垂体柄的显微解剖及其临床意义

目的 :探讨垂体柄的显微解剖特点及相关的临床意义。方法 :采用 1 5个成人尸颅 ,在手术显微镜下观察垂体柄的大小、形态及周围关系。结果 :垂体柄上粗下细 ,平均长度约为 1cm ,血管丰富 ,有径直、“V”形和螺旋状三种形态。其上端含有漏斗隐窝 ,隐窝下端呈圆顶状而非锥状。垂体柄常通过一些纤维小梁与周围结构相连 ,上端前面与视交叉间的连系尤为紧密。结论 :垂体柄中点均较基底动脉细 ,是影像判定垂体柄增粗的重要指标。在视交叉池内操作时 ,对纤维小梁网的处理要轻柔 ,防止垂体柄的粗暴牵拉损伤。经翼点入路手术中 ,内推视交叉利于垂体柄的显露     

垂体动脉的应用解剖

目的 :为蝶鞍区肿瘤手术提供垂体动脉的显微外科解剖学资料。方法 :采用显微解剖技术对17个甲醛固定、红色明胶动脉灌注的成年尸头标本的垂体上动脉和垂体下动脉进行观察。结果 :垂体上动脉主要起自颈内动脉床突上段的内侧壁或内下壁 ,发起后向内、向上斜行 ,直至垂体柄 ,行程中可分支至视神经、视交叉 ,起始部直径为 (0 .2± 0 .1)mm。垂体下动脉起自脑膜垂体干 (94.1% )或直接起自颈内动脉 (5 .9% ) ,发起后沿颈内动脉内侧前行 ,再穿出海绵窦内侧壁自鞍底至垂体 ,起始部直径为 (0 .8± 0 .2 )mm。结论 :鞍区肿瘤手术应注意垂体上、下动脉的走行特点 ,并保护好这些动脉 ,以减少手术并发症的发生。     

Dorello管区的显微解剖和新概念

Dorello管区位于中线旁中、后颅凹底交界处。内含外展神经 ,上邻岩床后褶 (硬脑膜折叠形成的褶 )、小脑幕和三叉神经 ;前邻颈内动脉海绵窦段 ;后邻桥脑、延髓 ;内邻基底动脉和其分支 ;外下侧与面听神经、岩骨和其内的位听器官相邻 ,是手术治疗上最困难的区域之一 [1 - 3] 。然而 ,大型听神经瘤、岩骨内侧型和上斜坡脑膜瘤、三叉神经鞘瘤和向后侵袭的鞍区肿瘤如 :垂体腺瘤、颅咽管瘤和脊索瘤等许多肿瘤常常侵犯此区。一些颈动脉海绵窦瘘和海绵窦区的硬膜动静脉瘘也常以岩下窦和斜坡基底窦作为重要引流静脉。基底动脉干和两侧椎动脉汇合部附…     

脊髓动脉的显微解剖

在手术显微镜下观察了37例婴幼儿脊髓前(正中)动脉和脊髓后(外侧)动脉的分支,其主要结果如下:婴幼儿脊髓平均长度为14.08±1.49cm,脊髓前(正中)动脉外侧分支平均为76.17±18.64支,中央动脉平均为169.78±25.51支.中央动脉分布到灰质前角、侧角和后角底部及邻近灰质的深层白质,而白质浅层和后角大部,则由软膜动脉网发出的穿支供应.此外.还讨论了与临床应用有关的问题.     

ⅨⅩⅪ脑神经和颈静脉孔的显微解剖研究

目的：通过颈静脉孔以及Ⅸ、Ⅹ、Ⅺ脑神经的显微解剖研究，对重要结构进行量化分析，为手术提供解剖依据，并进一步澄清颈静脉孔的概念。方法：用10例成人尸头，在手术显微镜下对双侧重点观察了颈静脉孔的分隔，脑神经和颈静脉球的关系，同时对25例干性颅骨标本进行了大体测量。结果：Ⅸ和Ⅹ、Ⅺ脑神经之间有纤维(80％)或骨桥(20％)形成的不完全分隔，仅在1例干性颅骨标本中发现颈静脉孔被完全分隔为两个部分。Ⅸ、Ⅹ、Ⅺ脑神经全部位于颈静脉孔的前内侧，它们在孔内有各自单独的神经鞘膜，出孔后和颈内动脉、颈内静脉有共同的纤维包膜。在颈静脉球和颈内静脉的连接部，舌咽神经被一致密的结缔组织纤维固定在颈内动脉上。结论：颈静脉孔内的结构分成神经部，岩部和乙状部是比较合理的，有助于更好地理解颈静脉孔区特殊结构。Ⅸ、Ⅹ、Ⅺ脑神经在孔内的结构较为疏松，这种特点为术中辨认和神经保护提供了依据。     

Heubner返动脉的显微解剖研究

目的：为有关鞍区手术提供Heubner返动脉的显微外科解剖资料。方法：应用手术显微镜对32例Heubner返动脉进行解剖学观察、测量。结果：返动脉恒定存在,起源于大脑前动脉或其分支,单支型90．6％,双支型9．4％;返动脉主干平均长度为29．4mm,起始处平均管径为1.02mm;57％于大脑前动脉外侧向后行走,89％行于颈内动脉床突上段上方,17％贴附于颈内动脉床突上段内侧缘后行,86％于前床突与大脑前动脉之间跨越视神经上方,100％从视交叉外侧缘外侧通过;77％在外侧裂池与颈动脉池交界处出现”U”形虹吸部;80％出现粗大终支从前穿质进入基底节区。结论：深入了解返动脉的解剖学特点及其与鞍区各结构的解剖关系,对于Willis动脉环动脉瘤的合理处置及经眶、经翼点人路鞍区手术神经血管的保护有重要的意义。     

Dorello管区的显微解剖研究

目的:为Dorello管区显微神经外科手术及影像学诊断提供解剖学依据。方法:在5-20倍手术显微镜下,对30例成人头颅Dorello管区进行观测;并应用生物塑化技术制作Dorello管区横、矢状及冠状薄层塑化切片。结果:Dorello管位于岩斜静脉腔内,Dorello管直径为(1.93±0.62)mm,长(5.09±1.50)mm;Gruber韧带长度为(10.97±1.85)mm,宽为(3.72±1.03)mm。Dorello管区生物塑化薄层切片可清楚显示Dorello管的解剖结构。结论:本文结果可指导与Dorello管相关的颅底外科手术,以免损伤重要神经和血管。Dorello管区塑化薄片与显微解剖所见有良好对应关系,并可直接与MRI图像进行对照,为Dorello管区影像诊断提供解剖学依据。     

颅后窝三角显微解剖及临床意义

目的：研究颅后窝三角的显微特征，为颅后窝手术提供快速辨认神经、血管的方法。方法：旁正中切口、乙状窦后入路，逐层开颅并切开硬脑膜，显微观察12具成人头部标本硬脑膜形成的三角。结果：颅后窝硬脑膜皱襞反光形成一个三角形：外上顶点即“光点”，位于横窦与乙状窦移行处的前方；内上顶点恰是岩静脉注入岩上窦的位置；颈静脉孔构成颅后窝三角内下顶点。结论：手术显微镜下，颅后窝硬脑膜形成的标志性三角，可以帮助迅速辨认三叉神经、岩静脉，经过内耳门的面神经、前庭蜗神经以及经过颈静脉孔的舌咽神经、迷走神经、副神经。     

海绵窦三角的显微解剖

30侧经颈内动脉灌注红色乳胶的成人颅底标本,在手术显微镜(目镜10×有测微器)下解剖和观测。海绵窦外侧壁下份内有Parkinson三角,我们还观察到其上方另有一个三角,由动眼神经、滑车神经和小脑幕游离缘的后份形成。海绵窦顶亦呈三角。确定了这三个三角的界限。研究了动眼神经、动眼神经与滑车神经的交点、滑车神经与眼神经的交点在窦壁上的表面投影。观察了通过各个三角内的颈内动脉各段及其分支。从而明确了窦壁内结构与窦内结构的毗邻关系,为找寻海绵窦内诸结构入路,和临床应用提供参考。     

人颈静脉孔区显微解剖研究

目的研究人颈静脉孔区显微解剖,为手术入路的选择提供形态学资料。方法手术显微镜(15倍)下对15个头颅标本,30侧颈静脉孔进行显微解剖和观察。结果颈静脉孔分为三部,即岩部、神经部、乙状部。岩部为接收岩下窦、舌下神经管静脉、岩斜裂静脉和椎静脉丛分支的静脉窦;神经部由位于结缔组织鞘中的舌咽、迷走、副神经所组成,行于颈静脉球上方的内侧,舌咽神经位于最前方,神经间被纤维或骨性结构隔开;乙状部接收乙状窦血流。结论颈静脉孔区结构复杂,熟悉颈静脉孔区的显微解剖有利于手术中保护重要的神经和血管。     

Embryological development of the arterial system of the forelimb in Tupaia

Background: The arterial system of the upper extremities in man shows drastic developmental changes and many individual variations related to interspecific variations in primates. The ontogenetic development in Tupaia was examined from the viewpoint of comparative embryology. Methods: Histological specimens of 39 embryos were observed and reconstructed in three dimensions using a computer program. Four adult animals were dissected and examined with angiography to ascertain the end stage of development. Results: At the proximal end of the upper arm the deep brachial artery appears first as a concomitant vessel with the radial nerve. It becomes reduced in size and is succeeded by the posterior circumflex humeral artery, which is accompanied initially by the axillary nerve and finally by the radial nerve. The main arterial passageway to the fingers consists of the brachial and interosseous arteries during early development. The superficial brachial artery and median artery are formed later, and their connection becomes the main route of blood supply for the finger arteries up to the adult stage. The ulnar artery is formed at the end of arterial development to form the ulnar end of the superficial palmar arch. The superficial antebrachial arteries are also recognized. Conclusions: All the arterial elements of the forelimb in Tupaia are observed in a variety of primates, including man, and the characteristics of Tupaia are thought to represent the primitive conditions of the common ancestor of tree shrews and primates. © 1994 Wiley-Liss, Inc.     

脉络丛前动脉显微解剖结构的临床应用研究

目的研究脉络丛前动脉显微解剖结构的临床应用及其意义。方法用体视显微镜和手术显微镜对21例（42侧）成人脑标本进行观察,研究脉络丛前动脉显微解剖结构特点。结果脉络丛前动脉来源于颈内动脉者37侧（88.1%）;来源于大脑中动脉者3侧（7.2%）;来源于后交通动脉者2侧（4.8%）。左侧脉络丛前动脉比右侧粗大者占78.9%。脉络丛前动脉的起始处管径变异较大,平均（0.79±0.27）mm。管径从起始部发出随行程延伸越来越细,中段管径0.35~0.71 mm;末段管径0.16~0.33 mm。脉络丛前动脉主干长（2.88±0.48）cm。海马旁回钩前沟定位与交点的距离右侧为（11.17±1.78）mm,左侧为（10.93±2.13）mm。结论双侧脉络丛前动脉管径无明显差异,发生痉挛易导致视束的供血障碍。相关颞叶内侧附近手术时,海马旁回钩前沟定位比较准确,手术时要注意在以海马旁回钩前沟为标志的交点处保护脉络丛前动脉。     

海绵窦内外侧膜交接处的显微解剖

目的：寻找进入海绵窦的新方法。方法：对8例成人头颅海绵窦(共16侧)结构进行显微解剖研究。结果：颅底硬脑膜有两层，内层在海绵窦内外侧膜交接处与外层分离，与眼神经等包膜融合，并同海绵窦外侧膜的内外两层形成外侧膜潜在间隙，自颅中窝撕开内外侧膜交接处的颅底硬脑膜内层后，通过该潜在间隙可直接进入海绵窦。结论：经外侧膜潜在间隙可进入海绵窦。     

Vertebral microanatomy in squamates: structure, growth and ecological correlates

The histological study of vertebrae in extant squamates shows that the internal vertebral structure in this group differs from that of other tetrapods. Squamate vertebrae are lightly built and basically composed of two roughly concentric osseous tubes--one surrounding the neural canal and the other constituting the peripheral cortex of the vertebra--connected by few thin trabeculae. This structure, which characteristically evokes that of a tubular bone, results from a peculiar remodelling process characterised by an imbalance between local bone resorption and redeposition; in both periosteal and endosteo-endochondral territories, bone is extensively resorbed but not reconstructed in the same proportion by secondary deposits. This process is particularly intense in the deep region of the centrum, where originally compact cortices are made cancellous, and where the endochondral spongiosa is very loose. This remodelling process starts at an early stage of development and remains active throughout subsequent growth. The growth of squamate centra is also strongly asymmetrical, with the posterior (condylar) part growing much faster than the anterior (cotylar) part. Preliminary analyses testing for associations between vertebral structure and habitat use suggest that vertebrae of fossorial taxa are denser than those of terrestrial taxa, those in aquatic taxa being of intermediate density. However, phylogenetically informed analyses do not corroborate these findings, thus suggesting a strong phylogenetic signal in the data. As our analyses demonstrate that vertebrae in snakes are generally denser than those of lizards sensu stricto, this may drive the presence of a phylogenetic signal in the data. More comprehensive sampling of fossorial and aquatic lizards is clearly needed to more rigorously evaluate these patterns.     

The Embryological development and cytodifferentiation of the pars distalis of the golden hamster (Mesocricetus auratus)

Summary The embryological development and cytodifferentiation of the hamster pars distalis was investigated using light and electron microscope techniques in order to obtain basic information for comparison with pituitary development in other mammalian species. The normal chronological events in the development of the hamster pars distalis closely paralleled the pituitary organogenesis of other laboratory rodents. Rathke's pouch formed and touched the infundibulum at 8 1/2 days of gestation and separated from the stomodeum 3 days later. Penetration of vascular elements from the developing hypophysial portal system into the pars distalis occurred at 12 1/2 days gestation. This was also the first day that small secretory granules were seen in any of the parenchymal cells. Further cytodifferentiation during the following prenatal, and first few postnatal days of life revealed granulated cells which, in most cases, could not be identified using morphological criteria or granule size as may be done in the adult. An orderly sequence of inductive and morphological events appears to take place in the developing hamster adenohypophysis paralleling similar events observed in other animals.Submitted by the senior author to the Graduate School of Louisiana State University, Baton Rouge, in partial fulfilment for the Ph.D.     

Role of sex hormones in development of pituitary adenoma

Role of sex hormones in the development of pituitary adenomas was investigated by analyzing the content of nuclear estradiol and testosterone receptors in different tumors of the anterior pituitary: prolactinomas, meningiomas, growth hormone-producing adenomas, astrocytomas, neurinomas, and ependymomas. The concentration of nuclear estrogen and androgen receptors in prolactin-secreting pituitary adenomas was much higher than in growth hormone-producing adenomas and other pituitary tumors.