Objective To study the electrical stimulation motor evoked potentials in Arnoid Chiari malformation.Methods Electrical stimulation motor evoked potentials were recorded in 30 cases with Arnoid Chiari malformation proved by MRI.Results Abnormality rate of MEP was 96.7%,and the abnormal patterns mainly consisted of the delay of latency and the delay of central motor conduction time(CMCT). The change of MEP was connected with myodynamia and the type of Arnoid Chiari malformation .Conclusions The change of MEP is more sensitive than clinical change, and can indicate the damage of the motor function objectively and quantitatively, and MEP can be used as an objective criterion for surgical effect, and can predict the recovery of motor function.

Objective To study the role of cell apoptosis during the chemotherapy of human gliocytoma in order to get effective suvilliance on the effect of chemotherapy. Methods Gliocytoma cells were isolated and cultured from 40 human gliocytoma samples. Mitochondrial membrance potential (MMP), cell cycle, the level of Bcl-2 and Bax were detected by flow cytometry (FCM) at 24, 48, 72 hours respectively of incubation with Lomustine (CCNU) and Teniposide (VM-26), and the trends were also analysed. Results MMP decreased greatly, the apoptosis part in the cell cycle ananlysis increase, the expression level of Bcl-2 decreased, and that of Bax increase rapidly, while the Bcl-2/Bax ratio decreased. Conclusions CCNU and VM-26 have singnificant effect in gliocytoma chemotherapy on inducing gliocytoma cell apoptosis. VM-26 has more stronger effect on the cell cycle. MMP is the most sensitive and the fastest index in apoptosis detection.

Objective 　To investigate methods for the diagnosis and treatment of primary angitis of central nervous system (PACNS). Methods　Radiological and clinical feature, operative resutls of 12 patients with mass lesion presentations of PACNS were analyzed retrospectively. Results　The lesions showed low density on CT and long T1 and long T2 signal on MRI. The ring-wall enhanced lesions on MRI were flowery in 7 patients. Gross total resection of the lesions were performed in 10 patients with excellent recovery postoperatively. Growth of lesions were observed in 2 patients who underwent subtotal resection. Conclusions　 Lesions of PACNS have special appearance on enhanced MRI. More patients with mass lesion presentations of PACNS could be diagnosed preoperatively according to radiological and clinical feature.For these patients, surgery is the optimal treatment at present.

OBJECTIVETo investigate the diagnosis and surgical techniques of intramedullary hemangioblastoma of the cervical spinal cord.

METHODSMR imaging and the methods and results of surgery were analyzed in 21 patients.

RESULTSThe tumors were divided into three types on MR imaging. Syringeal type, where the tumor varied in size and was accompanied by syringobulbia and syringomyelia; Cystic type, where the tumor presented as a cyst with a small mural node; and Solid type, where the tumor was revealed as a huge solid mass. All tumors were totally removed and diagnosis was confirmed by histological study. Post-operative neurological status was improved in 20 patients and aggravated in 1.

CONCLUSIONSThe localization and the nature diagnosis of the tumor can be made by cervical MR imaging. Operative methods vary with tumor types. It is the most important that the tumor is dissected along the right interface and removed after devascularization.

Adolescent ; Adult ; Cervical Vertebrae ; Female ; Hemangioblastoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Neoplasms ; diagnosis ; surgery

Objective To describe the clinical features, operative methods and postoperative management of the intra-axial tumors of medullocervical junction, and to make differential diagnosis for different subtypes.Methods Fifteen patients with intra-axial tumors of medullocervical junction were treated from August 1988 to June 1997. The diagnoses were confirmed by MRI and histological examinations. The tumors were divided into two subtypes according to the clinical features and the main body of the tumor. The distinctive points of the two subtypes and the appropriate surgical methods of different pathological type tumors were expounded.Results Tumors were totally removed in 10 patients and subtotally in 5. There was no death caused by operation. Postoperative complications included respiratory disturbance in six cases, upper digestive tract bleeding in one, depressed cough reflex in two, most of which recovered after proper treatment. On discharge, the nervous system status was improved in 11 cases, stable in 2 and worsened in 2.Conclusions The intra-axial tumors of medullocervical junction can be divided into cervicomedullary and medullocervical subtypes. The MRI examination is decisive in the distinction of the diagnosis, and is important in the determination of the nature of the medullar cystic lesions and the guidance of the resection of tumor extent. The cervicomedullary tumors are more amenable to an aggressive surgical treatment, during which the surgeon should remove the tumors first in the cervical spinal cord area, then in the medullar area with the tumor resection expanding rostrally. It can make the operation safer to remove the tumors using appropriate techniques varied with pathological types of the tumors. Managing postoperative respiratory disturbances without delay is one of the important points in improving the therapeutic effect.

OBJECTIVETo investigate the effects of combination therapy with methylprednisolone (MP) and brain-derived neurotrophic factor (BDNF) on axonal remyelination and functional recovery after spinal cord injury in rats.

METHODSForty-five rats were randomly divided into three groups: Group A received MP and BDNF; group B received MP and cerebrospinal fluid (CSF); and group C received CSF only. Contusion injury to adult rat spinal cord was produced at the T(10) vertebra level followed by immediate intravenous MP or CSF, and was thereafter infused intrathecally with BDNF or CSF for 6 weeks. Axonal remyelination and functional recovery was observed using RT-PCR, immunohistochemistry and open field locomotion.

RESULTSAn increase of 28.4% +/- 2.3% in the expression of proteolipid protein (PLP) gene, an endogenous indicator of axonal remyelination, was demonstrated in group A 24 hours after injury. Ten weeks later, there were significant decreases in hematogenous inflammatory cellular infiltration in groups A and B compared to C (P < 0.05). Concomitantly, a significant amount of axonal remyelination was observed in group A compared to groups B and C (P < 0.05). Furthermore, combination therapy using MP and BDNF in group A resulted in stimulation of hindlimb activity as well as improvement in the rate of functional recovery in open field locomotion (P < 0.05).

CONCLUSIONSCombined therapy of MP and BDNF can improve functional recovery through mechanisms that include attenuating inflammatory cellular infiltration and enhancing axonal remyelination at the injury site. Such a combination may be an effective approach for treatment of spinal cord injury.

Animals ; Axons ; physiology ; Brain-Derived Neurotrophic Factor ; administration & dosage ; Drug Therapy, Combination ; Female ; Methylprednisolone ; administration & dosage ; Myelin Proteolipid Protein ; genetics ; Nerve Regeneration ; drug effects ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Spinal Cord Injuries ; drug therapy ; metabolism ; physiopathology

Objective: To evaluate the therapeutic effect of dental autotransplantation with the application of digital design combined with 3D printing of donor tooth models and recipient alveolar fossa model preoperatively. Methods: Twelve cases that could not be retained due to tooth fracture or extensive absorption of alveolar bone were recruited in the study. Cone-beam computed tomography (CBCT) data were imported into Mimics software for digital design, and the best-matched third molar was selected as the donor tooth. Replicas of the donor teeth and the recipient socket were printed out with three-dimensional (3D) printing technologies as a simulation model for recipient tooth socket preparation. During tooth autotransplantation, preparation of the recipient tooth socket and the donor tooth were guided by the 3D-printed replicas sequentially. Then, the donor tooth was implanted into the recipient tooth pocket. Patients were followed up at 3, 6 and 12 months after the operation, with CBCT examination to evaluate the status of bone reconstruction and periodontal ligaments at each time point. Results: Twelve patients were transplanted with an autogenous third molar with the apical foramen completely closed. Among them, 7 patients had alveolar fossa infection before the operation, of which 1 had extensive resorption of the alveolar bone due to the infection. All 12 patients recovered well after the operation and were followed up for at least 12 months. In total, 11 caseswere successful in tooth autotransplantation with normal mastication, and 1 case had root resorption 14 months postoperation. Conclusion Digital design combined with 3D printing technology can assistin the selection of thebest-matched donor tooth and preparation of the recipient socket before tooth transplantation proceduresand reduce the extra-alveolar exposure time of the donor tooth and number of trial placementsintothe alveolar fossa. Thus, this combined strategy can effectively improve the outcome of dental autotransplantation.

Humans ; Phosphorylation ; Serine ; Protein Serine-Threonine Kinases/metabolism* ; Spasms, Infantile