Acta Universitatis Carolinae. Medica. Monographia最新文献

Vascular bed and its relationship to differentiating muscular tissue was studied in a set of 104 upper limbs of human embryos and foetuses, gradually increasing from 10 to 120 mm C-R length. Knowledge obtained on the ontogeny of vascular bed was supplemented by findings in 75 limbs of adults treated by preparation technique. Embryonic and foetal material was treated histochemically a--to demonstrate vascular bed reaction for alkaline phosphatase (AP), ATPase, and dipeptidylpeptidase IV (DPP IV), b--to study differentiating muscular tissue for enzyme--ATPase and tetrazoliumreductase (NaDH2, c--to distinguish muscular tissue elements with toluidine blue staining for degree of maturity. Observations concerned several items, namely a--the ontogeny of main arterial trunks in the forearm and hand, b--muscle fibre type differentiation in antebrachial muscular primordia, c--formation of vascular bed as related to differentiating muscular tissue in the forearm and hand. Therefore our results are grouped as follows: ad a--Arterial trunks differentiate along with other limb structures in 12-18 mm C-R length embryos. Thus in embryos above 18 mm C-R length antebrachial and hand trunks are fully formed. Vascular trunks differentiate from deep vascular network via gradual reduction and magistralization in conformity with the general laws of haemodynamics. All arterial trunks forming in the limb during the ontogeny branch off the original axial artery in regio cubiti. In a. radialis trunk it has been ascertained that this blood vessel does not originate from a. brachialis superficialis, as generally reported, but its formation conforms to the same general principles as blood vessel trunks. So it branches off the original axial artery, as other trunks do. A. mediana formed during vascular trunks differentiation later in the ontogeny does not obliterate but changes into the constant a. comitans n. mediani. ad b--First involved in differentiation in antebrachial muscular primordia are the "fast" type fibres (according to Peter et al., 1972) (fast glycolytic-FG-type fibres followed by fast oxidative glycolytic-FOG-type fibres) in 27-30 mm C-R length embryos. "Slow" type fibres (slow oxidative-SO-type fibres) may not be demonstrated histochemically in antebrachial muscles earlier than 45 mm C-R length foetuses. The maturity of muscular elements may be demonstrated by staining with toluidine blue on cytoplasm basophilia of cells. Sarcolytic myotubes in muscular primordia histochemically display typical features which distinguish them markedly from other differentiating muscle fibres.(ABSTRACT TRUNCATED AT 400 WORDS)

When analysing the function of a neuronal system, it is important to know how the connections of the various neuronal elements are organized. One way in which the structure of nervous tissue can be studied is to become acquainted with the basic principles of its development. This can be achieved by studying the process of normal development, or else by experimental means aimed at inducing changes which help to uncover the laws of the interrelationships of the various elements forming the neuronal system. We studied pyramidal cell structure in the CA1 region of the rat hippocampus during normal postnatal development and after repeated exposure to altitude hypoxia (8 h a day from birth to 17 days at a simulated altitude of 7000 m). At 18 and 90 days the brains of the experimental and control animals were impregnated by the Golgi-Cox method for light microscopy. The brains of 5-, 10-, 15-, 24-, 48- and 90-day-old animals which had developed normally were treated similarly and subjected to a parallel analysis including quantitative methods of electron microscopy. The various parts of the dendritic system are not formed simultaneously. Up to the 15th day, the basal dendrites and the shaft of the apical dendrite, together with its terminal branches, develop. Between the 15th and the 24th day development continues with the proliferation and ramification of the lateral and preterminal branches of the apical dendrite. The number of dendrites is established the first, followed by growth and branching. Development of the dendritic spines involves a change in their shape as well as an increase in their number. From being short and thick the spines develop into structures with a thin neck and a claviform and sometimes branched head. Development of the receptive component of neuronal structure is accompanied by an increase in the number of afferent fibre terminals. Type I synapses are differentiated earlier and in larger numbers than type II synapses. The pyramidal cells of the hippocampus of rats exposed to hypoxia in early life have fewer basal dendrites and fewer terminal fibres on the apical dendrites at 18 days. Hypoxia also leads to lower dendritic spine density and to changes in the shape of the spines reminiscent of less mature forms.(ABSTRACT TRUNCATED AT 400 WORDS)

Both authors have dedicated most of their time since 1948 to the treatment of fractures in children. On the basis of their experience they are therefore submitting to the medical public those methods and results of the conservative treatment of fractures and dislocations in children which stood the test of time. The experiences of both authors as well as successful therapeutic methods of other surgeons are discussed in this book. Differences are stated between fractures in adults and in children which may be attributed to the growth factor of children's bones and their enormous biological drive. These factors will play their part in correcting certain displaced fractures by re-moulding, fractures which in an adult would have to be perfectly reduced unless a permanent deformity should ensue associated with subsequent impairment of function to the injured limb. The authors are stating which displaced angulations and side to side displacements in a fracture may be left and which must be repaired under all circumstances and why, if conservative treatment fails, surgery has to be performed. Sideways and longitudinally displaced fractures, especially metaphysial ones do not warrant a perfect reduction. Rotational displacements must be corrected every time even in very small infants e.g. in newborn babies. Age plays an important part in the healing of fractures. Moulding and union of a fracture will be most rapid in newborn babies and infants while in fractures of adolescents a similar procedure has to be adopted as in fractures of adults. Special problems of epiphysiolyses and epiphysial fractures are discussed emphasizing that conservative treatment may be unsuccessful in epiphysiolyses Salter-Harris type III and IV and surgical intervention may be indicated. Fractures of upper and lower limbs are dealt with in detail while paying special attention to obstetrical fractures. Fractures round the elbow are treated in a similar manner, they will frequently heal in angulation of the upper limb and may cause nerve injuries and ischaemic changes of the forearm. Special attention is being paid to the longitudinal overgrowth of fractures of the femoral diaphysis associated with the sequelae of the treatment of these very serious injuries to newborn babies and infants as well as to toddlers and older children.

On the basis of the author's own experiences and drawing on data available in the literature, present possibilities of neuroradiological diagnosis of developmental disorders of the spine and skull, developmental anomalies of meninges of the brain and the spinal cord and of the central nervous system, the brain and the spinal cord are discussed. The rapid development of investigative methods in the past decades has brought about an immense amount of new information gained in the diagnosis of these anomalies and has facilitated their early detection and a more accurate evaluation. The morphological aspect is not, however, the only factor in the estimation of the clinical relevance of these disorders. For this reason not only the morphological, but also the functional relationship of developmental disorders of the nervous system to the adjacent structures is emphasized and, on the other hand, the influence of these anomalies on the nervous system is discussed. Many years' experiences in clinical neurology and problems of manual medicine indicate that these relations may be the cause of the various clinical symptoms. In this respect the presented findings mean a contribution to the treatment of the clinical complaints that are pathogenetically related to developmental disorders.

Focal epileptic activity (FEA) in amygdalohippocampal complexes (AHC) is mostly highly intensive (except in patient BUK where it is nearly missing). Unilateral FEA is hardly ever propagated to the superficial EEG electrodes, bilateral FEA only very rarely (patients BRY and DUS), in some patients solely in deep synchronous sleep (patient LOB). FEA intensity rises in relaxed vigilance and in superficial sleep while tending to decrease in deep synchronous sleep. FEA intensity tends to drop or even disappear in active vigilance during mental activity or paradoxical sleep. Epileptic activity generalized in all the superficial and deep-implanted leads is mostly accompanied by clinical manifestations (absences, twitching, motor automatisms), or to put it the other way round: if a clinical paroxysms is in progress, there is evidence of generalized epileptic activity in all the leads. The time parameter is of no consequence, the inconspicuous motion of the hand is due to a second-lasting discharge of polyspike and wave (patient BRY in sleep). If prolonged discharges remain localized there is subclinical paroxysm (patient IRL). Similar findings were reported by Lieb et al. (1976). All we can add is that the start of an attack depends not only on the amplitude and frequency of the spikes but also on the regularity of spike intervals. Superficial "neocortical" EEG and deep "paleocortical" SEEG exhibit equal sleep stages equally, i.e. either there is synchronization in all the leads (like in synchronous sleep), or there is desynchronization (such as in active vigilance or in paradoxical sleep); those two cortical structures are not antithetical such as in, e.g., rats or cats. The sleep stages show quantitative as well as qualitative changes. There is increasingly more wakefulness and superficial sleep at the expense of spindle and paradoxical sleep. EEG graphoelements often show little differentiation, e.g. the sleep spindles are short and irregular in shape, delta activity is low in amplitude and also irregular in shape, and paradoxical sleep shows insufficient desynchronization in EEG and preserved tonic muscular activity. Epileptic activity variability is often found helpful for the reliable identification of the sleep stage concerned.(ABSTRACT TRUNCATED AT 400 WORDS)