认识桡骨近端19项解剖学指标对人工假体及肘关节生物力学重建的价值*★

背景：制约桡骨近端骨折治疗及内固定物、假体设计和改进的一个重要因素是该部位的解剖学形态。 目的：测量桡骨近端19项解剖学指标, 为桡骨近端骨折内固定物的合理放置及桡骨头正确切除、假体的设计和改进提供参考依据。 设计、时间及地点：重复测量，对比观察实验，于2007-12/2008-04在江苏省南通大学附属医院创伤研究室完成。 材料：成人30对防腐尸体上肢标本，男、女各15对。 方法：对上述标本解剖并取出尺桡骨，利用精度0.01 mm的游标卡尺、分规、量角器对桡骨近端数项解剖学指标进行测量。 主要观察指标：①桡骨近端相关角度：桡骨颈干角、桡骨头环状关节面和尺骨桡骨切迹在前臂中立位时接触弧、前臂最大旋前位时接触弧度、前臂最大旋后位时接触弧度、非接触弧度；②桡骨近端相关高度、长度、横径、矢状径等：桡骨近端长度、环状关节面内侧、外侧、前侧及后侧高度、桡骨头凹最大深度、桡骨近端外侧弧长度、外侧弧的最大垂直高度、桡骨转子上缘桡骨颈横径、桡骨转子上缘-桡骨头近端距离、桡骨转子中部-桡骨头近端距离、桡骨头横径、桡骨头矢状径、桡骨头凹直径。 结果：男、女在桡骨近端相关角度方面测量值的差异无统计学意义(P > 0.05)；而在桡骨近端相关高度、长度、横径、矢状径等方面男性测量值大于女性(P < 0.05) 。 结论：桡骨近端骨折在行内固定或桡骨头切除、假体置换时, 需遵循桡骨近端各项解剖参数；因男性桡骨近端的解剖参数略大于女性，设计时应根据不同性别做成各种型号的假体。     

Scripto continuo : destins du verbe dans la manie

The psychopathology of the mania as a modality of the psychosis constitutes a fundamental chapter of the corpora of psychiatry and phenomenology.This article proposes to study the place of mania in the psychoanalysis and in particular the function of Flight of ideas like a phenomenon of language.Flight of ideas has as a principal characteristic to induce a particular temporality on the level of the language and word. It highlights on the one hand the eclipse of the significance and on the other hand the levelling of the speech in the clinical field of the mania.This fact no product intended for the communication is formed and does not communicate of nothing; the statement of the maniac remains then without punctuation and address. Accordingly such a verbal production is not articulated at the rythm as a formative element of the report to the other and the report at time.Such an approach of Flight of ideas conditions the specificity of the report to the other of the patient maniac and the singular temporality which governed it.How to make occur to say it maniac like effect of have rythm? constitute the which question direct the act of the clinician.We then propose a clinical case which questions the possibilities of introduction of a place of address to the heart of the tranferential bond. This place a such topos common, true point of nomination, can allow a reorganization of the elements of the language and word and promulgate the passage of the state maniac to the development of a request for listening.     

Cingulate gyrus of the cat receives projection fibers from the thalamic region ventral to the ventral border of the ventrobasal complex

Direct projections to the cingulate gyrus from the thalamic region lying just ventrally to the ventral border of the ventrobasal complex (VB) were found in the cat by two sets of experiments that used WGA-HRP (wheat germ agglutinin-horseradish peroxidase conjugate). In the first set of experiments, WGA-HRP was injected into the thalamic region around the ventral border of the VB. When the site of injection involved the thalamic region lying ventrally to the ventral border of the VB at the levels of the caudal two thirds of the VB, the cerebral cortex in the rostral part of the cingulate gyrus ipsilateral to the WGA-HRP injection contained fine HRP-positive granules, which indicated anterograde labeling of axon terminals. These labeled presumed axon terminals were mainly distributed to the superficial part of layer I, deep part of layer II, layer IV, and the most superficial part of layer V in the cingulate cortex. In the second set of experiments, WGA-HRP was injected into the cerebral cortex of the rostral part of the cingulate gyrus. When the site of injection involved the region of the cingulate gyrus, where presumed axon terminals had been labeled in the first set of experiments, the thalamic region just ventral to the ventral margin of the caudal two-thirds of the VB ipsilateral to the WGA-HRP injection contained neuronal cell bodies labeled retrogradely. The results indicate that some neurons that are located in the thalamic region just ventral to the ventral border of the caudal two-thirds of the VB send their axons to the cerebral cortex in the rostral part of the cingulate gyrus. The possible significance of the thalamocingulate projection found in the present study is discussed with relation to nociceptive behavior and function.     

The role of vascular endothelial growth factor in the progression of amytrophic lateral sclerosis

We investigated the content of vascular endothelial growth factor (VEGF) in the blood plasma of patients suffering from the sporadic form of amyotrophic lateral sclerosis (ALS). Two groups of patients were selected for the study: in the first group, the disease started before the age of 40 and, in the second group, after the age of 40. In the older patients, the decrease in the content of VEGF correlated with the age and duration of the disease. This demonstrates the involvement of VEGF in the mechanisms of motor neuron death. In patients with early onset of ALS, the paradoxical reaction of VEGF under hypoxia conditions was revealed. This may be one of the mechanisms which determine the progression and severity of the disease in this group of patients. Our data on the impairment of VEGF regulation in the patients with sporadic form of ALS are the basis for the development of new methods of therapy with the use of neurotrophic factors.     

Role of commissural projections in the representation of bilateral auditory space in the barn owl's inferior colliculus

The central nucleus of the barn owl's inferior colliculus (ICc) contains a representation of both the ipsilateral and contralateral auditory hemifields. The representation of ipsilateral space is found in the "core" of the ICc, a subdivision defined by the terminal field of nucleus laminaris, the avian analogue of the medial superior olivary nucleus. The representation of contralateral space is found in the lateral portion of the "shell" of the ICc. The shell surrounds the core and is defined by the terminal field of the nucleus angularis, one of the cochlear nuclei. The representation of ipsilateral space in the core of the ICc may be accounted for by the crossed projection from the nucleus laminaris because most of the nucleus laminaris is devoted to a representation of contralateral space. We present evidence to suggest that the representation of contralateral space is due to a commissural projection from the core of one side to the lateral shell of the opposite side. Injection of horseradish peroxidase (HRP) into the lateral portion of the ICc shell produced retrogradely labeled somata in the core of the opposite side. Injection of tritiated proline into the core produced anterograde label confined to the lateral shell, thus confirming the observations made with HRP. Thus, for example, the left ICc core, which contains predominantly a representation of the left hemifield, innervates the right lateral shell, endowing it with a representation of the left, or contralateral hemifield. The representation of contralateral space in the lateral shell is ultimately conveyed to the external nucleus of the inferior colliculus where it contributes the horizontal axis to a two-dimensional map of space.     

Physiological and anatomical evidence for a discontinuous representation of the trunk in S-I of tree shrews

Microelectrode mapping methods revealed that the representation of the body surface in the first somatosensory area of cortex, S-I, of the tree shrew is unique in that only the ventral trunk was found in the usual location of the trunk representation in cortex of the dorsolateral surface of the cerebral hemisphere. Instead, the dorsal trunk was found as an extension of the representation of the posterior leg in cortex on the medial wall. The separation of the representation of the trunk occurs along a line that is counter to the orientation of the dorsal root dermatomes, so that S-I of the tree shrew clearly cannot be characterized as a serial representation of dermatomes. Anatomical studies of connections support the conclusion that the representation of the trunk is split in S-I. Both the representation of the dorsal trunk on the medial wall of the cerebral hemisphere and S-I of the dorsolateral surface were found to project to S-II when horseradish peroxidase was injected into S-II.     

Changes in the quantitative characteristics of the efferent activity of the scratching generator when the influence of the descending systems is removed

The effects of signals coming from descending systems of the spinal cord on parameters of the activity of scratching generators were investigated on the decerebrated immobilized animals. It was shown that the removal of modulation influences of the cerebellum on the nuclei of descending systems (decerebellation) caused changes in the ratio of the activity of the generator half-centres, rose instability of the generator work, weakened the statistical dependence between changes in parameters of the activity of the generator half-centres and strengthened the generators sensitivity to afferent signals. The total removal of influences of descending systems (after decapitation) induced reduction of the intensity of the efferent activity and afferent sensitivity of the scratching generator. The functional role of descending signals in the work of the scratching generator is discussed.     

An autoradiographic study of the efferent connections of the superior colliculus in the cat

The differential projections of the three main cellular strata of the superior colliculus have been examined in the cat by the autoradiographic method. The stratum griseum superficiale projects caudally to the parabigeminal nucleus and rostrally to several known visual centers: the nucleus of the optic tract and the olivary pretectal nucleus in the pretectum; the deepest C laminae of the dorsal lateral geniculate nucleus; the large-celled part of the ventral lateral geniculate nucleus; the posteromedial, large-celled part of the lateral posterior nucleus of the thalamus. Several of these projections are topographically organized. The stratum griseum profundum gives rise to most of the descending projections of the superior colliculus. Ipsilateral projections pass to both the dorsolateral and lateral divisions of the pontine nuclei, the cuneiform nucleus, and the raphe nuclei, and to extensive parts of the brainstem reticular formation: the tegmental reticular nucleus, and the paralemniscal, lateral, magnocellular, and gigantocellular tegmental fields. Contralateral projections descending in the predorsal bundle pass to the medial parts of the tegmental reticular nucleus and of some of the tegmental fields, the dorsal part of the medial accessory nucleus of the inferior olivary complex, and to the ventral horn of the cervical spinal cord. Ascending projections of the stratum griseum profundum terminate in several nuclei of the pretectum, the magnocellular nucleus of the medial geniculate complex and several intralaminar nuclei of the thalamus, and in the fields of Forel and zona incerta in the subthalamus. The strata grisea profundum and intermediale each have projections to homotopic areas of the contralateral superior colliculus, to the pretectum, and to the central lateral and suprageniculate nuclei of the thalamus. However, the stratum griseum intermediale has few or no descending projections.     

Mechanisms of action and biochemical toxicology of valproic acid

The first part of this article presents the hypotheses of the mechanism of action of the anti-epileptic drug, valproic acid (VPA). In the case of the GABAergic hypothesis, two major types of mechanism of action have been proposed, one at the pre-synaptic level, the other at the post-synaptic level. The action at the pre-synaptic level brings into play one or more enzymes of the GABA shunt. The action at the postsynaptic level consists of the potentiation of the inhibitory effect of GABA by VPA. This has justified the examination of the possible action of VPA at the level of the postsynaptic GABAergic receptor complex. The non-GABAergic hypotheses have been also considered to explain the anti-epileptic action of VPA, one hypothesis depends on the effects of VPA directly on the membrane, another hypothesis brings into play aspartate, and finally a hypothesis depending on the inhibition of aldehyde reductases. The second part of this article concerns the possible mechanism for the undesirable effects of VPA such as hyperammonaemia, hepatotoxicity and hypoglycaemia. The role played by beta- and omega-oxidation of VPA in the explanation of the undesirable effects of this molecule is particularly discussed.     

The location of descending fibres to sympathetic neurons supplying the eye and sudomotor neurons supplying the head and neck.

Evidence is given of the location in man of the fibres going to the sympathetic neurons of the lateral horn that supply the intrinsic and extrinsic muscles of the eye and the sweat glands of the head and neck. For the region of the pons and medulla, the evidence is abstracted from the literature. For the cervical spinal cord, the evidence is from our cases of anterolateral cordotomy. In the medulla, thrombosis of the artery of the fossette latérale destroys the fibres; this locates the fibres in the posterolateral retro-olivary area. But not all fibres to the sudomotor neurons lie there: some run elsewhere, though they probably remain ipsilateral. In the cervical cord, the fibres supplying the sympathetic neurons of the intrinsic and extrinsic muscles of the eye run near the posterior angle of the anterior horn. Most of the fibres supplying the sudomotor neurons lie in the same region, though some lie outside this area but on the same side of the cord.     

Surabondance des objets

A certain number of recent writings observe a drift of the subject, which they explain by the collapse of the fathers, itself effect of the disappearance of the reference marks of symbolic system. Another point of view is possible which would show that it acts less one change of the structure of the subject than an evolution of the imaginary representations that the society gives itself of itself. The multiplication of the objects, even their real abundance, is the axis which the author follows to show how can be constructed; such representations they are described through daily clinical situations, the psychopathology of eating behavior, and certain forms of a return of the religious fanatasism. It appears whereas the denunciation of the situation of the postmodern subject paradoxically finds the accents of the pleas for strong ego.     

Psychologie universelle, psychologie plurielle : la psychologie est-elle une production culturelle ?

Psychology is envisaged in this article as a “cultural product” of the Western World. The Greek etymology of the word itself and the history of the discipline indicate the cultural origin of psychology and justify questioning the universal value of concepts wrought in the midst of the western context. Following its birth at the end of the 19th century, psychology, emancipated relatively to philosophy from which it came and claiming it was following the model of natural science, pretended finding an extension of laws governing natural phenomena in man. But the epistemological crisis exemplified by the works of W. Dilthey (1883) led to the now classical opposition between natural sciences and social sciences. Concurrently, the question of meaning became paramount in the field of clinical psychology and of psychopathology. If the historical perspective clearly shows the western sources of psychology the notion of Western World remains to be defined. This definition is essentially cultural and the author examines both the ideal of mastery and control and the project of conquest of western man symbolised by the Promethean myth. The missionary enterprise and the civilising action of the Western World were underlain by the conviction that western civilisation was the incarnation of an ideal model of culture that had attained perfection. Toward the middle of the 20th century the universalist view of psychology was shaken by the recognition of cultural differences more particularly identified in the field of psychopathology. The transcultural perspective, with the notion of a basic personality, showed up the specificity of western mentality. It also showed up two essential traditional dimensions of western thought: the dualism at the origin of the development of science and technology and the individualism that favoured interest in the individual, in his mental life, in its cognitive and affective aspirations and in the meanders of his interior life. The questioning of the universal value of psychology as it is currently envisaged, applied and taught in the Western World is inseparable from the debate relative to the epistemological statute of the discipline. This could be formulated as follows: should psychology be considered as a science of nature or as a science of subjectivity? Psychopathology is exemplary in showing the necessity of the recourse to a specific anthropological model to render the problems that are observed and the proposed interpretations intelligible as both the problems and the interpretations differ according to the cultural context within which they are expressed. Beginning in the 1940’s American works, by denouncing the potential dangers of a standardizing approach of psychic problems, showed the lack of references to nature and underlined the requirements of analysing the cultural milieu. For the last fifty years or so the encounters with historical and cultural realities foreign to the Western World that were nevertheless coherent, and the discovery of different models that had their own pertinence have shaken the secular confidence in the unbeatable superiority of western knowledge. Comparing the western model of the person to the traditional African model, the author tries to show the relation between the diversity of psychopathological expressions and the plurality of cultural models that are encountered. Autonomy and interiority are characteristic traits of the person in the West, however, in Africa, the person is defined by the explicit bonds that guarantee its unity and coherence by connecting it to family, community and spiritual axes. The field of psychopathology turns out to be particularly heuristic to show up the interest and necessity of taking into account models of representation of the world and of man which, if they are different from those with which we are familiar, are not the less useful, and even necessary to listen to man’s suffering and to try to give it meaning in the midst of a cultural universe which is incomprehensible using only the key of Western discourse. The author claims the interest of an ethnopsychology and concludes by indicating the necessity of taking into account cultural specificities not only in the domain of psychopathology but also in the other fields of psychology, including those concerned with measurement that is supposed to guarantee their objectivity, scientific nature and universality.     

Thalamic afferents to the rostral portions of the middle suprasylvian gyrus in the cat

It was demonstrated morphologically that nerve cells in the rostrodorsal areas of the complex of the anterior ventral and lateral ventral nuclei, the posterior lateral nucleus and the lateral central nucleus of the thalamus in the cat send axons to rostral portions of the middle suprasylvian gyrus. In the animals with lesions in the rostral portions of the middle suprasylvian gyrus, marked cell loss and gliosis were observed mainly in the rostrodorsal areas of the complex of the anterior ventral and lateral ventral nuclei as well as in the posterior lateral nucleus. The identification of thalamoparietal projection cells was also attempted by means of retrograde axonal transport of the horseradish peroxidase. In all animals in which the horseradish peroxidase was injected in the rostral areas of the middle suprasylvian gyrus, peroxidase-labeled neurons were found in the rostrodorsal areas of the complex of the anterior ventral and lateral ventral nuclei, the posterior lateral and the lateral central nuclei. Functional significance of the thalamoparietal projection cells in the rostrodorsal areas of the complex of the anterior ventral and lateral ventral nuclei is discussed in terms of the relay cells of the cerebello-thalamoparietal pathways.     

Cells of origin of the spinocerebellar tract in the rat, studied with the method of retrograde transport of horseradish peroxidase

Following injections of horseradish peroxidase into the cerebellum, the distribution of labeled neurons was studied in the whole length of the spinal cord of the rat. To find the ascending side of the axons, injections were made following hemisections at C1 or between C1 and C2. Labeled spinocerebellar tract neurons were classified into two groups according to the axonal course in the spinal cord; one is composed of neurons with uncrossed ascending axons and the other, neurons with crossed ascending axons. Neurons of origin of the uncrossed tracts were located in the medial part of lamina VI of C2 to C8, the central part of lamina VII of C4 to C8, lamina V of C7 to L3 and Clarke's column. Neurons of origin of the crossed tracts were found in the central cervical nucleus of C1 to C3, the intermediate zone and the ventral horn of the lower thoracic and the lumbar segments (T11 to L3), and in the dorsal horn, the medial part of lamina VII and the ventrolateral part of the ventral horn of the sacral and caudal spinal cord. In comparison with our previous results in the cat, it was suggested that the spinocerebellar system in the rat is organized in the same fashion as in the cat, in terms of the location and the intraspinal axonal course of the cells of origin.     

Disturbance of self-evidence and delusion

Psychopathologically we study the process from the disturbance of self-evidence to the formation of delusions. When delusions arise on the basis of the disturbance of self-evidence, this disturbance impairs the way of judgment. We present a case of schizophrenia in which the unlimited questions about grounds make it impossible for the patient to establish the self-evident as itself and to judge inductively. The formation of delusions is the psychopathological extrication from the impairment of the inductive judgment. In the formation of delusions on the basis of the disturbance of self-evidence, we can observe the process from the weakening to the substantiation toward the outside of the transcendental organization.     

Post-ischaemic paraesthesiae in diabetes mellitus

A quantitative assessment of post-ischaemic paraesthesiae has been made in 50 diabetic subjects and in a group of healthy age-matched controls. The results show a highly significant diminution of the paraesthetic response in the diabetic subjects. The degree of depression of the paraesthetic response was associated with the duration of the disease and the severity of the metabolic abnormality as determined by the degree of insulin dependence. Diabetics with the juvenile onset type of the disease were more adversely affected than those with the maturity onset type. There was no consistent relationship between the degree of depression of the paraesthesiae and the presence of peripheral neuropathy. The significance of these results is discussed in relation to the factors which determine the composition of the ionic micro-environment of myelinated nerve and the level of electrical excitability of the nerve fibre.     

Principle of uncertainty in vision

When investigating the dependence of the bandwidth of the spatial frequency characteristic (delta F) of the receptive fields of the cat striate cortex on the size (D) of the receptive field it was shown that delta FD = 1.2. Thus in the system of elements performing the processing of information in the visual cortex the inaccuracy of the signal representation in the spatial frequency and in space is related by an uncertainty principle. The size of the constant evidences that the weighting functions of elements are sinusoids or cosinusoids modulated by squarewave impulse rather than by the Gabor elements. The performing of uncertainty principle and the size of the constant are arguments in favour of the hypothesis that the receptive fields of the visual cortex organize a quasilinear basis.     

Morphology of the giant interneurons and cercal nerve projections of the American cockroach

We have investigated the morphology of the giant interneurons (GIs) and the main sensory projections to these interneurons in the American cockroach. These neurons are thought to mediate the animal's escape behavior. We describe here the dendritic branching pattern of each of the 14 GIs (7 bilateral pairs) in the terminal ganglion, the pattern of projection of the cercal sensory nerve, and the overlap of the cercal projections with the dendrites of the GIs. Visualization of the GIs and cercal nerve projection was accomplished by single cell injection and axonal backfilling with cobalt. Comparisons of the same identified GI in different animals show the position of the soma and the locations and orientations of the major processes are characteristic for each GI. The axons of the cercal nerve project to a well-defined ipsilateral region of the terminal ganglion. After entering the terminal ganglion, the cercal afferents split into lateral and medial tracts. The projections of the lateral cercal tract overlap extensively with the dendritic fields of the GIs. In contrast, the medial tract does not overlap the dendritic fields of the GIs in the posterior portion of the ganglion and shows only a small degree of overlap in the anterior portion. Correlations between physiological properties of the GIs and cercal afferents are discussed in relation to our anatomical findings.