Survey of hypoglossal canal and its adjacent structures and their clinical significances

目的:研究舌下神经管及其毗邻结构的位置关系,为临床手术提供解剖学依据.方法:取成人头颅干骨标本60例(120侧),观察和测量舌下神经管及其毗邻结构的距离,并对双侧距离差别作统计学分析.结果:舌下神经管长度左(11.22±1.67)mn,右(11.28±1.79)mm;其长轴与矢状面的夹角左45.19°±1.51°、右45.30°±1.33°;其长轴与枕髁长轴的夹角左62.44°±3.62°、右62.32°±3.64°;枕髁后缘到达舌下神经管内口、外口的距离左(9.38±1.67)mm、(16.18±1.97)mm,右(9.35±1.70)mm、(16.13±1.94)mm.颈静脉结节上表面到达舌下神经管内口的距离左(6.17±1.34)mm、右(6.22±1.36)mm;髁管的出现率为65％,2侧均含有双髁管1.67％.舌下神经管内口有骨性突起分隔者8.33％,内口分为双管者18.33％、三管者6.67％、二分管1.67％.以上结果左、右侧差异没有统计学意义.结论:熟悉舌下神经管及其毗邻结构的解剖知识,有助于临床相关疾病的诊断和手术治疗方案的制定.     

骨性颈静脉孔区的显微解剖学研究

目的　研究骨性颈静脉孔区的显微解剖 ,为影像医学和手术入路的选择提供形态学资料。方法　肉眼和手术显微镜 (16倍 )下观测 3 1例 (62侧 )成人头颅干标本的颈静脉孔 (jugularforamen ,JF)及毗邻结构。结果　①JF位于颞、枕骨之间 ,左、右两侧无统计学显著性意义 ;②JF外口与星点、茎突根部的间距分别为 [(5 4 11± 4 4 0 ) (45 2 0～ 65 2 8) ]mm和 [(1 88±1 62 ) (0 0 0～ 7 2 4 ) ]mm ;③髁管出现率为 72 5 8% (45侧 ) ,分别开口于JF(73 3 3 % )、乙状窦 (17 78% )、舌下神经管 (2 2 2 % )及前 3个结构之间 (6 67% )。舌下神经管开口呈双管状 8 0 6% (5侧 )。结论　熟悉JF及其毗邻结构的解剖有利于该区域影像诊断和手术的顺利进行     

内窥镜下经口咽至中下斜坡入路的应用解剖研究

目的研究内窥镜下经口咽入路至中、下斜坡局部解剖学并测量相关解剖数据,为临床手术提供形态学依据。方法交替使用手术显微镜和0°、30°硬质内窥镜研究10例成人尸头,测量与入路相关的60具成人颅骨标本数据。结果斜坡常规开窗20 mm×30 mm,对应脑干侧前方的解剖结构为:口咽→咽后壁软组织→骨性标志(枕骨大孔前缘→下斜坡→咽结节→中斜坡)→硬脑膜→非骨性标志(VI~X II颅神经、椎基底动脉及其分支,以及其之间解剖毗邻关系);切牙孔、前鼻棘、后鼻棘、卵圆孔、破裂孔、颈动脉外口及舌下神经管外口的内侧缘至咽结节及后四项至中线的距离分别为:71.0±4.1、78.3±4.3、33.7±4.3、27.2±2.1、13.2±2.0、25.7±2.3、19.7±1.3、23.3±2.1、10.5±2.0、25.2±3.7、17.2±2.7 mm。结论应用内窥镜经口咽入路可完成中下斜坡脑干腹侧部位病变的手术治疗,以处理椎基底动脉瘤及体积较小且血供一般的病变为佳。     

远外侧经枕髁手术入路防止椎动脉损伤的应用解剖

目的:为远外侧经枕髁入路手术保护椎动提供较详细的解剖资料。方法:应用20具(40侧)成人尸头湿标本进行显微解剖研究。结果:寰椎横突、第2颈神经前支、肩胛提肌、椎动脉周围静脉丛、头外侧直肌为确认第2、3段椎动脉的重要标志。寰、枢椎横突孔间距左侧为(15.3±1.6)mm,右侧(15.8±2.2)mm;枕骨大孔后缘中点距椎动脉入硬脑膜口处左侧(21.6±2.0)mm,右侧(21.5±2.0)mm;椎动脉于寰椎后弓上方向后呈弓形弯曲,其外侧跨度左侧(17.9±3.2)mm,右侧(17.7±3.2)mm;内侧跨度左侧(9.8±2.5)mm,右侧(9.8±2.2)mm;向后距椎板高左侧(7.4±2.3)mm,右侧(6.3±3.3)mm。结论:熟悉椎动脉第2、3、4段的毗邻关系及解剖标志,对保护椎动脉、安全地施行远外侧经枕髁入路手术至关重要。     

颅底外面枕骨基底部及周边骨性结构的测量和临床意义

目的为斜坡区肿瘤手术提供解剖资料。方法20例整颅,10例行水平切面,10例行正中矢状切面。测量切牙孔、前鼻棘、后鼻棘、枕骨大孔前端、枕髁前端、卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至咽结节的距离;测量卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至正中线的距离;测量枕骨基底部颅底外面的长径、枕骨大孔纵径(FML)、枕骨大孔前正中点与枕髁后缘连线垂直距离(AOCP)、枕髁轴径(OCA)、枕髁间距。结果切牙孔后缘、前鼻棘、后鼻棘、枕骨大孔前端、枕髁前端、卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至咽结节的距离分别为(mm):72.12±4.25、77.77±3.89、33.73±2.07、13.14±1.91、15.71±1.74、27.51±2.12、15.98±1.98、25.93±2.23、19.15±1.49。卵圆孔、破裂孔、颈动脉管及舌下神经管外口的内侧缘至中线的距离分别为:25.55±1.63、11.72±1.70、25.75±1.98、17.41±1.41。枕骨基底部颅底外面长径、FML、AOCP、OCA、枕髁间距分别为(mm):28.80±2.67、35.84±2.59、17.10±1.13、24.55±2.35、21.07±1.92。结论经口咽至斜坡区的手术入路中,开骨窗时安全范围是以咽结节为中心,以15mm为半径做斜坡磨除;也可以做矩形骨窗,即以咽结节为中心开一长(高)25mm×宽20mm的骨窗。     

经口入路至颈静脉孔区的显微外科解剖

目的:为经口入路至颈静脉孔区处理颈静脉孔区病变提供解剖学依据。方法:在显微镜下对经彩色乳胶灌注成人尸头湿标本的颈静脉孔区经口入路进行解剖,观察路径中组织结构的暴露情况和走行关系,定位相关解剖标志,记录测量数据。结果:尸头标本的颈静脉孔区颅外部分均显露良好,可暴露自颈动脉嵴内侧至枕骨髁后外侧缘和中线至茎突根部区域,磨除颈静脉孔前内侧骨质后,可观察到岩下窦、Ⅸ～Ⅺ神经在孔内走行和毗邻关系。测量相关参数,枕髁前缘距舌下神经管外口前缘(12.47±1.49)mm;舌下神经管外口上缘距颈动脉嵴内侧(9.90±1.40)mm等。结论:经口入路可较好的暴露颈静脉孔区前内侧,以枕髁和颈动脉嵴为解剖标志,有助于避免此入路处理颈静脉孔区病变时对重要血管和神经的损伤。     

枕骨大孔腹侧区肿瘤手术入路的应用解剖

目的:探讨枕骨大孔区腹侧肿瘤的最佳手术入路及其应用解剖学基础.方法:在5例共10侧正常人尸头标本上模拟枕下外侧经枕髁入路逐层解剖观测毗邻结构,到达枕骨大孔腹外侧区.结果:应用此入路切除部分枕髁可满意暴露枕骨大孔腹外侧区,而对重要的血管神经损伤最小.结论:枕下远外侧入路是枕骨大孔腹侧区肿瘤的最佳手术入路.     

枕下极外侧手术入路的解剖学研究

目的：为枕下极外侧手术入路提供解剖学基础。方法：10例成人尸体头湿标本按手术入路在手术显微镜下进行解剖和观测。结果：枕下三角是枕下极外侧入路中重要的解剖学标志，在分离移位椎动脉后，切除枕骨髁后部1／3以辨别和暴露舌下神经管，枕骨髁的磨除可显著扩大枕骨大孔前缘的暴露范围，磨除颈静脉结节对扩大斜坡中下部的暴露有重要的作用。椎动脉硬膜内段及其分支与后组脑神经有复杂的毗邻和穿行关系。结论：枕下极外侧入路尽管解剖复杂，但可在不牵拉延髓的基础上充分暴露颈延髓交界部腹侧面和外侧面的区域，达到充分暴露的枕骨髁磨除范围限于其后1／3即可.     

内镜辅助的乙状窦前-迷路后锁孔手术入路的解剖学研究

目的:研究内窥镜辅助下乙状窦前-迷路后锁孔手术入路的相关解剖,为临床应用提供参考。方法:取15具30侧经福尔马林固定成人头颅标本,模拟乙状窦前迷路后手术,内窥镜下观察颅内相关解剖,测量入路相关数据。结果:岩上窦-乙状窦交点至Meckel’s囊、Dorelle’s管、内耳门、舌咽神经、舌下神经、椎动脉的距离分别为(38.41±2.49)mm(31.18～45.14mm),(48.65±2.94)mm(44.78～56.78mm),(27.32±2.55)mm(23.76～33.00mm),(31.16±3.20)mm(22.38～36.90mm),(43.71±2.54)mm(39.64～49.46mm),(48.10±2.90)mm(42.20～54.56mm)。内窥镜经小脑外侧间隙可顺利到达桥小脑角和脑干腹侧前方,清晰显示颅神经及其附近走行的血管。结论:内窥镜在桥小脑角的应用可弥补手术显微镜的不足,对显微外科手术起到重要的辅助作用。     

内镜下经口入路至颈静脉孔区处理沟通型肿瘤的临床应用解剖

目的　研究内镜下经口入路至颈静脉孔区解剖,以期为临床上切除该区域的沟通型肿瘤提供解剖学依据。 方法　在内镜下对15具尸头模拟经口入路,观察颈静脉孔区颅内外的暴露情况,定位解剖标志并记录相关参数。 结果　内镜下经口入路可很好显露颈静脉孔区颅外段,尤其是其前内侧区域,在磨除舌下神经管外口至中线骨质后可获得颅内脑干腹侧中线区域的最佳暴露。枕髁、髁上槽、颈动脉嵴为重要的解剖标志。其中枕髁前缘距舌下神经管外口下缘(14.51±2.30) mm,枕髁前缘距颈动脉嵴(24.11±2.19) mm,枕髁前缘距颈静脉结节上端(21.26±2.26) mm。 结论　该入路有助于处理肿瘤主体偏于颈静脉孔内侧的沟通型肿瘤。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.     

THE ODYSSEY – A JUNGIAN PERSPECTIVE: INDIVIDUATION AND MEETING WITH THE ARCHETYPES OF THE COLLECTIVE UNCONSCIOUS

Homer's epic tale of the 20-year return of Odysseus from the Trojan War is investigated with particular reference to Jung's theory of individuation. Odysseus' meetings with 'the anima' in the form of goddesses, sirens and female monsters and his visit to Hades demonstrate the confrontation and humanization of aspects of the archetypal level of the psyche, central to Jung's theories of psychic growth and development. Jung's important ideas of the psychoid level and the transcendent function are explored and linked both to his investigations into medieval alchemy and with findings from contemporary neuroscience. The importance of Jung's constructive method of the interpretation of dreams and myths is shown to be central.