ABSTRACT
Objective To study the giant invasive pituitary tumor neuroendoscopic operation indications,operation excision,risk aversion,and the operation skills.Methods The clinical data of 7 patients with giant invasive pituitary tumor among of endoscopic transsphenoidal surgery 61 cases of neurological patients with pituitary tumors were analyzed retrospectively.Results There were 1 case of total resection,6 cases of subtotal resection invading cavernous sinus cases,diaphragma sellar was seen in 5 cases of resection of the tumor,and 2 cases showed no diaphragma sellar.The average operation time was 100 minutes.No intraoperative transfusion.Postoperative hemorrhage in 2 cases,and 1 death case in this group after 36 hours,and 1 case undergoing endoscopic hematoma resection and cured.Conclusions With the development of endoscopic techniques,indications for operation with the new changes,for the giant invasive pituitary tumor operation therapy,endoscopic technique provides a disposable operation resection,the method is safe and avoid catastrophic consequences.
ABSTRACT
The aim of this study was to analyse the clinical characteristics and laboratory data, treatment and prognosis of polycythemia vera (PV). A retrospective study was performed for 71 PV patients treated in our hospital during January 2001 to July 2011 including analysis of clinical characteristics, laboratory data, myelogram chromosome karyotypes, BCR/ABL and JAK2V617F genes, as well as lactate dehydrogenase (LDH) and neuron-specific enolase (NSE) levels in serum and so on. The results showed that 71 patients (37 males and 34 females with a average age of 57.8 years) were diagnosed. Thrombosis and embolism occurred in 34 patients (47.89%), hemorrhage in 10 patients (14.08%), splenomegaly occurred in 44 patients. The onset of the disease was insidious, 13 patients (18.31%) were found to have PV during the treatments for other diseases. The average hemoglobin at diagnosis was 206.31 (171 - 242) g/L. JAK2V617F mutation was detected in 31 (81.58%) of 38 patients studied. The average levels of serum LDH and NSE were higher than normal and both positively correlated with hemoglobin (P = 0.007, P = 0.005). The disease outcomes were myelofibrosis for 3 patients, death from cerebral hemorrhage for 1 patient, and death from ineffective chemotherapy in 1 patient with ANLL-M2. It is concluded that PV is a chronic myeloproliferative disorder characterized predominantly by thrombosis and hemorrhage. The serum LDH and NSE levels are higher than the normal values. It is inferred that the serum LDH and NSE levels can reflect the degree of malignant proliferation of bone marrow hematopoietic cells and also can be used as an indicator to judge the therapeutic effect of PV.