Supracerebellar arachnoid cyst - A rare cause of acquired Chiari I malformation.

Chiari I malformation (CM) associated with a cervico-thoracic syrinx due to supracerebellar arachnoid cyst has not been reported in the literature. We report such a case, managed by fenestration of the arachnoid cyst and foramen magnum decompression (FMD), aiming to reduce the inferiorly directed pressure on the cerebellum and eliminate the craniospinal pressure dissociation respectively. Imaging done post-operatively showed upward displacement of the cerebellar tonsils with a decompressed craniovertebral junction and disappearance of the syrinx.     

Chemical modification of poly(vinyl chloride) resin using poly(ethylene glycol) to improve blood compatibility

Poly(vinyl chloride) (PVC) was aminated by treating the resin with a concentrated aqueous solution of ethylenediamine. The aminated PVC was then reacted with hexamethylene diisocyanate to incorporate the isocyanate group onto the polymer backbone. The isocyanated PVC was further reacted with poly(ethylene glycol) (PEG) of molecular weight 600 Da. The modified polymer was characterized using infrared and X-ray photoelectron spectroscopy (XPS) and thermal analysis. Infrared and XPS spectra showed the incorporation of PEG onto PVC. The thermal stability of the modified polymer was found to be lowered by the incorporation of PEG. Contact angle measurements on the surface of polymer films cast from a tetrahydrofuran solution of the polymer demonstrated that the modified polymer gave rise to a significantly hydrophilic surface compared to unmodified PVC. The solid/water interfacial free energy of the modified surface was 3.9 ergs/cm(2) as opposed to 18.4 ergs/cm(2) for bare PVC surface. Static platelet adhesion studies using platelet-rich plasma showed significantly reduced platelet adhesion on the surface of the modified polymer compared to control PVC. The surface hydrophilicity of the films was remarkably retained even in the presence of up to 30 wt% concentration of the plasticizer di-(2-ethylhexyl phthalate). The study showed that bulk modification of PVC with PEG using appropriate chemistry can give rise to a polymer that possesses the anti-fouling property of PEG and such bulk modifications are less cumbersome compared to surface modifications on the finished product to impart anti-fouling properties to the PVC surface.     

Childhood and adolescent meningiomas: a report of 38 cases and review of literature

Summary Background  The aim is to study the clinical, radiological and pathological features of childhood and adolescent meningiomas and analyse outcome prognosticators. Method  A retrospective analysis of the case records of patients less than 20 years of age operated for a meningioma in our institute since 1982 was performed. The variables analysed included age, sex, presentation, associated neurofibromatosis (NF), imaging characteristics, extent of resection and histopathology. Results  The study group included 20 males and 18 females with a mean age of 15.53 years. Eleven children (28.9%) had evidence of NF of whom three had NF2 with bilateral vestibular schwannomas. The common presenting symptoms were seizures (76.3%), raised intracranial tension (71%), and focal neurological deficits (39.4%). The location of the operated tumours were as follows: ten skull base (24.4%), ten falx/parasagittal (24.4%), eight spinal (19.5%), five convexity (12.2%), three posterior fossa (7.3%), three intraventricular (7.3%) and two optic nerve sheath (4.9%). Two children (4.9%) had cystic meningiomas. Grade I excision was achieved only in twenty tumours (48.8%). On histopathology, thirty (73.2%) were grade I, nine (21.9%) were grade II and two (4.9%) were grade III meningiomas. Seven tumours recurred of which six were located at the skull base. During the mean follow up period of 4.74 years, the majority, 32 (84.2%) had a good outcome and five (13.2%) had a poor outcome. One child (2.6%) expired due to post-operative sepsis. Conclusion  Childhood meningiomas are uncommon but not rare lesions with a marginal male predominance. Absence of large series with long follow up precludes any definite conclusions on the clinical course and outcome. Uniform observations made in different series including ours, include a higher incidence of the skull base location and tumours with atypical histopathology. Favourable prognostic factors include younger age (<than 10 years), superficial location, total excision and absence of neurofibromatosis. Location and extent of excision appear to be more important than histopathology grade in predicting outcome.     

Curcumin/turmeric solubilized in sodium hydroxide inhibits HNE protein modification--an in vitro study

Free radical mediated lipid peroxidation has been implicated in multiple diseases. A major oxidation by-product of this deleterious process is 4-hydroxy-2-nonenal (HNE). HNE is cytotoxic, mutagenic and genotoxic and is involved in disease pathogenesis. Curcumin, a non-steroidal anti-inflammatory agent (occurring as the yellow pigment found in the rhizomes of the perennial herb Curcuma longa known as turmeric), has emerged as the newest "nutraceutical" agent that has been shown to be efficacious against colon cancer and other disorders, including correcting cystic fibrosis defects. Since curcumin has been reported to have anti-oxidant properties we hypothesized that it will inhibit HNE-modification of a protein substrate. Using an ELISA that employed HNE-modification of solid phase antigen following immobilization, we found that the curcumin solubilized in dilute alkali (5mM sodium hydroxide, pH 11) inhibited HNE-protein modification by 65%. Turmeric also inhibited HNE-protein modification similarly (65%) but at a much lower alkali level (130muM sodium hydroxide, pH 7.6). Alkali by itself (5mM sodium hydroxide, pH 11) was found to enhance HNE modification by as much as 267%. Curcumin/turmeric has to inhibit this alkali enhanced HNE-modification prior to inhibiting the normal HNE protein modification induced by HNE. Thus, inhibition of HNE-modification could be a mechanism by which curcumin exerts its antioxidant effects. The pH at which the inhibition of HNE modification of substrate was observed was close to the physiological pH, making this formulation of curcumin potentially useful practically.