胆囊床内血管的应用解剖

本文选用 12 8例经福尔马林固定的成人原位或离体带有保存完整胆囊的肝脏标本进行解剖 ,观测了胆囊床内血管的直径、位置、行程、分支及分布范围。结果如下 :(1)胆囊动脉深支 ,10 2例 (占 79.7% )标本胆囊动脉深支分为胆囊支和肝支 ,胆囊支分布于胆囊 ,肝支有 2～ 3支 ,直径 0 .35～ 1.3mm,进入肝 ,与肝内血管存在吻合。 (2 )肝中静脉及其属支 ,16例 (占 12 .5 % )标本肝中静脉及其属支在胆囊窝内部分或全部突出于肝组织表面 ,参与组成胆囊床 ,其中肝中静脉主干 3例 ,占 2 .3% ,直径 5 .8～ 6 .8mm,长度 11.3～ 14.2 mm;右前叶支、或左内叶…     

胆囊床内血管的应用解剖

目的：为腹腔镜胆囊切除手术提供形态学基础.方法：对128例肝脏标本进行解剖,观察胆囊床内血管的位置、行程,测量其在胆囊床内的长度和直径.结果：胆囊床内血管有：（1）胆囊动脉深支及分支,占71.1%（91例）;（2）肝中静脉及其属支,占12.5%（16例）,其突入形式分①肝中静脉主干,②右前叶支、或左内叶支、或两者一起突出,③右前叶支属支、左内叶支属支、或两者一起突出3种类型;（3）肝门静脉右支及其分支,分主干和分支两类,主干占39.8%（51例）,肝门静脉右支的分支占14.8%（19例）;（4）肝门静脉左支的分支,占2.34%（3例）;（5）胆囊静脉,在胆囊附着面有小静脉与肝中静脉、肝门静脉左、右支的分支相连.结论：切除胆囊时应注意胆囊床左、右缘,以及具有肝门右切迹的病例,保护突入胆囊床内的肝中静脉及其属支,以防止出血.     

胆囊床内肝中静脉的应用解剖

目的：为临床胆囊切除术提供形态学资料。方法：对１２８例肝脏标本的胆囊床进行解剖,观察突入胆囊床内肝中静脉及其属支的和 入段的直径和长度。结果：肝中静脉及其属支突胆囊床的占１２．５％（１６例）,突人形式主要有：（１）肝中静脉主干;（２）右前叶支、或左内叶支、或两者一起突出;（３）右前叶支属支、左内叶支支、或两者一起突出３种类型。结论：胆囊切除时,应注意保护肝中静脉及属支,以防止出血。     

肝中静脉及其属支的应用解剖

目的通过对肝中静脉(middle hepatic vein,MHV)及主要属支的观测,为胆道外科手术中MHV损伤和出血以及肝切除和肝移植手术中MHV属支的保留与重建提供解剖学基础。方法在51例成人无病变标本肝膈面沿肝中裂切开肝实质显露MHV及肝段(Ⅴ和Ⅷ)的分离解剖以显露MHV分支,观测MHV的起源、汇入下腔静脉(IVC)形式以及突入胆囊床属支的解剖形态等。结果 MHV起源类型分3型,即胆囊窝、肝脏Ⅴ段和肝脏Ⅵ段,以胆囊窝起源为主;MHV主要属支分布具有多样性,肝脏Ⅴ、Ⅷ段都可能存在一支到多支;MHV汇入下腔静脉(IVC)的形式,以肝左、肝中静脉合口居多,占70.6%;MHV突入胆囊床属支长度(17.95±5.35)mm,直径(4.35±0.65)mm,C点多位于胆囊纵轴的右侧(45.1%)。结论肝中静脉及其属支清晰的解剖学认识对于胆道外科手术、肝切除以及肝移植手术有着重要意义。     

肝铸型标本肝静脉吻合的观测及临床意义

目的：观察肝静脉之间的吻合情况；方法：观察88个铸型标本中肝静脉侧支吻合的出现率，并对一例有丰富吻合支的肝脏用游标卡尺测量吻合中点处的直径；结果：88个肝铸型标本中有侧支吻合22例，显示率25％；1例丰富吻合标本，其中有17处吻合，最大直径为2．28mm，最小直径为0．62mm。副肝静脉与肝静脉吻合3处；结论：在肝静脉结扎或病理变化后，侧支循环开放、增多，受累肝段与未受累肝段间发生浅表和深部肝静脉侧支吻合，使得肝内血管解剖变得异常复杂而完全不同于正常解剖结构，为肝外科手术中处理肝静脉提供了解剖学依据。     

腹腔镜胆囊切除术的应用解剖

在３０例成人肝外胆道标本上解剖观察了胆囊管与邻近的结构，胆囊淋巴结，胆囊动脉的动源，行程以及与肝脏的关系，提出了腹腔镜胆囊切除术中胆囊淋巴结可作为了寻找胆囊管的标志，结扎胆囊管的位置宜选择在离胆囊颈左侧６ｍｍ以外处，而结扎担囊动脉的部位应在胆囊体浆膜下，距胆囊颈６．３ｍｍ范围内，在处理胆囊窝时应注意有胆囊动脉的肝支和胆囊下肝管的存在。     

与LC术有关的胆囊动脉解剖

目的：为临床ＬＣ术提供形态学资料。方法：随机选用３０例肝脏标本,经胆囊动脉及门静脉右支注入乳胶后,在６倍大视场显微镜下观察胆囊动脉的起源、行程、及其与肝脏的关系。结果：据胆囊动脉深、浅支行径的不同,将其分为５种类型。其深支可发出肝支和胆囊支,分别供应肝脏和胆囊;并特别对肝支进入胆囊窝的部位进行了观察和统计。胆囊静脉从胆囊窝底注入门静脉右支,而部分门静脉右支位置表浅,参与组成了胆囊床。结论：处理胆囊窝时,尤应重视胆囊动脉肝支和位置表浅的门静脉右支的存在,以防止出血。     

肝左内叶及右前叶肝段超声解剖

目的:为发生于肝左内叶和右前叶的肝占位性疾病治疗提供超声解剖资料。方法:随机选取健康成人61例(男42,女19),利用彩色多普勒超声诊断仪经腹途径获取各断面超声声像图,并观察测量。结果:Ⅳa亚段内门静脉分支仅见1种类型;Ⅳb亚段内门静脉分支见2种类型,分别占62.30%、37.70%;右前叶门静脉分支见3种类型:a型占75.41%,b型占16.39%,c型占8.20%;左内叶两亚段间有48例可见肝静脉属支走行,占78.69%,其中肝中静脉属支占95.83%,肝左静脉属支占4.17%;右前叶两亚段间有54例可见肝静脉属支走行,占88.52%,其中肝中静脉属支占92.59%,肝右静脉属支占7.41%。结论:在超声水平,进一步证明右前叶两亚段间及左内叶两亚段间存在肝静脉属支,并可作为相邻两亚段间分界的解剖学标志。     

5例布-加氏综合征彩色多普勒超声诊断分析

目的探索彩色多普勒超声对肝静脉阻塞型布-加氏综合征的诊断价值。方法应用彩色多普勒超声观察5例肝静脉阻塞型布-加氏综合征的彩色多普勒超声的声像图特点。结果下腔静脉型3例,肝静脉型2例。结论彩色多普勒超声可较准确地判定血管狭窄及阻塞的部位和类型。     

5例布-加氏综合征彩色多普勒超声诊断分析

目的 探索彩色多普勒超声对肝静脉阻塞型布-加氏综合征的诊断价值.方法 应用彩色多普勒超声观察5例肝静脉阻塞型布-加氏综合征的彩色多普勒超声的声像图特点.结果 下腔静脉型3例,肝静脉型2例.结论 彩色多普勒超声可较准确地判定血管狭窄及阻塞的部位和类型.     

Asymmetry of the internal connections of the striate cortex of the cat in the projection zone of the center of the field of vision

Studies were carried out on the organization of the internal connections of the striate cortex in cats in the projection zone of the center (0–5°) of the field of vision by microintophoretic application of horseradish peroxidase to electrophysiologically identified orientational columns. The area containing neurons showing retrograde labeling in most cases extended in the mediolateral direction. Labeled cells were located in the upper (II, III) and lower (V, VI) layers of the cortex, and the shapes and orientations of the areas containing labeled neurons in these layers coincided. Spatial asymmetry was detected in the distribution of labeled neurons relative to the orientational column studied. Labeled cells were located predominantly medial to the columns, regardless of the distance from the projection of the area centralis. Considering the visuotopical map of field 17, the asymmetry detected here provides evidence that neurons in orientational columns have more extensive connections with neurons of the peripheral part of the cortex. An asymmetrical distribution of “silent” zones around the receptive fields of neurons in orientational columns is suggested, and that these appear to receive influences from the periphery of the visual field. Laboratory of Visual Physiology and Laboratory of Central Nervous System Morphology, I. P. Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarov Bank, 199034 St. Petersburg, Russia. Translated from Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 82, No. 12, pp. 23–29, December, 1996.     

Effects of the lesion of the postcommissural part of the septum on the behavior of the rat.

The effects of the lesion of the postcommissural part of the septum on behavior of the rat has been studied. Results may be summarized as follows. An increase in the exploratory behavior in the open field which decreases rapidly; a decrease in the number of defecations in this test and a decrease in time leaving a dark environment for exploration. In the shuttle box test, no facilitation of the acquisition, but a permanent and quite significant increase in the intertrial activity has been found. We conclude that the lesions tend to decrease the emotivity of the subjects. An interpretation on the basis of the species -- specific defensive reactions explains the transitory and permanent effects of the lesions on the spontaneous activity.     

The development of the ligament of the head of the femur

The hip joints of 30 human male and female fetuses and stillborns between 20 mm and 350 mm crown-rump length were studied by light microscopy. The ligament of the head of the femur developed in situ as a condensation of mesenchyme at the end of the second month of intra-uterine life (IUL), and was vascularized by branches of acetabular vessels early in the fourth month. In the majority of fetuses older than 5.5 months IUL, vessels in the ligament passed a short way into the femoral head within cartilage canals, to supply a small region around the fovea capitis. The remainder of the head was supplied by vessels in canals from around the upper part of the neck. The ligament changed from predominantly cellular to fibrous during the last 4 months of IUL. This increase in strength suggested significant mechanical functions in utero: limitation of adduction-flexion and opposition to postero-superior dislocation were the most likely.     

Counterpointing the functional role of the forebrain and of the brainstem in the control of the sleep-waking system

This paper reviews the lifetime contributions of the author to the field of sleep-wakefulness (S-W), reinterprets results of the early studies, and suggests new conclusions and perspectives. Long-term cats with mesencephalic transection show behavioral/polygraphic rapid eye movement sleep (REMS), including the typical oculo-pupillary behavior, even when the section is performed in kittens prior to S-W maturation. REMS can be induced as a reflex. Typical non-rapid eye movement S (NREMS) is absent and full W/arousal is present only after a precollicular section. The isolated forebrain (IF) rostral to the transection exhibits all features of W/arousal and NREMS [with electroencephalographic (EEG) spindles and delta waves], arousal to olfactory stimuli, and including the appropriate oculo-pupillary behaviors. These features also mature normally after neonatal transection. REMS is absent from the IF. After deprivation there is NREMS pressure and rebound in the IF, but the decerebrate cat only shows pressure for REMS. Most IF reactions to pharmacologic agents are within expectations, except for the tolerance/withdrawal effects of long-term morphine use which are absent. In contrast, these effects are supported by the brainstem (i.e. seen in the decerebrate cat). In cats with ablation of the telencephalon, or diencephalic cats, delta waves are absent in the thalamus. EEG thalamic spindle waves are seen triggering S for only 4-5 days after ablation. Therefore, true NREMS is absent in chronic diencephalic cats although pre- and postsomniac behaviors persist. These animals are hyperactive and show a pronounced, permanent insomnia; however, a low dose of barbiturate triggers a dramatic REMS/atypical NREMS rebound. Cats without the thalamus (athalamic cats), initially show a dissociation between behavioral hyperactivity/insomnia and the neocortical EEG, which for 15-20 days exhibits only delta and slower oscillations. Fast, low-voltage W rhythms appear later on, first during REMS, but spindle waves and S postures are absent from the start, such that these cats also display only atypical NREMS. Athalamic cats also show barbiturate-sensitive insomnia. Cats with ablation of the frontal cortices or the caudate nuclei remain permanently hyperactive. They also show a mild, but significant hyposomnia, which is permanent in afrontal cats, but lasts for about a month in acaudates. The polygraphic/behavioral features of their S-W states remain normal. We conclude and propose that: (a) the control of the S-W system is highly complex and distributed, but is organized hierarchically in a well-defined rostro-caudal manner; the rostral-most or highest level (telencephalon), is the most functionally complex/adaptative and regulates the lower levels; the diencephalic/basal forebrain, or middle level, has a pivotal role in inducing switching between S and W and in coordinating the lowest (brainstem) and highest levels; (b) W can occur independently in both the forebrain and brainstem, but true NREMS- and REMS-generating mechanisms exist exclusively in the forebrain and brainstem, respectively; (c) forebrain and brainstem S-W processes can operate independently from each other and are preprogrammed at birth; this helps understanding normal and abnormal polygraphic/behavioral dissociations in humans and normal dissociations/splitting in aquatic mammals; (d) NREMS homeostasis is present in the IF, but only REMS pressure after deprivation persists in the decerebrate cat; (e) the thalamus engages in both NREMS and W; (f) insomnia in diencephalic cats is the result of an imbalance between antagonistic W- and S-promoting cellular groups in the ventral brain (normally modulated by the telencephalon); (g) the EEG waves, which are signature for each S-W state, appear to truly drive the concomitant behaviors, e.g. a hypothetical human IF could alternate between behavioral NREMS and W/arousal/awareness; (h) a role for REMS is to keep the individual sleeping at the end of the self-limiting NREMS periods. The need for accelerating research on telencephaling NREMS periods. The need for accelerating research on telencephalic S-W processes and downstream control of the lower S-W system levels is emphasized.     

Topical organization of the projections of neurons of the substantia nigra and the ventral field of the tegmentum of the midbrain to the head of the caudate nucleus of the cat

Neuroscience and Behavioral Physiology -     

Involvement of the striatum in the central regulation of the hormonal functions of the gonads

Studies reported here show that intrastriatal administration of corticoliberin to rats decreases the blood testosterone level. However, in conditions of chemical deficiency of dopaminergic transmission in the dorsal striatum induced by injection of 6-hydroxydopamine, the effect of this neurohormone did not appear. It is concluded that extrahypothalamic corticoliberin is involved in regulating the hormonal reproductive system acting via dopaminergic mechanisms. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 85, No. 4, pp. 594–597, April, 1999.     

Ultrastructure of the endothelium of the drainage system of the eye

The endothelium of the ocular drainage system (Schlemm’s canal, collector tubules, and aqueous veins) in primary juvenile glaucoma undergoes degenerative dystrophic changes with compensatory hypertrophy and proliferation at the initial stages of the glaucomatous process and atrophy and desquamation at advanced and terminal stages. Progressive decrease in the pinocytous function of endotheliocytes, reduction of the protein-synthesizing and mitochondrial compartments of the cytoplasm, and formation of autophagosomes reflect the process of endotheliocyte degeneration in general. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 5, pp. 574–577, May, 2008