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<p><b>OBJECTIVE</b>To study the techniques and efficacy of neuronavigation-guided puncture and drainage in the treatment of brain abscesses.</p><p><b>METHODS</b>From February 2006 to December 2012, 31 patients with brain abscesses treated by the technique of neuronavigation-guided puncture and drainage were retrospectively analyzed. There were 27 male and 4 female patients, age ranged from 10 months to 69 years, average (34 ± 19) years.Single brain abscesses were found in 26 patients, multiple abscesses in 5 patients. The abscesses were located in eloquent regions in 19 patients. The mean diameter of the abscess was 4.1 cm (2.5-6.7 cm). The first follow-up visit was on the first month after surgery, and if residual was observed on enhanced MRI, then the patient was followed up every 3 months until the abscess disappeared completely. After residual absorbed, the patient was followed up every year.</p><p><b>RESULTS</b>Incisions of all patients were healed well and no infection. The length of hospital stay after surgery was 6-42 days, mean (14 ± 9) days. Bacterial culture of pus was performed regularly including aerobic, anaerobic and fungal culture after surgery. Thirteen patients had positive culture whereas the other 18 patients had negative culture. The duration of antibiotic use was 18-42 days, mean (22 ± 5) days. All the patients were followed up for 3 months to 3 years. Twenty-nine patients recovered well postoperatively, 1 case died 2 months after operation.One case was performed the second drainage after 10 days from the first surgery.Eighteen patients showed the improvement of neurological status within the first day following surgery, 4 patients got improvement in the next day, 1 patient with hemiplegia showed improvement in 10 days postoperatively, 1 patient with aphasia recovered gradually after 1 month, 1 patient with hemiplegia showed deterioration temporarily after surgery, and recovered gradually after 15 days.</p><p><b>CONCLUSION</b>The technique of puncture and drainage guided by neuronavigation has many advantages to treat brain abscesses, such as small trauma, short operation time, high accuracy and safety, simple surgical procedures and good prognosis.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Brain Abscess , Therapeutics , Drainage , Methods , Neuronavigation , Retrospective StudiesABSTRACT
OBJECTIVE: To determine the efficacy of endoscopic surgery in combination with long-acting somatostatin analogues (SSAs) in treating patients with growth hormone (GH)-secreting pituitary tumor. METHODS: We performed retrospective analysis of 133 patients with GH producing pituitary adenoma who underwent pure endoscopic transsphenoidal surgery in our center from January 2007 to July 2012. Patients were followed up for a range of 3-48 months. The radiological remission, biochemical remission and complication were evaluated. RESULTS: A total of 110 (82.7%) patients achieved radiological complete resection, 11 (8.2%) subtotal resection, and 12 (9.0%) partial resection. Eighty-eight (66.2%) patients showed nadir GH level less than 1 ng/mL after oral glucose administration. No mortality or severe disability was observed during follow up. Preoperative long-acting SSA successfully improved left ventricle ejection fraction (LVEF) and blood glucose in three patients who subsequently underwent success operation. Long-acting SSA (20 mg every 30 days) achieved biochemical remission in 19 out 23 (82.6%) patients who showed persistent high GH level after surgery. CONCLUSION: Endoscopic transsphenoidal surgery can biochemically cure the majority of GH producing pituitary adenoma. Post-operative use of SSA can improve biochemical remission.
Subject(s)
Humans , Blood Glucose , Follow-Up Studies , Glucose , Growth Hormone , Heart Ventricles , Mortality , Pituitary Neoplasms , Retrospective Studies , SomatostatinABSTRACT
Objective To investigate the level of IL-17 and its clinical significance in patients with primary Sj(o)gren's syndrome (pSS) complicated with interstitial lung disease (ILD).Methods IL-17 levels were detected by enzyme linked immunosorbent assay (ELISA) in 53 untreated patients with pSS (25patients with only lacriminal and/or salivary gland involvement,28 with only interstitial lung disease involvement) and 15 healthy controls.The related clinical and laboratory data were recorded.ANOVA,LSDtest and Pearson test were used for statistical analysis.Results There were significant differences between the 3 groups(F=22.504,P=0.000).The mean concentration of sera IL-I7 in the patients with ILD was significantly higher than in patients with only lacriminal or salivary gland involvement (P＜0.05).There was no difference in the levels of sera IL-17 between the patients with only lacriminal and/or salivary gland involvement and healthy controls (P＞0.05).Conclusion Our results show that patients with pSS concomitant with ILD have high serum IL-17 levels,which highlight the role of IL-17 in Sj(o)gren's syndrome interstitial lung injury.
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Objective In order to explore the localization of NGB protein in spinal cord of adult rat. Methods Spinal cord of adult rat was used to make frozen section. The localization of NGB protein in the spinal cord of adult rat was examined by immunohistochemistry method. Results NGB protein immunoreactive cells were mainly distributed in the gray matter of spinal cord, including in the ventral horn, intermediate zone and dorsal horn. NGB-immunoreactive product located in the plasm of neurons.Conclusion The results indicated that NGB widely expressed in the neurons of spinal cord, suggested that NGB might play an important role in the physiological function of the spinal cord.
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Objective To observe the dynamic changes in neuroglobin (NGB) expression in cerebral cortex and hippocampus after cerebral ischemia-reperfusion injury in gerbils. Methods The global cerebral ischemia of gerbils was induced by clamping bilateral carotid arteries for 20 minutes, then they were released to allow reperfusion for 2h, 8h, 16h, 24h, 48h and 72h. The NGB expression in cerebral cortex and hippocampus was measured with immunohistochemical methods coupled with computer-assisted image analysis. Results The changes in NGB expression were different in cerebral cortex and in the hippocampus. NGB protein was up-regulated from 16h to 48h after ischemia-reperfusion insult to cerebral cortex, whereas it was down-regulated hippocampus. Conclusion The different expressions of NGB in cerebral cortex and hippocampus are suggestive of compensatory and repair mechanisms in ischemia-damaged neurons after transient global cerebral ischemia. The increased expression of endogenous NGB in the brain after ischemia-reperfusion may be associated with the protective response to ischemic damage.
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Objective To evaluate the value of the StealthStation neuronavigation in the operation of intracranial lesions. Methods 22 patients with different intracranial lesions, including 14 cases of glioma, 2 cases of meningioma,4 cases of cavernous angioma,1 case of lymphoma and 1 case of metastatic cancer, were operated on with the aid of StealthStation neuronavigational system. The neuronavigational accuracy and surgical effect were analysed. Results All intracranial lesions were found accurately with StealthStation neuronavigational system, the predicted accuracy (PA) value was 2.53?0.73mm, accuracy sphere of intracranial lesions in the neuronavigational system was within 2mm in all patients. 13 cases out of 14 gliomas were totally removed under microscope, in 1 case removal was subtotal. In 2 patients, neurological symptoms became worse immediately after the operation but improved within 3 months after the operation. The other 12 patients recovered very well. In another 8 cases total removal under microscopy was successful, but one lymphoma patient showed exacerbation of neurological symptoms immediately after operation, but improved within 1 week after operation. The other 7 cases recovered very well. Conclusion The StealthStation neuronavigational system is reliable and accurate in neurosurgical operation, thus it is helpful to facilitate total resection of intracranial lesions with less operative complications.