出版消息

由丁大连、姜泗长编著的《豚鼠内耳解剖检验技术手册》已于1989年8月由学林出版社出版,南京铁道医学院印刷发行。全书共8万字。17幅插图,32开本.内容包括豚鼠生物学特性和实验动物的选择,内耳病理实验室布局,豚鼠内耳的解剖结构,内耳标本的固定技术和切片技术,全内耳膜迷路的取材技术和铺片技术,内耳组织化学技术,内耳样品的电镜制备技术和内耳酶细胞化学技术。读者对象为从事耳科、     

人膜迷路三维精确建模与虚拟可视化

目的建立精确的人内耳膜迷路的三维模型，以满足内耳可视化研究和生物力学建模的需要。方法制作全系列、不染色、层厚20μm的新鲜成人颞骨火棉胶连续切片，使用幻灯机和高像素数码相机结合图像拼合技术获取全部切片的高清晰度数字图像。在3D-Doctor软件中，将全系列图像进行对位、设定标度参数、分割后，采用表面重建法生成内耳膜迷路三维模型。结果建立了能清晰显示膜迷路精细结构的内耳三维模型，在3D-Doctor软件中实现了不同的显示效果，并利用Cortona虚拟现实建模语言软件在个人电脑上实现了模型的桌面虚拟可视化。结论全系列不染色的火棉胶连续切片、数码相机拍摄结合图像拼合和高性能图像处理软件的使用可以满足膜迷路精确建模的需要，并能提高建模的精确度。利用虚拟现实软件和设备可以实现内耳膜迷路的虚拟可视化，有利于形态学研究和教学。     

实验动物标准颞骨切片规范

颞骨切片技术是观察和评估实验性内耳病理学改变的重要手段。由于内耳复杂的迷宫式立体结构,从不同方向和角度获取的颞骨切片很难进行相互间的组织病理学比较。因此,统一颞骨标准切片技术规范,对于评判内耳听觉感受器和前庭各个平衡感受器以及耳蜗和前庭周边神经元的病变部位和病变程度十分重要,因为只有统一了规范的颞骨样品制备和切片角度,才有可能对实验性内耳病变做出正确的比较和评判。颞骨切片的标准方向是将切片平面平行于外耳道和内听道的水平面,从上鼓室向下鼓室方向依次收集到的需要进行重点评估的切片层次分别为上半规管壶腹嵴和外半规管壶腹嵴、椭圆囊斑和球囊斑及前庭上神经元、球囊斑和前庭下神经元、耳蜗中轴、内淋巴管及内淋巴囊、以及后半规管壶腹嵴。本文还根据作者的实践经验讨论了颞骨切片样品制备过程中有关样品固定、脱钙、颞骨整体染色、渗透和定向包埋等技术细节,期望能对从事内耳病理学研究的同道有所帮助。     

内耳膜迷路积水的基础研究和临床诊治

我们对内耳膜迷路积水的认识一般来源于梅尼埃病。1938年Hallpike和Cairns发现梅尼埃病的病理学改变为内耳膜迷路积水，又称内淋巴积水。其实，膜迷路积水是许多耳科疾病内耳损伤后相同的病理改变，梅尼埃病只是其中一种，称为有症状特发性膜迷路积水。内耳膜迷路积水的基础研究，尤其是动物模型的建立，成为为研究眩晕机制且最终根治眩晕的关键。掌握不同种类膜迷路积水疾病的临床特点，有助于眩晕的诊断、鉴别诊断和临床治疗。     

先天性内耳畸形的影像学诊断及进展

先天性内耳畸形是指内耳胚胎期不同阶段发育障碍导致的内耳结构异常的一组疾病,是儿童感音神经性聋的主要病因,其群体发病率约为1/2 000～1/6 000。内耳分为骨迷路和膜迷路,迷路由前向后分为耳蜗、前庭和半规管。先天性内耳畸形可发生在骨迷路和膜迷路的任何部分,其中约20%为骨迷路畸形,约80%为膜迷路畸形。由于内耳位置深在,结构细小,过去一直是影像学检查的盲区,随着能清     

迷路炎性骨化的放射线诊断

迷路炎性骨化是膜迷路腔的病理性变化。常发生于炎症反应过程中,它损坏膜迷路或耳囊(otic capsule)的骨内膜。化脓性迷路炎是最常见的原因,其他如肿瘤、耳硬化症、颞骨骨折及内耳出血。化脓性迷路炎可通过以下三条径路之一发生感染:血源性(败血性)、脑膜源性或鼓室源性。组织病理学研究指出迷路炎性骨化是化脓性迷路炎的后果。内耳感染可引起短时间的浆液纤维渗出,并很快化脓及膜性组织的液化和坏死,内、外淋巴腔充满成纤维肉芽组织。成骨细胞从有病变的间叶组织中产生,如骨内膜、蜗轴及基底膜,并长入纤维组织块中,骨化由此形成。     

CT与MRI对内耳畸形的诊断价值

目的 :探讨 CT与 MRI对内耳畸形的诊断价值。方法 :通过 1例先天性内耳畸形病例的 CT与 MRI的影像学表现 ,并复习文献 ,分析内耳 CT与 MRI的成像特点及 MR膜迷路液成像优点。结果 :CT能清晰地显示内耳骨结构 ,而 MRI能清晰地显示膜迷路。结论 :CT与 MRI诊断内耳畸形优势互补 ,MR膜迷路液成像技术对内耳畸形有非常重要的诊断价值     

内耳开窗术对豚鼠耳蜗电图和膜迷路水肿的影响

目的 通过比较耳蜗电图CAP阈值、SP幅度及组织切片,探讨内耳开窗术对豚鼠听力的影响.方法 将听力正常的5只成年豚鼠的双耳进行配对设计.实验耳在耳蜗鼓岬上行内耳开窗,外接注入生理盐水的微泵,在圆窗膜上放置银球记录电极;对照耳只放置记录电极.分别于术后0,2,4,6天记录耳蜗电图的阈值及SP幅度,比较实验耳和对照耳的差异.结果 实验耳和对照耳的耳蜗电图在8 kHz的CAP阈值、SP幅度无统计学差异(P＞0.05),耳蜗组织切片均未见膜迷路水肿.结论 内耳开窗术对豚鼠听力无影响,不会导致膜迷路水肿,可作为内耳给药的有效途径及动物病理模型建立.     

突发性聋的病理学

对引起突发性聋的原因一直存在争论,本文作者主张内耳病毒感染学说,1962年曾报告4例突发性聋患者颞骨组织病理学观察结果,类似病毒性迷路炎病变。此次又报告7例不明原因的听力骤降,其中1例双耳患病,6例单耳,因此共观察8个内耳的组织病理学。发现螺旋器、盖膜和血管纹有不同程度的萎缩。据判断,这些病变比较类似病毒性迷路炎的表现,而不象动物实验造成内耳血管阻塞时所呈现情况。     

老年鼠白色念珠菌感染并发急性迷路炎

观察老年鼠白色念珠菌感染后并发急性迷路炎的组织病理变化，旨在研究年龄因素在内耳霉菌感染发病中的作用。CBA／CAH雌性鼠分两组；实验组10只老年鼠年龄18个月左右，对照组5只幼鼠年龄6～8周。静脉内注射3X105白色念珠菌芽生拖于，4天后处死。标本福尔马林固定、脱钙、石蜡包理，连续切片，光镜观察。结果：注射后4天老年鼠发生严重眩晕、衰竭，对照组无明显症状。对照组内计组织学改变原火术提及。老年鼠内耳组织学观察见膜迷路有白色念珠菌的酵母型和菌丝，受累的严重程度依次为椭圆囊、半规管壶腹呢附近、中阶、鼓阶、球囊和前庭阶…     

PCR技术对大鼠内耳膜迷路线粒体DNA的检测

目的：建立灵敏、可靠的大鼠内耳膜迷路线粒体ＤＮＡ提取和检测方法。方法：结合ＰＣＲ技术扩增ｍｔＤＮＡ编码ＮＤ１－１６ＳｒＲＮＡ基因的６０１ｂｐ片段，检测大听泡内耳膜迷路线粒体ＤＮＡ方法，并对两种ｍｔＤＮＡ获取方法进行比较。结果：采用Ｓｅｉｄｍａｎ的方法，将１只大鼠的以侧听泡内耳膜迷路作为一个样品，检测１０个样品均成功扩增出编码ＮＤ１－１６ＳｒＲＮＡ基因的６０１ｂｐ片段；而采用ＥｄｒｉｓｍｔＤＮＡ提取     

自身免疫性内耳病动物模型的抗内耳特异性抗体谱系分析

目的 为明确哪几种膜迷路蛋白成分参与了实验性自身免疫性内耳病（ａｕｔｏｍｍｕｎｅｉｎｎｅｒ－ｅａｒ ｄｉｓｅａｓｅ，ＡＩＥＤ）的形成。方法 以同种内耳组织抗原免疫豚鼠，建立自身免疫性内耳病动物模型。用免疫转印迹技术（Ｗｅｓｔ－ｅｒｎ ｂｌｏｔ）检测动物血液中抗膜迷路蛋白抗体。结果 豚鼠膜迷路蛋白成分复杂，ＳＤＳ－ＡＰＧＥ电泳至少可分出５种，但免疫后大多数动物（１５／２０）体内仅产生了抗６８ｋＤ和１     

Evaluation of the inner ear fluorescence

Searching for the methods, which may improve the visualisation of the membranous labyrinth, authors decided to evaluate autofluorescence of the membranous structures of the inner ear. The analysis of the inner ear autofluorescence parameters was performed. We assessed, whether the detected differences in autofluorescence between the bony elements and the membranous structures, allows the practical apply, owning to increased contrast in the operating microscope. The optimal wave length inducing autofluorescence of membranous labyrinth amounts to 465 nm. Obtained in these circumstances contrast of the membranous structures don't cause a significant improvement in their visualisation, comparing with the picture received in the traditional optical microscope.     

Anatomic study of maximum intensity projection of the membranous labyrinth and the internal auditory meatus - MRI scan in 16 Chinese adults

CONCLUSION: Three-dimensional reconstruction of maximum intensity projection (MIP) might document objectively, stereoscopically and directly the minute structures of the membranous labyrinth and internal auditory meatus. In this study, we establish magnetic resonance imaging (MRI) measurement criteria of the inner ear in Chinese adults. OBJECTIVE: The goal of this study was to provide an anatomic basis for otolosurgery and neurosurgery in Chinese adults. MATERIALS AND METHODS: Sixteen healthy volunteer subjects were scanned by a GE-signa 1.5T MRI scanner. All original images were transferred to an MRI workstation and all the structures of the inner ear were reconstructed, rotated at various angles and measured with an MIP program. RESULTS: Anatomic structures of the membranous labyrinth and internal auditory meatus were well demonstrated in MIP images in all volunteers. All inner ear structures including utricle, saccule, cochlear duct, internal auditory meatus and three semicircular ducts produced high intensity signals.     

Normal anatomy of the inner ear.

The three parts of the inner ear have been reviewed: the membranous (endolymph containing) labyrinth surrounded by the osseous (perilymph containing) labyrinth, and the otic capsule of bone that encases the osseous labyrinth. This is a brief survey of the normal anatomy, but one must always remember that the hallmark of the temporal bone is variation.     

Intermediate filaments in the newborn inner ear of the mouse

The presence of intermediate filaments in the inner ear of the newborn mouse was analyzed with immunofluorescence techniques using antibodies against the five classes of intermediate filaments: cytokeratins, vimentin, desmin, neurofilaments and glial fibrillary acid protein (GFA). Neurofilaments were found in all nerve fibers from the ganglion cell to the hair cell. In the vestibular ganglion two subpopulations of ganglion cells were identified: a minor part staining intensively with neurofilament and the major part of cells lacking this immunofluorescence. Vimentin occurred in a number of supporting structures in the membranous labyrinth, but not in vestibular or cochlear ganglion cells. Cytokeratins, desmin or GFA were not identified in the inner ear.     

Anatomic study of maximum intensity projection of the membranous labyrinth and the internal auditory meatus – MRI scan in 16 Chinese adults

Conclusion. Three-dimensional reconstruction of maximum intensity projection (MIP) might document objectively, stereoscopically and directly the minute structures of the membranous labyrinth and internal auditory meatus. In this study, we establish magnetic resonance imaging (MRI) measurement criteria of the inner ear in Chinese adults. Objective. The goal of this study was to provide an anatomic basis for otolosurgery and neurosurgery in Chinese adults. Materials and methods. Sixteen healthy volunteer subjects were scanned by a GE-signa 1.5T MRI scanner. All original images were transferred to an MRI workstation and all the structures of the inner ear were reconstructed, rotated at various angles and measured with an MIP program. Results. Anatomic structures of the membranous labyrinth and internal auditory meatus were well demonstrated in MIP images in all volunteers. All inner ear structures including utricle, saccule, cochlear duct, internal auditory meatus and three semicircular ducts produced high intensity signals.     

Identification of previously "undetectable" abnormalities of the bony labyrinth with computed tomography measurement

BACKGROUND: In patients with congenital sensorineural hearing loss (SNHL), a computed tomography (CT) scan of the temporal bone identifies inner ear malformations in approximately 25%, whereas the inner ear is grossly normal to visual inspection in the remaining 75% of the patients. In the latter group, the hearing loss is often attributed to radiologically undetectable abnormalities of the membranous labyrinth. However, subtle bony malformations may be missed because visual inspection alone is insensitive for detection. OBJECTIVE: To test the hypothesis that there are subtle bony abnormalities of the inner ear in patients with SNHL who are radiologically deemed to have normal otic bone, using standardized measurements of the inner ear. STUDY DESIGN: Retrospective review. METHODS: Measurements of the cochlea, vestibule, and semicircular canals (SCCs) were made on axial and coronal temporal bone CT scans on 15 patients with normal hearing and 15 patients with congenital SNHL and grossly normal temporal bone CT scans. Student's t-test was performed to compare the measurements of the two groups.RESULTS All studies from the SNHL group were deemed normal by visual inspection and standardized measurements (+/-2 SD from normal). Surprisingly, there were significant differences in the measurements of the cochlea and of the SCCs between patients with and without SHNL (P <.05). CONCLUSIONS: As a group, patients with SNHL and a "normal CT scan" have significant differences in the dimensions of the inner ear. This suggests that these patients have disturbed morphogenesis of both membranous and bony labyrinth. This novel observation has important implications for understanding the etiology of SNHL.     

A technique for reembedding celloidin sections for electron microscopy

A new technique for reembedding celloidin sections of human temporal bones for transmission electron microscopy is described. It consists of four steps: 1. loosening of celloidin sections from glass slides with use of xylene and dissection of the area of interest, 2. removal of celloidin with use of clove oil, 3. staining with 1% osmium tetroxide and 1% tannic acid, and 4. embedding in epoxy resin. Autolytic changes were seen due to poor fixation. TEM of reembedded celloidin sections of optimally fixed tissue revealed that the celloidin-embedding procedure affected ul-trastructural preservation to some degree. This included less well-preserved cell membranes and some increased electron density of the cytosol decreasing the EM resolution of intracytoplasmic organelles. The technique allows TEM analysis of the intact labyrinth at all regions in the same specimen without dissection of the fragile tissue components of the membranous labyrinth. This might make the technique useful for processing freshly fixed human inner ear tissue and temporal bones for ultrastructural histo-pathological analysis.