BACKGROUND： Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OB...BACKGROUND： Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OBJECTIVE： To analyze the effectiveness and complications of 501 cases with pituitary adenoma by using gamma-knife retrospectively.DESIGN： Case-analysis.SETTING： Gamma-knife Center, the 363 Hospital of Chinese PLA.PARTICIPANTS： A total of 501 cases were selected from Gamma-knife Center, the 363 Hospital of Chinese PLA from January 1997 to December 2002. All patients were certainly diagnosed with CT and MRI scanning. There were 186 males and 315 females. Their ages ranged from 15 to 84 years with the mean age of 39 years. All patients provided confirmed consent.METHODS： All 501 cases with pituitary adenomas were treated by gamma-knife or combined with operations： The average iso-dose curve was 50% （30% - 65%）, peri-dose was 14 Gy and the average target number was 5.17. ① At 35 months after treatment, patients received follow-up including clinical symptoms,imaging symptoms and endocrine symptoms. ② Patients who received second gamma-knife treatment were analyzed and their complications were observed after operation.MAIN OUTCOME MEASURES： ① Follow-up results of clinical symptoms, image and endocrine indexes; ② second gamma-knife treatment; ③ postoperative complications.RESULTS： Among 501 accepted patients, 275 cases were involved in the follow up of clinical symptoms,154 in image symptoms and 98 in endocrine symptoms. ① Follow-up results of clinical symptoms, image and endocrine indexes： Follow up of clinical symptoms demonstrated that clinical symptoms of 169 cases were relieved, of 68 disappeared, and of 38 deteriorated. Follow-up of image symptoms indicated that pituitary tumor of 25 cases disappeared, of 84 shortened, of 42 not changed, and of 3 enlarged. Follow-up of endocrine symptoms suggested that endocrine of 50 cases was abnormal, of 29 recovery to normal value, and of 19 not changed obviously. ② Second gamma-knife treatment： At 6- 24 months after gamma-knife treatment, 15 patients with pituitary tumor received second gamma-knife treatment; especially, one patient received for the three times. The conditions in details were recorded as follows： The peri-dose for the first treatment ranged from 8 to 12 Gy; in addition, that for the second one ranged from 6 to 12 Gy. ③ Postoperative complications： The complications were as follow： hypopituitarism occurred in 2 patients （0.7%）; tumor apoplexy in 2 patients （0.7%）;weakened eyesight in 5 patients （1.8%）; 3 of which recovered with dehydration and hormone treatment; 2 patients received tumor resection and optical nerve decompression operation with dehydration and hormone treatment ineffectively.CONCLUSION： Gamma-knife is effective and safe for pituitary adenoma.展开更多
BACKGROUND： Some experiments have demonstrated that injecting orphanin FQ （OFQ） into lateral ventricle, which can obviously decrease the pain threshold. It is indicated that OFQ is an anti-opiate substance. However...BACKGROUND： Some experiments have demonstrated that injecting orphanin FQ （OFQ） into lateral ventricle, which can obviously decrease the pain threshold. It is indicated that OFQ is an anti-opiate substance. However, whether OFQ has effects on sensory neuron ion channel in cerebral cortex needs to be further studied. OBJECTIVE： To investigate the effects of OFQ, morphine or their combination on sodium channel current of somatosensory neurons in rat cerebral cortex. DESIGN： Repeated measurement trial. SETTING： Department of Physiology, Harbin Medical University. MATERIALS： Fifty healthy Wistar rats, aged 12 - 16 days, of either gender, were provided by the Experimental Animal Center, Second Hospital Affiliated to Harbin Medical University. OFQ was purchased from Sigma-Aldrich Company, and morphine was provided by the Shenyang First Pharmaceutical Factory. PC2C patch clamp amplifier and LabmasterTLlwere purchased from Yibo Life Science Instrument Co.,Ltd. of Huazhong University of Science and Techgnology. METHODS： This experiment was carried out in the Department of Physiology （provincial laboratory）, Harbin Medical University between January 2005 and May 2006. Cortical neurons were acutely isolated from rats, and prepared into cell suspension following culture. ①Sodium channel current of somatosensory neurons in rat cerebral cortex was recorded before and after administration by whole-cell Patch clamp technique after 50 nmol/L OFQ being added to extracellular fluid. ②The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was recorded before and after administration by the same method after 20 μmol/L morphine being added to extracellular fluid, and then the change of sodium channel current was recorded after 50 nmol/L OFQ being added. MAIN OUTCOME MEASURES： The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex following the administration of OFQ, morphine separately or their combination.. RESULTS： ①The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was significantly lower after administration of 50 nmol/L OFQ than before at the clampe of the voltage of -30 mV （P 〈 0.05）.②The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was significantly lower after administration of 20 μmol/L morphine than before at the clampe of the voltage of-30 mV （P 〈 0.05）. The sodium channel current recovered to - （2 345.24±174.18） pA after 50 nmol/L OFQ was administrated. There were significant differences in the amplitude of Na^＋ channel current between two interventions （P 〈 0.05）. CONCLUSION： Morphine and OFQ can respectively reduce the amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex, and OFQ can reverse the effect of morphine partly. It is indicated that OFQ can produce antiopioid activity in the central nervous system by influencing sodium channel current.展开更多
文摘BACKGROUND： Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OBJECTIVE： To analyze the effectiveness and complications of 501 cases with pituitary adenoma by using gamma-knife retrospectively.DESIGN： Case-analysis.SETTING： Gamma-knife Center, the 363 Hospital of Chinese PLA.PARTICIPANTS： A total of 501 cases were selected from Gamma-knife Center, the 363 Hospital of Chinese PLA from January 1997 to December 2002. All patients were certainly diagnosed with CT and MRI scanning. There were 186 males and 315 females. Their ages ranged from 15 to 84 years with the mean age of 39 years. All patients provided confirmed consent.METHODS： All 501 cases with pituitary adenomas were treated by gamma-knife or combined with operations： The average iso-dose curve was 50% （30% - 65%）, peri-dose was 14 Gy and the average target number was 5.17. ① At 35 months after treatment, patients received follow-up including clinical symptoms,imaging symptoms and endocrine symptoms. ② Patients who received second gamma-knife treatment were analyzed and their complications were observed after operation.MAIN OUTCOME MEASURES： ① Follow-up results of clinical symptoms, image and endocrine indexes; ② second gamma-knife treatment; ③ postoperative complications.RESULTS： Among 501 accepted patients, 275 cases were involved in the follow up of clinical symptoms,154 in image symptoms and 98 in endocrine symptoms. ① Follow-up results of clinical symptoms, image and endocrine indexes： Follow up of clinical symptoms demonstrated that clinical symptoms of 169 cases were relieved, of 68 disappeared, and of 38 deteriorated. Follow-up of image symptoms indicated that pituitary tumor of 25 cases disappeared, of 84 shortened, of 42 not changed, and of 3 enlarged. Follow-up of endocrine symptoms suggested that endocrine of 50 cases was abnormal, of 29 recovery to normal value, and of 19 not changed obviously. ② Second gamma-knife treatment： At 6- 24 months after gamma-knife treatment, 15 patients with pituitary tumor received second gamma-knife treatment; especially, one patient received for the three times. The conditions in details were recorded as follows： The peri-dose for the first treatment ranged from 8 to 12 Gy; in addition, that for the second one ranged from 6 to 12 Gy. ③ Postoperative complications： The complications were as follow： hypopituitarism occurred in 2 patients （0.7%）; tumor apoplexy in 2 patients （0.7%）;weakened eyesight in 5 patients （1.8%）; 3 of which recovered with dehydration and hormone treatment; 2 patients received tumor resection and optical nerve decompression operation with dehydration and hormone treatment ineffectively.CONCLUSION： Gamma-knife is effective and safe for pituitary adenoma.
基金Department of Health of Heilongjiang Province, No. 2003-097Youth Science Foundation of Medical Basic Subjects of Harbin Medical University,No. 060035
文摘BACKGROUND： Some experiments have demonstrated that injecting orphanin FQ （OFQ） into lateral ventricle, which can obviously decrease the pain threshold. It is indicated that OFQ is an anti-opiate substance. However, whether OFQ has effects on sensory neuron ion channel in cerebral cortex needs to be further studied. OBJECTIVE： To investigate the effects of OFQ, morphine or their combination on sodium channel current of somatosensory neurons in rat cerebral cortex. DESIGN： Repeated measurement trial. SETTING： Department of Physiology, Harbin Medical University. MATERIALS： Fifty healthy Wistar rats, aged 12 - 16 days, of either gender, were provided by the Experimental Animal Center, Second Hospital Affiliated to Harbin Medical University. OFQ was purchased from Sigma-Aldrich Company, and morphine was provided by the Shenyang First Pharmaceutical Factory. PC2C patch clamp amplifier and LabmasterTLlwere purchased from Yibo Life Science Instrument Co.,Ltd. of Huazhong University of Science and Techgnology. METHODS： This experiment was carried out in the Department of Physiology （provincial laboratory）, Harbin Medical University between January 2005 and May 2006. Cortical neurons were acutely isolated from rats, and prepared into cell suspension following culture. ①Sodium channel current of somatosensory neurons in rat cerebral cortex was recorded before and after administration by whole-cell Patch clamp technique after 50 nmol/L OFQ being added to extracellular fluid. ②The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was recorded before and after administration by the same method after 20 μmol/L morphine being added to extracellular fluid, and then the change of sodium channel current was recorded after 50 nmol/L OFQ being added. MAIN OUTCOME MEASURES： The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex following the administration of OFQ, morphine separately or their combination.. RESULTS： ①The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was significantly lower after administration of 50 nmol/L OFQ than before at the clampe of the voltage of -30 mV （P 〈 0.05）.②The amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex was significantly lower after administration of 20 μmol/L morphine than before at the clampe of the voltage of-30 mV （P 〈 0.05）. The sodium channel current recovered to - （2 345.24±174.18） pA after 50 nmol/L OFQ was administrated. There were significant differences in the amplitude of Na^＋ channel current between two interventions （P 〈 0.05）. CONCLUSION： Morphine and OFQ can respectively reduce the amplitude of sodium channel current of somatosensory neurons in rat cerebral cortex, and OFQ can reverse the effect of morphine partly. It is indicated that OFQ can produce antiopioid activity in the central nervous system by influencing sodium channel current.
