Tumstatin transfected into human glioma cell line U251 represses tumor growth by inhibiting angiogenesis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiogenesis is a prerequisite for tumor growth and plays an important role in rapidly growing tumors, such as malignant gliomas. A variety of factors controlling the angiogenic balance have been described, and among these, the endogenous inhibitor of angiogenesis, tumstatin, has drawn considerable attention. The current study investigated whether expression of tumstatin by glioma cells could alter this balance and prevent tumor formation.</p><p><b>METHODS</b>We engineered stable transfectants from human glioma cell line U251 to constitutively secrete a human tumstatin protein with c-myc and polyhistidine tags. Production and secretion of the tumstatin-c-myc-His fusion protein by tumstatin-transfected cells were confirmed by Western blotting analysis. In the present study, we identify the anti-angiogenic capacity of tumstatin using several in vitro and in vivo assays. Student's t-test and one-way analysis of variance (ANOVA) test were used to determine the statistical significance in this study.</p><p><b>RESULTS</b>The tumstatin transfectants and control transfectants (stably transfected with a control plasmid) had similar in vitro growth rates compared to their parental cell lines. However, the conditioned medium from the tumstatin transfected tumor cells significantly inhibits proliferation and causes apoptosis of endothelial cells. It also inhibits tube formation of endothelial cells on Matrigel. Examination of armpit tumors arising from cells overexpressing tumstatin repress the growth of tumor, accompanying the decreased density of CD31 positive vessels in tumors ((5.62 ± 1.32)/HP), compared to the control-transfectants group ((23.84 + 1.71)/HP) and wild type U251 glioma cells group ((29.33 + 4.45)/HP).</p><p><b>CONCLUSION</b>Anti-angiogenic gene therapy using human tumstatin gene may be an effective strategy for the treatment of glioma.</p>

Facial nerve preservation following microsurgical removal of large and huge acoustic neuroma / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the long-term facial nerve function of patients following microsurgical removal of large and huge acoustic neuroma, and to identify the factors that influence these outcomes.</p><p><b>METHODS</b>A retrospective review was performed which included 176 consecutive patients with a large acoustic neuroma (≥ 30 mm) underwent a retrosigmoid craniotomy for tumor resection between January 2002 to November 2009. House-Brackmann (HB) Scale was used preoperatively and in a long-term follow-up after surgery. Test for linear trend was applied for statistic analysis.</p><p><b>RESULTS</b>Complete resection was achieved in 168 (95.5%) of these 176 patients with a mortality of 1.7%. Anatomic preservation of the facial nerve was attained in 96.0% of the patients. In the series of 96 patients who had at least 1-year follow-up (mean 3.0 years) the facial nerve function preservation (HB grade 1 - 2) was totally attained in 79 patients (82.3%), and 40 of 55 patients (72.7%) who presented huge tumors (diameter > 40 mm) among the 96 patients had facial nerve function preserved. Analysis showed that facial nerve function correlated linearly with tumor sizes (χ(2) = 14.114, ν = 1, P < 0.05).</p><p><b>CONCLUSIONS</b>Complete removal of large and giant acoustic neuroma may be obtained via retrosigmoid approach with facial nerve preservation. Excellent long-term facial function can be expected in the majority of patients who undergo microsurgical removal of vestibular schwannoma via the suboccipital retrosigmoid approach. Tumor size is a significant prognostic parameter for facial nerve function following vestibular schwannoma surgery.</p>

Surgical outcomes of pediatric symptomatic epilepsy and their influencing factors / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the surgical outcomes of pediatric symptomatic epilepsy and the influencing factors for postoperative outcomes.</p><p><b>METHODS</b>A cohort of 48 children with symptomatic epilepsy received surgical treatment from October 2004 to September 2008. The surgical outcomes were followed up.</p><p><b>RESULTS</b>A 27.3 months (range 12-51 months) follow-up was performed in 43 cases. Engel classification for evaluating postoperative epileptic outcomes showed that class I in 32 cases (74%), class II in 4 cases (9%), class III in 4 cases (9%) and class IV in 3 cases (7%). Preoperative seizure frequency is an independent predictor of postoperative epileptic outcomes (P<0.05).</p><p><b>CONCLUSIONS</b>Operative treatment can lead to a favorable result in children with symptomatic epilepsy. Preoperative seizure frequency is an independent influencing factor for postoperative outcomes.</p>

Neuroendoscopy for treatment of multilocular brain abscess in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Multilocular brain abscess in children is a serious neurosurgical emergency and remains a serious, life-threatening disease. This study evaluated the role of neuroendoscopy in treating multilocular brain abscess in children.</p><p><b>METHODS</b>Between January 2002 and June 2007, 16 children with multilocular brain abscess underwent an operation using a pure endoscopic procedure.</p><p><b>RESULTS</b>Increased intracranial pressure was relieved after operation in the 16 patients. CT/MRI after operation showed the abscess cavities disappeared and only the residual abscess walls existed in the 16 patients. Fourteen patients were followed up for 6 months to 5 years after surgery. Abscess walls disappeared in 13 patients and abscess recurred only in 1 patient.</p><p><b>CONCLUSIONS</b>Neuroendoscopy for treatment of multilocular brain abscess is safe and effective in children.</p>

Surgical treatment of childhood craniopharyngioma: clinical analysis of 31 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the diagnosis, surgical treatment and outcome of craniopharyngioma in 31 children.</p><p><b>METHODS</b>The clinical data of 31 children (aged 7-14 years) with craniopharyngioma were studied retrospectively.</p><p><b>RESULTS</b>Headache, visual disorder and growth retardation were main manifestations in the 31 children. The 31 children were definitely diagnosed with craniopharyngioma by CT and MRI. In the 31 cases, 19 (61.3%) underwent total tumor removal, 5 (16.1%) subtotal removal, and 7 (22.6%) partial removal. After tumor removal, transient diabetes insipidus occurred in 19 cases (61.3%) and long-term diabetes insipidus in 3 cases. Six cases (19.4%) presented hypothalamic injuries after surgery. No patient died after surgery. Five patients (16.1%) had recurrent tumor in a mean follow-up of 32.5 months.</p><p><b>CONCLUSIONS</b>The diagnosis of childhood craniopharyngioma may be based on clinical manifestations and CT/MRI examinations. Craniotomy is a preferred surgical treatment. Proper extent of tumor resection should be determined in order to reduce the tumor recurrence and the incidence of postoperative complications.</p>

Quantitative analysis of the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region / 中华外科杂志

<p><b>OBJECTIVE</b>To study the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region based on quantitative measurements, and provide reliable anatomic data for selecting surgical approach individually and protecting the function of important structures.</p><p><b>METHODS</b>The complete approach of the suboccipital far-lateral approach and the postauricular transtemporal approach were reproduced in twelve (twenty-four sides) head-neck specimens of adults be fixed in 10% formalin. The exposure area to the jugular foramen region was obtained using a stereotactic device, and the length of exposure of the clivus and the trigeminal nerve were measured using a vernier caliper.</p><p><b>RESULTS</b>In the suboccipital far-lateral approach, the significant increase in exposure was noted after removal of the jugular process and partial resection of occipital condyle. In the postauricular transtemporal approach, the exposure increased significantly after complete retrolabyrinthine approach, partial labyrinthectomy and transcochlear approach.</p><p><b>CONCLUSIONS</b>Resection of jugular process is the key to expose the jugular foramen through the far-lateral approach. The infralabyrinthine approach and the partial labyrinthectomy approach are ideal approaches to expose the jugular foramen region laterally.</p>

Clinical significance of the expression of the RCAS1 mRNA and protein in astrocytic tumors / 中南大学学报(医学版)

OBJECTIVE@#To determine the mRNA and protein expressions of RCAS1 in human astrocytic tumors, and to explore the relation between their expression and the genesis and development of tumor.@*METHODS@#The RCAS1 mRNA expression in human astrocytic tumors was evaluated by RT-PCR, and the RCAS1 protein expression was studied by immunohistochemical staining.@*RESULTS@#The quantities of RCAS1 mRNA expression between diffusive astrocytoma(Grade II) and anaplastic astrocytoma(Grade III), anaplastic astrocytoma and glioblastoma(Grade IV) were significantly different(P<0.05), while the expression scores of RCAS1 protein were different only between the anaplastic astrocytoma and glioblastoma(P<0.01). RCAS1 protein expression was positively correlated with the tumor grade (r=0.573,P<0.001). The RCAS1 protein was not detected in normal brain tissues by immunohistochemical staining.@*CONCLUSION@#The RCAS1 expression is related to the histological grade of astrocytic tumor. In astrocytic tumors, the RCAS1 expression is regulated transcriptionally and posttranscriptionally.

Mononostril-septum-transsphenoidal approach for pituitary adenoma / 中南大学学报(医学版)

OBJECTIVE@#To summarize the mononostril-septum-transsphenoidal approach for pituitary adenoma.@*METHODS@#The clinical features, operative techniques, and outcome of 36 patients with pituitary adenoma were analyzed retrospectively.@*RESULTS@#Tumors were totally removed in 28 cases, and subtotally resected in 8 patients. No patient died after the operation. Endocrine symptom of 31 patients returned to the normal level, the symptom of the other 5 cases were improved. Thirty patients with visual field defects recovered after the operation. Cerebrospinal fluid leakage occurred in one patient, and was cured with conservative treatment in 2 weeks.@*CONCLUSION@#Mononostril-septum-transsphenoidal approach can make use of the natural space of the nasal cavity, which has many advantages, such as direct approach, short operative time, minimal invasion, and few complications. It is a effective transsphenoidal surgical approach.

Microsurgical treatment for craniopharyngioma combined transorbital-subfrontal and temporal craniotomy / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience in microsurgical removal of craniopharyngioma using combined transorbital-subfrontal and temporal craniotomy.</p><p><b>METHODS</b>Eighteen patients with craniopharyngioma varied from 3.1 cm to 6.2 cm in diameter. The tumor was located in the suprasellar region in 7 patients, extended to the third ventricle in 6, and down to the intrasellar from the suprasellar region in 4, and in the third ventricle in 1. Complete or partial cystic tumor was seen in 13 patients, and solid tumor in 5, and calcified tumor in 12. All the patients were operated on via combined transorbital subfrontal and temporal approach. The tumor was dissected in the spaces I, II and IV with great attention to the preservation of the perforating arteries from the carotid, posterior communication and anterior choroidal arteries to the structure of the hypothalamus. The solid portion of the tumor was removed by piecemeal.</p><p><b>RESULTS</b>The tumor was totally removed in 14 patients and subtotally in 4. Postoperation, follow-up for 8 to 41 months showed no change in 3 residual tumors and one lost to follow-up. All patients Postoperative Karnofsky scales showed 80 - 90, in 12 patients, 60 - 70 in 5 patients, and 50 in 1.</p><p><b>CONCLUSIONS</b>Combined transorbital-subfrontal and temporal approach can provide an excellent exposure to the sellar region, craniopharyngioma and its surrounding structures. This approach ensures less cerebral retraction for easy access to craniopharyngioma, including other large neoplasm of the middle cranial base with ventricle or posterior cranial base extension. Microsurgical techniques play an important role in removing tumor and preserving hypothalamic function.</p>

The clinical significance of petrosal vein in operation of cerebellopontine angle tumor / 中华显微外科杂志

Objective To discuss the clinical significance of petrosal vein in operation of cerebel- lopontine angle(CPA)tumor.Methods From Dec.2004 to Mar.2006,33 patients with tumor in CPA were operated,the petrosal vein were protected well in 31 cases and failed to protect in 2 cases.Results No hemorrhagic infarction observed in 31 cases with well protection of petrosal vein.Two cases with petrosal vein damage occured with vein infarction and hemorrhagic edema.One was dead and the other was recovered well after decompression of posterior cranial fossa.Conclusion Petrosal vein should be well protected in the tumor operation of CPA area,the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.