Relation between recurrent hemorrhage and both ultrastructural features of vascular and expressions of angiopoietin 1,CD68 and matrix metalloproteinase-9 in intracranial cavernous hemangioma / 中华神经医学杂志

Objective To investigate the relation between recurrent hemorrhage and both ultrastructural features of vascular and expressions of angiopoietin 1 (Ang-l),CD68 and matrix metalloproteinase-9 (MMP-9) in intracranial cavernous hemangioma.Methods Thirty-five intracranial cavernous hemangioma samples,35 hepatic cavernous malformation samples and 4 normal brain tissues were chosen in our study; the ultrastructural features of vascular were observed with optical microscope and electron microscope; immunohistochemical methods were used to analyze the expressions of Ang-1,CD68 and MMP-9.Results The vascular wall was very thin in intracranial eavemous hemangioma samples,only with thin monolayer of endothelial cells and adventitia,but without basal lamina and elastic layer; gap junctions were obviously observed between endothelial cells; basement membrane showed unintelligible,and a large number of high electron density of sediment was presented at the surrounding blood vessels.Tissues from intracranial cavernous hemangioma obviously expressed higher levels of CD68 and MMP-9 than the normal brain tissues (P＜0.05); Rank correlation analysis indicated that the expressions of CD68 and MMP-9 had a high degree of positive correlation (r=0.870,P=0.000).Tissues from intracranial cavernous hemangioma expressed less Ang-1 than normal brain tissues without significant difference (P＞0.05).Conclusion The vascular structural and functional defection and instability in patients with cavernous hemangioma provide favorable conditions for the happaning of recurrent hemorrhage; and high expressions of CD68 and MMP-9 are closely related with recurrent hemorrhage.

Gamma knife for hypersecreting pituitary adenoma: analysis of 120 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To estimate the efficacy of Gamma knife radiosurgery (GKR) especially as a primary surgical treatment for hypersecreting pituitary adenoma.</p><p><b>METHODS</b>One hundred and twenty cases with hypersecreting pituitary adenoma had been treated by Gamma knife radiosurgery. The clinical date had been analysed retrospectively. The tumor margin was covered by an isodose ranging from 45% to 70%. The margin dose was 15 to 32 Gy (mean 28.5 Gy) and the maximum dose varied from 35 to 70 Gy (mean 45.5 Gy). The total number of isocenter was 165 (mean 1-3).</p><p><b>RESULTS</b>One hundred and eleven cases had been followed-up by hormone level, and 104 cases had been followed-up by image of MRI. The mean follow-up duration was 12-72 months (mean 36 months). The control rate of hormone level was 48.6%, the control rate of tumor growth was 96.2%, the incidence of hypopituitarism was in 2.7% and the incidence of tumor apoplexy was in 0.9% in followed-up cases.</p><p><b>CONCLUSIONS</b>As a primary surgical treatment for hypersecreting pituitary adenoma, GKR can be effective and safe in controlling tumor growth and inducing hormonal normalization.</p>