气管旁入法与高位侧入法行星状神经节阻滞的解剖学比较

目的为气管旁入法与高位侧入法行星状神经节阻滞提供解剖学依据。方法选取10具成人头颈胸尸体标本,在舌骨下区和颈外侧区以及胸锁乳突肌区由浅入深解剖至星状神经节处,观察星状神经节及其毗邻结构的关系,用游标卡尺测量相关数据,进行两种入路的比较。结果星状神经节位于第7颈椎基部前方和第1肋骨颈之间,其上缘与颈中神经节中点的距离,男性为(18.10±1.07)mm,女性为(16.71±1.10)mm;从第6颈椎横突前结节的前面观测,星状神经节上下径和左右径分别为(10.25±0.13mm和(14.02±0.58)mm,从侧面观测,其上下径和前后径分别为(9.22±0.14)mm和(2.12±0.52)mm。结论星状神经节阻滞选择气管旁入路法比高位侧入法更为安全且易掌握。     

星状神经节阻滞麻醉的应用解剖

目的:为气管旁入路星状神经节阻滞麻醉提供解剖学依据。方法:对17具(34侧)成人尸体标本进行解剖,对星状神经节的形态、位置及其毗邻结构进行观测。结果:星状神经节出现率为82.35%,其位置位于第7颈椎横突基部和第1肋骨颈之间前方;从颈前皮肤至星状神经节的垂直距离为(31.86±0.72)mm。结论:气管旁入路星状神经节阻滞麻醉选择第6颈椎横突前结节为进针部位是较为安全的方法。     

上胸段交感干切断术的微创外科解剖学

目的:探索胸交感干及其周围的显微解剖,为交感干切断术提供解剖学依据。方法:28例成人胸腔标本,在放大5×25倍手术显微镜下,对交感干及其周围组织进行逐层显微解剖、观察及测量。结果:星状神经节(颈胸神经节)及T2￣T5神经节的长径依次是(21.5±3.2)、(10.6±2.8)、(8.5±3.1)、(8.2±2.7)和(7.1±1.8)mm。T2￣T5神经节出现在相应肋间水平的发生率依次是92.7%、85.5%、40.0%、36.4%。旁路纤维只在T1或T2及T2或T3之间发现,出现率分别是69.1%、49.1%。结论:针对手汗症、头面多汗症治疗以及复合性局部疼痛综合症的交感干切断手术,只需切断节间束纤维及其旁路上传纤维即可,其余交感干的相关结构应尽量保护。     

经胸腔上肢交感神经切除术的解剖学基础

目的:探讨上胸段交感干及其与肋间神经或胸神经前支之间的神经联系,为经胸腔行上肢交感神经切除术提供解剖学基础.方法:对50侧成人尸体标本的上胸段交感干(神经节及节间支)、上5对肋间神经(或胸神经)及其它们之间的神经联系进行显微解剖.结果:星状神经节出现率为80%,胸2、胸3、胸4神经节多位于相应肋间,出现率分别为92%、68%、50%.第1、2肋间支出现率分别为40%、6%,星状神经节的降支出现率为46%,胸2、胸3、胸4神经节的升支或降支出现率分别为54%、24%、14%.额外交通支与第1胸神经前支的连接点均位于后者发支至臂丛的近侧,与第2～4肋间神经连接点到胸交感干的最远水平距离是29.1mm.只有16%的个体双侧胸2～胸4神经节的交通支配布有类似的解剖学特征,而且胸2神经节的变异较胸3、胸4神经节大.结论:上胸部交感干与肋间神经或胸神经前支间神经联系的变异很大,这些变异可能是手术失败或复发的原因.经胸腔行上肢交感神经切除术治疗多汗症、复合性局部疼痛综合征、雷诺现象等难治性疾病时,应注意这些解剖变异,以改善手术效果.     

下颌下神经节的形态学观察

为了颌面外科手术的需要和积累中国人的体调资料,选用了北京地区,经福尔马林固定的完好成人尸头30侧,在耳科手术显微镜下分别观察其位置,形态,神经根的数目等。并应用游标卡尺分别测量,最后经统计学分析,处理。结果如下:1.下颌下神经节的位置:(1)下颌下神经节的中心点至上颌第二磨牙牙冠咬牙合面的直线距离(mm):均值:28.43±2.17;(2)下颌下神经节中心点至舌神经上缘的垂直距(mm):均值:5.03±0.72。(3)下颌下神经节位于:下颌下腺上方:28侧,占:93.33%;下颌下腺深方:2侧,占:6.67%。2.下颌下神经节的形态(侧面观):(1)椭园,有19侧(63.33%),均长3.24 mm,均宽2.32 mm,均厚1.05 mm;     

颈部交感神经干及交感神经节受刺激因素的解剖学观察及其临床意义

目的:了解颈交感神经干及交感神经节的解剖特点及其与颈椎周围组织的解剖关系,为临床诊治椎(间)孔外颈神经卡压提供解剖学基础。方法:解剖20具(40侧)成人尸体标本,观察颈交感神经干及交感神经节与周围组织结构的解剖关系,测量前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带外缘与交感神经干的距离。2具新鲜尸体作Masson染色,了解前斜角肌、头长肌、颈长肌腱性组织成分。结果:颈上交感神经节周围常有肿大的淋巴结,颈下(星状)神经节下端紧贴第一肋椎关节。前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带均为腱性结合。颈交感干在C_5横突处距前斜角肌腱性交叉起点左侧为2.6±0.5cm,右侧为2.1±1.1cm,距头长肌、颈长肌腱性束带外缘左侧为2.4±0.4cm,右侧为2.5±0.8cm。结论:颈上交感神经节周围肿大的淋巴结,颈下(星状)神经节下端增生的第一肋椎关节,前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带是造成颈交感神经干及交感神经节在椎(间)孔外受到刺激的解剖学因素。     

大鼠面神经颅外段的解剖及其应用

目的 :为大鼠面神经损伤模型的制备提供解剖学依据。方法 :解剖和观测大鼠面神经颅外段。结果 :大鼠面神经出茎乳孔后可分为两段。第 1段长度为 (5 .2 1± 0 .4 8)mm ,中点外径为 (1.31± 0 .13)mm ,第 2段分三个终末支 ,其中耳睑神经较短为(8.97± 0 .95 )mm ,颊肌神经和下颌缘神经平均长度分别为 (2 5 .2 3± 1.4 1)mm、(2 6 .6 1± 1.2 2 )mm ,中点外径为 (1.0 5± 0 .2 0 )mm、(0 .95± 0 .2 0 )mm。二者在口角外侧汇合成神经节样体。结论 :大鼠面神经的第 1段宜作钳夹、结扎损伤模型 ;第 2段的颊肌神经和下颌缘神经宜作神经断离自体静脉套接、神经断端外膜缝合及电生理检测等。     

双轴点掌背皮动脉轴行皮瓣的应用解剖

目的 :报道手背一种新型皮动脉岛状皮瓣设计的解剖学基础。方法 :对 2 0侧新鲜成人标本 ,在 5倍显微镜下观测掌背血管、肌腱、神经的解剖特点和皮肤的血供。结果 :手掌背皮下组织内存在掌背动脉相平行的皮动脉。第 1掌背动脉出现率为 95 % ,起点外径 ( 0 .8± 0 .1)mm ,长度 ( 7.8± 1.1)cm ,末端外径 ( 0 .4± 0 .2 )mm。第 2掌背动脉出现率为 10 0 % ,起点外径 ( 0 .6± 0 .1)mm ,长度 ( 6.5± 0 .8)cm ,末端外径 ( 0 .4± 0 .1)mm。第 3掌背动脉出现率为 10 0 % ,起点外径 ( 0 .5± 0 .1)mm ,长度 ( 6.5± 0 .7)cm ,末端外径 ( 0 .3± 0 .1)mm。第 4掌背动脉出现率为 90 % ,起点外径 ( 0 .4± 0 .1)mm ,长度 ( 5 .5± 0 .9)cm ,末端外径 ( 0 .3± 0 .1)mm。结论 :掌背皮动脉走行、分支较为恒定 ,可以其为蒂 ,设计双轴点的顺行或逆行岛状皮瓣 ,用于腕、手及手指的软组织缺损的修复。     

大鼠舌咽和迷走神经感觉神经节内P2X_2、P2X_3受体与calretinin和IB4结合位点的共存

应用免疫组织化学荧光三标方法结合激光共聚焦显微镜技术研究了大鼠舌咽和神经迷走神经感觉神经节内ATP受体P2X2、P2X3与calretinin、植物凝集素(IB4)结合位点的共存。结果显示:舌咽和迷走神经感觉神经节内可见大量P2X2、P2X3阳性的神经元胞体和纤维,P2X2受体阳性细胞多为大、中、小型神经元,P2X3阳性细胞多为中、小型神经元;可见较多的P2X2/IB4及P2X3/IB4双标神经元。有(91.1±4.7)%(结状神经节)、(78.8±2.4)%(岩神经节)、(76.8±2.7)%(颈静脉神经节)为P2X2阳性细胞;(77.0±3.2)%(结状神经节)、(91.2±3.9)%(岩神经节)、(78.4±3.6)%(颈静脉神经节)的P2X3阳性细胞结合IB4;有8.9±1.6%(结状神经节)、7.7±1.4%(岩神经节)、9.1±1.1%(颈静脉神经节)的P2X2阳性细胞呈calretinin阳性;三神经节内均观察到少量P2X2/calretinin/IB4三标细胞。P2X3/calretinin双标或P2X3/calretinin/IB4三标神经元数量较少。这些结果提示,舌咽和迷走神经感觉神经节内ATP受体P2X2、P2X3与IB4结合位点存在广泛的共存,部分P2X2受体与calretinin存在着共存。     

碱性成纤维细胞生长因子对豚鼠耳蜗螺旋神经节细胞谷氨酸钠毒性损伤的保护作用

目的　在体研究碱性成纤维细胞生长因子 (bFGF)对谷氨酸钠所致豚鼠耳蜗螺旋神经节细胞毒性损伤的拮抗作用。方法　谷氨酸钠组 :谷氨酸钠 2g·kg-1·d-1,ip× 18d ;bFGF组 :bFGF 80 0U·kg-1·d-1,ip ,谷氨酸钠 2g·kg-1·d-1,ip× 18d。停止用药后耳廓反射粗略测定动物听觉水平 ,后取耳蜗 ,固定包埋、切片染色 ,光镜观察。结果　谷氨酸钠组表现为基底转与顶转几乎均匀一致的耳蜗螺旋神经节细胞的消失 ,平均细胞密度为 (1976 3± 10 18 9)个 /mm2 ,占正常的 4 5 % ;bFGF组细胞密度为 (384 0 9± 373 1)个 /mm2 ,约为正常组的 89%。经方差分析 ,F 检验 ,谷氨酸钠组与bFGF组比较 ,耳蜗螺旋神经节存活细胞密度差异显著 ,P <0 0 5。结论　bFGF对豚鼠谷氨酸钠耳蜗旋神经节细胞在体毒性损伤具有保护作用     

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.