以腓动脉终末穿支为蒂的皮瓣应用解剖

在33侧成人标本上,观察了以腓动脉的终末穿支为蒂的外踝上皮瓣血供。腓动脉终末穿支在外踝上方5.9cm 处,穿出骨间膜,外径为1.7mm,本干长为0.7cm,分为升支和降支、有91%的个体,以穿动脉的升支为蒂,设计为外踝上皮瓣:以穿动脉的降支为蒂,设计为足外侧皮瓣。在9%的个体中,腓动脉穿支细小,不能作为皮瓣的血管蒂,只能改用外踝前动脉升支为蒂的外踝上皮瓣.     

以骨间前血管为蒂前臂骨膜骨瓣的临床应用

应用骨间前血管为蒂.桡、尺骨骨膜骨瓣移位治疗上肢骨不连或骨缺损38例,均获得成功。该术式与以桡、尺动脉为蒂的桡、尺骨骨膜骨瓣移位相比较,有不损伤前臂主要血管干、移位范围大、适应症较广和操作简便易推广等特点.     

Ventrolateral medullary neurons projecting to the medial preoptic/anterior hypothalamic area through the medial forebrain bundle: an electrophysiological study in the rat

Summary A total of 152 ventrolateral medullary neurons was antidromically stimulated from both the medial preoptic/anterior hypothalamic area (MPOAH) and the medial forebrain bundle (MFB) in urethane anesthetized rats. These neurons were located primarily dorsal to the lateral reticular nucleus and could be readily classified in at least two groups, type I and type II cells on the basis of electrophysiological properties. The action potentials of type I cells had a shorter duration, and their conduction velocities ranged from 0.45 to 3.1 m/s. By contrast, type II cells, most predominantly observed, were characterized by a longer duration and an unusual shape of their action potential, and the antidromic propagation into the somatodendritic complex was often blocked. The conduction velocity (mean = 0.21 m/s) and absolute refractory period (mean = 2.63 ms) of type II cells are consistent with them having fine non-myelinated axons. Injection of 6-hydroxydopamine (6-OHDA), but not 5,7-dihydroxytryptamine, directly into the MFB blocked antidromic responses of 57% of type II cells tested. The residual type II cells whose antidromic responses were not affected by 6-OHDA were located significantly rostral to the 6-OHDA sensitive cells. Neither antidromic response of type I cells tested, on the other hand, was affected by 6-OHDA. The majority of type I cells were dramatically activated by noxious pinches of the tail, whereas the noxious stimuli produced no detectable change in the firing of type II cells. These data demonstrate that ventrolateral medullary neurons projecting to the MPOAH through the MFB are comprised of at least three distinct populations: 6-OHDA resistant fast conducting cells with somatic afferents, 6-OHDA sensitive and resistant slow conducting cells.     

Development of the retinal pathway to the pretectum of the cat

The development of retinal projections to the pretectal complex of prenatal and early postnatal cats has been examined using the anterograde transport of horseradish peroxidase and tritiated amino acids. As early as embryonic day 38, the entire dorsal pretectum is penetrated by retinal ganglion cell axons. At this stage the bilateral complement of retinal efferents appears to be dispersed uniformly within the pretectal anlage. A week later, on embryonic day 46, indistinct foci of peroxidase reaction product can be discerned within 2 of the primordial nuclei: the nucleus of the optic tract and the olivary nucleus. By embryonic day 56, five distinct bilateral fields of retinal fiber termination are apparent within the following regions:

(i) the nucleus of the optic tract;

(ii) the pretectal olivary nucleus;

(iii) the posterior pretectal nucleus;

(iv) the anterior pretectal nucleus; and

(v) the medial pretectal nucleus. Four days before birth, on embryonic day 61, crossed and uncrossed retinal arbors are partially segregated within the nucleus of the optic tract and the pretectal olivary nucleus.

The early postnatal retinal connection to the pretectum has an overall pattern virtually indistinguishable from that of the mature cat. The ontogeny of the retinal influx to the pretectum is similar to that of the retinocollicular projection.⁶¹ However, the development of retinal projections to the pretectum and superior colliculus appears to lag behind those to the dorsal lateral geniculate nucleus.⁴⁹ These differences may reflect temporal and spatial gradients in the maturation of three major classes of retinal ganglion cells.     

骨间前血管腕背支骨膜瓣移位修复骨不连的临床应用

报道用骨间前血管腕背支骨膜瓣移位修复骨不连、骨坏死的手术方法及疗效。方法：根据应用解剖学研究，设计以骨间前动脉腕背支为蒂的骨膜瓣，顺行移位修复尺、桡骨骨不连，逆行移位修复手舟骨、月骨不连与骨坏死。结果：临床应用19例，随访1年，在术后3～6月均达到骨愈合和骨坏死修复，关节活动功能明显改善。结论：骨间前血管腕背支为蒂的骨膜瓣移位术适合邻近骨不连、骨坏死修复。     

Supradiaphragmatic ectopic adrenocorticotropic hormone-secreting adenoma

A 22-year-old woman with Cushing's syndrome, caused by an extremely rare suprasellar ectopic pituitary adenoma, is presented. Magnetic resonance imaging and computed tomography revealed a well-circumscribed mass in the right suprasellar region. Endocrinological tests showed elevated s-adrenocorticotropic hormone level and hypercortisolemia. The tumor was totally removed by right subfrontal approach. At the time of the operation, the tumor was in continuity with the distal pituitary stalk but not with the pituitary gland. The diaphragma sellae was intact. Histologic diagnosis of the tumor specimen was confirmed as a pituitary adenoma. After surgical removal of the tumor, continued improvement in the patient's laboratory results and disappearance of her endocrine symptoms strongly indicated the absence of adenoma cells in the pituitary gland or stalk. Six years post-surgery, there was no evidence of recurrence in the patient's clinical and laboratory examination. This tumor probably originated from aberrant anterior pituitary cells of the pituitary stalk.     

Apoptosis of CD4+ T cells occurs in experimental autoimmune anterior uveitis (EAAU)

To investigate the spontaneous turning off mechanism of endogenous uveitis, EAAU was induced in Lewis rats. Immunohistochemical and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) stains revealed that CD4+ T cells were predominant in the uveal tissue of EAAU and that the apoptosis of these cells had occurred and progressed throughout the inflammatory period in EAAU eyes. The immunohistochemistry and in situ hybridization for Fas ligand (FasL) expression showed that the expression of Fas ligand was increased in the EAAU eyes compared with control eyes. These results suggest that the apoptosis of CD4+ T cells may play a key role in the spontaneous turning off mechanism of intra-ocular inflammation and that the induction of apoptosis may be mediated by the Fas-FasL system in EAAU.     

Hypothalamic laterality in regulating gonadotropic function: unilateral hypothalamic lesion and ovarian compensatory hypertrophy

Regardless of the side of hemiovariectomy, unilateral lesion placed in the right-side medial anterior hypothalamus suppressed ovarian compensatory hypertrophy, but the lesion made in the left side failed to suppress it. This suggests the presence of a hypothalamic laterality in regulating gonadotropin secretion.     

桡侧腕屈与腕长伸肌腱部分转位修复手部关节脱位应用解剖

目的 :为桡侧腕屈与腕长伸肌腱部分转位修复桡尺远侧及第 1腕掌关节脱位提供解剖学基础。方法 :3 0侧成人上肢标本 ,分别对桡侧腕屈肌腱、桡侧腕长伸肌腱进行形态学测量。结果 :桡侧腕长伸肌腱性部长 ( 17.8± 2 .6)cm ,肌腱的上、中、下段宽分别为 ( 13 .7± 3 .1)、( 5 .6± 1.1)和 ( 4 .6± 0 .5 7)mm肌腱的上、中、下段厚分别为 ( 1.5± 0 .5 )、( 2 .0± 0 .3 )和 ( 2 .4± 0 .3 )mm。桡侧腕屈肌腱性部长 ( 14 .3± 1.1)cm ,肌腱的上、中、下段宽分别为 ( 9.11.4)、( 5 .5± 0 .9)和 ( 4 .0± 0 .4) ,肌腱的上、中、下段厚分别为 ( 2 .4± 0 .6)、( 2 .2± 0 .4)和 ( 2 .6± 0 .5 )mm。结论 :采用桡侧腕屈肌腱和桡侧腕长伸肌腱部分转位 ,有足够的长度和强度 ,适用于桡尺远侧关节或第 1腕掌关节脱位的修复 ,临床应用获得良好效果     

HLA antigens in uveitis

HLA antigens are associated with a number of inflammatory eye diseases, most notably HLA B2 with anterior uveitis (AU). This association varies between different populations and ethnic groups. The aim of this study was to investigate the relationship between uveitis and HLA A, B and DR locus antigens in an Australian population. Seventy-two consecutive patients with uveitis were studied (37 males and 35 females) over a 6 month period. Thirty-two percent of the AU patients were HLA B27+, as were 42% of males (19% females) with their first attack of AU compared with 60% of males (23% females) with recurrent AU. The only significant difference in etiology between males and females was the greatly increased incidence of rheumatic diseases in males, in whom 77% (10/13) had radiological evidence of sacroiliitis. Additional findings included a lack of association between the HLA B7 cross reactive group and DR locus antigens in AU as well as the lack of any HLA associations in the 13 patients with posterior uveitis (PU).