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早期癒合症（以下ULS）は，乳児期早期には変形が軽度のため，頭位性斜頭（以下PP）との鑑別が困難なことがある．今回生後2か月時に頭位性斜頭と臨床的に診断したが，生後7か月時にULSの特徴（対側頭頂部の突出，同側耳の下方偏位と突出）が顕在化した症例を経験した．ULSとPPの鑑別では，特に低月齢児では，両者の特徴を念頭において頭蓋形状を注意深く経時的に観察することが重要で，必要に応じて縫合部超音波検査やレントゲン検査を用いることが望ましい．

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当院にて内視鏡支援下縫合切除術と術後ヘルメット療法を施行した9症例について，手術手技と結果を検討した．手術時の平均月齢は4.4か月（1～9か月），平均体重は6.6 kg（5.1～8.3 kg）であった．平均手術時間は99.4分（59～176分），平均出血量は87.9 ml（11～381 ml）で，9例中5例に輸血を要した．内視鏡支援下縫合切除術と術後ヘルメット療法の併用は，適応症例は限られるものの，従来法や骨延長法と比較して低侵襲であり結果も遜色なく，低月齢症例では第一選択となり得る．

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 中硬膜動脈損傷による急性硬膜外血腫と進行性に増大する帽状腱膜下血腫の合併例を経験した. 症例は16歳の男性でバイクの自損事故で受傷した. 入院時の頭蓋単純写と頭部CTでの離解と帽状腱膜下血腫を認めた. 受傷翌日に施行したCTおよびMRIで, 帽状腱膜下血腫の急速な増大と離解部での少量の硬膜外血腫との交通を認めた. 脳血管撮影では離解部に近接した中硬膜動脈からの持続性出血を認めた. 中硬膜動脈損傷による急性硬膜外血腫が, 縫合離解部を通り帽状腱膜下に流出したものと考えられた. 血管内手術で中硬膜動脈分枝を塞栓し, その後帽状腱膜下血腫の穿刺吸引および頭皮の圧迫固定を行い治癒させることができた. 急性硬膜外血腫と帽状腱膜下血腫の合併例に, 中硬膜動脈塞栓術後の経皮的血腫吸引は有効な治療法であった.

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我々は南米インカ人骨と思われる頭蓋骨1コ, 下顎骨5コについて調査した.その結果を要約すると次のごとくである.1. 頭蓋骨の計測結果によると, 頭長幅示数では短頭型, 頭長高示数では高頭型であった.またコルマン氏上顔示数では中上顔型, 眼窩は高眼窩型, 鼻は広鼻型, 口蓋は広口蓋型であった.2. 後頭部においてはインカ骨ならびに多くの縫合骨が認められ, 骨全般の縫合状態はきわめて緩かであった.3. 頭蓋骨に残存している6本の歯はやや大きく, 咬耗も少なく, 且つ智歯はまだ萌出していない.従って, 頭蓋骨は20才前後の若年者ではないかと思われる.4. 5コの下顎骨はいずれもがっしりした構造をしており, 特に下顎枝の発達がよく, 咀嚼筋の停止部は強い粗面を呈していた.また, 下顎切痕示数値は低い数値を示し, 切痕が浅いことが認められた.5. 歯は現代人にくらべやや大きく, 特に智歯が大きく, 退化的形態はあまり認められなかった.また歯の咬耗は, No.1, 2, 3が最も強く, いずれも40才代前後の熟年者だと考えられる.No.4は咬耗が少なく, 智歯も未萌出で, 20才前のものと考えられる.No.5は30才代以上の熟年者ではないかと思われる.

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Cleidocranial dysostosis (CD) is a rare congenital osseous disease which is characterised by anomaly of the clavicle and skull with dental abnormalities. The most common deformity is the absence of the central clavicular segment and the dental abnormalities are prolonged retention of primary teeth, late eruption of permanent teeth, supernumerary teeth and so on.
Since the first description of this disease was made by Martin in 1765, more than 150 cases were reported in Japan. On the other hand in 1936 Haneda proposed to define CD with a systemic bone anomaly in the whole body as dysostosis generalisata (DG). The authors experienced a young boy with dental abnormalities and a large extent of bone anomaly at the clavicles, skull, rib, pelvis and carpal bone. We diagnosed this case as DG, therefore, clinical findings and a review of the literature are reported here.

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　　In posterior cranial vault distraction（PCVD）, it is necessary to accurately determine the direction of the venous sinus. A three-dimensional fluoroscopic composite image was created from the venous cava by MRI and the cranial bone on CT using SYNAPSE VINCENT^®. Four patients who underwent PCVD for craniosynostosis at our hospital between 2019 and 2020 were analyzed. As a measurement of the accuracy of the composite image, the distance from the intersection of the suture lines during the operation to the lower edge of the osteotomy（λ-A）and the distance from the intersection of the suture lines on postoperative CT to the lower edge of the osteotomy（λ-B）were measured. The average of the difference（A-B）was 0.5 mm. As a measurement of the accuracy of setting the cutting line, the average distance between the lower edge of the osteotomy line and the upper edge of the sinus was 9.4 mm. The three-dimensional fluoroscopic composite image was an accurate indicator. The setting of the bone-cutting line was appropriate. If images of different modalities are synthesized and examined, three-dimensional fluoroscopic composite images are considered a useful method in PCVD.

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Hajdu-Cheney Syndrome is a rare cataplastic osseous infusion. We encountered a 12-yearold female who was diagnosed with this syndrome after pediatric and orthopedic scrutinized examinations. Findings on systemic examination were clubbed fingers, lateral curvature of the spine, infusion of the phalangis distali F of the fingers, and oar-like deformity of the ribs. Findings in the oral cavity were remnant tardive deciduous teeth, delayed budding of permanent teeth, specific cleft-like paatal formation with gingival hypertrophy, absorption of the alveolar bone, poor growth of the upper and lower jaws, expansion of the Turkish saddle, aplasia of the frontal sinus, and detachment of the cranial suture. This case is summarized.

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In the present study, the histogenesis and fate of the tectum cartilage appearing under the sagittal suture from day l6 of embryonic gestation to 15-day-old mice were examined histochemically and immunohistochemically. Cartilage tissues were persistent as alcian blue-positive cartilaginous aggregates under the posterior fontanel and sagittal suture from 17 days embryonic development until day 9 after birth. The size of these cartilage specimens reached a maximum at 6 days old and disappeared by 10 days old accompanying sutural ossification.

<br>Connective tissues, including the perichondrium of the tectum cartilages, and calvarial bone were immunopositive for type I collagen, whereas the cartilage matrix was a typical hyaline cartilage showing positive features for anti-type Ⅱ collagen antibody during the degeneration of the cartilage. The tectum cartilage at 6 days old was comprised of hypertrophic chondrocytes showing immunoreactivity for type X collagen, and it was confirmed by BrdU-incorporation that these hypertrophic cells had no mitotic capacity. Apoptotic cells were not detected in the hypertrophic chondrocytes during the degenerating stage at 9 days old. TRAP (tartrate-resistant acid phosphatase)-positive cells and macrophages showing resorption of cartilage matrix and cellular debris were not observed in the degenerating tectum cartilage. Immunoreactivity for MMP-1(matrix metalloproteinase), indicating the existence of collagenase, was visualized in the cartilage matrix<br>These results suggested that tectum cartilage retained features of hyaline cartilage, and its disappearance may be induced by matrix degradation with collagenase.

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  Background: Dermoid cysts (DCs) reportedly occur at the suture line of the skull. We report a case of DC arising from the sphenofrontal suture, and provide a summary of DCs from the sphenofrontal suture on cranial invasion reported in the literature.
  Case: The patient was a two year old boy. His tumor was located at the sphenofrontal suture and invaded the bone of the skull, and was surgically removed. We performed CT and MRI. They showed DC from the subcutaneous layer to full thickness of the bone. Recurrence occurred, and so a second operation was performed.
  Consideration: We summarized DCs from the sphenofrontal suture reported in the world, their degree of bone invasion, and evaluation methods. DCs from the sphenofrontal suture are rare, and relatively frequently invade bones. Therefore, we prefer to perform CT or MRI for preoperative diagnosis.
  Conclusion: DCs from the sphenofrontal suture are rare. Their preoperative evaluations are important because they are prone to invade bones.

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Wister rats at the age of 1, 3, 6 days were irradiated with GaAlAs diode lasers (805 nm) at several power levels ranging from 13 to 200 mW for 15 min at the point located above the cerebellar culmen. They were sacrificed 6 hours after irradiation, and their cerebella were removed and processed for microscopic observation. In the mid-sagittal sections through the vermis, incidences of pyknotic cells and mitotic cells among matrix cells in the external granular layer along the primordial culmen were estimated. Cerebellar temperaturesunder irradiated spots in rats at the age of 3 days were also measured by a needle-shaped thermocouple. Cerebellar temperatures in rats irradiated at power levels more than 100 mW were significantly higher than those of sham-irradiated group. No significant difference from sham-irradiated groups was observed in the incidences of pyknotic and mitotic cells in all rats irradiated with diode lasers. In rats at the age of 3 days irradiated with diode laser of a clinical instrument (NIR monitor) of Shimadzu Corp., no significant change in temperatures and the incidences of pyknotic and mitotic cells was found in their cerebella. These facts suggest that diode laser irradiation at power less than 200 mW does no cause cell death in the neonatal rat brain.

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羽島貝塚は岡山県倉敷市に所在する縄文時代前期の貝塚である。当遺跡から1920年に発掘された頭骨1点には左前頭部に楕円形の孔があるが，それは先行研究で非人為的と報告されていた。この損傷について，肉眼およびCT画像を用いて法医人類学的観点から検討したところ，それは典型的な人為損傷の特徴を示し，形態的に「刺器損傷」に分類すべきものであることがわかった。さらに東京大学総合研究博物館所蔵資料の中で，人為損傷が報告されている頭骨3例に対しても同様に再検討を行い，法医人類学で用いられる鈍器損傷，刺器損傷，鋭器損傷の3つに分類した。そのうち2例のいくつかの孔は刺器損傷に相当すると判断された。このような損傷を生じた利器としては，これまで論じられてきた槍や矢だけでなく，近接武器としての鹿角や骨角器の可能性を検討すべきであろう。これらの損傷の性状を吟味しながら，意図的暴力や儀礼的遺体損壊を含む，損傷の背景について考察した。

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小児頭部外傷の画像診断は虐待に起因する頭部外傷（abusive head trauma; AHT）を鑑別する意味においても極めて重要である．しかし，AHTの病態や画像診断に関しては多くの議論があり，今なお一定の見解は得られていない．本稿では，AHTを含めた小児頭部外傷の理解を深めるため，特に乳幼児期の外傷例（頭血腫，硬膜外血腫，頭蓋冠骨折および硬膜下血腫）から頭蓋冠（特に縫合）と髄膜（特に硬膜境界細胞層：dural border cell layer）の発生と解剖について検討する．加えて，急性硬膜下血腫に併発する外傷後急性脳浮腫の発生機序についても神経興奮毒性の観点から考察する．

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