Treatment of C1-2 instraspinal neoplasms by laminoplasty via posternmedial approach / 中华神经医学杂志

Objective To investigate the techniques and curative effects of laminoplasty via posternmedial approach in treating C1-2 instraspinal neoplasms.Methods Twenty-seven patients (15males and 12 females) with C1-2 instraspinal neoplasms,admitted to and performed laminoplasty via posternmedial approach in our hospital from January 2007 to December 2011,were chosen in our study.Their clinical data and treatment efficacy were summarized.Results Total excision was achieved in all patients,and no patient in this study died.Pathological diagnosis showed 21 having schwannoma,1 neurofibroma and 5 meningioma.Follow up for 6-48 months indicated that 1 patient could take care of himself and the other 26 patients could live normally.No cervical spine instability or tumor recurrence was found.Conclusion Posternmedial approach may be regarded as the first selection to resect C1-2instraspinal neoplasms; laminoplasty can keep the stability of spine.

Microsurgery treatment of intradural extramedullary tumors in the foramen magnum / 中华神经医学杂志

Objective To investigate the curative effects of different surgical techniques on intradural extramedullary tumors in the foramen magnum.Methods Thirty five patients with intradural extramedullary tumors in the foramen magnum (21 males and 14 females),admitted to and underwent surgeries in our hospital from January 2007 to June 2012,were chosen in our study.Tumors were removed with microsurgeries (27 via suboccipital midline approach and 8 via suboccipital far lateral approach).Their clinical data and curative effects were summarized.Results Total excision was achieved in 32 patients,sub-total excision in 3 patients,and no patient in this study died.Pathological diagnosis showed 15 having schwannoma,3 having neurofibroma,14 having meningioma and 3 having hemangioblastoma.After operation,symptoms of pain in the neck and limb muscle weakness were relieved.All the patients were followed up for 3-48 months showing no cervical spine instability.Conclusion The correct choice of surgical approach and microsurgical skills are keys to remove the intradural extramedullary tumors in the foramen magnum effectively and safely.

Expressions of glucose transporter-3 and hypoxia-inducible factor-1α in astrocytoma / 中华神经医学杂志

Objective To explore the expressions and clinical significances of glucose transporter protein-3 (GLUT-3) and hypoxia-inducible factor-1α (HIF-1α) in astrocytoma. Methods The astrocytoma tissues from 80 patients with astrocytoma were chosen as experimental group; and the normal cerebral tissues from another 10 patients performed depression around the astrocytoma were chosen as control group. Immunohistochemistry and RT-PCR were employed to detect the GLUT-3 and HIF-1α expressions in these tissues. Results The protein of GLUT-3 in grade Ⅰ, grade Ⅱ, grade Ⅲ and grade Ⅳ astrocytomas were positively expressed, respectively, as 35%, 60%, 80% and 100% by immunohistochemistry; the protein of HIF-1α in grade Ⅰ, grade Ⅱ, grade Ⅲ and grade Ⅳ astrocytomas were positively expressed, respectively, as 20%, 50%, 75% and 95% by immunohistochemistry; positive correlation was noted between the protein levels of GLUT-3 and HIF-1α (r=0.550, P=0.000). The mRNA levels of GLUT-3 in grade Ⅰ, grade Ⅱ, grade Ⅲ and grade Ⅳ astrocytomas were expressed, respectively,as 0.19±0.03, 0.45±0.12, 0.67±0.11 and 0.89±0.19 by RT-PCR; the mRNA levels of HIF-1α were expressed, respectively, as 0.21 ±0.06, 0.48±0.11, 0.72±0.16 and 0.93±0.12 by RT-PCR; and the mRNA expression level of GLUT-3 were positively correlated to that of HIF-1α (r=0.530, P=0.000).Significant difference between each 2 different pathological grades of astrocytoma was noted (P＜0.05). The mRNA expression levels of GLUT-3 and HIF-1α were positively correlated to the pathological grades of astrocytomas (r=0.887, P=0.000; r=0.813, P=0.000). Conclusion The expression of GLUT-3 and HIF-1α in astrocytoma are significantly correlated to tumors' pathology grade, which can be taken as a useful marker for predicting the biological behavior.

Microsurgical treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia / 中华神经医学杂志

Objective To investigate the methods ofmicrosurgical treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia and their curative effects.Methods The clinical data of 185 patients with Arnold-Chiari Ⅰ malformation combined with syringomyelia,admitted to our hospital from January 1997 to June 2010 and received different surgical treatments,were summarized.The relationship between curative effects and operative methods were analyzed.Results When these 185 patients were discharged from our hospital,the clinical signs and symptoms eliminated in 156 (84.3％)and not changed in 29; no symptomatic deterioration and death were noted.One hundred and forty-seven patients were followed up for 3 months-12 years; symptoms disappeared or alleviated in 110 (74.8％),not changed in 26 and deteriorated in 11.The MR findings in 95 patients demonstrated that the cisternals reconstructed and expanded in 82 and the cavities in spinal cords reduced in 79.Conclusion Both posterior fossa decompression + duraplasty and removal of cerebella tonsils + plastic operation of cistern magna are effective and advisable methods in the treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia.