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AIM: To discuss the use of inferior petrosal sinus sampling in distinguishing between pituitary and ectopic sources of adrenocorti cotropindependent Cushing syndrome.

R%E9X2DD2{;l0 目的:探讨岩下窦静脉取血在鉴别垂体和异位来源的ACTH依赖性Cushing综合征的意义。

Methods Suboccipital approach was applied and the diameter of Labbe veins was microanatomy measured in 10 adult cadaver heads after vascular perfusion. Results The main types of Labbe vein were single, doubles, candlestick and venous sinus or multiples.

对10具(20侧)经福尔马林溶液固定的不同性别的成人头颅湿性标本进行血管灌注染色,然后行颞下-乙状窦后-枕下联合开颅,对Labbe静脉进行显微解剖测量。

The ways for surgical treatment of distal abnormalities of LSVC were reconstruction of atrial septum, translocation of LSVC and reconstruction of atrial septum, right atrium and LSVC anastomosis, cavopulmonary anastomosis and repair of partially unroofed coronary sinus.

对LSVC的处理方法采用房间隔重建、LSVC移位合并心房间隔重建、LSVC连接到右心房、腔静脉-肺动脉吻合、部分性无顶冠状窦的修补。

Objective To evaluate the clinical application of CT diagnosis of arteriovenous fistula in cavernous sinus.

目的:为了进一步认识海绵窦动静脉瘘的发生与发展,提高临床及CT诊断的准确率。

Results: The light microscope pictures of group A(no [α-32P] ATP in the perfusate) showed that there was no specially labeled silver pellet in or out of rat liver cell. But the light microscope pictures of group B (37 MBq [α- 32P]ATP in the perfusate) showed that distribution of numerous [α-32P]ATP autoradiographic silver pellets in rat liver cell, and no autoradiographic silver pellet was found in the hepatic sinus and vessel.

结果:灌流液中不加[α-32P]ATP的A组光镜照片显示大鼠肝细胞内外均未见特异性标记银粒显影,而灌流液中含37 MBq[α-32P]ATP的B组光镜照片显示大鼠肝细胞内可见多个大小不等的[α-32P]ATP自显影银粒分布,而肝窦及肝小叶中央静脉等血管内则几乎无黑色自显影银粒分布。

The distal dural ring is a thick membrane that fuses with the adventitia of the ICA and its thickness is(0.52±0.07)mm,The proximal dural ring loosely surrounds the entire length of clinoid segment of ICA and admits a variable number of veins from the cavernous plexus that accompany this segment.

远侧硬膜环厚而坚韧,厚度为(0.52±0.07)mm,近侧硬膜环薄而松弛,厚度为(0.22±0.06)mm,在二者之间有海绵窦的静脉丛突入。

Comclusion: transpetrous presigmoid retrolabrinth approach was rational approach for surgery on petroclivus and -4- CPA; it抯 important for accomplish the surgery to study and master the anatomy and variance of this approach; there was relative anatomical relationship among those structure on posterior of petrous bone; AAMP was the extracranial mark of inflexion of TS and SS; LAM and PSC were obvious bone marks for operation; we can confirm the abraded range of petrous bone lean upon LAM and/or GSS beside abrading step by step as literature, and it抯 unnecessary and unrational to emphasize to show PSC if the surgical space was enough; preceding sigmoid sinus and high jugular bulb often appeared at right and would bring disadvantage effect; interspace ,between CN V and CNVII or CNVII and CNJXI, were available to reach clivus and manage the mass on the range.

经SS前迷路后入路是处理岩斜坡区、桥小脑角区病变理想的手术入路;研究和熟悉手术入路中的解剖结构及部分变异对指导手术十分必要;岩骨内测面的骨性结构之间有着相对稳定的空间关系;顶乳缝前角是SS和TS转接处在颅外的标志;IAM和PSC等结构可以作为手术中的重要骨性标志;以PSC确定岩骨的磨除范围是较安全和可靠的,但亦可以结合影像检查,以内耳道和乙状窦前缘为基点判定切除范围,如果操作空间足够,过分强调磨出半规管是不适当的;右侧GSS的宽度和深度较对侧大,SS前置和颈静脉球高位较对侧多见,这些都对右侧入路有不利的影响,但仍可以进行手术操作;三叉神经和面神经间隙及面l 神经和舌咽神经间隙方便到达斜坡并处理病变。l

Objective To investigate the diagnostic and therapeutic methods of dural arteriovenuoe fistula in carotid cavernous sinus region.

目的 探讨海绵窦区硬脑膜型动静脉瘘的诊断和治疗方法。

Results:①All gallstones type Ⅰ and Ⅳ in animal models were dissolved quickly, however, MTBE showed somewhat toxicity in inhibiting CNS, so that the dose of MTBE should be controlled precisely.②No abnormal change of liver and renal functions of dogs were found before and after operations.③Choloecyst pathological sections of gallbladder suggested that no evident of damage and inflammation of gallbladder was of found. Hemopexis with reversible histological change was observed in hepatic sinusoid and centeral vein short time after administation of MTBE.

结果:①动物模型的Ⅰ、Ⅳ型结石均全部迅速溶解,但MTBE有一定毒性,其对中枢神经系统有一定的抑制作用,应用时须严格掌握单位时间内的灌注剂量及总量(控制在60ml左右);②实验犬实验前后的肝、肾功能检查无异常;③病理检查结果提示MTBE对胆囊组织无明显损伤,无严重炎性反应,给药后短期内肝窦和中央静脉有凝血现象,但其组织学变化是可逆的。

Predisposing factors leading to SSS thrombosis may be grouped into one of three categories: hypercoagulable state, venous flow disturbance, and in association with infection or inflammation.

导致上矢状窦血栓的致病因素可以分为三类:高凝状态、静脉血流紊乱、炎症或感染相关状况。

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