胆胰汇合部异常与胆源性慢性胰腺炎的关系

目的探讨胆胰管合流异常（APBDJ）在胆源性慢性胰腺炎（BCP）中的发生率及相关性。方法回顾性分析自2000年1月至2012年1月间我院临床确诊MRCP、ERCP以及T管造影显示胆胰管共同显影的患者1373例临床资料。结果本组共发现47例BCP患者,其中17例发现有APBDJ,共同通道的平均长度（19．3±7．2）mm,最长40mm,最短11mm。结论APBDJ造成的胰反流可能是胆源性慢性胰腺炎的重要原因。     

Gross dissection and immunohistochemical studies on branch fusion type of ventral and dorsal pancreatic ducts: A case report

Summary A case of fusion via two inferior branches between the ventral and dorsal pancreatic ducts was studied both macroscopically and immunohistochemically, based on the organogenesis of the pancreas. Radiologically, the branch fusion seemed to be composed of an inferior branch of the ventral pancreatic duct and an inferior branch of the dorsal pancreatic duct. By mapping pancreatic polypeptide cells in the material obtained by pancreatoduodenectomy, however, the branch was identified as a branch of the dorsal pancreatic duct. Thus, fusion between two inferior branches was not established, but was found to consist of an inferior branch of the dorsal pancreatic duct connected with the ventral pancreatic duct. We therefore challenge the concept of the ansa pancreatica.

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Etude macroscopique et immunohistochimique d'une anastomose entre les conduits pancréatiques ventral et dorsal: À propos d'un cas

Résumé Un cas d'anastomose entre les canaux pancréatiques ventral et dorsal par l'intermédiaire de deux branches inférieures a fait l'objet d'une étude à la fois macroscopique et immuno-histochimique, basée sur l'organogénèse du pancréas. Radiologiquement, l'anastomose semblait être constituée par une branche inférieure du conduit pancréatique ventral et une branche inférieure du conduit pancréatique dorsal. La cartographie des cellules pancréatiques polypeptidiques dans le matériel obtenu par duodéno-pancréatectomie, a permis de constater que la branche anastomotique était une branche du conduit pancréatique dorsal. Ainsi, il s'agissait non pas d'une anastomose entre deux branches inférieures, mais d'une anastomose entre une branche inférieure du conduit pancréatique dorsal et le conduit pancréatique ventral. La notion d'anse pancréatique est remise en question par les auteurs.

     

Reactive changes in dorsal roots and dorsal root ganglia after C7 dorsal rhizotomy and ventral root avulsion/replantation in rabbits

Current surgical treatment of spinal root injuries aims at reconnecting ventral roots to the spinal cord while severed dorsal roots are generally left untreated. Reactive changes in dorsal root ganglia (DRGs) and in injured dorsal roots after such complex lesions have not been analysed in detail. We studied dorsal root remnants and lesioned DRGs 6 months after C7 dorsal rhizotomy, ventral root avulsion and immediate ventral root replantation in adult rabbits. Replanted ventral roots were fixed to the spinal cord with fibrin glue only or with glue containing ciliary neurotrophic factor and/or brain-derived neurotrophic factor. Varying degrees of degeneration were observed in the deafferented dorsal spinal cord in all experimental groups. In cases with well-preserved morphology, small myelinated axons extended into central tissue protrusions at the dorsal root entry zone, suggesting sprouting of spinal neuron processes into the central dorsal root remnant. In lesioned DRGs, the density of neurons and myelinated axons was not significantly altered, but a slight decrease in the relative frequency of large neurons and an increase of small myelinated axons was noted (significant for axons). Unexpectedly, differences in the degree of these changes were found between control and neurotrophic factor-treated animals. Central axons of DRG neurons formed dorsal root stumps of considerable length which were attached to fibrous tissue surrounding the replanted ventral root. In cases where gaps were apparent in dorsal root sheaths, a subgroup of dorsal root axons entered this fibrous tissue. Continuity of sensory axons with the spinal cord was never observed. Some axons coursed ventrally in the direction of the spinal nerve. Although the animal model does not fully represent the situation in human plexus injuries, the present findings provide a basis for devising further experimental approaches in the treatment of combined motor/sensory root lesions.     

Pancreatographic investigation of pancreatic duct system and pancreaticobiliary malformation

To clarify the anatomy of the pancreatic duct system and to investigate its embryology, we reviewed 256 pancreatograms with normal pancreatic head, 81 with pancreas divisum and 74 with pancreaticobiliary maljunction. Accessory pancreatograms were divided into two patterns. The long-type accessory pancreatic duct forms a straight line and joins the main pancreatic duct at the neck portion of the pancreas. The short-type accessory pancreatic duct joins the main pancreatic duct near its first inferior branch. The short-type accessory pancreatic duct is less likely to have a long inferior branch arising from the accessory pancreatic duct. The length of the accessory pancreatic duct from the orifice to the first long inferior branch was similar in the short- and long-type accessory pancreatic ducts. The first long inferior branch from the long-type accessory pancreatic duct passes though the main pancreatic duct near the origin of the inferior branch from the main pancreatic duct. Immunohistochemically, in the short-type accessory pancreatic duct, the main pancreatic duct between the junction with the short-type accessory pancreatic duct and the neck portion was located in the ventral pancreas. The long-type accessory pancreatic duct represents a continuation of the main duct of the dorsal pancreatic bud. The short-type accessory pancreatic duct is probably formed by the proximal main duct of the dorsal pancreatic bud and its long inferior branch.     

Visual and visuomotor processing of hands and tools as a case study of cross talk between the dorsal and ventral streams

A major principle of organization of the visual system is between a dorsal stream that processes visuomotor information and a ventral stream that supports object recognition. Most research has focused on dissociating processing across these two streams. Here we focus on how the two streams interact. We tested neurologically-intact and impaired participants in an object categorization task over two classes of objects that depend on processing within both streams—hands and tools. We measured how unconscious processing of images from one of these categories (e.g., tools) affects the recognition of images from the other category (i.e., hands). Our findings with neurologically-intact participants demonstrated that processing an image of a hand hampers the subsequent processing of an image of a tool, and vice versa. These results were not present in apraxic patients (N?=?3). These findings suggest local and global inhibitory processes working in tandem to co-register information across the two streams.     

经下颌下咽后入路颅颈交界腹侧区手术的应用解剖

目的:为临床经下颌下咽后入路处理颅颈交界腹侧区病变提供解剖学基础。方法:对15例(30侧)带颈头颅标本模拟经下颌下咽后入路进行显微外科解剖,同时进行了有关的数据测量。结果:该入路浅层的重要结构均位于各自的筋膜层中,以这些结构为解剖学标志可鉴别各层并引导手术进行。咽结节是显露的上限,限制骨窗侧方显露范围的各重要结构的内缘距正中线的水平距离分别为寰枢外侧关节,左(7.78±1.03)mm,右(7.81±1.01)mm;寰枕关节,左(9.27±1.86)mm,右(9.22±1.69)mm;舌下神经管内口,左(12.76±2.77)mm,右(12.81±2.53)mm及椎动脉C2水平,左(18.36±2.27)mm,右(18.47±2.14)mm;C1水平左(25.35±2.31)mm,右(25.18±2.33)mm;穿硬膜处,左(12.69±2.42)mm,右(12.72±2.39)mm。结论:(1)经下颌下咽后入路解剖上大致可分为3个层次:浅层,深层和骨、韧带及硬膜层。(2)掌握每个层次的解剖特点及操作要点,有助于安全充分的显露和处理咽颅颈交界腹侧区病变。     

Visual processing in Noonan syndrome: dorsal and ventral stream sensitivity

Global spatial and motion processing abilities were assessed in 18 patients with Noonan syndrome (NS) and in 43 matched controls using form and motion coherence testing, respectively. We observed a discrepancy between the two groups since the study group had significantly lower performances than the control group for form coherence while there was no impairment on motion coherence. All the patients were also assessed on the Movement Assessment Battery for Children (M-ABC) to evaluate visuomotor skills. Thirteen of the 18 (72%) also had global poor performances on the M-ABC. The results show that children with NS have a specific impairment in the global processing of visuospatial information and are likely to have a specific ventral stream deficit as also suggested by the frequent visuomotor perceptual difficulties. Testing form and motion coherence thresholds may be a useful diagnostic tool for this group of patients, despite their normal cognitive abilities, since aspects of global form processing and visuomotor perceptual difficulties can be identified and potentially targeted for a specific rehabilitation program.     

Multipolar cells in the ventral cochlear nucleus project to the dorsal cochlear nucleus and the inferior colliculus

When retrograde markers are placed in the dorsal cochlear nucleus two classes of labeled cells are found in the ventral cochlear nucleus. These are multipolar cells and granule cells. The structure and distribution of labeled multipolar cells greatly resemble those seen following injection of retrograde markers into the contralateral inferior colliculus. When one retrograde marker is placed in the dorsal cochlear nucleus and another simultaneously placed into the contralateral inferior colliculus, large numbers of multipolar cells containing both markers are found in the ventral cochlear nucleus. These findings show that all or most cells in the ventral cochlear nucleus that project to the inferior colliculus also send collaterals to the ipsilateral dorsal cochlear nucleus.     

Efferent connections of dorsal and ventral agranular insular cortex in the hamster, Mesocricetus auratus

The anterior portion of rodent agranular insular cortex consists of a ventral periallocortical region (AIv) and a dorsal proisocortical region (AId). Each of these two cortical areas has distinct efferent connections, but in certain brain areas their projection fields are partially or wholly overlapping. Bilateral projections to layers I, III and VI of medial frontal cortex originate in the dorsal agranular insular cortex and terminate in the prelimbic, anterior cingulate and medial precentral areas; those originating in ventral agranular insular cortex terminate in the medial orbital, infralimbic and prelimbic areas. The dorsal and ventral regions of the agranular insular cortex project topographically to the ipsilateral cortex bordering the rhinal fissure, which includes the posterior primary olfactory, posterior agranular insular, perirhinal and lateral entorhinal areas. Fibers to these lateral cortical areas were found to travel in a cell-free zone, between cortical layer VI and the claustrum, which corresponds to the extreme capsule. The dorsal and ventral regions send commissural projections to layer I, lamina dissecans and outer layer V, and layer VI of the contralateral homotopical cortex, via the corpus callosum. Projections from the ventral and dorsal regions of the agranular insular cortex to the caudatoputamen are topographically arranged and terminate in finger-like patches. The ventral, but not the dorsal region, projects to the ventral striatum and ventral pallidum. The thalamic projections of the ventral and dorsal regions are largely overlapping, with projections from both to the ipsilateral reticular nucleus and bilaterally to the rhomboid, mediodorsal, gelatinosus and ventromedial nuclei. The heaviest projection is that to the full anteroposterior extent of the medial segment of the mediodorsal nucleus. Brainstem areas receiving projections from the ventral and dorsal regions include the lateral hypothalamus, substantia nigra pars compacta, ventral tegmental area and dorsal raphe nucleus. In addition, the ventral region projects to the periaqueductal gray and the dorsal region projects to the parabrachial and ventral pontine nuclei.These efferent connections largely reciprocate the afferent connections of the ventral and dorsal agranular insular cortex, and provide further support for the concept that these regions are portions of an outer ring of limbic cortex which plays a critical role in the expression of motivated, species-typical behaviors.     

Afferent connections of dorsal and ventral agranular insular cortex in the hamsterMesocricetus auratus

The agranular insular cortex is transitional in location and structure between the ventrally adjacent olfactory allocortex primutivus and dorsally adjacent sensory-motor isocortex. Its ventral anterior division receives major afferent projections from olfactory areas of the limbic system (posterior primary olfactory cortex, posterolateral cortical amygdaloid nucleus and lateral entorhinal cortex) while its dorsal anterior division does so from non-olfactory limbic areas (lateral and basolateral amygdaloid nuclei).The medial segment of the mediodorsal thalamic nucleus projects to both the ventral and dorsal divisions of the agranular insular cortex, to the former from its anterior portion and to the latter from its posterior portion. Other thalamic inputs to the two divisions arise from the gelatinosus, central medial, rhomboid and parafascicular nuclei. The dorsal division, but not the ventral division, receives input from neurons in the lateral hypothalamus and posterior hypothalamus.The medial frontal cortex projects topographically and bilaterally upon both ventral and dorsal anterior insular cortex, to the former from the ventrally located medial orbital and infralimbic areas, to the latter from the dorsally-located anterior cingulate and medial precentral areas, and to both from the intermediately located prelimbic area. Similarly, the ipsilateral posterior agranular insular cortex and perirhinal cortex project in a topographic manner upon the two divisions of the agranular insular cortex.Commissural input to both divisions originates from pyramidal neurons in the respective contralateral homotopical cortical area. In each case, pyramidal neurons in layer V contribute 90% of this projection and 10% arises from layer III pyramidals.In the brainstem, the dorsal raphe nucleus projects to the ventral and dorsal divisions of the agranular insular cortex and the parabrachial nucleus projects to the dorsal division.Based on their cytoarchitecture, pattern of afferent connections and known functional properties, we consider the ventral and dorsal divisions of the agranular insular cortex to be, respectively, periallocortical and proisocortical portions of the limbic cortex.     

Changes in body weight and food-related behaviour induced by destruction of the ventral or dorsal noradrenergic bundle in the rat

Three experiments contrasted the effects of 6-hydroxydopamine-induced lesions of the ventral noradrenergic and dorsal noradrenergic projections, predominantly to hypothalamus and cortex, respectively, upon body weight changes and food-related behaviour in the rat. In general, ventral noradrenergic bundle lesions enhanced weight gain and these effects were exaggerated by the provision of palatable cheese to the standard chow diet. In contrast, lesions of the dorsal noradrenergic bundle produced minor changes in body weight. Associated with the effects of ventral noradrenergic bundle lesions were hyperphagia, enhanced suppression of intake of food adulterated with quinine, (at high concentration), a small attenuation of food neophobia, and enhanced acquisition, but not performance, of the eating response to tail-pinch stimulation. These ventral noradrenergic bundle lesions failed to alter basal activity levels, amphetamine anorexia or the diurnal pattern of eating or activity. In contrast, lesions of the dorsal noradrenergic bundle did not produce either hyperphagia or enhanced rejection of food adulterated with quinine. However, there was a strong attenuation of food neophobia and a retarded acquisition (but unimpaired performance) of eating in response to tail-pinch stimulation.

The results are discussed in connection with previous studies of ventral and dorsal noradrenergic bundle lesions, with the effects of ventromedial hypothalamic lesions and with the underlying behavioural and physiological processes that mediate these contrasting effects of different neuroanatomical patterns of central noradrenaline depletion.     

Dependence of the cognitive set on the involvement of the ventral and dorsal visual systems in cognitive activity

Measures of the stability of a non-verbal visual set were compared in healthy human subjects in three series of experiments: 1) controls, in which a pair of set-forming stimuli (images of circles) were presented; 2) in the context of a test with a non-verbal set, subjects were presented with an additional task consisting of recognition of pseudowords (words); and 3) as before, but the additional task consisted of identifying the position of a target stimulus in a matrix of letters. There was a significant decrease in the stability (rigidity) of the non-verbal set on introduction of the additional task consisting of identifying the spatial position of a target stimulus; conversely, there was an increase in rigidity when the task consisted of recognizing the quality of a stimulus. Coherence analysis of cortical potentials in the alpha range showed that changes in the spatial organization of cortical electrical activity were significantly different, depending on the nature of the additional task: when the additional task involved recognition of a verbal stimulus, coherence connections were strengthened in the frontal-temporal-parietal areas of the right hemisphere; presentation in the context of a visuospatial task resulted in greater changes being observed in the anterior areas of the right hemisphere. It is suggested that the successful performance of mental functions requiring relatively rapid shifts in unconscious sets on changes in situation occurs in conditions of alternation of different types of cognitive tasks when cortical processing of visual information is mediated predominantly by one of the visual systems — either the ventral (“what?”) or the dorsal (“where?”) and, correspondingly, with the involvement of the anterior and posterior cortical selective attention systems.