Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Between January 2004 and June 2007 we conducted a retrospective analysis to assess post-operative complications related to endoscopic pituitary surgery in a series of 150 patients. Patients were treated with an endoscopic endonasal transsphenoidal approach to the sellar region for removal of pathological sellar and suprasellar lesions. We analysed the complications in groups according to the anatomical structures of the approach and the functional systems of the pituitary gland (anterior and posterior endocrine systems), and compared them to a large historical series using the traditional microsurgical transsphenoidal approach. ⋯ We believe that the reduction of the complication rate observed in this study was mainly due to the wide structural overview offered by the endoscope as well as the anatomically direct, and therefore minimally invasive, character of the procedure. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Furthermore, close cooperation between a multidisciplinary team consisting of endocrinologists, neurosurgeons, ear, nose and throat surgeons, radiologists, and radiation oncologists is of utmost importance.
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Spinal cord injury (SCI) continues to result in high morbidity and mortality throughout the world. An effective neuroprotective agent is still not available to counteract secondary damage caused by traumatic injury. Thrombospondin-1 (TSP-1) and transforming growth factor-beta (TGF-beta) have a role in angiogenesis, scar deposition, inflammation and may affect astrocyte phenotype and mobility. ⋯ Elevations in TSP-1 and TGF-beta concentrations persisted for 24 h after injury. These results show that elevated expression of TSP-1 and TGF-beta can be detected in the injured segment of the spinal cord 12 and 24 h after injury. Thus, TSP-1 and TGF-beta may have a role in SCI.