Synchrotron X-ray microtransections: a non invasive approach for epileptic seizures arising from eloquent cortical areas.

Synchrotron-generated X-ray (SRX) microbeams deposit high radiation doses to submillimetric targets whilst minimizing irradiation of neighboring healthy tissue. We developed a new radiosurgical method which demonstrably transects cortical brain tissue without affecting adjacent regions. We made such image-guided SRX microtransections in the left somatosensory cortex in a rat model of generalized epilepsy using high radiation doses (820 Gy) in thin (200 µm) parallel slices of tissue. This procedure, targeting the brain volume from which seizures arose, altered the abnormal neuronal activities for at least 9 weeks, as evidenced by a decrease of seizure power and coherence between tissue slices in comparison to the contralateral cortex. The brain tissue located between transections stayed histologically normal, while the irradiated micro-slices remained devoid of myelin and neurons two months after irradiation. This pre-clinical proof of concept highlights the translational potential of non-invasive SRX transections for treating epilepsies that are not eligible for resective surgery.

The radiotherapy clinical trials projects at the ESRF: technical aspects.

The radiotherapy clinical trials projects, both aiming at treating aggressive brain tumors, require several major modifications and new constructions at the ESRF ID17 Biomedical beamline. The application of the Stereotactic Synchrotron Radiation Therapy (SSRT) technique mainly necessitates an upgrade of the existing patient positioning system, which was formerly used for the angiography program. It will allow for accurate positioning, translation and rotation of the patient during the treatment. For the Microbeam Radiation Therapy (MRT) clinical trials project, a new white beam hutch will be constructed to accommodate a dedicated patient positioning system. Consequently, the existing control hutches and the related installations will also be completely refurbished. Furthermore, the foreseen installation of a second X-ray source, which will allow doubling the currently available photon flux at high energies, requires a redesign of most optical components to handle the increased power and power densities. Starting from the current ID17 Biomedical beamline layout, the paper will present an update of the different modification/construction projects, including the general organization and planning.

TheraDrive: a new stroke therapy concept for home-based, computer-assisted motivating rehabilitation.

Stroke results in functional arm impairments that persist even after rehabilitation training. The increasing numbers of persons at-risk in the population for stroke creates an increased need for therapy programs that can be effectively administered in both home and outpatient clinics. The aim of this work is to create a low-cost, commercially-viable, home-based rehabilitation system that can capitalize on computer-assisted motivating rehabilitation concepts of game therapy and skill training with functional training related to real activities to induce user-dependent CNS plasticity. The TheraDrive concept combines the motivational elements of relearning steering tasks with playing driving video games using commercial force-feedback steering wheels to create an upper arm stroke therapy environment that is usable at home or in the clinic. This paper presents the concept and reports on investigations to evaluate the main commercial building blocks for the prototype: the steering wheel and driving software. Evaluation results of three force-feedback steering wheels and the driving gaming software called SmartDriver are presented. Future evaluation trials with stroke subjects will be completed.

Real-time interaction between a neuromorphic electronic circuit and the spinal cord.

We present a novel demonstration of real-time dynamic interaction between an oscillatory spinal cord (isolated lamprey nervous system) and electronic hardware that mimics the spinal motor pattern generating circuitry. The spinal cord and the neuromorphic circuit were interfaced in unidirectional and bidirectional modes. Bidirectional coupling resulted in stable, persistent oscillations. This experimental platform offers a unique paradigm to examine the intrinsic dynamics of neural circuitry. The neuromorphic analog very large scale integration (aVLSI) design and real-time capabilities of this approach may provide a particularly powerful means of restoring complex neuromotor function using neuroprostheses.

Oral health status and needs for dental treatment in geriatric patients in a Danish district hospital.

Oral health status and dental treatment needs were investigated in 50 randomly selected patients in the geriatric department of a Danish district hospital. All the participants were examined clinically and radiologically. Oral health status was generally poor. Ten participants required no dental treatment. The remaining 40 participants needed some kind of treatment, mainly prosthetic and surgical. The 40 participants requiring treatment were all asked whether or not they wanted the proposed treatment. Only 18 were interested. The participants were divided into three groups according to their medical status. 28 participants had a poor medical status. It was estimated that these patients once having left the hospital would never be able to visit a dentist on their own initiative, and therefore should be treated institutionally.

Contractile vacuoles in cells of a fresh water sponge, Spongilla lacustris.

Forty or more independently functioning contractile vacuoles (CVs) occupy the central region of fresh water sponge pinacocytes. Eash CV undergoes a cycle of enlargement by fusion, movement, shape change, rounding up, and emptying over the course of 5--30 min. Diameter at discharge varies between 1 and 13 micron. CVs in all cell types are associated with submicroscopic coated vesicles. Filled CVs are bounded by an unmodified trilaminar membrane, but vacuoles with excess membrane frequently show coated evaginations. These evaginations are thought to pinch off as coated vesicles, providing an avenue for membrane recycling in the CV system.

Prognosis of survival in a geriatric population.

With the aim of demonstrating prognostics as regards death in a geriatric population, the mortality among 1 486 patients (516 men and 970 women) in De Gamles By, Copenhagen, was observed over a 2-year period. The mortality curves for the groups examined were found to be rectilinear in logarithmic form and could therefore be described with sufficient certainty by one value, viz. the probability of death in any one year. The probability of death was just over 20% and was the same for both sexes. Of the parameters examined, particularly high mortality was found where there was urinary incontinence, severe mental abnormality, a great need for nursing, and poor physical mobility (especially inability to walk). On the other hand, there was no particular relationship with age. Where the degree of the handicapping factors was severe, there was generally greater mortality among the men than among the women, but this was not so in the less severe cases. The length of stay in the institution had no effect on the mortality. The results of the present study are in good agreement with previous findings reported from New York (7).

Mortality and functional prognosis in a geriatric population.

The prospects of survival and changes in function (need for care) are evaluated after a two-year period for the 1486 persons resident in the geriatric institution "De Gamles By", Copenhagen, on January 15, 1967. It is shown that the logarithm of the survival percentages is approximately a linear function of the time. The prospect of survival is slightly better for the females than for the males because of a significantly higher mortality among the dependent men than among the dependent women. There is no difference as regards sex in the mortality rate for the independent patients (25%). The prospect of survival is poorest in the heavily dependent patients, regardless of sex. Only 5% of the patients were discharged to their homes or transferred to a hospital or some other institution. There was an improvement in the care status, regardless of sex, in 4%, the condition was unchanged in 61%, and there was deterioration in 35% of the 870 patients who survived the two-year period. On the basis of the prospects of surviving whilst waiting for admittance, the saving in institutional places is discussed. The increased need for more accomodation in geriatric institutions is emphasized in order to reduce the unfortunate consequences of the time spent in waiting for admission.

Changes in age and need for care among patients in a geriatric institution during a two-year period.

Two cross-sectional studies, carried out at an interval of exactly 2 years at a geriatric institution accomodating about 1400 residents, show an increase in the age of the patients and in the need for care after the 2 years. An analysis of the conditions shows that the changes are due to the surviving patients becoming older and in need of more care, without adequate compensation for this trend having been taken into account when admitting new patients. The admittance and staff aspects connected with these changes are discussed.