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Objective To study the relationship of sphenoidal intersinus septa with transsphenoidal resection of sellar area tumor. Methods The pre-operative MRI and CT images of the sphenoid intersinus septa and its importance in transsphenoidal resection of sellar area tumor were studied in 107 patients, admitted to our hospital from January 2008 to December 2010. The amounts, locations, anatomic specialties of the septa and its relationships with the floor of selle, the internal carotid artery canals and the tumors were analyzed to guide the operative procedures during the operation. Results Total removal of the tumors in seller region was obtained in 67 patients, subtotal removal in 21 and partial removal in 19. According to the MRI and CT images of the sphenoid intersinus septa, the location of the tumor and the carotid artery in 47 patients were quickly determined; complex sphenoid intersinus septa was noted in 11 patients, and the relation of sellar floor with the septa was quickly determined and the scope and direction of removal were determined too. Rupture of the internal carotid artery occurred in 1 patient, and damages of the cavernous sinuses occurred in 4. Conclusion Careful study of the pre-operative MRI or CT images of the sphenoidal intersinus septa and its relationship with the floor of seller, the internal carotid artery and the tumor will assure the transspenoidal surgery more precisely and safely, and the complication can be efficiently prevented and decreased.
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Objective To explore the problems of microsurgical treatment of multiple intracranial aneurysms with regard to the indications,surgical timing,operative approaches and the prevention of complications, and improve their diagnoses and treatments. Methods We retrospectively reviewed the data of 33 patients with multiple intracranial aneurysms admitted to our hospital from Jan.2000 to Dec.2008 and their clinical manifestations,imaging features and microsurgical treatments were summarized. Results In the 33 cases of multiple intracranial aneurysms,the male-to-female sex ratio was 1:1.75 and the average age at onset of symptoms was 56.52.Twenty-four patients showed good postoperative prognosis(Glasgow Outcome Scale IV-V) with 2 deaths.Conclusion Individual treatment should be adopted in the treatment of differently localized multiple intracranial aneurysms with different sizes and clinical classifications,and the utilization of temporary blockade and ultrasound during the operation can improve the therapeutic effects and reduce the postoperative complication rates.
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Objective To explore the methods, efficacy and advantages ofstereotactic surgery.Methods A retrospective analysis of 29 consecutive patients with 37 lesions (mean age, 34.6 years),received surgery between Dec 2002 and Nov 2009, was performed. Histological findings showed 11 craniopharyngiomas, 5 cystic gliomas, 3 metastases and 10 cerebral abscesses. Eighteen patients underwent cyst aspiration by the Ommaya reservoir system combined with 32P endocavitary irradiation;median irradiation doses were 800 μCi. One was treated with aspiration and then radiotherapy only. Ten patients with cerebral abscesses received cystic drainage (8 cases) and aspiration (2 cases). Results No operative bleeding and death were found in this experiment. Follow up was performed for a median of 10.6 months (range, 1-60 months) and 4 were out of contact. All patients with craniopharyngiomas remained stable without recurrence after treatment; complete resolution was achieved in all patients with cerebral abscess; in the other 8 patients with tumors(12 lesions), 5 were under control of the symptoms for an average of 14 months and 3 (2 with metastases and 1 with glioblastoma) did not get improvement after the treatment. Two patients with craniopharyngioma experienced a transient slightly worsening of hypothalamic functions, including transient diabetes insipidus, low fever and vomit. Conclusion Stereotactic technique has its advantages in treating patients with cerebral abscess, craniopharyngiomas,metastatic tumors and gliomas that were small size, while it does not that effective in the cystic metastases that are in large size and difficult to control in a short term.
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<p><b>OBJECTIVE</b>To explore the expression and changes of protooncogene c-myc in early restenosis after carotid endarterectomy (CEA).</p><p><b>METHODS</b>Using New Zealand Rabbits, carotid atherosclerotic stenosis (CASS) model were created. The expression of c-myc in early restenosis after CEA were detected by quantitative real-time polymerase chain reaction (qRT-PCR).</p><p><b>RESULTS</b>In this experiment protooncogene c-myc was analysed at pre-operation, 4 hours and 1 d after CEA by qRT-PCR, and the level of mRNA of c-myc was reached maximum at 4 hours, and decreased following significantly, but still higher than pre-operation.</p><p><b>CONCLUSIONS</b>The activation of protooncogene c-myc may be generator factor of vascular smooth muscle cell proliferation.</p>