翼管神经封闭术治疗过敏性鼻炎的应用解剖

<正>为给临床进行翼管神经封闭术治疗过敏性鼻炎提供形态学资料,作者对5个尸体头颅及50个颅骨标本进行了应用解剖和形态测量.结果表明:翼管神经穿行了蝶骨翼管,出翼管前口后进入蝶腭神经节,然后由此神经节发出节后纤维分布到鼻腔粘膜.翼管前口位于中鼻甲后缘梢上方.从鼻下点经鼻腔穿刺到翼管前口需穿过中鼻甲后端组织及鼻腔粘膜.穿刺深度左侧为5.8±0.4(5.1～6.7)cm[SD±(min-max)下同],右侧为     

鼻内窥镜下泪囊鼻腔造口术的应用解剖

目的：为鼻内窥镜下泪囊鼻腔造口术提供解剖学基础。方法：在３０侧成人头部正中矢状剖面标本上，观测了泪囊的形态、毗邻、在鼻腔外侧壁上的投影及泪囊窝内侧壁骨质厚度。以鼻小柱基部为基准，鼻腔底为平面，对泪囊进行了定位。结果：泪囊的长度为１３．３±２．２ｍｍ，内侧壁宽为６．０±１．１ｍｍ，横径为４．９±０．９ｍｍ，容积为０．３３±０．０７ｍｌ。从鼻小柱基部至泪囊下部和顶部的距离分别为３２．８±３．７ｍｍ和４３．４±４．３ｍｍ，两者与鼻腔底的夹角分别为４７．５°±３．６°和６５．６°±５．１°。结论：提出了泪囊鼻腔造口术时内窥镜进入深度和角度的安全范围，造口位置的选择及手术并发症的预防     

蝶腭孔、翼管前口的应用解剖及临床意义

目的 为鼻内窥镜翼管神经切断术等临床应用提供解剖学依据。方法 用15个30侧经防腐处理的成人头颅标本，经正中矢状面剖开，解剖观察测量蝶腭孔、翼管前口及穿过的血管、神经。结果 19例(63．33％)蝶腭孔位于中鼻甲后端前方平均8．09mm；11例(36．67％)位于在中鼻甲后端前上方平均7．24min。蝶腭孔呈圆形24例，直径平均3．25mm；呈卵圆形6例，最大径平均4．92mm穿过蝶腭孔的动脉有蝶腭动脉，或其分支鼻后外侧动脉和鼻中隔后动脉。翼管前口位于蝶腭孔后方约7mm，呈圆形漏斗状，横径约3mm，略向外下方开口，距离鼻小柱平均71．72mm，有翼管神经和翼管动脉穿过。结论 经鼻腔暴露翼管前口及翼管神经，以及进入翼腭窝处理上颌动脉末端的分支时，蝶腭孔及其周围骨质菲薄的部位是理想的手术入路部位。     

经皮腹腔神经丛穿刺的应用解剖

目的：为提高腹腔神经丛穿刺阻滞的成功率、减少并发症提供形态学基础。方法：在１８具成人尸体腹部横断层标本上对腹腔神经丛的位置、毗邻，穿刺部位、角度、深度进行观测。结果：腹腔神经丛平对胸十二至腰－椎体高度者为９４．４％。该丛最佳显示层面为腹部第九横断层面。腹腔神经丛左、右穿刺点距后正中线分别为４．０±０．６ｃｍ；５．９±１．１ｃｍ，穿刺角度分别为１４．０°±４．５°；２８．８°±３．７°，穿刺深度为９．７±１．１ｃｍ；１１．６±１．４ｃｍ。结论：穿刺点应选在第十二胸椎棘突下缘，中线向外旁开左４ｃｍ、右６ｃｍ处。穿刺角度较大时易损伤主动脉、腰升静脉、脊神经，反之易损伤肾、肾上腺和下腔静脉     

双肺上叶及右肺中叶的叶,段支气管的CT应用解剖

目的：为左、右肺上叶、段支气管及右肺中叶、段支气管的ＣＴ显示提供解剖学基础。方法：用３０具成人标本的左、右肺支气管树及其中左、右肺各１３例ＣＴ影像进行观测。结果：左、右肺上叶支气管及右肺中叶支气管的内径分别为５．２±０．６ｍｍ、５．１±０．９ｍｍ和４．０±０．６ｍｍ。段支气管内径为２．３～２．６ｍｍ。左肺Ｂ１＋２、Ｂ３的夹角分别为１８２．８°±３．６°和９２．０°±５．０°；右肺Ｂ１、Ｂ２、Ｂ３、Ｂ４和Ｂ５的夹角分别为１７３．８°±１４．３°、９２．２°±２．０°、８１．５°±４．５°、４０．５°±１０．１°和４５．５°±１１．０°。结论：可为ＣＴ诊断提供一个以数据为依据确定支气管异常的方法，通过调整段支气管与ＣＴ扫描层面间的夹角，可提高斜位ＣＴ扫描显示率。     

翼腭窝神经阻滞相关解剖及其临床意义

目的:探讨翼腭窝神经阻滞相关解剖及其临床意义.方法:在33个干性颅骨标本上对翼腭窝相关孔道和穿刺路径进行解剖观测.应用SPSS17.0分析并比较相关解剖数据.结果:不同穿刺测量法测量翼腭窝的长度,分别为:颧弓下法之侧入法,左侧为(54.87±3.44)mm、右侧为(54.79±2.81)mm;颧弓下法之侧前入法,左侧为(52.90±3.39)mm、右侧为(52.98±2.76)mm;颧骨上法,左侧为(47.59±2.93)mm、右侧为(47.34±3.05)mm.穿刺针与颅骨正中矢状面的角度上述3种方法依次为:左侧(75.5±6.4)°、右侧为(73.4±4.7)°,左侧(83.0±7.1)°、右侧(82.7±5.2)°,左侧(101.4±7.4)°、右侧(101.9±6.6 )°.结论:翼腭窝神经阻滞术以颧骨上法、颧骨下法应用较多.以颧骨上法风险较小,效果较好.     

成人左肺下叶支气管CT显示的应用解剖

目的：为左肺下叶支气管的ＣＴ显示提供应用解剖学基础。方法：用３０具成人标本的支气管树及其中的１３例ＣＴ影像进行观测。结果：叶支气管内径５．０±０．６ｍｍ。段支气管内径２．４～３．１ｍｍ。Ｂ６、Ｂ７、Ｂ８、Ｂ９和Ｂ１０的夹角分别为８６．４°±５．４°、１８．１°±１．３°、１９．０°±２．２°、１７．０°±３．１°和２１．５°±３．１°。结论：本研究可为左肺下叶支气管的ＣＴ诊断增加一个以数据为依据确定管腔狭窄或管壁增厚的方法，并可为调整段支气管与ＣＴ层面间的夹角以提高其ＣＴ显示率提供倾斜角度     

腰椎神经根管狭窄神经根受压的形态学变化及其临床意义

目的:为神经根管狭窄神经根压迫的影像学诊断和手术进路选择提供依据。方法:解剖了５６例腰骶椎标本神经根,观察神经根有关压迫因素。结果:椎管内压迫为上关节突的内侧缘及黄韧带,椎间孔内压迫为增生上关节突、膨隆的椎间盘,椎间孔外压迫为膨隆的椎间盘和椎体的骨唇。在无明显椎间盘膨隆标本,Ｌ４、Ｌ５神经根与硬膜的夹角分别为４０．４°±３．１°和４５．９°±３．７°,１２个因椎间盘膨隆的神经根与硬膜夹角分别为６７．０°±８．２°和６９．６°±８．１°。结论:解剖学神经根压痕的存在不能绝对证明生前有神经根损害症状,但对神经根压迫的研究有助于解释神经根造影像,明确神经根压迫因素。     

右肺下叶段支气管CT显示的应用解剖

目的：为给ＣＴ对右肺下叶作斜位扫描提供倾斜角度及对诊断提供参考数据。方法：以３０例标本制成支气管树和１３例ＣＴ影像观测叶、段支气管内径、段支气管与叶支气管的夹角。结果：叶支气管内径５．０±０．２ｍｍ。相邻底段支气管内径无显著差别。ＢⅥ、ＢⅦ、ＢⅧ、ＢⅨ和ＢⅩ的夹角分别为８８．１°±１．７°、１８．２°±３．５°、２０．２°±２．８°、１５．８°±２．６°和１６．７°±３．６°。结论：叶段支气管内径、管壁厚度可为ＣＴ诊断增加一个以数据为依据确定管腔狭窄或管壁增厚的方法以提高中心型肺癌的正确诊断率，依段支气管的倾斜角度将ＣＴ机架和体位作相应的倾斜和偏移使扫描层面与段支气管垂直可提高其ＣＴ显示率。     

翼腭神经节的解剖研究及其临床意义

目的　研究翼腭神经节及毗邻结构的显微外科解剖关系,为临床手术治疗相关疾病提供解剖学依据。 方法　成人尸头标本15例（30侧）,采用手术显微镜及鼻内镜观察翼腭神经节及毗邻结构。 结果　翼腭神经节为翼腭窝内副交感神经节,为翼管神经、上颌神经、腭神经三者交汇处,位于内上方为翼管神经,位于外下方为上颌神经,位于下方为腭神经,腭神经起始于腭骨垂直板与上颌骨后壁的夹角处,腭神经起始处外径为（1.23±0.32）mm,向前内走行,并于腭降动脉的后内侧逐渐紧贴腭骨垂直板下降进入翼腭管。 结论　翼腭神经节与腭神经及翼管神经相邻,先通过腭神经寻找到翼腭神经节,再通过翼腭神经节可定位翼管神经,因此可作为翼管神经切除术中的重要解剖标志。     

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.     

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.