Objective To introduce the microsurgical experience of total removal in large and middle sized recurrent sphenoid ridge meningiomas and discuss the recurrent reasons Methods A series of 24 cases large and middle sized recurrent sphenoid ridge meningiomas operated microsurgically by combined frontotemporal orbitozygomatic approach were analysed retrospectively Result Totol removal(Grade Ⅱ of Simpson system)were achieved in 14 of the 24 patients,and subtotal in 6,partial in 4 There were isolative tumor nodi near main tumor in 5 cases Conclusion Combined frontotemporal orbitozygomatic approach and microsurgical technique are helpful to totally remove the tumor Resection uncompletely and tumor implantation within operation were recurrent reasons of sphenoid ridge meningiomas

Objective To evaluate the clinical effect of cerebellomedullary fissure approach to resect the fourth ventricle tumors. Methods Eightten cases of the fourth ventricle tumors that have been operated on through the posterior fossa craniotomy and cerebellomedullary fissure approach were analyzed retrospectively. Results Total turmor resection was achieved in 13 patients and subtotal in 5 patients. All patients were conscious after surgery. None of them presented mutism. Three cases suffered from postoperative hydrocephalus, ventriculoperi-toneal hunts were applied in 2 cases, another case died of acute obstructive hydrocephalus. Conclusion The cerebellomedullary fissure approach can provide a sufficent exposure to resect the fourth ventricle tumor without incision of the inferior vermis.

BACKGROUND: Many scholars have paid attentions on neural stem cells (NSCs), which are regarded as the cell source to repair the injured nervous tissues. And it is becoming a key point that NSCs will be obtained in an effective way.OBJECTIVE: To observe the characteristics of isolation, proliferation and differentiation of in vitro NSCs from subventricular zone (SVZ) and hippocampus of neonatal rats.DESIGN: Single-sample trial.SETTING: Department of Neurosurgery in the Third Affiliated Hospital of Sun Yat-sen University.MATERIALS: Ten SD rats aged 3 days, of either gender, were offered from the Experimental Animal Center of Sun Yat-sen University. Nestin antibody (rabbit-anti-rat), neurofilament (NF-200) antibody (rabbit-anti-rat), and glial fibrillary acidic protein (GFAP) antibody (mice-anti-rat) were all purchased from Sigma Company.METHODS: The experiment was carried out in the Laboratory of Histology and Embryology, Basic Medical College of Sun Yat-sen University from September to December in 2006. According to the ethical requirement, the serum-free DMEM/F12 medium containing basic fibroblast growth factor and epidermal growth factor was utilized to isolate and incubate NSCs from SVZ and hippocampus of neonatal rats. Then the proliferation and differentiation of NSCs in vitro were observed.MAIN OUTCOME MEASURES: Fluorescence immunocytochemistry was applied to detect the antigen of nestin expressed from NSCs, NF expressed from neuron cells and GFAP expressed from astrocytes. The differentiation of NSCs was identified.RESULTS: The cells isolated from SVZ and hippocampus of neonatal rats possessed the ability of proliferation and self-renewal. Through inverted microscope, nestin positive cells could be found in the cell clone sphere at passage 20 of cells. Cells induced to differentiate could express antigen of NF and GFAP by the attached cell clone sphere.CONCLUSION: The NSCs successfully isolated from SVZ and hippocampi of neonatal rats possess the ability of self-renewal, proliferation, and differentiation into neuron-like cells and astrocytes.

Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posternmedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases (81.25%),a subtotal tumor resection was conducted in 6 cases(18.75%). A cemplete recovery was achieved in 23 cases(71.88%), an improvement of symptoms was achieved in 6 cases(18.75%), and no improvement in 3 cases(9.38%), no death was encountered. Follow up observations were carded out in 30 cases for 3 months to 3 years. MRI examinatious 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability ,spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

AIM: To observe the effects of vascular endothelial growth factor(VEGF) on the proliferation and differentiation of neural stem cells(NSCs) of rats in vitro.METHODS: NSCs isolated from the hippocampal gyrus of SD rats were primary cultured and subcultured,and then divided into two groups:(1) the cells in VEGF group were treated with 150 ?g/L VEGF in the culture system,and VEGF was removed at the 7 th day;(2) control group(without VEGF treatment).The cellular morphology of two groups was observed by contrast phase microscope.Nestin and NF-200 expressing cells were detected via immunofluorescence method.The percentages of the immunostaining positive cells in each group at the 7 th day and at the 11 th day were determined.RESULTS: At the 7 th day,the percentage of nestin positive cells in VEGF group was 52.19%?7.95%,vs 29.26%?4.12% in control group(P

Objective To evaluate the value of CT virtual endoscopy(CTVE)for microsurgery of pituitary microadenomas via transsphenoidal approach.Methods In 18 patients with pituitary micmadenomas underwent microsurgery via transsphenoidal approach,the presurgical CT data was transfered to work station,the anatomies of the sphenoid sinus were then reconstructed by CTVE.The CTVE images were used to make the preoperative planning and indentify sphenoid sinus, sellar floor,and the position of the tumor during surgery.The CTVE images and the views from intraoperative microscope were compared. Results CTVE could display the anotomoties of sphenoid sinus in a three-dimentional mode.The display rates of superfical antomies such as sphenoid septa,sellar floor,carotid prominence,optic prominence and opticocarotid recess were 344.4%,100%,41.7%,36.1%and 58.3%respectively and the visual fields of these anatomic landmarks were larger than the views from the intraoperative microscope. CTVE could depcit the anatomies of the enhanced carotid ateries and pituitary tissue and some optic canals underlying the sellae by transparent function or heighten the threshold.The sites of the tumor could be marked correctly on CTVE images.CTVE could simulate the operative approach and some operating procedures properatively. Conclusion CTVE can display the anatomies of sphenoid sinus in a three-dimensional mode. In transsphenoidal treatment of pituitary microadenoma,CTVE can help to make preoperative planning,locate the intraoperative structures and make a precise bone window during surgery.