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Objective To summarize experiences of microsurgical treatment of dumbbell tumors of the high cervical spine. Methods A series of 12 patients with dumbbell tumors of the high cervical spine were treated by using microsurgical techniques through posterior approach or antero-lateral approach. Results Complete resection was achieved in 10 patients. Postoperative neurological symptoms improved greatly in all. Conclusion The key points of treatment in dumbbell tumors of the high cervical spine are to analyze the preoperative image carefully and have knowledge about anatomy of high cervical spine as well as the experience of microsurgical technique.
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BACKGROUND: The observation of vascular endothelial growth factor gene expression of cerebrovascular diseases and ultrastructure of cells may be helpful to understand angiogenesis and its relative cellular factors involved in the pathogenesis at cellular and molecular levels. OBJECTIVE: To investigate the method of culture of human cerebral cap illary endothelial cell by separation of capillary fragment in vitro, and to ob serve vascular endothelial growth factor gene expression and ultrastructure of cells. DESIGN: A randomized controlled research on technique and method. SETTING: The neurosurgery department of a general hospital of a military area command of Chinese PLA and the neurosurgery department of a college hospital. PARTICIPANTS: Eighteen patients with arteriovenous malformation of brain(Spetzler Ⅱ-Ⅲ grade), as confirmed by aortocranial angiography before operation, in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA were included. The material was obtained from fresh integrated specimen of arteriovenous malfor mation of brain with surrounding fresh brain tissues during the opera tion. Capillary endothelial cell was separated by homogenate, filtration and enzymatic digestion techniques. Cells grew well in culture flask and were divided into 4 groups(hypoxia state for 2, 4, 8 hours groups and control group). Each group contained four flasks.METHODS: Simulation of anoxia condition: volume faction 0.95 N2 and volume fraction 0.05 CO2. Expression of factor Ⅷ related antigen in cells was detected by immunohistochemistry. mRNA expression of vascular endothelial growth factor on endothelial in every group was observed by RT-PCR, protein content of vascular endothelial growth factor in supernatant detected by enzyme-linked immunoadsordent assay, and cellular ultrastructural change observed by transmission electron microscopy.MAIN OUTCOME MEASURES: mRNA expression of vascular endothelial growth factor on endothelial cell and protein content of vascular endothelial growth factor in supernatant in control group and every hypoxia groups; cellular ultrastructural changes.RESULTS: Under phase contrast microscope, cultured living cells had mono-layer pebble-like typical character. More than 90% of were factor Ⅷrelated antigen(FⅧ-RA) staining positive. mRNA and protein expression of vascular endothelial growth factor in hypoxia 4 hours group was 0.98 ±0. 19,( 180. 77 ± 20. 15) ng/L, which was significantly higher than in control group [0, (26. 20 ± 6.33) ng/L, P ＜ 0.01 ]. Eight hours later, expression decreased [(0. 35 ±0.07), (31.68 ±8.34) ng/L]; swollen mitochondrion, dilated endoplasmic reticulum, and lysosome vesiculation were found.CONCLUSION: Humane cerebral capillary endothelial cell can be cultured by separation of capillary fragment, which is easy to operate and the cellular purity is reliable. In the early stage of ischemia and hypoxia, expression of vascular endothelial growth factor is not enough to maintain cellular ultrastructure integrity. Cells may be injured along with the prolong of hypoxia.Zhao MG, Tang T, Gao YZ, Pu PY, Wei XZ. Culture of human cerebral capillary endothelial by separation of capillary fragment and the observation of vascular endothelial growth factor gene expression and cell ultrastructure. Zhongguo Linchuang Kangfu 2005; 9(21):211-3 (China) [www. zglckf. com]
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Objective To study the mechanism of glycerol in treatment of trigeminal neuralgia. Methods After chronic constriction injury was produced to the infraorbital nerve and the model of trigeminal neuralgia in rats was successfully established, the trigeminal ganglion and preganglionic rootlets were exposed through infratemporal fossa approach. In the experimental group, pure glycerol was instilled into the preganglionic rootlets, while in the control group physiologic saline instead. The electrophysiologic response and the results of the electron microscopy were observed at different time points after glycerol injection. Results The latency of sensory evoked potential in the experimental group was longer than that in control group. Under the electron microscope, demyelination and degeneration were very similar in two groups, but disruption of neuraxon was only observed in the experimental group. Neuraxon regeneration occurred 10 weeks later. Conclusion Retrogasserian glycerol rhizotomy in treatment of trigeminal neuralgia was through disruption of myelinated nerve fiber that is reversible.
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The anatomy of the trunks and branches of anterior inferior cerebellar artery(AICA) was studied and its surgical importance especially in the operation for acoustic neuroma(AN), was discussed.15 fresh adult cadavers were perfused with ABS via internal carotid artery and vertebral artery and then dissected under operation microscope in detail. AICA was constantly present in all specimens. The incidence of labyrinthine artery(LA), recurrent perforating artery(RPA), subarcuate artery(SA),and cerebellar subarcuate artery (Cer.SA) was 100%,86.7%,80% and 16.7%, respectively. 97.1% of LA entering the internal auditory meatus (IAM) were located under the facial vestibulocochlear nerve complex, 56.7% of RPA passed between it ,and 75% of SA was located posteroinferiorly to it .60.7% of the loop of AICA was situated close to the IAM, and 53.6% of them lay between the Ⅶ and Ⅷ cranial nerves. These data may be helpful in microneurosurgical operation and radiography.
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To discuss treatment of wide-necked aneurysms.Methods Guglielmi detachable coil(GDC)after stent Pacement treat wide-necked aneurysm.Results Aneurysm was complete embolized,parent artery was intact.Conclusions Endovascular treatment of wide-necked aneurysms using and GDC is technically feasible.
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Objective To review the complications of initial phacoemulsification in a grass-roots hospital and to investigate preventive measures from complications. Design Retrospective cases series. Participants 184 cataract patients of initial phacoemulsification in the Fangshan First Hospital. Methods 184 patients (188 eyes) were performed phacoemulsification and intraocular lens (IOL) implantation. The complications were observed and recorded. All patients were followed up 3-6 months. Main Outcome Measures The rate of main complications. Results Major complications during and after phacoemulsification cataract surgery included posterior capsule rupture in 8 eyes (4.3%), iris injury in 2 eyes (1.1%), corneal edema in 23 eyes (12.2%), uveitis in 16 eyes (8.5%), ocular hypertension in 4 eyes (2.1%), detachment of retina in 2 eyes (1.1%), after-cataract in 21 eyes (11.2%). At the last visit, the post-surgery visiual acuities were 0.5 or better in 149 eyes (79.3%). Conclusion There may be more complications happened in the initial phacoemulsification in a grass-roots hospital. It should be gradually developed under the direction of skilled surgeons.