Polymodal therapy for high grade gliomas: a case report of favourable outcomes following intraoperative radiation therapy.

High grade gliomas, frequently with their infiltrative nature, often make the outcome from neurosurgical intervention alone unsatisfactory. It is recognized that adjuvant radiochemotherapy approaches offer an improved prognosis. For these reasons, we opted for surgical debulking, intraoperative radiation therapy (IORT) in combination with whole brain irradiation therapy and chemotherapy (temozolamide cycles) in the management of a 42 year-old lady with Glioblastoma Multiforme (GBM). Her troublesome symptoms improved after 3 months of this polymodal therapy and remained independently functional for more than two years.

LINAC based radiosurgery and radiotherapy for neurosurgical diseases: what have we learnt so far.

BACKGROUND: Stereotactic radiosurgery uses a single fraction high dose radiation while stereotactic radiotherapy uses multifractionated lower dose focused radiation. MATERIALS AND METHODS: Radiosurgery used rigid CRW head frame while stereotactic radiotherapy utilized GTC or HNL relocatable frames. Stereotactic planning and radiation involved Radionics X-plan and LINAC system. RESULTS: Since December 2001, we have treated 83 lesions from 77 patients using either radiosurgery or fractionated stereotactic radiotherapy. Eighty six percent (86%) of our treated lesions showed favourable outcomes with median follow-up of 32 months (0-7 years). CONCLUSIONS: Our lessons from LINAC precision radiation therapy uphold its value as a promising and effective tool in treating a range of nervous system pathologies.

Presence of telomerase activity with undetectable p16 gene mutation in Malaysian patients with brain tumor.

Recent study has shown that activation of the telomerase and p16 gene mutation are both necessary for tumorigenesis. Our objectives were to detect telomerase activity and investigate the possibility of p16 gene mutations in various types of brain tumor. We analyzed 23 tumor tissues collected in 2000 to 2002. Telomerase activity was detected by a TRAP assay using a TRAPEZE Telomerase Detection Kit (Intergen, Co). PCR-SSCP (Single Strand Conformation Polymorphism) analysis was performed to screen for p16 gene mutation at exon 1 and 2. The activity was detected in 26.1% of the brain tumor samples and mostly present in high-grade tumors. There was a significant association between telomerase activity status and tumor grade but not with patient criteria. Telomerase activity was detected in the analyzed tumors, supporting the fact that activation of telomerase is an important feature for tumorigenesis. There was no mobility shift of p16 gene using SSCP and suggested no mutation at exon 1 and 2 occurred in all samples. These results suggest that another mechanism of p16 gene alterations could be involved and associated with detectable telomerase activity in the progression of tumors.

Enumeration of Pseudomonas species and Pseudomonas aeruginosa bacteriophages in domestic sewage.

Domestic sewage in Kuwait is mainly treated by an activated sludge process. Pseudomonas species were enumerated at all steps of sewage treatment. About 98-99% reduction in the number of these bacterial species were found in the treated effluent compared with raw sewage, which indicates a rather efficient removal of Pseudomonas from sewage. Spherical tail-less phages of Pseudomonas aeruginosa were found in all sewage samples. About 25-85% of the total phages encountered with the raw sewage were retained in the treated effluents. Seasonal variations of Pseudomonas spp and P. aeruginosa phages in two treatment stations are reported.

Preliminary studies on some coliphages from Kuwait.

Seasonal data for raw sewage indicated a higher concentration of bacteriophages in the warmer months compared with the cooler months. Regardless of the amount of phages in the raw sewage and the time of year the efficiency of removal was as high as 83-96% for effluent II and 93-98% for sludge II. Four major types of plaque sizes were identified as Q1, Q2, Q3 and Q4. Although all isolates contained DNA, they showed variation in host range and heat sensitivity from 50 degrees C to 80 degrees C.

Studies on the mechanism of callus cartilage differentiation and calcification during fracture healing.

The morphologic and biochemical events during fracture callus cartilage differentiation and calcification are presented. 1. Histologic studies have demonstrated that unimmobilized fractures heal through endochondral ossification. 2. Biochemical studies have demonstrated an increase in the activities of alkaline phosphatase, enzymes involved with aerobic glucose metabolism, and lysosomal enzymes and a decrease in activities of enzymes involved with glycogen synthesis and anaerobic glycolysis. Hexosamines and hydroxyproline show a net decrease with cartilage differentiation. 3. Electron microscopic studies have demonstrated the intracellular origin and aggregation of collagen molecules, the cellular origin of matrix vesicles, and the early sites of calcification in the fracture callus.

The ultrastructural cytology and chemical composition of fracture callus cartilage.

The differentiation and calcification of fracture callus cartilage studied by light microscopy resembles that of the epiphyseal plate cartilage. In this study, a correlation between the ultrastructural cytology and the chemical composition of the various cartilage types found in fracture callus was attempted. Fibrocartilage cells were very active with profuse secretion of collagen into the matrix. Collagen fibres were observed in close proximity to the cell membrane. Cells from hypertrophic and calcifying cartilage showed progressive degeneration while their mitochondria contain dense osmiophilic granules. Mitochondria granules were occasionally seen in fibrocartilage cells. The intercellular matrix of hypertrophic and calcifying cartilage showed needle-shaped crystals quite often arranged as a cluster in a radiated pattern. Chemical analyses of the various types of cartilage found in fracture callus demonstrated the presence of a high molecular weight bound phosphate and an increase of sialic acid in the differentiated types of cartilage.