Study on the clinical application of pulsed DC magnetic technology for tracking of intraoperative head motion during frameless stereotaxy

BACKGROUND: Tracking of post-registration head motion is one of the major problems in frameless stereotaxy. Various attempts in detecting and compensating for this phenomenon rely on a fixed reference device rigidly attached to the patient's head. However, most of such reference tools are either based on an invasive fixation technique or have physical limitations which allow mobility of the head only in a restricted range of motion after completion of the registration procedure. METHODS: A new sensor-based reference tool, the so-called Dynamic Reference Frame (DRF) which is designed to allow an unrestricted, 360° range of motion for the intraoperative use in pulsed DC magnetic navigation was tested in 40 patients. Different methods of non-invasive attachment dependent on the clinical need and type of procedure, as well as the resulting accuracies in the clinical application have been analyzed. RESULTS: Apart from conventional, completely rigid immobilization of the head (type A), four additional modes of head fixation and attachment of the DRF were distinguished on clinical grounds: type B1 = pin fixation plus oral DRF attachment; type B2 = pin fixation plus retroauricular DRF attachment; type C1 = free head positioning with oral DRF; and type C2 = free head positioning with retroauricular DRF. Mean fiducial registration errors (FRE) were as follows: type A interventions = 1.51 mm, B1 = 1.56 mm, B2 = 1.54 mm, C1 = 1.73 mm, and C2 = 1.75 mm. The mean position errors determined at the end of the intervention as a measure of application accuracy were: 1.45 mm in type A interventions, 1.26 mm in type B1, 1.44 mm in type B2, 1.86 mm in type C1, and 1.68 mm in type C2. CONCLUSION: Rigid head immobilization guarantees most reliable accuracy in various types of frameless stereotaxy. The use of an additional DRF, however, increases the application scope of frameless stereotaxy to include e.g. procedures in which rigid pin fixation of the cranium is not required or desired. Thus, continuous tracking of head motion allows highly flexible variation of the surgical strategy including intraoperative repositioning of the patient without impairment of navigational accuracy as it ensures automatic correction of spatial distortion. With a dental cast for oral attachment and the alternative option of non-invasive retroauricular attachment, flexibility in the clinical use of the DRF is ensured

Is there a role for the quantification of RRM1 and ERCC1 expression in pancreatic ductal adenocarcinoma?

<p>Abstract</p> <p>Background</p> <p>RRM1 and ERCC1 overexpression has been extensively investigated as potential predictive markers of tumor sensitivity to conventional chemotherapy agents, most thoroughly in lung cancer. However, data in pancreatic cancer are scarce.</p> <p>Methods</p> <p>We investigated the mRNA and protein expression of ERCC1 and RRM1 by RT-PCR and immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded pancreatic ductal carcinoma (PDA) tissues. The primary outcome investigated was the association between RRM1 and ERCC1 expression and overall survival (OS) or disease-free survival (DFS).</p> <p>Results</p> <p>A total of 94 patients with resected PDA were included in this study. Most of them (87%) received gemcitabine based chemotherapy. Data for OS analysis was available in all cases but only 68% had enough information to estimate DFS. IHC analysis revealed information for 99% (93/94) and 100% of the cases for RRM1 and ERCC1 expression respectively. However, PCR data interpretation was possible in only 49 (52%) and 79 (84%) cases respectively. There was no significant association between high or low expression of either RRM1 or ERCC1, detected by IHC and OS (14.4 vs. 19.9 months; <it>P </it>= 0.5 and 17.1 vs. 19.9; <it>P </it>= 0.83 respectively) or PCR and OS (48.0 vs. 24.1 months; <it>P </it>= 0.21 and 22.0 vs. 16.0 months; <it>P </it>= 0.39 respectively). Similar results were obtained for DFS.</p> <p>Conclusions</p> <p>RRM1 and ERCC1 expression does not seem to have a clear predictive or prognostic value in pancreatic cancer. Our data raise some questions regarding the real clinical and practical significance of analyzing these molecules as predictors of outcomes.</p

[PSI+] Maintenance Is Dependent on the Composition, Not Primary Sequence, of the Oligopeptide Repeat Domain

[PSI+], the prion form of the yeast Sup35 protein, results from the structural conversion of Sup35 from a soluble form into an infectious amyloid form. The infectivity of prions is thought to result from chaperone-dependent fiber cleavage that breaks large prion fibers into smaller, inheritable propagons. Like the mammalian prion protein PrP, Sup35 contains an oligopeptide repeat domain. Deletion analysis indicates that the oligopeptide repeat domain is critical for [PSI+] propagation, while a distinct region of the prion domain is responsible for prion nucleation. The PrP oligopeptide repeat domain can substitute for the Sup35 oligopeptide repeat domain in supporting [PSI+] propagation, suggesting a common role for repeats in supporting prion maintenance. However, randomizing the order of the amino acids in the Sup35 prion domain does not block prion formation or propagation, suggesting that amino acid composition is the primary determinant of Sup35's prion propensity. Thus, it is unclear what role the oligopeptide repeats play in [PSI+] propagation: the repeats could simply act as a non-specific spacer separating the prion nucleation domain from the rest of the protein; the repeats could contain specific compositional elements that promote prion propagation; or the repeats, while not essential for prion propagation, might explain some unique features of [PSI+]. Here, we test these three hypotheses and show that the ability of the Sup35 and PrP repeats to support [PSI+] propagation stems from their amino acid composition, not their primary sequences. Furthermore, we demonstrate that compositional requirements for the repeat domain are distinct from those of the nucleation domain, indicating that prion nucleation and propagation are driven by distinct compositional features

Problems in health management of professional boxers in Japan

Objective: To investigate whether the incidence of boxing accidents is higher in Japan than in other countries. Method: A nationwide survey of boxers was conducted. Results: A total of 632 boxers responded. Most Japanese boxers were relatively mature when they started boxing (mean starting age of 19.2 years). A high percentage of boxers was found three weight divisions higher than previously reported. Many boxers stated that losing weight was not a big problem. It was found that a punch that turns the head can cause serious physical damage, and it was clarified that only a simple punch, rather than accumulated damage from multiple punches, can cause cerebral concussion. Severe shock causing retrograde amnesia is very rare after a fight and disappears relatively quickly. Many additional symptoms are related to damage to the hearing organs, such as hearing difficulties, tinnitus, and vertigo, but these symptoms also resolve quickly. Many boxers experience memory disturbance, not just after a fight but in daily life. Conclusion: The approach to boxing has become more oriented towards the method of practice and scientific training, rather than psychological factors, which used to be emphasised