Neuropathological changes induced by neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in male Swiss albino mice

We investigated the level of dopamine in the striatum of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated male Swiss albino mice (40 mg/kg), after 7 days, we measured the levels of non-enzymatic antioxidants, the reduced glutothione (GSH), enzymatic anti-oxidants such as superoxide dismulase (SOD), cataloes (CAT) and also observed the histopathology of the mesencephalic areas after MPTP treatment by transmission electron microscopy (EM). We found that the MPTP treatment in mice caused a significant depletion of GSH, increased the specific activity of SOD, CAT, and thiobarbituric acid-reactive substances (TBARS) in mesencephalic region after 7 days of treatment, and decreased the striatal dopamine level to 75% by 7 days of MPTP treatment. The EM results also suggested that the mitochondrial alternation, nuclear membrane invagination, condensation of cytoplasm, vacuoles and perinuclear inclusion in the cytoplasm, and nuclear membrane disappearance were observed in MPTP-treated mice.     

Malignant peripheral nerve sheath tumour of the parapharyngeal space in a patient with neurofibromatosis type 1

A malignant peripheral nerve sheath tumour, the sarcoma most common in patients with neurofibromatosis type 1, arising in the parapharyngeal space is rare. They usually arise from pre-existing neurofibromas, particularly the plexiform type. The most common presenting symptoms are an enlarging neck mass, pain, and a neurological deficit. They are aggressive tumours that carry a poor prognosis despite wide excision and adjuvant radiochemotherapy. Patients with neurofibromatosis type 1 should be investigated, including deep biopsy, if pain and enlargement of the neurofibromas or any neurological deficit develop.     

Multiligament knee injuries with associated tibial plateau fractures: A report of two cases

The management of a combination of fracture and multiligament knee injury (MKI) in traumatic knee injury remains controversial, and there are evolving treatment recommendations. Currently, there are no studies focusing on older adult patients with MKI’s in combination with tibia fractures. As a result, there is no well-established treatment algorithm for older adult patients with these complex injuries. We report two cases of MKI’s with concomitant fractures in patients fifty years of age or older. Both patients were treated surgically for their associated tibial plateau fractures, but were managed with conservative treatment of the multiligamentous knee injuries. We also provide a review of the literature and guidelines for older adult patients with these types of complex traumatic injuries. Early to mid term acceptable outcomes were achieved for both patients through surgical fixation of the tibial plateau fracture and conservative treatment of the ligament injuries. We propose a comprehensive treatment algorithm for management of these complex injuries.     

Occipital nerve stimulator systems: review of complications and surgical techniques

Introduction: Stimulation of the occipital nerves is becoming more widely accepted in the treatment of occipital neuritis and migraine disorders. Objective: Presently, equipment available for spinal cord stimulation is adapted for insertion into the subcutaneous space over the occipital nerves. Many technical factors need to be reassessed to optimize the therapy. Methods: We performed a retrospective review of patients implanted from 2003 to 2007 at a single center. We aimed to analyze the rate of surgical complications related to implantation technique. A total of 28 patients were present for analysis. Patients were followed up to 60 months with a mean follow‐up of 21 months. Results: There is a 32% revision rate for electrode migration or displacement, 3.6% removal rate for infection, and a 21% removal rate for lack of efficacy. Although not well studied secondary to small patient populations, this was consistent with a review of the literature which demonstrated a 10–60% revision rate. Other factors such as anchoring strategy, strain relief, and battery location were all considered in the analysis and will be presented. A major determination was that use of a second incision with an additional strain relief loop had only a 10% revision rate of the lead while those without this additional strain relief loop had a 62.5% revision rate. Conclusion: Many technical factors need to be addressed for optimization of occipital nerve stimulation.     

Malignant fibrous histiocytoma: outcome of tumours in the head and neck compared with those in the trunk and extremities

Malignant fibrous histiocytoma is one of the commonest soft tissue sarcomas in adults, affecting, in order of frequency, the extremities, trunk and head and neck. We treated 131 patients with malignant fibrous histiocytoma by radical, wide, or marginal resection. Their mean age was 43 years, and there were 54 in the head and neck and 77 in the trunk and extremities. The extent of clearance of the tumour, local recurrence, and 5-year survival were studied in these two groups. In the head and neck group, local recurrences developed in 86% after marginal resection, 66% after wide resection and 27% after radical resection. The comparative figures in the trunk and extremities group were 75, 71 and 18%, respectively. The overall 5-year survival was 48% in the head and neck group and 77% in the trunk and extremities group (p=0.03). Repeat operations for recurrences of tumour offered a 'cure rate' of 23% in the head and neck group and 61% in the trunk and extremities group. Inadequate resection of the sarcoma in the head and neck was associated with a high incidence of local recurrence and a poor prognosis. Therefore, we suggest that the initial operation for sarcoma in the head and neck should be as radical as possible to reduce the chance of local recurrence and to improve the outcome.     

Population movement and malaria persistence in Rameswaram Island

During 1982-84, the Vector Control Research Center (VCRC) of the Indian Council for Medical Research (ICMR) at Pondicherry studied the role of population movement in the persistence of malaria transmission in Rameswaram Island, Tamil Nadu, between mainland India and Sri Lanka. While the island supports a population of 56,000, mostly fishermen, there is also a periodic, back and forth migration of fishermen between mainland villages and Rameswaram. This population movement greatly contributes to the high prevalence of malaria in both areas, since fishermen can be either donor or recipient of malaria in either place. The VCRC monitered and recorded the movement of fishermen in various seasonal camps by questioning them and by the VCRC staff accompanying them when possible. In 9 fishing camps 412 of 1098 families had migrated from mainland villages; 686 families had migrated from villages within Rameswaram Island. A mass blood survey found 138 of 4073 individuals examined positive for malaria; 107 of 680 fever cases examined were positive for malaria. Mosquito collections, the lack of permanent treatment facilities for the transient population, and ecological factors indicate a high receptivity for malaria on Rameswaram Island. With the island attracting between 1000-4000 tourists daily and over 200,000 travelers annually between India and Sri Lanka, evidence exists for considerable danger from the importation of chloroquinine resistant malaria strains into Rameswaram. Adequate attention to human ecology will be needed for malaria control in this area.     

Metastasising pleomorphic adenoma of the parotid gland

A 33-year-old man had a left superficial parotidectomy for a pleomorphic adenoma. He remained well, but 28 years later developed a metastasis in a lymph node in the left supraclavicular fossa.     

Reflective mirror-based line-scan adaptive optics OCT for imaging retinal structure and function

Line-scan OCT incorporated with adaptive optics (AO) offers high resolution, speed, and sensitivity for imaging retinal structure and function in vivo. Here, we introduce its implementation with reflective mirror-based afocal telescopes, optimized for imaging light-induced retinal activity (optoretinography) and weak retinal reflections at the cellular scale. A non-planar optical design was followed based on previous recommendations with key differences specific to a line-scan geometry. The three beam paths fundamental to an OCT system –illumination/sample, detection, and reference– were modeled in Zemax optical design software to yield theoretically diffraction-limited performance over a 2.2 deg. field-of-view and 1.5 D vergence range at the eye’s pupil. The performance for imaging retinal structure was exemplified by cellular-scale visualization of retinal ganglion cells, macrophages, foveal cones, and rods in human observers. The performance for functional imaging was exemplified by resolving the light-evoked optical changes in foveal cone photoreceptors where the spatial resolution was sufficient for cone spectral classification at an eccentricity 0.3 deg. from the foveal center. This enabled the first in vivo demonstration of reduced S-cone (short-wavelength cone) density in the human foveola, thus far observed only in ex vivo histological preparations. Together, the feasibility for high resolution imaging of retinal structure and function demonstrated here holds significant potential for basic science and translational applications.     

Assessment of serum macro and trace element homeostasis and the complexity of inter-element relations in bipolar mood disorders

BACKGROUND: Bipolar disorders are complex neuropsychiatric in nature and are clinically classified as Type I, Type II, and Type V. The etiological factors include environmental-genetic inter-relations. Trace metals play a significant role in neurological disorders. There is very limited information on the role of macro and trace elements in bipolar disorders. METHODS: Trace elements namely Na, K, S, Ca, Mg, P, Cu, Fe, Zn, Mn and Al were analyzed in serum samples of 3 bipolar types: bipolar I, bipolar II and bipolar V with a control group using inductively coupled plasma-atomic emission spectrometry (ICP-AES). The patients were assessed as per the standard diagnostic criteria and classified into the bipolar type I, II hypomanic, II depressives and V. RESULTS: In bipolar I (mania), Na, K, P, Cu, Al and Mn were increased significantly (p<0.001). In bipolar II hypomania, Na, S, Al and Mn were increased significantly (p<0.02), while in bipolar II depression, Na, K, Cu and Al were increased (p<0.001). In bipolar V, Na, Mg, P, Cu, and Al were increased significantly (p<0.002), though S (p<0.00001), Fe (p<0.002) and Zn (p<0.004) were decreased in all 3 bipolar groups. CONCLUSIONS: There is a disturbance in the charge distribution and element-element interdependency in bipolar serum when compared to controls. These results suggest that there is a definite imbalance in macro and trace element homeostasis as evidenced by element inter-relationships in serum samples of bipolar groups when compared to controls.