Endoscopic endonasal approach to the pterygopalatine fossa: anatomic study.

Objective: The pterygopalatine fossa is a relatively small anatomic region. Because of its rich vasculonervous contents and its connections with several intracranial and extracranial compartments, it is of particular surgical interest. Because of its deep localization and despite its small size, however, it can require extensive anatomic approaches, especially for invasive cranial base lesions.

Endoscopic endonasal treatment of a spontaneous temporosphenoidal encephalocele with a detachable silicone balloon. Case report.

Temporosphenoidal encephaloceles are rare entities that occur when the temporal lobe herniates into the sphenoid sinus through a skull base defect of the temporal bone. Both an iatrogenic and a traumatic pathogenesis have been proposed. The authors describe a spontaneously occurring temporosphenoidal encephalocele in a 63-year-old woman who had a 4-year history of rhinorrhea.

Endoscopic glabellar approach to the anterior skull base: a technical note.

Object: An endoscopic glabellar transethmoidal approach via a small nasional incision to the anterior skull base is reported as a minimally invasive neurosurgical technique.

Surgical Technique: A frontonasal craniotomy (2 x 2 cm in size) between the medial orbits is made via a nasional skin incision approximately 3-cm in length. An ethmoidectomy is performed in order to expose the skull base at the anterior cranial fossa.

Human aldolase C gene expression is regulated by adenosine 3',5'-cyclic monophosphate (cAMP) in PC12 cells.

We have examined the effects of an adenosine 3',5'-cyclic monophosphate (cAMP) analog on human aldolase C gene expression in the rat pheochromocytoma cell line PC12. Incubation for 4 h with 500 microM 8-Br-cAMP increased aldolase C mRNA expression 2.5-fold and the expression was still above basal level 24 h later.

Endoscopic removal of third ventricular tumors: a technical note.

Object: An endoscopic surgical technique utilizing a rollable vinyl tube as a surgical corridor is described for removal of third ventricular tumors.

Surgical Technique: Transcortical transventricular access is made via a burr hole placed at the point which is one inch lateral from the midline at the coronal suture area. A one-cm-diameter vinyl tube is slit longitudinally, rolled like a cigarette, and tied at its ventricular end with a release tie.

Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study.

Objective: In order to develop an endoscopic endonasal approach to the ventral cranio-cervical junction and odontoid process under the concept of a minimally invasive surgical strategy, a cadaver study was performed.

Methods: Sixteen artery-injected adult head specimens were used. Endonasal endoscopic approach was made through one- or two-nostril routes following the Jho's endonasal paraseptal technique.

Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations.

An endoscopic endonasal approach was performed to remove an intra-suprasellar Rathke's cleft cyst. Rathke's cleft cyst are benign lesions, rarely diagnosed because they are often asymptomatic. To the best of our knowledge, at least 475 cases of Rathke's cleft cysts have been reported.

Post-operative monitoring of cortical taurine in patients with subarachnoid hemorrhage: a microdialysis study.

Intracerebral MD enables the retrieval of endogenous substances from the extracellular fluid (ECF) of the brain and has been demonstrated to be a sensitive technique for early detection of subtle vasospasm-induced neurometabolic abnormalities in patients with subarachnoid hemorrhage (SAH). The aim of this study was to monitor cortical extracellular concentrations of energy metabolism markers, such as glucose and lactate, neurotransmitter amino acids, such as glutamate, aspartate, GABA and taurine to identify any neurochemical patterns of cerebral ischemia. A prospective clinical study was conducted on a group of 16 patients with non-severe SAH operated on within 72 hours after initial bleeding.

Endoscopic endonasal approaches to the cavernous sinus: surgical approaches.

Objective: After completion of an earlier endoscopic transsphenoidal anatomic study, we studied various endoscopic transsphenoidal approaches using cadaveric specimens to develop endoscopic endonasal surgical approaches to the cavernous sinus.

Methods: Ten cavernous sinuses in five artery-injected adult cadaveric heads were studied with 0-, 30-, and 70-degree angled 4-mm rod-lens endoscopes. The extent of the surgical exposure, the skewed endoscopic anatomic view, and the maneuverability of surgical instruments through their relative operating spaces were studied after various endoscopic endonasal approaches via one nostril.

Single-screw fixation for acute Type II odontoid fracture.

Background: The management of odontoid fractures is still controversial. The main current trends of treatment are conservative management with HALO immobilization, posterior surgical fixation or anterior surgical fixation. The authors report a consecutive series of 17 cases of patients with acute Type II odontoid fracture treated between November 1994 and February 2000.

Endoscopic endonasal pituitary surgery: evolution of surgical technique and equipment in 150 operations.

Objective: The evolution of the senior author's (HD Jho) surgical experience on endoscopic endonasal transsphenoidal pituitary surgery is reviewed in order to introduce a standardized surgical technique for pituitary endoscopy.

Methods: The progressive evolution of the surgical technique and the development of surgical instrumentation in transsphenoidal endoscopy is reviewed based upon the experience of more than 150 operations performed by the senior author between the years 1993 and 1998.

Results: An endoscope was used to assist visualization during conventional microscopic surgery in the first four cases (endoscope-assisted microsurgery).

Endoscopic endonasal cavernous sinus surgery: an anatomic study.

Objective: The endoscopic surgical anatomy of the cavernous sinus was studied to establish an anatomic basis for endoscopic endonasal cavernous sinus surgery.

Methods: Five adult cadaveric heads were studied with 0-, 30-, and 70-degree 4-mm rod-lens endoscopes. The posterior wall of the sphenoidal sinus was approached via a paraseptal, middle turbinectomy, or middle meatal approach.

Effects of Motexafin gadolinium on tumor metabolism and radiation sensitivity.

Purpose: Experiments were undertaken to determine if metabolic changes induced by Motexafin gadolinium (Gd-Tex(+2), XCYTRIN) predict time intervals between drug and radiation wherein there is enhancement of radiation efficacy.

Methods And Materials: We evaluated the effect of Gd-Tex(+2) on tumor metabolism and on tumor growth using a mouse mammary carcinoma model and (31)P nuclear magnetic resonance (NMR) experiments. Response to therapy was evaluated based on time for the tumor to regrow to pretreatment size and also tumor doubling time.

Nitric oxide synthases and cyclophosphamide-induced cystitis in rats.

The role of inducible (iNOS) and neuronal nitric oxide (nNOS) synthases and of tachykinin NK1 receptors on the pathogenesis of cyclophosphamide (CYP)-induced cystitis was investigated, in rats. CYP-induced cystitis was characterized by large increases in bladder-protein plasma extravasation (PPE), increases in the urinary excretion of nitric oxide (NO) metabolites and histological evidences of urothelial damage, edema, extensive white blood cell infiltrates and vascular congestion of the bladder. The specific iNOS inhibitor, S-methylthiourea (MITU), produced marked inhibition (>90%) of CYP-induced increases in PPE associated with amelioration of tissue inflammatory changes.

Endoscopic transsphenoidal pituitary surgery: various surgical techniques and recommended steps for procedural transition.

Various techniques in pituitary endoscopy are reviewed in the attempt to assemble the transitional steps necessary to take a neurosurgeon from traditional microscopic transsphenoidal surgery to endoscopic endonasal pituitary surgery. The senior author's (HDJ) experiences of endonasal endoscopy in more than 200 operations as well as the reports in the literature on pituitary endoscopy are reviewed. Two distinct advantages that an endoscope has over an operating microscope are its ability to visualize through a narrow surgical corridor and its ability to provide angled, close-up views.

Cell lines from the same cervical carcinoma but with different radiosensitivities exhibit different cDNA microarray patterns of gene expression.

Combining chemotherapy with radiotherapy has improved the cure rate among patients with cancers of the cervix. Although one-half to two-thirds of the patients can be cured by radiation alone, such patients cannot be identified at present and must therefore suffer the burden of chemotherapy. Our long-range goal is to identify those cervical cancers that are radiosensitive and could be cured by radiotherapy alone.

Liver irradiation: a potential preparative regimen for hepatocyte transplantation.

Advances in the understanding of hepatocyte engraftment and repopulation of the host liver have already led to the use of hepatocyte transplantation (HT) with some success in the treatment of inherited and acquired liver diseases. Wider application of HT is severely limited by the unavailability of large number of transplantable hepatocytes and difficulties associated with transplanting an adequate number of cells for achieving therapeutically satisfactory levels of metabolic correction. Therefore, there is a need for preparative regimens that provide a growth advantage to the transplanted (healthy) hepatocytes over the host's own (diseased) hepatocytes so that the former can repopulate the host liver.

Adenovirus-mediated antisense ATM gene transfer sensitizes prostate cancer cells to radiation.

Treatment failure after radiation therapy of prostate cancer (PC) could be a significant problem. Our objective is to design genetic radiosensitizing strategies for the treatment of PC. Cells from individuals with the genetic disorder ataxia telangiectasia (AT) are hypersensitive to ionizing radiation.

Nitric oxide and NK(1)-tachykinin receptors in cyclophosphamide-induced cystitis, in rats.

The present study was conducted to investigate the role of NK(1) receptors and of nitric oxide (NO) on the pathogenesis of cyclophosphamide-induced cystitis, in rats. This bladder toxicity was characterized by marked increases in protein plasma extravasation, urothelial damage, edema, white blood cell infiltrates, and vascular congestion. These changes were associated with appearance of Ca(2+)-independent NO-synthase (NOS) activity [characteristic of inducible NOS (iNOS)] in the bladder and with increases in urinary NO metabolites.

Nitric oxide and salt sensitivity.

Studies in laboratory animals suggest that altered nitric oxide (NO) production may be associated with salt sensitivity. In this investigation we determined whether the endogenous NO production was altered in salt-sensitive human subjects when salt intake was changed. Salt sensitivity was assessed from the magnitude of the blood pressure (BP) lowering obtained when the salt intake was reduced from high to a low intake.

Antisense ATM gene therapy: a strategy to increase the radiosensitivity of human tumors.

Atm, the gene mutated in ataxia-telangiectasia (AT) patients, is an essential component of the signal transduction pathway that responds to DNA damage due to ionizing radiation (IR). We attenuated ATM protein expression in human glioblastoma cells by expressing antisense RNA to a functional domain of the atm gene. While ATM expression decreased, constitutive expression of p53 and p21 increased.

Effects of short- and long-term exercise on urinary cGMP excretion in healthy subjects and in patients with coronary artery disease.

The possibility that systemic formation of cyclic guanosine monophosphate (cGMP) could reflect the level of cardiovascular fitness was investigated. The relations between physical activity and systemic formation of cGMP were evaluated in healthy volunteers and in patients with coronary artery disease (CAD). No significant differences were observed in the basal urinary excretion of cGMP in highly trained runners, sedentary subjects, and in patients with CAD, despite the large differences in aerobic exercise training between groups.

Endoscopic endonasal transsphenoidal surgery in recurrent and residual pituitary adenomas: technical note.

Despite a good cure rate after surgery, the recurrence rate in pituitary adenomas is globally high. The decision making in such cases can be problematic for the nature of the lesion, for the anatomic structures involved, for the different pharmacological, surgical, radiotherapeutic and radiosurgical options nowadays available. In the perspective of an improvement and refinement of the surgical procedure an endoscopic endonasal transsphenoidal approach to the pituitary was recently adopted in the Neurosurgical Department of the University of Naples.