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<p><b>OBJECTIVE</b>To study the changes of vascular endothelial cell function and platelet activation in rabbit spinal cord following ischemia-reperfusion (I/R) injury and their roles in the spinal cord injury.</p><p><b>METHODS</b>Rabbit spinal cord I/R injury models were established using Zivin method, and the changes in plasma NO and GMP140 levels were dynamically monitored after the injury.</p><p><b>RESULTS</b>Plasma NO level increased significantly in the I/R group at the end of the ischemia, and reached the peak level at 2 h of reperfusion as compared to that in sham-operated group (P<0.01). Plasma NO level decreased at 6 h of reperfusion, but still significantly higher than the level in the sham-operated group (P<0.05). Plasma GMP140 underwent no significant changes in the sham-operated group, but significantly increased in the I/R group at the end of the ischemia, followed by gradual declination to the normal level at 2 h of reperfusion.</p><p><b>CONCLUSION</b>Spinal cord I/R injury causes overexpressions of NO and GMP140, suggesting the involvement of endothelial cell injury and platelet overactivation in the pathological process and repair of spinal cord I/R injury.</p>
Assuntos
Animais , Coelhos , Células Endoteliais , Metabolismo , Óxido Nítrico , Sangue , Selectina-P , Sangue , Ativação Plaquetária , Traumatismo por Reperfusão , Sangue , Patologia , Medula Espinal , PatologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the association of microsurgical anatomy and growth of pituitary tumors with the recovery of visual pathway, and describe the intraoperative protection of the pituitary stalk and visual pathway.</p><p><b>METHODS</b>A total of 113 patients undergoing pituitary tumor surgery were retrospectively analyzed, including 102 with visual disorder and 106 with pituitary dysfunction with the tumor size ranging from 1.9 to 6.8 cm. All the operations were performed via a transpterygoid approach or transfrontal approach.</p><p><b>RESULTS</b>Radical resection of the tumors was performed in 86 cases, subtotal resection in 21 cases, and partial resection in 5 cases. After operation, 133 eyes showed vision improvement (77.8%), 29 showed no vision changes (17%) and 9 had deteriorated vision. Two patients died due to hypothalamic disorder and multiple organ failure.</p><p><b>CONCLUSION</b>The arachnoid barrier between the pituitary tumor and visual pathway is an important structure for visual pathway protection during operation. Total separation of the tumor from the visual pathway allows total removal of the tumor. The preoperative localization and intraoperative identification of the pituitary stalk are critical for pituitary stalk protection.</p>
Assuntos
Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Adenoma , Patologia , Cirurgia Geral , Complicações Intraoperatórias , Microcirurgia , Métodos , Procedimentos Neurocirúrgicos , Métodos , Hipófise , Patologia , Neoplasias Hipofisárias , Patologia , Cirurgia Geral , Estudos Retrospectivos , Resultado do Tratamento , Vias Visuais , PatologiaRESUMO
Objective: To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods: Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reperfusion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results: There was no significant difference between L Gln group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P0.05), whereas there was a significant difference in SOD activity and Glu content (P<0.05). Conclusion: Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reperfusion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.
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Objective To observe the changes in serum and spinal cord nitric oxide (NO) levels after spinal cord ischemia-reperfusion (IR) injury in rabbits. Methods The Zivin method was used to induce spinal cord IR injury in rabbits, in which the NO levels in the serum and spinal cord tissues were observed dynamically. Results In rabbits with spinal cord IR injury, the serum NO levels increased gradually after spinal cord IR injury and reached a peak level at 2 h, showing significant difference from the levels of before ischemia (P<0.05), and followed by obvious reduction at 6 and 12 h after the injury (P<0.05). In the spinal cord tissue homogenate, the NO levels increased significantly to reach the peak level at the end of the ischemia (P<0.05), and then decreased obviously at 2 and 6 h to the level comparable to that in the sham-operated group (P>0.05). Conclusions NO is over-expressed in the serum and spinal cord tissue in rabbits following spinal cord IR injury, and may play a role in neuronal damage and repair in the event of spinal cord IR injury.
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Objective To summarize our experience with intraoperative neural electrophysiological monitoring during spinal cord surgery. Methods The clinical data of 11 patients undergoing spinal cord surgery with intraoperative neural electrophysioiogical monitoring were retrospectively reviewed, and the monitoring was performed by recording the motor-evoked potential (MEP), somatosensory evoked potential (SEP), and evoked electromyography (EMG). Results Subtotal resection of the intramedullary cystic lesion was performed in 1 case and partial resection of the intramedullary tumor in another. In 9 cases of tethered spinal cord syndrome, obvious improvement was obtained in 8 cases, and the other 1 case showed no obvious changes in the symptoms after the operation. In all the 11 cases, the spinal cord remained intact and its function was totally preserved without damage of the eonus medullaris or the cauda equine. Conclusion Combined monitoring of MEP, SEP, and evoked EMG during spinal cord surgery is useful for protecting the spinal cord and the nerves roots, and may enhance the detection of the tethered tissue and ensure better safety of operations.