成人单独心室间隔缺损的解剖分型与临床合并症

目的　探讨成人单独心室间隔缺损的解剖分型为临床合并症的探讨和室缺修补术提供解剖依据。方法　术中观察 89例成人单独心室间隔缺损病例并根据室间隔的解剖分区对该组室缺进行分型。统计各型占的比例和合并症、并发症的发生。结果　室间隔缺损以膜部多见 ,在本组占 6 6 %。成人干下型室间隔缺损常合并有主动脉瓣关闭不全 ,本组主漏病例占干下型的 33%。感染性心内膜炎是较严重的合并症 ,占本组的 5 .6 %。结论　不同部位和大小的室缺影响邻近的解剖结构 ,造成不同的合并症和并发症。室缺的解剖分型对手术治疗有重要指导意义 ,并为减少手术并发症的发生提供解剖依据     

HLA—A,B血清学分型与DNA分型的比较

目的：比较１３６例样本ＨＬＡ－Ａ，Ｂ血清学分型与ＤＮＡ分型结果。方法：应用聚合酶链反应－序列特异性引物（ＰＣＲＳＳＰ）技术，设计３８对引物，检测常见的ＨＬＡ－Ａ，Ｂ基因。结果：１３６例样本中有６０例血清学分型与ＤＮＡ分型结构不符合（４４．１％）；ＨＬＡ－Ａ特异性血清学分型错误率在纯合子中分别占２３．３％与９．４％（共１１．２％），在ＨＬＡ－Ｂ中分别占４７．４％与１８．４％（共２０．６％）；ＨＬＡ－Ａ特异性血清学分型假阴性６．６％，假阳性２．５％，错误指认特异性２．１％，ＨＬＡ－Ｂ错异性则分别为６．７％，３．６％，１０．３％。结论：ＩＬＡ－Ａ纯合子血清学分型错误率明显高于杂合子（Ｐ〈０．０５）；ＨＬＡ－Ｂ纯合子血清学分型错误率也明显高于杂合子（Ｐ〈０．００５）；ＨＬＡ－Ｂ特异性血清学分型错误率显著高于ＨＬＡ－Ａ特     

室间隔膜部瘤破裂与室间隔缺损伴发的膜部瘤

室间隔缺损与膜部瘤的关系日益受到重视，主要包括两种情况：即室间隔膜部瘤破裂与室间隔缺损伴发的膜部瘤，前者被称为真性膜部瘤，后者则为假性膜部瘤。有文献报道膜周部室间隔缺损伴有膜部瘤者达30％～60％，作者在对膜周部室间隔缺损进行介入治疗研究中，发现有48．75％的患者合并有膜部瘤。张玉顺等报告的膜周部室间隔缺损伴膜部瘤形成者高达86％。     

正中神经掌皮支形态特点及其临床意义

目的：为腕掌部手术避免损伤掌皮支提供解剖学基础。方法：在双目放大镜下对５０侧成人上肢正中神经掌皮支的来源、走行及分支进行解剖和观测。结果：５０侧均存在掌皮支，距离“Ｏ”点即远侧腕横纹４６．０ｍｍ处自正中神经桡侧发出，穿出前臂筋膜处距Ｏ点１９．６ｍｍ；穿出掌腱膜处距Ｏ点８．３ｍｍ。掌皮支长４８．５ｍｍ，起点宽１．２ｍｍ，距舟骨结节垂直距离８．２ｍｍ。掌皮支有３个分支的２８侧（５６．０％）；只有外侧支和中间支的１１侧（２２．０％）；只有内侧支和外侧支的４侧（８．０％）；只有外侧支的４侧（８．０％）；只有中间支的３侧（６．０％）。结论：掌皮支的来源、行程较恒定。腕掌部手术应尽量靠近尺侧，采取纵行切口，免伤掌皮支。     

尺神经深支的形态特点及其临床意义

目的：为临床尺管综合征和尺神经深支损伤的诊治提供解剖学基础。方法：在３０只成人手标本上解剖观测了尺神经深支的走行、毗邻关系、终末分支和分布。结果：依据尺神经深支的走行可分为：豆钩管段、小鱼际肌段、掌中段和终末段。小鱼际肌段行于小指对掌肌与第５掌骨之间的占５６．７％；在小指对掌肌间隙的走行占３０％；在小指短屈肌与小指对掌肌之间占１３．３％。终末段分支为４支型的占８６．７％，３支型占１３．３％。结论：尺神经深支的豆钩管段与豌豆骨、钩状骨钩关系密切；小鱼际肌段与第５掌骨基底紧邻。豌豆骨、钩骨钩和第５掌骨基底部骨折，极易损伤此神经。     

直窦的形态及其临床意义

解剖观测了１００例（男５７、女４３）成人硬脑膜标本。结果如下：１．按直窦前后走行方向，将其分为４种类型：①前后水平型，占６２％；②前高后低型，占１９％；③前低后高型，占１２％；④弯曲型，占７％。２．直窦平均长度３．８０±０．４６ｃｍ，宽平均０．３６±０．１１ｃｍ。３．单直窦占９３％；双直窦占７％。４．本文还对直窦属支与侧支循环径路以及直窦和硬脑膜动静脉瘘等与临床有关的内容进行了讨论。     

中斜角肌内缘腱性束带的形态及其临床意义

目的：探讨中斜角肌内缘腱性束带与臂丛受压的关系，为临床诊治提供解剖学基础。方法：３０具成人尸体标本，观察中斜角肌内缘腱性束带的位置及其与臂丛下干的关系。结果：中斜角肌内缘腱性束带出现率为８０％，其长度为３１．５±１．５１ｍｍ、宽度为６．１±２．４ｍｍ、厚度为０．６±０．１ｍｍ。腱性束带起自第７颈椎横突上方，止于第１肋内侧缘（锁骨下动脉沟内侧端处），其形态为一条扁带形弦带，张于第１肋内侧缘上。束带与臂丛下干相交处距第１肋上面高度为４．１±１．５ｍｍ；臂丛下干的合成点与束带的关系有３种类型：Ⅰ型（束带外合干型）占１６％；Ⅱ型（束带上合干型）占３０％；Ⅲ型（束带内合干型）占５４％。结论：Ⅰ型构成对臂丛下干压迫，是导致胸廓出口综合征的主要病因之一，Ⅱ型也可以引起此征，以手术切除束带，解除压迫为最佳治疗手段。     

脊神经根的形态变异观测及其临床意义

目的：为临床脊神经根性疾患的诊治提供解剖学基础。方法：对３５具（７０侧）成人尸体的全部脊神经前后根形态、位置、解剖汇合点和前后根的横径进行观测。结果：①脊神经后根有复根现象，双根的占２４．３％（双侧），三根占０．４％（双侧），而且有１．３２％的前根位于后根上方的变异；②前后根解剖汇合点８０％位于脊神经节的远端，２０％位于节的中部；③前后根横径之比在１１．５～２．５之间。结论：脊神经存有形态和位置上的变异，在临床手术治疗中应加以注意。     

喉切除发音管重建术中环咽肌与喉下神经的应用解剖

目的：为提高全喉切除术后用发音管发音重建的成功率提供解剖学基础。方法：对４０具（男３０，女１０）成人标本环咽肌进行解剖，观测左右侧喉下神经入喉处与甲状软骨下角的距离、喉下神经和环咽肌的关系。结果：喉下神经入喉点距甲状软骨下角的距离，左侧（５．５±１．４） ｍｍ；右侧（５．３±１．３） ｍｍ。７５％（６０侧）喉下神经在环咽肌的下方穿入喉部；２５％（２０侧）喉下神经在环咽肌纤维之间穿入喉部。结论：本研究对于指导环咽肌切断术，诊治环咽肌失驰缓症，探讨喉下神经和环咽肌的关系等有重要的临床意义。     

拇,趾短岂应用解剖及去神经游离移植的临床应用

目的：旨在为拇、趾短伸肌去神经子移植修复腭裂、腭咽闭合不全，面瘫等提供形态学莽莽：（１）对２２只足标本的拇、趾短伸肌的形态变异及神经支配进行解剖观察；（２）在１０９ 以神经刺激仪确认拇、趾短伸肌的神经，并测肌的长度，体积及重量。结果：（１）拇、趾短伸肌与长腱舍并机会分别为５５．７％、６２．８％；趾短伸出腱至第５趾的占７６．９％；（２）肌的神经支配三类型比率分别是２４．４％、３２．８％、４２．７％：     

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.