Anatomical consideration of vascularized bone graft transfer from the medial calcaneus to the talus

To investigate the possibility of use of the calcaneal branches of the posterior tibial artery as the pedicle for the vascularized bone graft to the talus, a detailed anatomical study was carried out on 30 fresh cadaver feet. Although there are several branches from the posterior tibial artery to the calcaneus, the largest posterior branch was defined as the main calcaneal branch. We recognized frequently a large branch nourishing the superior part of the calcaneus and named it the superior calcaneal branch. Twenty feet had the superior calcaneal branches. Pedicled bone grafts using the superior calcaneal branch to the postero-medial portion of the talar body were possible in 18 of 20 feet. Pedicled bone grafts using the main calcaneal branches were possible in 9 of 12 feet in which the superior calcaneal branches were not available. Finally, vascularized bone grafts were judged to be feasible in 27 feet (90%).     

Anatomical basis of the anterior vertebral graft using a pediculated rib

Summary The rib is frequently used as a bone graft in the surgery of the anterior spine. The advantage of the rib is that it is easily used as a pediculated vascularized graft when it is transfered to the anterior vertebrae. The average length of the pedicle is over 5 cm for the ribs number 3 to 10. Their useful length of bone is 12 cm. With this technique fusion of 4 to 6 lumbar or thoracic vertebrae is possible.

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Bases anatomiques de la greffe vertébrale antérieure par côte pédiculée

Résumé L'étude anatomique de 20 sujets a permis de préciser les possibilités d'utilisation des greffes costales pédiculisées en îlot dans la chirurgie du rachis. La longuer du pédicule dépasse environ 5 cm pour les côtes n° 3 à 10 dont la longueur utile est voisine de 12 cm. Ce potentiel permet une greffe osseuse de 4 à 6 vertèbres lombaires ou thoraciques.

     

腓骨骨膜瓣移植在儿童四肢骨肿瘤瘤段骨射线灭活回植术中的应用观察

目的 探讨腓骨骨膜瓣移植覆盖灭活瘤段骨断端在儿童四肢骨肿瘤射线灭活再植术中应用的可行性和临床效果。方法 回顾性分析2016年6月—2017年6月郑州大学附属肿瘤医院骨与软组织科8例原发四肢恶性或侵袭性骨肿瘤患儿临床资料,男4例、女4例,年龄9~17(13.6±2.5)岁;骨肉瘤5例,尤文肉瘤、软骨肉瘤、反复复发的侵袭性朗格汉斯组织细胞增生症各1例。均采用瘤段骨扩大切除+术中灭活自体瘤段骨回植术治疗,回植的瘤段骨断端均应用带蒂或游离腓骨骨膜瓣覆盖。肿瘤位于胫骨中上段5例,应用同侧带腓血管蒂腓骨膜瓣逆行转位覆盖瘤段骨远侧断端;肿瘤位于股骨中下段2例、肱骨中段1例,应用游离腓血管蒂腓骨膜瓣移植覆盖近侧断端。瘤段骨为单纯骨干5例,包含关节面3例,长度13~26(18.1±3.9)cm。灭活方法均为术中离体射线灭活。术后定期随访,拍摄X线、CT观察记录瘤段骨体内愈合情况,并观察患肢长度变化。结果 本组8例患儿术后随访12~24(18.8±3.5)个月。8例患儿共有13处断端均获得骨愈合,腓骨膜覆盖的断端平均愈合时间6~10(7.3±1.3)个月,且骨膜覆盖区域可观察到成骨现象。末次随访时,5例骨干灭活和1例骨关节灭活的患儿未发生双侧肢体不等长,2例骨关节灭活患儿患侧下肢长度较对侧短缩1.5 cm和2.0 cm。结论 在儿童四肢骨肿瘤手术治疗中,应用腓骨骨膜瓣移植覆盖灭活瘤段骨断端的方法可行,能够有效促进瘤段骨的愈合和防止骨不愈合、骨不连发生,且操作简便,并发症较少,推荐临床开展应用。     

带尺侧上副动脉尺神经转位的解剖及临床意义

目的为临床上带血管蒂的尺神经移植在健侧颈7移位治疗臂丛根性撕脱伤中的应用提供解剖学依据。方法取新鲜经动脉灌注红色乳胶的成人上肢标本22侧进行显微解剖,观察尺神经外部营养动脉的来源。另取患骨肿瘤而截肢新鲜成人上肢6侧作仅保留尺侧上副动脉的尺神经游离,采用动脉灌注墨汁和尺神经组织切片的方法,观察尺侧上副动脉对尺神经内部血供营养的范围。结果尺神经在腋部由胸外侧或腋动脉的分支供应,在内侧肌间隔后方由尺侧上副动脉供应,在尺神经沟由尺侧上副动脉与尺侧返动脉后支的吻合支供应,在前臂由尺侧返动脉和尺动脉的分支供应。尺侧上副动脉灌注墨汁后,尺神经腕部、手背支及腋部的神经束内微血管被墨汁充填。结论以尺侧上副动脉的起始处为血管蒂部旋转点,尺神经可提供平均为(46.5±2.6)cm的有血供的移植长度,可经胸前皮下隧道逆向转位与对侧颈7神经根吻合。以尺侧上副动脉为血供的尺神经移植的设计是合理的。     

Anatomic bases of a vascularized allogenic knee joint transplantation: arterial blood supply of the human knee joint

Summary The vitality of a graft in a vascularized allogenic knee joint transplantation in humans will depend strongly on maintaining the arterial blood supply to the bone. As can be demonstrated in injected specimens on cadavers, only periostal aa. are important to ensure the blood supply of the human knee joint. The main arteries have defined nutritive areas. According to our results access to the vessels should most probably be conducted from the dorsal side of the knee. During the explantation the popliteal a. should be ligated proximally as high up as possible and distally just above its trifurcation. The articular branch of the descending genicular a. of both the donor and the recipient can be ligated because of a rich anastomotic network. The medial and lateral inferior genicular aa. of the donor should be ligated ventrally as far forward as possible. One should, above all, preserve the medial inferior genicular a. of the donor in order not to endanger the medial part of the distal segment of the graft. If an operation is to be performed according to the results of our anatomical studies, vascularized allogenic knee joint transplantations should be successful from an anatomical point of view.

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Bases anatomiques de la transplantation d'une allogreffe vascularisée de genou : vascularisation artérielle de l'articulation du genou humain

Résumé La vitalité d'une greffe lors d'une transplantation d'allogreffe vascularisée de genou dépendra principalement du maintien de la vascularisation artérielle de l'os. Comme on peut le montrer sur des spécimens cadavériques injectés, seules les artères périostées sont importantes pour assurer la vascularisation artérielle du genou humain. Les principales artères ont des territoires définis. En fonction de nos résultats, l'accès aux vaisseaux serait au mieux mené par le versant dorsal du genou. Pendant le prélèvement, l'a. poplitée devrait être sectionnée proximalement aussi haut que possible, et distalement juste au-dessus de sa trifurcation. Le rameau articulaire de l'a. descendante du genou du donneur et celui du receveur peuvent être liées en raison du riche réseau anastomotique. Les aa. géniculées inféro-médiale et inféro-latérale du donneur devraient être liées aussi loin que possible en avant. Il faudrait par dessus tout préserver l'artère géniculée inféromédiale du donneur pour éviter de léser la partie médiale du segment distal de la greffe. Si une transplantation d'un allogreffe vascularisée de genou devait être réalisée en tenant compte du résultat de nos travaux, elle devrait être un succès du point de vue anatomique.

     

尺动脉腕背支第5掌骨骨膜瓣修复三角纤维软骨的解剖基础

目的：为三角纤维软骨修复提供新的手术方法。方法．在40侧经动脉灌注红色乳胶的成人尸体标本上，解剖观测尺动脉腕背支的走行、分支及分布。结果：尺动脉腕背支在豌豆骨近侧3．9cm处起于尺动脉，分为升支和降支。其中降支为腕背支的延续，大多数(70％)沿第5掌骨尺侧缘径直下行达第5掌骨头、体交界处与小指动脉尺侧支相吻合；少数(30％)降支至豌豆骨附近变为纤细，由小指动脉尺侧支上行与之吻合。降支或小指动脉尺侧支循第5掌骨头尺侧走行时发1～3支、外径0．3～0．7mm骨膜支，分布于第5掌骨背内面骨膜。结论：可以尺动脉腕背支降支为蒂设计第5掌骨骨膜瓣转位修复三角纤维软骨的新术式。     

Anatomical study of the symmetry of lateral extensor compartment of the wrist

The anatomy of the lateral extensor compartment of the wrist has been extensively studied, since it is the site of stenosing tenosynovitis of the tendons of abductor pollicis longus and extensor pollicis brevis (de Quervain's disease). Septation of the compartment and multiplicity of the tendons within it have been thought, by some surgeons, to cause overcrowding and thus contribute to the pathogenesis of the condition. This anatomical study of ten pairs of cadaveric hands has shown that these variations are common, confirming previous reports in the literature, and, more importantly, that they are frequently bilaterally symmetrical. Since de Quervain's disease tends to occur unilaterally, it seems unlikely that anatomical variations are important in its pathogenesis. Appreciation of these variations is, however, important in surgical treatment. Adequate exposure is necessary to recognize the anatomical structures, so that all subcompartments within the fibroosseous tunnel may be decompressed. © 1993 Wiley-Liss, Inc.     

颞骨岩部结构的定位解剖及临床意义

目的:为颅底手术中耳蜗的定位、岩尖的磨除范围提供解剖学方法。方法:在12个成人头颅标本上利用颅中窝入路暴露岩内面神经、耳蜗、颈内动脉等结构。观测岩内膝状神经节、颈内动脉(internalcarotidartery,ICA)的膝部、内耳道内侧缘、棘孔与耳蜗之间的解剖关系。结果:耳蜗位于面神经膝状神经节的前下方和岩内ICA膝部的后上方,耳蜗覆盖到ICA膝部的上方。ICA水平段与ICA膝部和内耳道内侧缘连线的夹角为67.1°±4.3°。结论:以棘孔和膝状神经节连线的中点、膝状神经节、内耳道内侧缘形成的三角定位耳蜗。在耳前—颞下窝斜坡手术入路中,在中颅底,过ICA膝部做与ICA水平段成67.1°±4.3°的夹角,在这个夹角内磨除岩尖骨质,不会损伤耳蜗、内耳道及其内容物。耳蜗基底圈至ICA膝部的距离为(0.302±0.016)cm。从前向后磨除岩尖骨质时,ICA膝部后方的骨质磨除不要超过(0.302±0.016)cm,否则会损伤耳蜗。     

Comparison of mesencephalic free-floating tissue culture grafts and cell suspension grafts in the 6-hydroxydopamine-lesioned rat

Ventral mesencephalon (VM) of fetal rat and human origin grown as free-floating roller-tube (FFRT) cultures can survive subsequent grafting to the adult rat striatum. To further explore the functional efficacy of such grafts, embryonic day 13 ventral mesencephalic tissue was grafted either after 7 days in culture or directly as dissociated cell suspensions, and compared with regard to neuronal survival and ability to normalize rotational behavior in adult rats with unilateral 6-hydroxydopamine (6-OHDA) lesions. Other lesioned rats received injections of cell-free medium and served as controls. The amphetamine-induced rotational behavior of all 6-OHDA-lesioned animals was monitored at various time points from 18 days before transplantation and up to 80 days after transplantation. Tyrosine hydroxylase (TH) immunostaining of the histologically processed brains served to assess the long-term survival of grafted dopaminergic neurons and to correlate that with the behavioral effects. Additional cultures and acutely prepared explants were also fixed and stored for histological investigation in order to estimate the loss of dopaminergic neurons in culture and after transplantation. Similar behavioral improvements in terms of significant reductions in amphetamine-induced rotations were observed in rats grafted with FFRT cultures (127%) and rats grafted with cell suspensions (122%), while control animals showed no normalization of rotational behavior. At 84 days after transplantation, there were similar numbers of TH-immunoreactive (TH-ir) neurons in grafts of cultured tissue (775 ± 98, mean ± SEM) and grafts of fresh, dissociated cell suspension (806 ± 105, mean ± SEM). Cell counts in fresh explants, 7-day-old cultures, and grafted cultures revealed a 68.2% loss of TH-ir cells 7 days after explantation, with an additional 23.1% loss after grafting, leaving 8.7% of the original number of TH-ir cells in the intracerebral grafts. This is to be compared with a survival rate of 9.1% for the TH-ir cells in the cell-suspension grafts. Immunostaining for the calcium-binding proteins calretinin, calbindin, and parvalbumin showed no differences in the neuronal expression of these proteins between the two graft types. In conclusion, we found comparable dopaminergic cell survival and functional effects of tissue-culture grafts and cell-suspension grafts, which currently is the type of graft most commonly used for experimental and clinical grafting. In this sense the result is promising for the development of an effective in vitro storage of fetal nigral tissue, which at the same time would allow neuroprotective and neurotrophic treatment prior to intracerebral transplantation. Received: 11 March 1997 / Accepted: 19 August 1997     

以内踝前或跗内侧血管为蒂第一楔骨瓣转位术的应用解剖

在30侧成人下肢标本上,解剖观测了第一楔骨动脉的来源、走行、分支和分布.内踝前动脉和跗内侧动脉恒定地紧邻胫骨前肌腱两侧走行,分别发2～6支和2～9支外径0.2～0.8mm的骨膜支至第一楔骨背内侧面.以内踝前血管或跗内侧血管为蒂可截取约1.5×1.0×0.5cm大小的骨瓣,经摹拟手术和临床应用,证实是修复距骨颈骨折、距骨体缺血性坏死以及踝足部诸关节植骨融合的一种简易可行的新术式.     

手舟骨血供3D可视化模型的制备

目的　建立手舟骨动脉血供三维数字可视化模型,为基础研究及临床应用提供形态学基础。 方法　8具尸体行一次性全身动脉造影、螺旋CT扫描,运用Mimics软件构建腕骨及手舟骨滋养动脉的3D可视化模型。 结果　（1）该模型能够清晰显示桡骨、尺骨远端与手部各骨及其周围血管网,并可任意旋转观察与测量;（2）手舟骨有3支主要的滋养动脉;（3）通过选择性透明或隐藏处理后,对手舟骨营养血管入骨点及其在骨内的分布情况得到了很好的显示。 结论　该模型可清晰的显示手舟骨及其滋养动脉的来源、分布、及空间毗邻,可为手舟骨疾患的临床诊治提供直观的数字化解剖学依据。     

两种改进的自体骨融合方式在后路腰椎融合术中的应用研究

目的　回顾研究两种改进的自体骨融合方案(自体颗粒骨打压植骨、自体骨cage植骨)与PEEK cage植骨在腰椎后路融合手术中的临床疗效差异,旨在证实其临床价值。 方法　收集2010年6月至2016年6月因退行性腰椎疾患在我科行腰椎融合术的患者,根据腰椎融合的采用情况将患者分为自体骨打压组36例、自体骨cage组35例、PEEK cage组39例。观察手术前后的 VAS、ODI评分,并在影像学资料上计算术后24h、术后6月、术后12月的椎间隙高度丢失度及椎体融合率。术前患者一般资料无统计学差异,资料可比性良好。 结果　三组术后均未发生严重的手术相关并发症。影像学结果示术后6月、12月的椎体高度丢失度分别为：打压植骨组(6.1±2.5、6.5±3.8)%;自体骨cage组(5.6±2.9、5.8±3.7)%;PEEK cage 组(5.4±3.3、5.9±4.1)%。术后6月、12月的椎间相对融合率为：打压植骨组(27.5±10.5、26.5±9.1)%;自体骨cage组(31.2±8.7、28.1±8.7)%;PEEK cage 组(28.4±7.1、29.3±8.2)%。各组结果均无统计学差异(P＞0.05)。术后三组的ODI、VAS评分亦无统计学差异(P＞0.05)。 结论　三组术后的临床疗效及术后融合率无明显差异,自体颗粒骨打压植骨、自体骨cage植骨融合效果良好。     

两种引导组织再生膜骨修复效果的比较

文题释义： 压电效应：指晶体材料受到压力作用时会在两端面间出现电压。1880年,法国物理学家P.居里和J.居里兄弟发现,把重物放在石英晶体上后晶体某些表面会产生电荷,电荷量与压力呈比例。 压电常数：是压电体将机械能与电能相互转变的转换系数,主要反映了压电材料弹性(机械)性能与介电性能之间的耦合关系。 背景：课题组前期研究证实,含体积分数5%钛酸钡纳米颗粒的钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜可明显促进骨髓间充质干细胞的黏附、生长、成骨分化及骨缺损修复,然而针对临床应用,该材料作为引导组织再生膜与现有临床上不可降解膜产品的骨修复效果有何差异尚不清楚。 目的：对比考察钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜材料与商用聚四氟乙烯膜修复大鼠颅骨临界尺寸缺损的效果。 方法：采用溶液浇铸法制备出含体积分数5%钛酸钡纳米颗粒的钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜,经过电晕极化处理后使其表面带电。通过扫描电镜、原子力显微镜和水接触角测量仪检测钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜与聚四氟乙烯膜的表面形貌、表面粗糙度及表面亲疏水性。在SD大鼠(购自北京大学口腔医学院实验动物中心)颅骨矢状缝两侧制作直径为5 mm的全厚骨缺损,左侧覆盖聚四氟乙烯膜(对照组),右侧覆盖钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜(实验组),术后4,12周,利用Micro-CT和组织学方法评价材料覆盖大鼠颅骨缺损的骨修复情况。实验已经通过北京大学口腔医学院实验动物伦理委员会讨论批准。 结果与结论：①钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜表面平整致密,钛酸钡纳米颗粒均匀分布在基体内;聚四氟乙烯膜由疏松的粗大纤维组成;钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜的表面粗糙度低于聚四氟乙烯膜(P < 0.001),亲水性优于聚四氟乙烯膜(P < 0.001);②Micro-CT和组织学检测显示,术后4周时,两组缺损处均有新骨生成,但实验组缺损中央有明显的新骨生成;术后12周时,两组缺损均已愈合,但实验组新骨成熟程度高于对照组;③结果表明,钛酸钡/聚偏氟乙烯三氟乙烯压电纳米复合膜可能作为引导组织再生膜。 ORCID: 0000-0002-6993-5627(尹颖) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

两种不同复合唑来膦酸骨水泥的体外浸提对比实验研究

目的对比观察不同唑来膦酸含量的两种骨水泥在体外的药物释放情况,为临床应用其治疗骨巨细胞瘤奠定体外药物释放动力学基础。方法将唑来膦酸分别与聚甲基丙烯酸甲酯骨水泥及磷酸钙骨水泥以0.2%、0.4%、0.6%的质量比混合制备复合唑来膦酸骨水泥的测试标本,并同时设立空白对照,所制两种不同骨水泥标本均分成a(空白对照)、b(含0.2%的唑来膦酸)、c(含0.4%的唑来膦酸)、d(含0.6%的唑来膦酸)4组,每组1个标本。将4组标本分别放于5m L生理盐水中,并最终置于智能溶出仪中持续浸提42天,于特定时间点取样待测,用高效液相色谱仪测定浸提液中唑来膦酸的浓度,计算各时点的药物释放浓度和释放总量百分比,并绘制相应曲线。结果复合唑来膦酸聚甲基丙烯酸甲酯骨水泥的各实验组浸提液色谱图中未发现唑来膦酸吸收峰的出现,而复合唑来膦酸磷酸钙骨水泥的各实验组浸提液色谱图中均可见唑来膦酸吸收峰的出现且各实验组在第42天实验结束时的唑来膦酸累计溶出量百分比:b组d组c组。结论唑来膦酸不能从聚甲基丙烯酸甲酯骨水泥中释放,但可以从磷酸钙骨水泥中释放并最终可以以一稳定药物浓度缓慢、持久释放。     

带血管蒂跟骨瓣转位修复距骨骨折的应用解剖

在解剖观察30侧成人足标本时,观察到跟外侧动脉恒定地分支分布到跟骨体外侧,滋养动脉有7.5(6～12)支,外径为0.5mm。跗外侧动脉、腓动脉穿支的降支和外踝前动脉亦以肌骨支分布于跟骨前外侧端,上述动脉之间有恒定的吻合。根据跟骨外侧血管分布的解剖学规律性,设计了外侧骨瓣转位修复距骨颈骨折、关节植骨融合术,经临床应用证实,取踝后外侧入路,可任意选择上述血管之一为蒂的跟骨瓣。文中讨论了骨瓣设计,骨瓣截取的应用解剖要点。     

冠状动脉旁路移植术后静脉桥再狭窄的基因治疗研究进展

冠状动脉旁路移植术是治疗缺血性心脏病安全、有效的方法.自体大隐静脉是术中最常用的移植血管材料.但是血栓形成、内膜增厚和粥样硬化导致的静脉桥再狭窄严重影响了其通畅率,而且至今尚无有效的治疗药物.分子生物学技术理论的发展为冠状动脉旁路移植术后静脉桥再狭窄的防治提供了新思路,基因治疗静脉桥再狭窄已成为目前研究的热点.本文主要从静脉桥再狭窄防治的目的基因、基因导入方式、基因载体等方面,对静脉桥再狭窄基因治疗的研究进展进行综述.     

富血小板血浆复合自体松质骨移植的生物重建治疗陈旧性腕舟状骨骨不连的临床效果分析

目的 观察富血小板血浆（platelet-rich plasma, PRP）复合自体松质骨移植治疗腕舟状骨骨不连的近期临床效果。方法 收集中国人民解放军联勤保障部队第989医院自2019年6月至2021年6月期间收治的30例陈旧性腕舟状骨骨不连的患者作为研究对象,按照随机数表分为观察组和对照组。观察组（15例）采用PRP复合自体松质骨移植的生物重建方法,对照组（15例）采用只采用自体松质骨移植并内固定的手术方式。对比两组的手术时间、住院时间、骨折愈合情况、骨痂等级评分、腕关节功能评估及术后并发症。结果 术后30例患者均得到随访,随访周期为12个月。观察组骨折愈合率为93.3%,对照组骨折愈合率为66.7%,两组比较差异具有统计学意义（P＜0.05）。观察组的手术时间为（1.83±0.23）h,对照组的手术时间为（1.73±0.30）h,两组比较差异无统计学意义（P＞0.05）;观察组骨折愈合时间［（16.54±0.74）周］少于对照组［（20.70±4.73）周］,术后住院时间［（14.27±2.43） d］少于对照组［（19.53±6.29） d］,两组比较差异具有统计学意义（P＜0.05）。观察组术后4、8、12周骨痂等级评分比较优于对照组,两组比较差异具有统计学意义（P＜0.05）;观察组术后16周骨痂等级评分比较优于对照组,两组比较差异无统计学意义（P＞0.05）。数据显示术后6个月,观察组的Mayo评分高于对照组,VAS评分低于对照组,两组比较差异具有统计学意义（P＜0.05）;术后12个月,两组间Mayo评分及VAS评分比较,差异无统计学意义（P＞0.05）。观察组术后并发症共2例,对照组术后并发症共6例,两组比较差异具有统计学意义（P＜0.05）。结论 富血小板血浆（PRP）复合自体松质骨移植治疗腕舟状骨骨不连可促进腕舟状骨骨折愈合,减少手术相关并发症,利于腕关节功能恢复,近期临床效果较好。     

Tests of two hypotheses to account for different-sized saccades during disjunctive gaze shifts

Rapid shifts of the point of visual fixation between objects that lie in different directions and at different depths require disjunctive eye movements. We tested whether the saccadic component of such movements is equal for both eyes (Hering’s law) or is unequal. We compared the saccadic pulses of abducting and adducting movements when horizontal gaze was shifted from a distant to a near target aligned on the visual axis of one eye (Müller paradigm) in ten normal subjects. We similarly compared horizontal saccades made between two distant targets lying in the same field of movement as during the Müller paradigm tests, and between targets lying symmetrically on either side of the midline, at near side of the midline, at near or far. We measured the ratio of the amplitude of the movements of each eye in corresponding directions due to the saccadic component, as well as corresponding ratios of peak velocity and peak acceleration. In response to a Müller test paradigm requiring about 17° of vergence, the change in position of the unaligned eye was typically twice the size of the corresponding movement of the aligned eye. The ratio of peak velocities for the unaligned/aligned eyes was about 1.5, which was greater than for saccades made between distant targets. The ratio of peak acceleration for unaligned/aligned eyes was about 1.0 during shifts from near to far and about 1.3 for shifts from far to near, these values being similar to corresponding ratios for saccades between distant targets. These measurements of peak acceleration indicate that the saccadic pulses sent to each eye during the Müller paradigm are more equal than would be deduced by comparing the changes in eye position. We retested five subjects to compare directly the peak acceleration of saccades made during the Müller paradigm with similar-sized ”conjugate” saccades made between targets at optical infinity. Saccades made during the Müller paradigm were significant slower (P<0.005) than similar-sized conjugate saccades; this indicated that the different-sized movements during Müller paradigm are not simply due differences in saccadic pulse size but are also influenced by the concurrent vergence movement. A model for saccade-vergence interactions, which incorporates equal saccadic pulses for each eye, and differing contributions from convergence and divergence, accounts for many of these findings. Received: 31 December 1998 / Accepted: 14 July 1999     

Intranigral ventral mesencephalic grafts and nigrostriatal injections of glial cell line-derived neurotrophic factor restore dopamine release in the striatum of 6-hydroxydopamine-lesioned rats

We have previously reported that grafting of fetal ventral mesencephalic (VM) tissue to the nigral region of unilaterally 6-hydroxydopamine (6-OHDA)-lesioned rats, in conjunction with glial cell line-derived neurotrophic factor (GDNF) injection between nigra and striatum, restores nigrostriatal tyrosine hydroxylase (TH) immunoreactivity. In this study, we investigated the electrochemical indices of dopamine (DA) release in these grafted animals in the striatum and nigra. Adult Sprague-Dawley rats were anesthetized and unilaterally injected with 6-OHDA into the medial forebrain bundle. The completeness of lesions was tested by measuring methamphetamine-induced rotations. One to two months after 6-OHDA administration, fetal VM tissues were grafted in the lesioned nigral area followed by injection of GDNF, brain-derived neurotrophic factor (BDNF), or phosphate-buffered saline (PBS), along a tract from nigra to striatum. Animals receiving transplantation and GDNF, but not BDNF or PBS, injection showed a significant decrease in rotation 1–3 months after grafting. High-speed chronoamperometric recording techniques, using Nafion-coated carbon fiber electrodes, were used to evaluate DA overflow in the striatum. We found that 6-OHDA lesions resulted in a loss of KCl-induced DA overflow in the urethane-anesthetized rats. Three months after GDNF-bridged grafting, application of KCl elicited DA release both in nigra and striatum. The KCl-evoked DA release area was limited to the GDNF-bridging tract in the striatum. On the other hand, KCl did not induce DA release in the BDNF- or PBS-bridged grafts. Immunocytochemical studies indicated that TH-positive neurons and fibers were found in the nigra and striatum after GDNF-bridged grafting. Taken together, our data suggest that fetal nigral transplantation and GDNF injection may restore the nigrostriatal DA pathway and DA release in these hemiparkinsonian animals and support the hypothesis of trophic activity of GDNF on fiber outgrowth from midbrain DA neurons. Received: 8 August 1997 / Accepted: 9 August 1997     

腕部掌侧带血供皮瓣游离移植修复手指皮肤缺损的应用解剖研究

目的　介绍腕部掌侧皮肤带血供游离移植修复手指皮肤缺损的应用解剖学基础。 方法　解剖观测20例成人尸体上肢标本,2例标本做带骨骼动脉铸型,18例标本做肱动脉乳胶灌注。在手术显微镜下进行解剖,观测腕部掌侧皮肤的营养动脉、回流静脉、神经支配来源、其内的掌长肌腱。 结果　腕部掌侧皮肤主要由桡动脉掌浅支分支营养,静脉回流有深浅两种途径,神经支配以正中神经掌皮支为主,桡神经浅支为辅,游离移植可切取面积为2cm×4cm~2 cm×5cm[2cm×（4.42±0.58）cm]。桡动脉掌浅支起始处直径为 （1.25±0.24）mm, 与指动脉直径相仿。 结论　传统的腕部掌侧供皮区皮肤可以形成以桡动脉掌浅支为蒂的复合组织皮瓣游离移植修复手指的皮肤缺损。