以胫前返血管为蒂腓骨上段移植的应用解剖

目的:为胫前返血管蒂腓骨瓣的设计提供解剖学基础。方法:30侧经动脉红色乳胶灌注的成人下肢标本,解剖观测胫前返动脉的起始、走行、分支及分布。结果:胫前返动脉始于胫前动脉,起始点距腓骨头尖下(4.5±0.7)cm(3.0～6.0cm),动脉主干长(0.5±0.2)cm(0.2～1.2cm),外径(2.0±0.4)mm(1.3～3.0mm),伴行静脉2条,外径为(2.1±0.5)mm(1.5～3.0mm)和(2.6±0.4)mm(1.7～3.2mm)。胫前返动脉腓骨头支1～2支,外径(1.7±1.3)mm(0.6～2.1mm),分布于腓骨头的前内侧面骨膜,并与其它来源的腓骨上段骨膜支构成动脉网。腓骨头支起始点至胫前返动脉起始点长度为(1.0±0.4)cm(0.3～1.8cm),其中长度≥1.0cm者占46.7%。腓骨头支起始点以远1.5cm处的胫前返动脉外径为(1.4±0.5)mm(0.8～2.1mm)。结论:胫前返血管蒂腓骨瓣的的设计具有可行性,为临床带血管腓骨上段移植提供一种新的可供选择的血管蒂。     

运用三维摄影测量排量头关节面形态及其意义

测量腓骨头关节面形态，为临床上用带血管蒂的游离骨头植替代桡骨远端重建腕关节提供理论依据。方法：用三维摄影测量法测量４０例成人腓骨头标本，重建差了面数学模型，然后测量关节面倾角，弧长和曲率。结果：腓骨头关节在 后倾角为（９．９６±１．４７）°，内倾角为（２３．０７±２．１４）°，关节面冠状面弧长为１５．９±１．９０ｍｍ，太面弧长为１２．８±１．３０ｍｍ，冠状面屈率为０．１５４±．　，矢状面曲率为０．     

前路经寰枢关节螺钉内固定术的临床解剖学研究

目的:为前路经寰枢关节螺钉内固定术提供临床解剖学依据。方法:在100对中国成人干燥寰枢椎配对标本上,对与临床前路经寰枢关节螺钉内固定术相关的数据进行解剖学测量。结果:前路经寰枢关节螺钉内固定术冠状面上螺钉植入最小外偏角(5.5±2.0)°(0°～13.0°),最大外偏角(23.6±2.1)°(17.5°～32.5°),矢状面上螺钉植入最小后倾角(14.9±2.6)°(9.0°～27.0°),最大后倾角(25.6±2.5)°(17.5°～33.5°),内侧钉道距离(16.58±1.49)mm(13.78～21.86mm),外侧钉道距离(26.44±1.75)mm(21.81～33.78mm)。结论:前路经寰枢关节螺钉内固定术,16～26mm长度的螺钉,外倾5°～23°、后倾15°～26°方向拧入是安全的。     

膝下外侧动脉腓骨上段骨皮瓣移植的应用解剖

目的:为膝下外侧动脉蒂腓骨上段骨皮瓣的设计提供应用解剖学基础。方法:在42侧经动脉内灌注红色乳胶的成人下肢标本上重点观测膝下外侧动脉的起始、走行、分支、分布和吻合。结果:膝下外侧动脉始于动脉,起点距腓骨头尖上方(1.9±0.7)cm,起始部外径(1.7±0.3)mm。从起点至第一下行骨膜支距离(3.2±0.8)cm,至第一皮支距离(3.9±0.2)cm。结论:膝下外侧动脉可携带腓骨上段骨皮瓣。皮瓣面积约为9.0cm×6.0cm。     

带血管蒂腓骨头移植重建内外踝的解剖学基础

目的:为设计带血管蒂的腓骨头移植重建内外踝提供依据。方法:在60根成人干燥胫腓骨标本上,对腓骨头和内外踝进行形态学测量。结果:腓骨头与外踝形态比较,最大周径:腓骨头为(7.3±0.9)cm,外踝为(6.7±0.6)cm;关节面横宽:腓骨头为(1.4±0.2)cm,外踝为(1.6±0.2)cm;关节面纵长:腓骨头为(1.5±0.2)cm,外踝为(2.0±0.2)cm;关节面夹角:腓骨头为(144°±11°),外踝为(162°±10°);腓骨头或外踝与腓骨干倾斜角:腓骨头为(173°±7°),外踝为(171°±6°);内踝关节面横宽纵长均为(1.3±0.2)cm。结论:腓骨头与外踝形态相似,设计带血管的腓骨头移植重建外踝具有可行性,而与内踝差别较大,不适宜用腓骨头移植重建内踝。     

带腓肠外侧皮神经及其营养血管筋膜皮瓣的应用解剖

<正> 为带腓肠外侧皮神经及其营养血管筋膜皮瓣的临床应用提供解剖学基础.在32侧成人下肢标本上,对腓肠外侧皮神经及其营养血管进行解剖观测.结果:腓肠外侧皮神经在腓骨头平面上方(7.l±2.4)cm处起于腓总神经,横径为(2.6±1.0)mm,沿腘窝及小腿后外侧面下行,腓骨头平面的横径为(3.0±0.9)mm,发出1-3个终支,分布于小腿后外侧上半或上2/3的皮肤.其营养动脉主要为:①腓肠外侧皮动脉;起自腘动脉外侧壁,在排骨头平面上方(5.0±1.5)cm处浅出,外径为(0.9±0.3)mm,穿出前长度为(3.11.2)cm,伴腓肠外侧皮神经及其主要分支下行;②肌间隔筋膜皮支:起自胫后动脉(占54.5%)和腓动脉(占45.5%),向后外行,自小腿三头肌与腓骨长、短肌之间的肌间隔穿出,穿出点分别在腓骨头平面下方(9.2±3.8)cm和(15.8±3.8)cm,外径为(0.7±0.3)mm和(0.9±0.4)mm,穿出前长度分别为(3.6±1.1)cm和(3.6±1.4)cm.该营养动脉除在腓肠外侧皮神经主干及其分支旁或其内呈相互吻合,形成纵行的动脉丛(网)外,沿途还发出分支至周围的筋膜皮肤,并借吻合支     

带监测皮岛的腓骨头移植修复肱骨头缺损重建肩关节

目的 :探讨带监测皮岛的腓骨头移植修复肱骨头缺损重建肩关节的可行性与临床价值。方法 :对 13例因肿瘤或创伤致肱骨头缺损病例 ,用带监测皮岛的腓骨头移植修复肱骨头缺损并重建肩关节。结果 :3～ 10年随访 ,13例监测皮岛存活 ,移植腓骨头增大塑形 ,形似受区肱骨头 ,移植腓骨与肱骨的口径相当 ,肩关节活动度 :前屈 64 .6°± 8.3° ,后伸 2 7.7°± 5 .3° ,外展 72 .3°± 7.8° ,内收 17.3°± 4.4° ,上举 13 8.8°± 12 .8°。结论 :带监测皮岛腓骨头移植修复肱骨缺损重建肩关节疗效可靠。     

腓骨肌皮瓣移植修复下颌区组织缺损的应用解剖

<正>在36侧灌注红色乳胶或墨汁的成人下肢标本上,结合下颌区多种组织缺损的修复术,对腓骨肌皮复合瓣血供,神经等进行了解剖学研究.腓动脉起于胫后动脉的占97.2%;与胫前、胫后动脉三者共干而起于腘动脉的占2.8%.其起始处在腓骨头下方5.4±1.2cm,起点外经为3.2±0.8mm.然后沿腓骨的内后方下行,在距腓骨头8.9±2.0cm处进入(足母)长屈肌深方,余段被该肌所复盖.由起点下方1.8±1.4cm处始沿途发出绕腓骨向外的弓状动脉7.4±1.0支.腓动脉伴行静脉的外经分别为4.4±1.0mm和3.2±0.7mm,都汇入胫后静     

胫腓关节坡度测量的临床应用解剖

人类胫腓关节坡度对关节本身的稳定性有影响。本文采用两种方法分别对 10 9侧胫腓关节坡度进行了测量 ,结果显示 ,腓骨干纵轴与关节面的夹角 (∠ A)为 59.93°± 9.2 9°,左右侧比较无显著性差异 ( P=0 .2 5) ,该角度越大 ,坡度越平坦 ;角度越小 ,坡度越陡直 ;关节面与水平线的夹角 (∠ B)为 30 .2 5°± 9.32°,左右侧比较也无显著性差异 ( p=0 .2 5) ,该角度越大 ,坡度越陡直 ,角度越小 ,坡度则越平坦。两种方法测量结果之间呈负相关 ( r2 =- 0 .157,t= 4 .4 7,P<0 .0 0 1)。研究的解剖和临床意义在于了解人胫腓关节的坡度和估价胫腓关节的稳定性 ,尤其是对胫腓关节不稳 (半脱位 )的诊断具有参考价值     

前路经枢椎体至寰椎侧块螺钉内固定的解剖学研究

目的:为临床上行前路经枢椎体至寰椎侧块螺钉内固定提供实验依据。方法:对21例成人寰枢椎标本进行测量,计算出前路经枢椎体至寰椎侧块螺钉内固定术中螺钉走向的最小、最大外偏角和最大后倾角;将21例寰枢椎标本摄正、侧位CR片,在CR片上测量出此术式中螺钉走行的最小、最大外偏角和最大后倾角,将从标本上所测算出的数据与在CR片上测量得的数据作统计学分析,在标本上模拟此术式。结果:在前路经枢椎体至寰椎侧块螺钉内固定术中螺钉走向的最小外偏角为14°±1.6°,最大外偏角为30°±2.3°,最大后倾角为29°±2.9°,左、右两侧无明显统计学差异(P>0.05),从标本上所测算出的数据与在CR片上测得的数据无明显统计学差异(P>0.05);标本上所有螺钉都位于理想位置。结论:只要正确掌握螺钉的进钉方向,则采用前路经枢椎体至寰椎侧块螺钉内固定治疗寰枢椎脱位是安全可行的。     

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.     

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.     

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.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'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 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.