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>

Electrocorticography monitoring in microsurgical treatment of solitary cavernous angiomas / 中南大学学报(医学版)

OBJECTIVE@#To investigate the curative effect of electrocorticography (ECoG) monitoring in the microsurgical treatment of cavernous angiomas.@*METHODS@#Clinical data of 71 patients with epileptogenic cavernous angiomas,who had been performed ECoG monitoring during the operation,were analyzed retrospectively.@*RESULTS@#The foci of cavernous angiomas and epilepsy of the 71 patients were resected during the operation. In the 58 patients who were followed up,42 had not epileptic seizure,and 16 still had epileptic seizure,while the frequencies of 13 patients reduced to below 10%,and 3 patients over 10%.@*CONCLUSION@#The drug treatment of epileptogenic cavernous angiomas can not control epileptic seizure,and the patients should receive the microsurgical treatment early. Electrocorticography monitoring can direct the surgical procedure,and control the postoperative epileptic seizure.

Effect of different tidal volume ventilations on atelectasis in patients during general anesthesia by CT scan / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of different tidal volume ventilations on the amount of atelectasis during general anesthesia.@*METHODS@#Twenty adults, ASA physical status I and status II patients, who were scheduled for elective excision of intracranial lesion were randomly divided into 2 groups: Group TV (traditional tidal volume ventilation, 10 mL/kg) and Group LV (low tidal volume ventilation, 6 mL/kg). Atelectasis, as determined by CT and artery blood gas (ABG) analysis, was measured before the anesthesia, after the tracheal intubation, and at the end of the operation, respectively. Respiratory mechanical parameters were measured at 30, 120, and 240 min after the intubation.@*RESULTS@#After the tracheal intubation, CT scan showed obvious atelectasis in both groups. The atelectasis area was(4.35+/-2.15)cm2 (3.12%+/-1.94%) in the TV group and (4.80+/-2.45)cm2 (3.89%+/-2.11%) in the LV group, with a nonsignificant difference between the 2 groups. At the end of the operation, there was no significant increase in the amount of atelectasis between and within the 2 groups. Artery blood gas analysis showed no difference after the tracheal intubation and at the end of the operation in either group. Ppeak, Pplat, Pmean and lung compliance(Cst)were significantly higher in the TV group than those in the LV group.@*CONCLUSION@#Low tidal volume(6 mL/kg) ventilation is more feasible during general anesthesia in patients with healthy lungs, and it does not increase the atelectasis and impairment of gas exchange.

Detection and clinical significance of urinary epidermal growth factor in brain tumor patients / 中南大学学报(医学版)

OBJECTIVE@#To investigate the clinical significance of urinary epidermal growth factor (EGF) in patients with brain tumors.@*METHODS@#The levels of EGF in urine samples collected from 20 patients (9 low grade astrocytomas, 6 anaplastic astrocytomas, and 5 meningiomas) and 5 healthy individuals were determined. EGF levels were measured by radioimmunoassay technique. A preoperative and one postoperative determination were performed.@*RESULTS@#Preoperative urinary EGF levels of astrocytoma patients were statistically higher than those of meningioma patients and the controls (P 0.05).@*CONCLUSION@#The urinary EGF levels of astrocytoma patients correlate with the WHO grade of malignance and significantly decrease after gross total removal. Urinary EGF may be of practical value in diagnosing and evaluating the surgical efficacy of astrocytomas.

Gamma knife treatment for pituitary prolactinomas / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the outcome of gamma knife for prolactinomas.@*METHODS@#Eighty-nine patients were treated by gamma knife and 51 were followed up. The dose to the tumor margin ranged from 18 Gy to 35 Gy (mean 26.1 Gy). The maximum radiation dose varied from 36 Gy to 60 Gy (mean 50.41 Gy). The mean tumor diameter was 15.5 mm (5 - 26 mm).@*RESULTS@#The follow-up data were available for 51 patients ranging from 6 to 108 months (mean 37 months). The tumor growth control rate was 100%. The endocrinological remission rate was 40%. The rate of hypopituitarism was 17.6%.@*CONCLUSION@#Gamma knife radiosurgery can be used as a primary treatment for selected prolactinomas,especially for pituitary microadenomas.