小儿肝的年龄解剖学研究

分六个年龄组观察了１８０个小儿肝的形态、度量、位置及体表投影。小儿肝相对较大，右叶大于左叶，下界位置较低并逐渐上移。在右锁骨中线的肋弓下一般均可触到。小儿肝重随其年龄的增长而增长，其增长速度相对较慢，尤以Ⅶ组小儿更明显。     

小儿食管的年龄解剖学研究

解剖观测了六个年龄组180具(男102、女78)小儿尸的食管的形态和度量.测量了自中(上)切牙和鼻前孔分别至食管的起始部、与主动脉弓邻接处、与左主支气管邻接处、穿膈肌食管裂孔处、与贲门连接处的距离和上述五处的内径及其与椎骨的对应关系.小儿食管行程弯曲,其长度随身高相应增长,其中以Ⅰ～Ⅲ组增长较快.     

小儿胃的年龄解剖学研究

分６个年龄组观测了１８０具小儿尸胃的形态，位置及度量。小儿胃的形态分三型，Ｉ组多为垂直位型，Ⅱ￣Ⅳ组多为斜位型。新生儿胃的位置略低，生后逐渐上移，至Ⅵ组时，胃已升至成人的位置。小儿胃的贲门和幽门与椎骨的对应关系与成人相近。胃大弯最低点体表投影，从Ｉ￣Ⅵ组呈逐渐向挤上方移位的趋势。     

小儿十二指肠的年龄解剖学研究

分六个年龄组观察了180具（男98，女82）小儿尸十二指肠的形态，位置，度量及其与腹膜的关系，小儿十二指肠的形状分四型：I组多为“C”型，Ⅱ-Ⅵ组多为“U”型，小儿十二指肠长度以I－Ⅳ组增长较快，小儿十二指肠起，止部位与椎骨的对应关系与成人基本一致。     

小儿食管的年龄解剖学研究

解剖观测了六个年龄组１８０具小儿尸的食管的形态和度量，测量了自中（上）切牙和鼻前孔分别至食管的起始部，与主动脉弓邻接处、与左主支气管邻接处，穿膈肌食管裂孔处，与贲门连接处的距离和上述五处的内径及其与椎骨的对应关系。小儿食管行程弯曲，其长度阴身高相应增长，其中以Ｉ￣Ⅱ组增长较快。     

小儿咽的年龄解剖学研究

利用１８０具小儿尸（男１０３。女７７），分六个年龄组，观测其咽的形状，位置及有关结构。咽的位置（下界）随年龄（身长）的增长而下降，咽的长度以Ⅰ－Ⅲ组小儿增长较快；咽穹不明显；咽鼓管咽口的形态Ⅰ－Ⅲ组多为裂隙形，Ⅳ－Ⅵ组多为卵圆形；腭扁桃体呈规律性增长，咽扁档体以Ⅲ组增长最快。     

小儿肝外胆道系统的年龄解剖学研究

分六个年龄组解剖观测了１８０具（男９７，女８３）小儿尸肝外胆道系统的形态和度量。小儿胆囊多为梨形。从学龄前组（ＩＶ组）开始，胆囊周径增长相对较快。胆囊底在体表的投影点，随年龄（身高）的增长而逐渐向上外方移位。小儿（Ｉ～ＶＩ组）胆总管长度基本上成比例增长，六组增速基本相同。     

小儿空回肠的年龄解剖学研究

分六个年龄组观测了180具（男100，女80）小儿尸的空回肠位置，肠袢排列，小肠系膜根走行，空回肠长度及其与年龄（身长）之间的关系，小儿Ⅰ-Ⅲ组空回肠的长度增长较快，相对较长，其他组相对增长较慢，较短。     

小儿肝外胆道系统的年龄解剖学研究

分六个年龄组解剖观测了180具(男97,女83)小儿尸肝外胆道系统的形态和度量。小儿胆囊多为梨形。从学龄前组(Ⅳ组)开始,胆囊周径增长相对较快。胆囊底在体表的投影点,随年龄(身高)的增长而逐渐向上外方移位。小儿(Ⅰ～Ⅳ组)胆总管长度基本上成比例增长,六组增速基本相同。     

小儿筛窦的年龄解剖学观测

作者观测180例小儿（男97，女83）前，中，后三组筛小房的数目，大小，并测量了筛窦整体的前后径，左右径和上下径等，为小儿年龄解剖学提供了资料。     

患有肝脏疾病成人骶静脉丛的解剖及临床意义

目的:为患有肝病的直肠癌的外科治疗提供解剖学基础。方法:在20具患有肝脏疾病的成人尸体上解剖观测骶静脉丛的组成及结构特点。结果:①骶静脉丛吻合丰富,呈网状弯曲如蚓。②管壁薄,管腔大、充盈扩张,缺乏静脉瓣。③骶静脉丛与直肠静脉丛、骶管椎内静脉丛有直接交通。结论:。本研究结果为直肠癌根治术的开展提供解剖学基础与参考数据。     

小儿胰的年龄解剖学研究

分六个年龄组解剖观测了180具（男97，女83）小儿尸胰的位置毗邻，形态及度量，小儿胰多数横过T12－L1或L1－L2椎体的前方，胰的整体3形状多为“弓”形成“一”形，胰的长重量均随年龄（身高）的增长而增加，前者在幼儿组以后增速缓慢，后者在学龄前组以后增速平稳。     

脑血管性痴呆的CT与解剖学研究

目的:探讨脑血管性痴呆的病理和解剖学基础,分析CT对脑血管性痴呆的诊断价值。方法:本文对90例符合脑血管性痴呆的患者进行CT检查,观察脑梗塞的部位和数目。结果:痴呆患者脑内存在单发或多发性梗塞灶,其中病灶位于基底神经节区73例、额叶52例、颞叶46例、丘脑区22例、顶叶5例、脑干区5例,二处以上病灶38例。结论:特殊部位脑内多发性小梗塞为脑血管性痴呆的主要原因,CT对脑血管性痴呆的诊断有重要价值,但为非特异性。     

弓状线位置的应用解剖

目的观察和测量弓状线的形态和位置，为临床提供解剖学资料。方法在77具（152例）成年国人尸体标本上观察和测量弓状线的形态和位置。结果弓状线为弧形者有占64．10％，直线形者占28．90％，逐渐变薄消失者占7．00％。弓状线位于脐以下2～4cm的有34例（24．11％），位于脐以下5～9cm的有64例（45．39％），而位于脐以下4～5cm之间的有43例（30．50％）。脐至耻骨联合上缘和弓状线的距离分别为15．05±1．49cm和4．90±1．31cm。脐至弓状线长度与脐至耻骨联合上缘长度的比值为0．33。结论弓状线的形态有多种，位置以脐至耻骨联合上缘连线的中、上1／3交界处来描述更加合理。     

Long Term Outcomes of Pediatric Liver Transplantation According to Age

Liver transplantation (LT) has been the key therapy for end stage liver diseases. However, LT in infancy is still understudied. From 1992 to 2010, 152 children had undergone LT in Seoul National University Hospital. Operations were performed on 43 patients aged less than 12 months (Group A) and 109 patients aged over 12 months (Group B). The mean age of the recipients was 7 months in Group A and 74 months in Group B. The patients'' survival rates and post-LT complications were analyzed. The mean Pediatric End-stage Liver Disease score was higher in Group A (21.8) than in Group B (13.4) (P = 0.049). Fulminant hepatitis was less common in Group A (4.8%) than in Group B (13.8%) (P = 0.021). The post-transplant lymphoproliferative disorder and portal vein complication were more common in Group A (14.0%, 18.6%) than in Group B (1.8%, 3.7%) (P = 0.005). However, the 1, 5, and 10 yr patient survival rates were 93%, 93%, and 93%, in Group A and 92%, 90%, and 88% in Group B (P = 0.212). The survival outcome of pediatric LT is excellent and similar regardless of age. LTs in infancy are not riskier than those of children.

Graphical Abstract

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婴幼儿肌内注射部位的解剖学观测

目的:为婴幼儿肌内注射最佳部位的选择提供解剖学资料.方法:对20具婴幼儿尸体标本和4套幼儿断层标本的臀区、股外侧区和三角肌区的血管神经走行和毗邻关系进行解剖观察,测量各区皮肤、浅筋膜和肌的厚度.结果:臀区外上部的皮肤和浅筋膜厚(0.86±0.23)cm,肌厚(1.65±0.30)cm;股外侧区中部皮肤、浅筋膜厚(0.64±0.28)cm,肌厚(1.29±0.18)cm;三角肌区中部皮肤、浅筋膜厚(0.65±0.11)cm,肌厚(0.74±0.12)cm.以上各部肌质较厚,无重要血管神经.结论:从安全角度考虑,婴幼儿肌内注射以股外侧区中部作为首选部位为宜,次选臀区.     

The Anatomical Society core regional anatomy syllabus for undergraduate medicine

The Anatomical Society's core syllabus for anatomy (2003 and later refined in 2007) set out a series of learning outcomes that an individual medical student should achieve on graduation. The core syllabus, with 182 learning outcomes grouped in body regions, referenced in the General Medical Council's Teaching Tomorrow's Doctors, was open to criticism on the grounds that the learning outcomes were generated by a relatively small group of anatomists, albeit some of whom were clinically qualified. We have therefore used a modified Delphi technique to seek a wider consensus. A Delphi panel was constructed involving ‘experts’ (n = 39). The revised core syllabus of 156 learning outcomes presented here is applicable to all medical programmes and may be used by curriculum planners, teachers and students alike in addressing the perennial question: ‘What do I need to know ?’     

Withdrawal of Immunosuppression in Pediatric Liver Transplant Recipients in Korea

Purpose

We identified pediatric liver transplant recipients with successful withdrawal of immunosuppression who developed tolerance in Korea.

Materials and Methods

Among 105 pediatric patients who received liver transplantation and were treated with tacrolimus-based immunosuppressive regimens, we selected five (4.8%) patients who had very low tacrolimus trough levels. Four of them were noncompliant with their medication and one was weaned off of immunosuppression due to life threatening posttransplant lymphoproliferative disorder. We reviewed the medical records with regard to the relationship of the donor-recipients, patient characteristics and prognosis, including liver histology, and compared our data with previous reports.

Results

Four patients received the liver transplantation from a parent donor and one patient from a cadaver donor. A trial of withdrawal of the immunosuppressant was started a median of 45 months after transplantation (range, 14 months to 60 months), and the period of follow up after weaning from the immunosuppressant was a median of 32 months (range, 14 months to 82 months). None of the five patients had rejection episodes after withdrawal of the immunosuppression; they maintained normal graft function for longer than 3 years (median, 38 months; range, 4 to 53 months). The histological findings of two grafts 64 and 32 months after weaning-off of the medication showed no evidence of chronic rejection.

Conclusion

The favorable markers for successful withdrawal of immunosuppression were 1) long-term (> 3 years) stable graft function, 2) no rejection for longer than 1 year after withdrawal of immunosuppression, 3) non-immune mediated liver diseases, and 4) pediatric patients.