The histopathological features of the middle cerebral artery（MCA） and superficial temporal artery（STA） from moyamoya disease（MMD） and their relationships with gender,age,angiography stage were explored.The cause...The histopathological features of the middle cerebral artery（MCA） and superficial temporal artery（STA） from moyamoya disease（MMD） and their relationships with gender,age,angiography stage were explored.The causes and the clinical significance of vasculopathy of STA were also discussed.The clinical data and specimens of MCA and STA from 30 MMD patients were collected.Twelve samples of MCA and STA from non-MMD patients served as control group.Histopathological examination was then performed by measuring the thickness of intima and media,and statistical analysis was conducted.The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group.There was no significant pathological difference between the hemorrhage group and non-hemorrhage group,and between the males and females in MMD patients.Neither the age nor the digital subtraction angiography（DSA） stage was correlated with the thickness of intima in MCA and STA.MMD is a systemic vascular disease involving both intracranial and extracranial vessels.Preoperative external carotid arteriography,especially super-selective arteriography of the STA,benefits the selection of donor vessel.展开更多
BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors ...BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors introduced a bypass technique using the occipital artery(OA).CASE SUMMARY Two female patients complained of hemiparesis.Brain magnetic resonance imaging(MRI)indicated contralateral infarction from the MCA steno-occlusion.On Diamox single photon emission computed tomography or perfusion MRI,the contralateral front parietotemporal reserve was diminished.On transfemoral cerebral angiography,the STA was thin with a weak flow;however,the OA was prominent.Direct OA-MCA end-to-side extracranial-intracranial bypass surgery was implemented instead of STA because the caliber was too narrow.The postoperative course was uneventful in both cases,with well-maintained bypass patency and neurological stability during follow-up.CONCLUSION OA might be an acceptable alternative for MCA cerebral ischemic cases with an unsuitable STA.展开更多
The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow dive...The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow diverters. The study was a retrospective review of giant intracranial aneurysms treated by superficial temporal artery to middle cerebral artery bypass combined with endovascular occlusion of the parent artery. From 1990 to 2003, 29 consecutive cases of giant cerebral aneurysms, not suitable to selective treatment were managed in that way. Twenty-one medical records had enough data to allow objective evaluation. Sixteen female and five male patients bearing 21 giant aneurysms were involved. Their mean age was 46 years. The aneurysm was revealed by mass effect in 13 cases and subarachnoid hemorrhage in one case. On admission 19 patients presented with unruptured aneurysms and two have sustained a subarachnoid hemorrhage. The balloon occlusion test before the bypass operation was not tolerated in 18 patients. The treatment was completed in 19 patients and 17 of them had parent artery occlusion with latex detachable balloons. The only death of the series occurred before the endovascular treatment. The mean follow-up period was 30 months. After completion of the treatment, 16 (84%) patients had no symptom. Aneurysm recanalization or rupture was not observed after the parent artery occlusion. With the combination of superficial temporal artery to middle cerebral artery bypass + endovascular parent artery occlusion, 90% of giant intracranial aneurysms untreatable selectively were permanently excluded with a good outcome in 95%.展开更多
The extracranial-intracranial （EC-IC） bypass surgery has been widely used in the treatment of cerebral ischemia,intracranial aneurysms,and other diseases for more than 40 years.In terms of treating atherosclerotic c...The extracranial-intracranial （EC-IC） bypass surgery has been widely used in the treatment of cerebral ischemia,intracranial aneurysms,and other diseases for more than 40 years.In terms of treating atherosclerotic cerebral ischemia,the surgery is presumed to be helpful for the subgroup of hemodynamic compromise in prevention of subsequent stroke.However,two multicenter trials presented with high perioperative stroke rate and failed to demonstrate the profit of the surgery.1-3 On this point,one of the crucial issues currently is how to lower down the perioperative stroke rate,the centerpiece of which is early postoperative infarction （EPI）.3展开更多
Objective To detect the content of the basic fibroblast growth factor in blood samples of patients with Moyamoya disease, and investigate the relationship between Moyamoya disease and the basic fibroblast growth facto...Objective To detect the content of the basic fibroblast growth factor in blood samples of patients with Moyamoya disease, and investigate the relationship between Moyamoya disease and the basic fibroblast growth factor. Methods This tissue microarray study included 24 cases of superficial temporal artery samples, 15 cases of Moyamoya disease, and 9 cases of normal arteries as control, and bFGF immunofluorescence assay was applied to test the samples. The number of positive cells and total cells of the muscular layer and the endothelium layer were counted separately in every picture, the positive rates were calculated, and the experimental data were analyzed statistically. Results The bFGF immunofluorescence staining of smooth muscular layer cells, intima cells and endothelial cells from the moyamoya disease group were obviously stronger than that from the control group （P0.01）. Conclusion The enhancement expression of bFGF in the Moyamaya disease group implicates that bFGF plays an important part in the pathogenesis of Moyamoya disease.展开更多
目的:探究桡动脉掌浅支腕横纹皮瓣游离移植修复手指软组织缺损的临床疗效。方法:选择2019年1月-2021年12月笔者医院收治的23例手指软组织缺损患者为研究对象,均给予桡动脉掌浅支腕横纹皮瓣游离移植修复治疗,术后随访6~12个月,评估疗效...目的:探究桡动脉掌浅支腕横纹皮瓣游离移植修复手指软组织缺损的临床疗效。方法:选择2019年1月-2021年12月笔者医院收治的23例手指软组织缺损患者为研究对象,均给予桡动脉掌浅支腕横纹皮瓣游离移植修复治疗,术后随访6~12个月,评估疗效、手指功能[Michigan手部功能问卷(Michigan hand outcomes quest ionnaire,MHQ)]及徒手肌力。结果:本组23例患者皮瓣均完全存活,手术优良率为100.00%,其中优14例,良9例;手术操作时间(3.16±0.21)h,术中出血量(83.27±6.59)ml,创面愈合时间(18.03±2.12)d;皮瓣两点分辨觉(7.41±0.43)mm。术后6个月MHQ评分:整体手功能(80.02±5.17)分,日常活动(78.94±6.13)分,工作情况(79.17±6.02)分,疼痛(77.02±6.13)分,外观(81.16±5.02)分,手功能满意程度(83.02±3.95)分。术后6个月肌力:4级5例,5级18例。随访期间出现术后创缘部分坏死1例,并发症发生率为4.35%。结论:桡动脉掌浅支腕横纹皮瓣游离移植修复手指软组织缺损疗效好,可有效恢复手指功能及徒手肌力,患者满意程度较高。展开更多
基金supported by the key project of the Natural Science Foundation of Hubei Province of China(No.ZRZ2014000254)the National Natural Science Foundation of China(No.81571146)
文摘The histopathological features of the middle cerebral artery（MCA） and superficial temporal artery（STA） from moyamoya disease（MMD） and their relationships with gender,age,angiography stage were explored.The causes and the clinical significance of vasculopathy of STA were also discussed.The clinical data and specimens of MCA and STA from 30 MMD patients were collected.Twelve samples of MCA and STA from non-MMD patients served as control group.Histopathological examination was then performed by measuring the thickness of intima and media,and statistical analysis was conducted.The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group.There was no significant pathological difference between the hemorrhage group and non-hemorrhage group,and between the males and females in MMD patients.Neither the age nor the digital subtraction angiography（DSA） stage was correlated with the thickness of intima in MCA and STA.MMD is a systemic vascular disease involving both intracranial and extracranial vessels.Preoperative external carotid arteriography,especially super-selective arteriography of the STA,benefits the selection of donor vessel.
基金Supported by a grant from Chonnam National University Hospital Biomedical Research Institute,No.BCRI22053.
文摘BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors introduced a bypass technique using the occipital artery(OA).CASE SUMMARY Two female patients complained of hemiparesis.Brain magnetic resonance imaging(MRI)indicated contralateral infarction from the MCA steno-occlusion.On Diamox single photon emission computed tomography or perfusion MRI,the contralateral front parietotemporal reserve was diminished.On transfemoral cerebral angiography,the STA was thin with a weak flow;however,the OA was prominent.Direct OA-MCA end-to-side extracranial-intracranial bypass surgery was implemented instead of STA because the caliber was too narrow.The postoperative course was uneventful in both cases,with well-maintained bypass patency and neurological stability during follow-up.CONCLUSION OA might be an acceptable alternative for MCA cerebral ischemic cases with an unsuitable STA.
文摘The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow diverters. The study was a retrospective review of giant intracranial aneurysms treated by superficial temporal artery to middle cerebral artery bypass combined with endovascular occlusion of the parent artery. From 1990 to 2003, 29 consecutive cases of giant cerebral aneurysms, not suitable to selective treatment were managed in that way. Twenty-one medical records had enough data to allow objective evaluation. Sixteen female and five male patients bearing 21 giant aneurysms were involved. Their mean age was 46 years. The aneurysm was revealed by mass effect in 13 cases and subarachnoid hemorrhage in one case. On admission 19 patients presented with unruptured aneurysms and two have sustained a subarachnoid hemorrhage. The balloon occlusion test before the bypass operation was not tolerated in 18 patients. The treatment was completed in 19 patients and 17 of them had parent artery occlusion with latex detachable balloons. The only death of the series occurred before the endovascular treatment. The mean follow-up period was 30 months. After completion of the treatment, 16 (84%) patients had no symptom. Aneurysm recanalization or rupture was not observed after the parent artery occlusion. With the combination of superficial temporal artery to middle cerebral artery bypass + endovascular parent artery occlusion, 90% of giant intracranial aneurysms untreatable selectively were permanently excluded with a good outcome in 95%.
基金This research was supported by grants from the National Natural Science Foundation of China （No.81371292）,Beijing Natural Science Foundation Program and Scientific Research Key Program of Beijing Municipal Commission of Education （No.KZ201010025021）.
文摘The extracranial-intracranial （EC-IC） bypass surgery has been widely used in the treatment of cerebral ischemia,intracranial aneurysms,and other diseases for more than 40 years.In terms of treating atherosclerotic cerebral ischemia,the surgery is presumed to be helpful for the subgroup of hemodynamic compromise in prevention of subsequent stroke.However,two multicenter trials presented with high perioperative stroke rate and failed to demonstrate the profit of the surgery.1-3 On this point,one of the crucial issues currently is how to lower down the perioperative stroke rate,the centerpiece of which is early postoperative infarction （EPI）.3
基金supported by the Beijing talents supporting foundation [No.20071D030040007]
文摘Objective To detect the content of the basic fibroblast growth factor in blood samples of patients with Moyamoya disease, and investigate the relationship between Moyamoya disease and the basic fibroblast growth factor. Methods This tissue microarray study included 24 cases of superficial temporal artery samples, 15 cases of Moyamoya disease, and 9 cases of normal arteries as control, and bFGF immunofluorescence assay was applied to test the samples. The number of positive cells and total cells of the muscular layer and the endothelium layer were counted separately in every picture, the positive rates were calculated, and the experimental data were analyzed statistically. Results The bFGF immunofluorescence staining of smooth muscular layer cells, intima cells and endothelial cells from the moyamoya disease group were obviously stronger than that from the control group （P0.01）. Conclusion The enhancement expression of bFGF in the Moyamaya disease group implicates that bFGF plays an important part in the pathogenesis of Moyamoya disease.
文摘目的:探究桡动脉掌浅支腕横纹皮瓣游离移植修复手指软组织缺损的临床疗效。方法:选择2019年1月-2021年12月笔者医院收治的23例手指软组织缺损患者为研究对象,均给予桡动脉掌浅支腕横纹皮瓣游离移植修复治疗,术后随访6~12个月,评估疗效、手指功能[Michigan手部功能问卷(Michigan hand outcomes quest ionnaire,MHQ)]及徒手肌力。结果:本组23例患者皮瓣均完全存活,手术优良率为100.00%,其中优14例,良9例;手术操作时间(3.16±0.21)h,术中出血量(83.27±6.59)ml,创面愈合时间(18.03±2.12)d;皮瓣两点分辨觉(7.41±0.43)mm。术后6个月MHQ评分:整体手功能(80.02±5.17)分,日常活动(78.94±6.13)分,工作情况(79.17±6.02)分,疼痛(77.02±6.13)分,外观(81.16±5.02)分,手功能满意程度(83.02±3.95)分。术后6个月肌力:4级5例,5级18例。随访期间出现术后创缘部分坏死1例,并发症发生率为4.35%。结论:桡动脉掌浅支腕横纹皮瓣游离移植修复手指软组织缺损疗效好,可有效恢复手指功能及徒手肌力,患者满意程度较高。
