健康成人半自动递增刺激法运动单位数目估测研究

目的:建立在健康正常个体用半自动递增刺激法作运动单位数目估测(MUNE)的方法学.方法:使用半自动递增刺激法对67名(年龄18～72岁,平均40.6±12.3岁)健康成人进行双侧大、小鱼际肌MUNE测定;对其中13名个体相隔1周进行重复检测,分析MUNE数值与年龄、性别和侧别的关系.结果:67名健康成人平均大鱼际肌MUNE值为245.5±79.4个,小鱼际肌MUNE值为247.3±70.7个,大、小鱼际肌的平均MUNE数值与年龄、性别及侧别均无显著相关性(P>0.05).对67名健康成人中的13名个体,经两次重复检测所获得的平均MUNE值差异无显著意义(P>0.05).结论:用半自动递增刺激法进行MUNE检测有良好的可重复性,健康成年个体MUNE值与年龄、性别和侧别无明显的相关性.     

运动单位数目测定:正常值的建立及其在下运动神经元病变中的价值

目的 :建立运动单位数目测定 (MUNE)的正常值并初步探讨其在下运动神经元病的临床应用价值。方法 :应用VikingⅣ型肌电图仪中的“Poisson分布法”程序 ,对 75例健康人和 5 6例下运动神经元病变者选择趾短伸肌和鱼际肌进行测定。记录和刺激电极均为表面电极。结果 :在对照组 ,其结果显示可重复性好 ;<6 0岁时 ,运动单位 (MU)数与年龄、性别和侧别无关 ;>6 0岁时 ,MU数显著减少。在病人组 ,结果的可重复性更佳 ;运动神经元或轴突受损者均显示为运动单位 (MU)数减少 ;随着病情的好转 ,功能性MU数增加。结论 :MUNE可定量地评价运动单位的丧失 ,方法简便、快速、无创 ,是检测下运动神经元性病变的理想手段。     

运动单位数目测定在神经源性疾病中的价值

目的：探讨运动单位数目测定(MUNE)对神经肌肉疾病的诊断价值。方法：应用Viking IV型肌电图仪中的“统计学方法”对85例健康人和56例神经源性病变患者的趾短伸肌和鱼际肌进行测定。记录和刺激电极均为表面电极。结果：对照组的结果显示可重复性好,≤60岁时,运动单位(MU)数与年龄、性别和左右侧无关;＞60岁时,MU数显著减少。56例患者均表现MU数减少,可重复性高于对照组,并且随着病情的好转,功能性MU数增加。结论：MUNE是显示肌肉MU丧失的一种简单、非创伤性的快速方法,是检测神经源性疾病的理想手段之一。     

正中神经返支的观测及表面解剖定位

对100侧正中神经返支的形态进行观察、计测,82±3.84%源于正中神经主干分叉处。依其形态分为多支形(85±3.57%),双支型(10±3.60%),单支型(1±0.99%)、重复型(4±1.96%)。鱼际肌群(拇收肌除外)各肌神经分布呈多源性,拇对掌肌98%由正中神经返支支配。设计自舟骨结节中点与手掌第2指胰中点连线为纵轴线,通过第1掌骨小头顶端作纵轴线垂线为横轴线,以此座标测计正中神经返支的表面Ⅰ解剖定位。采用距纵轴线尺侧10～15mm设计适于临床应用的纵行切口,可避免损伤正中神经返支。     

人背阔肌肌内神经分布和肌构筑特征及其临床意义

目的:为背阔肌亚部肌移植的临床应用提供形态学基础。方法:改良Sihler’s肌内神经染色法和肌构筑法。结果:(1)支配背阔肌的胸背神经发出2～3支一级神经支入肌,入肌后发出呈树枝状分支分布到该肌,在肌中部构成网格状的神经分支密集区。(2)背阔肌内上部肌重(58.91±10.29)g、肌长(18.76±1.67)cm、生理横切面积(3.39±0.65)cm2,外下部肌重(119.60±20.89)g、肌长(29.33±1.70)cm、生理横切面积(4.69±0.92)cm2。结论:(1)背阔肌有恒定的肌内神经分支分布,可分为两个亚部:内上部和外下部。(2)背阔肌内上部在肢体运动中更多的维持肩关节的稳定;而背阔肌外下部则更多参与肢体的速度运动。     

肱三头肌外侧头神经肌支和血供的应用解剖

目的 :为肱三头肌外侧头的神经肌支移位和游离肌皮瓣移植提供解剖学基础。方法 :在 3 0侧成人上肢标本上对肱三头肌外侧头的神经肌支和血管进行详细解剖观测。结果 :外侧头肌支数 2～ 4支 ,一般为 3支。入肌部位位于大圆肌腱下缘 ( 5 .3 1± 2 .0 1)、( 6.0 6± 1.2 1)、( 5 .96± 1.0 )cm ,横径分别为( 1.4± 0 .5 )、( 1.2± 0 .2 )、( 1.9± 0 .9)mm。肌皮神经肱二头肌平均 2个肌支 ,入肌部位分别在大圆肌下缘以下 ( 4 .2 1± 1.66)和 ( 4 .5 8± 1.3 2 )cm ,横径为 ( 1.4± 0 .6)和 ( 1.2± 0 .8)mm。腋神经入肌部位在大圆肌下缘以上发出。肱三头肌外侧头血供来源于肱深、旋肱后及部分近侧肌支 ,且均与肱深血管有关。结论 :肱三头肌外侧头肌支有足够长度和横径 ,在肌门处可无张力移位至肌皮神经肱二头肌支及部分腋神经肌支。以肱深血管为蒂的肱三头肌外侧头游离肌皮瓣是修复前臂肌肉皮肤缺损的良好供体     

家兔半膜肌肌构筑、肌内神经和运动终板分布

目的探究家兔半膜肌的肌构筑与肌内神经和运动终板分布的关系。方法用肌构筑法、改良SihlerWs染色法、乙酰胆碱酯酶染色法对家兔半膜肌肌构筑、肌内神经和运动终板可分布进行观察。结果家兔半膜肌为长肌。肌重(3.31±0.03)g,肌长(5.45±0.09)cm,肌纤维长(3.00±0.01)cm,肌生理横切面积(1.04±0.01)cm2,FL/CSA为2.88,CSA/MW为0.31。支配家兔半膜肌的神经分3条干入肌,即上、中、下干。上干主要支配上1/3的肌束;中干分布到肌的中上部;下干沿途发出的分支最多,司中下部的肌束。中干和下干的分支之间有吻合。肌表面上、中、下部都有线状排列的运动终板短带,尤以肌下部较密。结论家兔半膜肌是长肌,倾向于速度型构筑设计;肌内神经分支密集区,运动终板分布密集;肌内神经和运动终板的分布与肌纤维排列有关。     

三角肌神经入肌点定位及肌内神经分布的研究

目的　揭示三角肌神经入肌点和肌内神经分支分布 ,为其临床应用提供较为详尽的形态学资料。方法　①用经甲醛固定 2年以上的成人尸体 (2 0～ 5 0岁 ) 12具 (男 9,女 3)共 2 4侧。以肩峰后角为骨性标志 ,测量三角肌各亚部神经支入肌点的位置。②用经甲醛固定 1年以内的童尸 3具 (3～ 10岁 )及成人尸体 2具 (2 0、4 0岁 )完整取下三角肌 ,采用Sihler′s肌内神经染色法观察肌内神经分支分布。结果　①三角肌各亚部神经入肌点的体表投影 :三角肌前亚部、中亚部、后亚部的神经入肌点分别在距肩峰后角下方 (5 7± 0 7)cm、(5 9± 0 8)cm、(4 8± 0 5 )cm处的水平线上 ,距三角肌前缘外后方 (3 6± 0 4 )cm处及距三角肌后缘外前方 (3 5± 0 6 )cm、(2 3± 0 3)cm处 ,上述三点均在肌的中 1/3部。②肌内神经分布 :三角肌前、后亚部的肌内神经支在肌内为直接横过肌纤维中部 ,沿途再发出分支与肌纤维并行走行 ;而中亚部肌内神经支在各个羽内 ,与肌纤维相交 ,行向短肌纤维的起止端。结论　①三角肌的神经入肌部位及入肌形式与该肌的形态和功能有关联 ;②三角肌的肌内神经分支分布可能与该肌的肌纤维长度及肌纤维型有关 ;③三角肌中亚部的肌内神经吻合网较宽而致密 ,推测有着更精细的神经调节。     

健康人周围神经刺激阈值的初步研究

目的探索建立健康人周围神经刺激阈值的正常值范围,初步探讨年龄、性别对周围神经刺激阈值的影响。方法选取符合纳入标准的健康志愿者120例,其中男性58例,女性62例;年龄20~79岁,平均年龄49.3岁。采用Keypoint workstation肌电图及诱发电位仪,带通20 Hz~10 kHz(运动传导检测)或1 Hz~2 kHz(感觉传导检测),扫描速度每格5 ms,灵敏度每格5 mV(运动传导检测)或每格20μV(感觉传导检测),刺激频率1 Hz,刺激时限0.2 ms。检查时室温27℃~30℃,保证健康志愿者皮肤温度在30℃以上。在神经传导检测的基础上采用双向测量法分别对正中神经、尺神经、腓神经及腓浅神经感觉支进行检测,得到各神经不同年龄组的神经刺激阈值,并对结果进行统计学分析。结果将健康志愿者按照年龄分为6组,即20~29岁组(A组)、30~39岁组(B组)、40~49岁组(C组)、50~59岁组(D组)、60~69岁组(E组)、≥70岁组(F组),每组20例。采用单因素方差分析,正中神经与尺神经刺激阈值F组与A组、B组、C组间差异有统计学意义;腓神经和腓浅神经感觉支刺激阈值F组与A组、B组间差异有统计学意义;其余各组间差异无统计学意义。正中神经、尺神经、腓神经及腓浅神经感觉支神经刺激阈值随年龄增长有逐渐增大趋势,尤其高龄组(≥70岁),其神经刺激阈值明显高于低龄组(20~40岁组)。不同性别间同名神经刺激阈值差异无统计学意义。上下肢比较发现,下肢神经刺激阈值明显高于上肢。结论采用双向测量法检测周围神经刺激阈值是可行的;年龄对神经刺激阈值的影响虽然微小但的确存在,尤其对于老年人;性别对于神经刺激阈值没有显著影响,这一点尚需深入研究进一步明确;上下肢神经刺激阈值的差异可能与其生理功能差异、神经纤维长度有关。     

肌电图在腕管综合征早期诊断中的探讨

目的:利用肌电图检测技术,通过刺激环指分别记录正中神经,尺神经的感觉神经诱发电位(SNAP)潜伏期之差值,对腕管综合征(CTS)早期诊断提供依据。方法:采用肌电诱发电位仪对14例CTS患者及20例正常人在环指近端放置一组环形记录电极,分别在腕上屈面正中神经、尺神经处刺激,对二组SNAP的潜伏期之差值作比较。结果:正中神经与尺神经SNAP的潜伏期之差值:正常人对照组:0.137±0.005,CTS组:0.368±0.019。结论:当正中神经、尺神经SNAP的潜伏期之差值处于0.368±0.019范畴时应高度怀疑CTS的可能。     

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.     

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.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.