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.

First two bilateral hand transplantations in India (Part 4): Immediate post-operative care, immunosuppression protocol and monitoring.

INTRODUCTION: Being able to counter immune-mediated rejection has for decades been the single largest obstacle for the progress of vascular composite allotransplantation (VCA). The human immune system performs the key role of differentiating the 'self ' from the 'non-self '. This, although is quintessential to eliminate or resist infections, also resists the acceptance of an allograft which it promptly recognises as 'non-self'. MATERIALS AND METHODS: Pre-operative evaluation of the recipient evaluation included immunological assessment in the form of panel reactive antibodies (PRA), human leucocyte antigen (HLA) typing, donor-specific antibody detection assays (DSA) and complement-dependent cytotoxicity assays (CDC). Induction immunosuppression was by thymoglobulin and the maintenance by the standard triple-drug therapy. RESULTS: Both the recipients were managed by the standard triple drug therapy and have had only minor episodes of rejections thus far which have been managed appropriately. DISCUSSION: Induction immunosuppression was by thymoglobulin and the maintenance by the standard triple-drug therapy. Various groups have tried various other formulations and regimes as well. CONCLUSION: A comprehensive plan has to be drawn up for immunological screening, selection and the post-operative immunosuppressant usage. The ultimate goal of these immunosuppression modalities is to achieve a state of donor-specific tolerance.

First two bilateral hand transplantations in India (Part 3): Rehabilitation and immediate outcome.

INTRODUCTION: This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India. MATERIALS AND METHODS: The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands. The involvement of the team with the patients started in the 1st week itself and continued on a daily basis for the entire year. RESULTS: Outcome analysis was performed at 6 months and 1 year using the disability of shoulder and hand evaluation and hand transplant scoring system. Functional magnetic resonance imaging was done at the end of 1 year to assess the cortical integration of the transplanted hand. CONCLUSION: Despite more than 110 hands being transplanted worldwide, hand transplant remains an experimental procedure. It is still not considered the "standard of care" for hand amputees. Outcome analyses performed worldwide do indicate that the procedure can provide a substantial improvement in the quality of life for the hand amputee, especially the bilateral amputees.

CdS-sensitized TiO2 nanocorals: hydrothermal synthesis, characterization, application.

Cadmium sulfide (CdS) nanoparticle-sensitized titanium oxide nanocorals (TNC) were synthesized using a two-step deposition process. The TiO(2) nanocorals were grown on the conducting glass substrates (FTO) using A hydrothermal process and CdS nanoparticles were loaded on TNC using successive ionic layer adsorption and reaction (SILAR) method. The TiO(2), CdS and TiO(2)-CdS samples were characterized by optical absorption, X-ray diffraction (XRD), FT-Raman, FT-IR, scanning electron microscopy (SEM) and contact angle. Further, their photoelectrochemical (PEC) performance was tested in NaOH, Na(2)S-NaOH-S and Na(2)S electrolytes, respectively. When CdS nanoparticles are coated on TNCs, the optical absorption is found to be enhanced and band edge is red-shifted towards visible region. The TiO(2)-CdS sample exhibits improved photoelectrochemical (PEC) performance with maximum short circuit current of (J(sc)) 1.04 mA cm(-2). After applying these TiO(2)-CdS electrodes in photovoltaic cells, the photocurrent was found to be enhanced by 2.7 and 32.5 times, as compared with those of bare CdS and TiO(2) nanocorals films electrodes respectively. Also, the power conversion efficiency of TiO(2)-CdS electrodes is 0.72%, which is enhanced by about 16 and 29 times for TiO(2), CdS samples.

Reduced graphene oxide layered WO3 thin film with enhanced electrochromic properties.

The electrochromic (EC) properties of inorganic-organic hybrids of tungsten oxide/reduced graphene oxide (WO3/rGO) thin films were examined. Using hydrothermal method WO3 nanorods were deposited on a conducting Indium-doped tin oxide (ITO) glass substrate. In succession, the reduced graphene oxide thin film was coated on WO3 thin film using improved Hummers method. The structural, morphological, optical, and electrochromic responses of WO3, rGO, and WO3/rGO films are illustrated. Compared with pure WO3 film, WO3/rGO composite film demonstrates improved EC performance because of enhanced double insertion/extraction of ions and electrons. It realizes a large optical modulation (58.8% at 633 nm) with a significant increase in Coloration Efficiency (CE) and EC stability.

Molecular modelling studies on adamantane-based Ebola virus GP-1 inhibitors using docking, pharmacophore and 3D-QSAR.

The pathogenic Ebola virus (EBOV) causes a potential health risk and global spread. To date, few drugs are available for the treatment of Ebola virus disease (EVD) that allow researchers to use computational methods for designing potential drugs. The developed PHASE-based common six-point pharmacophore hypothesis (AADHPR_1) showed the necessity of two hydrogen bond acceptor features, one hydrogen bond donor feature, one hydrophobic group feature, one positively ionizable and one aromatic ring feature for further designing. We developed best 3D-QSAR models with high regression coefficients for the training (r2>0.82) and test (Q2>0.5) sets for both atoms-based and field-based 3D-QSAR models. The molecule 1A-4 (docking score = -4.711 kcal/mol) was obtained as best docked (SP mode) on Ebola virus envelope glycoprotein (PDB ID-3CSY) as compared with the standards oseltamivir (docking score = -4.39 kcal/mol) and zanamivir (docking score = -3.392 kcal/mol). The obtained ZINC hit ZINC58935541 showed a good docking score of -4.892 kcal/mol. The ZINC58935541 molecule also showed a strong binding affinity towards the receptor cavity of Ebola virus envelope glycoprotein when simulated for 1.2 ns. The good QikProp parameters reflect the fact that this molecule, upon optimization into a lead, might become a good candidate for the treatment of EVD.

Reductive dechlorination of 1, 2-dichloroethane using anaerobic sequencing batch reactor (ASBR).

The objective of this research was to study the dechlorination of 1,2-dichloroethane (1,2-DCA) in a synthetic wastewater with lab-scale anaerobic sequencing batch (ASBR) reactors. Anaerobic sludge was used as a biocatalyst. Sodium acetate and dextrose served as the main methanogenic substrate. Experimental studies were conducted at wide-range of volumetric (0.25-1.25 g COD/L.d) and specific (0.0362-0.181 g COD/ g VSS.d) loading rates and influent wastewater CODs (500-2500 mg/L). During 266 days of reactor operation, the mixed culture degraded 1,2 dichloroethane at concentrations of up to 50 mg/L, with an HRT of 48 hrs. No chlorinated intermediates or residues were found. 1,2-DCA degradation resulted in ethene and ethane formation. Acetate was the most effective electron donor for dechlorination, although, dextrose was also effective, but to a lesser extent. The mixed culture degraded 1,2 Dichloroethane in the temperature range of 28+/-4 degrees C, with the pH range of 7.25 to 7.95. The 1,2-DCA removal rates achieved, and the safe nature of the end products, signify the anaerobic sequencing batch (ASBR) reactor technology for practical decontamination of waters containing such types of organochlorines. The COD removal efficiencies were in the range of 95 to 98% depending on volumetric and specific loading rates applied.

Juvenile sex-only and sex-plus offenders: an exploratory study on criminal profiles.

In this study, research was done on the criminal profiles of a large group of juvenile sex-only and sex-plus (sex and other offenses) delinquents (N = 4,430) in the Netherlands. Use was made of information from police records. Results show that sex-plus offenders start their careers earlier, that more of these offenders are of non-Dutch origin, that they commit more crimes, and will partly continue their criminal career after their adolescence. Juvenile sex-only offenders rarely go on committing crimes. In sex-plus offenders, sexual crimes play only a minor role in their total crime repertory. As time goes by, their criminal career will develop into the direction of property crimes. Finally, the implications and limitations of this study will be discussed.

Orchidectomy followed by radiotherapy in 176 stage I and II testicular seminoma patients: benefits of a 10-year follow-up study.

Results are presented for 176 patients with stage I and II primary testicular seminoma treated at the Dr. Daniel den Hoed Cancer Center (DDHCC) between 1975 and 1985. The median follow-up time was 7 years and 4 months. One-hundred and seventy-four (99%) of these patients were treated primarily with radiotherapy after extensive staging. According to the Royal Marsden Staging Classification, 132 patients (75%) were stage I, 8 (5%) were stage IIA, 21 (12%) were stage IIB, 9 (5%) were stage IIC and for 6 stage II patients a further subdivision was not possible. At 5 years the actuarial relapse-free survival and the actuarial survival were 95 and 99%, respectively, for stage I, and 77 and 91% for stage II. Prophylactic irradiation of the mediastinum has not been performed for stage II patients. Five stage II patients relapsed in the mediastinum. Four out of these five relapses were cured with chemotherapy, and in one case, in combination with radiotherapy, at the time of relapse. These results indicated that prophylactic irradiation of the mediastinum appeared to be unnecessary for stage II patients. Tumour markers were not useful in the discovery of metastases. Five years after treatment no relapses were seen. Therefore, it is proposed that a maximum follow-up of 5 years is sufficient to measure disease-free survival.

[Biopsy of potentially malignant bone disorders using an electric minidrill; results of 215 diagnostic drillings]. / Biopsie van mogelijk maligne botafwijkingen met behulp van een elektrische miniboormachine; resultaten van 215 diagnostische boringen.

The results were evaluated of cytological and histological examination of 215 bone biopsies taken with an electric minidrill in 211 patients with suspected malignancies in bones. 171 biopsies were taken in 167 patients with a known malignancy. In 78 cases a malignancy was demonstrated including 4 cases of a second primary malignancy. 44 biopsies of patients without a known primary malignancy resulted in 19 cases of malignancy, mainly metastatic disease. There were no primary bone tumours. Follow-up showed a false negative result in 5 patients, all with known primary malignancies. Follow-up of the patients without known malignancies showed no false negatives. The sensitivity of cytology alone was 92% and the sensitivity of histology alone was 76%. The combination of cytology and histology resulted in a sensitivity of 95%. The specificity of the procedure was 100%.

[When latex disintegrates, or a mechanical pyloric ulcer]. / Wanneer latex loslaat, ofwel een mechanisch ulcus pylori.

Complications of Celestin oesophageal tube disintegration are discussed with reference to the case of a patient with a tube inserted because of extrinsic stenosis presenting with upper abdominal complaints.

Reduced toxicity and superior cellular response of preosteoblasts to Ti-6Al-7Nb alloy and comparison with Ti-6Al-4V.

There are serious concerns on the toxicity of vanadium in Ti-6Al-4V alloy. In this regard, we describe the biological footprint of Ti-6Al-4V and compare with a viable alternate Ti-6Al-7Nb alloy, in terms of novel experimentation pertaining to cellular activity that include qualitative and quantitative analysis of Feret's diameter of cells, area, and perimeter, and proteins-actin, vinculin, and fibronectin. Interestingly, Ti-6Al-7Nb was characterized by superior cell attachment, proliferation, viability, morphology, and spread, which were significantly different from Ti-6Al-4V alloy. Additionally, immunofluorescence studies demonstrated stronger vinculin signals associated with actin stress fibers in the outer regions of the cells and cellular extensions in Ti-6Al-7Nb alloy. These striking observations suggest enhanced cell-substrate interaction and activity on the surface of niobium-containing titanium alloy. The significant differences in the cellular response between the two alloys clearly point to the determining role of alloying element (Nb versus V) in a conclusive manner. Based on this study, next generation of titanium alloys is proposed to focus on niobium-containing alloy.

Development of biodegradable flexible films of starch and poly(lactic acid) plasticized with adipate or citrate esters.

Biodegradable films were produced from blends contained a high amount of thermoplastic starch (TPS) and poly(lactic acid) (PLA) plasticized with different adipate or citrate esters. It was not possible to obtain pellets for the production of films using only glycerol as a plasticizer. The plasticization of the PLA with the esters and mixture stages added through extrusion was critical to achieve a blend capable of producing films by blow extrusion. Adipate esters were the most effective plasticizers because they interacted best with the PLA and yielded films with appropriate mechanical properties.

Evaluation of anti-ulcer effect of amlodipine in gastric ulcer models in rats.

AIMS: To study anti-ulcer effect of Amlodipine and compared it with ranitidine in indomethacin, alcohol and pyloric ligation-induced gastric ulcers in wistar rats. MATERIALS AND METHODS: Gastric ulcers were induced in Wistar albino rats by oral administration of indomethacin (200 mg/kg), alcohol (80%, 1 ml/100 gm) and by pyloric ligation. Antiulcer activity of amlodipine (0.5 mg/kg, i.p.) was observed either alone or in combination with ranitidine (15 mg/kg, i.p.), on ulcer index, gastric pH and gastric volume. Statistical analysis was done by ANOVA and unpaired one tailed 't' test. P<0.05 was considered statistically significant. RESULTS: Amlodipine produced significant (P<0.05) decrease in ulcer index and gastric pH as compared to control. It also produced significant (P<0.05) increase in gastric volume as compared to ranitidine. The anti-ulcer effects of ranitidine were significantly higher than that of amlodipine. Combination of amlodipine and ranitidine did not show significant increase in anti-ulcer activity as compared with ranitidine alone. CONCLUSIONS: Amlodipine produced significant anti-ulcer effects in all 3 experimental models. Amlodipine increased the volume of gastric secretions as compared to ranitidine.

Cellular activity of bioactive nanograined/ultrafine-grained materials.

Our recent electron microscopy study on biomimetic nanostructured coatings on nanograined/ultrafine-grained (NG/UFG) substrates [Mater Sci Eng C 2009;29:2417-27] indicated that electrocrystallized nanohydroxyapatite (nHA) on phase-reversion-induced NG/UFG substrates exhibited a vein-type interconnected and fibrillar structure that closely mimicked the hierarchical structure of bone. The fibrillar structure on NG/UFG substrate is expected to be more favorable for cellular response than a planar surface. In contrast, hydroxyapatite (HA) coating on coarse-grained (CG) substrate more closely resembled a film rather than a fibrillar structure. Inspired by the differences in the structure of HA coating, we describe here the cell-substrate interactions of pre-osteoblasts (MC 3T3-E1) on bioactive NG/UFG and CG austenitic stainless steel substrates. NG/UFG austenitic stainless steel was obtained by a novel controlled phase-reversion annealing of cold-deformed austenite. This example provides an illustration of how a combination of cellular and molecular biology, materials science and engineering can advance our understanding of cell-substrate interactions. Interestingly, the cellular response of nanohydroxyapatite (nHA)-coated NG/UFG substrate demonstrated superior cytocompatibility, improved initial cell attachment, higher viability and proliferation, and well-spread morphology in relation to HA-coated CG substrate and their respective uncoated (bare) counterparts as implied by fluorescence and electron microscopy and MTT assay. Similar conclusions were derived from an immunofluorescence study that involved examination of the expression levels of vinculin focal adhesion contacts associated with dense actin stress fibers and fibronectin, protein analysis through protein bands in SDS-PAGE, and quantitative total protein assay. The enhancement of cellular response followed the sequence: nHA-coated NG/UFG>nHA-coated CG>NG/UFG>CG substrates. The outcomes of the study are expected to counter the challenges associated with the engineering of nanostructured surfaces with specific physical and surface properties for medical devices with significantly improved cellular response.