Unilateral absence of the lunate sulcus: an anatomical perspective.

The present study examines the gross anatomical features of anomalous lunate sulcus detected incidentally in a cadaveric brain and discusses its clinical importance. The absence of lunate sulcus was carefully studied in a dissected brain specimen. The absence of lunate sulcus was observed unilaterally on the right side of a cadaveric brain specimen. The lunate sulcus was clearly appreciated on the left side whilst on the right side it was absent. The right hemisphere of the cerebellum was also bigger in size as compared to the left. The absence of lunate sulcus is a rare finding, which may be detected incidentally. The anatomical knowledge of the lunate sulcus may be important for neurosurgeons operating on the occipital lobe and the radiologists interpreting CT scan.

The potential role of herbal products in the treatment of Parkinson's disease.

Parkinson's disease (PD) is a multifactorial disorder of the nervous system in which there is a progressive loss of dopaminergic neurons. There is a disturbance in the movement in PD and these include resting tremors, rigidity, bradykinesia or akinesia, disturbance, posture and freezing (motor block). The substantia nigra and other parts of the brain are commonly affected. The disorder could be related to oxidative stress and there is an important role of reactive oxygen species (ROS). A number of herbal products contain active components which are known to possess antioxidant action. Hence, the potential role of herbal products in treating PD cannot be undermined. In the present narrative review, the main aim is to discuss the pathogenesis of PD, define the role of different potential herbal extracts on its pathogenesis which may form the basis of treatment. We also discuss in detail the active chemical compounds present each herb which are effective in the treatment of PD. These herbs include Baicalei, Erythrina velutin, Resveratrol, Peganum Harmal, Curcuma longa (Zingiberaceae), Carthamus tinctorius L. (Safflower), Pueraria lobate, Juglandis Semen (Walnut), Tianma Gouteng Yin (TGY), Lycium barbarum L fruit, Mucuna pruriens (Velvet bean), Chunghyuldan (CHD), Paeoniae Alba Radix. The present review may be beneficial for designing future drugs for effective treatment of PD.

Unusual venous sinuses.

The dural venous sinuses lie in between the two layers of the dura mater. The dural venous sinuses are important, because they receive blood from the brain and the cranial bones. All sinuses are related to the inner surface of the skull, except for the inferior sagittal and the straight sinus. The sinuses related to the inner surface of the skull produce impressions on it. During routine ostelogical teaching for undergraduate medical students, we observed an unusual oblique sinus, which connected the right and the left transverse sinuses. This unusual oblique sinus measured 2 cm and had a course from the right to the left side. The superior sagittal sinus turned onto the right but at a much higher level than the left transverse sinus. Although these sinuses communicated with each other, the normal position of the confleunce of the sinus (meeting point of superior sagittal sinus, right and left transverse sinus and the occipital sinus) was not seen. The impression meant for the posterior lobe of the left cerebral hemisphere was distinctly greater than that of the right side. The presence of such an anomaly suggests a possible developmental defect or handedness of the individual. The knowledge of the anatomical variations of the dural venous sinuses may have great clinical implications during venography, shunt surgeries and also helpful for neurologists and radiologists in addition to academic interest (Fig. 2, Ref 10) Full Text (Free, PDF) www.bmj.sk.

Anatomical study of anomalous posterior horn of lateral ventricle of brain and its clinical significance.

The present cadaveric study, describes asymmetrical right cerebral hemisphere and anomalous posterior horn of the right lateral ventricle and discusses its clinical implications. The occipital lobe of right cerebral hemisphere extended more posteriorly as compared to the left and so did the posterior horn of the lateral ventricle, resulting in the thinning of the occipital cortex. Till now, the dimension and volumetric study of the lateral ventricles have been usually performed by MRI and CT scans. A gross anatomical study of such a case, is the rarest of its kind. The abnormal anatomy of the lateral ventricles may be of great academic interest regarding CSF circulation and also important for clinical, radiological and surgical interventions (Fig. 2, Ref 8). Full Text (Free, PDF) www.bmj.sk.

Spina bifida with higher position of sacral hiatus: a case report with clinical implications.

Spina bifida is a developmental defect in the vertebral column, in which the laminae fail to fuse and thereby the spinal cord is relatively unprotected. We report a case of spina bifida, in a dried specimen of sacrum, characterized by a prominent S1 spine and a higher sacral hiatus. Conventional textbooks of anatomy provide less information about the clinical implications of such anomalies and research studies are the only source of information. The present study, discusses in detail, the structural and radiological aspects of spina bifida, with a higher sacral hiatus. Precise knowledge of normal and abnormal anatomy of the sacrum may be clinically important for anesthetists, neurologists, radiologists and orthopedic surgeons, in their clinical practice (Fig. 3, Ref. 16). Full Text (Free, PDF) www.bmj.sk

Refeeding syndrome: the danger of feeding a starving man.

Refeeding syndrome is a potentially fatal clinical condition characterized by severe electrolyte and fluid shifts associated with metabolic abnormalities in severely malnourished or starved patients undergoing oral, enteral or parenteral refeeding. We here present a case of a 50-year-old Indian male with a background of depression and alcoholic liver disease presented with alleged ingestion of a detergent. He subsequently developed an oesophageal stricture resulting in severe malnutrition. He developed refeeding syndrome following commencement of TPN associated with clear biochemical alteration. This was immediately identified and rectified. This case report highlights the prevalence of refeeding syndrome in a typical hospital setting that can easily be overlooked and stresses the importance of early recognition as this is a preventable disorder.

Does long term supplementation of vitamin E cause detrimental effects on the central nervous system? Morphological and histological study in experimental male Wistar rats.

AIM: Aging is attributed to neuronal loss associated with increased oxidative stress. Vitamin E, and in particular, tocotrienol are potent antioxidants, which have been shown to be neuroprotective. The main aim of the present study was to observe the effect of long term intake of vitamin E in the form of tocotrienol rich fraction (TRF) and refined, bleached, deodorized palm olein (RBDPO) on the brain of experimental rats. MATERIALS AND METHODS: Thirty male Wistar rats aged 3 months were either supplemented with TRF (dose of 200 mg/kg body weight), RBDPO (dose of 1 ml/kg body weight) or distilled water, continuously for 8 months. The animals were then examined in vivo for clinical magnetic resonance imaging (MRI) studies before being sacrificed. The brain was extracted, measured and studied for histological changes. RESULTS: The magnetic resonance imaging (MRI) scan of the lateral ventricle, cortical thickness of cingulate gyrus and hippocampus size did not show any significant changes in all three groups. The brain weight, length and width as well as histological sections of the brain showed no significant changes between the groups. CONCLUSION: It is thereby concluded that chronic consumption of vitamin E was not detrimental to the central nervous system.

Factors associated with cognitive impairment in patients with Parkinson disease: an urban study.

BACKGROUND AND AIMS: Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment. MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale. RESULTS: Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness. CONCLUSION: Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.

Ankle Injuries in Sports: Anatomical Considerations and Clinical Implications

Ankle injuries are commonly seen in various sports. The main aim of the present review was to highlight the normal anatomy of the ankle, mechanism of injuries related to sports, congenital abnormalities or anatomical variations related to ankle injury and discuss its effective management. A review of literature was done to determine the ankle injuries which occur as a result of various sports related activities. We documented all sports which involved injury to the ankle joint. The anatomy of various structures in the sole of foot and their involvement in injuries were discussed at length. The anatomical knowledge of ankle injury may be beneficial for future diagnosis and treatment purpose.

A preliminary study of reactive oxygen species activity within motile Boer buck sperm using confocal laser scanning microscope (CLSM).

OBJECTIVE: There is an association between reactive oxygen species (ROS) and DNA damage to sperm. Researchers believe that ROS is always present at the sperm's head. The variation of ROS concentration within the area has an impact on the integrity of the DNA. MATERIALS AND METHODS: A study was conducted to confirm the location of ROS within a group of motile Boer buck sperm. A dual photon confocal laser scanning microscope (CLSM) with a 507 nm excitation and 529 nm emission was used on thawed cryopreserved sperms mixed with 10% polyvinyl pyrrolidone (PVP) and stained with 10 mmol/l dihydrorhodamine 123. ROS production was observed and captured under the CLSM at 400x magnification and a frame rate of 35 fps. All fluorescent images were then automatically overlaid with images obtained through Brightfield (BF) to the location of the sperm's membrane. A 3-D reconstruction of the sperm was also conducted to confirm the location of ROS activity. RESULTS: ROS activity was present at the acrosome, midpiece one third of the sperm's tail and whole area of the sperm head. ROS in immotile sperm was also present at the acrosome, one third of sperm tail and the whole area of the head compartment. Relatively fluorescence intensity of ROS was found lower in motile Boer buck sperm as compared to the immotile Boer buck sperm. CONCLUSION: It is concluded that sperm viability largely depends on the ability of the sperm to confine ROS within the acrosome, midpiece and one third of the sperm's tail.