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| 1 | 脑干海绵状血管瘤手术入路选择显示文摘目的探讨脑干海绵状血管瘤手术适应证和手术入路的选择。方法回顾分析70例手术治疗的脑干海绵状血管瘤,其中位于:中脑15例、中脑-桥脑交界8例、桥脑34例、桥脑-延髓交界5例、延髓8例。我们共采用8种手术入路:经菱形窝27例、颞下或颞-枕入路14例、远外侧经髁7例、外侧小脑上幕下7例、中线小脑上幕下8例、枕经天幕4例、乳突后2例,以及眶颧1例。结果本组病例的年出血率为2.9%(77/2364),占同期颅内海绵状血管瘤的44%(70/159);97%的病例手术选择在亚急性或慢性期、且所有患者均有颅神经症状和(或)运动功能障碍、感觉障碍、共济失调(包括失平衡)。中脑病变手术入路选择以中线小脑上(46.7%,7/15)、颞下或颞-枕(26.7%,4/15)为主;桥脑病变多选择菱形窝(58.8%,20/34)、颞下或颞-枕(23.5%,8/34);而病变位于延髓者以远外侧经髁(62.5%,5/8)和菱形窝入路(37.5%,3/8)为主。结论脑干海绵状血管瘤表现为进行性神经功能缺失、具有占位效应、接近脑干表面者可考虑手术治疗;个体化地选择手术入路、术中神经电生理监测以及直接的电刺激是手术成功的关键。 | 卞留贯 Helmut Bertalanffy 孙青芳 沈建康 Ulrich Sure Wuttipong Tirakotai 赵卫国 | 2007 | 中华神经外科疾病研究杂志2007，6，1： | 20 |
| 2 | 经菱形窝切除脑干海绵状血管瘤显示文摘目的探讨28例经菱形窝入路切除的脑干海绵状血管瘤的适应证、手术技巧及术中注意点。方法术中采取坐位,枕下正中开颅,广泛打开小脑延髓裂;在脑干表面有色素沉淀或膨隆处,或在B超、导航引导、术中颅神经监护下切开脑干,病变暴露后清除血肿,然后切除病变,保留含铁血黄素沉淀的胶质组织。结果28例中有21例位于桥脑;术中发现脑干表面有含铁血黄素沉淀21例,其中脑干表面膨隆9例;所有病变位于脑干背侧;随访期间:症状和体征较术前改善的19例,保持术前水平的5例,加重、出现新的颅神经症状、或其他神经功能障碍(共济失调、运动障碍、感觉障碍)共4例。MRI随访未见病变残留或复发。结论经菱形窝入路主要适于桥脑部、且位于背侧的海绵状血管瘤;脑干表面的含铁血黄素沉淀和(或)膨隆是脑干的安全进入区,术中结合神经电生理监测、B超以及导航是手术成功的关键;术中尽可能全切病变,但保留含铁血黄素沉淀的胶质组织。 | 卞留贯 Bertalanffy H 孙青芳 Sure U Tirakotai W 沈建康 | 2007 | 中华神经外科杂志2007，23，12： | 12 |
| 3 | Loss of heterozygosity on chromosome 22 in sporadic schwannoma and its relation to the proliferation of tumor cells显示文摘Background Schwannoma is the tumor arising mainly from the cranial and spinal nerves. Bilateral vestibular schwannoma is the hallmark of neurofibromatosis type 2 (NF2). The NF2 gene has been cloned with comprehensive analysis of its mutations in schwannoma. However, most studies focused on vestibular schwannoma. There!are differences in proliferation of tumor cell and ultrastructure between vestibular and spinal schwannomas. It is unknown whether genetic alterations in vestibular schwannoma are different from those in non-vestibular schwannoma. We analyzed the loss of heterozygosity (LOH) on chromosome 22 in patients with sporadic schwannoma including vestibular and spinal schwannomas and correlated this genetic alteration with tumor proliferation. Methods In 54 unrelated patients without clinical NF1 or NF2, 36 patients had sporadic vestibular schwannoma, and 18 dorsal spinal root schwannoma. Four highly polymorphic linkage to NF2 gene microsatellite DNA markers (D22S264, D22S268, D22S280, CRYB2) were used to analyze LOH. The proliferative index was evaluated by Ki-67 and proliferative cell nuclear antigen (PCNA) immunostaining. Student’s t test was used to analyze the difference of the proliferative index between schwannoma with LOH and that without LOH. The difference of the frequency of LOH in vestibular and spinal schwannomas was investigated by the chi-square test. Results Twenty-three schwannomas (42.6%, 23/54) showed allele loss. The frequency of LOH in vestibular schwannoma was significantly higher than that in spinal schwannoma (χ2=5.14, P<0.05). The proliferative index of schwannoma with LOH was significantly higher than that without LOH (t_ ki-67=2.97, P=0.0045; t_ PCNA=2.93, P=0.0051). Conclusions LOH on chromosome 22 is a frequent event in the tumorigenesis of sporadic schwannoma. And, there is a correlation between LOH on chromosome 22 and proliferative activity in schwannoma. The frequency of LOH in vestibular schwannoma is significantly different from that in spinal schwannoma. | BIAN Liu-guan SUN Qing-fang Tirakotai Wuttipong ZHAO Wei-guo SHEN Jian-kang LUO Qi-zhong Bertalanffy Helmut | 2005 | Chinese Medical Journal2005，，18： | 8 |
| 4 | 小脑海绵状血管瘤的手术治疗显示文摘目的小脑海绵状血管瘤较少见,通过回顾分析手术的11例小脑海绵状血管瘤的临床资料,探讨其临床特征、放射学表现以及手术策略。方法11例小脑海绵状血管瘤中男性3例,女性8例(男:女=1:2.7);年龄17~74岁,平均40岁;临床均为急性发病,以头痛、小脑症状为主;所有患者均行CT和MRI扫描,9例为ZabramskiⅡ型,2例属Ⅰ型;4例术前全脑血管造影,2例发现合并静脉畸形。结果所有患者均采用常规枕下入路,均全切病变,无手术死亡,无手术相关并发症,随访期内无再出血,无病变复发。结论小脑海绵状血管瘤具有独立于后颅窝其他部位的海绵状血管瘤的特征,常急性起病,与其他部位的海绵状血管瘤相比,年龄、性别没有差异,外科治疗安全有效。 | 卞留贯 Bertalanffy Helmult 孙青芳 李云峰 王健 郑励力 沈健康 赵卫国 | 2009 | 中华神经外科疾病研究杂志2009，8，4： | 7 |
| 5 | Immunohistochemical study in dural arteriovenous fistula and possible role of ephrin-B2 for development of dural arteriovenous fistula显示文摘Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion Methods We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk 1 and Flt 1, ephrin B2, MIB 1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques Results A positive immunostaining was found for all antibodies studied except MIB 1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases VEGF stained positive in all of the available specimens (6/6) Flk 1 showed a positive immunoreaction in only 2/6 cases and Flt 1 in 4/6 cases Ephrin B2 was expressed in the majority (5/6) of the cases Conclusions These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity Vascular growth factors like VEGF and ephrin B2 might play a pivotal role in the formation of | 王宝隆 卞留贯 Helmut Bertalanffy Siegfried Bien Ulrich Sure | 2004 | Chinese Medical Journal2004，17，12： | 5 |
| 6 | 神经导航整合超声(双超和多普勒)技术在术中血管解剖标记的作用显示文摘目的探讨神经导航整合超声技术在术中标记血管中的作用。方法建立在神经导航中整合进超声平面视频影像的技术,并将该技术应用于47例患者(动静脉畸形22例、胶质瘤17例、海绵状血管瘤8例)的手术中。结果该系统支持超声平面函数与术前获得导航资料的结合。多普勒超声和双向超声可以显示术中血管解剖结构,并确定其界标。这些界标可以自动整合入神经导航数据集中,用来提供血管解剖的术中更新影像。本组病例应用该技术的成功率是45/47(96%),45例患者手术过程顺利、全切病灶,且保护了病灶周围的血管结构。结论超声和双向超声所显示的血管解剖资料整合入神经导航数据集中在技术上是可行的。该技术为复杂脑部病变的手术提供有价值的术中信息,尤其显示血管的解剖结构。 | 卞留贯 Ulrich Sure 孙青芳 沈建康 Wuttipong Tirakotai Helmut Bertalanffy | 2006 | 中华神经外科杂志2006，22，11： | 3 |
| 7 | 经单侧半椎板切除髓内海绵状血管瘤显示文摘目的探讨脊髓髓内海绵状血管瘤的出血性损伤风险、临床特征以及经单侧半椎板切除髓内海绵状血管瘤的手术技巧。方法回顾性分析11例髓内海绵状血管瘤病人的病历资料。均经单侧半椎板切除肿瘤。采用统计学分析,在性别分布、平均年龄、年出血率等方面与同期颅内(145例)、脑干(61例)海绵状血管瘤进行比较。术前Frankel分级D级8例,C级2例,A级1例。结果本组女性7例,男性4例,女性与男性之比高于颅内(80∶65)和脑干(33∶28)海绵状血管瘤;年出血率为2.8%/病人,稍低于颅内(3.3%)和脑干(3.1%)海绵状血管瘤。病变均获全切;术后随访期内8例神经系统症状改善(Frankel分级D级升到E级6例,C级升到D级2例),3例临床症状无变化。结论脊髓髓内海绵状血管瘤应全切以防复发和再出血;选择微侵袭的半椎板入路,以及术中采用体感诱发电位监护,是取得满意结果、预防附加损伤的关键。 | 卞留贯 Helmut Bertalanffy 孙青芳 Wuttipong Tirakotai Boris Krischek Ulrich Sure LudwigBenes | 2006 | 中国微侵袭神经外科杂志2006，11，9： | 2 |
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| 16 | Quality of Life After Brainstem Cavernoma Surgery in 71 Patients显示文摘 | Thomas Dukatz Johannes Sarnthein Helmut Sitter Oliver Bozinov Ludwig Benes Ulrich Sure Helmut Bertalanffy | 2011 | Neurosurgery2011，，3： | 1 |
| 17 | The Principle of Allometry in Biology and the Social Sciences 显示文摘 | Naroll R S Bertalanffy L yon | 1956 | General Systems Yearbook1956，1，： | 1 |
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