Dysembryoplastic neuroepithelial tumor: a clinicopathological study of 32 cases

Dysembryoplastic neuroepithelial tumor (DNT) is a relatively newly described entity and is an important cause of intractable epilepsy. We report 32 cases of DNT who were operated and treated in our hospital over a period of 12 years. Immunostaining for various proliferative markers and tumor suppressor gene proteins was done to assess the proliferative potential of these tumors. The most common presentation was partial complex seizures followed by generalized tonic–clonic seizures, focal motor seizures, and myoclonus. The most common location was temporal lobe followed by frontal and in one patient lesion was multifocal. All patients were seizure free at the last postoperative follow-up which varies from 12 to 96 months with mean of 33.7 months. Microscopic examination showed classical histology comprising of intracortical multinodular microcystic lesions with floating neurons. Proliferative indices were very low (<1%) and tumor suppressor gene protein expression was not seen in the present study. Cortical dysplasia of the surrounding brain was observed in 37.3% of cases.     

Health-related quality of life using QOLIE-31: before and after epilepsy surgery a prospective study at a tertiary care center

Background: Outcome following epilepsy surgery has traditionally been measured in terms of relief of seizures. However, changes in health-related quality of life (HRQOL) after surgery for intractable epilepsy are also important to document. There are no studies on the Indian population which assess the outcome of epilepsy surgery in terms of HRQOL. Materials and Methods: We conducted a prospective study on the patients undergoing epilepsy surgery for intractable seizures, between February 2004 and May 2006 at our center. All patients cleared for epilepsy surgery by the epilepsy surgery team were taken up for study. All patients Results: Thirty-six patients satisfying the inclusion/exclusion criteria were included in the analysis. Twenty-nine of these (Group 1) had good seizure outcome (Engel 1 and 2), while seven patients (Group 2) had poor seizure outcome (Engel 3 and 4) at six months. Overall, 77% of all study patients were completely seizure-free at follow-up. There was no baseline difference in the seven domains of QOLIE-31 between the two groups. There was very significant improvement (P value> 0.005 using paired sample T test) in all the domains of QOLIE-31 in the good outcome group after surgery. Health-related quality of life improvement was seen in all the domains in the poor outcome group also, however, it was statistically significant only for the following parameters: seizure worry, overall QOL, emotional wellbeing, energy fatigue and social functioning domains. Improvement in seizure worry, overall QOL, emotional wellbeing and social functioning was significantly more in Group 1 as compared to Group 2. Conclusion: Complete seizure-free state after surgery is associated with very significant improvement in HRQOL parameters. Several, but not all parameters of HRQOL as assessed by QOLIE-31, improved after surgery even in the poor seizure outcome group. The improvement in domains of seizure worry, overall QOL, emotional wellbeing and social functioning is significantly more in those patients in whom complete seizure-free state is achieved.     

A novel mutation of the cytochrome-b5 reductase gene in an Indian patient: the molecular basis of type I methemoglobinemia

We report here a novel mutation in the cytochrome b5 reductase gene resulting in type I methemoglobinemia. A single T->C transition in exon 8 at position 25985 was identified, changing codon 217 from Leu to Pro (L217P). The mutation is located in the NADH binding domain at the base of alpha-helix Nalpha3, a region of sequence highly conserved from yeast to man. A quantitative assessment of the thermodynamic cost of this mutation at 37 degrees C revealed a ten-fold drop in the free energy of stability. Alterations in hydrogen bonding and solvent accessibility surrounding residue 217 were predicted based on computer modeling.     

Tuberculosis nearly preventing a curative resection for colorectal liver metastasis: A case report

Perihepatic lymph node involvement portends a poor prognosis, and is reported to be the most important prognostic factor following R0 resection of colorectal liver metastases. Tuberculous lymphadenitis is one of the common presentations of tuberculosis and is often diagnosed only after histopathological confirmation. In this patient, a frozen section revealing tuberculosis in the perihepatic nodes allowed us to proceed with the curative liver resection.     

Spinal angiolipoma: Report of three cases and review of MRI features

We report three cases of spinal angiolipoma, two intramedullary and one epidural, and review their MRI features. Diagnoses were established preoperatively in all cases. Specific MRI features including the importance of postgadolinium fat‐saturated T1‐weighted images and presence of vascular flow‐voids are discussed with histopathological correlation. A characteristic morphological appearance of intramedullary angiolipoma has been suggested.     

Ortho-quinones of benzene and estrogens induce hyperproliferation of human peripheral blood mononuclear cells

Benzene is a known leukemogen. It has been hypothesized that benzene and natural estrogens initiate cancer by forming ortho-quinones (catechol quinones) that react with DNA in cells. These quinones form depurinating DNA adducts that generate the mutations leading to cancer. This study examined whether the treatment of normal human peripheral blood mononuclear cells with the ortho-quinones of benzene or estradiol would form DNA adducts and elicit an alteration in the proliferation of these cells. Both estradiol-3,4-quinone and benzene ortho-quinone formed depurinating DNA adducts and significantly increased the mitogen-induced proliferation of normal blood mononuclear cells. Immunophenotyping of the estradiol-3,4-quinone-treated blood cells indicated that monocyte/macrophage, natural killer and T-cells were particularly prone to hyperproliferation. Thus, DNA damage induced by the ortho-quinones of benzene and estradiol may promote the growth of human blood mononuclear cells, including those that appear in large numbers in leukemia and lymphoma.     

Neuropeptide Y in the olfactory system, forebrain and pituitary of the teleost, Clarias batrachus

Distribution of neuropeptide Y (NPY)-like immunoreactivity in the forebrain of catfish Clarias batrachus was examined with immunocytochemistry. Conspicuous immunoreactivity was seen in the olfactory receptor neurons (ORNs), their projections in the olfactory nerve, fascicles of the olfactory nerve layer in the periphery of bulb and in the medial olfactory tracts as they extend to the telencephalic lobes. Ablation of the olfactory organ resulted in loss of immunoreactivity in the olfactory nerve layer of the bulb and also in the fascicles of the medial olfactory tracts. This evidence suggests that NPY may serve as a neurotransmitter in the ORNs and convey chemosensory information to the olfactory bulb, and also to the telencephalon over the extrabulbar projections. In addition, network of beaded immunoreactive fibers was noticed throughout the olfactory bulb, which did not respond to ablation experiment. These fibers may represent centrifugal innervation of the bulb. Strong immunoreactivity was encountered in some ganglion cells of nervus terminalis. Immunoreactive fibers and terminal fields were widely distributed in the telencephalon. Several neurons of nucleus entopeduncularis were moderately immunoreactive; and a small population of neurons in nucleus preopticus periventricularis was also labeled. Immunoreactive terminal fields were particularly conspicuous in the preoptic, the tuberal areas, and the periventricular zone around the third ventricle and inferior lobes. NPY immunoreactive cells and fibers were detected in all the lobes of the pituitary gland. Present results describing the localization of NPY in the forebrain of C. batrachus are in concurrence with the pattern of the immunoreactivity encountered in other teleosts. However, NPY in olfactory system of C. batrachus is a novel feature that suggests a role for the peptide in processing of chemosensory information.     

Lipomedulloblastoma in a child: a controversial entity

Lipomedulloblastoma is regarded as a distinct entity that occurs exclusively in adults and has a low proliferative potential and a favorable outcome. We describe a rare case of lipomedulloblastoma in a 6-year-old female child showing a high labeling index that needs documentation. The various hypotheses of adiposal change are discussed.     

An efficient green protocol for the synthesis of 1,2,4,5-tetrasubstituted imidazoles in the presence of ZSM-11 zeolite as a reusable catalyst

In this study, we have synthesized a series of ZSM-11 zeolite catalysts using tetrapropyl ammonium hydroxide as a structure-directing agent through a highly efficient hydrothermal method. The series of catalysts were studied by different techniques such as FT-IR spectroscopy, XRD, FE-SEM, HR-TEM, EDS, pyridine-FT-IR spectroscopy, and BET analysis. We focused on varying reaction time intervals from 18 to 48 hours to investigate the effect on catalytic activities of the synthesized series of catalysts. The percentages of aluminum increased in the framework of zeolites with increasing crystallinity, surface area, external surface area, and acidity in the series of ZSM-11 zeolites by increasing the time from 18 to 48 h. Then, we studied the catalytic activity of a series of ZSM-11 zeolites and found that the ZSM-11 zeolite (48 h) possesses higher catalytic activity towards the synthesis of 1,2,4,5-tetrasubstituted imidazoles under solvent-free conditions. The present protocol scored well with excellent yield, short reaction time, clean reaction profiles, low catalyst loading, and no tedious workup. The catalyst (ZSM-11 zeolite 48 h) was recycled and reused in five runs without any considerable loss of activity and product yield.

We synthesized a series of ZSM-11 zeolite catalysts, investigating the effect of varying the reaction time interval from 18 to 48 h. The ZSM-11 zeolite (48 h) has higher catalytic activity for the synthesis of 1,2,4,5-tetrasubstituted imidazoles.     

Electrocautery maze in chronic atrial fibrillation: An early experience

Introduction The maze procedure is the only surgical treatment that can alleviate the three physiologic sequelae of atrial fibrillation i.e. tachycardia, thromboembolic events and hemodynamic compromise. In the present study, we attempted ablation of atrial fibrillation (AF) using monopolar conventional cautery. Objective is to demonstrate efficacy of electroxcautery maze in chronic AF in patients undergoing mitral valve surgery and long term efficacy of it in maintaining sinus rhythm. Methods In this series 25 patients who underwent electrocautery maze since 2002 were studied, the age ranged from 20–60 years, 60% of patients were females. 20 patients were in NYHA class IV and 5 patients were in class III, who had left atrium (LA) ranging from 5–6.5 cms with LA appendage clot in 8 patients. All patients underwent mitral valve replacement, 3 patients under went tricuspid valve repair and 2 underwent aortic valve replacement as concomitant procedures. The electrocautery maze was done encircling left & right pulmonary veins along with interconnecting portion. Left atrial appendage was ligated only in cases with LA clot. Results The hospital mortality rate was nil in this group of patients. Freedom from atrial fibrillation or atrial flutter was 92% at 6mths followup. Patients were followed up with regular electrocardiography. Conclusion Electrocautery maze procedure, an adjunctive procedure is safe, time sparing & effective in eliminating atrial fibrillation & restoring atrial transport function. Presented at the 50^th Annual Meeting of IACTS, New Delhi, Feb., 2004.