ABSTRACT
BACKGROUND: Deep brain stimulation (DBS) has become a reliable method in the treatment of movement disorders, e.g. idiopathic Parkinson's disease (IPD) and is technically based on stereotaxy. The Starfix® platform is a new type of stereotactic frame that allows an individualized and patient-optimized therapeutic regimen in IPD. OBJECTIVES: The aim of this study was to retrospectively compare the outcomes of IPD patients who underwent surgery with the use of conventional stereotactic frames (31 patients) to those who underwent implantation of DBS with the use of Starfix® frames (29 patients). MATERIAL AND METHODS: Surgery time, the unified Parkinson's disease rating scale III (UPDRS/III) score, L-dopa and L-dopa equivalent doses (LED) were compared prior to surgery as well as 4 weeks, 12 weeks, 6 months and 1 year postoperatively. RESULTS: The IPD-related symptoms improved significantly in both groups with respect to the UPDRS III score (conventional 69.6% vs. 72.4% Starfix®). After surgery significant reductions of L-dopa and LED were seen in both groups. Inherent advantages of the Starfix® platform included simultaneous positioning of the stimulating electrodes and a significant reduction in surgical time. CONCLUSION: In summary, both stereotactic procedures are reliable and safe procedures for the placement of stimulating electrodes as well as the stimulation effect achieved. The logistical uncoupling of presurgical planning from surgical therapy emphasizes the benefits of the individualized stereotactic procedure.
Subject(s)
Deep Brain Stimulation/instrumentation , Deep Brain Stimulation/methods , Electrodes, Implanted , Movement Disorders/therapy , Parkinson Disease/therapy , Prosthesis Implantation/instrumentation , Stereotaxic Techniques/instrumentation , Adult , Aged , Equipment Design , Equipment Failure Analysis , Female , Humans , Longitudinal Studies , Male , Middle Aged , Movement Disorders/etiology , Parkinson Disease/complications , Prosthesis Implantation/methods , Treatment OutcomeABSTRACT
Microfluidic systems provide a unique platform for investigation of fundamental reaction processes, which is critical to understanding how to control nanostructure synthesis on a production scale. We have examined the synthesis of cysteine-capped CdS quantum dot nanocrystals (CdS-Cys) between two interdiffusing reagent streams in a continuous-flow microfluidic reactor. Using spatially resolved photoluminescence imaging and spectroscopy of the microreactor, we have acquired kinetic and mechanistic data on the CdS-Cys nanoparticle nucleation and growth, and observed a binary shift in the particle emission spectrum from a higher (2.9 eV) to lower (2.5 eV) energy emission peak within the first second of residence time. Several reactor models have been tested against the spatially and spectrally resolved signals, which suggest that homogeneous reaction and particle nucleation are diffusion-limited and occur only at the boundary between the two laminar streams, while a slower activation process occurs on a longer (seconds) time scale. The results provide direct insight into the rapid processes that occur during crystallization in microfluidic mixing channels, and demonstrate the potential of using controlled microfluidic environments with spatially resolved monitoring to conduct fundamental studies of nanocrystal nucleation and growth.
