ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE:Considered as immune effector cells of the central nervous system, microglia represent a major component of the inflammatory cells found in malignant gliomas. Although their role in brain tumor biology is unclear, accumulation of microglia in malignant brain tumors may be mediated through active secretion of cytokines by glioma cells. Because hepatocyte growth factor/scatter factor (HGF/SF) has been shown to modulate glioma motility through an autocrine mechanism, and because microglia have been reported to express the HGF/SF receptor Met, we hypothesized that microglia recruitment by gliomas may also occur through the secretion of HGF/SF.METHODS:The effect of glioma cells in augmenting BV-2 murine microglia motility was studied by using an in vitro Boyden chamber migration assay. To determine the chemokines involved in microglia migration, neutralizing monoclonal antibodies against monocyte chemotatic protein-1 and HGF/SF were tested. Immunoblotting was used to check for the expression of HGF/SF by glioma cells, and the expression of Met by BV-2 cells was examined by flow cytometry.RESULTS:BV-2 migration was noted within 7 hours of incubation with both human (U251 MG and U373 MG) and murine (GL261) glioma cell lines. This migration corresponded to HGF/SF secretion by glioma cells and was completely inhibited by neutralizing monoclonal antibody against HGF/SF, but not monocyte chemotactic protein-1. Exposure of BV-2 cells to recombinant HGF/SF, but not monocyte chemotactic protein-1, resulted in their migration and down-regulation of Met in a dose-dependent fashion.CONCLUSION:HGF/SF, which plays a role in glioma motility and mitogenesis, may also act as a chemokine for microglia and may be responsible for the microglia infiltration in malignant gliomas. This active recruitment of microglia may play an important role in glioma biology.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVES:To simplify the practice of stereotactic surgery by using an original method, apparatus, and solid anatomic replica for trajectory planning and to validate the method and apparatus in a laboratory and clinical trial.METHODS:The patient is marked with fiducials and scanned by using computed tomography or magnetic resonance imaging. The three-dimensional data are converted to a format acceptable to stereolithography. Stereolithography uses a laser to polymerize photosensitive resin into a solid plastic model (biomodel). Stereolithography can replicate blood vessels, soft tissue, tumor, and bone accurately (< 0.8 mm). A stereotactic apparatus is referenced to fiducials replicated in the biomodel. The trajectory for the intervention is determined and saved. The apparatus is attached to the patient fiducials, and the intervention is replicated.RESULTS:Three types of apparatus (template, Brown-Roberts-Wells frame, and D'Urso frame) were tested on phantoms and patients requiring the excision/biopsy of tumors. The localization errors determined from the phantom studies were template, 0.82 mm; Brown-Roberts-Wells frame, 1.17 mm; and D'Urso frame, 0.89 mm. The surgeons reported that clinical use of the template and D'Urso frame was accurate and ergonomic. The Brown-Roberts-Wells frame was more difficult to use and somewhat inaccurate.CONCLUSION:Biomodel-guided stereotaxy has significant advantages. It is performed quickly; it is based on simple, intuitive methodology; it enhances visualization of anatomy and trajectory planning; it enhances patient understanding; it uses inexpensive equipment; it does not require rigid head fixation; and it has greater versatility than known techniques. Disadvantages are biomodel cost and a manufacturing time of 12 to 24 hours.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE:Endoscopes have been increasingly used during neurosurgical procedures. Previously, they have been shown to offer better visualization than the microscope in selected situations and frequently have allowed less invasive surgery. This study was undertaken to determine whether endoscopy is safe and effective during suboccipital surgery for vestibular schwannomas.METHODS:Ten patients with vestibular schwannomas underwent suboccipital transmeatal craniotomies for tumor excision. Endoscopy with a rigid glass lens endoscope (Hopkins telescope) was used during tumor removal to examine posterior fossa neurovascular structures and after excision to inspect the internal auditory canal.RESULTS:Complete tumor excision was achieved in nine patients. Endoscopy allowed improved identification of tumor and adjacent neurovascular relationships in all cases without the need for significant retraction of the cerebellum or brain stem. In addition, residual tumor at the fundus of the internal auditory canal (n = 2) and exposed petrous air cells (n = 3) not seen with the microscope were identified endoscopically. Operative time was not significantly increased by incorporating the endoscope.CONCLUSION:Posterior fossa endoscopy can be performed safely during surgery for tumor removal. Endoscope-assisted surgery for vestibular schwannomas may offer some advantages over standard microsurgery in selected cases. The advantages may include improved visualization, more complete tumor removal, and a lowered risk of cerebrospinal fluid leakage.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID