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Histological classification and grading are prime procedures in the management of patients with astrocytoma, providing vital data for therapeutic decision making and prognostication. However, it has limitations in assessing biological tumor behavior. This can be overcome by using newer immunohistochemical techniques. This study was carried out to compare proliferative indices using proliferating cell nuclear antigen (PCNA), extent of p53 expression and micro vessel morphometric parameters in patients with low grade and anaplastic astrocytoma. Twenty-five patients, each of grade II and grade III astrocytoma were evaluated using monoclonal antibodies to PCNA, p53 protein and factor VIII related antigen. PCNA, p53-labeling indices were calculated along with micro vessel morphometric analysis using Biovis Image plus Software. Patients with grade III astrocytoma had higher PCNA and p53 labeling indices as compared with grade II astrocytoma (29.14 plus/minus 9.87% vs. 16.84 plus/minus 6.57%, p 0.001; 18.18 plus/minus 6.14% vs. 6.14 plus/minus 7.23%, p 0.001, respectively). Micro vessel percentage area of patients with grade III astrocytoma was also (4.26 plus/minus 3.70 vs. 1.05 plus/minus 0.56, p 0.001), higher along with other micro vessel morphometric parameters. Discordance between histology and one or more IHC parameters was seen in 5/25 (20%) of patients with grade III astrocytoma and 9/25 (36%) of patients with grade II disease. PCNA and p53 labeling indices were positively correlated with Pearson′s correlation, p less than 0.001 for both). Increased proliferative fraction, genetic alterations and neovascularization mark biological aggressiveness in astrocytoma. Immunohistochemical evaluation scores over meet the challenge of accurate prognostication of this potentially fatal malignancy.

Background: Some patients with focal cerebral calcification (FCC) have no seizure or a benign course of epilepsy, whilst others with a similar lesion have uncontrolled epilepsy. Aims: To look for [...]

The Achromobacter fischeri nitrite reductase used in the preserver studies was monodisperse as judged by ultracentrifugation and disc-gel electrophoresis. The native enzyme has an average molecular weight of 80000 as determined by the Archibald approach-to-equilibrium method, disc-gel electrophoresis and from a combination of hydrodynamic properties. The sedimentation and diffusion coefficients are 5.25 S and 60.5 µm² s-1 respectively, frictional ratio (///0) 1.25, and Stokes' radius 3.49 nm. Nitrite reductase does not dissociate in the presence of 6 M guanidine-HCl or 6 M urea. The enzyme however splits into two physically indistingiushable subunits upon treatment with 6 M guanidine-HCl, in combination with 1% 2-mercaptoethanol or 1% sodium dodecylsulfate and 1% 2-mercaptoethanol. In both the systems the subunit molecular weight has been found to be approximately 39000. Methionine is the sole N-terminal residue detected. These results indicate that Achromobacter nitrite reductase is composed of two subunits of equivalent size which are covalently bonded by a disulfide bridge. [ABSTRACT FROM AUTHOR]

After advent of the power driven tools, the ease of surgeons and pace of surgery has been enhanced. Nowadays, most of the neurosurgeons are tend to use the motorized drills for elevating a bone flap to make a craniotomy. The bone cutting by the craniotome is wide and nonbeveled, which mandates the fixation of bone flap at closure, either by wiring, miniplates, or other fixation techniques. This not only lengthens the duration of surgery but also adds extra cost of miniplates to the patient. Here we are presenting a novel technique of elevating a bone flap where fixation at the end of surgery is not obligatory, without any risk of sinking of bone flap into the craniotomy defect.

Aim: To evaluate the technique and outcome of endoscopic management of intraventricular neurocysticercosis (NCC)., Material and Methods: We retrospectively analysed the records of 30 consecutive patients of intraventricular (intra-third and fourth ventricle) NCC who underwent endoscopic management. The clinical profiles of the patients were evaluated which included age, symptoms and signs. Transcranial endoscopy was performed through a frontal burr hole using a Gaab Universal Endoscope system with rigid 0° and 30° telescope for endoscopic third ventriculostomy and removal of the cyst was described. The mean follow-up period was 22.6 months., Results: In 86.67% (26/30) patients we are able to visualize/excise/decompress the cyst. We were able to successfully excise all the third ventricular cysts (16/16) and in 66.67% (8/12) of the fourth ventricular cysts. In 90% (27/30) patients we were able to successfully divert the CSF flow and achieve long-term shunt free period., Conclusion: We found that endoscopic cerebrospinal fluid (CSF) diversion in cases of intraventricular NCC is feasible and associated with high success rate. Endoscopic CSF diversion in NCC related hydrocephalus usually produces a long-term cure.

A 43-year-old male presented with 3-month history of low-grade fever and headache. Radiological investigations revealed unilateral hydrocephalus. Unilateral obstruction of the foramen of Monro due to chronic tubercular ependymal inflammation was suspected and endoscopic septostomy was planned. Though ventriculo-peritoneal shunt is a simple method to treat hydrocephalus, complications related to this procedure are numerous. Neuroendoscopy is a safe method to treat hydrocephalus in selected cases, and also provides access to biopsy the lesion in question. An isolated tuberculoma obstructing the foramen of Monro was seen during endoscopy. Presentation and management of this unusual tuberculoma is reported along with a review of the pertinent literature.

Background and Purpose: It is known that intracranial mass lesions are relatively isotropic on diffusion-weighted imaging. The purpose of this study is to report an unusually high fractional anisotropy (FA) and mean diffusivity (D(av)) in the cavity of the brain abscess compared with other cystic lesions., Methods: We performed diffusion tensor imaging (DTI) in 12 patients with cystic intracranial lesions (pyogenic abscess, n = 5; cysticercus cysts, n = 2; and low-grade astrocytoma, n = 5). Mean FA, D(av) from the lesion core, perifocal edema, and corresponding contralateral normal-appearing regions were measured and compared for relative changes in these parameters. In the abscess cases, we placed regions of interest on areas with FA >0.2 and FA <0.2 to get FA and D(av) values., Results: There were two patterns of FA values in the abscess cavity in all five patients. Part of the abscess showed mean FA = 0.440 +/- 0.135, with D(av) = (0.993 +/- 0.185) x 10(-3) mm(2)/s, whereas other parts had FA = 0.131 +/- 0.039 with D(av) = (0.824 +/- 0.183) x 10(-3) mm(2)/s. The cystic tumors and neurocysticercosis showed very high D(av) = (2.806 +/- 0.25, 2.654 +/- 0.35)x 10(-3) mm(2)/s, with low FA = (0.108 +/- 0.037, 0.08 +/- 0.01), respectively., Conclusion: Brain abscess cavity shows regions of increased FA values with restricted mean diffusivity compared with other cystic intracranial lesions. This information may prevent misinterpretation of the DTI information as white matter fiber bundle abnormalities associated with mass lesions.

Cerebrospinal fluid (CSF) rhinorrhea is a common condition managed by most otolaryngologists with the help of nasal endoscopy (sinoscopy). In the last 2 years, we have used a neuroendoscope with a working sheath to treat nine patients with CSF rhinorrhea. One patient developed a recurrence 1 month after treatment but then responded to conservative treatment. We conclude that the treatment of CSF rhinorrhea by a neuroendoscope with a working sheath is safe, effective, and easy and obviates the need for a separate sinoscope.

Background and Purpose: Intractable epilepsy is a well-recognized complication following head trauma, and many factors have been implicated in its pathogenesis. This study was performed to determine the severity of tissue damage after severe head injury as assessed with magnetization transfer (MT) MR imaging and the relationship of this damage with seizure intractability., Methods: Forty-four patients, 13 without seizures (disease controls) and 31 with seizures, underwent T1-weighted MT MR imaging 1-10 years after head trauma. Phase-corrected gradient-echo (GRE) imaging was also performed in all patients to look for the presence of hemosiderin. All patients were evaluated for the presence of an MT abnormality beyond an abnormality seen on T2-weighted images, an MT abnormality within a T2 abnormality, and hemosiderin deposition., Results: Patients with an MT abnormality beyond a T2 abnormality had a significantly higher intractability of seizures compared with those with an MT abnormality within a T2 abnormality (P <.05). In addition, the mere presence of hemosiderin deposit was not associated with seizure intractability; however, gliosis around the hemosiderin as seen on T1-weighted MT images was associated with seizure intractability., Conclusions: T1-weighted MT imaging may be of value in predicting the intractability of the seizure in delayed posttraumatic epilepsy.