Progress in the role of high resolution magnetic resonance imaging technology in the risk assessment of intracranial aneurysm rupture / 中南大学学报(医学版)

The traditional classification, diagnosis, and treatment of intracranial aneurysms are based on the characteristics of their vascular lumen. However, in the past few years, some advances in MRI technology with high-resolution imaging can assess the pathology of intracranial vascular walls. Compared with traditional methods of computed tomography angiography, magnetic resonance angiograhpy, and digital subtraction angiography, high resolution magnetic resonance imaging technology can help us to newly understand the disease by directly evaluating the characteristics of vascular wall, such as aneurysm wall thickness, inflammation, enhancement, permeability and hemodynamics. At present, high-resolution magnetic resonance imaging is increasingly used in clinic to assess the rupture risk of intracranial aneurysms, which is of great significance for guiding the diagnosis and treatment of intracranial aneurysms.

Efficacy of antiangiogenic targeted immunotoxin DTAT and DTATEGF against glioblastoma multiforme / 中南大学学报(医学版)

OBJECTIVE@#To investigate the in vitro and in vivo anticancer efficacy of the immunotoxin DTAT and DTATEGF against globlastoma multiforme.@*METHODS@#The in vitro cytotoxicity of DTAT and DTATEGF was measured using MTT assay. In vivo studies were performed in which 18 nude mice were randomly divided into 3 groups and the glioma xenograft intracranial mouse model was constructed with U87-luc cell line of human glioma. Then 1 μg of DTAT, or DTATEGF, or a control protein Bickel3 was delivered intracranially by convection-enhanced delivery (CED) via an osmotic minipump. The brain tumor fluorescence signal intensity was investigated by bioluminescent imaging (BLI). Microvessel density (MVD) was measured by immunchistochemistry SABC method in each group.@*RESULTS@#In vitro DTAT and DTATEGF were found highly potent against U87-luc cell line, with IC(50) <0.01 nmol/L and IC(50)<1 nmol/L, respectively. In vivo BLI monitoring of the control group showed progressively increasing luminescence, while in the two treatment groups, luminescence was reduced on day 8, and increased slowly (P<0.05). The MVD of DTAT (31.6±5.2)/mm(2) and DTATEGF (25.1±6.5)/mm(2) groups had significant difference with that of the control group (51.3±7.4) /mm(2) (P<0.01).@*CONCLUSION@#Both DTAT and DTATEGF have potential in clinical application against globlastoma multiforme because of their ability to target the tumor cells and neovasculature simultaneously.

Clinical features of 417 patients with chronic subdural hematoma / 中南大学学报(医学版)

OBJECTIVE@#To discuss the clinical features of chronic subdural hematoma (CSDH) in different age groups.@*METHOD@#A total of 417 patients with CSDH were divided into 3 groups: 0 to 39, 40 to 59 and elder than 60 years. We analyzed the clinical features in different groups, including sex, trauma history, potential hemorrhage factors, trauma to symptoms interval, encephalatrophy, onset symptom and hematoma volume.@*RESULTS@#The incidence of trauma, potential hemorrhage factors, encephalatrophy, consciousness disorders and paralysis increased with age, while the incidence of intracranial hypertension symptoms and seizures decreased with age (P<0.001). The trauma to symptom interval in the group elder than 60 was longer than in other groups (P<0.05) and the hematoma volume increased with age(P<0.05).@*CONCLUSION@#The clinical features of CSDH including onset symptoms, trauma history, potential hemorrhage factors, encephalatrophy, trauma to symptoms interval and hematoma volume vary in different age groups.

Efficacy of bispecific targeted immunotoxin DTATEGF against NSCLC brain metastatic tumor PC9-BrM3 cells / 中南大学学报(医学版)

OBJECTIVE@#To investigate the in vitro and in vivo anticancer efficacy of the immunotoxin DTATEGF against human NSCLC brain metastatic tumor PC9-BrM3 cell line.@*METHODS@#The effect of the immunotoxin DTATEGF was tested for its ability to inhibit the proliferation of PC9-BrM3 cells in vitro by MTT assay. The cell cycle and the apoptosis of cells with 1 pmol/L DTATEGF were examined by flow cytometry. In vivo, 2 μg of DTATEGF or control Bickel3 was given intratumor to nude mice with established PC9-BrM3 xenografts on their hips, and tumor volumes were measured and tumor samples were investigated by immunchistochemistry SABC method. The microvessel density (MVD) was measured in each group.@*RESULTS@#In vitro, DTATEGF killed PC9-BrM3 cells and showed an IC50 of 1 pmol/L. The apoptotic rate in the 1 pmol/L DTATEGF group was (64.0±0.5)% , significantly higher than that in the control group (1.5±0.4)% (P<0.01). The cell cycle was obviously inhibited by DTATEGF in a dose-dependent manner. The percentage of cells treated with 1 pmol/L DTATEGF in SubG0/G1 phase was (32.0±1.5)%, significantly higher than that in the control group (2.0±0.4)% (P<0.01). In vivo, DTATEGF significantly inhibited the growth of PC9-BrM3 hip tumors (P<0.05). The MVD of the DTATEGF group was (15.6±4.6)/mm2, significantly lower than that of the control group (31.2±5.4)/mm2 (P<0.01).@*CONCLUSION@#DTATEGF inhibits the growth of the PC9-BrM3 cell line and induces its apoptosis. It is highly efficacious against human metastatic NSCLC brain tumor and against neovascularization.

Microsurgery for parasellar menningiomas and impact factors of recurrence / 中南大学学报(医学版)

Objective:To study the effect of microsurgery for parasellar menningiomas and to analyze the impact factors of recurrence. Methods:Clinical and follow-up data in a consecutive series of 134 patients with parasellar meningiomas were retrospectively analyzed. Results:A total of 109 patients (81.3%) had radical removal (Simpson grade I and II), and 116 patients were followed up for an average period of 81.6 months. The mean quality of life score (KPS) was 91.9, 90 patients regained full daily activity and 16 patients were able to take care of themselves. Oculomotor paralysis occurred in 7 patients, epilepsy in 8, and another 9 patients suffered hemispheral paralysis. Tumor recurred atfer the radical removal in 12 out of the 96 follow-up patients (12.5%). Tumor progressed atfer subtotal removal in 12 out of the 20 follow-up patients (60%). Tumor with cavernous sinus (CS) invasion had significantly higher risk of recurrence campared with non-CS invasion (P=0.043). The recurrence rate increased with the pathological grade (P<0.01). Conclusion:Patients with parasellar meningiomas undergoing microsurgical resection may have a good long-term function outcome. For most patients, total removal by microsurgery is the ifrst choice. Careful follow-up is needed if tumor invaded the CS and radiosurgery is proposed for WHO grade 1 and 2.

The prevention cerebrospinal fluid leakage during operating anterior skull base meningioma involving paranasal sinuses / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To introduce a kind of method for skull base reconstruction after resecting anterior skull base tumors involving paranasal sinuses.@*METHOD@#A retrospective analysis was carried out on 13 patients who underwent anterior skull base reconstruction. Pericranial flap were detached with integrity from the frontal bone during craniotomy, after the tumor had been resected partitionedly, the cribriform plate of ethmoid bone which was involved by tumor was resected. Using the fat tissue to fill the skull-base defects and sutured the pedicled pericranial flap with surrounding normal dura mater. Then reinforced at the junction of pericranial flap and dura mater with biogel.@*RESULT@#The pathogenic diagnosis of all cases were meningioma. I grade resection was acquired in 12 cases and II grade in 1 case according to Simpson grading standard of meningioma resection. The postoperative complications were 3 cases aseptic meningitis, 3 cases frontal syndrome. No CSF leakage, intracranial infection, nor death occurred. An average of 3. 4-year follow-up was achieved in all the cases from 9 months to 8 years, no tumor relapse.@*CONCLUSION@#CSF leakage can be effectively prevented by filling the skull-base defects with the fat tissue, suturing the pedicled pericranial flap with surrounding normal dura mater, and reinforcing at the junction of pericranial flap and dura mater with biogel.

Efficacy of subarachnoid space protection in intracranial operation: a report of 156 cases / 中南大学学报(医学版)

OBJECTIVE@#To determine the efficacy of subarachnoid space protection in intracranial operation.@*METHODS@#Data collected from 156 consecutive cranial operations, in which subarachnoid space protective technology was prophylacticly used, were analyzed.@*RESULTS@#Fourteen patients had a postoperative fever for more than 1 week and 16 patients who required lumbar puncture to release blood contaminated cerebro-spinal fluid (CSF) or exclude meningitis. All except 3 patients were discharged as expected. No patients had symptomatic vasospasm and hydrocephalus.@*CONCLUSION@#The subarachnoid space protective technology has good effect on preventing postoperative fever and improving the outcome of patients.

Clinical characteristics and operative effect of hippocampus lesions / 中南大学学报(医学版)

OBJECTIVE@#To study the clinical characteristics and operative effect of hippocampus lesions.@*METHODS@#We retrospectively analyzed the clinical characteristics and operative outcome of 44 patients with hippocampus lesions between August 2005 and April 2010.@*RESULTS@#Seizure attack was the initial symptom among 40 of the 44 patients. Pathological examinations revealed 18 gliomas, 9 cavernous malformations, 12 hippocampus sclerosis, 2 focal cortical dysplasia, 1 atypical hyperplasia, 1 injury glial scar, and 1 encephalomalacia. Thirteen patients received anterior medial temporal lobectomy and the other 31 received lesionectomy or selective amygdalohippocampectomy via transsylvian approach. An average of 15.7 month follow-up was accomplished in 37 patients. Postoperative epileptic outcomes were evaluated according to Engel classification: Grade I 73.0%(27/37), Grade II 13.5%(5/37), Grade III 10.8%(4/37) and Grade IV 2.7%(1/37). No perioperative death occurred. One patient experienced hemiplegia but recovered 8 months after the operation. Noticeable postoperative visual field deficit was left in 2 patients. Two patients with glioma died of remote tumor recurrence during follow-up.@*CONCLUSION@#Seizure attack is a major complaint of hippocampus lesions. Satisfactory seizure and tumor control may be achieved through anterior medial temporal lobectomy or selective amygdalohippocampectomy with lesionectomy.

Dynamic monitoring of arterial blood lactic acid in the prognosis of heart operation / 中南大学学报(医学版)

OBJECTIVE@#To determine the clinical value of arterial blood lactic acid monitoring in patients after cardiac surgery.@*METHODS@#Relationship between dynamic blood lactic acid level and the prognosis of 200 patients (9 patients in the dead group, and 191 patients in the healing group) was analyzed after cardiac operation.@*RESULTS@#The level of blood lactic acid was (1.2+/-0.3) mmol/L in the healing group,and (5.6+/-0.9) mmol/L in the death group. The level of blood lactic acid in the healing group descended to normal in 24 hours, while that in the death group rose persistently. The dynamic change of lactic acid indicated more sensitively the prognosis of the disease than pH and BE.@*CONCLUSION@#The higher the arterial blood level of lactic acid, the longer the duration, the more critical the condition, the higher the mortality rate. Blood lactic acid level can be used as an excellent prognosis index for patients after cardiac surgery.