Adult ; Central Nervous System Diseases ; diagnosis ; surgery ; Hamartoma ; diagnosis ; surgery ; Humans ; Male

Neurogenesis occurs in the adult brain, and neural stem cells (NSCs) reside in the adult central nervous system (CNS). In the adult brain, newly generated neuronal cells would originate from a population of glial cells with stem cells properties, and be involved in processes such as learning and memory, depression, and in regenerative attempts in the diseased brain and after injuries. In human, a recent study reported no evidence of migrating neural progenitor cells along the subventricular zone (SVZ) to the olfactory bulb (OB), contrary to other species, highlighting the particularity of adult neurogenesis in human. Though the origin and contribution of newly generated neuronal cells to CNS pathophysiology remain to be fully understood, the discovery that NSCs reside in the adult CNS force us to re-evaluate our knowledge and understanding of brain functioning, and suggest that the adult CNS may be amenable to repair. In this manuscript,we will review the recent data, debates and controversies on the identification, origin and function of newly generated neuronal cells in the adult brain, in human and in other species. We will discuss their contribution and significance to CNS pathophysiology, and for cellular therapy.
Adult Stem Cells ; cytology ; transplantation ; Aging ; Animals ; Brain ; cytology ; Central Nervous System ; cytology ; growth & development ; Central Nervous System Diseases ; pathology ; surgery ; Humans ; Stem Cell Transplantation ; methods

All of neural stem cell within the central nervous system and derived from transplantation or embryonic stem cell have the ability of differentiating into various kinds of neural cells. Regeneration of neural cells plays a critical role on function recovery damaged central nervous system (CNS). Advances in repairing of injury in central nervous system with neural stem cell and embryonic stem cell in recent years are reviewed in this article.
Adult Stem Cells ; cytology ; Animals ; Central Nervous System Diseases ; physiopathology ; surgery ; Embryonic Stem Cells ; cytology ; Humans ; Nerve Regeneration ; physiology ; Neuronal Plasticity ; Neurons ; cytology ; Stem Cell Transplantation

OBJECTIVE: We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. MATERIALS AND METHODS: Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. RESULTS: All the lesions were located in the cortex and their mean size was 1.3 +/- 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. CONCLUSION: Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.
Adolescent ; Adult ; Aged ; Brain Diseases/*surgery/ultrasonography ; Brain Neoplasms/surgery/ultrasonography ; Female ; Glioma/surgery/ultrasonography ; Hemangioma, Cavernous, Central Nervous System/surgery/ultrasonography ; Humans ; Male ; *Microsurgery ; Middle Aged ; *Ultrasonography, Interventional ; Young Adult

PURPOSE: The purpose of this study was to analyze the effectiveness of saline solution vs. heparinized-saline for maintenance of arterial lines and to detect changes in platelet and aPTT as physiological indexes. METHODS: In this nonequivalent control group, non-synchronized, double-blind study the effects of heparinized and saline solution on the maintenance of arterial lines were compared. Fifty five patients received the heparinized solution and fifty nine patients received the saline solution. All patients who had surgery in K-university hospital between September and December 2011 were eligible for participation in the study. RESULTS: There was no statistically significant difference between the saline and the heparin group in the maintenance time of the arterial lines or the number of irrigations. There was no statistically significant difference between the groups in changes in the number of platelets and aPTT for interaction between the groups and time intervals. CONCLUSION: The results indicate that saline solution can be used as an irrigation solution for the maintenance of arterial lines of adult surgical patients, rather than heparinized-saline, in view of potential risk factors in the use of heparin.
Adult ; Aged ; Anticoagulants/*therapeutic use ; Central Nervous System Diseases/surgery ; Digestive System Diseases/surgery ; Double-Blind Method ; Female ; Heparin/*therapeutic use ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases/surgery ; Partial Thromboplastin Time ; Platelet Count ; Respiratory Tract Diseases/surgery ; Risk Factors ; Sodium Chloride/*therapeutic use ; Vascular Access Devices

OBJECTIVETo study the clinicalpathologic features of intracranial multiple lesions.

METHODSThe clinical, radiologic and pathologic features of intracranial multiple lesions in 62 cases during the period from 2005 to 2009 in Xuanwu Hospital were retrospectively reviewed.

RESULTSThere were 32 males and 30 females in 62 cases. The mean age of seize onset and duration of disease were 37.4-year-old and 11.6 months, respectively. The lesions could affect cerebral hemisphere, basal ganglia, brain stem, cerebellum and other parts, most lesions were located above the tentorium. Pathological diagnosis as follows: 13 patients with glioma; metastatic tumors in 13 cases; 12 cases of central nervous system infection; immune-mediated inflammatory demyelinating disease in 8 cases; 5 cases of primary lymphoma of central nervous system; primary angiitis of the central nervous system 3 cases; mitochondrial encephalopathy 2 cases; vein thrombosis in 2 cases; Rosai-Dorfman disease in 2 cases; 2 case of radiation encephalopathy. Among them, mitochondrial encephalopathy and vein thrombosis lesions located in the cortex; metastatic tumor and blood-borne infection mainly involving junction of grey and white matter; glioma, radiation encephalopathy and demyelinating disease include white matter lesions; vascular inflammation showed cortical and subcortical white matter lesions.

CONCLUSIONSA variety of tumor and non-neoplastic diseases can be expressed in intracranial multiple lesions, which gliomas, metastatic tumor and central nervous system infections are more common. In order to improve the diagnosis of intracranial multiple lesions, active work in the brian biopsy, study the clinical, imaging and pathological findings must be closely.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; pathology ; surgery ; Child ; Demyelinating Diseases ; diagnosis ; pathology ; surgery ; Female ; Glioma ; diagnosis ; pathology ; surgery ; Histiocytosis, Sinus ; diagnosis ; pathology ; surgery ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Neuroepithelial ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Toxoplasmosis, Cerebral ; diagnosis ; pathology ; surgery ; Tuberculosis, Central Nervous System ; diagnosis ; pathology ; surgery ; Young Adult

BACKGROUND: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. MATERIAL AND METHOD: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. RESULT: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. CONCLUSION: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.
Anesthesia ; Angiography ; Arteries ; Brain ; Carotid Arteries ; Central Nervous System ; Female ; Head ; Heart Valve Diseases ; Humans ; Informed Consent ; Critical Care ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Male ; Mass Screening ; Medical Records ; Myocardial Ischemia ; Neck ; Perfusion ; Preoperative Care ; Prevalence ; Thoracic Surgery