Jafri Malin Abdullah

Endoscopic treatment of suprasellar arachnoid cysts

SummaryFour cases of large suprasellar arachnoid cysts in children are described. The authors propose a large fenestration into the lateral ventricles and into the basal cisterns as the treatment of choice. A specific multipurpose cerebral endoscope has been designed by the first author. The endoscopic technique with different instruments and with the use of a laser is illustrated. Results and complications are discussed.

Acute toxicity study of the standardized methanolic extract of Mitragyna speciosa Korth in Rodent

ETHNOPHARMACOLOGICAL RELEVANCE Mitragyna speciosa Korth (ketum) is widely used in Malaysia as a medicinal agent for treating diarrhea, worm infestations and also acts as an analgesic and antipyretic. AIM The aim of the study is to determine the acute toxicity of Mitragyna speciosa Korth standardized methanol extract in vivo in 4-weeks-old Sprague-Dawley rats. METHODOLOGY Rats were orally administrated single dose of 100, 500 and 1000 mg/kg Mitragyna speciosa Korth standardized methanol extract and the control group received 430 mg/kg of morphine orally. There were 10 rats in each group. All animals were sacrificed after 14 days of treatment. Eight parameters were tested: cage side observation, body weight measurement, food and water consumption, blood pressure, absolute and relative organ weight, hematology, biochemical analysis and histopathology, to look for evidence of toxicity. RESULT No mortality was noted after 14 days of treatment. In general, behavior, food and water consumption, hematological studies and organ weights showed no significant changes. The standardized methanol extraction of Mitragyna speciosa Korth increased rat blood pressure (systolic: 147.4+/-1.01, 131.64+/-4.94 and 137.8+/-4.46) after an hour of 100, 500 and 1000 mg/kg doses, respectively. Biochemical studies showed significant elevation of ALT, AST, albumin, triglycerides, cholesterol and albumin (p>0.05), at all levels of doses. But, nephrotoxicity evidenced by elevated creatinine was seen only at a dose of 1000 mg/kg. Histological examination showed congestion of sinusoids, hemorrhage hepatocytes, fatty change, centrilobular necrosis and increased number of Kuppfer cells in the liver of all Mitragyna speciosa Korth standardized methanol extract treated groups. CONCLUSION Oral administration of standardized methanolic extraction of Mitragyna speciosa Korth resulted in increasing rat blood pressure after an hour of drug administration. The highest dose of extract also induced acute severe hepatotoxicity and mild nephrotoxicity. However, Mitragyna speciosa Korth shows no effects on body weight, food and water consumption, absolute and relative organ weight and also hematology parameters.

Diagnostic and therapeutic stereotactic cerebral endoscopy

SummaryModern neuro-imaging caused a renewed interest in endoscopic techniques. Several indications for stereotactic endoscopy are illustrated. A prototype of a new four channel endoscope is used. Lesions in the posterior part of the third ventricle and even the fourth ventricle are reachable for biopsy. Cystic intra-or paraventricular lesions can be approached stereotactically and treated. Continuous rinsing is mandatory to preserve a clear vision.

Intracerebral haematomas after deep brain stimulation surgery in a patient with Tourette syndrome and low factor XIIIA activity

A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulation (DBS) and developed subsequent bilateral subcortical haematomas. Additional blood tests revealed abnormalities of plasma factor XIIIA and tryptophan levels, which may be associated with Tourette syndrome. Neurosurgeons who perform DBS surgery on patients with Tourette syndrome must be aware of possible disastrous complications resulting from factor XIIIA disorders of blood haemostasis. Routine screening for this condition is not typically performed prior to surgery in these patients.

Outcome of 2 different types of operative techniques practiced for chronic subdural hematoma in Malaysia: an analysis

BACKGROUND Traumatic chronic subdural hematomas in Malaysia are increasingly common in young patients after road traffic accidents as well as the elderly who fall at home. Most surgeons in this country manage these pathologies without irrigation, with only a drainage system. This has led to criticism that the recurrence rate might be higher when no irrigation is done and that rates are lower with irrigation and drainage. Thus, a study was done to look into the outcome of TCSH operated with and without irrigation, followed by drainage, to guide the surgeons in Malaysia as to what best could be done for these cases. METHODS A cross-sectional study was conducted on 2 surgical treatments: burr hole drainage with irrigation and without irrigation based on the internal architecture of chronic subdural hematomas based on CT of the brain and their outcome in relation to their clinical parameters. RESULTS A total of 42 patients treated with the burr hole craniotomy without irrigation with drainage were compared to 40 patients with irrigation and drainage. In both groups, univariate and multivariate analysis revealed that good clinical outcome was associated with preoperative Markwalder grade and the presence of postoperative hematoma recurrence. There was no difference in good outcome between the 2 operative methods. CONCLUSION There was no significant difference between these 2 operative techniques in relation to outcomes whether good or bad. The recurrence rate was 12.2%. When either technique is done properly, no difference to the outcome is seen. Neurosurgeons or general surgeons in Southeast Asia may choose not to irrigate the chronic subdural space, although drainage placement is necessary afterwards.

Endoscopic Diagnosis and Treatment of Para- and Intra-Ventricular Cystic Lesions

Different cystic lesions can be located in or around the ventricular system, eventually causing hydrocephalus. Twenty-one patients are described where endoscopic intervention, mainly large fenestration towards the ventricular cavity, has been performed. This treatment can sometimes replace open surgery or extracranial shunting. Most rewarding are the arachnoid and ependymal intra- and paraventricular cysts. With careful and adequate endoscopic technique this procedure is safe and much less invasive than other methods described.

Newcastle diseases virus strain V4UPM displayed oncolytic ability against experimental human malignant glioma

Abstract Introduction: Newcastle disease virus (NDV) is a virus of paramyxovirus family and lately has been studied for the treatment of cancer in human. In this study, we successfully determined the oncolysis potential of NDV vaccine, V4UPM tested on the human glioblastoma multiform cell line (DBTRG.05MG) and human glioblastoma astrocytoma cell line (U-87MG) in vitro and in vivo. The V4UPM strain is a modified V4 strain developed as thermostable feed pellet vaccine for poultry. Objective: The objectives of this study were mainly to evaluate the cytolytic effect and subsequently determine the brain tumor regression potential induced by this strain in athymic mice model. Methodology and results: V4UPM, the avirulent strain of NDV, was propagate and screened for the cytolytic activity towards DBTRG.05MG and U-87MG using MTT assay. The inhibition concentration 50% (IC50) values by monolayer method measured at hour 72 were 23 and 9 HAU/ml, respectively. Further study was carried out to observe an apoptosis of the infected cells by AO/PI staining and revealed the apoptosis features of the treated cells. Subcutaneous human brain tumors grown on the nude mice were treated by V4UPM at IC80 and complete regression of U-87MG-bearing tumor mice was observed. TUNEL assay analysis of treated tumor tissues from treated mice showed an occurrence of apoptosis. Conclusion: From this study, NDV strain V4UPM inhibits the proliferation of experimental human gliomas in tissue culture and IC80 at 520 HAU V4UPM gives potent effect to induced tumor regression and apoptosis in malignant gliomas.

Teratocarcinosarcoma of the nasal cavity and ethmoid

Sinonasal teratocarcinosarcoma is very unusual malignant neoplasm histologically consisting of an epithelial element and one or more mesenchymal components. This is a report of teratocarcinosarcoma, in a 74-year-old male, involving the right nasal cavity and ethmoids with intracranial extension. The tumour was totally resected via the craniofacial approach and the patient was given post-operative chemotherapy. Extensive tumour necrosis, rapid growth and local destruction are the prominent features of this tumour. The clinical presentation, pathological features and clinical course of this rare malignancy are discussed with a review of the literature.

IGF-1 acts as controlling switch for long-term proliferation and maintenance of EGF/FGF-responsive striatal neural stem cells.

Background: Long-term maintenance of neural stem cells in vitro is crucial for their stage specific roles in neurogenesis. To have an in-depth understanding of optimal conditional microenvironmental niche for long-term maintenance of neural stem cells (NSCs), we imposed different combinatorial treatment of growth factors to EGF/FGF-responsive cells. We hypothesized, that IGF-1-treatment can provide an optimal niche for long-term maintenance and proliferation of EGF/FGF-responsive NSCs. Objective: This study was performed to investigate the cellular morphology and growth of rat embryonic striatal tissue derived-NSCs in long-term culture under the influence of different combinatorial effects of certain growth factors, such as EGF, bFGF, LIF and IGF-1. Methods: The NSCs were harvested and cultured from striatal tissue of 18 days old rat embryos. We have generated neurospheres from these NSCs and cultured them till passage 7 (28 days in vitro) under four different conditional microenvironments: (A) without growth factor, (B) EGF/bFGF, (C) EGF/bFGF/LIF, (D) EGF/bFGF/IGF-1 and (E) EGF/bFGF/LIF/IGF-1. Isolated NSCs were characterised by Immunoflouroscence for nestin expression. The cell growth and proliferation was evaluated at different time intervals (P1, P3, P5 & P7), assessing the metabolic activity based cell proliferation. Apoptosis was studied in each of these groups by In situ cell death assay. Results: Our results demonstrated certain important findings relevant to long-term culture and maintenance of striatal NSC-derived neurospheres. This suggested that IGF-1 can induce enhanced cell proliferation during early stages of neurogenesis, impose long-term maintenance (up to passage 7) to cultured NSCs and enhance survival efficiency in vitro, in the presence of EGF and FGF. Conclusions: Our findings support the hypothesis that the enforcement of IGF-1 treatment to the EGF/FGF-responsive NSCs, can lead to enhanced cell proliferation during early stages of neurogenesis, and an extended life span in vitro. This information will be beneficial for improving future therapeutic implication of NSCs, by addressing improved in vitro production of NSCs.

Effects of asiatic acid on passive and active avoidance task in male Spraque-Dawley rats.

AIM OF THE STUDY Centella asiatica has a reputation to restore declining cognitive function in traditional medicine. To date, only a few compounds that show enhancing learning and memory properties are available. Therefore, the present study investigates the effects of for acute administration of asiatic acid (A-A) isolated from Centella asiatica administration on memory and learning in male Spraque-Dawley rats. MATERIALS AND METHODS 4-5 weeks Spraque-Dawley rats were administered with concentration 1, 3, 5, 10, 30 mg/kg of A-A, baclofen, scopolamine and saline intra peritoneally and were evaluated for passive avoidance (PA), active avoidance (AA) and changes in blood pressure (BP). RESULTS Treatment 30 mg/kg of A-A resulted in significantly dose-dependently improved memory, with increased retention latency to enter difference compartment in PA test compared to baclofen, saline and scopolamine. Furthermore, 30 mg/kg of A-A was significantly higher on learning abilities on 1st day but there was no significantly difference on avoidance memory ability after 7 days of retention. Low reading in blood pressure dose-dependent significantly difference was observed in the 30 mg/kg of A-A group compared to saline group. CONCLUSIONS Administration A-A facilitated PA and AA on memory and learning and but had no effect on active avoidance on memory. Hence, may serve useful memory and learning with less effect in blood pressure in promoting memory and learning increases.