颞骨岩部入路颅底手术有关的应用解剖

目的:为经岩部入路颅底手术提供解剖学参数.方法:观测成人的100例干燥整颅、20例颅底标本、15例尸头及36侧正常颅底CT资料;观测项目为与经岩部入路颅底手术有关的颞骨表面标志与岩部内重要结构的位置及其间距.结果:整颅及颅底内面各项测量结果左右侧比较U均<1.96,P均>0.05,颞骨内重要结构间及与表面标志间距离测量结果多数项目男女性间比较U均>1.96或>2.58,P<0.05或<0.01;颅中窝入路可以弓状隆起作标志寻认上骨半规管以确认内耳道,也可以岩大神经管裂孔为标志暴露面神经膝状神经节与迷路段确认内耳道底;磨除岩尖部骨质时可以颈动脉管后壁与内耳门内侧缘的连线作为界线.结论:颞骨表面标志点间距及颞骨岩部内重要结构间的位置关系可为经岩部入路颅底手术提供重要参考,有利于术中岩部重要结构的定位与保护.     

扩大经鼻-蝶窦入路至颅底中央区的显微及内镜解剖学研究

目的：为临床单纯内镜或内镜辅助下经鼻一蝶窦入路至颅底中央区的手术提供解剖学标志和参数。方法：乳胶灌注汉族成人尸头湿标本10例,在神经内镜下及手术显微镜下模拟经鼻-蝶窦入路至颅底中央区的手术,按手术步骤分鼻腔内、蝶窦内及蝶鞍和周围结构3部分进行观察和测量。结果：蝶窦是内镜下经鼻-蝶窦入路中的关键结构。蝶窦后壁常见的解剖标志有鞍底、斜坡凹陷、视神经颈内动脉隐窝、颈内动脉隆起、视神经隆起、蝶骨平台;其中,斜坡凹陷是确定鞍底最可靠的标志。此入路可分别向前、中、后颅底方向扩展,内镜下可清晰显露硬脑膜下及海绵窦内部分结构。结论：采用内镜经鼻-碟窦入路是显露颅底中央区病变的良好的手术方法。     

中国人侧颅底区可视化研究

目的建立中国人体侧颅底区局部可视化数字模型，为该区疾病的影像学诊断及外科手术治疗提供数字形态学依据。方法应用我室建立的数字化可视人体数据集，采用体绘制及面绘制重建方法，分别在P4微机和SGI工作站上对侧颅底区重要结构进行计算机三维重建及立体显示。结果侧颅底区局部可视化数字模型能够清晰显示侧颅底各重要结构。本研究着重显示了侧颅底神经血管区、颞骨内结构、颈内动脉及其毗邻结构与侧颅底骨性组织的三维解剖关系。三维重建结构可以单独或联合显示，重建结构的任意径线及角度均可进行适时三维测量。结论我室建立的数字化可视人体数据集能够较好地重建侧颅底区可视化解剖模型，反映该区域重要解剖结构及其空间毗邻关系，该结果可应用于侧颅底外科手术辅助教学以及手术入路的辅助设计等。     

内镜经眉弓上锁孔入路的解剖学研究

目的 探索内镜经眉弓上锁孔入路暴露颅底中线区域的解剖结构,为临床该术式切除颅底中线区域肿瘤提供解剖学基础。 方法 内镜经眉弓上锁孔入路解剖5具成人尸头标本,观察该入路暴露的颅底中线区域脑组织、血管及神经。 结果 内镜经眉弓上锁孔入路可充分暴露前床突及其内侧前颅底硬脑膜、嗅沟及嗅神经;蝶鞍区可显露视神经、视交叉、视交叉前间隙、垂体上动脉、眼动脉、颈内动脉及其周围间隙;上斜坡区域可显露鞍背硬脑膜、乳头体、基底动脉末端、小脑上动脉、大脑后动脉、后交通动脉、动眼神经、滑车神经、三叉神经、面神经、前庭蜗神经及脑桥腹侧。 结论 内镜经眉弓上锁孔入路切除颅底中线区域肿瘤在解剖学上可行,临床上可作为常规显微镜手术及经鼻内镜入路手术的有效补充。     

神经内镜扩大经鼻入路中的几个重要解剖标志及其临床意义

目的　观察扩大经鼻手术入路中的几个重要解剖标志,为经鼻颅底外科手术入路方案的制定提供形态学依据。 方法　对10 例尸头标本进行扩大经鼻入路神经内镜解剖, 操作方法为双鼻孔入路,颅底开放范围包括后组筛窦、蝶窦及中上斜坡,外侧完整暴露两侧颈内动脉海绵窦\斜坡段。 结果　确认了筛前、筛后动脉的正常解剖位置,探明了视神经-颈内动脉隐窝(OCR)的解剖构成,内镜下观察重新对海绵窦进行解剖分区,并从经鼻内镜视角对展神经进行解剖分段。 结论　熟悉上述经鼻入路重要解剖标记,对于提高该手术入路的有效性及安全性具有重要意义。     

扩大颅中窝硬脑膜外经颞骨岩部入路至岩斜区的应用解剖

目的：研究中窝硬膜脑膜外经颞骨岩部入路进行岩斜区直接手术的手术方法，并提供相应的解剖依据。方法：用15例成人尸体头部标本模型颅中窝硬脑膜外经颞骨岩部入路进入岩斜区及其邻近结构的显露和解剖。结果：（1）岩大神经是磨除颞骨岩部十分重要的标志，通过它可以定位岩部颈内动脉、耳蜗和膝状神经节；（2）颅中窝硬脑膜外经颞骨岩部入路可以充分暴露从鞍背到桥延沟的岩斜区。结论：（1）以岩大神经为标志磨除颞骨岩部为安全手术提供了保证；（2）此入路具有暴露好，神经血管损伤的特点，特别适用于骑跨中，后窝的岩斜区病变。     

经口咽入路切除巨大斜坡肿瘤一例报告

目的：探讨斜坡肿瘤的临床特点和手术治疗,以提高治疗效果。方法：对甘肃省人民医院神经外科经口咽入路切除巨大斜坡肿瘤1例病例的临床及手术资料进行回顾性分析。结果：本例患者主因吞咽困难、声音嘶哑2年,加重伴左颈肩部疼痛2个月入院,影像学检查提示中下斜坡巨大占位性病变,向后压迫桥脑和延髓,向前推挤咽后壁软组织,鼻咽腔变窄,颅底斜坡、左侧颞骨和寰椎左侧骨质破坏。在耳鼻喉科、口腔颌面外科医生的协助下为患者施行了经口咽入路斜坡肿瘤切除术。术后患者临床症状明显缓解。病理检查提示为脊索瘤。结论：手术入路的选择、多学科协作、熟练的手术技巧是手术成功的重要因素。     

斜坡区断层与显微解剖学研究

目的 :探讨斜坡区各结构的形态及相互间的毗邻关系 ,为斜坡区相关的手术入路提供解剖基础。方法 :①使用大脑切片机 ,对 4个尸头标本切制 0 .5～ 1 .0mm显微断层切片 ,对斜坡区及周围结构进行观测 ;②对 30个颅底斜坡区进行显微解剖观测。结果 :斜坡区与脑桥、延髓腹侧及第Ⅴ～Ⅻ对脑神经关系密切 ,两侧毗邻破裂孔、颈内动脉、内耳门及颈静脉孔。斜坡长 40 .5mm ,可分为上、中、下斜坡三部。两破裂孔、两颈内动脉、两内耳门、两颈静脉孔间最小间距分别为 2 0 .2、1 4 .0、30 .5和 2 3 .3mm。结论 :了解斜破区各结构的形态及相互间的毗邻关系 ,可提高该区相关手术时的安全度和成功率     

经颞骨岩部乙状窦前入路处理岩斜区病变的应用解剖

目的 :研究经颞骨岩部乙状窦前入路进行岩斜区直接手术的方法 ,寻找出该入路的标志点和颞骨岩部的磨除方法 ,并观察手术的暴露范围和优缺点。方法 :用 15例血管经彩色乳胶灌注的成人尸头标本 ,显微镜下 (× 6～ 2 5 )解剖经颞骨岩部乙状窦前入路。结果 :岩乙状窦交叉点、内淋巴囊裂是磨除颞骨岩部后面的重要标志 ,用内淋巴囊裂可以初步定位前庭小管、总脚和后半规管。此入路能够暴露从鞍背到延髓中上部的区域 ,以暴露中岩斜区最佳。离断内淋巴囊 ,可扩大骨磨除的面积 ,增加手术的暴露。结论 :以岩乙状窦交叉点、内淋巴囊裂为标志为安全磨除颞骨岩部后面提供了保证。经颞骨岩部乙状窦前入路具有手术距离短、视野暴露充分的特点 ,特别适用于骑跨颅中、后窝而以颅后窝为主的岩斜区病变     

改良扩大前颅底入路的解剖及临床应用

目的　探讨改良扩大前颅底入路的显微解剖和临床应用效果。 方法　选用福尔马林固定的成人尸头标本15例，颅骨标本20例进行解剖学观察，并对13例应用该入路切除的颅底中线区肿瘤进行临床分析。 结果　与标准前颅底入路相比改良扩大前颅底入路的暴露范围明显扩大。通过将鼻骨与眶板一起截除，可保留足够长度的鼻中隔粘膜。术式的暴露范围主要受限于双侧的视神经、颈内动脉、翼管、舌下神经管等结构。本组13例中，9例全切除；1例近全切除；3例大部切除。术后发生并发症5例。无手术死亡。 结论　改良扩大前颅底入路具有暴露充分、脑损伤小、可有效保护嗅觉等优点。该入路是切除颅底中线部位侵犯眶、鼻、筛、蝶和斜坡肿瘤的较佳入路。     

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 -     

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.     

Characteristics of the topographic interrelation of the head of the pancreas and the duodenum and pathology of the organs of the pancreatoduodenal area

Seventy pancreatoduodenal complexes of 55 patients with chronic pancreatitis and tumours of this zone and 15 patients died from other diseases are studies histotopographically . The pieces of the pancreatic head tissue in the medial wall of the duodenum were found in 12 cases of the first group and in 4 control cases. The pancreatic tissue consisted either of all elements of this organ or cystically dilated ducts and seemed to infiltrate different layers of the duodenum wall. Three variants of the pancreatic head structure are suggested on the basis of anatomo-topographical interrelationships of the pancreatic head and duodenum. In 12 out of 14 cases chronic pancreatitis and carcinoma of organs of this zone were combined with the variants of the pancreatic head structure, in 2 cases there was a true heterotopy . Pathogenetic significance of these variants for the development of chronic pancreatitis is discussed.     

Influence of the level of the transmembrane potential on the dynamics of the extinction of the amplitude of the synaptic reactions of the snail under voltage clamping conditions

The influence of the level of the transmembrane potential on the dynamics of the extinction of the amplitudes of summary excitatory postsynaptic currents arising in identified giant parietal neurons in response to rhythmic stimulation of the intestinal nerve was investigated in a preparation of the isolated CNS of the common snail in order to identify the possibility of the participation of the postsynaptic element in synaptic plasticity. It was demonstrated that, at a greater value of the transmembrane potential, the decrease in the amplitudes of the postsynaptic currents which have been induced by rhythmic stimulation takes place more rapidly. It was also demonstrated that at a higher frequency of stimulation of the nerve, the effect of the influence of the membrane potential level on the dynamics of the synaptic reactions is more prominent. The data obtained may be regarded as an argument in favor of the possibility of the participation of the post-synapse in plasticity. This study was partially supported by the Russian Basic Research Fund (project No. 94-04-12209). Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow. Translated from Zhurnal Vysshei Nervnoi Deyatel'nosti imeni I. P. Pavlova, Vol. 45, No. 1, pp. 171–179, January–February, 1995.     

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.     

Effect of the conditions of adaptation of the optic analyzer to the function of the thermoreceptors of the human skin

Summary A discussion is presented of the effect produced by light stimulation applied to the optic analyzer alone on the function of the temperature analyzer. The cutaneous-temperature analyzer was kept on constant illumination and temperature. The light effects from the retinal photoreceptors on the cutaneous thermoceptor system led to reflex changes of the functional rate of the latter. Conditions of the optic analyzer of light adaptation caused reflex adjustment of cold receptors as to heating. Dark adaptation of the eyes changed the functional state of the cold receptors, corresponding to their adjustment to low temperatures.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 57, No. 3, pp. 3–6, March, 1964