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

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