颈,胸,腹部,上肢多处动脉变异1例

颈、胸、腹部、上肢多处动脉变异１例钱迅，章明，韩永坚，王利宏局部解剖实习课中，在一约５５岁左右的男性尸体上，见多处动脉变异，包括颈部舌动脉、喉上动脉变异，胸部的胸廓内动脉变异，腹腔内肝右动脉变异，上肢肱深动脉变异等。心脏及大血管无异常发现，现报道如下...     

髂内动脉及其分支的观察

测量了 90侧成人尸体髂内动脉及其分支和输尿管数值 ,解剖观察了髂内动脉分支的起源、髂内动脉与输尿管及子宫动脉与输尿管的关系。为国人体质调查积累资料 ,同时也为经髂内动脉插管及结扎双侧髂内动脉和子宫动脉时 ,保护输尿管提供临床应用数据。结果如下 :1　材料与方法1 2　成年尸体 45具 (90侧 ,男 5 0 ,女 40 )。对髂内动脉及其分支用游标卡尺进行了测量。2　结果和讨论2 1　髂内动脉及其分支测量数值 ,见表 1。表 1　髂内动脉及其分支的测量 ( ｘ±ｓ ｘ ,ｍｍ)测量项目 侧别 男 (左 2 5 ,右 2 5 ) 侧别显著性 女 (左 2 0 ,右 2 0 …     

阴阴茎动脉起于髂内动脉1例

在解剖一男性尸体标本盆会阴部时 ,见髂内动脉发阴茎动脉及其他分支变异 (附图 ) ,报道如下 :1　阴茎动脉变异变异的阴茎动脉起于髂内动脉前干 ,其起始处管径为 1.6ｍｍ ,发出后于盆腔侧壁与直肠下段和前列腺之间行向前下方 ,沿途依次发支至直肠和前列腺 ,发支后的动脉主干管径为 1.2ｍｍ ,此于在耻骨联合的后下方 ,经盆膈裂孔进入尿生殖区 ,分出尿道球动脉后再进一步分为阴茎深动脉 (管径 1.18ｍｍ)、阴茎背深动脉 (管径 1.4 6ｍｍ)两终支。阴茎深动脉经阴茎脚后端进入阴茎海绵体 ,阴茎背深动脉行于深阴茎筋膜和阴茎白膜之间。本例的阴部内…     

动脉血压的调控

正常人体动脉血压 (ＢＰ)是生命活动的重要体征 ,是内环境保持稳态的重要内容。ＢＰ受着中枢神经系统 (ＣＮＳ)和多种体液因子复杂而精确的调控。1　边缘前脑内重要的升、降压系统及其作用机制　　近年来对边缘前脑内各升、降区之间以及它们与脑干各区间的机能联系及其所形成的系统有了进一步研究。1 1　边缘前脑内的升压系统1 1 1　岛皮层 (ＩＮＳ) 中央杏仁核 (ＡＣ) 室旁核(ＮＰＶ) 延髓头端腹外侧区 (ＲＶＬ)系统　ＩＮＳ参与情绪反应 ,且有纤维投射到ＡＣ ,ＡＣ的神经纤维投射到多个升压区 :包括蓝斑 (ＬＣ)、臂旁核 (ＮＰＢ)、…     

跟腱血供的显微外科解剖及其临床意义

目的：研究跟腱血供的显微外科解剖,为跟腱手术提供参考数据。方法：采用新鲜及下肢固定的标本各１５例,注射红色乳胶,用体视显微镜观测。结果：跟腱血供来自胫后动脉和腓动脉,其分支为跟腱深动脉,内侧动脉、外侧动脉及跟内,外侧支。结论：跟腱深动脉为跟腱的主要营养血管,另在跟腱的内,外侧及下端分别形成动脉网。跟腱的外膜内尚有丰富的膜内动脉网。     

桥小脑间隙内血管神经的显微外科解剖

借助于手术显微镜,在137侧标本上,对桥小脑间隙有关结构进行解剖观测。31.3%小脑下前动脉分成外侧支、内侧支;98.9%形成动脉袢。根据动脉袢与Ⅶ、Ⅷ对颅神经关系分成五型。脑干的桥支纤细而且角度大;迷路动脉走在Ⅶ、Ⅷ对颅神经凹槽间或内听道底。讨论了桥小脑间隙内神经血管位置关系的临床意义。     

右侧闭孔动脉变异一例

在正常情况下,闭孔动脉通常起于髂内动脉的前干,沿骨盆侧壁行向前下方,经盆内筋膜与腹膜之间,输精管盆侧或子宫圆韧带自其内侧跨过,其上、下分别有闭孔神经和闭孔静脉与之伴行,至闭孔上方进入闭膜管,出骨盆至股部,分为前后两终支。闭孔动脉在盆内除分支至髂骨、髂肌、膀胱等外,尚发出一耻骨支,耻骨支沿耻骨后面内进,与对侧同名支以及腹壁下动脉的耻骨支吻合,有时这个吻合支变得很粗,而正常的闭孔动脉很小或不存在,由该吻合支所代替,这种粗大吻合支即为异常闭孔动脉（椐资料统计约占169／6-209／6）。笔在进行教学标本制作时,发现一成年女性右侧闭孔动脉变异,而左侧闭孔动脉与上述正常闭孔动脉描述无异。现将变异情况报告如下。     

面动脉鼻中隔支

了解鼻中隔动脉血管的来源、配布、管径和走行,对进一步开展鼻病的诊治和鼻的显微整形外科具有重要的意义。供应鼻中隔的动脉主要有发自眼动脉的筛前和筛后动脉、上颌动脉的蝶腭动脉和腭降动脉以及发自面动脉主干和上唇动脉的鼻中隔支。这些血管在鼻中隔内形成广泛的毛细血管丛或网,在鼻中隔的前下部形成黎氏动脉血管丛（90％的鼻出血发生于此）。源于面动脉的鼻中隔支,国内曾有人报道,但在一般经典解剖学中描述都较简单。为此,笔者对成人尸体的面动脉鼻中隔支进行了较详细的调查。     

右心室壁内的动脉构筑

本文对50例成人离体心标本分别用铸型法、X线造影法和墨汁注射火棉胶切片法作右心室壁内及乳头肌的动脉构筑研究。与左心室柑同,可将右室壁内的动脉分为心外膜支、树枝状支、直支和乳头肌支四种类型。与左心室不同的是树枝状支在右室壁内匍匐斜行一段距离后再分支到右室壁的部分或全层心肌,它也分支到达肉柱。直支以斜行或直角纵主干上发出分支分布于右室壁肌肉并可达肉柱。乳头肌血管类型有钩形和叉形,但类型较左心室乳头肌少。心壁内可见少数心内膜下丛。多数乳头肌至少有二个以上的血管供应,少数小的乳头肌为单一动脉支配呈单支中央型。用图像分析仪对左、右心室壁及乳头肌的毛细血管密度和支数进行了对比。对右室壁内和乳头肌内的小血管和毛细血管形态与心肌的关系作了观察。讨论了它们形态和功能的一致性,以及对心肌梗塞的应用意义。     

胫后动脉腓动脉变异1例

患者男性 ,30岁 ,因“右小腿被电线杆砸伤 6ｈ”入院。查体 :右小腿中下段前侧可见多个不规则皮肤裂伤 ,创腔内有散在碎骨块 ,渗血。右足凉 ,足背动脉和胫后动脉搏动消失。右足感觉丧失。初步诊断 :(1)右胫前后动静脉损伤 ;(2 )右胫腓骨中下段粉碎性骨折。急诊行“血管探查吻合术”。术中见 :胫后动静脉断裂 ,动脉血管外径 1.5ｍｍ ,于胫神经内侧伴行 ,近断段可见胫骨骨膜分支 ,踝上 10ｃｍ胫后动脉走向前内分布于内踝内侧 ,踝上 6ｃｍ有一分支与腓动脉相通。胫神经外侧方 2ｃｍ处腓动静脉断裂 ,动脉血管外径 2 .0ｍｍ ,于小腿下段走向内侧 …     

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.