寰椎的解剖学测量及其临床意义

目的　探讨寰椎因素致椎 基底动脉供血不足的发病机制及手术切开横突孔减压提供解剖学依据。方法　在5 0例中国成年人干燥寰椎标本上 ,对具有临床意义的数据进行解剖学测量。结果　寰椎横突孔与椎动脉沟的成角左侧为(6 7 87± 5 39)°,右侧为 (6 9 84± 4 5 5 )° ;椎动脉沟绕寰椎侧块成角 :左侧为 (6 2 4 6± 4 6 6 )°,右侧为 (6 3 6 1± 2 31)°。寰椎横突孔前壁厚度 :左侧为 (2 96± 0 5 4 )mm ,右侧为 (3 2 1± 0 4 0 )mm。横突孔后壁厚度 :左侧为 (2 2 8± 0 5 7)mm ,右侧为 (2 0 2± 0 2 6 )mm。以上数据左、右侧比较差异无显著性。结论　椎动脉行经在寰椎横突孔与椎动脉沟内时 ,在骨性结构上有明显的两个成角 ,即横突孔与椎动脉沟的成角和椎动脉沟绕过侧块的成角 ,椎动脉的这两个成角增加了血液循环的阻力 ,同时在头颈部旋转运动时 ,椎动脉与骨性成角间更加贴近 ,这两个成角与椎 基底动脉供血不足的发生有关。寰椎横突孔后壁较前壁薄 ,此数据可作炒寰椎横突孔后壁切开减压时手术参考依据     

颈椎前路减压及内固定的解剖学问题

目的 :探讨颈椎前路减压安全界限的解剖标志及适合国人的颈椎前路钢板螺钉设计参数。方法 :采用 17例完整成人颈部标本 (含C3～C7) ,对颈椎前路减压及钢板螺钉内固定设计的有关解剖学参数进行测量 ,包括颈长肌间距、横突孔间距、椎体矢状径及钩突与横突孔间距等。结果 :在C3～C7相应椎体 ,颈长肌内侧与横突孔之间有 7～ 9mm的距离 ;钩突内侧缘距横突孔 5mm ,钩突前脚距横突孔 4mm。从C3～C7,钩突前脚间距从 15 .4mm增大到 2 3 .2mm ,椎体矢状径为 14 .8～ 16 .3mm ,钩突前后径约 11mm。结论 :颈椎前路减压的安全区域可以双侧钩突前角为解剖标志 ,在此之间手术比较安全。适合国人的颈椎前路钢板设计以宽度 16～ 17mm ,螺钉长度 12mm为合适。     

下颈椎血供的解剖研究及其临床意义

目的为颈椎前路减压手术中减少出血量,改善显露和减少手术并发症的发生提供解剖学基础。方法在15具成人尸体标本上,解剖观测C3～7椎体前后部血供的起源、走行、分支及吻合。结果椎体前部血供来自颈升动脉脊支、甲状腺下动脉和颈深动脉脊支,C4～7椎前动脉在椎体上的分支相互吻合,在颈长肌的内侧缘处常吻合成一纵行动脉链;椎体后部血供来自椎间动脉发出的椎后动脉,其分支在颈椎体后部吻合形成节段性弧形动脉吻合链。结论阻断术椎的椎前动脉及其与相邻椎前动脉的纵行动脉吻合,并在颈椎后部减压时注意对硬膜囊外侧缘及椎体中部处的椎后动脉及其分支的处理,可减少颈椎前路减压手术的术野出血,改善手术显露。     

颈前路钩椎关节切除术的应用解剖

目的为临床颈前路钩椎关节切除手术提供应用解剖学基础。方法15套干燥成人颈椎标本,分别测定:①C3-C6横突孔的横、矢径;②钩椎关节与横突孔的间距;③横突孔前壁厚度;④钩椎关节与椎间孔的间距;⑤两侧椎间孔所在平面间夹角。14具成人尸体标本,解剖测定:①C3-C6各节段上下缘椎体正中线与椎动脉的距离;②各横突孔壁内和相邻横突孔间的椎动脉的长度;③椎间孔的横、竖径。结果①C3-C6中,C5的横突孔横径最小;②横突孔前壁厚度由C3-C6逐渐增加;③钩椎关节与横突孔间距在C6处最小;④椎体正中线与椎动脉V2段的距离由C3-C6逐渐增大。结论熟悉局部解剖是避免损伤椎动脉的关键     

枢椎横突孔观测及其临床意义

目的 :探讨枢椎横突孔结构在转头引起寰枢段椎动脉狭窄或闭塞的临床解剖学意义。方法 :观测 10 0例枢椎横突孔上口的开口方向、孔径、上口与下口之间的成角、以及横突孔水平距离。结果 :两侧枢椎横突孔孔径相差不大 ,最大径为 6.1± 0 .7mm,最小径 5.4± 0 .6mm。两侧横突孔上口开口方向明显不对称 ,上口与下口之间的角度为 12 7± 2 2°,左侧较右侧明显 ,甚至形成直角或锐角 ,且左侧横突孔水平距离较长 ,说明椎动脉在孔内弯曲或扭曲。结论 :枢椎横突孔的结构对其中椎动脉起着一种牵系作用 ,在寰枢椎不稳时易导致椎动脉的损害     

颈椎前路减压与椎内静脉丛相关的应用解剖学研究

目的探讨颈椎前路手术中减压范围与椎内静脉丛出血问题相关的应用解剖学研究.方法选择6具新鲜尸体和12具经防腐固定的完整的成人颈部标本(C1～T1),对椎体钩突前脚间距、钩突前脚与横突孔内壁垂直距离及椎内前静脉丛两侧纵行血管间距等进行解剖观察.结果椎内前静脉丛潜行于后纵韧带内,紧贴硬脊膜背面,两条纵行血管问形成横行交通支;在C3～C7相应椎体,钩突内侧缘与横突孔内壁间距为(5.25±0.85)mm,C3～C7相应节段椎内前静脉丛两侧纵行血管间距从(11.13±0.20)mm增大到(14.98±0.27)mm.C3～C7钩突前角间距从(14.60±1.03)mm增大到(21.51±1.91)mm,钩突前后径均大于11 mm.结论颈椎前路手术减压的安全区域可以双侧钩突前角为解剖标志,在此范同内,可完全显露椎内静脉丛两侧纵行静脉,从而有效地处理椎内静脉丛术中出血问题,手术安全,减压彻底.     

下颈椎观测对颈椎前路手术的意义

目的为下颈椎前方入路提供应用解剖学基础。方法测量广东地区出土成人干燥下颈椎(C3～C7)标本40套。测量项目包括椎体的前高、中高、后高、上矢径、中矢径、下矢径、上横径、中横径、下横径以及钩突间距。结果下颈椎椎体上横径平均为19.2mm,中横径21.1mm,下横径22.2mm;椎体上矢径平均为15.3mm,中矢径14.9mm,下矢径16.1mm。结论本文的测量数据为改进下颈椎前路手术及减少手术并发症提供了解剖学依据。     

颈椎横突和椎间孔的测量及临床意义

对山东地区50套成人椎骨的第3颈椎到1胸椎进行观察和测量，主要结果为：颈椎横突与脊柱水平面间的角度从上到下依次递增，其横突下倾角C3为10．82±2．18°，C7为134．12±12．43°。中位椎间孔的垂直轴线与脊柱正中矢状面之间的角度较小，而上下位角度较大，本结合临床及颈椎X线摄片方法进行了讨论。     

颈椎横突孔与椎动脉供血不足所致眩晕的影像研究

颈椎横突孔与椎动脉供血不足所致眩晕的影像研究孙宝珍，刘大荒山东省淄博市中心医院ＣＴ室关键词颈椎病，颈椎横突孔１临床资料选患者１００例为实验组，男６０例，女４０例，平均年龄４２．２５±７．３２岁。主要临床症状为眩晕、呕吐，常规彩色多普勒诊断为椎动脉供血...     

颈椎管的临床应用解剖学研究

目的：为临床发育性颈椎管狭窄脊髓病及颈椎最常见骨质增生部位提供解剖学依据。方法：对98套颈椎(C3-3)共486个颈椎孔进行测量并观察骨质增生情况。结果：C-3-7颈椎孔中矢径平均为13．58±1.47mm，横径为24.05±1.37mm，椎孔指数平均为56．47。有9套颈椎共24个椎孔中矢径狭窄(＜12mm)，占椎骨总数的49％，中矢径绝对狭窄的椎孔有8个(＜10mm)，占椎骨总数的1．6％。结论：椎孔中矢径狭窄80％以上集中在C5-7；颈椎骨质增生最常见的是钩突增生，其次是关节突及椎体增生，增生的部位以C5，最常见，其次是C6和C7，共占增生的84．5％，而C4和C3较步见。     

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.     

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.     

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.     

'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.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.