Fractures of the neural arch and odontoid process of the axis: A study of their causation

Summary The anatomical findings in 43 cases with fractures of the neural arch or odontoid process of the axis have been correlated to the reconstructions of the course of events in the accidents. Bilateral fractures of the neural arch anterior to the inferior apophyseal joints were the result of a violent anteroflexion of the head. Simultaneous traction or compression of the cervical spine were possibly of contributing importance. Considerable non symmetrical fractures of the neural arch were due to oblique anteroflexion of the head combined with traction of the cervical spine. Trauma against the posterior part of the neck resulted in fractures of the neural arch posterior to the inferior apophyseal joints. The fractures of the odontoid process were the result of a violent anteroflexion or retroflexion of the head. Simultaneous compression of the cervical spine and rotation of the head were possibly of contributing importance in some cases.     

Functional anatomy of the dorsal hood or the hand: correlation of ultrasound and MR findings with cadaveric dissection

The main aim of this study was to provide an overview of the anatomy of the dorsal hood (DH) based on the dissection of sixteen cadaver hands, correlated with magnetic resonance (MR) and ultrasound findings. A secondary aim was to assess the function of components of the DH. Sixteen embalmed hands were evaluated by MRI and ultrasound before being dissected. Each hand was photographed during each stage of dissection. Secondly we evaluated the role of the different structures of the DH in the stability of the extensor tendon by transection of the different components alternatively at the ulnar and radial sides. MR, ultrasound, and dissection showed that the extensor tendon (ET) is stabilized by the sagittal band (SB) at the level of the metacarpophalangeal (MCP) joint and more distally by the transverse and the oblique bands, respectively. Transection of the radial SB of the second finger leads systematically to ulnar dislocation of the ET. The transection of the ulnar DH does not lead to instability of the ET. The SB is the most important structure of the DH in the stability of the ET at the MCP level. Rupture of the radial SB of the second finger leads systematically to ulnar dislocation of the ET.     

Mistakes in the diagnosis and treatment of the complete dislocation and fractures of the acromial end of the clavicle

The analysis of the mistakes in the operative treatment of the sick with such a trauma was conducted. Two typical examples were given. The mistakes were stipulated non-diagnosis of the simultaneous break of the coracoclavicular ligament and not taking measures for its recovery. The radiodiagnosis based on N. Z. Shmidt's method is considered to be inevitable for this category of the sick. After the confirmation of the diagnosis the operation of choice can be the operation of Yotkins-Leochuk for the sick with the complete dislocation of the acromial end of the clavicle, and the operation of Yotkins for the sick with fractures of the acromial end of the clavicle with the break of the coracoclavicular ligament. By means of these methods 43 sick men with the dislocation and 7 sick men with fractures of the acromial end of the clavicle have been operated since 1973. No cases had complications, relapses or unsatisfactory results.     

Computed tomography of cerebral infarction along the distribution of the basal perforating arteries. Part II: Thalamic arterial group

Computed tomographic (CT) manifestations of cerebral infarction along the distribution of the basal perforating arteries were reviewed and correlated with cerebral angiography. Infarcts in the territories of perforators were demonstrated individually based on knowledge of their three-dimensional distribution as shown by microangiography of cadavers. In Part II of the study, the posterior areas supplied by the thalamic arteries were examined. Infarcts in the area supplied by the thalamotuberal arteries involved the anterior pole of the thalamus; those in the area of the thalamoperforate arteries involved the medial portion of the thalamus, along the lateral wall of the third ventricle; those in the area of the thalamogeniculate arteries involved the posterolateral portion of the thalamus; and those in the area of the choroidal arteries of the lateral ventricle involved the most posterolateral and dorsolateral portions of the thalamus. Clinical and neuroradiological correlations are discussed.     

Informational function of heart and its apply if diagnostics of medical disease

Biophysical properties of the electric, magnetic and hydrodynamic impulses generated by the heart suggest the existence of the informational function of the heart: the ability to apply impulses across the body; probable variability of their main parameters, the presence in the heart of the amplitude and frequency-phase modulation carries the information into the cardiosignls. The main tenets of the theory of information functions of the heart are implemented in the technology of informational analysis of electrocardiosignals based on encoding--transformation of the probable variability of parameters electrocardiosignals into the code text. Specific sets of combinations of symbols of norm and rules of internal diseases were indentified. On their basis diagnostic systems which let to diagnose the most common diseases of internal organs were tested. Practical recommendations for the use of diagnostic systems in medical practice are given.     

肾周间隙积液的CT表现及解剖学基础

目的:结合肾周间隙的解剖学基础分析肾周间隙积液的CT表现。材料和方法:观察59例肾周间隙积液的分布及CT表现。结果:肾周间隙积液CT表现:肾窦水肿,肾被膜下积液,肾周间隙内桥隔增厚,肾周间隙脂肪层内斑片状影,肾被膜及肾前、肾后筋膜增厚,部分同时有圆锥侧筋膜增厚肿胀。右侧肾周间隙积液向上可至肝裸区。结论:CT能够清楚显示肾周间隙积液和肾筋膜的分隔作用,了解这些解剖结构,可合理地解释影像学征象及了解疾病扩展途径,为泌尿外科及介入治疗提供依据。     

A review of 16 cases of honour killings in Jordan in 1995

The purpose of the study was to determine the causes of death as reported in court files of the female victims of honour crimes, the Jordanian penal codes regarding crimes of honour, the evidence used in the sentencing of the defendants, the types of weapons used, the characteristics of the physical assaults on the victims and the sentencing of the offenders. A retrospective study of crimes of honour in Jordan was conducted, and the 16 homicide cases considered to be crimes of honour were reviewed. The autopsy reports of the victims provided information on the physical condition of the victims, including the type and severity of injuries. In over 60% of the honour crime cases, multiple gunshot wounds were the direct cause of death. In cases where the victim was a single pregnant female, the offender was acquitted of murder or received a reduced sentence. The majority of murders were committed by the brother of the victim and the length of sentence received by the offender varied from no sentence to life with hard labour. Offenders who received the harshest punishment were those whose victims married without the family consent. Received: 26 January 1998 / Accepted: 3 May 2000     

Significance of proteinuria in patients with acute ischemic brain disease]

Brain vascular diseases are ranked the third as the cause of morbidity and mortality in majority of the countries of the world. In about 80% of the cases of vascular brain diseases, it is ischemic brain disease (IBD). Atherosclerosis of main cerebral arteries is most frequently responsible for the occurrence and development of IBD. In recent years it was reported for the first time of the association of atherosclerosis and/or its complications and proteinuria. Assuming that there exists the significant association between the degree of proteinuria and clinical parameters of IBD, the aim of this study was to investigate the frequency and patterns of the association of proteinuria and clinical IBD parameters. The study was performed in 180 patients with IBD of atherothrombotic origin and 60 patients with the diseases of non-vascular origin, as the control group. In all patients quantitative determination of proteinuria was performed, and in the patients with IBD was determined the degree of IBD and afterwards the degree of functional and neurologic impairment prior to and at the end of treatment in acute phase using the standardized scales. The results of the study revealed the existence of significant frequency of proteinuria in the patients with IBD, as well as the significant association between the degree of proteinuria and severity of IBD. It was concluded that proteinuria in patients with IBD was probably associated with the atherogenic processes and physiopathologic processes of IBD, respectively, which could have predictive value for the outcome of the disease in the early stage.     

A retrospective analysis of spontaneous sphenoid sinus fistula: MR and CT findings

BACKGROUND AND PURPOSE: The sphenoid sinus is rarely implicated as a site of spontaneous CSF fistula. We undertook this study to evaluate the potential etiopathogenesis of spontaneous CSF fistula involving the sphenoid sinus and to review the imaging findings. METHODS: We retrospectively reviewed the imaging findings of 145 cases of CSF fistula from our departmental archives (August 1995 through August 1998). Fifteen (10%) patients had CSF fistulas involving the sphenoid sinus. Eleven (7%) patients had spontaneous CSF fistulas, whereas in four patients, the CSF fistulas in the sphenoid sinus were related to trauma. Of the 11 patients, nine underwent only plain high-resolution CT and MR cisternography. One patient additionally underwent contrast-enhanced CT cisternography, and one other patient underwent MR cisternography only. For each patient, the CSF fistula site was surgically confirmed. The MR imaging technique included T1-weighted and fast spin-echo T2-weighted 3-mm-thick coronal sequences obtained with the patient in the supine position. The plain high-resolution CT study included 3-mm-thick, and sometimes 1- to 1.5-mm-thick, coronal sections obtained with the patient in the prone position. Similar sections were obtained after injecting nonionic contrast material intrathecally via lumbar puncture for the CT cisternographic study. We evaluated each of the 11 patients for the exact site of CSF leak in the sphenoid sinus. We also determined the presence of pneumatization of lateral recess of the sphenoid sinus, orientation of the lateral wall of the sphenoid sinus, presence of arachnoid pits, presence of brain tissue herniation, and presence of empty sella in each of these patients. RESULTS: The exact sites of the CSF fistulas were documented for all 11 patients by using plain high-resolution CT, MR cisternography, or CT cisternography. In nine (82%) patients, the sites of the CSF fistulas were at the junction of the anterior portion of the lateral wall of the sphenoid sinus and the floor of the middle cranial fossa. In the remaining two (18%) patients, the sites of the CSF fistulas were along the midportion of the lateral wall of the sphenoid sinus. Of these 11 patients, one had bilateral sites of the CSF fistula at the junction of the anterior portion of the lateral wall of the sphenoid sinus with the floor of the middle cranial fossa. In nine (82%) patients, the presence of brain tissue herniation was revealed, and this finding was best shown by MR cisternography. Ten (91%) patients had extensive pneumatization of the lateral recess of the sphenoid sinus, with an equal number having outward concave orientation of the inferior portion of the lateral wall of the sphenoid sinus. In seven (63%) patients, the presence of arachnoid pits, predominantly along the anteromedial aspect of the middle cranial fossa, was shown. In seven (63%) patients, empty sella was shown. For comparison, we reviewed the CT studies of the paranasal sinuses in 100 age-matched control subjects from a normal population. Twenty-three had extensive lateral pneumatization of the sphenoid sinus along with outward concavity of the inferior portion of the lateral wall. None of these 23 patients had arachnoid pits. CONCLUSION: The sphenoid sinus, when implicated as a site of spontaneous CSF leak, yields a multitude of imaging findings. These are extensive pneumatization of the lateral recess of the sphenoid sinus, outward concave orientation of the inferior portion of the lateral wall of the sphenoid sinus, arachnoid pits, and empty sella. Considering the normative data, we speculate that this constellation of findings could play a role in the etiopathogenesis of spontaneous sphenoid sinus fistulas. Our findings also show the efficacy of noninvasive imaging techniques, such as plain high-resolution CT and MR cisternography, in the evaluation of sphenoid sinus CSF leak. Our data also suggest that spontaneous sphenoid sinus CSF leak is not an uncommon occurrenc     

肘关节动脉的应用解剖

成人上肢标本30例,动脉灌注红色乳胶和常规固定后,解剖、观察和测量。肘关节囊动脉供应,后壁优于前壁,动脉支在囊前壁和后上壁内多纵行,其余部分多横行。肱骨下端骨外动脉均来源于肘区动脉网;外侧髁的后外侧面血供最丰富;在滑车内侧面常有呈半环形行走的滑车内侧唇动脉。尺骨上端主要由尺侧和骨间返动脉分支供应。分布于桡骨上端的动脉支,形成紧贴骨面上行的颈升动脉,该动脉分支稀疏,吻合不良。根据观测结果,讨论了肘关节动脉分布的临床应用要点。     

塔里木大学入学新生异常血压检测分析

目的了解塔里木大学入学新生血压异常状况及发生规律。方法用水银柱血压计随机检测2000名新生血压。结果新生异常血压检出率男生低于女生，男生高血压检出率明显高于女生，而低血压检出率明显低于女生；城市新生异常血压检出率低于农村新生，高血压检出率城市和农村男生都分别高于城市女生与农村女生，低血压检出率城市和农村男生明显低于女生，而城市女生低于农村女生。结论新生异常血压检出率较高，应加强青少年人群防治高血，压、低血压的知识教育。     

Pathogenesis of pulmonary edema caused by blast waves]

In the study of pathogenetic mechanisms of pulmonary edema to blast wave generated by detonation of the aerosol explosive in the open air, the dynamics of changes of the eicosanoid contents, the products of the energy metabolism as well as the glucose metabolism in the lung tissue of sheep have been examined. On the basis of data from the literature as well as own results the authors have given the original scheme of possible mechanisms of pulmonary edema caused by effects of the blast wave.     

不同密度腔内阴性对比剂CT肠壁显示比较

目的:比较不同密度腔内阴性对比剂与肠壁显示的关系,确定显示肠壁的最佳CT值范围。方法:选用新鲜离体猪结肠,用各种不同密度腔内阴性对比剂的替代物(碘油与食用油按不同比例混合)进行灌肠,而后将灌好的结肠放入CT值与肠系膜脂肪密度相似的液体中,进行扫描。结果:离体结肠扫描发现腔内对比剂CT值在-40HU~-120HU对肠壁显示效果较好。肠腔内外CT值差值在10HU以内共有5组,其肠壁显示均为优,肠腔内外CT值差值在20HU以上共7组,其中2组肠壁显示为优,2组为良,其余3组为差。结论:腔内阴性对比剂对离体猪肠壁显示较水和空气为佳,当腔内阴性对比剂的CT值密度与腔外脂肪密度相似时,对肠壁显示效果最好。     

两种一次性医用防护口罩的临床细菌学评价

目的了解佩戴时间对一次性医用防护口罩防护功能的影响。方法将采集的标本用琼脂培养法作细菌培养对结果进行分析。结果(1)随着佩戴时间的延长,口罩内、外层的细菌总数均增多,且口罩内层细菌数越多,外层的细菌数也相应增加;(2)随着佩戴时间的延长,滤菌率逐渐降低。两种口罩在2 h内,滤菌率均在95%以上,符合国家对一次性口罩滤菌率的要求。结论一次性医用防护口罩的最佳使用时间是2 h。     

粪便中灵芝孢子与肝吸虫卵形态学鉴别

目的探讨粪便中灵芝孢子形态与肝吸虫卵形态的鉴别要点。方法将口服灵芝保健品患者粪便用0.9%氯化钠溶液涂片,在显微镜下观察灵芝孢子形态与肝吸虫卵形态,并对两者进行比较。结果粪便中灵芝孢子与肝吸虫卵形态上有很多相近之处,但两者还是有各自的特征。结论在实际工作中,粪便检查查到大量肝吸虫卵样物质时,应掌握两者的形态学特征,询问病史,结合临床,可以通过显微镜下形态学特征鉴别粪便中灵芝孢子与肝吸虫卵。     

游泳训练对大鼠肝组织自由基代谢及肝脏超微结构的影响

本文研究不同时间游泳训练对大鼠肝组织过氧化脂质（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）活性的影响，同时观察肝组织超微结构的变化。结果显示：实验组Ⅰ自由基产生与清除基本达到动态平衡，保证了细胞结构和功能的完整；实验组ⅡＳＯＤ活性与实验组Ⅰ相比显著升高，肝细胞内线粒体多，粗面内质网丰富，糖元多呈区域分布，膜结构完整等超微结构的适应性改变，促进了肝组织的物质和能量代谢。力竭组大鼠肝细胞中ＭＤＡ含量显著增加，ＳＯＤ活性有所下降，肝细胞内线粒体减少，内质网断裂，细胞空化，膜结构破损，大量内容物进入血窦。认为运动后自由基增多是导致细胞膜结构损伤的因素之一，肝线粒体结构和功能受损，进一步提供产生ＬＰＯ的基础，ＵＯ明显介入肝组织损伤的过程，从而引起细胞内酶外逸，所以脂质过氧化也是引起血清酶活性增高的主要原因。ＳＯＤ显著增加对防止线粒体及细胞免受自由基损伤，保证线粒体进行正常呼吸供能，进一步维持整个器官的生理功能具有重要意义。     

Biochemical background of ethanol-induced cold susceptibility

The process of cooling is always associated with the depletion of energetic reserves and burning the ketone bodies covers the tissues' needs. Ethanol shows antiketonaemic effects changing the cellular redox potential, inhibiting beta-oxidation of fatty acids, stimulating the release of insulin and inhibiting the release of its antagonist. The aim of the study was to determine whether the cooling process of the organism in the presence of ethanol intoxication may be related to inhibition of the physiological mechanism of ketogenesis induced by hypothermia. The study involved the 67 autopsy cases from 1996 to 2002, in which the circumstances of death indicated the effects of overcooling. This was confirmed on the basis of the data from the Prosecutor's Offices. Then, the chromatograms of autopsy blood alcohol determinations were analyzed and the acetone levels recorded. The analysis supported the hypothesis that the severity of ketosis is inversely proportional to the blood ethanol concentration. Furthermore, it demonstrated that signs of prolonged cold exposure were less frequently observed in unsober persons (frostbites, gastric hemorrhages). Increased sensitivity of intoxicated individuals to cold may be related not only to the dilation of the peripheral vessels, inhibition of shivering thermogenesis caused by muscle relaxation, central nervous system depression and behavioral factors but also to the antiketonaemic effects of ethanol.     

Sonographically observed echogenic response during intraoperative radiofrequency ablation of cirrhotic livers: pathologic correlation

OBJECTIVE: We performed a study to determine the correlation between the diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver and the mean diameter of tissue necrosis. SUBJECTS AND METHODS: A total of 22 intraoperative radiofrequency ablations were created in 11 cirrhotic livers. The largest diameter of the sonographically observed echogenic response surrounding and perpendicular to the radiofrequency probe was measured. The subsequent zone of necrosis observed at pathology in the hepatectomy specimens after liver transplantation was measured in three planes and compared with the measured diameter of the echogenic response. RESULTS: During all except three ablations, a hyperechoic region was visualized surrounding the radiofrequency probe. The diameter of the echogenic response correlated significantly with the mean diameter of necrosis (correlation coefficient, 0.84). However, the echogenic response overestimated the minimal diameter of necrosis (mean difference, 0.8 +/- 0.4 cm) in 18 of 22 ablations and underestimated the maximum diameter of necrosis (mean difference, 0.9 +/- 0.8 cm) in 16 of 22 ablations. CONCLUSION: The diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver correlates closely with the mean diameter of the subsequent area of tissue necrosis. However, the solitary diameter of the echogenic response as measured in our study was often greater than the smallest diameter and less than the largest diameter of the area of tissue necrosis. Therefore, the echogenic response associated with radiofrequency ablation of the cirrhotic liver should be viewed only as a rough approximation of the area of induced tissue necrosis; the final assessment of the adequacy of ablation should be deferred to an alternative imaging technique.     

The skin: its structure and response to ionizing radiation

The response of the skin to ionizing radiation has important implications both for the treatment of malignant disease by radiation and for radiological protection. The structural organization of human skin is described and compared with that of the pig, with which it shows many similarities, in order that the response of the skin to ionizing radiation may be more fully understood. Acute radiation damage to the skin is primarily a consequence of changes in the epidermis; the timing of the peak of the reaction is related to the kinetic organization of this layer. The rate of development of damage is independent of the radiation dose, since this is related to the natural rate of loss of cells from the basal layer of the epidermis. Recovery of the epidermis occurs as a result of the proliferation of surviving clonogenic basal cells from within the irradiated area. The presence of clonogenic cells in the canal of the hair follicle is important, particularly after non-uniform irradiation from intermediate energy beta-emitters. The migration of viable cells from the edges of the irradiated site is also significant when small areas of skin are irradiated. Late damage to the skin is primarily a function of radiation effects on the vasculature; this produces a wave of dermal atrophy after 16-26 weeks. Dermal necrosis develops at this time after high doses. A second phase of dermal thinning is seen to develop after greater than 52 weeks, and this later phase of damage is associated with the appearance of telangiectasia. Highly localized irradiation of the skin, either to a specific layer (as may result from exposure to very low energy beta-emitters) or after exposure to small highly radioactive particles, 'hot particles', produces gross effects that become visibly manifest within 2 weeks of exposure. These changes result from the direct killing of the cells of the skin in interphase after doses greater than 100 Gy. Dose-effect curves have been established for the majority of these deterministic endpoints in the skin from the results of both experimental and clinical studies. These are of value in the establishment of safe radiation dose limits for the skin.