小肠代食管的应用解剖研究

根据小肠代食管手术设计的要求,解剖并测量了50例成年尸体的小肠血管、胸廓内血管和甲状腺上动脉。1.小肠动脉小肠动脉的枝数平均为5.4枝。小肠动脉的管径为1.5—10.0mm,3mm以上的占半数以上。第1—6小肠动脉的平均长度为25.3—45.4mm,30mm以上的占半数以上。其中以第3小肠动脉最长(45.4mm),管径也较大(4.0mm),是较为理想的吻接动脉,第1小肠动脉起点高,长度较短,有10%没有形成动脉弓,一般不宜作为吻接选用的动脉。小肠动脉平均有22%的短干出现,短干一般分为2—3枝。在这些分枝中,都有1—2枝较长且粗,手术中可当作一个小肠动脉加以利用。小肠动脉弓的级数甲均为2.7级。第1.2级动脉弓管径都较粗大,第3级弓以下的管径在0.9mm以下的较多。故手术中展直小肠时,以保留第2级弓为宜。2.小肠的长度空回肠的总长度为530.6cm(328—765)。小肠动脉所分布的肠管长度,由第1小肠动脉至第8小肠动脉是逐渐增加的(36.9—252.5cm)。在空肠上段,保留有代偿能力的、管径在1.0mm以上的动脉弓,剪断系膜展直肠攀,每展直1cm,所对应的肠管长度为2.6cm。3.小肠静脉小肠静脉平均枝数为2.9枝(1—5),比动脉少。一个小肠静脉往往与两个以上的动脉相对应,它的第1级属枝基本上与动脉伴行。甲状腺上动脉在动脉分枝前测量了管径,左侧为3.1mm,右侧为2.8mm。甲状腺上动脉是受区较为理想的一个吻接动脉。5.胸廓内血管胸廓内动脉在第二、三肋间的管径平均为2.6—2.8mm。静脉的管径平均为2.4—3.1mm。胸廓内动脉的管径与小肠动脉的很接近,但静脉管径显得细小。因此,胸廓内动脉是小肠代食管手术中的理想备用的吻接动脉,但受区的静脉则以选用颈外静脉或颈前静脉为宜。     

自体静脉移植血管的应力应变关系及其相关组织形态学研究

本文研究了自体移植静脉的应力应变关系 ,将狗股静脉移植于股动脉 ,术后 6个月切取移植静脉进行轴向及环向的单轴拉伸实验及组织形态学观测 ,并和正常股静脉、股动脉的应力 应变关系及组织形态学进行了比较。结果表明 ,轴向移植静脉及正常静脉、动脉的应力 应变关系可表示为 :T =C1 (eα1(λ-1 ) - 1) (T <10kPa)和T =C2 eα2 (λ-1 ) - β(T≥ 10kPa) ,环向应力 应变关系可表示为 :T =C3(eα3(λ-1 ) - 1)。移植术后的静脉与正常静脉、动脉相比 ,轴向和环向静脉的应力 应变曲线均向左移 ,移植术后血管管壁组织结构的刚度比正常静脉、动脉的大 ;比如 ,移植静脉和正常静脉、动脉轴向的α2 (mean±SD)的值分别为 :34 .0 6± 7.30、19.2 1± 2 .35和 11.68± 0 .2 636,环向的α3(mean±SD)的值分别为 :55.76± 2 0 .16、2 7.56± 2 .82和 2 3 .0 8± 1.2 74 1,这显示了移植血管管壁组织在术后硬化的特性。组织形态学的研究表明 ,移植术后血管的管壁材料组份及结构发生了变化 ,管壁弹性纤维含量与正常静脉相比无显著差异 ,但远低于正常动脉 ;例如 ,弹性纤维在正常动脉、静脉及移植血管中的含量分别为 (mean±SD) :4 8.9± 4 .3、19.6± 0 .6和 19.9± 2 .7,说明移植血管并未出现动脉化趋势。此外 ,移植术     

人大脑内血管铸型的显微解剖观察

应用6212-Ⅲ型手术显微镜,观察了灌注ABS的10个儿童脑半球的脑内血管,并用TSM-Ⅰ型扫描电镜进行了观察。 1.软膜动脉网为不规则的吻合网,网眼内有许多未梢支并未吻合,而直角弯曲穿入脑实质。穿入点多沿脑回纵行排成非直线的两行,且多偏于一侧。2.软膜静脉网多在动脉网深面,汇成较大的支以后才越至动脉网的浅面。3.皮质动脉平均直径44.30±6.28μm,可由各级分支直接发出,垂直穿入,丛密如刷毛样。4.皮质静脉属支汇集成倒置的宝塔松样。5.髓质动脉长短粗细不一,平均直径158.20±75.71μm,在脑回顶穿入的是直的,在脑沟穿入的,穿过皮质后有不同程度的弯曲。穿经皮质无分支,中段直角分支呈“T”形分岔,深段又锐角分支如树根样,与中央动脉形成广泛的吻合。还发现不少波浪形扭曲的髓质动脉。本文还把这些动脉的铸型标本经扫描电镜观察。对髓质静脉和中央动脉等也进行了显微解剖和描述。     

胎儿和新生儿肾上腺的血管构筑

本文采用血管复型扫描电镜,注射墨汁切片光镜下观察和注射铅丹乳胶X线照像3种方法,研究了28例胎儿和新生儿肾上腺的血管构筑。发自膈下动脉、腹主动脉和肾动脉的肾上腺上、中、下动脉及其分支,在肾上腺囊表面和穿过囊的过程中逐级分支,最后形成毛细血管。动脉和毛细血管共同构成囊血管丛,从该丛发出的皮质动脉和髓质动脉,分别分支供给皮质和髓质。从囊血管丛发出的“V”型动脉在皮质中行一段距离后又返回囊中分支。永久性皮质毛细血管网是囊毛细血管的直接延续。在胎儿性皮质中,毛细血管有两个来源,其一是永久性皮质毛细血管的延伸;另一来源是由皮质动脉分支构成。它们共同构成胎儿性皮质毛细血管网。在胎儿性皮质的中部,毛细血管汇成小静脉。中央区的髓质由髓质动脉供血。在皮质中,正在迁移的髓质细胞团由与之伴行的动脉供应。在皮质中形成的小静脉呈向心性行走。其中一部分在近中央区又分为毛细血管,这些毛细血管相互吻合,最后入中央静脉的属支中。这种分布特点属于门脉形式的血管;另一部分属于中央静脉的第一级属支,它们逐级汇合后形成中央静脉主干。中央静脉系呈树枝状,其主干在腺的前面穿出腺后为肾上腺静脉。左侧肾上腺静脉人左肾静脉;右侧的人下腔静脉。而与动脉伴行的肾上腺上、中、下静脉的末级属支与囊毛细血管相连。本研究讨论了胎儿和新生儿肾上腺血管的分布规律,为胎儿内分泌学和肾上腺移植等方面提供了血管形态学基础。     

中国人肺的支气管和血管 四、左肺上叶的支气管和血管

用解剖法观察了50例中国成人左肺上叶的外形、肺段支气管和血管。左肺上叶支气管的分枝型式以二分枝型为主,占96±2.77%。多数上干支气管分为尖后段支气管(B~(1+3))和前段支气管(B~2)两枝(68+6.60%)。讨论了尖后段支气管分枝的命名问题。尖后段支气管分枝型式以B~(1+3)a,B~(1+3)b的型式较多,占68+6.60%。前段支气管分裂的颇多,占48±7.07%,分裂的原因主要是由于B~2a移位所致。舌干及其两个肺段支气管的变异比上干少。左肺上叶的动脉有2—6枝,其中以三枝及四枝的例数较多,共占82±5.43%。左肺动脉的第一个分枝多分布于前段或前段和尖后段,共占76+6.04%。前段动脉来自前部的占60±6.93%,有前、后部两个来源的占40±6.93%。舌段动脉多来自后部,占80±5.66%,来自前部的占10±4.24%,兼有前、后两源的占10±4.24%。在左肺上叶各肺段厢,多有跨段动脉存在,占94±3.36%。分布至舌段的动脉的起点平面,常低于左下叶尖段动脉(A~6)发出点,或与A~6相平,两者共占80±5.66%。左肺上叶的静脉通常汇集为三个干(60±6.93%)。尖后段静脉的后枝(V~(1+3)a)行经B~2后方的较多,占48±7.07%。左肺上叶支气管的变异性较小,静脉次之,动脉较多。三者在分枝数目、分枝型式和分布的关系上,以舌段较为稳定,前段次之,尖后段变化最多。     

15 人脑海马内部微血管三维构筑的研究

<正>本文采用5例有机玻璃单体铸型标本,暗视野全景观察和日立S—450扫描电镜观察,较完整地显示人脑海马内部血管从动脉—微动脉—毛细血管前括约肌—毛细血管—微静脉—小静脉连续性立体构筑。海马内微动脉与微静脉有着特殊的分布形式,本文观察到一支动脉分细支或数条动脉的分支组成血管网,数支微动脉伴随一条微静脉为-血管单位,毛细血管互相交织成不规则的血管网.皮质动脉分支走向及毛细血管袢长轴与神经纤维走向平行。皮质长、短动脉各序支管随年龄增长而变粗;皮质动脉在深部发支返回浅层。本文观察到微血管间存在多种吻合:1.微动脉间吻合;2.毛细血管前动脉间吻合;3.微动脉与微静脉间吻合;4.微静脉间有搭桥式吻合。微血管形态特征;小动脉壁有卵圆形的内皮细胞核压迹,排列整齐,清晰可见。小静脉壁有圆形的内皮细胞核压迹。较大数量的毛细血管前括约肌和微动脉末端肌纤维包绕管壁形成纹理的微动脉括约肌,微动脉管径突然变细呈锥状与毛细血管相连接。毛细血管汇入静脉,静脉属支呈“树根状”。     

骨胳肌微血管立体构筑的扫描电镜观察

本文报道应用微血管腐蚀铸型扫描电镜技术,观察了2例3岁男童的翼内肌和咬肌的微血管系统。在扫描电镜下观察,可见微动脉的分支分为三种类型;1.树叉样边分支;2.对称性分支;3.细丛状分支。本文描述了动脉和静脉铸型表面上的内皮细胞核压痕的差别;前毛细血管括约肌压痕的形态特征;拱形动脉的Ⅱ级吻合形式及其生理学意义。毛细血管铸型的直径为5.6±1.9μm。2～3条静脉湍毛细血管汇合成毛细血管后微静脉。可见1条独立的毛细血管直接注入微静脉干。上述形态学因素在骨胳肌的微循环方面,有着重要的生理学意义。     

甲状腺血流图的研究

一、甲状腺解剖与生理特点: 甲状腺为人体最大的内分泌腺,成人甲状腺重约15—20克,腺体呈蝶形,分左右二侧叶和峡部,位于喉及气管下方。甲状腺血液供应非常丰富,供血管有: 1.颈外动脉分枝成为左右甲状腺上动脉。 2.锁骨下动脉的分枝成为甲状腺下动脉。 3.主动脉的分枝成为甲状腺最下动脉(Thyridea ima)上述动脉最后分出微血管包围滤泡。 静脉血经颈内静脉引流至心脏。甲状腺的血流最为丰富,一般5—7ml/min/100g。     

实验性糖尿病对大鼠胸腺皮质上皮细胞的影响

目的　探讨糖尿病对大鼠胸腺皮质上皮细胞影响的形态学变化 ,了解其引起胸腺细胞凋亡及胸腺萎缩的可能机制。　方法　采用四氧嘧啶型糖尿病动物模型 ,电镜下观察了糖尿病大鼠胸腺皮质上皮细胞的超微结构变化。　结果　 2型上皮细胞发生 4种变化 :1 内分泌功能紊乱样变 ,以大量变性的空泡与囊泡为特征 ;2 退化样变 ,以大量的变性分泌泡、髓样小体和粗大张力细丝束为特征 ;3 吞噬细胞样变 ,以大量的溶酶体样致密颗粒及吞噬的凋亡细胞与小体为特征 ;4 细胞凋亡样变 ,以细胞凋亡的早期形态学变化为特征。 3型上皮细胞发生两种变化 :1 退化样变 ,伴有大量分泌肽类激素样的致密颗粒群。 2 增生样变 ,在其胞体周伴有大量的胶原原纤维。此外 ,在胸腺皮质中还发现大量的胸腺细胞凋亡及胸腺细胞数量减少。　结论　糖尿病可导致大鼠胸腺皮质上皮细胞发生多样性的超微结构变化 ,可能是影响胸腺细胞发育 ,并导致其凋亡及胸腺萎缩的主要机制之一。     

单干型动脉化静脉皮瓣血管干管壁的电镜观察

在成年日本大耳白兔耳背面制作3.0cmX3.5cm单干型动脉化静脉皮瓣,用透射电镜分期观察血管干的内膜与中膜.发现:(1)早期内皮细胞肿胀、吞饮小泡增多,细胞间连接开大;中膜平滑肌伸入内膜.(2)中期的中膜平滑肌细胞器发达,胶原纤维增生.(3)第70天内膜下出现呈波纹状,内含均匀基质的结构,与动脉内弹性膜相近,平滑肌整齐多层排列.证实了单干型动脉化静脉皮瓣血管干管壁于术后第70天已具动脉雏形.     

Cerebral and pial microvessels: differential expression of γ-glutamyl transpeptidase and alkaline phosphatase

 Pial microvessels have several important blood-brain barrier (BBB) characteristics in common with cerebral microvessels, despite lacking their astrocytic ensheathment. We have therefore determined whether they have the same distribution of two enzymes, γ-glutamyl transpeptidase (GGTP) and alkaline phosphatase, both of which are known to be astrocyte-dependent. GGTP was absent from all rat pial microvessels but strongly present in brain cortical capillaries. Alkaline phosphatase was heterogeneously expressed in pial microvessels, including capillaries, but strongly positive in brain cortical capillaries. Diffusible, inductive factors produced by astrocytes could account for these differences in enzyme distribution between the two vessel types. Furthermore, differences in expression between the two markers may reflect their differing sensitivities to the astrocytic factors. Caution is urged in the common usage of the pial microvessel as a model system in BBB studies. Accepted: 8 June 1998     

Effect of elastase on the histochemical demonstration of alkaline phosphatase activity in chick pecten

The effect of elastase on alkaline phosphatase activity in the chick pecten capillaries was studied electron histochemically. The pecten was treated with elastase before incubation in the medium for alkaline phosphatase. Inactive alkaline phosphatase in the chick pecten capillary under dark adaptation could be demonstrated electron histochemically after treatment with elastase. Under light adaptation, the elastase-treated pecten demonstrated more intense alkaline phosphatase activity in the same localization as in the untreated pecten. Biochemical data also supported histochemically demonstrated enhancement effect of elastase on alkaline phosphatase activity in the chick pecten oculi. Elastase is expected to be useful for demonstrating enzymatic activity which is otherwise hard to detect.     

Venulo-arteriolar communication and propagated response

The effect of microinjection of norepinephrine (10^–5 M) into precapillary microvessels of the rat mesentery was studied using intravital microscopy. Upon application, in 29 out of 40 cases (73%) flow ceased at the site of drug application, although in most cases the precapillary microvessels themselves did not show a diameter change due to a lack of smooth muscle cells as confirmed by transmission electron microscopy. In 17 out of the 29 cases with flow cessation (59%), an intimate contact between the venule draining the site of application and the supplying arteriole was found. Initial constriction was seen at the site where the venule crossed the arteriole. Constriction propagated both up- and downstream along the arteriole, and also across arteriolo-arteriolar arcades. Arteriolar constriction could be abolished by intentionally occluding the venule draining the norepinephrine solution. It is proposed that venuloarteriolar contacts and propagated vasomotor response may contribute to local blood flow regulation by providing a feedback loop between tissue capillaries and resistance arterioles. In three complete mesenteric microvessel networks, the arterioles (n=34) supplying 273 out of 401 capillaries (68%) were in close proximity to venules draining these same capillaries. Each of these arterioles served, on average, 43 capillaries, showing a bimodal distribution with peaks at 4 to 16 and at 64 to 256 capillaries. On average, 62% of all capillaries drained by a given venule crossing an arteriole originated from this very arteriole, indicating a reasonably effective feedback.     

Methods for histochemical demonstration of vascular structures at the muscle-bone interface from cryostate sections of demineralized tissue

In tissue decalcified with MgNa2EDTA at a neutral pH activity for ATPase can used be for demonstration of the vascular structures at the muscle-bone interface. The GOMORI method for alkaline phosphatase is only of value, when fresh unfixed tissue is to be examined. The azo-dye method for alkaline phosphatase failed to give satisfactory results, and so did the alpha-amylase PAS method. 5'-nucleotidase activity is present in both capillaries and in cells lining the surfaces of bones, while larger blood vessels are poorly stained.     

The distribution of alkaline and acid phosphatase in the liver of white rats during irradiation with the radioactive isotope of iron Fe59

Summary The distribution of the acid and alkaline phosphatase was studied in the liver of white rats irradiated internally with radioactive iron Fe⁵⁹. For 6 days 25–45 C per day of Fe⁵⁹ was given with food (to experimental animals). The phosphatases were examined by the Gomori's method.In control rats alkaline phosphatase was revealed in the nuclei of hepatic cells. High concentrations of the enzyme were noted in the leucocytes and the walls of the blood capillaries. The acid phosphatase was found in the nuclei of hepatic cells, endothelium of blood capillaries and in the epithelium of the bile interiobular ducts.Following a 6-day irradiation with Fe⁵⁹ an increase of the alkaline phosphatase activity along with the rise in the number of hepatic tissue elements containing it was observed. Acid phosphatase localization and its activity remain without any visible changes.Presented by Active Member Acad. Med. Sci. USSR, V. N. Chernigovskii     

Blood vascular beds of rat adrenal and accessory adrenal glands, with special reference to the corticomedullary portal system: a further scanning electron microscopic study of corrosion casts and tissue specimens

Blood vascular casts of the rat adrenal glands were observed with a scanning electron microscope. The cortical capillary plexus drains, through the corticomedullary venous radicles, into the subcortical veins continuous with the medullary collecting veins. The medullary capillary plexus drains into the corticomedullary venous radicles, subcortical veins and medullary collecting veins. No portal vessel was noted between the cortical and medullary capillaries. These findings indicate that the cortical blood rich in glucocorticoids preferentially and continuously flows into the corticomedullary venous radicles, subcortical veins and medullary collecting veins all three of which are fenestrated in type, and also suggest that the vascular route from the cortical capillaries to the medullary collecting veins functions as a substitute for the portal system, controlling the biosynthesis of catecholamines in the adrenal medulla. The vascular bed of the accessory adrenal gland (extra-adrenal cortical or chromaffin body) is sometimes annexed to that of the adrenal gland. On rare occasions, the vascular beds of the extra-adrenal cortical and chromaffin bodies fuse with each other. Additional scanning of tissue samples confirmed the direct drainage of cortical capillaries into the medullary veins and also the endothelial fenestrations of these capillaries and veins.     

An ultrastructural study of vascular proliferation and vascular alkaline phosphatase activity in the developing cerebral cortex of the rat

Alkaline phosphatase cytochemistry was employed to study the distribution of this enzyme in blood vessels during vascular differentiation and maturation during the postnatal development of the rat cerebral cortex. Enzyme reaction product was present in early vascular sprouts, and also throughout the subsequent maturation and differentiation of capillaries and arterial vessels. Cerebral capillaries appeared to be patent soon after the fusion of a sprout tip with another vessel; no evidence for delayed or synchronous opening was obtained. The distribution of alkaline phosphatase reaction product in vessel walls changed during vascular maturation. In vascular sprouts, reaction product was found mainly in the narrow lumen. As vessels became patent, reaction product appeared also on abluminal surfaces, at first chiefly in the narrow spaces between overlapping vascular cells. As vessels matured, reaction product became more generally distributed around the abluminal surface. In relatively mature capillaries and arterial vessels, it was restricted largely to endothelial cell surfaces and the spaces between smooth muscle cells. The significance of this distribution is unknown. Some possible explanations, including the possibility of artifact, are discussed. No alkaline phosphatase reaction product was found in differentiated veins.     

Patterns of vascular sprouting in the postnatal development of the cerebral cortex of the rat

Light microscopic histochemistry for alkaline phosphatase was employed in a study of the development of vascular sprouting, with respect to time and distribution, in the rat cerebral cortex. Sprouts were counted in the full thickness of the cerebral cortex at each day from birth to 21 days of age. Several distinct bursts of sprouting activity were observed at specific times and levels of cortex. From birth to 4 days of age, sprouting was intense in the superficial third of the cortex. At 7 to 8 days, a burst of sprouting was found which was greatest in the middle third. Additional bursts of sprouting appeared at 10 and 14 days. Developing vessels with characteristics of arteries, capillaries, or sprouts were alkaline-phosphatase positive, while veins were not. It is concluded that alkaline phosphatase is a useful marker for identification of both mature and immature vasculature, as it reveals patent and nonpatent vessels, and the sprouts which are precursors of the mature vascular bed. New vessels developing in the cortex arise mainly from blind sprouts of capillaries, evidently in response to the metabolic demands imposed by the maturational process. At birth, the majority of intracortical vessels are capillaries. By 10 days of age, most perforating vessels from the surface have taken on arterial or venous characteristics. The findings are discussed in connection with morphological and biochemical differentiation and the pattern of vascularization in the mature cerebral cortex.     

Enzyme histochemical studies on tumor blood vessels

The oxygenation, the growth rate and the metastatic potential of a solid tumor depend on its vascularization and, in particular, on angiogenesis; a therapeutic approach affecting angiogenesis has been suggested as an alternative to conventional ones. Especially the study of the metabolism in the cells of the vessel wall should be a useful prerequisite for this approach. In this connection, an enzyme histochemical study was performed to characterize the blood vessels in a solid tumor (Ehrlich carcinoma). The following enzymes were considered: (a) alkaline phosphatase, involved in the transcellular phosphate transport and in the response to inflammatory and growth promoting factors; (b) dihydrofolate reductase, involved in the metabolism of tetrahydrofolate (for the synthesis of nucleic acids and the metabolism of serine and glycine); (c) purine nucleoside phosphorylase, involved in the degradation of purines and, in particular, of extracellular ATP and ADP; (d) xanthine oxidoreductase, engaged in the same degradation path and leading to the formation of urate, a strong antioxidant. Various patterns of enzyme activities were observed in the vessel wall. In particular, thin linear capillaries (presumed to be host capillaries penetrating the tumor) were identified for the intense positivity of alkaline phosphatase, dihydrofolate reductase and purine nucleoside phosphorilase; tortuous capillaries with variable diameters (presumed to be induced by angiogenesis from the host vessels) were negative for the alkaline phosphatase and expressed an heterogeneous pattern for the dihydrofolate reductase. All the data suggest a different vessel behaviour concerning the response to cytokines and to inflammatory stimuli.     

Hypophosphatasia: a cytochemical study of phosphatase activities.

Skeletal abnormalities with defective formation of mature calcified bone are the most prominent clinical features of hypophosphatasia. Low concentrations of serum and tissue alkaline phosphatase and elevated plasma and urinary levels of phosphorylethanolamine (PEA) are also present. Although PEA is hydrolyzed by serum alkaline phosphatase, the relationship between PEA and the deficiency is unclear. PEA has not previously been tested as a cytochemical substrate for the in situ demonstration of human alkaline phosphatase activity. We have studied alkaline phosphatase activity in hypophosphatasia in tissue sections, utilizing PEA and adenosinetriphosphate (ATP) as well as the usual beta-glycerophosphate and naphthol phosphate substrates. Neutral and acid phosphatase activities were also examined. Our results demonstrate that PEA is a substrate for the localization of alkaline phosphatase in normal human tissue, but is not hydrolyzed in hypophosphatasia in the liver, brain or costochondral junction under alkaline conditions. In the kidney in hypophosphatasia only the straight segments of proximal tubules that rim the medullary rays are reactive with PEA. Similar results in hypophosphatasia were obtained at an alkaline pH with ATP, beta-glycerophosphate, and naphthol phosphate. However, the defect in hypophosphatasia is not a generalized deficiency of membrane-associated phosphatases because membranes that were deficient in alkaline phosphatase activity demonstrated normal reactivity with ATP at neutral pH. In addition, thiamine pyrophosphate was also split by Golgi membranes within the cytoplasm. Acid hydrolysis of beta-glycerophosphate by lysosomes was normal.