Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance...Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging （MR-DTI） and fluorescein sodium dyeing （FLS） guiding technique for surgery of glioma located in brain motor functional areas. Methods Totally 83 patients were enrolled according to our inclusion and exclusion criteria （56 patients in experimental group, 27 patients in control group）. In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6-24 months. Neurological deficits and Karnofsky scoring （KPS） were evaluated. Results There were no significant differences in balance test indexes of preoperative data （sex, age, lesion location and volume, and neurological deficits before operation） and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection （80.4% vs. 40.7%）, and the paralysis rate caused by surgery was lower in experimental （25.0%） vs. control （66.7%） groups （P 〈0.05）. The 6-month KPS in the low-grade and high-grade gliomas was 91＋11 and 73＋26, respectively, in the experimental group vs. 82＋9 and 43＋27, respectively, in the control group （P 〈0.05 for both）. Conclusions MR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.展开更多
Spinal ependymomas(SEs) are common adult intramedullary tumors; however,determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescei...Spinal ependymomas(SEs) are common adult intramedullary tumors; however,determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium(FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS(3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging(MRI) at 10 days and 3 months after surgical recovery; McC ormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92%(103/112). Ninetyfour patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function(85.8%(91/106)) and movement(84.3%(86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7%(16/24). The Mc Cormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade(I–IV), compared with preoperative classifications(each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.展开更多
We recently reported that L-ascorbic acid 2-phosphate (AP) stimulates the growth of human dermal papilla (DP) cells, induces secretion of IGF-1 from the DP cells to promote hair shafts elongation in cultured human hai...We recently reported that L-ascorbic acid 2-phosphate (AP) stimulates the growth of human dermal papilla (DP) cells, induces secretion of IGF-1 from the DP cells to promote hair shafts elongation in cultured human hair follicles, and triggers early progression from the telogen to anagen phase in mice. Since the magnesium salt of AP (APMg) is a highly hydrophilic ionic molecule, it is not easy to deliver this reagent to the skin or hair follicles by topical application alone. In order to enhance skin penetration of APMg without changing any molecular properties, a non-invasive iontophoretic delivery method was introduced. Iontophoresis of the negatively charged APMg under the electrode bearing same charge (cathode) significantly enhanced the in vitro penetration of APMg into a Franz cell equipped with mouse dorsal skin. In contrast, iontophoretic movement with the anode inhibited APMg penetration achieved with passive diffusion alone. The effect of iontophoresis on enhancing the penetration of APMg was also found to be much higher in the skin of hairy mice (3 - 8 times) compared to hairless mice (1.5 - 2.5 times). These findings indicated that iontophoretic movement induced the transfollicular pathway more strongly and effectively than the transdermal pathway. This phenomena was also demonstrated by the in vivo iontophoretic delivery of sodium fluorescein using hairy and hairless mice. The degree of iontophoretic enhancement during APMg penetration was also dependent on various conditions such as current density and application duration.展开更多
The eye is an immune-privileged and sensory organ in humans and animals.Anatomical,physiological,and pathobiological features share significant similarities across divergent species(1).Each compartment of the eye has ...The eye is an immune-privileged and sensory organ in humans and animals.Anatomical,physiological,and pathobiological features share significant similarities across divergent species(1).Each compartment of the eye has a unique structure and function.The anterior and posterior compartments of the eye contain endothelium(cornea),epithelium(cornea,ciliary body,iris),muscle(ciliary body),vitreous and neuronal(retina)tissues,which make the eye suitable to evaluate efficacy and safety of tissue specific drugs(2).展开更多
文摘Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging （MR-DTI） and fluorescein sodium dyeing （FLS） guiding technique for surgery of glioma located in brain motor functional areas. Methods Totally 83 patients were enrolled according to our inclusion and exclusion criteria （56 patients in experimental group, 27 patients in control group）. In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6-24 months. Neurological deficits and Karnofsky scoring （KPS） were evaluated. Results There were no significant differences in balance test indexes of preoperative data （sex, age, lesion location and volume, and neurological deficits before operation） and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection （80.4% vs. 40.7%）, and the paralysis rate caused by surgery was lower in experimental （25.0%） vs. control （66.7%） groups （P 〈0.05）. The 6-month KPS in the low-grade and high-grade gliomas was 91＋11 and 73＋26, respectively, in the experimental group vs. 82＋9 and 43＋27, respectively, in the control group （P 〈0.05 for both）. Conclusions MR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund(No.12015C1045)
文摘Spinal ependymomas(SEs) are common adult intramedullary tumors; however,determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium(FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS(3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging(MRI) at 10 days and 3 months after surgical recovery; McC ormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92%(103/112). Ninetyfour patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function(85.8%(91/106)) and movement(84.3%(86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7%(16/24). The Mc Cormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade(I–IV), compared with preoperative classifications(each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.
文摘We recently reported that L-ascorbic acid 2-phosphate (AP) stimulates the growth of human dermal papilla (DP) cells, induces secretion of IGF-1 from the DP cells to promote hair shafts elongation in cultured human hair follicles, and triggers early progression from the telogen to anagen phase in mice. Since the magnesium salt of AP (APMg) is a highly hydrophilic ionic molecule, it is not easy to deliver this reagent to the skin or hair follicles by topical application alone. In order to enhance skin penetration of APMg without changing any molecular properties, a non-invasive iontophoretic delivery method was introduced. Iontophoresis of the negatively charged APMg under the electrode bearing same charge (cathode) significantly enhanced the in vitro penetration of APMg into a Franz cell equipped with mouse dorsal skin. In contrast, iontophoretic movement with the anode inhibited APMg penetration achieved with passive diffusion alone. The effect of iontophoresis on enhancing the penetration of APMg was also found to be much higher in the skin of hairy mice (3 - 8 times) compared to hairless mice (1.5 - 2.5 times). These findings indicated that iontophoretic movement induced the transfollicular pathway more strongly and effectively than the transdermal pathway. This phenomena was also demonstrated by the in vivo iontophoretic delivery of sodium fluorescein using hairy and hairless mice. The degree of iontophoretic enhancement during APMg penetration was also dependent on various conditions such as current density and application duration.
文摘The eye is an immune-privileged and sensory organ in humans and animals.Anatomical,physiological,and pathobiological features share significant similarities across divergent species(1).Each compartment of the eye has a unique structure and function.The anterior and posterior compartments of the eye contain endothelium(cornea),epithelium(cornea,ciliary body,iris),muscle(ciliary body),vitreous and neuronal(retina)tissues,which make the eye suitable to evaluate efficacy and safety of tissue specific drugs(2).
