effect of bioGlue on cerebral cortex in experimental rats

BioGlue is a newly introduced sealant applied by several cardiovascular surgeons to seal graft anastomoses. This study was carried out to determine the effect of a synthetic BioGlue on the repair of meninges in comparison with contemporary bioadhesives. A synthetic BioGlue was provided by combining 45% human serum albumin and 10% glutaraldehyde. Forty Wistar female rats were randomly divided into 4 equal groups [Two case and two control groups]. After craniotomy, dural incision was performed and the motor cortex was exposed. In the case group, the motor cortex was exposed to BioGlue and in the control group, the incision was closed without application of BioGlue. The rats were studied histpathologically after 5 and 14 days postcraniotomy. Synthetic BioGlue caused an acute inflammatory response that resulted in a delayed gliosis in the superficial cerebral cortex, but the deep layers and adjacent areas of cortex were spared. Inflammatory changes and gliosis did not cause cell apoptosis or necrosis. Histopathological changes did not have any clinical significance as they were not accompanied by any neurological deficit or motor weaknesses and exposure to synthetic BioGlue could not cause any clinically significant neurological deficit either. The simplicity of producing this new synthetic BioGlue and its relative low cost, compared to other similar glues, opens a new horizon to the use of this synthetic BioGlue in the neurosurgical field

clinical investigations of the effects of minocycline antibiotic gel on periodontal pockets

The primary treatment of chronic periodontitis is scaling and root planning [SRP]. In deep pockets, surgery is recommended following primary treatment. It has been claimed that local delivery devices can improve healing of inflammation. The purpose of this study was to compare the efficacy of adjunctive use of sub gingival minocycline application in periodontal pockets in patients after SRP with those treated only by SRP. This study was performed on fifteen patients with probing depth of 5mm or more. Probing depth, clinical attachment level, plaque index and bleeding index were evaluated at base line, and then primary treatment [SRP] was performed in all patients. In every patient one tooth was selected as experimental and one as control. In pockets of the test teeth, minocycline gel 2% was applied in weeks 0, 2, 4 and then was compared with control teeth in week S 2, 4, 16 which received only SRP treatment. For statistical analysis paired t-test and student t-test were utilized. The mean of probing depth at base line, and 16th weeks in experimental group, was 6.53 +/- 0.83 and 3.46_0.76, while in control group it was 6.33 +/- 0.83 and 4.30 +/- 0.75 respectively. Pocket depth reduction in experimental group was more significant [p < 0.001]. The attachment level in experimental group at base line, and 16th weeks was 0.65 +/- 0.14 and 1.66 +/- 0.36 and in control group it was 0.78 +/- 0.16 and 1.33 +/- 0.36. The increased level of attachment in experimental group was more significant [p < 0.001]. The Bleeding and plaque Index also reduced in both group but they were more significant in experimental group [p < 0.001]. In this clinical trial, the results suggest that SRP with adjunctive sub gingival administration of minocycline gel is more effective compared to SRP alone. This may be related to good access and high concentration of drug in the area

Spina bifida aperta in southern Iran, 15 years experience

Spina bifida aperta is a lesion that communicates with the external environment; and includes meningomyelocele and meningocele. We investigated all clinical presentations in meningomyelocele and meningocele patients in Shiraz, southern Iran. Patients' files of spina bifida aperta who were admitted from 1989 through 2005 to Nemazee Hospital were reviewed for meningomyelocele and meningocele in Shiraz, southern Iran. CSF shunting by ventriculoperitoneal [VP] shunt was also performed. Out of 580000 patients, 100 cases of spina bifida aperta were registered. In 67 patients with meningomyelocele and 33 with meningocele with male and lumbar and lumbosacral areas predominance, cystic mass was more common. 35% of patients showed congenital anomalies including talipes equinovarus and congenital hip dislocation that were more in meningomyelocele patients. 10% of the patients were operated in the first 72 hours and the others 1 month to 1 year after birth. CSF shunt insertion was more in meningomyelocele patients. Among meningomyelocele patients, mortality occurred in 3 patients [meningitis in 2 and post-operative pneumonia in one case]. It seems that water-thigh dural closure and use of dural patch could decrease the rate of postoperative CSF leakage. Our results resembled the pattern in other series, except the low prevalence of hydrocephalus and a male predominance. Earlier referral of spina bifida aperta patients should be encouraged, because it could lower the complications and lead to better outcomes

[Phenylephrine and the prevention of postoperative tympanostomy tube obstruction]

Forty-seven patients were enrolled in this prospective, randomized, controlled study for determining of the efficacy of Phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction. Mehr 1378 to Mehr 1380, 40 patients [80 ears] returned for postoperative evaluation. In all patients preoperative diagnosis was bilateral otitis media with effusion. Twenty-two patients were males and 18 females. Mean age of the patients was 5 years/old [range 3 to 10]. Myringotomy with tymanostomy tube insertion was performed in all ears. Forty control ears received no medication, but 40 treatment ears received topical Phenylephrine immediately after the insertion of tubes. Two weeks and 2 months after surgery, tympanometry was done, and patency of tube was evaluated. The overall incidence of tympanostomy tube obstruction was 8.75%: 5% in the treatment group and 12.5% in the control group. That shows obstruction to be more than twice as much in the control group. Of course, by using Fisher's exact test, based on alfa = 0.05, p value was 0.43, so there was no significant difference between the two groups. According our plan Phenylephrine drops could be efficient in prevention of ventilation tube obstruction and safe for the inner ear