经皮椎间盘穿刺治疗腰椎间盘突出症

目的 评价经皮椎间盘穿刺(APLD)治疗腰椎间盘突出症的临床应用价值。方法 对1995年10月至2003年2月采用APLD手术治疗的324例腰椎间盘突出症进行回顾性分析，总结手术适应证的选择及术中、术后注意事项。结果 324例患者获得1～6年随访，优235例，良75例，差14例。优良率92．6％。无一例并发症。结论 经皮椎间盘穿刺治疗腰椎间盘突出症的方法比常规手术创伤小，恢复快，基本保留了脊柱后柱的完整性，对脊柱稳定影响小，手术安全。     

椎间盘镜与常规手术治疗腰椎间盘突出症疗效对比分析

目的对比研究椎间盘镜（MED）与常规开放手术治疗腰椎间盘突出症的治疗效果。方法回顾性分析600例腰椎间盘突出症病例，其中400例患者采用MED治疗，200例患者采用常规开放手术治疗，平均随访时间一年。结果MED治疗优良率在97％左右，常规开放手术治疗优良率在85％左右。结论MED方法具有创伤小、出血少、恢复快的优点，是一种有效的微创治疗腰椎间盘突出症的方法，比常规开放手术有明显优势。     

后路椎间盘镜治疗腰椎间盘突出症

目的 探讨后路椎间盘镜(MED)治疗腰椎间盘突出症的优点、手术适应证及评估其疗效.方法 本院自2000年1月～2005年10月应用该手术治疗腰椎间盘突出症106例,其中中后外侧突出型82例,中央突出型24例,合并侧隐窝狭窄78例.手术经后入路进行,采用椎间盘镜完成椎管开窗、椎间盘摘除术等减压步骤.结果 术后随访3～20个月,依据Machnab标准:优62例、良31例、可10例、差3例,优良率达87.7%,未出现椎间隙感染及椎体滑脱.结论 椎间盘镜治疗腰椎间盘突出症具有创伤小、痛苦轻、疗效好、恢复快及并发症小等优点,适用于大部分腰椎间盘突出症患者.     

后路腰椎间盘镜治疗腰椎间盘突出症疗效分析

目的 探讨腰椎后路椎间盘镜(microendoscopic discectomy MED)治疗腰椎间盘突出症的疗效.方法 自2006年4月～2010年3月,我科采用MED治疗腰椎间盘突出症共42例,其中女性18例,男性24例,年龄22～74岁,平均年龄46.4岁.结果 1例因术中操作困难改为开放手术,其余患者均顺利完成手术.参照Macnab疗效评价标准,优27例,良13例,一般2例.优良率达95.2%.结论 MED具有切口小,损伤小,术后疼痛轻,对脊柱稳定性影响小、术后并发症少、恢复快等优点.     

后路椎间盘镜治疗腰椎间盘突出症

目的探讨后路椎间盘镜（MED）治疗腰椎间盘突出症的优点、手术适应证及评估其疗效。方法本院自2000年1月～2005年10月应用该手术治疗腰椎间盘突出症106例，其中中后外侧突出型82例，中央突出型24例，合并侧隐窝狭窄78例。手术经后入路进行，采用椎间盘镜完成椎管开窗、椎间盘摘除术等减压步骤。结果术后随访3～20个月，依据Machnab标准：优62例、良31例、可10例、差3例，优良率达87．7％，未出现椎间隙感染及椎体滑脱。结论椎间盘镜治疗腰椎间盘突出症具有创伤小、痛苦轻、疗效好、恢复快及并发症小等优点，适用于大部分腰椎间盘突出症患者。     

经皮激光椎间盘减压术（PLDD）及其改良术式治疗腰椎间盘突出症

目的比较研究经皮激光椎间盘减压术(PLDD)及其改良术式治疗腰椎间盘突出症,评估PLDD改良术式的临床疗效。方法回顾性分析比较应用Nd:YAG激光进行常规单点髓核照射汽化19例和改良多点小能量髓核激光照射120例的治疗效果。结果通过12～24个月随访,对二者的疗效进行比较。二种不同的治疗方法产生了显著不同的疗效。参照改良MacNab手术评价标准,常规PLDD术组19例,疗效优2例,良10例,差7例,有效率63%。改良PLDD术组120例,疗效优52例,良50例,差18例,有效率85%。结论经皮激光椎间盘减压术减压效果好、安全性高、并发症少、术后康复快、术后复发率低。改良经皮激光椎间盘减压术治疗腰椎间盘突出症的疗效明显优于常规经皮激光椎间盘减压术,减少二次手术机会及其造成的痛苦,提高了手术的安全性,大大降低了手术和住院费用,是适合我国国情的腰椎间盘突出症的微创手术方法。     

经皮激光椎间盘减压术治疗腰椎间盘突出症临床疗效观察

目的观察经皮激光椎间盘减压术（PLDD）治疗腰椎间盘突出症的临床疗效。方法本组89例应用日本产脉冲式ND．YAG激光治疗仪（波长1064nm）进行治疗,其中68例得到6个月以上随访,男46例,女22例,平均年龄41岁。结果优28例,良27例,差13例;优良率80．88％。结论PLDD是一种安全、可靠的治疗腰椎间盘突出症的方法。随着年龄增大治疗优良率下降。     

采用牵引针刺与手法治疗腰椎间盘突出症微创手术后遗痛

目的 探讨腰椎间盘突出症微创手术后遗痛的牵引，手法与针刺治疗。方法 回顾分析我院2000年2月至2005年7月，经各种微创手术后遗痛患者166例，采用牵引。手法与针刺治疗。结果 经皮腰椎间盘切吸术32例，胶原酶溶盘术37例。经皮激光腰椎间盘减压术11例，内窥镜腰椎间盘摘出术38例，椎间盘热凝术43例，低温等离子椎间盘髓核消融术5例，总有效率（优＋良）92．2％，无效2．4％，结论 牵引，手法与针剌治疗各种微创手术后遗痛疗效确切，是腰椎间盘突出症微创手术后遗痛的主要补充治疗方法．     

腰椎间盘突出症的微创治疗

目的探讨3种腰椎间盘微创治疗的方法及疗效.方法对53例腰椎间盘突出症采用胶原酶注射、经皮穿刺激光椎间盘减压术(PLDD)、经皮穿刺腰椎间盘切吸术(PLD)等不同治疗方法,观察其疗效.结果术后3~12月随访,总优良率91%.结论根据各自的适应症及个体化因素选择治疗方法,疗效肯定,且微创治疗安全、不破坏脊柱的稳定、痛苦小,住院时间短,值得推广.     

腰椎间盘突出症的微创治疗

目的 探讨3种腰椎间盘微创治疗的方法及疗效。方法 对53例腰椎间盘突出症采用胶原酶注射、经皮穿刺激光椎间盘减压术(PLDD)、经皮穿刺腰椎间盘切吸术(PLD)等不同治疗方法，观察其疗效。结果 术后3～12月随访，总优良率91％。结论 根据各自的适应症及个体化因素选择治疗方法，疗效肯定，且微创治疗安全、不破坏脊柱的稳定、痛苦小，住院时间短，值得推广。     

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.     

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 case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

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.