The influence of tumor topography on the surgical outcome of craniopharyngiomas.

OBJECTIVE: Various topographical classifications for craniopharyngioma have been proposed based on their relationship with optic chiasm and the third ventricular floor. There is a paucity of literature evaluating the surgical outcome based on tumor topography. This study aims to compare the surgical outcomes of retrochiasmatic craniopharyngiomas (RCPs) and nonretrochiasmatic craniopharyngiomas (non-RCPs). METHODS: This retrospective study includes newly diagnosed patients with craniopharyngioma who underwent surgery between January 2000 and December 2015. Clinical features, the extent of resection (EOR), surgical outcomes, tumor recurrence, and progression-free survival (PFS) of craniopharyngiomas were compared with respect to their relationship to the optic chiasm and third ventricular floor. RESULTS: The authors identified RCPs in 104 and non-RCPs in 33 patients. RCPs were significantly larger and more associated with hydrocephalus than were non-RCPs (p < 0.001) at the time of diagnosis. Puget grade 2 hypothalamic involvement was more frequent with RCPs. EOR and PFS following either subtotal resection (p = 0.07) or gross-total resection (p = 0.7) were comparable between RCPs and non-RCPs. There was no significant difference in the postoperative visual outcome. Resection of RCPs resulted in higher postoperative hypopituitarism (64% vs 42%, p = 0.01) and hypothalamic dysfunction (18% vs 3%, p = 0.02). Location of the tumor, either retrochiasmatic (HR 0.5; 95% CI 0.14-2.2; p = 0.4) or nonretrochiasmatic (HR 1.3; 95% CI 0.3-5.5; p = 0.6), did not show association with recurrence. RCPs with extra- and intraventricular components (type 3b) had a higher incidence of postoperative hypothalamic morbidities (p = 0.01) and tumor recurrence (36% vs 19%; p = 0.05) during follow-up than the extraventricular (type 3a) RCP. Between prechiasmatic and infrachiasmatic/intrasellar craniopharyngiomas, EOR (p = 0.7), postoperative diabetes insipidus (p = 0.4), endocrinological outcome (p = 0.7), and recurrence (p = 0.1) were comparable. The patients with complex multicompartmental tumors had a lower rate of gross-total resection (25%, p = 0.02) and a higher incidence of tumor recurrence (75%, p = 0.004) than the rest. CONCLUSIONS: The tumor topography can influence the postoperative outcome. RCPs can be associated with a higher incidence of hypopituitarism and hypothalamic morbidities postoperatively. The influence of topography on EOR and tumor recurrence is controversial. However, this study did not find a significant difference in EOR and tumor recurrence between RCPs and non-RCPs. PFS and overall mortality are also comparable.

Analysis of Prognostic Factors, Extent of Resection, and Long-Term Outcome of Craniopharyngioma in Adults and Children.

Introduction: Surgical management of craniopharyngioma is debatable and still lacks clear guidelines. Long-term complications are attributed to radical resection of the tumor. Extent of resection may not be the only factor which determines the functional outcome, because studies have reported hypothalamic and visual morbidities even with conservative resection. In this article, we analyze the extent of resection, long-term outcome, and various prognostic factors in adults and children. Materials and Methods: Newly diagnosed cases of craniopharyngioma operated between 2001 and 2013 were reviewed retrospectively. PFS and OS were calculated. Predictors of various outcome parameters were analyzed. Results: Of 140 patients, 41% were children and 59% were adults. Postoperatively, vision has improved in 63% and worsened in 12%. GTR was achieved in 66%. The median follow-up was 67 months. PFS at 5 and 10 years was 95% and 41.5%, respectively. OS at 5 and 10 years was 92.6% and 89.5%, respectively. Symptoms of raised ICP and hypothalamic involvement, extensive calcifications, tumor size >5 cm, and multi-compartmental tumors were associated with presence of residual tumor. Regression analysis showed symptoms of hypothalamic involvement, size of the tumor > 5 cm, and hydrocephalus predicted postoperative hypothalamic morbidities. No significant difference was found in postoperative visual, endocrinological, hypothalamic, and functional outcomes between GTR and STR. Conclusion: Conservative resection should be carried out in patients with preoperative hypothalamic symptoms and imaging evidence of extensive hypothalamic involvement. Size of the tumor and invasiveness are the other factors should be considered before radical excision of craniopharyngiomas.

Disposition Kinetics of Amitraz in Lactating Does.

Amitraz, a member of the formamidine pesticide family, commonly used for ectoparasite control, is applied as a dip or low-pressure hand spray to cattle and swine, and the neck collar on dogs. Data on amitraz were generated mainly on laboratory animals, hens, dogs, and baboons. The data on the toxicity and disposition of amitraz in animals and its residues in the milk are inadequate. Therefore, the present study was intended to analyze the disposition kinetics of amitraz and its pattern of elimination in the milk of lactating does after a single dermal application at a concentration of 0.25%. Blood at predetermined time intervals and milk twice daily were collected for eight days post application. The drug concentration was assayed by high-performance liquid chromatography (HPLC). Amitraz was detected in whole blood as early as 0.5 h, which attained a peak concentration at 12 ± 5 h, followed by a steady decline; however, detection persisted until 168 h. Amitraz was present in the blood at its 50% Cmax even after 48 h, and was still detectable after 7 days. The disposition after a single dermal application was best described non-compartmentally. The mean terminal half-life (t1/2), mean residence time (MRT), and area under the curve (AUC0-t) were 111 ± 31 h, 168 ± 39 h, and 539 ± 211 µg/mL/h, respectively. The apparent volume of distribution (Vdarea) was 92 ± 36 mL/g with an observed clearance (Cl) of 0.57 ± 0.33 mL/kg/h. Thus, the drug was well absorbed, widely distributed and slowly eliminated from the animal body. Amitraz achieved milk concentration approximating 0.2 per cent of the total dose after a single exposure and the steady-state elimination of amitraz in milk above the recommended maximum residue limit (MRL) of 0.01 mg/kg can act as a source of public health concern when applied on lactating animals.

Modulation of the PGE2-Mediated Pathway in the Eclosion Blocking Effect of Flumethrin and Terpenoid Subfraction Isolated from Artemesia nilagirica in Rhipicephalus annulatus.

Prostaglandins are a group of important cell-signaling molecules involved in the regulation of ovarian maturation, oocyte development, egg laying and associated behaviors in invertebrates. However, the presence of prostaglandin E2 (PGE2), the key enzymes for PGE2 biosynthesis and its interference by drugs were not investigated previously in the ovary of ticks. The present study was undertaken to assess the modulation of the PGE2-mediated pathway in the eclosion blocking effect of flumethrin and terpenoid subfraction isolated from Artemisia nilagirica in Rhipicephalus annulatus ticks. The acaricidal activities and chemical profiling of the terpenoid subfraction were performed. The localization of the cyclooxygenase1 (COX1) and prostaglandin E synthase (PGES) enzymes and the quantification of PGE2 in the ovaries of the ticks treated with methanol (control), flumethrin and terpenoid subfraction were also undertaken. In addition, the vitellogenin concentration in hemolymph was also assayed. Both flumethrin and the terpenoid subfraction of A. nilagirica elicited a concentration-dependent inhibition of fecundity and blocking of hatching of the eggs. The COX1 could not be detected in the ovaries of treated and control ticks, while there was no significant difference observed in the concentration of vitellogenin (Vg) in them. The presence of PGES in the oocytes of control ticks was confirmed while the immunoreactivities against PGES were absent in the vitellogenic oocytes of ticks treated with flumethrin and terpenoid subfraction. The levels of PGE2 were below the detection limit in the ovaries of the flumethrin-treated ticks, while it was significantly lower in the ovaries of the terpenoid subfraction-treated ticks. Hence, the prostaglandin E synthase and PGE2 were identified as very important mediators for the signaling pathway for ovarian maturation and oviposition in ticks. In addition, the key enzyme for prostaglandin biosynthesis, PGES and the receptors for PGE2 can be exploited as potential drug targets for tick control. The detection of PGES by immunohistochemistry and quantification of PGE2 by LC-MSMS can be employed as valuable tools for screening newer compounds for their eclosion blocking acaricidal effects.

Acaricidal Activity of Artemisia nilagirica Leaves Against Rhipicephalus (Boophilus) annulatus Ticks.

Since time immemorial, human beings have used various parts of plants in either prevention or treatment of ailments. Plants are rich sources of secondary metabolites such as alkaloids, steroids, terpenoids, flavonoids, and phenolic compounds with a high structural diversity. Many plants/herbs with specific biological activities such as antitumor, antioxidant, anti-inflammatory, antifungal, sedative, and acaricidal activity have been reported. Artemisia nilagirica (C. B. Clarke) Pamp. (Compositae) is a plant traditionally used for insect control in the southern part of India. Previous studies have demonstrated the activity of Artemisia species against pests. The present study thus evaluates the acaricidal activity of crude ethanolic extract of A. nilagirica leaves and its fractions against Rhipicephalus (Boophilus) annulatus. Ticks are ectoparasites that transmit several protozoal, viral, and rickettsial diseases. In south India, R. (B.) annulatus is the commonly observed tick species. Control of these acarine parasites that adversely affect milk and meat production is a tough task. Chemical acaricides such as organophosphates, synthetic pyrethroids, amitraz, and ivermectin are commonly used in tick control. The high cost, environmental hazards, and development of acaricidal resistance are some of the drawbacks of these chemical acaricides. Plant-based formulations are one of the promising approaches for the control of ectoparasites. Previously, extracts from various medicinal/aromatic plants were reported for acaricidal activity from our laboratory, such as Tetrastigma leucostaphylum (Dennst.) Alston, Chassalia curviflora (Wall.) Thwaites, Jatropha curcas L., and Ageratum conyzoides Hieron. Biochemical quantification, fluorescence analysis, and primary phytochemical analysis are already reported for the ethanolic extract and its fractions of areal parts of A. nilagirica. Phytochemical characterization of ethanolic extract of A. nilagirica from Kerala, India was shown to have the presence of terpenoids, flavonoids, steroids, saponins, fixed oils and fats, tannins, and glycosides.

The implication of giant tumor size on surgical resection, oncological, and functional outcomes in craniopharyngioma.

OBJECTIVE: Implication of the tumor size on oncological and functional outcomes of craniopharyngioma is inconsistently reported. The aim of this study is to assess the postoperative outcome of giant craniopharyngiomas (> 4 cm in diameter) and to elucidate the impact of tumor size on various outcome parameters and survival. MATERIAL AND METHODS: Forty-four patients (children aged ≤ 18 years: 25; adults: 16) with giant craniopharyngioma, operated between January 2001 and December 2015, were included in this study. Various outcomes, progression-free survival (PFS) and overall survival (OS) were calculated. RESULTS: Gross total resection (GTR) was achieved in 17 (39%) and subtotal resection (STR) in 27 (61%) patients. Eleven patients (25%) received radiotherapy (RT) after STR. Postoperatively, new cranial nerve and motor deficits were noted in 12 (27%) and 9 (20%) patients, respectively. Tumor recurrence following GTR and STR without adjuvant RT was diagnosed in 3 (17%), and 5 (38%) patients, respectively. Following STR with RT, one (9%) experienced recurrence. PFS at 5-, and 10- year following GTR, STR, and STR + RT was 80.8%, 45.4%, and 90%, respectively. At 5- and 10- year, OS was 86.5%, 77.9% and 100% following GTR, STR, and STR + RT, respectively. The rate of GTR was significantly lower in patients with giant tumors (39% vs. 62%; Chi-square test, p value 0.008). Postoperatively, neurological deficit (20%), hypopituitarism (95%) and hypothalamic dysfunction (26%) were significantly higher for giant craniopharyngiomas. Hazards of recurrence were not significant between giant and non-giant tumors (hazard ratio 1.86; 95% CI 0.94-3.68; p 0.07). There was no significant difference in OS between the patients with giant and non-giant tumors (log-rank test 2.1; p value 0.14). CONCLUSION: Tumor size should be considered as an important predictor of the postoperative functional outcome. Although the rate of GTR is less than that of small tumors, the recurrence rate, progression-free survival, and overall survival of the patients with giant tumor are comparable to non-giant tumors.

Adult craniopharyngioma: The role of extent of resection in tumor recurrence and long-term functional outcome.

OBJECTIVE: The optimal therapeutic approach to craniopharyngioma has not been established conclusively. The surgical outcome following radical excision and conservative resection with adjuvant radiotherapy are comparable or even better with the later in pediatric or mixed populations. This study is aimed at reviewing the role of extent of resection in local tumor control and long-term outcome in adults with craniopharyngioma. PATIENTS AND METHODS: Ninety-five adults operated between 2001 and 2013 were included. Progression-free survival (PFS) and overall survival (OS) were calculated. Predictors of various outcome parameters were analyzed. RESULTS: The predominant presenting symptom was visual impairment (78 %) followed by symptoms of hypothalamic involvement (29 %). Total and subtotal excisions (TE, STE) were achieved in 63 %, and 47 % of patients, respectively. Vision improved in 62 % of patients in the early postoperative period. Thirteen patients (14 %) experienced vision deterioration postoperatively. On multivariate analysis, tumor >3 cm and optic atrophy predicted poor visual outcome. Hormonal replacement for hypopituitarism was required in 83 % during follow-up. Diabetes insipidus was seen in 73 %. Imaging evidence of 3rd ventricular floor destruction by tumor emerged as an independent predictor of postoperative hypothalamic morbidities. The recurrence rate following TE and STE was 11.6 % and 72 %, respectively. Unlike radical excision, PFS following STE was significantly shorter (p- 0.02). TE was not associated with increased visual impairment or hypothalamic-pituitary dysfunction postoperatively as compared to STE. Most of the patients (85 %) were independent and able to return to the premorbid occupation. CONCLUSION: Subtotal resection provides equally good long-term visual, endocrinological, and hypothalamic outcomes as radical surgery. When used with adjuvant radiotherapy, it also gives a better local control of the tumor. Hence, subtotal resection with adjuvant radiotherapy should be considered as an effective alternative strategy to radical excision.

Long-term outcome and prognostic factors of intramedullary spinal hemangioblastomas.

Spinal hemangioblastomas constitute 1.6-5.8% of all spinal cord tumors. Microsurgical excision of these tumors is challenging. The purpose of this study is to analyze the neurological improvement and long-term functional outcome of spinal hemangioblastomas. This retrospective study included 15 patients who underwent surgery for intramedullary spinal hemangioblastoma at the Department of Neurosurgery of Sri Chitra Tirunal Institute for Medical Sciences and Technology from January 2001 to June 2014. Eight patients (53%) were diagnosed to have von Hippel-Lindau (vHL) disease. Eight (53%) of them were females, and seven were males (47%). Mean age was 33.8 years (16-55 years). Duration of illness ranged from 2 weeks to 4 years, and average duration was 10.5 months. Most common symptom was motor weakness followed by sensory disturbances, pain, and bladder incontinence. Six (85.7%) sporadic spinal hemangioblastomas were in McCormick grade I; whereas, 7 (87.5%) of vHL spinal hemangioblastomas were in grade II or above. In the immediate postoperative period, three patients noticed improvement in their motor weakness. Six patients (40%) experienced deterioration of preoperative neurological status in the immediate postoperative period. Three of them were sporadic tumors, and others had vHL syndrome. Favorable long-term outcome was achieved in 80% of cases. Though neurological deterioration is common after surgical resection of spinal hemangioblastomas, majority of them are reversible. Long-term functional outcome is favorable with minimal postoperative morbidities. Both sporadic- and vHL-associated tumors share common clinical and radiological features, and neurological outcome is equally good in both.

Long-Term Effects of Kratom (Mitragyna speciosa) Use

@#Introduction: Kratom or (Mitragyna speciosa) leaves are consumed as a folk remedy and opioid substitute in the Southeast Asian region. There is still a lack of information about the long-term or toxic-causing effects of kratom use. Methods: A total of thirteen regular kratom users, with long-term (>20 twenty years) kratom use history were recruited for this cross-sectional pilot study. Respondents were required to undergo a blood-test and laboratory anaysis was conducted to determine the mitragynine content in an acquired street sample of kratom. Results: The regular, longterm consumption of brewed kratom decoction did not cause any significant alterations in haematological, kidney, liver, thyroid, inflammatory and gastrointestinal analytes in a cohort of kratom users who had no history of substance misuse. However, those who had a higher intake (>3 glasses per day) of kratom exhibited higher lipid values (except for HDL-cholesterol), and a moderate elevation of homocysteine level. Conclusion: Long-term (>20 years with a daily intake of ≥87.54mg of mitragynine) kratom consumption was not associated with altered biochemical levels, although prolonged and heavy use (>3 glasses daily) may result in cardiovascular risks. The latter finding, however, requires further investigation.

Ticks and accompanying pathogens of domestic and wild animals of Kerala, South India.

The objective of the present study was to detect the chosen nucleotide DNA or RNA sequences of the pathogens in ticks of domestic and wild animals of Kerala, South India based on molecular techniques. Among 602 ticks collected, 413 were from bovines (cattle and buffalo), 26 from goats, 101 from dogs and 62 from wild animals. Amblyomma integrum, Am. gervaisi, Dermacentor auratus, Haemaphysalis bispinosa, Ha. intermedia, Ha. shimoga, Ha. spinigera, Rhipicephalus annulatus, Rh. microplus, Rh. haemaphysaloides and Rh. sanguineus s.l. were identified from various domestic and wild animals of Kerala. The cDNA synthesized from the RNA isolated from fully or partially engorged adult female/nymphal ticks was used as template for the specific polymerase chain reactions (PCR). Out of 602 ticks examined, nucleotide sequences of pathogens were detected in 28 ticks (4.65%). The nucleotide sequences of tick-borne pathogens like Theileria orientalis, Babesia vogeli, Hepatozoon canis, Anaplasma marginale, An. bovis, Rickettsia sp. closely related to Ri. raoultii, Ri. massiliae, Ri. africae and Ri. slovaca were detected. The identification of the previously unreported nucleotide sequences of rickettsial pathogens from India is of particular interest due to their zoonotic significance. The phylogenetic analysis of the major piroplasm surface protein (MPSP) gene of T. orientalis amplified from Rh. annulatus ticks revealed that they were genetically close to type 7, which belong to the highly pathogenic Ikeda group.

Socio-demographic Characteristics, Kratom Use and Quality of Life (QoL) of Regular Kratom (Mitragyna speciosa Korth.) Users

Abstract@#Introduction: Kratom which is a tropical plant use as traditional remedy in rural areas of Malaysia and Thailand has recently been a research focus worldwide due to its potential as substitution therapy for opioid addiction. However, data on its effect on the quality of life of kratom users is scarce. This study aimed to describe the socio-demographic and history of kratom use as well as assessing the quality of life and its associated factors in Malaysian kratom users. Methods: This cross-sectional survey recruited 150 kratom users and they were administered with socio-demographic and substance history questionnaires, the World Health Organization Quality of Life- BREF (WHOQOL-BREF) to assess quality of life and the Kratom Dependence Scale (KDS) to assess severity of kratom dependence. Results: Respondents were all males with mean age of 34.4 years old (SD= 11.2). Sixty-percent of respondents use kratom > 6 years (mean duration = 8.5 years, SD= 5.3) while 55% (n=83/150) used >3 glasses of kratom daily. Duration of kratom use, quantity of kratom use and severity of kratom dependence were not associated with all the domains of quality of life except severe kratom dependence users had significant lower physical quality of life score when compared to that of users with mild to moderately severe kratom dependence. Conclusion: Based on our study, kratom consumption does not cause impairment in quality of life of kratom users except for severe kratom dependence which may cause deterioration in physical well-being of users.

Medical student's perception to different types of set induction in anatomy lectures / 대한해부학회지

Set induction refers to the process of using a thought-provoking statement, interesting fact, or an audio-visual stimulus at the beginning of lecture to gain student's attention and give an overview about the lecture topic. In the present study, students were introduced to three types of set induction namely narratives, food-based analogies and humor-based images or activities at the beginning of anatomy lecture and their response to it is collected and analyzed. The objective of the study is to estimate the difference in a questionnaire-based perception score between the three different types of set induction; estimate sex differences in the questionnaire-based perception score. Students rated the validated, 7-item perception questionnaire using a 5-point Likert scale. Students felt that food-based analogies and humor-based images were more interesting, motivated them to participate in lecture-discussion than the narrative set induction. The familiarity of set induction varied between all the three different types of set induction. There was no significant difference in the perception of different types of set induction between male and female undergraduate students. Based on the student's feedback, it could also serve as a memory aid and ease the students learning experience. Majority of students responded positively to the use of set induction and recommended for its use in future classes.

In vitro efficacy of amitraz, coumaphos, deltamethrin and lindane against engorged female Rhipicephalus (Boophilus) annulatus and Haemaphysalis bispinosa ticks.

The present study compares the in vitro efficacy of four chemical acaricides, viz. amitraz, coumaphos, deltamethrin and lindane, against Rhipicephalus (Boophilus) annulatus and Haemaphysalis bispinosa ticks based on adult immersion tests. Amitraz, at 350 ppm, elicited 29.2 ± 4.17% mortality against R. (B.) annulatus, 100% inhibition of fecundity and absence of hatching of eggs laid by treated ticks. The same compound at 300 ppm caused 62.5 ± 12.5% mortality against H. bispinosa, 96.7% inhibition of fecundity and complete blocking of eclosion. The LC50 value of amitraz against susceptible H. bispinosa was 181 ppm. Deltamethrin at 400 ppm, elicited 25.0 ± 4.81% adult R. (B.) annulatus mortality, 97.5% inhibition of fecundity and absence of egg hatching. Complete blocking of egg hatching was observed even at 30 ppm. However, deltamethrin (at 50 ppm) elicited 75.0 ± 10.76% mortality against H. bispinosa, 65.8% inhibition of fecundity and very low egg hatching (10%). The LC50 for deltamethrin against susceptible H. bispinosa was 33.8 ppm. Coumaphos at 50 ppm, caused mortality of 70.8 ± 4.17% with R. (B.) annulatus whereas 100% mortality was observed against H. bispinosa. The LC50 values of coumaphos against R. (B.) annulatus and H. bispinosa were 9 and 8.75 ppm, respectively. Complete inhibition (100%) of fecundity was observed even at 30 ppm against both parasites. Complete blocking of egg hatching was also observed even at 10 ppm of coumaphos. Lindane at 1000 ppm caused mortality of 87.5 ± 7.98% against R. (B.) annulatus and 83.3% mortality against H. bispinosa at 100 ppm. The LC50 values of lindane against R. (B.) annulatus and H. bispinosa were 157 and 8.61 ppm, respectively. Complete inhibition of fecundity was observed with R. (B.) annulatus treated with lindane above 200 ppm and with H. bispinosa at a concentration above 50 ppm. Complete blocking of egg hatching was observed in R. (B.) annulatus, even at 100 ppm. Lindane caused 100% blocking of egg hatching at 1 ppm in the case of H. bispinosa.

The influence of learning style in understanding analogies and 2D animations in embryology course / 대한해부학회지

Undergraduate students struggle to comprehend embryology because of its dynamic nature. Studies have recommended using a combination of teaching methods to match the student's learning style. But there has been no study to describe the effect of such teaching strategy over the different types of learners. In the present study, an attempt has been made to teach embryology using the combination of analogies and simple 2D animations made with Microsoft powerpoint software. The objective of the study is to estimate the difference in academic improvement and perception scale between the different types of learners after introducing analogies and 2D animation in a lecture environment. Based on Visual, Aural, Read/Write, and Kinesthetic (VARK) scoring system the learners were grouped into unimodal and multimodal learners. There was significant improvement in post-test score among the unimodal (P < 0.001) and multimodal learners (P < 0.001). When the post-test score was compared between the two groups, the multimodal learners performed better the unimodal learners (P=0.018). But there was no difference in the perception of animations and analogies and long-term assessment between the groups. The multimodal learners performed better than unimodal learners in short term recollection, but in long term retention of knowledge the varied learning style didn't influence its outcome.

Microsurgical Treatment of Sporadic and von Hippel-Lindau Disease Associated Spinal Hemangioblastomas: A Single-Institution Experience.

STUDY DESIGN: Retrospective cohort study. PURPOSE: To examine the clinical profile and surgical complications in patients with spinal hemangioblastomas and to evaluate the long-term outcome in them. OVERVIEW OF LITERATURE: Although considered to be histologically benign, hemangioblastomas may cause significant neurological deficits. The proportion of spinal hemangioblastomas associated with von Hippel-Lindau (VHL) disease has been estimated be 13%-59%. Preoperative neurological function correlates with postoperative neurological status. Studies have shown no difference in outcomes between sporadic and VHL-associated spinal hemangioblastomas. METHODS: This retrospective study included 14 consecutive patients treated for spinal hemangioblastomas at our institute between January 2000 and June 2013. The mean follow-up period was 5 years. Magnetic resonance imaging of the complete neuraxis was performed in all cases, and preoperative embolization was performed in two cases. RESULTS: In total, 14 patients underwent 18 surgeries, of which 15 were for spinal hemangioblastomas. Of all the patients, 86% had motor weakness and 79% presented with sensory disturbances. Preoperative McCormick functional grades were grade I in 7 (50%), grade II in 3 (21%), and grade III in 4 (29%) patients; 50% patients were diagnosed with VHL disease. All patients underwent complete resection of the tumor. Eight patients experienced deterioration in their neurological status in the immediate postoperative period; among them, five had gradual improvement. At 5-year follow-up, 11 (78.57%) patients showed good functional outcomes. CONCLUSIONS: Microsurgical excision of spinal hemangioblastomas can cause postoperative morbidity, mainly in the form of neurological deterioration. Almost half of our patients had deterioration in the McCormick grade in the immediate postoperative period. However, a complete microsurgical excision can result in good long-term functional outcomes, as most of the immediate postoperative neurological deterioration in our patients was reversible. There was no difference in the long-term functional outcomes between sporadic and VHL-associated spinal hemangioblastomas.

In vitro effects of caffeic acid, nortriptyline, precocene I and quercetin against Rhipicephalus annulatus (Acari: Ixodidae).

In the present study, the acaricidal effects of caffeic acid, nortriptyline, precocene I and quercetin against Rhipicephalus annulatus (syn. Boophilus annulatus) Say (Acari: Ixodidae) were evaluated. Adult immersion technique (24 ticks immersed for 2 min in one dilution of the compound) was used for the assessment of the effects of caffeic acid (0.39-100 mg/mL), nortriptyline (0.625-50 mg/L), precocene I (0.004488-5 mg/mL) and quercetin (6.25-100 mg/mL) against R. annulatus. Adult tick mortality, reproductive index, inhibition of fecundity and hatching were calculated. Caffeic acid, nortriptyline, precocene I and quercetin revealed very low adult mortality and inhibition of fecundity, even at the highest concentration tested. Quercetin (>50 mg/mL) caused blocking of hatching of eggs.

Microsurgical Treatment of Sporadic and von Hippel-Lindau Disease Associated Spinal Hemangioblastomas: A Single-Institution Experience

STUDY DESIGN: Retrospective cohort study. PURPOSE: To examine the clinical profile and surgical complications in patients with spinal hemangioblastomas and to evaluate the long-term outcome in them. OVERVIEW OF LITERATURE: Although considered to be histologically benign, hemangioblastomas may cause significant neurological deficits. The proportion of spinal hemangioblastomas associated with von Hippel–Lindau (VHL) disease has been estimated be 13%–59%. Preoperative neurological function correlates with postoperative neurological status. Studies have shown no difference in outcomes between sporadic and VHL-associated spinal hemangioblastomas. METHODS: This retrospective study included 14 consecutive patients treated for spinal hemangioblastomas at our institute between January 2000 and June 2013. The mean follow-up period was 5 years. Magnetic resonance imaging of the complete neuraxis was performed in all cases, and preoperative embolization was performed in two cases. RESULTS: In total, 14 patients underwent 18 surgeries, of which 15 were for spinal hemangioblastomas. Of all the patients, 86% had motor weakness and 79% presented with sensory disturbances. Preoperative McCormick functional grades were grade I in 7 (50%), grade II in 3 (21%), and grade III in 4 (29%) patients; 50% patients were diagnosed with VHL disease. All patients underwent complete resection of the tumor. Eight patients experienced deterioration in their neurological status in the immediate postoperative period; among them, five had gradual improvement. At 5-year follow-up, 11 (78.57%) patients showed good functional outcomes. CONCLUSIONS: Microsurgical excision of spinal hemangioblastomas can cause postoperative morbidity, mainly in the form of neurological deterioration. Almost half of our patients had deterioration in the McCormick grade in the immediate postoperative period. However, a complete microsurgical excision can result in good long-term functional outcomes, as most of the immediate postoperative neurological deterioration in our patients was reversible. There was no difference in the long-term functional outcomes between sporadic and VHL-associated spinal hemangioblastomas.

Comparison of in vitro acaricidal effects of commercial preparations of cypermethrin and fenvalerate against Rhipicephalus (Boophilus) annulatus.

Commercially available preparations of cypermethrin (Clinar and Ectomin) and fenvalerate (Flytik and Ticomax, 20% E.C) were compared for their acaricidal activity against Rhipicephalus (Boophilus) annulatus using adult immersion test. Adult tick mortality was higher with Ectomin compared to Clinar. Complete eclosion blocking was observed at all the tested concentrations with Ectomin while it was observed only at the highest concentration tested for Clinar. Compared to Flytik, adult tick mortality was higher with Ticomax at the tested concentrations. Complete blocking of hatching of laid ova was observed with Flytik at the highest concentration tested. At the manufacture recommended dosage of 200 ppm Ectomin elicited 93.37 per cent inhibition of fecundity, while it was 91.7 per cent for Clinar. For fenvalerate, the recommended concentration was 1200 ppm at which Ticomax showed 86 per cent and Flytik produced 80.05 per cent inhibition of fecundity respectively.

Determination of LC50 and LC95 values of fipronil against Haemaphysalis bispinosa based on adult immersion test.

The pattern of mortality of Haemaphysalis bispinosa ticks against fipronil was studied based on adult immersion test. Mortality occurred during 10-19 days post-treatment. The LC50 and LC95 values were calculated as 0.53 and 7.045 ppm, respectively.

Acaricidal activity of Cassia alata against Rhipicephalus (Boophilus) annulatus.

Using adult immersion test, the acaricidal activity of ethanolic extracts of leaves of Cassia alata L. was studied against Rhipicephalus (Boophilus) annulatus. The efficacy was assessed by measuring per cent adult mortality, inhibition of fecundity and hatching rate. The ethanolic extract of C. alata produced a concentration dependant increase in the adult tick mortality. The highest mortality (45.8%) and inhibition of fecundity (10.9%) were observed at the highest concentration tested (100 mg/ml). The plant extract did not affect egg hatchability.