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1.
Korean J Neurotrauma ; 20(1): 57-62, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38576506

RESUMO

A 42-year-old man presented with neck pain after a fall from a tree. Spine computed tomography (CT) illustrated the right C5 superior articular process fracture without displacement. Magnetic resonance imaging (MRI) confirmed the fracture and injury of the posterior ligament complex. Initially he was managed conservatively with a neck brace as there were no signs of instability or vertebral body misalignment. However, three days after discharge, right shoulder weakness and numbness of the right upper arm became prominent. X-rays and CT showed anterior slippage of the C4 vertebral body and locked C4/5 facet ??a fractured bony fragment of the C5 superior articular process was pushed forward by the locked inferior articular process of C4 and invaded the neural foramen. Anterior cervical discectomy and fusion (ACDF) was performed using allograft and plate/screws fixation. Although initial imaging showed no evidence of subluxation, surgeons should be aware of occult instability and the possibility of delayed dislocation associated with the unilateral cervical facet fracture.

2.
Emerg Infect Dis ; 30(3): 616-619, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38407167

RESUMO

In Jeju Island, South Korea, a patient who consumed raw pig products had subdural empyema, which led to meningitis, sepsis, and status epilepticus. We identified Streptococcus suis from blood and the subdural empyema. This case illustrates the importance of considering dietary habits in similar clinical assessments to prevent misdiagnosis.


Assuntos
Empiema Subdural , Sepse , Infecções Estreptocócicas , Streptococcus suis , Humanos , Animais , Suínos , Empiema Subdural/diagnóstico , Streptococcus suis/genética , República da Coreia , Comportamento Alimentar , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico
3.
J Korean Neurosurg Soc ; 66(6): 743-747, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37496405

RESUMO

Ruptured intracranial aneurysms in infants are rare and infantile fusiform anterior cerebral artery (ACA) aneurysms are much rarer. In this report, we described the case of a 7-month-old infant with a ruptured fusiform ACA aneurysm who presented with seizure and underwent endovascular treatment. The patient was initially in a coma and the neurologic condition did not improve after treatment. The clinical characteristics of the case and literature review were discussed.

4.
Anesth Pain Med ; 6(5): e40067, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27853682

RESUMO

INTRODUCTION: Spontaneous spinal epidural hematoma (SSEH) is an uncommon but potentially fatal condition. The increased bleeding tendency associated with anticoagulant medications has been proven to increase the risk of SSEH. The symptoms of SSEH usually begin with sudden severe neck or back pain and are followed by neurological deficits. However, some cases present with only axial pain or with radicular pain similar to herniated disc disorders. CASE PRESENTATION: A 28-year-old healthy man developed a sudden onset of severe neck and right shoulder pain with mild arm weakness. The MRI revealed an SSEH that was compressing his spinal cord in the right posterolateral epidural space from C2-C6. On the second hospital day, his symptoms suddenly improved, and most of the hematoma had spontaneously resolved. CONCLUSIONS: Currently, the incidence of SSEH is expected to increase. Pain physicians must include SSEH in their differential diagnosis for patients with axial pain or radicular symptoms alone, particularly when risk factors are present.

5.
J Korean Neurosurg Soc ; 59(2): 149-53, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26962421

RESUMO

OBJECTIVE: The aim of the present study is to estimate the incidence trend of head injury and the mortality based on traffic accident statistics and to investigate the impacts of rapid industrialization and economic growth on epidemiology of head injury in Korea over the period 1970-2012 including both pre-industrialized and post-industrialized stages. METHODS: We collected data of head injury estimated from traffic accident statistics and seven hospital based reports to see incidence trends between 1970 and 2012. We also investigated the population structure and Gross National Income (GNI) per capita of Korea over the same period. The age specific data were investigated from 1992 to 2012. RESULTS: The incidence of head injury gradually rose in the 1970s and the 1980s but stabilized until the 1990s with transient rise and then started to decline slowly in the 2000s. The mortality grew until 1991 but gradually declined ever since. However, the old age groups showed rather slight increase in both rates. The degree of decrease in the mortality has been more rapid than the incidence on head injury. CONCLUSION: In Korea during the low income stage, rapid industrialization cause considerable increase in the mortality and the incidence of head injury. During the high income stage, the incidence of head injury gradually declined and the mortality dropped more rapidly than the incidence due to preventive measures and satisfactory medical care. Nevertheless, the old age groups revealed rather slight increase in both rates owing to the large population structure and the declining birth rate.

6.
Korean J Neurotrauma ; 11(1): 18-21, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27169060

RESUMO

We report a case of spinal intradural abscess which shows serial changes on magnetic resonance imaging (MRI). Well-encapsulated, rim-enhancing lesion with mass effect was visualized at ventral side of lumbar spinal canal on 17 days after initial negative MRI, which was thought to be epidural abscess. It was revealed to be intradural in location on operation and successfully treated by drainage and antibiotics. Follow-up MRI showed resolution of abscess. Clinical significance and pathogenesis of this case was briefly discussed.

7.
Childs Nerv Syst ; 26(5): 627-36, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-19949802

RESUMO

OBJECTIVE: The aims of this study were to elucidate the processes of neuronal differentiation and ventrodorsal patterning in the spinal cord of the chick embryo from embryonic day (E) 3 to E17 and to study the effect of a prenatal spinal open neural tube defect (ONTD) on these processes. METHOD: Expression patterns of neuronal antigens (neuronal nuclear antigen, neurofilament-associated protein (NAP), and synaptophysin) and related ventral markers [sonic hedgehog, paired box gene (PAX)6, and islet-1], and dorsal markers (bone morphogenetic protein, Notch homolog 1, and PAX7) were investigated in the normal spinal cord and in a surgically induced spinal ONTD in chick embryos. Four normal and ONTD chick embryos were used for each antigen group. RESULT & CONCLUSION: There were no differences in the expression of neuronal and ventrodorsal markers between the control and ONTD groups. NAP and synaptophysin were useful for identifying dorsal structures in the distorted anatomy of the ONTD chicks.


Assuntos
Perfilação da Expressão Gênica , Proteínas do Tecido Nervoso/biossíntese , Defeitos do Tubo Neural/metabolismo , Medula Espinal/embriologia , Medula Espinal/metabolismo , Animais , Padronização Corporal , Embrião de Galinha , Expressão Gênica , Imuno-Histoquímica , Proteínas do Tecido Nervoso/genética , Defeitos do Tubo Neural/embriologia , Defeitos do Tubo Neural/genética
8.
Neurol Res ; 31(9): 996-1002, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19138477

RESUMO

OBJECTIVES: Previous works have reported that the transplantation of neural stem cells (NSCs) may improve functional recovery after spinal cord injury (SCI), but these results have been mainly obtained in rat models. In the present work, the authors sought to determine whether the transplantation of human NSCs improves functional outcome in a canine SCI model and whether transplanted NSCs survive and differentiate. METHODS: Human NSCs (HB1. F3 clone) were used in this work. Lateral hemisection at the L2 level was performed in dogs and either (1) Matrigel (200 microl) alone as a growth-promoting matrix or (2) Matrigel seeded with human NSCs (10(7) cells/200 microl) were transplanted into hemisected gaps. Using a canine hind limb locomotor scale, functional outcomes were assessed over 12 weeks. Immunofluorescence staining was performed to examine cell survival, differentiation and axonal regeneration. RESULTS: Compared with dogs treated with Matrigel alone, dogs treated with Matrigel + human NSCs showed significantly better functional recovery (10.3 +/- 0.7 versus 15.6 +/- 0.7, respectively, at 12 weeks; p<0.05). Human nuclei-positive cells were found mainly near hemisected areas in dogs treated with Matrigel + NSCs. In addition, colocalization of human nuclei and neuronal nuclei or myelin basic protein was clearly observed. Moreover, the Matrigel + NSC group showed more ascending sensory axon regeneration. CONCLUSIONS: The transplantation of human NSCs has beneficial effects on functional recovery after SCI, and these NSCs were found to differentiate into mature neurons and/or oligodendrocytes. These results provide baseline data for future clinical applications.


Assuntos
Traumatismos da Medula Espinal/cirurgia , Transplante de Células-Tronco/métodos , Células-Tronco/fisiologia , Animais , Antígenos Nucleares/metabolismo , Biomarcadores/metabolismo , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/fisiologia , Núcleo Celular/ultraestrutura , Células Cultivadas , Colágeno/farmacologia , Colágeno/uso terapêutico , Avaliação da Deficiência , Modelos Animais de Doenças , Cães , Combinação de Medicamentos , Proteína Glial Fibrilar Ácida/metabolismo , Sobrevivência de Enxerto/efeitos dos fármacos , Sobrevivência de Enxerto/fisiologia , Cones de Crescimento/metabolismo , Cones de Crescimento/ultraestrutura , Humanos , Laminina/farmacologia , Laminina/uso terapêutico , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Proteína Básica da Mielina/metabolismo , Regeneração Nervosa/efeitos dos fármacos , Regeneração Nervosa/fisiologia , Proteínas do Tecido Nervoso/metabolismo , Neurogênese/efeitos dos fármacos , Neurogênese/fisiologia , Proteoglicanas/farmacologia , Proteoglicanas/uso terapêutico , Recuperação de Função Fisiológica/efeitos dos fármacos , Recuperação de Função Fisiológica/fisiologia , Células-Tronco/citologia , Resultado do Tratamento
9.
Childs Nerv Syst ; 24(1): 105-10, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17805548

RESUMO

OBJECTIVE: The goal of our study was to evaluate the expression patterns of neuronal antigens during the process of secondary neurulation. MATERIALS AND METHODS: Chick embryos of Hamburger and Hamilton stages 16, 18, 20, 22, 24, 26, 30, 35, 40, and 45 were harvested, and tail sections were processed for neuronal antigen studies. RESULTS AND CONCLUSIONS: The areas and periods showing positive reactions for each antigen are as follows: neuronal cell adhesion molecule (N-CAM): the secondary neural tube and notochord from stages 18 to 26 and the germinal and mantle layers from stages 30 to 45; synaptophysin: the caudal cell mass, secondary neural tube, and notochord from stages 22 to 26, the germinal and mantle layers from stages 30 to 45, and the marginal layer at the later stages of development; neurofilament-associated protein (3A10): the dorsal white matter, dorsal root ganglion, and scattered cells around the germinal layer from stages 35 to 45; and neuronal nuclear-specific protein (NeuN): the mantle layer at stage 35, which shows decreased reaction at stages 40 and 45; islet-1: no remarkable staining on the caudal cell mass or on the other neural structures at all stages. Our results indicate that neuronal markers of the secondary neurulation in chick embryos have their own chronological patterns of expression. At early stages of secondary neurulation, N-CAM and synaptophysin are thought to modulate the differentiation of structures derived from the caudal cell mass. At later stages, N-CAM, synaptophysin, 3A10, and NeuN seem to be involved in the maturation of the caudal spinal cord.


Assuntos
Biomarcadores/metabolismo , Neurônios/metabolismo , Neurulação/fisiologia , Animais , Moléculas de Adesão Celular Neuronais/metabolismo , Embrião de Galinha , Imuno-Histoquímica/métodos , Proteínas de Neurofilamentos/metabolismo , Sinaptofisina/metabolismo
10.
J Neurosurg ; 106(3 Suppl): 237-42, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17465392

RESUMO

The authors describe a modified technique of encephaloduroarteriosynangiosis (EDAS) with bifrontal encephalogaleoperiosteal synangiosis (EGPS) and present the preliminary results of the procedure. Between January 2004 and June 2005 the authors performed modified EDAS with bifrontal EGPS in 17 patients with moyamoya disease. Surgical results were evaluated in terms of clinical outcomes, changes visible on neuroimages, extent of revascularization noted on angiograms, and hemodynamic changes demonstrated on single-photon emission computed tomography (SPECT) scans. The follow-up period ranged from 6 to 21 months (mean 11.5 months). The overall clinical outcomes were excellent or good in 15 patients (88.2%) and poor in two (11.8%). The overall morbidity rate was 5.9% (one of 17 patients). Based on changes in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) territories after surgery, as shown on SPECT scans following administration of acetazolamide, 14 patients (82.4%) exhibited an improved vascular reserve capacity in both the ACA and MCA territories. It is the authors' opinion that wide covering of the cortex is necessary for sufficient revascularization. In the present study they demonstrate that modified EDAS with bifrontal EGPS is a safe and efficient surgical approach that covers not only the MCA territory but also the ACA territory.


Assuntos
Revascularização Cerebral/métodos , Doença de Moyamoya/cirurgia , Adolescente , Circulação Cerebrovascular/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Doença de Moyamoya/fisiopatologia , Neovascularização Fisiológica/fisiologia , Estudos Retrospectivos , Retalhos Cirúrgicos , Resultado do Tratamento
11.
J Neurosurg Anesthesiol ; 18(4): 223-9, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17006118

RESUMO

OBJECTIVE: This study was performed to determine whether the preoperative multifractal Hurst analysis of heart rate variability might identify and characterize childhood patients with moyamoya disease (MMD) who showed temporary postoperative hypertension. METHODS: We studied 59 childhood patients with MMD. Thirty were classified as hypertensive group when the mean arterial pressure in the postoperative recovery room was 120% or greater than that during the preoperative period and 29 were classified as normotensive group. The 2 groups were compared with respect to preoperative indices of heart rate variability including frequency-domain measures, approximate entropy, and very short-term multifractal Hurst exponents of RR intervals (RRI). Using preoperative indices that showed significant differences, discriminant analysis was performed to identify postoperative hypertensive patients. RESULTS: Only exponents of the order > or =3 (H3alpha, H4alpha, and H5alpha) were significantly lower in the hypertensive group than in the normotensive group. Frequency-domain measures, approximate entropy, and the exponents of the order < or =2 were not significantly different in the 2 groups. Discriminant analysis using all of the three exponents correctly identified 27/30 (90%) of the postoperative hypertensive patients. CONCLUSIONS: Preoperative very short-term multifractal Hurst analysis of RRI variability identified 90% of childhood MMD patients who developed postoperative hypertension. The preoperative characteristic of RRI variability was the reduced smoothness at the 8-second-long, local RRI regions within which a very large change of RRI occurs.


Assuntos
Anestesia/efeitos adversos , Frequência Cardíaca/fisiologia , Hipertensão/etiologia , Doença de Moyamoya/diagnóstico , Doença de Moyamoya/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Adolescente , Artérias Cerebrais/cirurgia , Criança , Pré-Escolar , Eletrocardiografia , Entropia , Feminino , Fractais , Humanos , Masculino , Modelos Estatísticos , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/induzido quimicamente
12.
Childs Nerv Syst ; 22(9): 1136-42, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16628460

RESUMO

OBJECTS: The goals of this study were to evaluate the surgical outcomes of optic pathway glioma (OPG) and to analyze the prognostic factors related to the progression-free survival. MATERIALS AND METHODS: A retrospective review was conducted on 33 patients who underwent surgery for OPG; these included 15 male and 18 female patients with a mean age of 8.3 years. The mean duration of follow-up was 52 months. RESULTS AND CONCLUSIONS: The preservation rate of ipsilateral vision was 25%, while that of contralateral vision was 83% (P<0.001). There was no remarkable endocrine improvement after surgery. The overall and progression-free survival rates at 5 years were 93.6 and 52.4%, respectively. In our study, the predictors for tumor progression were children younger than 5 years of age (p=0.023) and of female gender (p=0.022). Because of the variable course of OPG, treatment policy should be optimized individually according to patient's status.


Assuntos
Glioma do Nervo Óptico/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Progressão da Doença , Intervalo Livre de Doença , Dominância Cerebral/fisiologia , Feminino , Humanos , Neoplasias Hipotalâmicas/patologia , Neoplasias Hipotalâmicas/cirurgia , Lactente , Masculino , Exame Neurológico , Quiasma Óptico/patologia , Quiasma Óptico/cirurgia , Glioma do Nervo Óptico/diagnóstico , Glioma do Nervo Óptico/mortalidade , Glioma do Nervo Óptico/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Prognóstico , Reoperação , Estudos Retrospectivos , Fatores Sexuais , Taxa de Sobrevida
13.
Neurosci Lett ; 364(2): 98-100, 2004 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-15196686

RESUMO

To evaluate the re-closure promoting capacity of human embryonic stem (hES) cells injected into the amniotic cavity on spinal open neural tube defects (ONTDs) of chick embryos, neural tubes were opened at Hamburger and Hamilton stage 18 or 19 and the embryos were divided into three groups: a control group (no injection), a vehicle group, and a hES cell group (injection of 20,000 hES cells immediately after neural tube incision). On postoperative days 3, 5, and 7, ONTDs were significantly more re-closed in the hES cell group than in the other two groups. hES cells were present at the area in the process of re-closure, and covered ONTDs, but were not found in the re-closed area, suggesting indirect effects rather than cell replacement on the neural tissue.


Assuntos
Defeitos do Tubo Neural/terapia , Transplante de Células-Tronco , Âmnio , Animais , Blastocisto/fisiologia , Embrião de Galinha , Desenvolvimento Embrionário e Fetal , Humanos , Defeitos do Tubo Neural/patologia , Análise de Sobrevida
14.
Epilepsy Res ; 56(2-3): 175-83, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14643002

RESUMO

Cortical dysplasia (CD) is a well-recognized cause of intractable epilepsy, especially in children and is characterized histologically by derangements in cortical development and organization. The objective of this study was to expand the current knowledge of altered gene expression in CD as a first step towards in the identification of additional genes operative in the evolution of CD. Surgical specimens were obtained from eight patients (4 males and 4 females; age range 2-38 years; mean 15 years) with a pathologic diagnosis of CD. Nondysplastic temporal neocortex was obtained from a 2-year-old boy with intractable epilepsy and medial temporal lobe ganglioglioma. After total RNA isolation from frozen brain tissues, we carried out gene expression profiling using a cDNA expression array. Differences in gene expressions between CD and the nondysplastic neocortex were confirmed by semi-quantitative conventional reverse transcription-PCR. Three genes (recombination activating gene 1 (RAG1), heat shock 60 kDa protein 1 (HSP-60), and transforming growth factor beta1 (TGF beta1)) were found to be up-regulated more than two-fold in CD, whereas four genes (phosphoinositide-3-kinase regulatory subunit polypeptide 1 [p85 alpha] (PI3K), frizzled homolog 2 [Drosophila], Bcl-2/adenovirus E1B 19 kDa interacting protein (NIP3), and glia maturation factor beta (GMF beta)) were down-regulated to less than 50% of their normal levels. Interestingly, the majority of genes showing altered expression were associated with apoptosis. Our study demonstrates diverse changes in gene expression in CD. However, it remains to be shown which of these are causally related to the evolution of CD.


Assuntos
Córtex Cerebral/anormalidades , DNA Complementar/genética , Epilepsia/genética , Regulação da Expressão Gênica/fisiologia , Adolescente , Adulto , Córtex Cerebral/patologia , Córtex Cerebral/cirurgia , Criança , Pré-Escolar , Sondas de DNA , Epilepsia/patologia , Epilepsia/cirurgia , Feminino , Regulação da Expressão Gênica/genética , Humanos , Processamento de Imagem Assistida por Computador , Hibridização In Situ , Imageamento por Ressonância Magnética , Masculino , RNA/genética , RNA/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa
15.
Stroke ; 34(12): 2835-41, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14605320

RESUMO

BACKGROUND AND PURPOSE: The etiology of moyamoya disease (MMD) remains obscure. This study was undertaken to identify specific proteins associated with the pathogenesis of MMD. METHODS: We studied cerebrospinal fluid (CSF) from 20 patients with angiographically confirmed MMD (4 boys and 16 girls; age range, 3 to 13 years; mean, 7.5 years) and 4 control patients with cerebral palsy who underwent selective dorsal rhizotomy (2 boys and 2 girls; age range, 5 to 10 years; mean, 7.3 years). CSF proteins were analyzed by 2-dimensional polyacrylamide gel electrophoresis, and protein identification was performed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The presence of specific CSF protein in patients with MMD was confirmed by Western blotting. In addition, cerebral CSF was also tested in 7 patients who had other brain diseases but no MMD (2 boys and 5 girls; age range, 1 to 12 years; mean, 6.9 years). RESULTS: We identified 1 polypeptide spot (Mr of 13 to 15 kDa and isoelectric point of 5 to 5.5) that was differentially expressed in the CSF samples of MMD patients (mean optical density intensity, 0.36+/-0.24; range, 0.05 to 0.92) and control spinal CSF samples (mean, 0.03+/-0.04; range, 0 to 0.08; P=0.002). This polypeptide was identified as cellular retinoic acid-binding protein (CRABP)-I. High levels of expression of CRABP-I in the CSF from 17 MMD children were confirmed by Western blotting. CONCLUSIONS: The analysis of the CSF of MMD patients reveals high CRABP-I expression. The present study suggests that the elevation of CRABP-I in CSF may be a candidate for pathogenesis of MMD.


Assuntos
Líquido Cefalorraquidiano/química , Doença de Moyamoya/líquido cefalorraquidiano , Receptores do Ácido Retinoico/análise , Biomarcadores/análise , Biomarcadores/líquido cefalorraquidiano , Western Blotting , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Eletroforese em Gel Bidimensional , Feminino , Humanos , Masculino , Doença de Moyamoya/etiologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
16.
Oncol Rep ; 10(5): 1121-6, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12883667

RESUMO

In gliomas, a high frequency of homozygous p16 gene deletions have been demonstrated, which are believed to be linked with malignant progression. The aim of this study was to assess the role of p16 in growth, invasion, and senescence. The human glioma cell lines U87 MG and U373 MG were transduced with Ad-p16, and cell viability was assessed by trypan blue staining. To examine the mechanism of cell growth inhibition, cell cycle analyses and annexin assays were performed. The invasive potential of Ad-p16 transduced cells was evaluated using a Matrigel invasion assay, and trimolecular complex (MMP-2/MT1-MMP/TIMP-2) synthesis was proven by zymography and Western blotting. To establish the link between p16 and cell senescence, we stained for Senescence-Associated beta-galactosidase activity. A cell proliferation assay demonstrated that Ad-p16 treatment significantly inhibits cell growth. Moreover, this cell growth inhibition was induced by cell cycle arrest, not by apoptosis. In vitro treatment of malignant glioma cells with Ad-p16 significantly decreased their invasive potential by Matrigel invasion assay. However, we were unable to demonstrate any differences in the constitutive productions and secretions of MMP-2, MT1-MMP, and TIMP-2, among the mock-treated, Ad-lacZ-transduced, and Ad-p16-transduced cells. p16 expression caused an enlargement of all cells, and these were morphologically similar to senescent cells. Staining for Senescence-Associated beta-galactosidase activity showed that the enlarged cells stained positively. Taken together these data strongly suggest that the anti-cancer effect of p16 is modulated by p16-mediated cell cycle arrest and by the induction of senescence.


Assuntos
Inibidor p16 de Quinase Dependente de Ciclina/genética , Técnicas de Transferência de Genes , Glioma/terapia , Anexina A5/farmacologia , Apoptose , Western Blotting , Ciclo Celular , Divisão Celular , Linhagem Celular Tumoral , Senescência Celular , Colágeno/química , Colágeno/farmacologia , Corantes/farmacologia , Progressão da Doença , Combinação de Medicamentos , Humanos , Laminina/química , Laminina/farmacologia , Invasividade Neoplásica , Proteoglicanas/química , Proteoglicanas/farmacologia , Fatores de Tempo , beta-Galactosidase/metabolismo
17.
Pediatr Neurosurg ; 39(2): 97-103, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12845200

RESUMO

Although the transsphenoidal approach offers a narrow operative field and poor visual control through a small sellar opening, this approach has the advantage of being associated with minimal surgical trauma, especially in children. We share our experience of good surgical outcome achieved by the transsphenoidal approach in selected craniopharyngiomas in childhood, and report on our pediatric series of transsphenoidal complete removals of six relatively large craniopharyngiomas and one Rathke's cleft cyst. The most common presenting symptom was visual dysfunction (6/7). All tumors were 'prechiasmatic' cystic masses with moderate to marked suprasellar extensions and elevated diaphragm sellae. The tumors measured from 25 to 37 mm in maximum diameter in the midsagittal plane (median 33 mm). In 5 of the 7 tumors, the suprasellar portion (range 11-27 mm) was larger than the intrasellar portion (range 8-14 mm). Gross total resection was achieved in all patients. Special attention should be paid to multicystic craniopharyngiomas to prevent the possibility of incomplete tumor resection. The 'bone in a fat pocket' method was useful for preventing postoperative cerebrospinal fluid leakage. Vision was improved in all six patients who had preoperative visual disturbances. Hypopituitarism was provoked by radical tumor removal in all patients and managed by hormonal supplementation therapy. Transsphenoidal surgery is an appropriate approach for the radical excision of intrasellar-suprasellar 'prechiasmatic' craniopharyngiomas, even in children, and even if the tumor has a relatively large suprasellar component.


Assuntos
Craniofaringioma/cirurgia , Microcirurgia , Seleção de Pacientes , Neoplasias Hipofisárias/cirurgia , Osso Esfenoide/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Padrões de Prática Médica , Estudos Retrospectivos
18.
Childs Nerv Syst ; 19(5-6): 316-24, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12743718

RESUMO

METHODS: To increase the blood flow of the anterior cerebral artery (ACA) and the middle cerebral artery (MCA) territories, we modified the "ribbon" procedure in combination with encephaloduroarteriosynangiosis (EDAS). This is referred to as "EDAS with bifrontal encephalogaleo(periosteal)synangiosis (EGS)." The surgical technique, clinical outcomes, complications, extent of revascularization, and changes in CBF in 67 pediatric MMD patients were retrospectively reviewed. RESULTS: The excellent and good clinical recovery rates were 57% and 31%. The rate for complete disappearance of TIA was 63%. All the bifrontal EGS made abundant collateral vessels in the ACA territory. When the EDAS with bifrontal EGS was performed in the first operation, collaterals of EGS sites developed more on the contralateral side of the EDAS. The arachnoid opening of the medial frontal lobe in the EGS site had no effect on the results. There was a positive correlation between the clinical outcome and the extent of angiographic revascularization. Improvements in the CBF and the reserve in ACA territory were observed in 57%. CONCLUSIONS: EDAS with bifrontal EGS resulted in excellent revascularization in both the MCA and ACA territories. The clinical and hemodynamic results were also excellent. This procedure may be an effective and safe surgical modality for the prevention of ischemia in the whole territory of the anterior circulation of the brain in pediatric MMD.


Assuntos
Infarto da Artéria Cerebral Anterior/diagnóstico por imagem , Infarto da Artéria Cerebral Anterior/metabolismo , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/metabolismo , Ataque Isquêmico Transitório/diagnóstico por imagem , Ataque Isquêmico Transitório/metabolismo , Doença de Moyamoya/diagnóstico por imagem , Doença de Moyamoya/metabolismo , Angiografia Cerebral , Revascularização Cerebral/métodos , Criança , Pré-Escolar , Circulação Colateral/fisiologia , Dominância Cerebral/fisiologia , Feminino , Seguimentos , Lobo Frontal , Humanos , Lactente , Infarto da Artéria Cerebral Anterior/cirurgia , Infarto da Artéria Cerebral Média/cirurgia , Ataque Isquêmico Transitório/cirurgia , Masculino , Doença de Moyamoya/cirurgia , Complicações Pós-Operatórias , Fluxo Sanguíneo Regional/fisiologia , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Resultado do Tratamento
19.
Spinal Cord ; 41(5): 310-5, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12714995

RESUMO

STUDY DESIGN: Case report. OBJECTIVE: To report three cases of spinal intramedullary lipoma seen in the last 10 years and present the clinical characteristics and surgical outcome of these cases. METHOD: Two patients were boys aged 12 years and 7 months, respectively. The other was a female patient aged 6 months. Chief complaints were hemiparesis, back swelling and thoracic scoliosis. All patients were diagnosed with magnetic resonance images. The lesion was located in the cervico-thoracic spine (foramen magnum to T1) in one case, thoracic spine (T9-T12) with the back swelling at L2-4 level in the second, and in the third, one mass extended from C6 to T11 and the other mass was located in the L1-2 level, separately. RESULT: All masses were removed subtotally and dysraphism was absent. Postoperatively, neurological status of the first and the second patient were unchanged, but in the third case weakness was transiently aggravated. CONCLUSION: Intramedullary lipoma is a rare spinal lesion and multiple intramedullary lipoma is extremely rare. Treatment principle is surgical decompression before symptom progression. Laminoplastic laminotomy is an appropriate approach for decompression of an intramedullary lipoma.


Assuntos
Lipoma/cirurgia , Neoplasias da Medula Espinal/cirurgia , Criança , Feminino , Humanos , Lactente , Lipoma/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Neoplasias da Medula Espinal/fisiopatologia
20.
Childs Nerv Syst ; 18(12): 694-701, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12483353

RESUMO

INTRODUCTION: There are controversies over the pattern of glial differentiation in spinal open neural tube defect (ONTD) at the prenatal stage. A surgical model of ONTD allows a more precise comparison of glial differentiation between the ONTD and control groups than chemical and genetic models. MATERIALS AND METHODS: To investigate the influence of ONTDs on the patterns of glial differentiation, ONTDs were induced by surgery using Hamburger and Hamilton stage 18 or 19 chick embryos. The spinal cord tissues on postoperative days (POD) 5, 7, 10, and 14 were processed to observe astrocytic, radial glial, and microglial differentiations by glial fibrillary acid protein (GFAP), vimentin and ricinus communis agglutinin-I (RCA-I) stainings, respectively. Four embryos were assigned to subgroups of each POD. Control embryos ( n=4) were staged but the neural tubes were not incised. RESULTS: In the control group, GFAP positivity was shown faintly at the dorsal midline on embryonic day (E) 10 (corresponding to POD 7), in the ventral one-third of the white matter on E 13 and in the whole white matter on E 17. Embryos with ONTDs showed earlier and stronger GFAP positivity from POD 7-14, especially at the dorsal surface and the adjacent gray matter. In the control group, vimentin staining demonstrated a positive reaction at the midline with positivity in a faint, radial pattern on E 8 and E 10. This had all disappeared by E 13 and 17. In embryos with ONTDs, vimentin positivity was enhanced and persisted from POD 5-14. These findings were prominent along the dorsal surface of ONTDs. No difference in RCA-I staining was found between the control and ONTD groups. CONCLUSION: The results reveal that ONTD promotes astrocytic differentiation and prolongs expression of radial glial fibers, which seems to be a reaction to the damage caused by exposure of the spinal cord tissue to amniotic fluid.


Assuntos
Defeitos do Tubo Neural/patologia , Neuroglia/patologia , Medula Espinal/anormalidades , Animais , Astrócitos/metabolismo , Astrócitos/patologia , Diferenciação Celular , Embrião de Galinha , Modelos Animais de Doenças , Proteína Glial Fibrilar Ácida/metabolismo , Imuno-Histoquímica , Defeitos do Tubo Neural/embriologia , Neuroglia/metabolismo , Lectinas de Plantas , Medula Espinal/embriologia , Medula Espinal/cirurgia , Coloração e Rotulagem , Fatores de Tempo , Vimentina
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