Release of endogenous catecholamines in two different regions of the nucleus of the solitary tract as influenced by carotid occlusion

Summary The effects of carotid occlusion on the release of catecholamines in the nucleus of the solitary tract (NTS) were investigated in anaesthetized cats. Two aspects of the nucleus (rostral or intermediate NTS) were superfused bilaterally through push-pull cannulae with artificial CSF and the release of the endogenous dopamine, noradrenaline and adrenaline was determined in the superfusate radioenzymatically. The superfusion rate was 150 l/min or 800 l/min. In some experiments, superfusion of the intermediate NTS was carried out after denervation of the aortic arch.In the rostral NTS superfused at a rate of 150 l/min, bilateral carotid occlusion led to a rise in blood pressure and decreased the release rate of dopamine. These changes continued after occlusion termination. The release rate of noradrenaline was transiently diminished during occlusion. The release of this amine was also decreased after occlusion termination. The release rate of adrenaline was not influenced during carotid occlusion, but it was found to be diminished after termination of the occlusion. Superfusion of the rostral NTS at a rate of 800 l/min also reduced the release rate of adrenaline after termination of carotid artery occlusion. In the intermediate NTS (superfusion rate 150 l/min) similar effects of the carotid occlusion on the release rates of dopamine and noradrenaline were observed. In this aspect of the NTS, denervation of the aortic arch abolished the decrease in the noradrenaline release during carotic occlusion, while the release rates of dopamine and adrenaline were decreased during and after termination of the carotid occlusion.The results suggest that (a) the rise in blood pressure in the carotid sinus after termination of a carotid occlusion decreases the release rates of noradrenaline and adrenaline in the NTS, (b) the decrease in the release of noradrenaline during carotid occlusion is due to impulses originating from the baroreceptors of the aortic arch.Thus, impulses from carotid sinus and aortic arch modify the release rates of noradrenaline in the NTS so as to counteract blood pressure changes.Supported by the Fonds zur Förderung der wissenschaftlichen Forschung Send offprint requests to A. Philippu at the above address     

Multiple intracranial aneurysms: A high risk condition

Summary There is still a relative silence in the literature on what policy should be followed in treating multiple aneurysms. The main risks are: bleeding of a formerly asymptomatic aneurysm during the haemodynamic tides of the peri-operative period; aneurysm(s) can be hidden on angiograms and tend to be overlooked easier in case of an already revealed aneursym; misjudgement of the ruptured one as a silent additional aneurysm, therefore left for second stage surgery.This paper, based on a material of 330 operations for multiple aneurysms, focuses on these problems. It advocates the one stage complete repair of all lesions using both options of bilateral pterional craniotomies or the contralateral approach. But it also describes those silent aneurysms which safely could be clipped later. Hazards and disadvantages concerning the more aggressive surgery proved to be less significant than the natural history of multiple aneurysms represents.Presented at the EANS Wintermeeting on High Risk Neurosurgery, Budapest, February 20–23, 1991.     

浅谈药用植物良种选育的目标和常规途径

针对传统药用植物的品质退化进行品质改良，选育优良品种，是优化中草药品质的根本途径。优质、高产、稳产、熟期适应、抗性强、适应性相对较广是各种药用植物育种的共同目标，但不同药用植物品种的侧重点和具体内容各有变化。在药用植物的良种选育工作中，确定育种目标是基础。通常用以下途径进行良种繁育：1．种质资源调查和收集；2．引种驯化；3．良种选育；4．建立良种繁育基地。     

颈静脉球解剖变异对经内镜行岩斜坡区病变手术的影响

目的 了解颈静脉球的解剖变异对颞骨径路在内镜下行桥小脑角区病变手术的影响。方法 在20例40侧成人尸头上模拟颞骨径路内镜手术,测量相关数据。结果 颈静脉球高度为左侧(7.39±2.11)mm,右侧(9.05±3.10)mm;宽度为左侧(6.28±1.25)mm,右侧(6.34±0.79)mm;颈静脉球顶距鼓室天盖、后半规管上、下缘、上半规管顶点、内淋巴囊上缘、面神经锥段中点、内听道下缘之间距离分别为:(16.05±3.34)mm、(8.73±3.11)mm、(3.13±1.83)mm、(14.63±3.33)mm、(5.01±2.88)mm、(3.70±3.36)mm、(5.03±3.19)mm。结论 高位颈静脉球对内镜手术有一定影响,但相对非内镜手术而言要小,高位颈静脉球的定义依不同的术式而不同。     

颞下经岩尖-小脑幕入路手术的显微解剖研究

目的 为颞下经岩骨入路手术处理斜坡及脑干腹侧病灶提供解剖学资料。方法 模拟颞下经岩尖—小脑幕入路的手术操作,在手术显微镜下对20侧(10具)福尔马林固定的国人成年带颈头颅标本进行解剖,并观测各主要解剖结构的相互关系。结果 颞下硬脑膜外经前内侧的三叉神经压迹、外侧的岩浅大神经沟及岩上窦所形成的三角区磨削岩骨尖。其周围结构的测量结果为:上半规管垂直于岩骨嵴,位于弓状隆起下方,耳蜗位于内听道前方、岩骨颈内动脉膝后方,内听道位于上半规管与岩浅大神经夹角中央。20侧中有2侧面神经膝裸露,耳蜗至膝状神经节的距离约为3.30 mm±0.79 mm,耳蜗距颈内动脉膝约2.48 mm±1.14 mm,内听道距岩斜缝约16.03 mm±1.94 mm,颈内动脉水平段距岩上窦约10.73 mm±2.00 mm。结论 颞下经岩尖—小脑幕入路能增加岩斜坡及脑干腹侧的显露,但显露范围有限,且需一定程度的颞叶牵拉。同时可能因为不熟悉解剖而误伤耳蜗、颈内动脉及第Ⅶ脑神经、第Ⅷ脑神经,选择应用时应审慎考虑。     

经迷路进路听神经瘤术后脑脊液漏的预防及处理

目的　探讨经迷路进路听神经瘤切除术后脑脊液漏发生的影响因素及处理方法。方法1999年以来采用迷路进路或扩大迷路进路听神经瘤切除术 85例 ,前 4 1例采用传统关闭术腔技术 ,后4 4例对关闭技术进行改良 ,分析其脑脊液漏的发生率。发生脑脊液漏者行保守或手术治疗。结果传统关闭技术组中脑脊液漏的发生率为 19 5 % ( 8 4 1) ,改良关闭技术组中脑脊液漏的发生率为 2 3%( 1 4 4 ) ,两组差异有显著性意义 (P =0 0 13)。传统关闭技术组中脑脊液漏多数发生在大型听神经瘤中 ,其发生率随肿瘤增大有上升的趋势。 9例脑脊液漏的患者中 ,3例经保守治疗 ;6例经手术修补成功 ,其中 5例 1次修补成功。结论　改良关闭术腔技术可显著降低经迷路进路听神经瘤切除术后脑脊液漏的发生率 ,手术修补为终止脑脊液漏的有效措施     

GM(1,1)灰色模型在尘肺患病人数预测的应用与评价

目的 探讨验证灰色模型在尘肺患病人数预测的应用效果。方法 利用该煤矿1996～1986年尘肺患病人数进行建模，并建立了数学模型X(I)=583e^0.038(T-II)-452，作外推预测验证。结果 该灰色预测模型的拟合程度较高，取得了较好的效果。结论 灰色模型可应用于尘肺患病人数的预测。     

经口咽入路显微手术治疗颅颈区畸形

目的 总结经口咽入路颅颈区畸形的显微手术治疗体会。方法 回顾30例颅颈区畸形病例的临床表现、术前准备、手术方法、术后效果及并发症，并结合文献进行分析。结果 本组30例颅颈区畸形，经行口咽入路显微手术后，随访3个月～4年，痊愈21例(70％)，好转6例(20％)。结论 采用经口咽入路显微外科手术是治疗颅颈区畸形的有效手段，术中良好的显露及镜下细心操作是降低并发症的关键。     

GLOMUS TUMORS──A REVIEW OF 8 CASES WITH INTRODUCTION OF A MODIFIED COMBINED INTRA-AND EXTRACRANIAL APPROACH

Eight cases of glomus tumors hospitalized in our department from 1982 through 1995 were reviewed. It comprised of five glomus tympanic tumors and three glomus jugular tumors. Discussion was centered on it’s contemporary diagnosis, classification and surgical treatment with introduction of a modified combined intra-and extracranial surgical approach to resect the extensive glomus tumors.     

咽旁间隙肿瘤及手术入路

为探讨咽旁间隙肿瘤的手术方法及入路的选择。报告６６例经各种手术入路治疗的良、恶性肿瘤。结果表明，经颈或经颈合并下颌及正中裂开外旋入路较之其他几种手术入路具有手术适应证广、安全、术后并发症少等优点。认为经颈或经颈合并下颌正中裂开外旋入路是一种安全、彻底切除咽旁间隙原发肿瘤效果最好的入路。