Humans ; Medicine ; methods ; Minimally Invasive Surgical Procedures ; methods ; Neurosurgery ; methods

China ; History, 20th Century ; History, 21st Century ; Neurosurgery ; history ; methods ; trends

Tae formation,development and rupture of intracranial aneurysms result from the interaction of genetic and environmental factors.The genetic mode may be nonclassical Mendelian inheritance for most patients with intracranial aneurysms.Studies have shown that COL3A1 and COLI A2 genes of the coded main extracellular matrix proteins in the arterial walls are closely associated with intracranial aneurysms.

OBJECTIVETo establish and optimize the proteomic analysis of protoscoleces-specific antigens from Echinococcus granulosus. To provide a foundation for identifying specific antigens in the soluble proteins of E. granulosus protoscoleces for further research.

METHODSBrood capsules were collected aseptically from fertile E. granulosus cysts from the livers of an infected patient. The fertile E. granulosus cysts were fractured, and protoscoleces were collected by centrifugation. The soluble proteins of protoscoleces were acquired using the 2D Quant kit according to the manufacturer's instructions. We employed two-dimensional electrophoresis (2-DE) combined with immunoblot assay (Western blot) to analyze the soluble components of E. granulosus protoscoleces antigens. The 2-DE and immunoblot maps obtained were analyzed with PDQuest 8.0 image analysis software.

RESULTSAbout 233 soluble protein spots were identified with Coomassie-stained gels. Most of the proteins had a molecular weight of 16,000 Da to 117,000 Da, and an isoelectric point value of 3.0 to 10.0. 2-DE immunoblot was conducted and 57 specific antigen spots were observed, among which 23 spots were identified.

CONCLUSION2-DE combined with Western blot is the key to successful proteomic analysis and presents a new possibility for searching the specific E. granulosus protoscoleces antigens.

Animals ; Antigens, Helminth ; chemistry ; metabolism ; Blotting, Western ; methods ; Echinococcus granulosus ; classification ; metabolism ; Electrophoresis, Gel, Two-Dimensional ; Gene Expression Regulation ; Helminth Proteins ; isolation & purification ; Proteomics ; methods

ObjectiveTo review the surgical technique and outcome of intracranial angiographically occult vascular malformations (AOVM) hemorrhage. Methods40 patients with spontaneous intracranial hemorrhage episodes and accepted microsurgery were analyzed retrospectively. ResultsAll AOVMs were successfully resected. No operative death occurred.36 patients were followed up for mean 28 months. CT and/or MRI revealed no residual lesions. Most neurological complications improved postoperatively. 1 case demonstrated rebleeding in surgical site 48 months after operation. Another case, a follow-up MRI scan revealed a contralateral denovo lesion 44 months after operation.ConclusionA current neurosurgical procedure is a satisfactory method to prevents AOVMs rebleeding. Long-term follow-up evaluation is necessary despite the lesion has been totally resected.

ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.

BACKGROUNDPrimary intraspinal hemangiopericytoma is a rare malignant mesenchymal tumor with high rates of recurrence and metastasis. Surgery is the main therapeutic procedure for this lesion. This clinical research was undertaken to analyze the pathological characteristics, clinical course, and the choice of treatment for this lesion.

METHODSTwenty-three patients with primary intraspinal hemangiopericytomas were treated from 1987 to 2004. The clinical and imaging features, pathological findings, therapeutic procedures, and prognosis were analyzed retrospectively.

RESULTSPrimary intraspinal hemangiopericytoma is more likely to attack middle-aged persons. The tumor mainly manifests as muscle weakness and sensor abnormalities. Microscopic examination showed slit-like vascular spaces and oral- or spindle-shaped cells with slightly acidic cytoplasm and oral nuclei. Tumors were subtotally resected in 11 patients, subtotally resected with postoperative radiotherapy in 4, totally resected in 5, and totally resected with postoperative radiotherapy in 3. Two patients were given spinal stabilization after total resection. Recurrence and metastatic rates were 50% and 0 in intradural patients. They were 73% and 27% in extradural patients, respectively.

CONCLUSIONSThe tumor should be resected en bloc with the neighboring dural mater to reduce recurrence and metastasis. Patients with subtotal resection need adjuvant radiotherapy. Patients with evident spinal involvement may benefit from spinal stabilization. The prognosis of the lesion arising from the dural mater is better.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Hemangiopericytoma ; pathology ; therapy ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Neoplasms ; pathology ; therapy

Ultrasound is used in the diagnosis, treatment and follow-up of cerebral arteriovenous malformation (AVM). Several parameters including flow velocity, flow volume, resistance index, pulsatility index, vasomotor reactivity and their influencing factors are reviewed. The applications of ultrasound in the preoperative evaluation, intraoperative monitor and postoperative follow-up of AVM, are summarized. Although some limits exist, ultrasound can provide more reliable information about AVM, if lesions are classified according to their characteristics, compared in different conditions between preoperation and postoperation, feeding and non-feeding side, patients and healthy adults, and if ultrasound method is combined with other examinations and different developed ultrasound techniques. With the appearance and development of new ultrasound technique, its application will be wider in management of AVM.
Humans ; Intracranial Arteriovenous Malformations ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Transcranial ; methods

Biomarkers, Tumor ; metabolism ; Carcinoma, Hepatocellular ; genetics ; metabolism ; CpG Islands ; Cyclin-Dependent Kinase Inhibitor p57 ; genetics ; metabolism ; DNA Methylation ; Gene Expression Regulation, Neoplastic ; Humans ; In Situ Hybridization ; Liver ; metabolism ; Liver Neoplasms ; genetics ; metabolism ; Polymerase Chain Reaction ; methods ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; metabolism

BACKGROUNDCompared with smaller aneurysms, giant intracranial aneurysms (GICAs) have a poorer prognosis and require more meticulous surgical planning and techniques to exclude them from the circulation. GICAs continue to challenge the limits of neurosurgical techniques. A series of 170 patients with GICAs were reviewed for understanding the clinical characteristics, surgical treatment and outcomes of patients with GICAs.

METHODSCollected data of 170 consecutive patients with GICAs from January 1995 to July 2007 were analyzed. The clinical characteristics in this study included age, sex, intracranial aneurysms size, the first presentations, locations and Hunt & Hess grade. Surgical methods included direct clipping of the aneurysm neck, parent artery reconstruction, proximal artery ligation, trapping and wrapping. Surgical results were evaluated postoperatively by the Glasgow Outcome Scale (GOS).

RESULTSGICAs were more commonly diagnosed at age 30 to 50 years with a mean age of 39.3 years and without obvious gender preponderance in our study (88 male and 82 female patients). The size of the GICAs ranged from 2.5 cm to 8.0 cm (mean, 2.9 cm). Hemorrhage (41%), mass effect (34%) and headache (12%) were the first 3 most common presentations. Regarding the Hunt & Hess classification, at admission there were 100 cases in grade 0, 24 in grade 1, 21 in grade 2, 16 in grade 3, 8 in grade 4 and 1 in grade 5. There were 84 cases of GICAs treated by direct neck-clipping, 47 by parent artery reconstruction, 19 by proximal artery occlusion (with 4 combined with revascularization), 18 by trapping and 2 by wrapping. The follow-up study (ranging from 6 to 115 months, mean 32 months) showed good results in 108 cases, moderate disability in 26 and severe disability in 15 according to GOS. Six cases died.

CONCLUSIONSSurgical treatment is an effective treatment for GICAs. Surgical strategies should be made carefully and individually. Doppler ultrasonography, neuroendoscope and intraoperative angiography are useful to perfect surgical results.

Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Infant ; Intracranial Aneurysm ; pathology ; surgery ; Male ; Middle Aged ; Neurosurgical Procedures ; methods ; Treatment Outcome