鞍区蛛网膜的显微外科解剖学研究

目的：了解鞍区蛛网膜的解剖学特点，为鞍区病变的显微手术提供解剖学依据。方法：采用显微外科技术解剖和观察8例脑标本鞍区蛛网膜。结果：鞍区蛛网膜包括颈内动脉内侧蛛网膜、颈内动脉外侧蛛网膜、后交通蛛网膜、脉络膜前蛛网膜、大脑前蛛网膜、视交叉蛛网膜、Liliequist膜、外侧裂蛛网膜、嗅神经蛛网膜、基底动脉分叉蛛网膜、后穿蛛网膜和动眼神经外侧蛛网膜，分割鞍区蛛网膜下腔，与下丘脑和动眼神经关系密切。结论：（1）颅内蛛网膜分为颅底蛛网膜、凸面蛛网膜和小梁蛛网膜；（2）鞍区蛛网膜与下丘脑关系密切，手术时强调锐性分离；（3）鞍区蛛网膜汇聚于动眼神经，为术中解剖和保护动眼神经提供了可靠的界面。     

松果体区脑池和蛛网膜的显微解剖研究

目的　系统研究松果体区脑池及其蛛网膜结构的显微解剖学特点,为手术入路及手术操作提供解剖学依据。 方法　在手术显微镜下观察20例尸头松果体区各个脑池的形态、边界、内容物及相关蛛网膜结构。 结果 松果体区的蛛网膜结构包括蛛网膜袖套、环中脑后膜和小脑前中央膜,其中蛛网膜袖套由枕叶底、内侧面及小脑上表面蛛网膜在幕尖处汇合而成,包裹Galen静脉系统、松果体及松果体上隐窝;环中脑后膜由枕叶底面及小脑上表面蛛网膜在幕切迹处汇合形成,环绕并附着于中脑背侧;小脑前中央膜由小脑上表面蛛网膜和蛛网膜袖套汇合处发出,前下方附着于下丘。四叠体池与小脑上池通过小脑前中央膜分隔,与后胼周池通过蛛网膜袖套分隔,与环池后部通过环中脑后膜的升段分隔,环池后部与小脑中脑裂池通过环中脑后膜的水平段分隔。 结论　重新划分了松果体区各个脑池的范围与交通情况,明确了蛛网膜的形态与分布。     

Jaw-opening reflex after CO2 laser stimulation of the perioral region in man

CO₂ laser pulses selectively excite A-δ and C mechano-thermal nociceptors in the superficial layers of the skin. To study the jaw-opening reflex elicited by a purely nociceptive input, we delivered laser pulses to the perioral region in 15 subjects. Sensory threshold was very low (9 mJ/mm²). High-intensity noxious laser pulses (more than 4 × sensory threshold) evoked a single phase of electromyogram suppression (laser silent period, LSP) at an onset latency of 70 ms in the contracted masseter and temporal muscles, bilaterally. Even maximum-intensity laser pulses failed to activate the suprahyoid muscles. The recovery curves to paired laser stimuli showed that at short interstimulus intervals the test LSP was strongly suppressed. At about 380 ms it recovered to 50%, i.e. its recovery curve resembled that of the masseter late silent period after electrical mental nerve stimulation (SP2). In experiments studying the interaction with heterotopic stimuli and non-nociceptive responses, chin-taps or electrical shocks delivered to the supraorbital, infraorbital or mental nerves before laser stimulation strongly suppressed the LSP. A preceding perioral laser pulse strongly suppressed the masseter SP evoked by supraorbital stimulation and the SP2 evoked by mental stimulation, but left SP1 unaffected. We conclude that the perioral A-δ fibre input elicits a jaw-opening reflex simply by inhibiting the jaw-closers. The LSP response is mediated by a multisynaptic chain of brainstem interneurons and shares with the masseter SP2 part of the central circuit in the ponto-medullary region. We also propose that a common centre processes the various inputs for jaw opening. Received: 18 July 1997 / Accepted: 20 October 1997     

CT appearances of Marjolin's ulcer in the left gluteal region of a young man

Chronic wounds and scar tissues are prone to skin cancer. In 1828, Jean-Nicholas Marjolin described the occurrence of tumours in post-traumatic scar tissue. He did not, however, identify the warty ulcers he described as malignant. It was Dupuytren, who about two years later, noted that these lesions were cancerous. The eponym was bestowed by Da Costa in 1903. Marjolin's ulcer no longer refers only to carcinomas secondary to burns and is classified as a malignancy that arises from previously traumatised, chronically inflamed, or scarred skin. It has been reported in relation to osteomyelitis, venous stasis ulcer, tropical ulcers, chronic decubitus ulcer, frostbite, pilonidal sinus, vaccination site, urinary fistula, hidradenitis suppurativa, skin graft donor site, gunshot wounds, puncture wounds, dog bites, and lupus rash. Early arising Marjolin's ulcer has rarely been described in literature. In this case report, we present the CT appearances of Marjolin's ulcer in the left gluteal region of a young man.     

Homozygosity in the major histocompatibility complex region influences natural killer cell activity in man

The effect of homozygosity at HLA loci on natural killer (NK) cell activity has been examined. Lymphocytes obtained from heterozygous and homozygous individuals were incubated with 51Cr-labeled, NK-sensitive K562 cells at different effector/target ratios, and lytic activity was determined. Homozygous cells, obtained from individuals who are known HLA homozygotes (homozygous typing cells) and from selected families, had low NK activity compared to those heterozygous donors. This low cytotoxic activity had no correlation with sex, but did correlate with homozygosity at the HLA-A, B and/or DR loci. A significantly lower number of cells, which bind to anti-Leu 7 antibody, was found in homozygous donors. However, this reduced number of Leu 7+ cells could only partially account for the decrease in NK activity. These studies suggest that in some individuals homozygosity at HLA may be linked to genes that control NK activity.     

乳糜池位置变异1例

乳糜池为胸导管的起始部位,正常情况下位于第11胸椎至第2腰椎之间,由左、右腰干和肠干汇合而成.据统计,乳糜池显示率为71％,均位于腹膜后隙内,长高体型人的乳糜池不明显,经常缺如;低矮体型人的乳糜池位置较低,多见于右膈脚腰部[1],但乳糜池在胸腔内的高位变导尚未见报道.     

Detection of cytokeratin in cells of the arachnoid and in meningiomas

Only few investigations have so far become known in the context of cytokeratin expression in cells of the arachnoid and in meningioma. Immunohistochemical studies, using three monoclonal anti-cytokeratin antibodies, were conducted into six arachnoids and 43 meningiomas. Consideration was given to all histological types of meningioma but the papillary type. Three arachnoids and nine meningiomas responded positively to cytokeratin. The highest ratio of positive meningiomas, that is four in ten, was recorded from unfixed cryostat sections, using the monoclonal antibody A45-B/B3.     

蛛网膜颗粒的研究进展

目的 总结蛛网膜颗粒(AG)的相关研究进展,为临床更好地开展AG的研究提供理论依据。方法 以“蛛网膜颗粒”“蛛网膜绒毛”“颅内高压”“脑静脉窦血栓”和“arachnoid granulation”“arachnoid villi”“intracranial hypertension”“cerebral venous sinus thrombosis”等为关键词分别在中国知网、万方数据库和PubMed等数据库检索1960年1月—2018年9月关于AG或蛛网膜绒毛的文献,并对AG的组织学特点、解剖形态、影像学研究及其在相关脑血管疾病发生中的作用等方面的研究成果进行归纳分析。结果 AG是蛛网膜绒毛增大形成的肉眼可见的正常解剖结构,两者的组成部分和功能相似。AG最常出现在上矢状窦,其次是横窦。巨大AG(＞10 mm)可引起静脉窦堵塞、颅内高压、甚至颅骨的外压型改变等。脑静脉血管造影是观察AG的优选方法,可结合CT、MRI等与相关性脑血管疾病鉴别诊断。结论 熟练掌握AG的组织解剖结构及影像学表现是研究临床病理状态下AG变化的重要基础。     

Structures in sensory region of snake spindles and their displacment during stretch.

1. Structures within the sensory region of short- and long-capsule snake muscle spindles have been visualized using differential interference contrast microscopy. Profiles seen with Nomarski microscopy have been identified by electron microscopy of the same preparations. 2. Sensory nerve terminals, nuclei and other cytoplasmic inclusions in the intrafusal fiber, collagen bands, and capsular cells may be seen in the living preparation. 3. The length changes of various elements within the sensory region in response to stretch of the spindle have been measured using high-speed ciné photomicrography. This has been corrleated with the impulse response from sensory endings in short-and long-capsule spindles. 4. Short-capsule spindles, which have a high dynamic sensitivity, show length changes in the sensory region in response to ramp-and-hold stretch, which are not parallel to the changes in impulse frequency. The implications for mechanical models of spindle behavior are discussed.     

Structures of the preantennal region of several species of Damalinia (Phthiraptera: Trichodectidae).

A comparative study was made of the structures of the preantennal region of nine species of Damalinia Mj?berg, 1910 (Phthiraptera: Trichodectidae). Variability in the form of the head, ventral carina, pulvinus, mandibles, and labrum was observed by light and scanning electron microscopy. According to previous studies, the form of the head is possibly influenced by the density and texture of the hair of the host. The ventral carina, which maybe sharp or blunt, and the pulvinus, a membranous lobe, of these parasite species of different hosts, were studied. Photographs of the mandibles and labrum show a high variability according to species.     

Spinal extradural arachnoid cysts in lymphedema-distichiasis syndrome

PurposeLymphedema-distichiasis syndrome is characterized by the presence of lower limb lymphedema and supernumerary eyelashes arising from the Meibomian glands. Spinal extradural arachnoid cysts have been observed in some families but their true frequency is unknown. The aim of this study is to determine the frequency of spinal extradural arachnoid cysts in lymphedema distichiasis syndrome.MethodsWe collected clinical information from all 45 living members of a complete family of 48 members and performed molecular analysis of the FOXC2 gene in 30 individuals. We obtained spinal magnetic resonance imaging from all family members with a FOXC2 gene mutation.ResultsTwelve family members carried a mutation in the FOXC2 gene and had clinical features of lymphedema-distichiasis syndrome. Of these, 58% (seven individuals) had extradural arachnoid cysts.DiscussionWe suggest that a follow-up protocol for lymphedema-distichiasis syndrome families should include spinal magnetic resonance imaging for all affected members so that the timing of surgery for removal of these cysts can be optimized.