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Biomedical subjects

Cheng-yuan Wu

Publications and source records attributed to Cheng-yuan Wu.

9 recordsLinked to original sources

Neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of intractable trigeminal neuralgia.

BACKGROUND: Percutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) is regarded as the first choice for most patients with trigeminal neuralgia (TN) because of its safety and feasibility. However, neuronavigator-guided PRTTG has been seldom reported. The purpose of this study was to assess the safety and efficacy of neuronavigator-guided PRTTG for the treatment of intractable TN. METHODS: Between January 2000 and December 2004, 54 patients with intractable TN were enrolled into this study and were randomly divided into two groups. The patients in navigation group (n = 26) underwent PRTTG with frameless neuronavigation, and those in control group (n = 28) received PRTTG without neuronavigation. Three months after the operation, the efficacy, side effects, and complications of the surgery were recorded. The patients in the control group were followed up for 10 to 54 months (mean, 34 +/- 5), and those in the navigation group were followed up for 13 to 58 months (mean, 36 +/- 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups. RESULTS: The immediate complete pain-relief rate of the navigation group was 100%, whereas it was 95% in the control. The proportion of sustained pain-relief rates at 12, 24 and 36 months after the procedure were 85%, 77%, and 62% in the navigation group, and 54%, 40%, and 35% in the control. Recurrences in the control group were more common than that in the navigation group. Annual recurrence rate in the first and second years were 15% and 23% in the navigation group, and 46%, 60% in the control group. No side-effect and complication was noted in the navigation group except minimal facial hypesthesia. CONCLUSION: Neuronavigator-guided PRTTG is a safe and promising method for treatment of intractable TN with better short- and long-term outcomes and lower complication rate than PRTTG without neuronavigation.

Aged↗

Epidermoid cyst with infiltrative malignant melanoma in the cerebellopontine angle.

We report a patient with an intracranial epidermoid cyst associated with malignant melanoma in the cerebellopontine angle. The CT, MRI and histopathological findings showed an intracranial epidermoid cyst with an adjacent infiltrating melanoma. Immunohistochemical staining of the solid tumour was positive for the melanoma marker HMB45 and negative for GFAP and cytokeratin. Both CT and MRI were helpful in this patient but the diagnosis could only be made on histopathology.

Cerebellar Diseases↗

[Clinicopathologic characteristics and microsurgical treatment of glioma of limbic and paralimbic system].

OBJECTIVE: To explore the features of the clinical manifestations, imaging, pathology and microsurgery on the patients with gliomas of limbic and paralimbic system. METHODS: The clinical data of 28 patients with gliomas of limbic and paralimbic system were analyzed respectively. RESULTS: Seizure was the most common symptom, presented in 24 cases. CT scans showed hypodensity in 19 cases and isodensity in 9 cases. MRI scans were achieved in 23 cases, showing hypointense signal on T(1)WI and hyperintense signal on T(2)WI. Total resection was achieved in 19 cases, subtotal in 6 cases and partial in 3 cases. All patients had excellent postoperative recovery, except 5 patients who developed temporary frontal aphasia and 6 patients who developed contralateral hemiplegia. The patients had a postoperative follow-up ranging from 6 months to 5 years, and 23 cases still survived. CONCLUSION: High-resolution CT and MRI may reveal the size, location, confines and sharp demarcation of the tumors. Gliomas can be microsurgically removed with considerable results.

Adolescent↗

[Experimental research of myogenic motor evoked potentials to transcranial magnetic stimulation for spinal cord monitoring].

OBJECTIVE: To evaluate the validity of intraoperative magnetic MEP (motor evoked potentials) monitoring in a spinal-cord-menaced surgery. METHODS: 32 rabbits were employed in weight-drop spinal cord contusion model. After anesthetized with a combination of Ketamine and Droperidol the spinal cords were surgically exposed with the dura intact, and the contusion injuries were delivered except the rabbits in control group. The MEPs were recorded and the relationship between the variation of the MEPs and the residual locomotor capacity after spinal cord injury was analyzed. RESULTS: The 6 rabbits in mild-spinal-cord-injury group experienced transient attenuation of their TMS-MEPs, and the locomotor capacity remained intact (scores of 5) in almost all rabbits (5 of 6) when assessed 24 hours later; In the moderate-spinal-cord-injury group the 8 rabbits lost their TMS-MEP immediately after the weight-drop contusion, but they regained them partly in 1 hour one after another and scored 4 or 5 in the assessment of muscle power next day except for one score of 2; 8 rabbits had their spinal cords impaired severely in the contusion procedure and lost their TMS-MEP too but without recovery, their locomotor capacity outcomes were very poor, 5 of them had no response to transcranial magnetic stimulation next day, and in the other 3 rabbits we only found some polyphase waves with variant latency and lower amplitude which did not resemble common compound muscle action potential (CMAPs) evoked by TMS. CONCLUSIONS: Myogenic TMS-MEPs was very sensitive to the spinal cord injury and should be a valid technique for intraoperative monitoring, and a slight change of them, even if a transient lose, should be unnecessarily related to a severe movement disorder. The warning threshold for a given patient should depend on the malady itself.

Acute Disease↗

[Multiple meningiomas: report of 32 cases].

OBJECTIVE: To explore the genesis and classification and diagnosis as well as the treatment of multiple meningiomas. METHODS: Retrospective study of the materials of 32 cases of multiple meningiomas, simultaneously review of the related articles. RESULTS: All patients were divided into 5 groups, primary 18 cases, postoperative 7 cases, accompanied by neurofibromatosis (NF) 4 cases, meningiomatosis 1 case, accompanied with other intracranial tumor 2 cases, one with pituitary adenoma and the other with glioma. All the patients accepted operation, cured 25 cases, improved 7 cases. CONCLUSIONS: The cytogenesis of different type of multiple meningiomas probably varied. Estrogen may play an important role in the genesis of multiple meningiomas. One stage resection of all the tumors was feasible to most cases and advocated. Most cases had strong tolerance to several times of operation, staging operation was permitted. The prognosis and principle of treatment of different group varied.

Adult↗

Traumatic subdural hydroma developing into chronic subdural hematoma.

OBJECTIVE: To probe the incidence, pathogenesis and clinical characteristics of traumatic subdural hydroma (TSH) developing into chronic subdural hematoma (CSDH). METHODS: We retrospectively analyzed the clinical data of 32 patients with TSH developing into CSDH and reviewed related literature. RESULTS: 16.7% of TSH developed into CSDH in this study. The time of evolution was from 22 to 100 days after head injury. All the patients were cured with hematoma drainage. CONCLUSIONS: TSH is one of the origins of CSDH. The clinical characteristics of TSH developing into CSDH follow that the ages of the patients are polarized, that the evolution often happens in the patients with small chronic hydromas and being treated conservatively, that the patients are usually injured deceleratedly and that the accompanying cerebral damage is often very mild.

Adolescent↗

[Type and its clinical characteristics of traumatic subdural hydroma].

OBJECTIVE: To explore the types and clinical characteristics of traumatic subdural hydroma (TSH). METHOD: One hundred and ninety-two cases of TSH were classified into four types: The types of resolution, steadiness, development and evolution on the basis of their clinical characteristics and dynamic observation of CT scanning. RESULTS: The patients in the resolution type often occurred in the prime of life. They had normal intracranial pressure and good prognoses using the conservative therapy. The majority of the elderly patients was in the steadiness type. Their main clinical manifestations included headache, dizziness, nausea, vomit, abnormal mentality and so on. Generally, there was no positive nervous systemic sign related to TSH. The prognoses of patients with the steadiness type treated by conservative therapy were satisfactory. The development type was common in the babies and children. This was mainly manifested as progressive increased intracranial pressure, mild hemiplegia, aphasia and abnormal mentality. The patients with development type often needed surgical treatment and might die once in a while due to accompanying cerebral parenchymal damage or postoperative complications. The evolution type was characterized by the polarized age, chronic increased intracranial pressure, often happening between 22 and 100 days after TSH and in the cases of small hydromas treated conservatively and mild accompanying cerebral damage, which always have a good prognosis by the treatment of surgery. CONCLUSIONS: The mechanism, clinical characteristics, treatment methods and prognoses varied with different types of TSH.

Adolescent↗

[Prognostic factors for deep situated malignant gliomas treated with linac radiosurgery].

BACKGROUND & OBJECTIVE: Though radiosurgery has been used for more than 10 years, the value of radiosurgery for malignant glioma has not been clarified. This paper was designed to investigate efficacy of radiosurgery to malignant glioma by analyzing the prognostic factors affecting prognosis of malignant gliomas treated with linac radiosurgery. METHODS: Fifty-eight patients with deep situated malignant gliomas, 28 anaplastic astrocytomas(AA) and 30 glioblastomas (GBM), aged from 7 to 70 years, were analyzed. The mean volume of tumor was 12.08 cm3, and mean prescription dose for linac radiosurgery was 19.42 Gy. The results were analyzed with Kaplan-Meier curve and Cox regression. RESULTS: There were 44.8% of the tumors shrank. Median tumor local control interval was 10 months(15 months for AA and 9 months for GBM). Tumor local control probability was 37.9% for 1 year and 10.3% for 2 years. Median survival was 22.5 months for AA and 13 months for GBM and 15 months for all patients. The survival probability was 79.3% at 1 year and 20.6% at 2 years. Isocenter numbers and tumor volume were the prognostic factors for tumor control, but conformity index was prognostic factor for survival as determined by Cox regression analysis. Considered of pathology, only isocenter number and target volume significantly affected the tumor control interval. Complication appeared in 44.8% of the patients and the median interval of complication onset was 8 months. Symptomatic cerebral edema was observed in 31.0% of the patients. CONCLUSION: Linac radiosurgery can effectively improve tumor local control and elongate survival for the patients with deep situated malignant gliomas. Tumor volume is the prognostic factor for tumor control, while conformity index is prognostic factor for survival.

Adolescent↗