Search

Objective: To localize the sensory motor cortex of human brain by analyzing the power change in Gamma band (> 60 Hz) of electrocorticography (ECoG) data., Methods: Eight patients with intractable epilepsy underwent temporary placement of subdural electrodes. After surgery, sensory evoked potential (SEP), electrocortical stimulation (CES) and event-related synchronization analysis of Gamma band (Gamma ERS analysis) were performed to reduce the risk of complications. The results of Gamma ERS analysis were compared with those of SEP and CES., Results: The results of Gamma ERS analysis had 80.7% electrodes fitting perfectly those of CES and SEP. And the percentage reached 92.3% if electrodes were superimposed or added adjacently., Conclusion: The Gamma ERS analysis is a new sensitive and precise method for cortical function mapping.

The present study was to investigate the effect of Salvia miltiorrhiza Bunge. f. alba (SMA) pharmacological pretreatment on apoptosis of cultured hippocampal neurons from neonate rats under oxygen-glucose deprivation (OGD). Cultured hippocampal neurons were randomly divided into five groups (n = 6): normal plasma group, low dose SMA plasma (2.5%) group, middle dose SMA plasma (5%) group, high dose SMA plasma (10%) group and control group. The hippocampal neurons were cultured and treated with plasma from adult Wistar rats intragastrically administered with saline or aqueous extract of SMA. The apoptosis of neurons was induced by glucose-free Earle's solution containing 1 mmol/L Na2S2O4 and labeled by MTT and Annexin V/PI double staining. Moreover, protein expressions of Bcl-2 and Bax were detected by immunofluorescence. The results showed that few apoptotic cells were observed in control group, whereas the number of apoptotic cells was greatly increased in normal plasma group and low dose SMA plasma group. Both middle and high dose SMA plasma could protect cultured hippocampal neurons from apoptosis induced by OGD (P < 0.05). The protective effect of high dose SMA plasma was stronger than that of middle one (P < 0.05). Compared to control, normal plasma and low dose SMA plasma groups, middle and high dose SMA plasma groups both showed significantly higher levels of Bcl-2 (P < 0.05 or 0.01), whereas expressions of Bax was opposite. There were no significant differences of Bcl-2 and Bax expressions between middle and high dose SMA plasma groups. Number of Bcl-2- and Bax-positive cells had similar tendency. Bcl-2/Bax (number of positive cells) ratio was higher in high dose SMA plasma group than those of all the other groups (P < 0.05 or 0.01). These results suggest that pharmacological pretreatment of blood plasma containing middle and high dose SMA could raise viability and inhibit apoptosis of OGD-injured hippocampal neurons by up-regulating the expression of Bcl-2 and down-regulating the expression of Bax.

Objective: To investigate the effects of topical fluorescein on the preoperative diagnosis of rhinorrhea of cerebrospinal fluid (CSF) and intraoperative localization of CSF fistula., Methods: Cotton pads soaked with 5% fluorescein were placed in the middle turbinate meatus, roof of ethmoid plate, and sphenoethmoidalis recesses via endoscopic endonasal technique of 15 patients with CSF rhinorrhea, 5 caused by accidental trauma and 10 spontaneous. Change of the color of fluorescein from yellow to green fluorescence denoted the presence of CSF, and thus the site of the leak could be traced. The accuracy rates of diagnosis and leak site identification by this technique were compared with those by glucose analysis, intraoperative findings, and follow-up., Results: The preoperative diagnosis rate of CSF rhinorrhea and the CSF fistula site localization rate by fluorescein-soaked cotton pad were both 100%. No recurrence was found during the follow-up for 2 - 24 months. No complication had been reported., Conclusions: Application of topical fluorescein is an easy, sensitive, safe, and highly accurate tool in the intraoperative localization of the site and extent of CSF fistulas and should be considered a viable noninvasive alternative to intrathecal fluorescein technique.

Objective: To explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis., Method: A total of 25 patients including 15 patients with cerebral paralysis and other 10 patients were diagnosed with clear etiology, spastic muscles with supplied nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was lovated with electronic stimuli and monitored with induced electromyography. The surgical results were analyzed., Results: A total of 36 of 37 (97%) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 10 - 45 degree, and 22 of 24 (85%) talipes equinovarus improved clinically. Of 37 feet with surgery, 24 feet (65%) were in normal position and could touch ground completely, 9 feet (24%) had 10 degree with ground or could contact ground with external one third of the feet, 4 feet (11%) were abnormal. Of 25 patents, 21 (84%) had improvement of motor activity at discretion, 5 patients (20%) improved dramatically. All the 4 patients failed after the operation were cerebral paralysis, and were presumably related to disorders of spinal function, abnormal reflex and the disappearance of inhibitory reflex., Conclusion: Neurotomy is an effective method to treat talipes equinovarus, and can improve the motor activity of low extremity.

Objective: To study causes of ineffectiveness of microvascular decompression (MVD) in treatment of hemifacial spasm (HFS)., Methods: Reoperative MVD was performed in 23 HFS patients with previous ineffective MVD. In the patients, the main causes of ineffectiveness included misjudgment of compressing vessels (7 patients), improper insertion of decompressing grafts (9), improper selection of grafts (5) and small grafts (2)., Results: Symptoms of HFS disappeared immediately after the second MVD in 21 patients and delayed in 2 patients (after 2 weeks, 6 weeks). No recurrence of HFS was noted during the follow-up period of 1.0 - 6.0 years (mean 3.4 years)., Conclusions: MVD is an effective microsurgical method for treating HFS. Accurate judgement of compressing vessels and proper decompression are the key to surgical effectiveness.