Localization of motoneurons innervating the extraocular muscles in Salamandra salamandra L. (Amphibia, Urodela)

The central innervation patterns of the extraocular muscles were investigated in the European fire salamander Salamandra salamandra L. by means of the horseradish peroxidase method. The ipsilateral portion of the nucleus nervi oculomotorii, which is located in the rostral ventral tegmentum mesencephali, supplies the musculi recti inferior and medialis and the musculus obliquus inferior without a clear somatotopic representation of the motoneurons. The musculus rectus superior is innervated mainly by a contralateral portion of this nucleus. A definite nucleus Edinger-Westphal could not be recognized. The nucleus nervi trochlearis, which rostrally joins the nucleus nervi oculomotorii with a gap of only about 40 micron between the nuclei, is situated completely contralateral to the musculus obliquus superior supplied by it. The nucleus nervi abducentis, innervating the musculus rectus lateralis, and the nucleus accessorius nervi abducentis, supplying the musculus retractor bulbi, are found in the ipsilateral medulla oblongata and exhibit a large rostrocaudal extension from the eighth cranial nerve to the first root of the vagus nerve. Dendrites of the nucleus nervi oculumotorii and of the nucleus accessorius nervi abducentis extend into neuropil areas receiving primary sensory afferents.     

回顾性分析不同方法治疗甲状腺相关性眼病眼压的变化

目的:比较甲基强的松龙静脉冲击治疗及眼外肌手术治疗甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)前后眼压(intraocular pressure,IOP)的变化.方法:回顾性分析收集2008-01/2010-12于我院眼科就诊的26例42眼TAO患者,患者行甲基强的松龙静脉冲击治疗或眼外肌手术,比较术前、术后第一眼位及上视时的眼压变化.结果:患者16例32眼采用甲强龙冲击治疗,治疗前平均眼压第一眼位时为21.13±4.10mmHg,向上注视时为23 75±5.67mmHg,治疗后分别为16.81±3.69mmHg(P＜0.05),18.50±4.03mmHg(P＜0.05);10例10眼采用眼外肌斜视手术,术前平均眼压第一眼位时为18.40±2 49mmHg,上视时为24.70±3.63mmHg,术后分别为17 30±1.55mmHg(P＞0.05),18.60±2.20mmHg(P＜0 01);术前眼压≥21mmHg的TAO患者眼压下降明显(P＜0.05).结论:两组患者用不同的方法治疗后眼压显著下降,但是眼外肌斜视手术前后眼压在第一眼位时的变化没有统计学差别.     

共同性外斜视弱侧眼外肌的病理改变及TGF-β1的表达

目的：通过研究共同性外斜视弱侧肌的病理改变及转化生长因子（TGF-β1）的表达,探讨共同性外斜视的发病机制。方法：收集共同性外斜视患者弱侧肌（作用力与眼位偏斜方向相反的眼外肌）30例,分成3组,每组10例,正常人眼外肌6例,分别行光镜和Masson三色胶原染色,采用免疫组化方法对弱侧眼外肌中TGF-β1定量研究。结果：共同性外斜视弱侧肌不同程度地显示肌组织萎缩,肌纤维体积减小、数量减少,纤维化、玻璃样变及肌纤维变性,正常人眼外肌和共同性外斜视患者弱侧眼外肌中均有TGF-β1阳性表达,先天性外斜视组、恒定性外斜视组的TGF-β1的表达高于对照组,其差异具有显著性意义。结论：共同性外斜视眼外肌发生病理改变的过程中,TGF-β1起到了促进作用。     

观察20MHz高频B型超声在眼外肌的应用

了解眼外肌在20MHz高频超声中的声像图特点,明确20MHz超声在眼外肌疾病中的适用范围及应用价值。 方法：自2011-01/12分别利用10MHz及20MHz高频超声对眼外肌进行对比观察,归纳总结正常人群眼外肌20MHz B型超声的声像图特点及其厚度,以及在不同眼外肌疾病中的表现。 结果：20MHz高频超声在正常人群及斜视患者中可以清晰地显示眼外肌的形态特点,正常人群双眼对称眼外肌厚度无明显差别。与10MHz超声相比,其测量值明显增大,两者差异有统计学意义。而在其他眼外肌疾病中表现各不相同。 结论：20MHz高频B型超声适合正常人群及斜视患者的眼外肌观察,其显示效果明显优于10MHz超声,而在眼外肌厚度增加类型的眼外肌疾病中的应用存在一定的限制。     

分离性垂直斜视手术治疗的临床观察

探讨分离性垂直斜视有效的手术治疗方法。 方法:回顾性分析38例61眼分离性垂直斜视患者行上直肌大量后徙,合并下斜肌亢进者同时行下斜肌后徙转位术的临床资料。观察术后效果。 结果:术后满意46眼,满意率75%,术后改善14眼,改善率23%,无效1眼。 结论:上直肌大量后徙术和下斜肌后徙转位术是治疗分离性垂直斜视的有效方法。合并有下斜肌亢进者,首选下斜肌后徙转位术,无下斜肌亢进者,首选上直肌后徙术。     

眼表微创法注射A型肉毒毒素治疗斜视

目的探讨手术显微镜下微创法经球结膜行眼外肌A型肉毒毒素(botulinum toxinA,BTXA)注射,治疗不同种类斜视的可行性和安全性。方法选取2010年5月至2011年4月来我院接受BTXA治疗的18例(18眼)斜视患者,在手术显微镜下于所需注射眼外肌附着处旁切开结膜约2mm,分离并清晰暴露巩膜和肌肉止端,用斜视钩将眼外肌肉轻轻提起,注射针头走向与肌肉呈15°夹角,在显微镜直视下将BTXA注入肌肉或肌鞘内。治疗后1周和6周时随访,观察眼位、眼球运动、代偿头位、复视症状改善程度以及并发症等。结果治疗前、治疗后1周及6周时的平均斜视度数分别为22.9△、6.9△、7.7△;随访中仅1例较治疗前无改善;治疗前分别与治疗后1周及6周的斜视度数进行比较,差异均有统计学意义(均为P<0.05);治疗后1周及6周间差异无统计学意义(P>0.05)。两次复诊的斜视度数以及正位率之间差异无统计学意义(均为P>0.05)。治疗前有明显眼球运动障碍者12例经BTXA注射后均得到改善;伴复视者12例中11例经治疗正前方及前下方复视消失,1例有所改善;伴代偿头位者3例,均得到改善。2例出现上睑下垂,2例出现垂直斜视。结论手术显微镜下经球结膜微小切口对眼外肌进行BTXA注射治疗斜视,近期效果理想,安全性高,且并发症少。     

先天性眼外肌纤维化ARIX基因多态性研究

目的 分析两个先天性眼外肌纤维化(congenital fibrosis of the extrapcular muscles,CFEOM)家系的临床表型,探讨家系ARIX基因多态性及其意义.方法 对两个CFEOM家系中所有成员共13人进行详细的临床检查,确定患者和正常人.提取DNA,进行PCR扩增,扩增产物进行纯化、DNA测序鉴定,测序结果与GenBank中人ARlX基因序列进行同源性比较.结果 两个家系的遗传方式均是常染色体隐性遗传,两个家系中共8例患者均表现为典型的CFEOM特征.家系I中3例患者均在ARIX基因外显子1出现同义突变156C＞T,在外显子2出现116G＞A,也为同义突变;家系Ⅱ中5例患者在ARIX基因外显子2发生两处突变,即21G＞A和116G＞A,其中116G＞A为同义突变;两家系中正常人均无上述改变.结论 此两家系均属于CFEOM2型,ARIX基因突变可能是导致该两家系致病的分子基础.     

Antigenic difference of acetylcholine receptor between single and multiple form endplates of human extraocular muscle

The acetylcholine receptor (AChR) of human extraocular muscle (EOM) has been studied by the immunological method using anti-AChR antibodies obtained from the sera of patients with myasthenia gravis (MG) of ocular type, whose symptoms have been restricted to EOM. Those antibodies could distinguish the AChR of multiple (en grappe) form endplates from that of single (en plaque) form endplates. This result indicates the antigenic difference of AChR between those two forms of endplates of human EOM.     

Transsphenoidal surgery of parasellar pituitary adenomas

Summary A series of 147 transsphenoidal operations for parasellar pituitary adenomas performed in a 4.5 year period is presented. The clinical and radiological features of the tumours are described and a new practical classification for the neurosurgeon is introduced. The results of surgery are analyzed with special attention to normalization rates in endocrinologically active adenomas and to the recovery rate of optomotoric nerve lesions in 10 of these cases. While in intraand parasellar microadenomas the surgical normalization rates are comparable to those not extending beyond the confines of the sella, correction of hormonal oversecretion is only exceptionally observed in invasive parasellar macroadenomas. The prognosis for extraocular nerve palsies was found to be favourable, irrespective of the duration of the palsies before surgical intervention. It is to be stressed that even adenomas invading the cavernous sinus can be totally removed via the transsphenoidal approach.     

Localization of motoneurons controlling the extraocular muscles of the rat

The localization of extraocular motoneurons in the rat was investigated by injecting horseradish peroxidase and [¹²⁵I]wheat germ agglutinin¹⁷ as retrogade tracer substances into individual eye muscles. The organization of subnuclei was found to be most similar to the rabbit. The subgroups representing the medial rectus and inferior rectus muscles are located in the rostral two thirds of the ipsilateral oculomotor nucleus (nIII) with some medial rectus motoneurons scattered laterally along the edge of the medial longitudinal fasciculus. The motor pool controlling the inferior oblique muscle is located in the middle third of the ipsilateral nIII. The motoneurons of the superior rectus muscles are in the caudal two-thirds of contralateral nIII while the levator palpebrae muscle has a bilateral innervation in the oculomotor nucleus. The motoneurons of the superior oblique are located in the contralateral trochlear nucleus although a few labeled neurons were scattered laterally in amongst the fibers of the medial longitudinal fasciculus. The cell bodies of lateral rectus motoneurons regional separation between the latter and internuclear neurons was found after injecting HRP into the oculomotor nucleus.