皮瓣移植后毛细血管襻变化的研究

目的探讨皮瓣移植后毛细血管襻(FCL)的变化。方法检测20例26个移植到手部的皮瓣,分别于移植后6、12、24h、3、5、7、14d观察皮瓣FCL的状况,并与皮瓣供区对应的健侧对比。结果皮瓣移植术后无血管危象的病例,术后瓣内FCL与健侧相应部位皮肤的FCL数量、宽度基本一致(P>0.05);术后出现静脉回流不足的病例,可于术后48h内观察到大量FCL,密度较健侧明显增多、宽大(P<0.05),阻断近端动脉后,FCL数目无明显变化,但襻的形态明显变小、变短;皮瓣发生动脉危象者,皮瓣内FCL消失,阻断近端静脉时,可见皮瓣内FCL缓慢出现,但密度、宽度较健侧明显小(P<0.01)。结论皮瓣FCL的检测是观察皮瓣术后血循环变化较好的方法。     

再植断指再灌注后微循环损伤的临床观察

目的 探讨断指再植后再植手指微循环损伤的特点及规律。方法 动态检测断指再植后患者血清超氧化物歧化酶(SOD)，观察断指再植后缺血再灌注损伤的变化。用甲襞微循环测定仪动态观察再植手指甲襞毛细血管的扩张、渗出、出血、毁损、再生及微循环血管的血流状况。结果 断指再植后SOD 2周内持续低于正常水平，且于1—6h和24—72h形成两个低峰期。再植断指甲襞微循环恢复血液灌注后经历渗出、结构毁损和结构功能恢复三个时期。结论 断指再植后缺血再灌注损伤至少在两周内持续存在，微循环损伤是再植手指缺血再灌注损伤最重要的部分。     

桡动脉穿刺置管对甲襞微循环的影响

目的观察桡动脉置管对甲襞微循环的影响。方法选14例心脏直视手术病人为观察对象,在手术前,术后,离开ICU前经桡动脉输入硝酸甘油、利多卡因和肝素时,及动脉导管拔除后第7d,观察无名指甲襞微循环。结果离开ICU前,甲襞血管襻的输入枝、输出枝和襻顶管径,均较手术前和导管拔除后显著减少(P<0.05);经桡动脉输入硝酸甘油和利多卡因可以显著扩张血管襻管径(P<0.01);动脉导管拔除7d后甲襞血管襻的管径和微循环加权积分与手术前比较无显著差异(P>0.05)。结论本实验结果显示桡动脉有创监测不会引起末梢微循环长期显著改变;通过桡动脉输入扩血管药物可以显著改善末梢微循环状态。     

健康儿童同足异趾甲襞微循环对比分析

目的：探讨儿童同足异趾甲襞微循环检测时质量控制。方法：用WX－753B微循环显微镜和图像处理系统，观察52名6岁健康儿童的左足五趾甲襞微循环十九项指标，并进行五趾甲襞微循环之间的两两比较。结果：同足异趾间的甲襞微循环形态学指标存在显著性差异，而流态和襻周状态指标各趾间无显著性差异。拇趾甲襞管襻清晰度较好、数目最多、襻长最长、直径最大、而小趾则相反。结论：同足异趾间甲襞微循环存在一定差异，因此，观测儿童足甲襞微循环时，特别是动态监测病例，应选择同一足趾甲襞观测，观测部位则以拇趾甲襞最佳。     

足甲襞微循环管襻构型的定量研究

目的研究人体生理状态下足甲襞微循环的血管构型，为探索病理状态下的足甲襞微循环形态学变化提供定量化的参考依据。方法使用ＷＸ—７５３Ｂ型微循环显微镜、ＴＨＩ－ＳＨＡＲＰ ＣＣＤ １３７型摄像机频系统、ＸＧ—８型多媒体微循环图像处理系统，对４０名健康儿童、４０名健康青春期青少年、４０名健康成人，行左足拇趾甲襞微循环观察，详细记录足甲襞微循环第一排管襻的形状，对各种类型管襻进行统计分析，求出每一类型管襻占总数的构成比。结果本组共观察１２０个拇趾甲襞共５７１９根管襻，平均每趾甲襞观察４７．６６±１５．０４根管襻，其中发夹型最多，有２１４６根，占总数３７．５％；其次为交叉型，有１２２４根，占总数 ２１． ４％；麻花型有 ７５９根，占总数 １３． ３％；扭曲型有８１７根，占总数１４．３％；枝生型有３４６根，占总数６．０％；纤细型有１７２根，占总数３．０％；扩张型有１５７根，占总数２．８％；尖状型有９８根，占总数１．７％。结论足甲襞微循环管襻存在多种构型，标准构型以发夹型为主，交叉型次之，也是足甲襞微循环管襻的基本形态，其余构型出现率较低，可视为异型管襻。健康人足甲襞微循环管襻异型率为４１．１％。本研究表明，足甲襞微循环构型与手甲     

高压氧治疗对断指再植术后微循环的影响

目的 观察高压氧治疗对断指再植的影响。方法 用高压氧治疗断指再植术后30例共42指,并以常规治疗30例共40指作对照,观察两组断指成活率和甲襞微循环的变化。结果 高压氧明显提高断指成活率,并有效改善再植指体微循循环。结论 高压氧可作为断指再植术后康复治疗的手段之一。     

足甲襞微循环管襻构型的定量研究

目的 研究人体生理状态下足甲襞微循环的血管构型，为探索病理状态下的足甲襞微循环形态学变化提供定量化的参考依据。方法 用微循环显微镜及其图像处理系统，对120名健康人（儿童40名、青春期青少年40名、成人40名）行左足拇趾甲襞微循环观察，详细记录足甲襞微循环第一排管襻的形态，对各种类型管襻进行统计分析，求出每一类型管襻占总数的构成比。结果 足甲襞微循环管襻以发夹型和交叉型为主，分别占37．5％和21．4％，麻花型占13．3％，扭曲型占14．3％，枝生型占6．0％，纤细型占3．0％，扩张型占2．8％，尖状型占1．7％。结论 足甲襞微循环管襻存在多种构型，以发夹型为主，是足甲襞微循环管襻的标准构型，交叉型次之，也是足甲襞微循环管襻的基本形态。其余构型包括麻花状、扭曲、枝生、纤细、扩张、尖状等，出现率较低，可视为异型管襻。健康人足甲襞微循环管襻异型率为41．1％。     

不稳定心绞痛微循环,血液流变学障碍及尿激酶的治疗作用

目的：观察ＵＡＰ病人甲襞微循环及血液流变学变化及ＵＫ的治疗作用，并探讨其可能机制，为临床ＵＡＰ治疗提供理论依据。方法：应用田牛加权积分法定量观测３０例ＵＡＰ病人甲襞微循环。应用毛细血管粘度计法测定血液粘度。结果：ＵＡＰ病人微循环表现为微血管痉挛，甲襞管襻短小，数目减少、红细胞聚集、白微栓形成、襻周外渗等较正常人比较有显著改变（Ｐ〈０．‘０１）。ＵＫ对ＵＡＰ病人微循环及血流变异常有治疗作用（Ｐ〈０．     

再生障碍性贫血甲襞微循环研究

目的：探讨再生障碍性贫血（再障）甲襞微循环变化规律及其与临床的关系。方法：用WX－753B型微循环显微镜和WIS－Ⅱ型血流测速仪，对65例再障患者进行了观测分析。结果：再障甲襞微循环管襻形态、血液流态、襻周状态和总积分值均显著高于正常对照组；重型再障上述各积分值均显著高于慢性再障；肾阴虚型甲襞微循环总积分值最高，肾阴阳两虚次之，肾阳虚最轻；证型转化时甲襞微循环也随之变化；再障甲襞微循环异常程度与外周血红蛋白浓度、血小板计数呈显著负相关。结论：再障患者甲襞微循环异常程度与中西医分型、病情变化、外周血细胞数、药物疗效等密切相关。     

甲襞毛细血管的自动跟踪研究

本文分析了甲襞毛细血管图像的特性，据此提出了甲襞毛细血管的软件自动跟踪窗口技术：即在时序图像上以视频速度搜索定位甲襞毛细血管，然后实施采样存贮。在计算机及图像输入设备给定的情况下，采样及存贮毛细血管图像窗口（其尺寸恒定）所需时间恒定，因而为了以视频速度跟踪甲襞毛细血管就必须将搜寻毛细血管所花时间降至最小。采用了两条措施来降低搜寻毛细血管的时间。第一条措施是，建立了甲襞毛细血管自动跟踪的数学模型，进而建立了ｆ函数，这种模型易于检测及搜索。第二条措施是，设计了最佳搜索算法，保证以最短时间搜索到毛细血管。最终实现了甲襞毛细血管的自动跟踪。     

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.