Instrument to test patency of lacrimal drainage system

The lacrimal drainage system drains fluid that exists normally on the surface of the eye into the nasal cavity. This paper describes a hand-held, personal-computer-based instrument to quantitatively estimate the resistance to fluid flow through the lacrimal drainage system. This resistance measurement is proposed as a possible means to diagnose blockage of the system and to verify the degree of change in resistance after clinical treatment. The instrument system consists of a hand-held syringe attached to pressure and flow transducers. Resistance is calculated as the ratio of differential pressure to flow rate and is displayed in real time on a computer monitor.     

泪前隐窝入路的解剖与手术学意义

本文就泪前隐窝入路相关的应用解剖以及该入路的临床应用进行概述,重点介绍泪前隐窝、齿槽隐窝、鼻泪管、筛前动脉鼻外侧支、中鼻甲动脉、下鼻甲动脉、下鼻道动脉、翼腭窝及其内容物、颞下窝及其内容物以及蝶窦外侧隐窝等的临床应用解剖结构,并对泪前隐窝入路在真菌性上颌窦炎、上颌窦囊肿、眼眶眶底骨折、翼腭窝肿瘤、颞下窝肿瘤以及蝶窦外侧隐窝病变中的应用,以及相应解剖结构对手术的影响加以分析,为耳鼻咽喉头颈外科临床医师开展此类手术提供参考。     

Morphogenesis of the human excretory lacrimal system

The aim of this study was to determine the principal developmental stages in the formation of the excretory lacrimal system in humans and to establish its morphogenetic period. The study was performed using light microscopy on serial sections of 51 human specimens: 33 embryos and 18 fetuses ranging from 8 to 137 mm crown-rump length (CR; 5-16 weeks of development). Three stages were identified in the morphogenesis of the excretory lacrimal system: (1) the formative stage of the lacrimal lamina (Carnegie stages 16-18); (2) the formative stage of the lacrimal cord (Carnegie stages 19-23); and (3) the maturative stage of the excretory lacrimal system, from the 9th week of development onward. A three-dimensional reconstruction of the excretory lacrimal system was performed from serial sections of an embryo at the end of the embryonic period (27 mm CR).     

股骨头颈骨内、外静脉回流的解剖学研究

目的 :为探讨Legg Perthes病的发病机理及临床治疗提供形态学依据。 方法 :采用巨微解剖、血管透明、组织切片、造影、扫描电镜等方法对 45例胎儿、新生儿及儿童的股骨头颈骨内、外静脉回流途径、骨内微血管构筑特点进行观察。结果 :(1 )髋关节骨外静脉包括 :旋股内、外侧静脉 ,闭孔静脉 ,臀上、下静脉 ,颈后静脉 ,髂腰静脉 ,股骨头韧带静脉 ,颈升静脉 ;骨内静脉包括 :前、后、上、下骺静脉 ,内骺静脉 ,前、后、上、下干骺静脉。关节囊内存在丰富的滑膜下静脉网 ,髋关节周围形成两个彼此有吻合的环状结构。(2 )一条微动脉一般有两条微静脉伴行 ,微静脉间有丰富的横行吻合支 ,在微动脉移行为毛细血管的部位 ,常可见到环形缩窄。结论 :(1 )Legg Perthes病与股骨头、颈静脉回流障碍密切相关。 (2 )根据股骨头、颈骨内外静脉回流特点 ,Legg Perthes病可以设计骨内、外双重介入治疗 ,骨内、囊内静脉搭桥的显微外科治疗方案     

Anatomy and histology of the cardiac conal valves of the adult dogfish (Scyliorhinus canicula)

Background: Knowledge of the structural arrangement of the cardiac conal valves in Elasmobranchs is scarce. The present study was designed to assess the anatomical and histological features of the conal valves of the dogfish as a starting point for further investigation of the mechanical properties of these valves. Methods: The sample examined consisted of 31 adult dogfishes. The study was carried out using scanning electron microscopy and histological techniques for light microscopy. Results: In the dogfish, the conus arteriosus contains two transverse rows of valves. The anterior row lies at the level of the conus-ventral aorta junction and is composed of three valves of similar size. The posterior row is near the conus-ventricular junction and consists of four valves, one of them very reduced in size. Each valve shows two components, namely, the leaflet and its supporting structure, the sinus. In the anterior valves, the length of the leaflets between their lateral attachments to the sinus wall is remarkably longer than the straight-line distance between the points of attachment. This allows each leaflet to close against the other two leaflets of the same row, even when the conus is relaxed. The leaflets of the posterior valves are anchored to the conus wall by means of tendinous cords and cannot practically bridge the lumen of the relaxed conus. Each leaflet has a stout central body in which the connective tissue is stratified in three layers: outer fibrosa, spongiosa, and inner fibrosa. The lateral parts of the leaflet mainly consist of a single fibrous layer that bifurcates into the outer and inner fibrosa layers of the central body. The sinus walls of the posterior valves are entirely made up of conal tissue, whereas those of the anterior valves incorporate an aortic component. Conclusions: The present findings suggest that the inner fibrosa and the fibrous lateral portions of the leaflets mainly bear the stress of pressure generated by blood backflow. The stretching of the leaflets in the radial direction may basically depend on the spongiosa, whereas the outer fibrosa determines the radial stiffness of the leaflets. © 1995 Wiley-Liss, Inc.     

临床1～3级肝管剖开术相关的解剖组织学研究

用31具成人正常肝标本人工镂空,赛璐璐灌注正常新鲜尸肝6具,观察和测量了1～3级肝管长度、周径和夹角以及与肝动脉、门静脉相互关系;正常尸肝15具和30例肝内胆管结石并狭窄的肝标本,光镜观察各级肝管壁组织结构和病理改变。讨论了胆管结石存在部位,高位肝管剖开取石和行胆肠吻合术的术式选择及注意事项。     

Anatomy and regulation of the central melanocortin system

The central melanocortin system is perhaps the best-characterized neuronal pathway involved in the regulation of energy homeostasis. This collection of circuits is unique in having the capability of sensing signals from a staggering array of hormones, nutrients and afferent neural inputs. It is likely to be involved in integrating long-term adipostatic signals from leptin and insulin, primarily received by the hypothalamus, with acute signals regulating hunger and satiety, primarily received by the brainstem. The system is also unique from a regulatory point of view in that it is composed of fibers expressing both agonists and antagonists of melanocortin receptors. Given that the central melanocortin system is an active target for development of drugs for the treatment of obesity, diabetes and cachexia, it is important to understand the system in its full complexity, including the likelihood that the system also regulates the cardiovascular and reproductive systems.     

Harderian gland and the lacrimal gland of the lizard Podarcis s. sicula: histology, histochemistry, and ultrastructure

Histology, histochemistry, and ultrastructure of the Harderian gland and lacrimal gland of the lizard Podarcis s. sicula were investigated. The Harderian gland, located at the medial corner of the orbit, can be divided into three zones showing different tinctorial features either with Mallory or hematoxylineosin stains. The glandular cells of the acinar medial zone secrete predominantly acidic sulphated mucosubstances. The acinar cells of the intermediate zone contain secretory granules that show a weak reaction to the histochemical tests for mucosubstances. The lateral zone has a tubulo-acinar type of structure and tests strongly for proteins, whereas Alcian-PAS staining is very weak. The lacrimal gland is smaller than the Harderian gland and lies in the region of the posterior commissure of the eyelids. it shows the same histological and histochemical characteristics of the medial zone of the Harderian gland, i.e., it is mucous secreting. At the ultrastructural level the zonation is well defined, especially when the secretory granules are examined. Granules of the mucoid type are found in the lacrimal gland and the medial zone of the Harderian gland. The secretory granules of the lateral part of the Harderian gland show a composite structure never described before. Therefore, they have been called "special secretory granules." Each of these granules is composed of three sharply separated components. It is not known whether the three components correspond to different secretions. Histochemical tests suggest that they are of the serous type. Both mucous and serous granules are secreted by the same glandular cells of the intermediate zone of the Harderian gland. The two types of granules usually occupy different cell compartments. The mechanism of secretion appears either merocrine or apocrine in both the Harderian gland and the lacrimal gland.     

Extracellular free calcium and fluid secretion by the rabbit lacrimal gland in vivo

A possible role of extracellular free Ca²⁺ in methacholine-induced fluid secretion in the in vivo rabbit lacrimal gland has been investigated. Lowering the extracellular Ca²⁺ concentration by either intra-arterial injection or infusion of EGTA at doses which caused no systemic effects produced a dose related and reversible inhibition of methacholine-induced secretion. The inhibitory effect of EGTA was diminished when EGTA chelated with CaCl₂ in varying concentration ratios was administered. On the other hand, intra-arterial injection of CaCl₂ potentiated fluid secretion stimulated by submaximal doses of methacholine. These results suggest that fluid secretion from the rabbit lacrimal gland is dependent on the extracellular free Ca²⁺ concentration.     

Cerebrospinal fluid drainage through the diploic and spinal epidural veins

The aim of this study was to quantitatively evaluate the function of the cranial diploic and spinal epidural veins as cerebrospinal fluid (CSF) drainage pathways by measuring lipocalin‐type prostaglandin D synthase (PGDS) and cystatin C (CysC) dissolved in the blood of these veins. This was a prospective study involving 51 consecutive patients, 31 males and 20 females, who underwent 41 cranial and 10 spinal surgeries. Intraoperatively, peripheral venous blood and diploic venous blood, or peripheral venous blood and spinal epidural venous blood samples were simultaneously collected and immediately centrifuged. For all samples, dissolved albumin (for reference), PGDS and CysC were measured using an enzyme‐linked immunosorbent assay. The diploic vein/peripheral vein ratios in five cranial locations and epidural vein/peripheral vein ratios were calculated and statistically evaluated for the three biomarkers. For PGDS, the diploic vein/peripheral vein ratio was significantly increased in the frontal (P = 0.011), temporal (P = 0.028), parietal (P = 0.046) and skull base (P = 0.039), while it did not reach statistical significance for CysC. For patients older than 45 years, the diploic vein/peripheral vein ratio for PGDS was significantly decreased in the frontal region (P = 0.028), and the epidural vein/peripheral vein ratio for CysC was significantly decreased (P = 0.014). These results show that the diploic veins constitute CSF drainage pathways with heterogeneous functional intensity at different cranial locations. Compared with the diploic veins, spinal epidural veins seem to drain less CSF. The cranial diploic and spinal epidural veins may jointly function as an alternative, age‐related trans‐dural CSF drainage system.     

Anatomy of the immune system: facts and problems

In the introductory section of this report, the anatomy of the immune system, from organs and tissues to molecules, will be reviewed briefly. Cell proliferation and differentiation in the central lymphoid organs (thymus and bone marrow) yield a repertoire of T- and B-cell clones that seed into peripheral lymphoid organs (spleen, lymph nodes and Mucosa-Associated Lymphoid Tissue, MALT), where humoral and cell-mediated antigen-specific immune responses occur. The stringent process of clonal selection in the central lymphoid organs implies deletion of inappropriate cells via apoptosis. In the peripheral lymphoid organs, the potential of unlimited activation and expansion of lymphocytes in response to antigens is primarily regulated by apoptosis and anergy. These events, on the one hand, are relevant to prevent autoimmunity and lymphoproliferative disorders; on the other hand, clonal deletion and anergy provide a detrimental escape to immune recognition of malignant cells. Two major inhibitory mechanisms of the immune response have emerged recently. One is linked to the existence of bona fide suppressor cells and cytokines; the other relies on the existence of inhibitory molecules expressed by T, B and NK cells, as well as by other leukocytes. In the studies herein reported, emphasis will be given to surface membrane molecules that down-regulate T-cell-mediated immune responses. These molecules control interactions between T cells and antigen presenting cells (APC's) or target (virus-infected or mutated) cells that have to be killed. Two sets of molecules exist that either upregulate (coactivation molecules) or down-regulate (inhibitory molecules) T-cell mediated responses. The latter aspect of the immune regulation, i.e. molecules that limit the expansion of T-cell clones following specific recognition of antigens will be considered in depth. Two inhibitory molecules, CD152 (CTLA-4) and CD85/LIR-1/ILT2 are expressed in all T cells, being largely confined within intracellular compartments of these lymphocytes when they are in a resting state, but ready to be shuttled to and from the plasma membrane when cells are activated following encounter with antigen. Membrane expression of the two inhibitory molecules is transient and is regulated by an internalization process directed to endosomal compartments and to receptor degradation and/or recycling. CTLA-4 and CD85/LIR-1/ILT2 play a pivotal role in T-cell homeostasis that follows any cell-mediated immune response; their localization and functional role will be thoroughly analyzed. In the last part of this study a major question will be faced, i.e. is the containment of the possibly unlimited expansion of the immune system due to a blockade of the cell cycle? Or, else, could be apoptosis the sole mechanism responsible? Experimental data in support of the latter contention will be provided.     

Harderian gland dependency of immunoglobulin A production in the lacrimal fluid of chicken

Involvement of the Harderian gland (HG) in the production of lacrimal immunoglobulin (especially IgA) was investigated. The lacrimal concentration of each immunoglobulin class was not affected by surgical bursectomy but was reduced by cyclophosphamide (CY) and testosterone (TP) treatments. Surgical removal of the Harderian gland caused a remarkable reduction of both the lacrimal concentration of each immunoglobulin class and the specific antibody titre, and and IgA was almost undetectable. The lacrimal concentration of each immunoglobulin class, as well as the specific antibody titre, was not affected by surgical removal of the Lacrimal gland (LG). The route of antigen administration produced no difference in the class of lacrimal immunoglobulin produced. The results indicate that the production of immunoglobulin in chicken tears may be dependent on the HG and that lacrimal immunoglobulin may be synthesized and secreted locally in the HG. Lymphocytes of the HG are of bursa of Fabricius origin and are seeded into the HG prior to hatching and its lymphocytes do not appear to be involved in systemic immunity.     

组织学数字化实验教学体系的构建及应用

正组织学是借助显微镜研究机体正常微细结构及其相关功能的一门学科。组织学实验是学习组织学的一个重要环节,然而实验教学与理论课不同,受实验设备和实验教学条件的影响。数字化实验教学是提高组织学教学效率的有效途径,随着数字技术的进步,组织学实验教学方法的选择日趋丰富~([1])。1组织学数字化实验教学体系构建的重要性组织学的实验教学具有2个重要作用:(1)以获取知识为目标,通过在实验课上对组织结构的形态观察,达到对理论的概念、结构描述及相关功能等知识的验证,巩固所学内容;(2)以     

Anatomy and histology of the foramen of ovarian bursa opening to the peritoneal cavity and its changes in autoimmune disease-prone mice

The ovarian bursa is a small peritoneal cavity enclosed by the mesovarium and mesosalpinx, which surrounds the ovaries and oviductal infundibulum in mammals. The ovarian bursa is considered as the structure facilitating the transport of ovulated oocytes into the oviduct. Our previous study revealed reduced oocyte pick-up function in the oviduct of lupus-prone MRL/MpJ-Fas^lpr/lpr mouse, suggesting the possibility of an escape of ovulated oocytes into the peritoneal cavity, despite the presence of an almost complete ovarian bursa in the mouse. In this study, we revealed anatomical and histological characteristics of the ovarian bursa in C57BL/6 N, MRL/MpJ, and MRL/MpJ-Fas^lpr/lpr mice. All strains had the foramen of ovarian bursa (FOB), with a size of approximately 0.04 to 0.12 cm², surrounded by the ligament of ovarian bursa (LOB), which is part of the mesosalpinx. The LOB was partially lined with the cuboidal mesothelial cells and consisted of a thick smooth muscle layer in all strains. In 6-month-old MRL/MpJ-Fas^lpr/lpr mice, in which the systemic autoimmune abnormality deteriorated and oocyte pick-up function was impaired, the size of the FOB tended to be larger than that of other strains. Additionally, in MRL/MpJ-Fas^lpr/lpr mice at 6 months of age, there was infiltration by numerous immune cells in the mesosalpinx suspending the isthmus; however, the LOB prevented severe inflammation and showed deposition of collagen fibers. These results not only indicate that the FOB is a common structure within mice, but also imply the physiological function of the LOB and its role in maintaining the microenvironment around the ovary, as well as regulating healthy reproduction.     

Anatomy of the renin-angiotensin system in the normal and pathological kidney

In this review we describe the contributions made by immunocytochemistry to our knowledge of the renin-angiotensin system in the normal and the pathological kidney. Most of the renin-secreting cells appear to be on the outer aspect of the vessel wall, supporting the view that renin is secreted mainly into the interstitium of the kidney rather than into the lumen of the vessel. Angiotensin II immunoreactivity is present within renin-secreting cells. The angiotensin II appears to be present in high concentration in the renin storage granules and is therefore presumably secreted from the cell with renin. The pathways by which renin is secreted from the cell have also been clarified. In pathological kidneys, the reactions of renin-secreting cells to variation in functional demand have been confirmed. Renin-containing cells have also been found in most types of renal tumours and occasional cases probably secrete renin or prorenin into the blood. In renal tumours and in the developing kidney (in all species studied) the renin-containing cells are also intimately associated with blood vessels.     

Effect of hormone replacement therapy on lacrimal fluid peroxidase activity in woman

OBJECTIVE: Lacrimal fluid peroxidase (POD) is an antioxidant and antimicrobial enzyme involved in the protection of the ocular surface. Our recent findings showed the existence of significant cyclic variations in POD activity that were positively correlated with those of 17beta-estradiol plasma levels throughout the menstrual cycle of fertile women. During the menopause, women lacrimal fluid POD activity significantly (P<0.05) decreased according to the natural oestrogen reduction. Since a possible influence of oestrogen on human POD activity was suggested, aim of the present investigation is to evaluate whether hormone replacement therapy (HRT) might influence this enzyme activity. METHODS: Lacrimal fluid POD activities of 10 healthy postmenopausal women (mean age: 52.0) and eight healthy postmenopausal women (mean age: 53.0) treated by oral or transdermal routes containing oestrogen or oestrogen plus progestin were determined. Enzyme activity of each tear sample (5 microl) was spectrophotometrically determined by the 5,5'-dithiobis, 2-nitrobenzoic acid thiocyanate (NBS-SCN) assay; total protein content of tears was determined too. 17beta-Estradiol plasma levels were assayed by ELISA test. RESULTS: HRT significantly (P<0.05) increased tear POD low postmenopausal levels. The significant (P<0.05) rise of 17beta-estradiol plasma levels of treated women was not strictly correlated to the enzyme activity increase in tears. CONCLUSIONS: The suggested estrogen regulation of lacrimal fluid POD activity could be one possible cause for the female gender predilection in some ocular diseases. HRT is able to increase tear POD activity levels of postmenopausal women, probably contributing to the effective relieve of ocular surface complications occurring during menopause.     

Anatomy and physiology of the vestibular system: review of the literature

The vestibular system is a complex system involving not only posterior labyrinth but also central structures such as cerebellum, striatum, thalamus, frontal and prefrontal cortex to assure balance, movements and walking. Information reaching the vestibular complex are not purely vestibular but also from visual, somatosensory and cerebellar origins. The equilibrium is also a complex physiological function needing concordance of vestibular, visual and somatosensory information or either central compensation after an injury but also an integrity of the central nervous system.