉其应用解剖对手术治疗侧颅底区沟通性肿瘤具有重要意义。     

人颈静脉孔区显微解剖研究

目的研究人颈静脉孔区显微解剖,为手术入路的选择提供形态学资料。方法手术显微镜(15倍)下对15个头颅标本,30侧颈静脉孔进行显微解剖和观察。结果颈静脉孔分为三部,即岩部、神经部、乙状部。岩部为接收岩下窦、舌下神经管静脉、岩斜裂静脉和椎静脉丛分支的静脉窦;神经部由位于结缔组织鞘中的舌咽、迷走、副神经所组成,行于颈静脉球上方的内侧,舌咽神经位于最前方,神经间被纤维或骨性结构隔开;乙状部接收乙状窦血流。结论颈静脉孔区结构复杂,熟悉颈静脉孔区的显微解剖有利于手术中保护重要的神经和血管。     

咽旁间隙腮腺入路的应用解剖学研究

目的 :为咽旁间隙肿瘤的外科手术提供解剖学基础。方法 :选用成人尸体头颈部 10例 2 0侧 ,模拟手术入路 ,按层次解剖方法解剖观察、测量其相关结构。结果 :咽旁间隙被茎突及茎突诸肌分为咽旁前、后间隙 ,咽旁前间隙内有腭帆提肌、腭帆张肌等 ,咽旁后间隙内有颈内动、静脉 ,第Ⅸ、Ⅹ、Ⅺ、Ⅻ脑神经等。茎突是达咽旁间隙的重要解剖标志 ,其外侧主要结构是腮腺及穿经腮腺的结构 ,间隙内容均位于茎突内侧 ,茎突与颈静脉孔相距 2 .98± 1.42mm。结论 :咽旁间隙的应用解剖对咽旁间隙肿瘤的外科手术具有重要的指导意义。     

颈静脉孔区计算机三维重建

目的　探讨计算机三维重建技术在颈静脉孔区研究中的应用。　方法　用生物塑化技术制作 1 2mm厚的薄层断面标本 ,在SGI工作站上对颈静脉孔及相关结构进行三维重建。　结果　计算机三维重建图像可显示颈静脉孔区重要神经、血管 ,能够清楚显示颈内动脉、颈内静脉及舌咽、迷走、副神经束与颅底骨结构的三维解剖关系。重建结构能够以单独或联合方式显示 ,并可绕任意轴进行旋转 ,任意径线及角度均可适时测量。　结论计算机三维重建技术对颈静脉孔区的解剖研究具有重要应用价值     

颈静脉孔穿行结构的标本制作

颈静脉孔是一个不规则的孔,位于枕骨与颞骨岩部的交界处。在颅底的内侧面观察其孔被硬脑膜覆盖,有舌咽神经、迷走神经、副神经三对脑神经穿行其中。位于前上的舌咽神经单独穿过硬脑膜进入孔内,中间的迷走神经和后方的副神经一起穿过硬脑膜入孔,乙状窦于孔内续于颈内静脉。位于颅底外侧面的颈静脉孔外口由于其位置较深,其穿行结构难以观察,也是局部解剖学教学的难点。我们组织学生指导他们进行从前外侧面进行解剖,观察经颈静脉孔穿行结构的位置和分布情况,并制作成教学标本,现将制作方法和制作体会介绍如下。材料与方法:1取材取经过福尔马林…     

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.