滑车神经的应用解剖研究

目的 :为颅底和眶内手术提供滑车神经的解剖依据和补充国人滑车神经的体质学资料。材料与方法 :在 2 1例 (4 2侧 )正常成年人头颅标本上 ,观测滑车神经的走行及各段长度和外径。结果 :滑车神经连脑处位于下丘的外下方 ,离中线 4 5± 0 .6mm ;穿小脑幕处在后床突后外方 1 3 .7± 3 .8mm ;在海绵窦外侧壁 ,与动眼神经相距 4.5±2 .1mm ,与眼神经相距 4 2± 1 .4mm。测得滑车神经颅段、幕潜行段、海绵窦段、眶上裂段和眶段的长度及各段中部的宽度和厚度。结论 :在颅底和眶内手术时 ,应重视该神经的解剖位置并加以保护。     

脑神经海绵窦段的应用解剖

目的 :为海绵窦手术避免脑神经损伤提供解剖学依据。方法 :对 17例成年头部标本的海绵窦内脑神经的位置、走行、毗邻进行解剖学观察。结果 :动眼神经入窦点在后床突的前外侧 7.8± 2 .1mm ,在颈内动脉床突上段后方 5 .0± 2 .0mm处。滑车神经窦内段长度为 10 .1± 3 .9mm ,其走行可分为窦内直行、中份凸向眼神经、“S”型双弯曲、前 1/2段凸向眼神经 4种类型。眼神经在窦内的长度为 15 .8±6.2mm。展神经在窦内为单干者占 5 2 .9% ( 18侧 ) ;2干者占 2 9.4% ( 10侧 ) ;3干者占 17.7% ( 6侧 )。结论 :滑车神经的走行变化较大 ,经Pakinson三角行海绵窦手术时 ,应注意保护滑车神经。切开海绵窦上壁分离窦腔时 ,应注意保护经上壁入窦的动眼神经。     

脑神经海绵窦段的显微解剖及其临床应用

目的　为海绵窦 (cavernoussinus,CS)直接手术提供解剖学基础。方法　在手术显微镜下对 15例 (30侧 )成人头颅标本CS内脑神经位置、行径以及与颈内动脉CS段的毗邻关系进行观测。结果　①动眼神经入窦点在前床突尖后方 (4 5 7± 1 0 5 )mm ,与滑车神经、眼神经垂直距离分别为 (2 2 0± 0 6 7)mm和 (4 37± 1 35 )mm。②滑车神经入窦点与眼神经垂直距离为 (5 5 2± 1 0 6 )mm。滑车神经CS段行程形状可分为三型。③颈内动脉后曲顶高出眼神经和展神经上缘分别为 (5 5 2± 1 84)mm和 (6 6 0± 1 94)mm。④经前床窦尖外侧或外下方时 ,动眼神经、滑车神经及眼神经与前床突尖垂直距离分别为 (1 85±0 75 )mm、(5 30± 1 0 4)mm和 (6 6 1± 1 6 3)mm。结论　掌握脑神经CS段的显微解剖对CS的直接手术具有重要意义。     

眶上裂区的显微外科解剖学研究

目的:为眶上裂(superior orbital fissure,SOF)区手术提供显微解剖学基础。方法:①观测30例(60侧)成人头颅干标本SOF骨性结构;②在手术显微镜下观测15例(30侧)成人头颅湿标本SOF区穿行神经、血管位置及毗邻关系。结果:①sOF外侧壁上、下半边夹角144.27°±20.03°;②泪腺神经距SOF外侧端(4.17±1.70)mm;③动眼神经上支至SOF内侧壁(1.83±0.62)mm;④滑车神经紧贴Zinn腱环外侧人SOF;⑤眼上静脉海绵窦段具有静脉窦结构。结论:SOF区穿行神经、血管位置的观测,对临床开展SOF区手术有参考意义。     

眼静脉与海绵窦前间隙的显微外科解剖学

目的：为临床治疗眶上裂区域的肿瘤和颈内动脉海绵窦瘘提供显微外科解剖学依据。方法：应用成人头颅湿标本在16倍显微镜下，观测海绵窦前间隙、眶内引流静脉及相互之间的关系，和胎儿眶上裂区血管铸型标本。结果：眼上静脉在眶内分为3段，各段直径平均为(2．13～2．57)mm，眼上、下静脉在眶内汇合形成长约(4．35～4．97)mm的眼静脉总干，眼静脉总干从海绵窦前间隙前方或前下方与海绵窦前间隙相连，眼静脉总干呈纺锤型。结论：本文结果为临床选择该区域适当的手术入路打下基础，经眼上静脉治疗颈内动脉海绵窦瘘是可行的。     

小儿与成人视神经管显微外科解剖学比较

目的 :研究小儿视神经管解剖特点 ,为小儿颅底外科提供解剖学资料。方法 :35例无颅眶疾病、经福尔马林固定的尸头 ,成人组 2 0例 ,小儿组 1 5例。在手术显微镜下测量视神经管的颅口、眶口、顶、底、内、外侧壁等参数。结果 :小儿颅口宽 4 35± 0 .5 8mm ,管顶长 6 95± 1 .2 4mm ,管底长 4 6 3± 0 .2 6mm ,内侧壁长 6 5 2± 1 .0 8mm ,外侧壁长 6 4 5± 0 .97mm。眶口宽 4 6 1± 0 .6 7mm ,高 4 93± 0 .2 9mm。小儿视神经管为实质型 ;成人视神经管依蝶窦、筛窦气化程度分为三型 :倒U型 ;C型 ;D型。结论 :小儿视神经颅内段较管腔内段相对较长 ;管壁厚 ,呈实质型 ,无狭部存在 ;至成人管顶伸长是管底的 3倍 ;颅口硬膜返折部短且边缘圆钝。     

经额胼胝体下入路垂体瘤切除术的应用解剖

目的为经额胼胝体下入路垂体瘤切除术提供显微外科解剖学基础.方法采用显微解剖技术对17个甲醛固定,红色明胶动脉灌注的成年尸头标本蝶鞍区的有关神经和血管进行观察.结果(1)视交叉前间隙之间的面积为(28.4±6.2)mm2,视交叉前缘至鞍结节之间的距离为(4.1±0.8)mm.(2)前穿动脉主要来源于大脑前动脉交通前段和颈内动脉终末段,穿入前穿质前可分成多支或形成动脉丛.(3)两侧颈内动脉海绵窦段水平部之间的距离为(16.5±4.4)mm,在穿经海绵窦上壁处间距为(13.3±2.5)mm,在大脑前动脉发起处,间距为(17.9±1.6)mm.(4)前交通动脉在视交叉之上者占82.4%,之前者占14.3%,侧方者占5.9%.(5)动眼神经在后床突的前外侧(7.8±2.1)mm处穿海绵窦顶入海绵窦,入窦点在颈内动脉床突上段后方(5.0±2.0)mm,两侧入窦点之间的距离为(21.9±2.3)mm.结论经额胼胝体下入路垂体瘤切除术主要是通过视交叉前间隙,在颈内动脉之间的区域操作,手术中,既要保护颈内动脉、视神经、动眼神经等较大结构,又要尽量避免穿动脉、下丘脑支动脉等小动脉的损伤,以减少并发症的发生.     

颅底段展神经的应用解剖

目的 :为颅底外科提供展神经的显微解剖学资料。方法 :观测 15例 ( 3 0侧 )成人头颅湿标本展神经的位置、行径及重要毗邻关系。结果 :①展神经在硬脑膜入口处两侧间距 ( 19.71± 1.79)mm ;②Dorello管顶与底间最大垂直距离 ( 2 .14± 0 .70 )mm ;③展神经在海绵窦内距破裂孔硬膜环 ( 5 .69± 1.45 )mm。结论 :在颞骨岩部、海绵窦及眶上裂区手术 ,展神经必须予以辨认和保护     

展神经的应用解剖

目的 :为颅底外科手术防止伤及展神经提供应用解剖依据和为国人的周围神经增添体质学资料。材料与方法 :选用固定后正常成人头颅标本 2 1例 (4 2侧 ) ,测量展神经穿硬脑膜和入外直肌的位置 ,测量展神经各段的长度及外径。结果 :展神经穿硬脑膜处位于后床突下方 1 7.0± 2 .1mm。入眶后 ,在总腱环前方 1 4.4± 2 .9mm处 ,从外直肌的内侧上半部入肌。全长约 60mm ,海绵窦段长约 2 5mm。结论 :颞骨岩部尖端、斜坡或海绵窦和鞍背区手术时 ,应注意辨认和保护展神经。     

眶上裂区临床应用解剖研究进展

眶上裂区是眼眶与颅中窝沟通的重要通道,动眼神经、滑车神经、展神经、三叉神经第一支（ 眼神经）、 眼上静脉、眼下静脉等诸多重要神经、血管从中穿行,并且与视神经、颈内动脉、海绵窦等结构关系密切。眶上 裂区解剖对于颅底手术至关重要,手术时如损伤眶上裂区的神经、血管结构将导致严重的并发症。现就眶上裂区 的大体、显微及内镜临床应用解剖作简要综述。     

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.