Objective To assess the outcome of percutaneous vertebroplasty for symptomatic vertebral hemangiomas. Methods Five cases with 7 symptomatic vertebral hemangiomas were treated with percutaneous vertebroplasty. Aggressive lesions were treated with absolute alcohol injection in addition. Patients were followed-up and clinical manifestations were observed and CT, MRI and X-ray plain film were compared between before and after vertebroplasty. Results Procedures were successful without complications. Most of the symptoms resolved within 24 hours after vertebraplasty. All patients were followed-up for 12～50 months and free of neurological deficits and symptoms. Imaging follow-up showed no vertebral collapse, nor recurrance of hemangiomas. Conclusion With effective long-term follow-up and quick elimination of symptoms, precutaneous vertebroplasty, added with absolute alcohol injection in aggressive cases, proves to be a safe and effective treatment for symptomatic vertebral hemangiomas.

OBJECTIVETo clarify the frequency, presentation, associated factors, treatment and outcome of hyponatremia after transphenoidal surgery of pituitary adenomas.

METHODSRetrospectively reviewed the database of 183 patients who underwent transphenoidal surgery of pituitary adenoma between January 1999 and June 2000 in our department.

RESULTS38.8% (71/183) had postoperative hyponatremia. Among them, 59.2% (42/71) appeared on the 4th to 7th day postoperatively. 59.2% (42/71) presented with nausea, vomiting, headache, dizziness, confusion and weakness. Hyponatremia was related to age, tumor size and adenoma type, but not related to sex and degree of resection. Treatment consisted of salt replacement and mild fluid restriction in 4 patients and salt and fluid replacement in 67 patients. Hyponatremia resolved within 16 days in all the patients.

CONCLUSIONSHyponatremia often appeared about 7 days after transsphenoidal surgery of pituitary adenomas, especially in elderly and patients with macroadenomas and huge pituitary adenomas. The principle of treatment was salt and fluid replacement.

Adenoma ; pathology ; surgery ; Adult ; Age Factors ; Female ; Humans ; Hyponatremia ; etiology ; therapy ; Hypophysectomy ; methods ; Male ; Middle Aged ; Pituitary Neoplasms ; pathology ; surgery ; Postoperative Complications ; therapy ; Retrospective Studies

Objective To study the diagnosis, management and prognosis of intracranial metastases of gestational trophoblastic tumour (GTT) patients who had emergency surgical decompression due to highly increased intracranial pressure. Methods Ninety-three patients with intracranial metastases of gestational trophoblastic tumour were hospitalized in our department of Peking Union Medical College Hospital from 1985 to 2004. Thirteen of them who underwent emergency craniotomy were retrospectively analyzed, and all of them presented with raised intracranial pressure and intracerebral haemorrhagic mass. Result Of the thirteen patients who underwent surgery in combination with multiagent systemic chemotherapy, seven achieved complete remission(CR), five had partial remission(PR), and one died of disease progression. Conclusions Emergency surgical treatment is the important method of choice for brain metastasis in patients displaying rapidly deteriorating signs. An undetermined intracranial haemorrhage in young female patients of reproductive age group should raise the suspicion of cerebral metastatic choriocarcinoma.

OBJECTIVETo illuminate the regulating effect of all-trans retinoic acid (ATRA) on gap junctional intercellular communication (GJIC) and connexin 43 (Cx43) gene expression in glioma cells, which is tissue- and organ-specific.

METHODRat C6 glioma cells were exposed to ATRA at a concentration of 1, 10, 100 micromol/L and the GJIC function of the cells was examined with scrape-loading dye transfer assay 24 hours, 48 hours and 72 hours after ATRA treatment. The effect of ATRA on Cx43 gene expression was measured with semiquantitative reverse transcription polymerase chain reaction (RT-PCR) 24 hours after ATRA exposure.

RESULTSThe GJIC function of C6 glioma cells was significantly increased by ATRA at each concentration applied. The dye passed 4 to 5 rows of cells from the scraping edge in ATRA treated cells, but only 1 or 2 rows in the control. The augment effect was observed 24 hours after each concentration ATRA treatment, and lasted till 72 hours after treatment with 1 micromol/L and 10 micromol/L ATRA. Forty-eight hours after exposed to 100 micromol/L ATRA, the enhancement of GJIC was less obvious. There was no significant increase induced by ATRA on the transcription of Cx43 gene, as demonstrated by semiquantitative RT-PCR.

CONCLUSIONATRA turned out to be a potent enhancer on GJIC function in C6 glioma cells, andthe enhancement effect was most probable at post-transcriptional level.

Animals ; Antineoplastic Agents ; pharmacology ; Brain Neoplasms ; metabolism ; pathology ; Connexin 43 ; biosynthesis ; genetics ; Gap Junctions ; physiology ; Gene Expression ; Glioma ; metabolism ; pathology ; RNA, Messenger ; genetics ; Rats ; Tretinoin ; pharmacology ; Tumor Cells, Cultured

OBJECTIVETo discuss the etiology, diagnostic criteria and treatment of Nelson's syndrome.

METHODSTwenty-three patients with Nelson's syndrome who were treated in our department over the last 19 years were analyzed retrospectively. Removal of adenoma by the transsphenoidal approach was done in 21 patients and by transfrontal craniotomy in 2. The follow-up period ranged from six months to nine years.

RESULTSThe incidence of Nelson's syndrome was 7.7% in a series of 300 patients with Cushing's disease treated by microsurgery in the same period. Hyperpigmentation was relieved and adrenocorticotropic hormone (ACTH) levels decreased in all patients after tumor excision. Eight patients with visual disturbance improved after surgery. The curative and remission rates were 56.5% and 26.1%, respectively.

CONCLUSIONSTranssphenoidal microsurgical removal of pituitary ACTH adenoma is the first choice in the prevention and treatment of Nelson's syndrome. Regular follow-up examinations should be performed over a long time.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Microsurgery ; methods ; Middle Aged ; Nelson Syndrome ; epidemiology ; etiology ; surgery

Three cases of pituitary metastases were reported. They all had operations and the pathological examination confirming the diagnosis. The clinical features of diabetes insipidus and extraocular nerve palsy were presented. In two cases, the original tumors were bronchioloalveolar carcinoma; in the other one, the original tumor was unknown. All three cases had poor outcome. These cases illustrate the fact that a pituitary metastasis can closely mimic a pituitary benign tumor, such as pituitary adenoma. Especially in the presence of suggestive symptoms such as diabetes insipidus and/or cranical nerve paralysis, the possibility of metastatic disease in the differential diagnosis of a pituitary mass should always be considered.
Adenocarcinoma ; secretion ; surgery ; Adenocarcinoma, Bronchiolo-Alveolar ; secondary ; surgery ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasms, Unknown Primary ; Pituitary Neoplasms ; secondary ; surgery

Heme is a key cofactor in aerobic life, both in eukaryotes and prokaryotes. Because of the high reactivity of ferrous protoporphyrin IX, the reactions of heme in cells are often carried out through heme-protein complexes. Traditionally studies of heme-binding proteins have been approached on a case by case basis, thus there is a limited global view of the distribution of heme-binding proteins in different cells or tissues. The procedure described here is aimed at profiling heme-binding proteins in mouse tissues sequentially by 1) purification of heme-binding proteins by heme-agarose, an affinity chromatographic resin; 2) isolation of heme-binding proteins by SDS-PAGE or two-dimensional electrophoresis; 3) identification of heme-binding proteins by mass spectrometry. In five mouse tissues, over 600 protein spots were visualized on 2-DE gel stained by Commassie blue and 154 proteins were identified by MALDI-TOF, in which most proteins belong to heme related. This methodology makes it possible to globally characterize the heme-binding proteins in a biological system.
Animals ; Carrier Proteins ; biosynthesis ; genetics ; Electrophoresis, Gel, Two-Dimensional ; Electrophoresis, Polyacrylamide Gel ; Heme ; chemistry ; Hemeproteins ; biosynthesis ; genetics ; Mass Spectrometry ; Mice ; Mice, Inbred ICR ; Protein Binding ; Proteins ; chemistry ; Proteome ; Proteomics ; methods ; Sepharose ; chemistry ; Tissue Distribution