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Reactive oxygen species (ROS) and lipid peroxidation (LPO) have been considered to play an important role in the pathogenesis of chronic fluoride ion (F) toxicity. Many studies have shown that F-induced apoptosis may be associated with oxidative stress and provoke the initiation of the apoptotic process. Apoptosis is mainly regulated by complex pro- and anti-apoptotic gene families. The Bcl-2 family of regulator proteins has been demonstrated to be involved in the regulation of apoptosis with Bcl-2 inhibiting apoptosis and Bax promoting it. Both genes are widely present in the mitochondria and endoplasmic reticulum of the cells. The aim of this study was to evaluate F-associated mitochondriopathy in human renal cells. The patient sample comprised 64 children, aged 4-12 yr, with nephrotic syndrome due to minimal change disease (NS-MCD) who were divided into two groups: (i) group 1 (n=32) with a normal urinary F (=1 mg/L) and (ii) group 2 (n=32) with a high urinary F (>1 mg/L). Renal biopsies, taken for clinical diagnostic indications, were processed for ultrastructural analysis of the tubular parts by Transmission Electron Microscopy (TEM). The group 2 patients showed a remarkably high level of mitochondriopathy including mitochondrial edema, cristolysis, and electron dense deposits in the mitochondrial matrix. These findings may help in understanding F-associated nephrotoxicity in humans and in paving the way for the early diagnosis of F-induced renal impairment. [ABSTRACT FROM AUTHOR]

Background: Since the end of last century, technology has taken a front seat in dispersion of medical education. Advancements of technology in neurosurgery and traditional training methods are now being challenged by legal and ethical concerns of patient safety, resident work-hour restriction and cost of operating-room time. To supplement the existing neurosurgery education pattern, various e-learning platforms are introduced as structured, interactive learning system. Materials and Methods: This study focuses on the concept, formulation, development and impact of web based learning platforms dedicated to neurosurgery discipline to disseminate education, supplement surgical knowledge and improve skills of neurosurgeons. 'Neurosurgery Education and Training School (NETS), e-learning platform' has integration of web-based technologies like 'Content Management System' for organizing the education material and 'Learning Management System' for updating neurosurgeons. NETS discussion forum networks neurosurgeons, neuroscientists and neuro-technologists across the globe facilitating collaborative translational research. Results: Multi-authored neurosurgical e-learning material supplements the deficiencies of regular time-bound education. Interactive open-source, global, free-access e-learning platform of NETS has around 1) 425 visitors/month from 73 countries; ratio of new visitors to returning visitors 42.3; 57.7 (2); 64,380 views from 190 subscribers for surgical videos, 3-D animation, graphics based training modules (3); average 402 views per post. Conclusion: The e-Learning platforms provide updated educational content that make them "quick, surf, find and extract" resources. e-Learning tools like web-based education, social interactive platform and question-answer forum will save unnecessary expenditure of time and travel of neurosurgeons seeking knowledge. The need for free access platforms is more pronounced for the neurosurgeons and patients in developing nations. [ABSTRACT FROM AUTHOR]

Though the necessity of cadaver dissection is felt by the medical fraternity, and described as early as 600 BC, in India, there are no practical guidelines available in the world literature for setting up a basic cadaver dissection laboratory for neurosurgery skills training. Hands-on dissection practice on microscopic and endoscopic procedures is essential in technologically demanding modern neurosurgery training where ethical issues, cost constraints, medico-legal pitfalls, and resident duty time restrictions have resulted in lesser opportunities to learn. Collaboration of anatomy, forensic medicine, and neurosurgery is essential for development of a workflow of cadaver procurement, preservation, storage, dissection, and disposal along with setting up the guidelines for ethical and legal concerns. [ABSTRACT FROM AUTHOR]

It is well known that quality of hearing decreases with increasing age due to changes in the peripheral or central auditory pathway. Along with the decrease in the number of neurons the neurotransmitter profile is also affected in the various parts of the auditory system. Particularly, changes in the inhibitory neurons in the inferior colliculus (IC) are known to affect quality of hearing with aging. To date, there is no information about the status of the inhibitory neurotransmitter GABA in the human IC during aging. We have collected and processed inferior colliculi of persons aged 11–97 years at the time of death for morphometry and immunohistochemical expression of glutamic acid decarboxylase (GAD67) and parvalbumin. We used unbiased stereology to estimate the number of cresyl-violet and immunostained neurons. Quantitative real-time PCR was used to measure the relative expression of the GAD67 mRNA. We found that the number of total, GABAergic and PV-positive neurons significantly decreased with increasing age (p < 0.05). The proportion of GAD67-ir neurons to total number of neurons was also negatively associated with increasing age (p = 0.004), but there was no change observed in the proportion of PV-ir neurons relative to GABAergic neurons (p = 0.25). Further, the fold change in the levels of GAD67 mRNA was negatively correlated to age (p = 0.024). We conclude that the poorer quality of hearing with increasing age may be due to decreased expression of inhibitory neurotransmitters and the decline in the number of inhibitory neurons in the IC. • A total number of neurons, GAD67, and PV-positive neurons in human IC was estimated using optical fractionator. • Total neuronal population, GAD67 and PV-positive neurons were negatively correlated with increasing age. • The relative gene expression of GAD67 mRNA decreased with aging. [ABSTRACT FROM AUTHOR]

Background: The stria vascularis (SV) is a vascularized epithelium that secretes endolymph and is located on the lateral wall of the membranous cochlea. The capillaries of SV directly influence the composition of the endolymph and hence the generation of impulses by the hair-cells that are auditory receptors and thus affect hearing. Therefore, the real morphology of the SV would be very important for understanding the hearing system. There are few reliable reports of the morphology of the human SV., Aims and Objectives: In this research, we have estimated the volume of the SV and total length of strial capillaries in the apical, middle and basal turns of the human cochlea by updated stereological techniques., Methods: The point-counting Cavalieri's method and hemispherical volume probes were applied on stained, 40 μm-thick serial sections of five celloidin-embedded, decalcified cochleae., Results: The mean age of persons at the time of death was 51 ± 15.25 years, the mean volume of the SV was 0.56 ± 0.054 mm3 and the mean length of the SV capillaries was 289.08 ± 72.96 mm. We also estimated the same parameters with different stereological parameters, probes and in differently stained sections and checked the relationship and limits of agreement between different methods by paired t -test and Bland-Altman plot. We found agreement in our results., Conclusion: We provide reliable baseline data on the real morphology of the human SV., Competing Interests: There are no conflicts of interest.

Background: Drilling of the anterior clinoid process (ACP) is an integral component of surgical approaches for central and paracentral skull base lesions. The technique to drill ACP has evolved from pure intradural to extradural and combined techniques., Objective: To describe the computerized morphometric evaluation of exposure of optic nerve and internal carotid artery with proposed tailored intradural (IDAC) and complete extradural (EDAC) anterior clinoidectomy., Methods: We describe a morphometric subdivision of ACP into 4 quadrangles and 1 triangle on the basis of fixed bony landmarks. Computerized volumetric analysis with 3-dimensional laser scanning of dry-drilled bones for respective tailored IDAC and EDAC was performed. Both approaches were compared for the area and length of the optic nerve and internal carotid artery. Five cadaver heads were dissected on alternate sides with intradural and extradural techniques to evaluate exposure, surgical freedom, and angulation of approach., Results: Complete anterior clinoidectomy provides a 2.5-times larger area and 2.7-times larger volume of ACP. Complete clinoidectomy deroofed the optic nerve to an equal extent as by proposed the partial tailored clinoidectomy approach. Tailored IDAC exposes only the distal dural ring, whereas complete EDAC exposes both the proximal and distal dural rings with complete exposure of the carotid cave., Conclusion: Quantitative comparative evaluation provides details of exposure and surgical ease with both techniques. We promote hybrid/EDAC technique for vascular pathologies because of better anatomic orientation. Extradural clinoidectomy is the preferred technique for midline cranial neoplasia. An awareness of different variations of clinoidectomy can prevent dependency on any particular approach and facilitate flexibility.