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1.
Turk Neurosurg ; 26(5): 795-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27349394

RESUMO

The aim of this report is to investigate the pathogenesis and surgical treatment of encephalocele located in the sphenoid sinus and presented with spontaneous rhinorrhea. The data of a patient with sphenoid sinus encephalocele was analyzed in association with the review of literature. The patient admitted to our clinic with rhinorrhea from the left nasal cavity. Cranial magnetic resonance imaging revealed bone defects in the left sphenoid sinus wall, and the presence of brain tissue and cerebrospinal fluid (CSF) in the sphenoid sinus. The patient underwent dural repair via left pterional approach. Rhinorrhea disappeared after surgery. The pathogenesis of the encephalocele in the sphenoid sinus is not clear. It may be related to the presence of lateral craniopharyngeal canal, extra-gasification in the sphenoid sinus, high intracranial pressure or other factors. It is very important to diagnose accurately the source of CSF fistula in preoperative period, choose the specific operation technique, and follow-up the patient for a long time period.


Assuntos
Rinorreia de Líquido Cefalorraquidiano , Encefalocele , Seio Esfenoidal , Rinorreia de Líquido Cefalorraquidiano/diagnóstico por imagem , Rinorreia de Líquido Cefalorraquidiano/etiologia , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Encefalocele/complicações , Encefalocele/diagnóstico por imagem , Encefalocele/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Seio Esfenoidal/anormalidades , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/cirurgia
2.
Arch Med Sci ; 12(3): 576-86, 2016 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-27279851

RESUMO

INTRODUCTION: The aim was to investigate the relationship between the tumor (clinicopathologic and radiological) characteristics and the morphological parameters of pituitary macroadenoma or giant adenoma patients using a three-dimensional (3D) reconstructed model. MATERIAL AND METHODS: Magnetic resoanance imaging (MRI) was performed preoperatively; tumor grade was determined by the Knosp-Steiner classification and tumor morphology by the SIPAP classification. Pituitary adenomas and adjacent structures were reconstructed three-dimensionally by volume rendering. RESULTS: Fifty-two and 6 patients underwent surgery via the transnasal transsphenoidal or pterional approach, respectively. Knosp-Steiner grades I to IV adenomas were observed in 5.2%, 25.9%, 22.4% and 46.6% of the patients, respectively. The 3D model was reconstructed in all cases with superb delineation of tumor morphology and the spatial relationship between the tumor and adjacent tissues. Pituitary adenomas were categorized into intrasellar (13.8%), suprasellar (20.7%), infrasellar (17.2%), and lobulated adenomas (48.3%). Suprasellar adenomas had the smallest (2.27 ±3.22 cm(3)) and lobulated adenomas the largest volume (24.61 ±30.50 cm(3)). Intrasellar adenomas were all functioning, while 75%, 60% and 60.7%, respectively, of suprasellar, infrasellar and lobulated adenomas were nonfunctioning, with a significant association between tumor morphology and secretory function (p = 0.005). CONCLUSIONS: Three-dimensional reconstruction of pituitary macroadenomas offers a simplified morphological classification of pituitary adenomas and may be helpful for neurosurgeons to categorize and characterize pituitary adenomas.

3.
Turk Neurosurg ; 26(3): 384-288, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27161465

RESUMO

AIM: To investigate the variation and significance of malondialdehyde (MDA) and superoxide dismutase (SOD) in brain tissue after secondary brain injury (SBI) with seawater immersion in rats. MATERIAL AND METHODS: We randomly divided 163 male Sprague Dawley rats into 4 groups, as normal (Group A), SBI (Group B), SBI with physiological saline immersion (Group C) and SBI with seawater immersion (Group D) groups. The animal model of ischemic SBI with seawater immersion was established based on the Marmarou's model of diffuse brain injury. The water content, and the MDA and SOD contents of brain tissue were detected at 1, 3, 6, 12, 24 and 48 hours after the injury. RESULTS: Compared to group A, there were significant changes of various indicators in group D after injury at 1 hour after injury (P < 0.05). The water content and MDA contents in brain tissue were persistently elevated and significantly higher than that in groups B and C at each time phase (P < 0.05). The SOD content showed a persistent decline and was significantly lower than that in groups B and C at each time phase (P < 0.05). The SOD content was negatively correlated with the MDA content with a correlation coefficient of -0.992 (P < 0.01). CONCLUSION: The SBI with seawater immersion is faster and more serious than the simple SBI.


Assuntos
Química Encefálica , Lesões Encefálicas/metabolismo , Lesões Encefálicas/fisiopatologia , Imersão/fisiopatologia , Malondialdeído/metabolismo , Água do Mar , Superóxido Dismutase/metabolismo , Animais , Antioxidantes/metabolismo , Lesões Encefálicas/enzimologia , Masculino , Ratos , Ratos Sprague-Dawley , Água/metabolismo
4.
Int J Clin Exp Med ; 7(10): 3270-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25419358

RESUMO

BACKGROUND: Neurosurgery in areas with restricted space and complicated anatomy can be greatly aided by the virtual reality (VR) technique. The clivus represents one of such challenging surgical areas, but its VR has not been established. The present study aimed to document a VR model of clival anatomy that may be useful in clival surgery. METHODS: High resolution CT angiography and MRI were used. The study included a total of 20 patients who did not have any obvious abnormalities detected in the oral, nasal, and clival areas. The images were fused with a Dextroscope. RESULTS: In the VR model, the key structures such as the clival bone, basilar artery, brainstem, pituitary gland, and paranasal sinuses were clearly observed. The morphology of the clivus and its spatial relationships with the neighboring structures were also illustrated. Visualization of the clival model can be made flexible from various planes, angles, or orientations. In addition, surgical access to the clivus via the transoral route or transnasal route was simulated in detail. CONCLUSION: The simulation of the VR model offers a straightforward, three-dimensional, interactive understanding of the size and shape of the clivus, and its relationships with the surrounding blood vessels and bones. It also demonstrates simulated operational procedures such as opening the surgical window, measuring the exposure distance and angles, and determining the critical boundaries in relation to key structures such as the brainstem and arteries. Digitalized VR modeling appears to be helpful for understanding the anatomy of the clivus and its surgical approaches.

5.
Turk Neurosurg ; 23(4): 491-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24101269

RESUMO

AIM: The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. MATERIAL AND METHODS: Data from 56 patients with craniocerebral firearm injury were analyzed retrospectively for projectile types, traumatic conditions, and treatment approaches. RESULTS: 43 patients exhibited intracranial foreign body residence. Of them, 40 were subjected to complete foreign body removal and 2 to partial removal, leaving 1 without receiving removal treatment. 54 patients (96.4%) survived and 2 (3.6%) died. Of the survivors, 36 (64.3%) recovered well, 15 (26.8%) were moderately disabled, 2 (3.6%) were severely disabled, and 1 (1.8%) lapsed into vegetative state. Patients receiving debridement within 8 h after injury had a significantly higher recovery rate than those receiving such treatment after 8 h (82.1% vs. 26.7%; P < 0.001). CONCLUSION: Craniocerebral firearm injury is characterized by rapid traumatic condition development as well as serious trauma and contamination. Accurately judging the traumatic condition and the ballistic tract, performing complete debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury.


Assuntos
Traumatismos Craniocerebrais/cirurgia , Procedimentos Neurocirúrgicos/métodos , Ferimentos por Arma de Fogo/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/mortalidade , Desbridamento , Descompressão Cirúrgica , Feminino , Corpos Estranhos/cirurgia , Escala de Coma de Glasgow , Escala de Resultado de Glasgow , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuronavegação , Procedimentos Neurocirúrgicos/instrumentação , Admissão do Paciente , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ferimentos por Arma de Fogo/diagnóstico , Ferimentos por Arma de Fogo/mortalidade , Adulto Jovem
6.
BMC Neurol ; 12: 146, 2012 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-23190528

RESUMO

BACKGROUND: It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region. METHODS: To investigate the value of using a virtual reality system for planning resection of sellar region tumors. The study included 60 patients with sellar tumors. All patients underwent computed tomography angiography, MRI-T1W1, and contrast enhanced MRI-T1W1 image sequence scanning. The CT and MRI scanning data were collected and then imported into a Dextroscope imaging workstation, a virtual reality system that allows structures to be viewed stereoscopically. During preoperative assessment, typical images for each patient were chosen and printed out for use by the surgeons as references during surgery. RESULTS: All sellar tumor models clearly displayed bone, the internal carotid artery, circle of Willis and its branches, the optic nerve and chiasm, ventricular system, tumor, brain, soft tissue and adjacent structures. Depending on the location of the tumors, we simulated the transmononasal sphenoid sinus approach, transpterional approach, and other approaches. Eleven surgeons who used virtual reality models completed a survey questionnaire. Nine of the participants said that the virtual reality images were superior to other images but that other images needed to be used in combination with the virtual reality images. CONCLUSIONS: The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.


Assuntos
Imageamento Tridimensional/métodos , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Cuidados Pré-Operatórios/métodos , Cirurgia Assistida por Computador/métodos , Interface Usuário-Computador , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sela Túrcica/patologia , Sela Túrcica/cirurgia , Resultado do Tratamento , Adulto Jovem
7.
Int J Endocrinol ; 2012: 958732, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23008711

RESUMO

Background and Purpose. To explore strategies for the diagnosis and treatment of Rathke's cleft cyst (RCC). Methods. The medical records of 24 patients with sellar RCC were retrospectively reviewed. Two patients had concomitant pituitary adenoma, 2 underwent transcranial surgery, and 22 underwent transsphenoidal surgery. The clinical features, especially the findings of intracystic nodules on MRI, were evaluated and compared with the pathological findings. Results. Preoperatively, only 2 patients were diagnosed with RCC or suspected RCC. Pre- and postoperative MRI images revealed 10 intracystic nodules in 9 (37.5%) patients. Two nodules had bull's eyelike changes. The signal intensity of the intracystic nodules varied on T1- and T2-weighted images. Not all nodules on T2-weighted images were visualized. Postoperative MRI revealed recurrence or residual lesion in 5 patients; none had new symptoms and a second surgery was not required. Conclusions. Identifying intracystic nodules is important in patients with sellar cystic lesions. Bull's eyelike change in an intracystic nodule on MRI, which is reported here for the first time, potentially might have value for confirming the diagnosis.

8.
J Craniomaxillofac Surg ; 40(6): 494-9, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21996723

RESUMO

OBJECTIVE: To examine the three-dimensional virtual anatomical features of the sphenoid sinus and adjacent structures during virtual surgery and explore their relevance to actual transsphenoidal surgery. METHODS: CT images of the sphenoid sinus and surrounding structures from 28 Chinese adult patients were measured using a 16-slice helical CT scanner. Image analysis was performed using the volume-rendering method. Two experienced neurosurgeons wearing stereoscopic glasses performed virtual transsphenoidal surgery by the transnasal approach. RESULTS: The virtual anatomical features of the sphenoid sinus and the adjacent structures during virtual surgery were described. The distance from the sphenopalatine foramen to the left and right sphenoid ostium was 10.1 ± 2.7 mm and 10.5 ± 3.2 mm, respectively, to the left and right sphenoidal crest 12.9 ± 2.0 mm and 12.8 ± 2.2 mm, respectively, and to the left and right uncinate process 24.0 ± 1.9 mm and 23.9 ± 2.0 mm, respectively. The distance from the uncinate process to the medial and lateral edge of the most prominent part of the anterior bend of the cavernous internal carotid artery (ICA) was 33.7 ± 3.7 mm and 34.8 ± 3.7 mm, respectively, and the angle between the two lines was 9.7 ± 1.9°. CONCLUSION: The study provides virtual anatomical information about the sphenoid sinus and important surrounding structures that is essential for successful real life transsphenoidal surgery.


Assuntos
Imageamento Tridimensional/métodos , Seio Esfenoidal/cirurgia , Cirurgia Assistida por Computador/métodos , Interface Usuário-Computador , Adulto , Pontos de Referência Anatômicos/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Cefalometria/métodos , Dissecação , Osso Etmoide/diagnóstico por imagem , Osso Etmoide/cirurgia , Feminino , Osso Frontal/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Septo Nasal/diagnóstico por imagem , Septo Nasal/cirurgia , Procedimentos Neurocirúrgicos , Palato/diagnóstico por imagem , Fossa Pterigopalatina/diagnóstico por imagem , Fossa Pterigopalatina/cirurgia , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/cirurgia , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/cirurgia , Seio Esfenoidal/diagnóstico por imagem , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/cirurgia , Tomografia Computadorizada Espiral/métodos , Conchas Nasais/cirurgia
9.
Guang Pu Xue Yu Guang Pu Fen Xi ; 29(6): 1698-701, 2009 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-19810564

RESUMO

The adsorption behavior of Ni (II) on potassium tetratitanate whisker was studied systemically by FAAS, seeing about the reasons for absorption, disentanglement and the effect of interfering ions on the recovery. The preconcentration method was simple, quick and had good selectivity. The adsorption rate of Ni(II) by potassium tetratitanate whisker was 100% at pH 5.0 and Ni(II) could be eluted from potassium tetratitanate whisker with hydrochloric acid (C: 0.5 mol x L(-1)), shake time exceeding 5 min, stick time exceeding 1.5 h, and the disentanglement ratio exceeding 90%. The relative standard deviation (RSD) was 2.6%. The results obtained indicate that the potassium tetratitanate whisker has good regenerate capability.

10.
Microsurgery ; 28(1): 65-70, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18074374

RESUMO

All surgical approaches to the anterior skull base involve the olfactory cistern and have the risk of damaging the olfactory nerve. The purpose of this study was to describe the microanatomical features of the olfactory cistern and discuss its surgical relevance. In this study, the olfactory cisterns of 15 formalin-fixed adult cadaveric heads were dissected using a surgical microscope. The results showed that the olfactory cistern was situated in the superficial part of the olfactory sulcus, which separated the gyrus retus from the orbital gyrus. In coronal section, the cistern was triangular in shape; its anterior part enveloped the olfactory bulbs and was high and broad; its posterior part was medial-superior to internal carotid artery and was also much broader. There were one or several openings in the inferior wall of the posterior part in 53.4% of the cisterns. The olfactory cistern communicated with the surrounding subarachnoind cisterns through these openings. The middle part of the olfactory cistern gradually narrowed down posteriorly. Most cisterns were spacious with a few fibrous trabeculas and bands between the olfactory nerves and cistern walls. However 23% of the cisterns were narrow with the cistern walls tightly encasing the olfactory nerve. There were two or three of arterial loops in each olfactory sulcus, from which long, fine olfactory arteries originated. The olfactory arteries coursed along the olfactory nerve and gave off many terminal branches to provide the main blood supply to the olfactory nerve in most cisterns, but the blood supply was in segmental style in a few cisterns. Moreover, the veins of the cistern appeared to be more segmental than the olfactory arteries in most cisterns. These results suggested that most olfactory cisterns are spacious with relatively independent blood supply, and it is reasonable to separate the olfactory tract with its independent blood supply from the frontal lobe by 1-2 cm in the subfrontal approach, the pterional approach, or anterior interhemispheric approach. However, in the minority of cases, separation of the olfactory tract is not safe because of the anterior origin of the olfactory arteries or segmental blood supply. It is difficult to separate the olfactory nerve without any damage to the olfactory nerve, even with very skilled hands.


Assuntos
Traumatismos dos Nervos Cranianos/prevenção & controle , Neurocirurgia/métodos , Nervo Olfatório/anatomia & histologia , Nervo Olfatório/cirurgia , Adulto , Cadáver , Dissecação , Humanos
11.
Guang Pu Xue Yu Guang Pu Fen Xi ; 27(5): 1018-20, 2007 May.
Artigo em Chinês | MEDLINE | ID: mdl-17655128

RESUMO

The nanometer-sized materials have attracted much interest of analysts in recent years because of their special physicschemistry characteristics. As the scale decreases to nanometer grade, the number of atoms on the surface increases remarkably, resulting in the unsaturation. This makes the nanometer-sized materials have a high adsorptivity for the metal atoms. In the present paper, the nanometer-sized TiO2 was applied in the separation and preconcentration of Cr(III) and Cr(VI) in water. The influence of pH on the adsorption of Cr(III) and Cr(VI) was studied. When pH is larger than 6, 90%, Cr(III) is adsorbed onto the nanometer-sized material surface, while is basically not adsorbed in aqueous solution. Therefore, the separation of Cr(III) and Cr(VI) is achieved. At the pH of 6.5, Cr(III) was adsorbed by nanometer-sized TiO2 and desorbed with 2.0 mol x L(-1) HCl, in which the Cr(III) could be preconcentrated. The Cr(III) solution, as well as the Cr(VI) aqueous solution was determined by FAAS. The detection limits of Cr(M) and Cr(VI) were 41 and 57 ng x mL(-1), respectively. And the linear ranges for Cr(III) and Cr(VI) were 0-9.0 microg x mL(-1) and 0.1-10 microg x mL(-1) with a RSDs of 2.6% and 3.4% (n=6, c = 2.0 microg x mL(-1), respectively. This method was applied in the simultaneous determination of Cr(III) and Cr(VI) in the industrial wastewater and river water, and the satisfactory recovery results were obtained.

12.
Di Yi Jun Yi Da Xue Xue Bao ; 23(5): 452-4, 2003 May.
Artigo em Chinês | MEDLINE | ID: mdl-12754127

RESUMO

OBJECTIVE: To observe the pathological impact of seawater on rabbit brain tissue with severe traumatic injury. METHODS: Modified rabbit models of severe brain injury was utilized, in which the damaged brain tissues were subjected to immersion with fresh seawater for 30 min. A control group was set up in which the trauma was induced without subsequent seawater immersion. Tissue sampling was performed at the brain injury sites at 0, 3, 8 h after seawater immersion and the pathological changes in the brain tissues were observed by means of HE staining. RESULTS: Severe traumatic brain edema occurred in both of the two groups, but the onset time of edema differed. In the control group, brain edema was obvious at 3 h after treatment and hardly aggravated at hour 8; while in seawater treatment group, severe brain edema occurred at 8 h after the treatment and aggravated progressively. CONCLUSION: Seawater immersion delays the onset and peak of traumatic brain edema following severe brain injuries, but can eventually aggravate the traumatic edema.


Assuntos
Encéfalo/patologia , Traumatismos Craniocerebrais/patologia , Água do Mar , Animais , Feminino , Imersão , Masculino , Coelhos , Fatores de Tempo
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