Study into the spread of heat from thermo-optic silicon photonic elements

Phase modulators based upon the thermo-optic effect are used widely in silicon photonics for low speed applications such as switching and tuning. The dissipation of the heat produced to drive the device to the surrounding silicon is a concern as it can dictate how compact and tightly packed components can be without concerns over thermal crosstalk. In this paper we study through modelling and experiment, on various silicon on insulator photonic platforms, how close waveguides can be placed together without significant thermal crosstalk from adjacent devices.

Digital Subtraction Angiography a Door Opener for Neurosurgical Residents who want to Perform Neurointerventional Procedures

Digital subtraction angiography (DSA) has been a fluoroscopic golden investigative tool to know the vascular angiography of the brain and spinal cord. The technique in performing this procedure exposes residents in accessing the major vessels, branches of the arch of aorta, selective angiography and diagnosing different vascular anomalies of brain and spine. They are also exposed to the knowledge of different diagnostic catheters, its manipulation, use of dye and radiation exposure and safety. We would like to share our experience in training and disseminating the knowledge of digital subtraction angiography to the residents.

Fungal Planet description sheets: 868-950

Novel species of fungi described in this study include those from various countries as follows: Australia, Chaetomella pseudocircinoseta and Coniella pseudodiospyri on Eucalyptus microcorys leaves, Cladophialophora eucalypti, Teratosphaeria dunnii and Vermiculariopsiella dunnii on Eucalyptus dunnii leaves, Cylindrium grande and Hypsotheca eucalyptorum on Eucalyptus grandis leaves, Elsinoe salignae on Eucalyptus saligna leaves, Marasmius lebeliae on litter of regenerating subtropical rainforest, Phialoseptomonium eucalypti (incl. Phialoseptomonium gen. nov.) on Eucalyptus grandis × camaldulensis leaves, Phlogicylindrium pawpawense on Eucalyptus tereticornis leaves, Phyllosticta longicauda as an endophyte from healthy Eustrephus latifolius leaves, Pseudosydowia eucalyptorum on Eucalyptus sp. leaves, Saitozyma wallum on Banksia aemula leaves, Teratosphaeria henryi on Corymbia henryi leaves. Brazil, Aspergillus bezerrae, Backusella azygospora, Mariannaea terricola and Talaromyces pernambucoensis from soil, Calonectria matogrossensis on Eucalyptus urophylla leaves, Calvatia brasiliensis on soil, Carcinomyces nordestinensis on Bromelia antiacantha leaves, Dendryphiella stromaticola on small branches of an unidentified plant, Nigrospora brasiliensis on Nopalea cochenillifera leaves, Penicillium alagoense as a leaf endophyte on a Miconia sp., Podosordaria nigrobrunnea on dung, Spegazzinia bromeliacearum as a leaf endophyte on Tilandsia catimbauensis, Xylobolus brasiliensis on decaying wood. Bulgaria, Kazachstania molopis from the gut of the beetle Molops piceus. Croatia, Mollisia endocrystallina from a fallen decorticated Picea abies tree trunk. Ecuador, Hygrocybe rodomaculata on soil. Hungary, Alfoldia vorosii (incl. Alfoldia gen. nov.) from Juniperus communis roots, Kiskunsagia ubrizsyi (incl. Kiskunsagia gen. nov.) from Fumana procumbens roots. India, Aureobasidium tremulum as laboratory contaminant, Leucosporidium himalayensis and Naganishia indica from windblown dust on glaciers. Italy, Neodevriesia cycadicola on Cycas sp. leaves, Pseudocercospora pseudomyrticola on Myrtus communis leaves, Ramularia pistaciae on Pistacia lentiscus leaves, Neognomoniopsis quercina (incl. Neognomoniopsis gen. nov.) on Quercus ilex leaves. Japan, Diaporthe fructicola on Passiflora edulis × P. edulis f. flavicarpa fruit, Entoloma nipponicum on leaf litter in a mixed Cryptomeria japonica and Acer spp. forest. Macedonia, Astraeus macedonicus on soil. Malaysia, Fusicladium eucalyptigenum on Eucalyptus sp. twigs, Neoacrodontiella eucalypti (incl. Neoacrodontiella gen. nov.) on Eucalyptus urophylla leaves. Mozambique, Meliola gorongosensis on dead Philenoptera violacea leaflets. Nepal, Coniochaeta dendrobiicola from Dendriobium lognicornu roots. New Zealand, Neodevriesia sexualis and Thozetella neonivea on Archontophoenix cunninghamiana leaves. Norway, Calophoma sandfjordenica from a piece of board on a rocky shoreline, Clavaria parvispora on soil, Didymella finnmarkica from a piece of Pinus sylvestris driftwood. Poland, Sugiyamaella trypani from soil. Portugal, Colletotrichum feijoicola from Acca sellowiana. Russia, Crepidotus tobolensis on Populus tremula debris, Entoloma ekaterinae, Entoloma erhardii and Suillus gastroflavus on soil, Nakazawaea ambrosiae from the galleries of Ips typographus under the bark of Picea abies. Slovenia, Pluteus ludwigii on twigs of broadleaved trees. South Africa, Anungitiomyces stellenboschiensis (incl. Anungitiomyces gen. nov.) and Niesslia stellenboschiana on Eucalyptus sp. leaves, Beltraniella pseudoportoricensis on Podocarpus falcatus leaf litter, Corynespora encephalarti on Encephalartos sp. leaves, Cytospora pavettae on Pavetta revoluta leaves, Helminthosporium erythrinicola on Erythrina humeana leaves, Helminthosporium syzygii on a Syzygium sp. bark canker, Libertasomyces aloeticus on Aloe sp. leaves, Penicillium lunae from Musa sp. fruit, Phyllosticta lauridiae on Lauridia tetragona leaves, Pseudotruncatella bolusanthi (incl. Pseudotruncatellaceae fam. nov.) and Dactylella bolusanthi on Bolusanthus speciosus leaves. Spain, Apenidiella foetida on submerged plant debris, Inocybe grammatoides on Quercus ilex subsp. ilex forest humus, Ossicaulis salomii on soil, Phialemonium guarroi from soil. Thailand, Pantospora chromolaenae on Chromolaena odorata leaves. Ukraine, Cadophora helianthi from Helianthus annuus stems. USA, Boletus pseudopinophilus on soil under slash pine, Botryotrichum foricae, Penicillium americanum and Penicillium minnesotense from air. Vietnam, Lycoperdon vietnamense on soil. Morphological and culture characteristics are supported by DNA barcodes.

Deep Brain Stimulation in Parkinsons Disease in Nepal

Background Parkinsons disease is a central nervous system degenerative disorder affecting motor system and characterized by progressive tremor, rigidity, gait abnormalities. Surgical treatment of Parkinsons disease is based on the changes in the basal gangliothalamocortical circuits which is altered in Parkinsons disease. Currently pallidotomy and Deep Brain Stimulation are available modes of surgical treatment of Parkinsons disease. Objective To know efficacy of deep brain stimulation in Parkinsons Disease in Nepal. Method All patients of idiopathic Parkinsons disease who underwent Deep Brain Stimulation in Annapurna Neurological Institute and Allied sciences since 2014 were included. The standard functional coordinates for Subthalamic nucleus and Globus pallidus internus was used. We used Zamarano-Dujovny (ZD) Fisher Frame with its software. Patients' Unified Parkinsons disease rating score, Modified Hoehn and Yahr Staging and Schwab and England Activities of daily living Scale were evaluated preoperativelyv as well as postoperatively. Result Ten patients underwent Deep Brain Stimulation. The male is to female ratio was 2:1. The mean age was 55.4±8.9 years and duration of illness was 5.5±2 years. There was a significant improvement in the scores for the main motor manifestations of the disease between the preoperative off-dopa and postoperative off-dopa/on-stim conditions. There was a significant improvement in Schwab and England Activities of daily living scale scores in the off-dopa condition between the preoperative score and the postoperative M6 score. Conclusion Our result of Deep Brain Stimulation is quite promising. However, it is very expensive and requires frequent follow-up for neuromodulation.

Nd: Yag laser treatment for sub-hyaloid hemorrhage in childhood acute leukemia

INTRODUCTION

Sub-hyaloid haemorrhage is common in acute leukemia.

OBJECTIVE

To investigate the effects of Nd: YAG Laser hyaloidotomy in 11 eyes of 8 patients with pre-macular haemorrhage in acute childhood leukemia.

MATERIALS AND METHODS

Premacular sub-hyaloid haemorrhage is one of the leading causes of visual disability in children with acute leukemia. Eleven eyes of 8 patients attending Kanti Children Hospital and BP Koirala Lions Centre for Ophthalmic Studies from January 2006 to July 2007 with premacular subhyaloid haemorrhage were included in the study and treated with Nd: YAG Laser. The haemorrhage originated from acute myeloid leukemia (AML) in 4 cases (6 eyes) and acute lymphoblastic leukemia (ALL) in 4 cases (5 eyes).

RESULTS

Drainage of premacular sub-hyaloid haemorrhage into the vitreous cavity within 3 months succeeded in 9 eyes out of 11 eyes treated. One eye had a dense clotted haemorrhage and the other had a re-bleed. Overall visual improvement was equal in both AML and ALL cases. No obvious epiretinal membrane, retinal breaks and tractional retinal detachment occurred in any eye.

CONCLUSION

Nd: Yag laser hyaloidotomy is a relatively safe, simple and alternative treatment for eyes with a dense premacular sub-hyaloid haemorrhage in acute childhood leukemia. The risks and benefits have to be weighed in randomized clinical trials to establish Nd: YAG hyaloidotomy treatment as a routine procedure in leukemic children.

Organized subdural hematoma with thick membrane in chronic subdural hematoma

INTRODUCTION

Chronic subdural hematoma (CSDH) may occasionally contain organized hematoma which can lead to recurrence and other complications after surgery. There is no exact study and data about OHTMF in Nepal so far. The main objective of this study is to study its prevalence and complications.

METHODS

This is a multicentric retrospective analytical study being carried out at Norvic International Hospital and Annapurna Neurological Institute. We retrospectively analyzed one hundred cases of CSDH between early 2006 to 2010 August. We focused our study mainly on OHTMF.

RESULTS

Of 100 cases, majority of the patients were male ranging from 4 to 85 years of age. Bilateral subdural hematoma was found in about 9% of cases. Majority of cases were treated in usual fashion with single burr hole and drain. OHTMF was found in 3 cases (3%) for which craniotomy with radical membranectomy was performed. In 2 cases membrane formation was noticed during surgery, craniotomy with total membranectomy was performed immediately. In one case there was recurrence of CSDH within 10 days of single burr hole evacuation. Craniotomy with membranectomy was performed in 2nd surgery. There was no recurrence after membranectomy. One case developed seizure post operatively.

CONCLUSIONS

OHTMF is one of the important causes of CSDH recurrence. It has to be treated radically. Different hypthotheses have been postulated regarding thick membrane formation in CSDH. We have tried to discuss these hypotheses.

Intraventricular Taenia solium Neurocysticercosis: A Report of Three Cases

Neurocysticercosis (NCC), caused by the pork tapeworm Taenia solium, is reported to be a common condition in Nepal. So far imaging diagnosis was mainstay of the diagnosis. In this paper, we report three patients presenting with neurological symptoms due to intraventricular NCC. We have diagnosed the causative agent as T. solium on molecular basis. Further research is warranted to assess the actual health impact of T. solium in Nepal. Keywords: Intraventricular neurocysticerosis, PCR-RELP, Taenia solium.

Intraventricular Taenia solium neurocysticercosis: a report of three cases

Neurocysticercosis (NCC), caused by the pork tapeworm Taenia solium, is reported to be a common condition in Nepal. So far imaging diagnosis was mainstay of the diagnosis. In this paper, we report three patients presenting with neurological symptoms due to intraventricular NCC. We have diagnosed the causative agent as T. solium on molecular basis. Further research is warranted to assess the actual health impact of T. solium in Nepal.

Why me? A missing girl

Demographic imbalance created because of the declining sex ratio in India is a cause of concern to policy makers, implementers, demographers and social reformers. To take situation under control, Pre Natal Diagnostic Techniques (PNDT) Act is operational since 1996. Authors have critically reviewed the status of women and socio-cultural factors influencing their status based on data from NFHS III and census 2001 and challenges faced in the operationalisation of PNDT Act in India.

A study on clinico-social factors for sexually transmitted diseases among urban males

This health center based study was conducted to find out the proportion and distribution of clinico-social factors for sexually transmitted diseases among male OPD attanders of urban health centre, Subharti Medical College, Meerut. Out of the total 150 male cases of genital diseases from January to June 2005, 42 were found to be symptomatic for STDs according to syndromic approach. The most common symptom was urethral discharge (35.7%). Illiteracy, trucker's occupation, multiple sex partners, extra marital relationship and non-usage of condom were found to be important socio-clinical factors for STDs.

Obstetric history and reproductive tract infections among married female (15-44 yrs.) in rural area of district Meerut, U.P

The prevalence of RTIs in 600 married females (15-44 yrs.) representing 12 subcentre villages of Daurala block of Meerut was 35.3%. The reproductive tract infections were significantly associated with place of last delivery (P< 0.001), person conducted the last delivery (P< 0.001) and in women had history of abortions (P< .005).

Does peripheral neuropathy allow for the clinical expression of tardive dyskinesia by unmasking central nervous system changes?

Tardive dyskinesia (TD) is a severe and troubling complication of long-term typical neuroleptic use whose etiology remains obscure. While it is widely believed that central nervous system (CNS) dopamine receptor super-sensitivity is involved in the pathogenesis of the condition, it is unclear why some patients develop TD while others do not. It is proposed that a subclinical peripheral motoneuropathy with consequent enlarging of the motor units may act to unmask neuroleptic-induced CNS changes allowing for the expression of TD. To investigate this hypothesis we examined motor unit size with electrographic examinations in 14 patients (six with mild TD; eight without and all with psychotic illness). There were no differences between the two groups of patients. While the data do not appear to support the hypothesis, a larger study with more severely affected patients is required to more adequately test the hypothesis.

A convenient method for the evaluation of anti-tumor agents affecting the cell cycle

Mitotic index (MI), defined as the ratio (%) of the mitotic-phase-arrested cell number to the total cell number, is higher in the presence of colcemid than in its absence. MI is reduced by anti-tumor agents used in conjunction with colcemid. The ratio of MI, which is defined by the dose of colcemid to that of the supplement with etoposide as an anti-tumor agent and is designated MIR, was 10% at an exposure of 2 h, suggesting that etoposide blocks the cell cycle before 2 h of the mitotic phase. Thus, we established a convenient method to identify a target point in the cell cycle for anti-tumor agents using colcemid. RBL-2H3, a mammalian cell line, exhibited a large number of 2-fold swollen nuclear envelopes after exposure to etoposide. The G2-index, which is the ratio of the number of swollen nuclei to the total number of nuclei, was higher when the cells were incubated with etoposide than without it. In this study, we suggest that the measurement of the G2-index contributes to the screening of putative anti-tumor agents.

Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma. Case report

The authors report on a patient who exhibited intractable epilepsy due to an inaccessible hypothalamic hamartoma and subsequently underwent stereotactic radiosurgery. This 25-year-old man had a 24-year history of intractable gelastic and tonic-clonic seizures. Magnetic resonance (MR) imaging performed at examination as well as that performed 30 months earlier demonstrated a nonenhancing and nonprogressive spherical mass, approximately 10 mm in diameter, located on the patient's right side at the floor of the third ventricle. Focal radiation treatment performed with a gamma knife unit administered 36 Gy to the center and 18 Gy to the periphery of the lesion. This treatment resulted in an improvement in seizure control. Before the patient underwent radiosurgery, he suffered from three to six generalized seizures per month in spite of attentive compliance with an anticonvulsant medication regimen. After irradiation of the harmatoma, the frequency of the seizures transiently increased and then subsided 3 months posttreatment. The patient has been free of seizures for the last 21 months, with no neurological or endocrinological complications. Magnetic resonance imaging performed 12 months posttreatment demonstrated complete disappearance of the lesion.

Trans-sellar color Doppler ultrasonography during transsphenoidal surgery

OBJECTIVE

To improve the safety and efficacy of transsphenoidal pituitary adenoma surgery, we investigated transsphenoidal intraoperative color Doppler ultrasonography using a biplane transducer system.

METHODS

We studied 23 patients with pituitary adenomas (18 patients with macroadenomas and 5 patients with microadenomas) who underwent transsphenoidal surgery. The Hitachi EUB555 color Doppler ultrasound system (Hitachi Medical, Tokyo, Japan) was used with a pediatric biplane transesophageal echo cardiography probe (EUP-ES533, 7.5 MHz, biplane phased array sector probe, 9.8-mm tip). The probe was inserted into the saline-filled sphenoid sinus after the sellar floor was opened. Intra- and suprasellar images were obtained just before dural incision and after the tumor removal was thought to have been accomplished.

RESULTS

In all patients, the tumor was depicted as a slightly hyperechoic mass, as compared with the cerebrum. Using color Doppler imaging, major cerebral arteries were depicted clearly in 74% of patients. The pituitary glands, pituitary stalks, and optic chiasms were observed in patients with small adenomas, but not when large adenomas were present. Cavernous sinus invasion, concomitant aneurysm, and residual tumor were clearly visualized. In patients with large adenomas, the end point of surgery was decided when there was an ultrasonographically demonstrated collapsed tumor capsule, subcapsular total vacancy, and reappearance of the optic chiasm.

CONCLUSION

Trans-sellar color Doppler ultrasonography seems to be a useful intraoperative guiding system that may improve the safety and efficacy of transsphenoidal surgery.

Blepharismin produced by a protozoan Blepharisma functions as an antibiotic effective against methicillin-resistant Staphylococcus aureus

A ciliated protozoan, Blepharisma japonicum, produces a photosensitive red pigment, blepharismin (BLR). This study showed that the pigment inhibits the growth of Gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) resistant to arbekacin (ABK), which is the most effective aminoglycoside antibiotic against MRSA and used world wide. Although the minimum inhibitory concentration (MIC) of BLR to the ABK-resistant MRSA strain was 6.25 micrograms/ml in dark, it was decreased to 1.25 micrograms/ml by irradiation with white light of 65 W/m2 for 30 min, suggesting that the antibacterial activity of BLR is photoactivated. Our findings suggested that the antibacterial activity of BLR in dark is due to inhibition of protein synthesis. In addition, we found that BLR is bactericidal and enhances synergistically the antibacterial activity of ABK.

Usefulness of three-dimensional phase contrast MR angiography on arteriovenous malformations

Prospective three-dimensional phase contrast (3D-PC) MR angiography was obtained in 34 patients with arteriovenous malformations (AVM) and comparison was made between digital substraction angiography (DSA) and three-dimensional time-of-flight (3D-TOF) methods. Velocity encoding (VENC) for 3D-PC was adjusted to 60 and 10 cm/sec., and was changed only when adequate information was not obtained. VENC 60 cm/sec, demonstrated the main feeders in 100% of cases and the nidus in 86% of cases whereas VENC 10 cm/sec. showed the draining vein in 78% of cases. The detection rate of feeder, nidus and drainer was 60%, 40% and 13% respectively by the TOF technique. The mean size of the nidus as compared with DSA as standard was 130% with MRI, 108% with 3D-PC and 92% with the TOF technique and this difference was not statistically significant. 3D-PC was clearly superior in detecting AVM in the presence of hemosiderin, hematoma or surgical clips. It also showed gradual disappearance of the lesion after radiosurgery. We found 3D-PC superior to 3D-TOF in the diagnosis, therapeutic planning and follow-up of AVM.

Incidence of intracranial aneurysm associated with pituitary adenoma

The incidence of intracranial aneurysm associated with pituitary adenoma is not definitely established although reported higher than in general population. This study was designed to find the existence of such association in a large series of pituitary adenoma cases. A retrospective study of 467 cases of pituitary adenoma (mean age: 41 +/- 15 years) was done. All patients underwent cerebral angiography at least of anterior circulation, detailed hormonal study, and 155 cases had additional magnetic resonance (MR) angiography. Twenty-five cases (5.4%) of pituitary adenoma (mean age 52 years) had intracranial aneurysm, 97% on anterior circulation, and 12% had multiple aneurysms. Two cases presented with aneurysmal rupture and the rest were incidental. Aneurysm was more frequently seen with increasing age (p < 0.001) and the age distribution resembled that of aneurysm among general population. Although the combination was most frequent among nonfunctioning adenoma (8.8%), and least frequent among prolactinoma (2.4%), this association was again due to age factor. There was no association between hormone secretion, size and invasive nature of the tumor. The results showed no association between intracranial aneurysm and pituitary adenoma. Our speculation is that such occurrence is merely a chance factor and the risk is no greater than that among general population.

Usefulness of two-dimensional time-of-flight MR angiography combined with surface anatomy scanning for convexity lesions

Thirty-eight patients with convexity lesions were studied prospectively with the two-dimensional time-of-flight (2D-TOF) magnetic resonance angiography (MRA) method. Of these 21 cases had additional surface anatomy scanning (SAS) and 7 cases had three-dimensional phase contrast (3D-PC) MRA. The findings were compared during surgery and the predictability of 2D-TOF evaluated. 2D-TOF was obtained with 2 mm slice thickness after the administration of contrast media for routine magnetic resonance imaging (MRI). Cortical veins were visualized with a good resolution with a scan time of only 5 minutes. The tumor was also visible in the background, due to enhancement, and thus the tumor-vessels relation was shown. Slow-flow vessels were also adequately seen. SAS was done at the same sitting with fast spin echo (FSE) with a scan time of 3 minutes. Once both images were incorporated, information on gyri and their relation to the lesions and vasculature could be obtained from a single image. We found 2D-TOF alone, or at times in combination with SAS, useful for planning of operation for convexity lesions.

Endoscopic resection of intraventricular ependymal cyst presenting with psychosis

BACKGROUND

Intracranial ependymal cysts are rare lesions generally located in the cerebral parenchyma, juxtraventricular region, or subarachnoid space; but no case of a purely intraventricular ependymal cyst has been reported.

CASE REPORT

A case of intraventricular ependymal cyst presenting with symptoms of psychosis is reported. The patient's symptoms resolved almost completely following endoscopic resection of the cyst. The embryologic basis of the development of an ependymal cyst inside the ventricle and its histologic characteristics are discussed. Possible mechanism of psychosis in this case is also discussed.

CONCLUSION

Minimally invasive techniques, as in this case, may be useful in refractory psychotic cases with cystic lesions.

Nerve conduction velocity and H-reflex recovery in bipolar illness

Bipolar illness may be characterized by dysregulation and dysfunction of biologically active ions and ion pumps, respectively. In an effort to examine whether purported physiologic abnormalities may have functional counterparts, nerve conduction velocities (NCVs) and H-reflex recovery were examined in 7 acutely manic, 11 euthymic bipolar, 13 remitted schizophrenic, and 6 normal control individuals. All electrophysiologic tests were clinically normal. However, euthymic bipolar patients had significantly slower NCVs than either manic or normal individuals. Percent decrement of H-reflex recovery was nonsignificantly increased in manic versus euthymic bipolar subjects. Data analysis suggests lithium was not responsible for these changes. These data indicate that different mood states in bipolar illness are associated with alterations in electroneurophysiologic function.

[Putaminal abscess occurring at the site of hemorrhage: a case report]

Brain abscesses following stroke have been reported only rarely. We presented a case of putaminal abscess following putaminal hemorrhage. The patient was admitted to our hospital because of acute onset of left hemiplegia. The size of the hematoma was medium and the patient was conservatively treated. In about two months after the ictus, he became intermittently febrile and laboratory examinations suggested the presence of general infections including meningitis. Meanwhile, CT and MRI revealed clearly abscess formation at the site of the hematoma with remarkable brain edema. Cerebrospinal fluid analysis showed the findings of meningitis. On diagnosis of brain abscess, stereotactic exploration was performed and pus mixed with old blood was aspirated. Bacteriological study of the specimen demonstrated Morganella morganii. Postoperative course was uneventful and the abscess cavity gradually subsided following drainage and irrigation of the abscess cavity.

Clonal propagation of Cnidium officinale by shoot tip culture

Multiple shoots were induced from the apical domes of shoot tips of Cnidium officinale Makino (Apiaceae) by culturing them on Murashige and Skoog (MS) 1 static media solidified with 0.2% gelrite and supplemented with 6-benzylaminopurine (BAP) 10 (-6)M. An average of 5.3 shoots per segment were obtained within 6 weeks and this ability did not decline even after two years of subculture. Subsequent transfer of these regenerated shoots on MS media supplemented with alpha-naphthaleneacetic acid (NAA) 10 (-7)M and BAP 10 (-7)M resulted in root formation. Rooted plantlets were able to grow in soil after a short period of acclimatization. Cytological observation in root tip cells of cultivated, as well as in vitro propagated plantlets revealed that in both cases the cells had 2n = 22 chromosomes indicating the homogeneity of the clonally propagated plants.

Delivery of primary neurosurgical care in developing countries--scope for mutual cooperation

As with other specialized services there is an ever increasing gap in neurosurgical care between developed and developing countries. The need for neurosurgery has always been present in developing countries, but the recent introduction of computed tomography has identified many previously undetected cases, increasing the number of patients seeking treatment. However, developing countries suffer severe shortages of trained manpower, proper equipment, and expertise to initiate the services to meet this demand. In contrast, some developed nations are experiencing a surplus of neurosurgeons leading to problems in case exposure. A well-designed cooperative project between these countries can answer some of these problems, becoming an ideal example of mutual benefit.

[A case report of chronic encapsulated intracerebral hematoma]

Chronic encapsulated intracerebral hematoma is a rare clinicopathological entity. The authors reported a case of a 52-year-old male who presented with progressive sensory disturbance of the left extremities three weeks prior to admission. Plain CT and MRI scans revealed a subcortical mass in the right temporal lobe associated with extensive peritumoral edema and intratumoral hemorrhage (mixed intensity on T1WI, low intensity on T2WI). There was a ring-like enhancement with GdDTPA. These findings strongly suggested metastatic melanoma associated with intratumoral hemorrhage. During the operation, the mass appeared partly at the surface of the brain and was easily extirpated totally. Histologically, the specimen showed chronic encapsulated hematoma with a thick, fibrous capsule and there was no evidence of neoplasm. The postoperative course was uneventful and follow up CT scan showed disappearance of the mass and the surrounding edema. The relevant literature was reviewed, and the pathogenesis of this entity was discussed.

Effect of surgery on gonadal function of premenopausal women with pituitary adenomas other than prolactinomas

The effects of surgery on pituitary-gonadal function were investigated in women with pituitary adenomas other than prolactinomas. The subjects were 46 women of premenopausal age with a pituitary adenoma. Twenty tumors were GH producing, 19 were nonfunctioning, and 7 were adrenocorticotropin producing adenomas. The surgery was performed mainly via the transsphenoidal route, with the aim of eradicating the tumor and preserving pituitary function. The menstrual cycle was preserved postoperatively in 9 out of 10 (90%) patients with regular preoperative menstruation. Menstrual disturbance was seen in 36 (78.3%) cases preoperatively. The causative factors for menstrual disturbance were gonadotropin impairment and hyperprolactinemia in GH producing and nonfunctioning adenoma. Excessive hormonal secretion itself is a major causative factor for menstrual disturbance in GH and ACTH producing adenoma. Regular menstruation was restored following surgery in 20 out of 36 (55.6%) patients with menstrual problems. The predicting factors for postoperative recovery of menstruation are: size of adenoma less than 40 mm, period of amenorrhea less than 5 years, and preoperatively preserved gonadotropin secretion. In addition, preoperative hyperprolactinemia was also a predicting factor in women with nonfunctioning adenoma. Thus, even in patients with pituitary adenomas other than prolactinoma, the restoration of menstruation is highly achievable when surgery is performed with attention to preserving pituitary function.

[A case of pineal germinoma presenting with severe amnesia]

Patients who have a pineal germinoma usually present with symptoms of intracranial hypertension or disturbances in vertical ocular motion but rarely present with amnesia. We recently encountered a case of pineal germinoma accompanied by severe amnesia, but not by hydrocephalus. A 32-year-old, right-handed man was admitted with severe memory disturbance which had gradually worsened in the preceding three months. On admission, he was alert and cooperative. His speech was well preserved and not fabricated. He had neither symptoms of intracranial hypertension or visual disturbance. There was no manifestation of interhemispheric disconnection symptoms. His immediate and semantic memory was preserved, however, his recent and antegrade episodic memory was severely impaired. The amnesia involved both verbal and visual modalities. He could recall only 1 out of 5 objects in 5 minutes. He was orientated to people, but not to time and place. And his motivation was severely affected. Magnetic resonance imaging (MRI) showed a heterogeneously enhanced tumor in the splenium and pineal body that extended into the bilateral ventricular trigon through major forceps and was accompanied by edema in the retrosplenial region. The bilateral crura of the fornix was obscured by the tumor. The enlarged pineal body was slightly compressing the upper colliculus but hydrocephalus was not observed. The tumor, which was partially excised through a right parietal corticotomy, had features typical of a germinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Pituitary function in patients with Rathke's cleft cyst: significance of surgical management

The pituitary function of patients with Rathke's cleft cyst before and after surgery was investigated to clarify the significance of surgery and operative indications. The authors have treated 19 patients with Rathke's cleft cyst. There were panhypopituitarism in 2 patients (11%), amenorrhea and/or galactorrhea in 3 (16%), diabetes insipidus in 4 (21%), and visual disturbance in 9 (47%). All the patients underwent systematic endocrinological examination and were found to have various degrees of pituitary dysfunction. Panhypopituitarism was endocrinologically confirmed in 2 patients. Hyperprolactinemia was observed in 4. These patients underwent aspiration of the cyst contents and biopsy of the cyst wall. Postoperative follow-up endocrinologic evaluation performed more than 3 months after surgery showed improvement in pituitary function in 9 out of 13 patients (69%). Amenorrhea and/or galactorrhea recovered or improved in 100% of patients and visual disturbance improved in 89%. However, diabetes insipidus and panhypopituitarism did not improve postoperatively, in any patient. The results of the present study indicate that the incidence of pituitary dysfunction in patients with Rathke's cleft cyst is higher than suspected and in most cases surgical intervention improves pituitary function and the clinical status of the patient. Therefore, surgical treatment is recommended even when the patient has only mild symptoms or signs, including pituitary dysfunction, to prevent irreversible panhypopituitarism.

A case of Cushing's disease accompanied by Rathke's cleft cyst: the usefulness of cavernous sinus sampling in the localization of microadenoma

A 42-year-old man presented with classical symptoms of Cushing's disease. Endocrinological examinations indicated the presence of a adrenocorticotropin-(ACTH) producing pituitary adenoma. Magnetic resonance imaging showed a cystic sellar lesion, which had features of a Rathke's cleft cyst, whereas the adenoma was not depicted. The ratio of blood ACTH concentration between cubital vein, left, and right cavernous sinus was 1: 1.4: 20. During transsphenoidal surgery, in addition to the Rathke's left cyst, a tiny adenoma was detected beneath the left pituitary lobe. Cavernous sinus sampling is a useful auxiliary in the localization of an ACTH-producing adenoma, as in this case.

Embolisation of orbital varix

A 34-year-old man with intermittent exophthalmos, found to have a large varix in the right orbit, was treated by endovascular surgery. Percutaneous transfemoral venous catheterisation and embolisation of the orbital varix was performed on two occasions. A Tracker 18 microcatheter was introduced through the right inferior petrosal sinus, cavernous sinus, superior ophthalmic vein and then into the varix, following a guidewire. Superselective venography of the right ophthalmic vein showed the varix. A total of 204 platinum microcoils was used to pack the varix. At the time of discharge, the exophthalmos had largely resolved. As this technique is much less invasive than surgical resection, we recommend an attempt at endovascular embolisation of orbital varices prior to surgical removal.

Cerebral circulation in moyamoya disease: a clinical study using transcranial Doppler sonography

Transcranial Doppler sonography was performed on eight patients diagnosed as Moyamoya disease. Angiographically, the patients-four adults (mean age 42) and four children (mean age 7.7)-underwent a complete six- or five-vessel angiographic study. The results showed the following: (1) Despite the presence of stenosis, all middle cerebral arteries showed very low-flow velocity compared to their ipsilateral distal internal carotid arteries. In adult cases, the difference was very significant (p < 0.02). (2) Relatively high-flow velocity was observed in the posterior cerebral arteries of children, and in the ophthalmic arteries of adult cases. (3) In several occasions, very low-flow velocity values were still detected despite the fact that with angiography, the respective arterial segments were hardly opacified. The relation and discrepancy between these results and the angiographic findings, and the potential application of transcranial doppler in assessing and grading the severity of moyamoya disease are discussed.

Multiply sectioned Bayesian networks for neuromuscular diagnosis

A prototype neuromuscular diagnostic system (PAINULIM) that diagnoses painful or impaired upper limbs has been developed based on Bayesian networks. This paper presents nonmathematically the major knowledge representation issues that arose in the development of PAINULIM. Motivated by the computational overhead of large application domains, and the desire to provide a user with an interface that gives a focused display of a subdomain of current interest, we built PAINULIM using the idea of multiply sectioned Bayesian networks. A preliminary evaluation of PAINULIM with 76 patients has demonstrated good clinical performance.

Receiver operating characteristic curve analysis in the prediction of carpal tunnel syndrome: a model for reporting electrophysiological data

Receiver operating characteristic (ROC) curves were used to predict the risk of carpal tunnel syndrome (CTS). Patients were classified clinically as: (1) normal exam and no symptoms (169 hands); (2) having a motor and/or sensory deficit typical of CTS (115 hands); (3) having a history characteristic of CTS (156 hands); and (4) nondiagnostic symptomatology (122 hands). Electrophysiological studies consisted of median and ulnar motor, sensory, and palmar measurements. Group mean values for group 1 differed significantly from groups 2 and 3 (not 4) for all measurements, but values overlapped considerably. Median distal motor latency (DMML) combined with median-ulnar palmar latency differences (MUPLD) had significantly superior discriminant power than other measurements and correlated highly for all groups (r values = 0.71-0.73). These variables were used to construct ROC curves and prediction tables. The approach used allows one to assign a percentage risk of having a CTS and can be used in outcome studies.

Facial neurorrhaphy with autologous sural nerve graft using the CO2 laser in a primate model

Cranial nerves, being of fine caliber and having a poorly defined epineurium, pose problems in intracranial sutural anastomosis. The CO2 laser is a comparatively new prospect that is being evaluated for sutureless neural anastomosis. Because there are no reports on the laser anastomosis of a peripheral spinal nerve to a cranial nerve, we designed this study to explore the possibility of performing a laser anastomosis of the facial nerve, using an autologous sural nerve graft in a primate model. Six monkeys underwent resection of the right facial nerve in the parotid fossa. In five of them, the CO2 laser was used to anastomose sural nerve interposition grafts by the use of microsurgical techniques. In one control animal, the sural nerve graft was interposed between the cut ends of the facial nerve and no anastomosis was performed. Compound muscle action potentials were recorded preoperatively and 2, 4, and 6 weeks postoperatively. At the end of 6 weeks, the wound was again explored and the grafts were examined. The neurophysiological results showed that in the five laser-welded nerves, at 4 weeks and 6 weeks postoperatively, the proximal latencies showed an improving trend with each successive recording. It was concluded that the CO2 laser can be used for the anastomosis of interposition grafts to the facial nerve.

Cortical excitability in amyotrophic lateral sclerosis: a clue to pathogenesis

Motor evoked potentials (MEPs) were recorded from selected non-wasted, non-denervated hand muscles in 40 patients with Amyotrophic Lateral Sclerosis (ALS) with both upper and lower motor neuron signs. In most the compound muscle action potential (CMAP) of the target muscle was normal. Compared to the control group, cortical threshold in ALS varied considerably and there was a significant (r2 = 0.702) inverse, exponential, correlation between cortical threshold and MEP/CMAP ratio. There was a linear correlation between threshold and disease duration (r2 = 0.66) so that early in the disease threshold was normal and later the motor cortex could not be stimulated. It is suggested that early in ALS normal threshold reflects glutamate-induced hyper-excitability of the corticomotoneuron. The findings lend support to the hypothesis that ALS is primarily a disease of the corticomotoneuron.

Duration of amyotrophic lateral sclerosis is age dependent

Since 1985, we prospectively followed 246 patients with ALS. The relationship between the age of developing neurological impairment and disease duration was analyzed in 138 patients (86 men and 52 women) who died. Mean disease duration was 4.0 +/- 3.8 years for men and 3.2 +/- 2.5 years for women. There was an inverse, exponential, relationship between onset age and duration (goodness-of-fit P > 0.05). Mean duration at onset age < or = 40 years was 8.2 +/- 5.0 years compared with 2.6 +/- 1.4 years for patients aged 61 to 70 years (P > 0.001). The ratio of young (< or = 40 years) men to women was 3.6:1. When matched for age, disease duration was the same for patients with bulbar and nonbulbar onsets. We conclude that onset age, but not sex, is the most significant predictor determining disease duration in ALS. Longer survival in younger patients probably reflects their greater neuronal reserve.

Transcranial magnetic stimulation for detection of preclinical cervical spondylotic myelopathy

Twenty-three patients, mean age 50.4 years, with cervical radiculopathy at C7 or more rostrally, were studied with electromyography, CT scans (in 16 cases) and transcranial magnetic stimulation. None had overt evidence of myelopathy. Motor evoked potentials (MEPs) were recorded from the hand muscles (C8/T1), and latency, amplitude, and the MEP/CMAP ratio and central motor delay between the hand motor cortex and the lower cervical spine were measured. One or more of these were abnormal in 15 of 23 cases (65%). The most common abnormality was a reduced MEP/CMAP ratio. The findings indicate that physiologic dysfunction of the spinal cord, caudal to a radiculopathy, frequently accompanies a radiculopathy and may antedate overt cervical spondylotic myelopathy. This may be valuable in directing more timely surgical intervention.

Amyotrophic lateral sclerosis (ALS): a phylogenetic disease of the corticomotoneuron?

It is proposed that the primary cell involved in amyotrophic lateral sclerosis (ALS) is the corticomotoneuron. The spinal motoneuron becomes affected as a result of antegrade effects. This hypothesis does not negate most of the presently popular theories regarding the pathogenesis of ALS, but directs focus to one cell type--the corticomotoneuron. It takes cognizance of the complex, monosynaptic, corticomotoneuronal-spinomotoneuronal connections that have evolved in primates, and especially in man. It might explain the lack of any natural or thus far induced animal model which closely mimics the human disease. Threshold measurements to transcotical magnetic stimulation might be used to test the hypothesis. Replication of ALS in an animal is only likely to succeed in a nonhuman primate.

In Vitro Propagation of Carrot (Daucus Carota) L

In vitro method for rapid propagation of Daucus carota L. was developed. Root, stem, leaf and nodal explants were cultured on MS medium supplemented with different concentration and combinations of hormones. Multiple shoot were induced from the nodal explant of D. carota by culturing them in MS medium supplemented with 0.5 mg/l of 6-benzylaminopurine (BAP). Differentiation of shoot initiated after one week of culture, and after eight weeks of primary culture, an average of six plantlets were developed from a single shoot. The nodal explant also induced same number of multiple shoot in MS medium supplemented with 2 mg/l of BAP and 1 mg/l of α-nephthalene acetic acid (NAA). The shoots when sub-cultured in the medium supplemented with 1 mg/l NAA produced roots after five weeks of sub-culture. Root and leaf explants induced roots and callus when cultured on MS medium with NAA at the rate of 1 mg/l and 2 mg/ l. Similarly, stem explants also induced roots and callus in the same concentration of hormones whereas few multiple shoot were induced when cultured on MS supplemented with 2 mg/l of BAP and 1 mg/l of NAA. This result suggests that this methodology can be applied for the rapid and mass propagation of this species. Key words: In vitro; Propagation; MS medium; Explant; Culture. DOI: 10.3126/sw.v5i5.2656 Scientific World, Vol. 5, No. 5, July 2007 51-53