The hippocampus and neurotransplantation

The present article is a review of our own results from histological and electron microscopic studies of hippocampal neurotransplants with different levels of integration with recipient brains. A model providing complete isolation from the brain was obtained using transplants developing in the anterior chamber of the eye. The growth, development, and cytological composition of transplanted tissue was found to depend on factors such as the age of the donor embryo tissue, the genetic compatibility between the donor and recipient, and the level of integration with the brain. Ultrastructural analysis of intraocular and intracortical transplants showed that overall, nerve and glial cells have the characteristics of highly differentiated, mature elements; the numerical density and structures of synaptic contacts were similar to those in normal conditions. However, transplanted tissues contained morphological features providing evidence of continuing growth of several nerve processes and increases in non-synaptic and transport-metabolic intercellular interactions. The ultrastructural deviations observed here are regarded as the manifestations of compensatory-adaptive changes during the development of tissues in conditions deficient in natural afferent synaptic influences. It is also demonstrated that the axons of transplanted neurons lacking adequate cellular targets can establish functional synaptic contacts with neuronal elements in the recipient brain which are not their normal targets.Translated from Zhurnal Vysshei Nervnoi Deyatelnosti, Vol. 54, No. 2, pp. 149–162, March–April, 2004.     

前路椎体次全切在治疗颈椎后纵韧带骨化中的应用

目的：探讨颈前路椎体次全切治疗颈椎后纵韧带骨化的手术减压范围。方法：采用前路椎体次全切植骨融合术治疗颈椎后纵韧带骨化56例，其中完全切除骨化者47例，用“漂浮法”处理者9例，并针对不同个体及病变特点采用不同的减压范围。结果：54例获得3个月-6a随访，平均28个月。植骨均于术后3-5个月内获得骨性融合。JOA评分由术前8．5分提高到术后14．1，平均改善率74％，优良率80．2％。结论：行椎体次全切术治疗颈椎后纵韧带骨化时应针对不同个体及病变特点采用不同的足够的减压范围，可以减少并发症，并获得较佳的疗效。     

The distribution of clinical findings in Bechterew's syndrome (ankylosing spondylitis) suggests distinct genetic subgroups

One hundred and twenty-two consecutive patients hospitalized for ankylosing spondylitis (AS) were reexamined. The frequency of clinical signs and results of tests for associations are presented. Psoriasis was associated with a distal pattern of peripheral arthropathy. Spinal rigidity was predominantly seen in males. Males with phalangeal arthropathy exhibited preserved spinal mobility. This was the case also when HLA B27 positives and patients who did not have psoriasis were considered separately. HLA B27 positive patients in this group had frequently experienced acute anterior uveitis. It seems possible that the disease in such males is the result of combined predisposition to ankylosing spondylitis and psoriatic arthropathy. Hip arthropathy was frequently present in males with spinal rigidity. The associations observed confirm that AS is a heterogenous group of diseases. The term "syndrome" may be suitable for such a heterogenous group, and we prefer the term "Bechterew's syndrome" as the name of this group. When these new findings are added to the previous observations that acute anterior uveitis probably is a clinical, sex-influenced characteristic of HLA B27 positive Bechterew's syndrome, that HLA B27 negative patients with Bechterew's syndrome frequently had psoriasis and were HLA B13 and B17 negative, and that psoriasis was frequent in HLA B27 positive patients as well, we tentatively conclude that different and interacting genetic mechanisms may be involved in the etiology of Bechterew's syndrome.     

髂前下棘的解剖及其在骨盆骨折外固定中的应用

目的:对髂前下棘进行应用解剖学研究,为骨盆外固定钉直径的选择和微创置钉技术提供参考依据.方法:对22例44侧骨盆的髂前下棘进行观察测量,获取髂前下棘横、矢径,以及体表投影等数据,按性别分组进行统计学处理.所得数据应用于26例骨盆骨折外同定手术.结果:男性髂前下棘横、矢径分别为(12.23±1.91)mm和(20.09±2.43)mm;女性分别为(11.05±1.56)mm和(19.25±1.85)mm.男性髂前下棘在髂前上棘下方(29.49±7.66)mm,内侧(21.79±6.48)mm;在耻骨结节上方(51.70±9.31)mm,外侧(67.74±5.36)mm.女性髂前下棘在髂前上棘下方(23.74±8.89)mm,内侧(16.86±8.92)mm;在耻骨结节上方(43.93±9.04)mm,外侧(70.16±6.39)mm.依据本研究数据对26例骨盆骨折髋臼上方行外固定手术.有效的减少术中放射学暴露和手术时间.结论:根据解剖学测量数据进行固定钉选择和术中定位,使得髋臼上置钉外固定支架可迅速准确实施,适应骨盆骨折急诊处理的需要.     

HLA antigens, psoriasis and acute anterior uveitis in Bechterew's syndrome (ankylosing spondylitis)

One hundred and twenty-two consecutively hospitalized patients with ankylosing spondylitis (AS) were reexamined. Ninety-two per cent were HLA B27 positive. Of the HLA B27 negative patients, 60% were found to have psoriasis, as opposed to 11 % of the HLA B27 positive patients. Acute anterior uveitis (AAU) was found only in HLA B27 positive patients, and more frequently in males than in females. The genetic and clinical heterogeneity of AS, together with the overlapping clinical criteria for AS and psoriatic spondylitis, may make the term "Bechterew's syndrome" preferable. Based on these findings and previous reports, we conclude that (i) AAU is a manifestation of Bechterew's syndrome in HLA B27 positive patients, (ii) HLA B27 negative patients without any obvious accompanying manifestations may suffer from psoriatic spondylitis, and (iii) genetic predisposition to psoriasis in persons who are HLA B13, B17 and B37 negative, may interact with the genetic predisposition to Bechterew's syndrome in HLA B27 positive persons and produce Bechterew's syndrome with psoriasis or psoriasis-like skin eruptions.     

小腿前外侧和足背外侧岛状皮瓣的应用解剖

目的:为临床施行经小腿骨间膜前方游离腓动、静脉的小腿前外侧岛状皮瓣和足背外侧岛状皮瓣转位术提供解剖基础。方法:用46侧成尸下肢标本动脉灌注红色乳胶,观测腓动脉穿支及其外径,外踝前动脉弓和足背外侧动脉弓的外径及其皮支。结果:腓动脉下1/3段紧贴小腿骨间膜后方走行,发出2～5支穿支营养小腿前外侧皮肤,动脉外径(1.2±0.4)mm,穿支之间相距10～20mm不等。外踝前动脉弓外径(1.3±0.5)mm,两条伴行静脉外径分别为(1.7±0.5)mm和(1.3±0.4)mm。足背外侧动脉弓外径(1.1±0.5)mm,两条伴行静脉外径分别为(1.3±0.5)mm和(1.1±0.4)mm,发出皮支营养足背外侧皮肤。皮瓣切取范围为小腿外侧和足背外侧。结论:经小腿骨间膜前方游离腓动脉及其穿支与外踝前动脉和跗外侧动脉吻合形成的小腿前外侧和足背外侧串联岛状皮瓣,增加了血管蒂的长度,扩大了皮瓣的切取面积,增加了临床应用的灵活性。     

Genetic ablation of FLRT3 reveals a novel morphogenetic function for the anterior visceral endoderm in suppressing mesoderm differentiation

During early mouse development, the anterior visceral endoderm (AVE) secretes inhibitor and activator signals that are essential for establishing the anterior–posterior (AP) axis of the embryo and for restricting mesoderm formation to the posterior epiblast in the primitive streak (PS) region. Here we show that AVE cells have an additional morphogenetic function. These cells express the transmembrane protein FLRT3. Genetic ablation of FLRT3 did not affect the signaling functions of the AVE according to the normal expression pattern of Nodal and Wnt and the establishment of a proper AP patterning in the epiblast. However, FLRT3^−/− embryos showed a highly disorganized basement membrane (BM) in the AVE region. Subsequently, adjacent anterior epiblast cells displayed an epithelial-to-mesenchymal transition (EMT)-like process characterized by the loss of cell polarity, cell ingression, and the up-regulation of the EMT and the mesodermal marker genes Eomes, Brachyury/T, and FGF8. These results suggest that the AVE acts as a morphogenetic boundary to prevent EMT and mesoderm induction in the anterior epiblast by maintaining the integrity of the BM. We propose that this novel function cooperates with the signaling activities of the AVE to restrict EMT and mesoderm induction to the posterior epiblast.     

小腿前外侧筋膜皮瓣的显微外科解剖学

在30例成人下肢标本上,观察了小腿前外侧筋膜皮瓣的血供。该部皮瓣血供来自腓浅动脉。该动脉在外踝尖上平均25.7±0.55cm处发自胫前动脉,与同名静脉、神经伴行,穿前外侧肌间隔浅出,沿小腿前外侧面下降,沿途向两侧发许多细小皮支,分别与小腿前,后皮动脉吻合,在深筋膜表面形成丰富的血管网。本文讨论了小腿前外侧筋膜皮瓣的应用解剖学要点。     

Intracortical inhibition of lower limb motor-evoked potentials after paired transcranial magnetic stimulation

The aim of the present study was to determine the characteristics of intracortical inhibition in the motor cortex areas representing lower limb muscles using paired transcranial magnetic (TMS) and transcranial electrical stimulation (TES) in healthy subjects. In the first paradigm (n=8), paired magnetic stimuli were delivered through a double cone coil and motor evoked potentials (MEPs) were recorded from quadriceps (Q) and tibialis anterior (TA) muscles during relaxation. The conditioning stimulus strength was 5% of the maximum stimulator output below the threshold MEP evoked during weak voluntary contraction of TA (33±5%). The test stimulus (67±2%) was 10% of the stimulator output above the MEP threshold in the relaxed TA. Interstimulus intervals (ISIs) from 1–15 ms were examined. Conditioned TA MEPs were significantly suppressed (P<0.01) at ISIs of less than 5 ms (relative amplitude from 20–50% of the control). TA MEPs tended to be only slightly facilitated at 9-ms and 10-ms ISIs. The degree of MEP suppression was not different between right and left TA muscles despite the significant difference in size of the control responses (P<0.001). Also, conditioned MEPs were not significantly different between Q and TA. The time course of TA MEP suppression, using electrical test stimuli, was similar to that found using TMS. In the second paradigm (n=2), the suppression of TA MEPs at 2, 3, and 4 ms ISIs was examined at three conditioning intensities with the test stimulation kept constant. For the pooled 2- to 4-ms ISI data, relative amplitudes were 34±6%, 61±5%, and 98±9% for conditioning intensities of 0.95, 0.90, and 0.85× active threshold, respectively (P<0.01). In conclusion, the suppression of lower limb MEPs following paired TMS showed similar characteristics to the intracortical inhibition previously described for the hand motor area. Received: 21 June 1996 / Accepted: 23 May 1997     

足内侧皮瓣的应用解剖

解剖观测了30侧成人下肢足内侧区皮肤血管.足底内侧动脉深支、浅支、内踝前动脉和跗内侧动脉,分别发4.5(3～8)支、7.4(3～12)支、5.9(2～12)支和2.8(1～6)支,外径在0.2～0.8mm之间的皮支分布足内侧区,动脉间吻合恒定.经选择性动脉注射显示,皮瓣面积约为9×6cm～10×8cm.以上述动脉为蒂的足内侧皮瓣,可转位修复内踝、跟腱、足跟和足底远侧区的软组织缺损,临床应用了12例均获得成功.