Microsurgery Resection of Intrinsic Insular Tumors via Transsylvian Surgical Approach in 12 Cases.

OBJECTIVE: To investigate the clinical characteristics, operative methods, and diffusion tensor imaging (DTI) in the resection of intrinsic insular gliomas via transsylvian approach. METHODS: From June 2008 to June 2010, 12 patients with intrinsic insular gliomas were treated via transsylvian microsurgical approach, with preoperative magnetic resonance imaging diffusion tensor imaging (MR DTI) evaluation. The data of these patients were retrospectively analyzed. RESULTS: All patients had astrocytoma, including 8 patients of Grades I to II, 2 patients of Grades III to IV, and 2 patients of mixed glial tumors. The insular tumors were completely removed in 9 patients, whereas they were only partially removed from 3 patients. No death was related to the operations. Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance. CONCLUSIONS: Most of the insular gliomas are of low grade. By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life.

[Surgical treatment of patients with cerebral schistosomiasis].

Clinical data from 48 cases with cerebral schistosomiasis, who received surgery, were analyzed retrospectively. Surgical treatment was performed when the patient had the following conditions: mass focus confirmed by CT scanning, cranial hypertension, or ineffective drug therapy, or indistinguishable from glioma by iconographic diagnosis. Treatment of praziquantel was given when the patients got improved. Among the 48 patients with surgical treatment, 35 cases recovered, 8 showed an exacerbation of hemiparalysis, 5 had hemianesthesia, and epilepsy occurred in 2 cases, no cases died during or after the operation. Surgery combined with praziquantel therapy has been an effective way for the treatment of cerebral schistosomiasis.

[Expression of integrin-alpha 3 mRNA in meningiomas and its biological significance].

BACKGROUND & OBJECTIVE: It was reported that reported that changes of the expression of integrins played critical roles in differentiation, proliferation, and invasion of lung carcinoma, melanoma, and glioma. However, no data was available on the expression of integrins in meningiomas. The aim of this study was to investigate the expression of integrin-alpha 3 in meningiomas and its biological significance. METHODS: Integrin-alpha 3 subunit was detected using in situ hybridization in meningiomas(36 cases), normal dura(2 cases), and arachnoid tissue(3 cases). SABC immunohistochemical assay was used to determine the expressions of Ki-67 nuclear antigen. RESULTS: Expressions of integrin-alpha 3 mRNA in benign, atypical, and malignant meningiomas were 2.52 +/- 0.362, 1.75 +/- 0.316, and 1.42 +/- 0.633, respectively. The expression levels of integrin-alpha 3 mRNA were significantly lower in the atypical and malignant meningiomas than in the benign meningiomas(P < 0.05, < 0.01). The integrin-alpha 3 mRNA expression in those with invasive biological behavior was lower than that in those without invasion(1.63 +/- 0.462 vs 2.61 +/- 0.526, P < 0.01). Moreover, the expression of integrin-alpha 3 mRNA was inversely associated with Ki-67 labeling index. CONCLUSIONS: Integrin-alpha 3 sub-unit participates the process of regulating growth of meningiomas. The proliferational activity and malignant grade of meningiomas correlates to decreased expression of integrin-alpha 3 subunit, and the down-regulation of integrin-alpha 3 mRNA is associated with the invasive biological behavior in meningiomas.