Serotonin and norepinephrine in the spinal cord of man

The content of serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA) and norepinephrine (NE) was analysed in 71 human spinal cords obtained post-mortem. The highest content of 5-HT, 5-HIAA and NE was found in the lumbar enlargement of the spinal cord. 5-HT and 5-HIAA content increased from fetal to adult spinal cord whereas the content of NE decreased. Characteristic segmental distribution of measured monoamines was present in adult spinal cord only. In two patients spinal cord lesion led to the reduction in spinal cord content of 5-HT, 5-HIAA and NE and loss of characteristic segmental distribution of these substances. These results are in general agreement with observations on spinal cord of different animal species.     

Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases

Extradural arachnoid cysts are uncommon expanding lesions in the spinal canal which may communicate with the subarachnoid space. Usually in the lower thoracic spine, they may cause symptoms by compressing the spinal cord or nerve roots. We report cases of thoracic and lumbar arachnoid cysts studied by cystography, myelography, CT and MRI. These techniques showed extradural cystic lesions containing cerebrospinal fluid, with variable communication with the subarachnoid space, causing anterior displacement and flattening of the spinal cord. Received: 3 November 1995 Accepted: 16 April 1996     

狗脊髓截除自体隐神经大网膜移植的初步观察

实验用6只狗于T13处切除脊髓8mm，局部用隐神经、大网膜移植。对照组6只狗单纯切除脊髓8mm。术后3个月、6个月实验组动物全部恢复到C／Ⅲ级功能，组织学切片见移植神经有不同程度存活，可记录到股四头肌、胫前肌电位。对照组动物仅达到0／0～A／I织功能，组织学切片见脊髓缺损处为结缔组织，诱电位波形消失。分析了影响脊髓神经功能恢复的原因。     

神经移位修复臂丛神经根性撕脱伤

１９８７年７月～１９９４年６月，对２１例臂丛神经根性撕脱伤采用神经移位修复。其中复合移位４组神经（膈神经、副神经、颈丛运动支、肋间神经）者１例，３组（膈神经、副神经、颈丛运动支）者６例，２组（膈神经、副神经）者９例，１组（膈神经或颈丛运动支或肋间神经）者５例。术中发现臂丛神经变异１例，对４例合并锁骨下动脉损伤者，在神经移位的同时进行血管修复，促进患肢的血液循环，有利于神经的康复。随访到１９例，随访时间为８个月～６年２个月，优良率达７３．７％。认为，神经移位术是修复神经根性撕裂伤的常规方法，合并血管损伤者也应同时修复，对促进神经功能恢复有利     

带蒂胸腹轴型皮瓣早期修复上肢深度蛇伤溃疡

总结胸腹轴型皮瓣早期修复上肢不同部位的深度蛇伤溃疡的经验，评价其应用价值。本组１６例，胸脐皮瓣２例，侧胸腹皮瓣１例，髂腰皮瓣５例，下腹皮瓣６例，下腹分叶皮瓣１例，髂腰加下腹Ｙ形皮瓣１例。术后１例皮瓣远端坏死，３例轻度感染，１６例断蒂后全部成活。随访３个月～７年，皮瓣质地和弹性均好，手功能基本恢复。认为，带蒂胸腹轴型皮瓣是修复上肢深度蛇伤溃疡理想的方法。     

胸腰椎稳定性重建方法的改进

为了改进胸腰椎脱位的治疗方法，更好地重建脊柱稳定性，设计了一种新的脊柱固定器械，由滚花钉及连接板构成，并通过椎弓根进行的一种脊柱后路短节段固定方法，脊柱固定范围限制在两个椎体间。１９８９年～１９９５年，临床应用这种新器械矫正胸腰椎脱位１２例，经１～４年随访，畸形矫正满意，固定牢固。结果表明：该器械具有手术方法简单、固定牢固和手术创伤小等优点。认为，该项技术适用于胸腰椎稳定性的重建。     

Open extremity fracture penetrating the skull

We present a case in which an open fracture of the ulna penetrated the skull and caused a comminuted, depressed skull fracture with a large intraparenchymal hematoma containing bone fragments.     

近节指骨段屈肌腱鞘不同范围损伤对肌腱功能的影响

目的 探索手指屈肌腱在近节指骨段不同范围损伤时对屈指肌腱功能的影响。方法 采用12只成人尸体手指。实验分为:第一阶段屈指肌腱完整,以后四个阶段依次沿近节指骨掌侧小线闭开小央1/4、1/2、3/4及全长。在掌指关节被动屈80°和掌指关节屈80°同时近侧指关节屈100°时,测量指浅屈肌腱(FDS)和指深屈肌腱(FDP)的滑动距离。根据肌腱力臂和滑动距离的关系,得出屈指肌腱在掌指关节处和近侧指间关节及肌腱在近节指骨段的弓弦畸形程度。结果 腱鞘中央1/4切开时,指屈肌腱的滑动距离、力臂均无显著变化;1/2切开后,单纯屈曲掌指关节时的FDS腱和掌指、近节指间关节屈曲时的FDS、HDP腱的滑动距离和力臂较腱鞘完整时显苫增大(P<0.05);切开3/4长度后,FDS、FDP腱滑动距离均有统计学意义变化,FDS、FDP腱力臂平均增加8～9％;全切开腱鞘,FDS、FDP腱滑动距离变化正统计学上有高度显著性(P<0.01),两腱力臂分别增加16％和15％。随腱鞘切开范围增大,FDS、FDP在近节指骨段的弓弦畸形程度也越来越大。结论 从肌腱的生物力学变化可见,近节指骨段腱鞘的小范围损伤如中间1/4以内损伤时,对肌腱功能影响小,可以不予修复;若损伤超过1/2长度,尤其对腱鞘全长损伤,应予以修复以恢复肌腱功能。     

Arthroscopy of the knee in children and adolescents

A retrospective review was done of 69 children and adolescents (7-17 years old) who underwent 75 arthroscopies of the knee during a 5-year period. Girls were overrepresented (71%). Thirty-eight were children under the age of 16. Of 46 injuries, 34 (74%) happened during sports. Children and adolescents were divided into two age groups based on their presumed state of skeletal maturity (boys 9–15 and girls 7–14 in group I and boys 16–17 and girls 15–17 in group II); meniscal lesions were equally common in the two groups, whereas anterior cruciate ligament tears were more common in older children (NS). Eleven of 17 (65%) anterior cruciate ligament lesions were combined with other intra-articular pathology, most often meniscal tears (9/11). As in other studies, half of the prearthroscopic diagnoses were incorrect. A high frequency of incorrect prearthroscopic diagnoses and of combined lesions justifies arthroscopy as an important diagnostic tool in children and adolescents with a history of twisting knee injury or chronic nonspecific knee problems. Girls practising ball games seem to be especially prone to knee injuries leading to arthroscopy.