ABSTRACT
<p><b>OBJECTIVE</b>To analyze the factors contributing to the occurrence of diabetes insipidus after operations for craniopharyngiomas.</p><p><b>METHODS</b>A total of 121 cases of diabetes insipidus following surgeries for craniopharyngiomas were retrospectively analyzed and the factors associated with postoperative diabetes insipidus were analyzed.</p><p><b>RESULTS</b>The incidence of diabetes insipidus was 27.3% (33/121 cases) before the operation, 89.9% (107/1119) early after the operation and 39.8%(37/93) in later stages after the operation. The occurrence of early postoperative diabetes insipidus showed a significant relation to the classification and calcification of the craniopharyngioma. Patients with supradiaphragmatic and extraventricular tumors had the lowest incidence of postoperative diabetes insipidus. Late postoperative diabetes insipidus was closely correlated to such factors as age, classification of craniopharyngioma, and intraoperative treatment of the pituitary stalk, but not to the scope of tumor resection or tumor calcification. Late diabetes insipidus was more frequent in children and patients with severed pituitary stalk. The incidence of late postoperative diabetes insipidus was significantly higher in patients with supradiaphragmatic and extra-intraventricular tumors than in those with tumors beneath the diaphragma sellae and extraventricular tumors.</p><p><b>CONCLUSIONS</b>Postoperative diabetes insipidus following surgeries for craniopharyngiomas is closely related to the tumor classification, calcification and pituitary stalk protection.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , China , Epidemiology , Craniopharyngioma , Pathology , General Surgery , Diabetes Insipidus , Epidemiology , Incidence , Neurosurgical Procedures , Methods , Pituitary Neoplasms , Pathology , General Surgery , Postoperative Complications , Blood , Regression Analysis , Retrospective Studies , Sella TurcicaABSTRACT
<p><b>OBJECTIVE</b>To investigate the growth of craniopharyngioma involving the third ventricular floor with regard to the hypothalamus by detecting expressions of leukocyte common antigen (CD45) and intercellular adhesion molecule (ICAM-1) in the tumor tissue.</p><p><b>METHODS</b>The expressions of CD45 and ICAM-1 proteins in 30 craniopharyngioma samples with third ventricular floor involvement were detected by SP immunohistochemistry.</p><p><b>RESULTS</b>The inflammations labeled by CD45 were identified commonly in the craniopharyngioma tissues involving the third ventricular floor. The expression of ICAM-1 was mainly in the inner tumor cells and interstitial cells, but not detected in the basilar tumor cells growing toward the third ventricular floor. Adamantinomatous craniopharyngiomas showed markedly higher CD45 and ICAM-1 expressions than squamous papillary tumors (P<0.05).</p><p><b>CONCLUSION</b>Inflammatory adhesion largely characterizes the growth of the craniopharyngioma tissues involving the third ventricular floor toward the hypothalamus without the tendency of invasion. The difference in the inflammation between the two types of craniopharyngioma may affect the prognosis of the patients.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Brain Neoplasms , Metabolism , Craniopharyngioma , Metabolism , Pathology , General Surgery , Hypothalamus , Metabolism , Pathology , Immunohistochemistry , Intercellular Adhesion Molecule-1 , Leukocyte Common Antigens , Neoplasm Invasiveness , Pituitary Neoplasms , Metabolism , Pathology , General Surgery , Third VentricleABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of Jingui Shenqi Pill (JSP) on the expression of glucocorticoid receptor (GR) in the skin lesion and its clinical effect in treating bullous pemphigoid (BP) patients.</p><p><b>METHODS</b>Thirty BP patients were randomly divided into the treatment group (n=15) treated with JSP plus prednisone and the prednisone group (n=15) with prednisone alone both for 4 weeks. And a normal control group was set up also. Expressions of GR-alpha and GR-beta in the skin lesion of BP patients and the normal skin of the normal control were detected by immunohistochemical assay. Results The total effective rate was 93.33% in the treatment group, significantly higher than that in the prednisone group which was 73.33% (P < 0.05); GR-alpha expression was higher in the treatment group than that in other two groups (P < 0.01), while GR-beta expression in the treatment group was lower than that in the prednisone group (P < 0.01).</p><p><b>CONCLUSION</b>JSP could increase GR-alpha expression and decrease GR-beta expression in the skin lesion of BP patients, so as to improve sensitivity of skin to glucocorticoid.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Drug Therapy, Combination , Drugs, Chinese Herbal , Therapeutic Uses , Glucocorticoids , Therapeutic Uses , Immunohistochemistry , Pemphigoid, Bullous , Drug Therapy , Metabolism , Pathology , Phytotherapy , Prednisone , Therapeutic Uses , Receptors, Glucocorticoid , Skin , Metabolism , Pathology , Treatment OutcomeABSTRACT
Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.