Novel smartphone assisted device for neurotargeting.

INTRODUCTION: Despite the widespread use of external ventricular drainage, revision rates, and associated complications are reported between 10 and 40%. Current available image-guided techniques using stereotaxy, endoscopy, or ultrasound for catheter placements remain time-consuming techniques. Also, brain targeting procedures in emergency setting are challenging. The development of an easy-to-use, portable, image-guided system could reduce the need for multiple passes and improve the rate of accurate catheter placement and other brain targeting interventions in emergency setting. This study aims to design a novel smartphone assisted device for external ventricular drainage (EVD) placement and neuronavigation. TECHNIQUE: In this study, authors have designed a novel 3D system composed of 3D software based on Android operating system and 3D design of a device in Autodesk 3D max using simple cranial measurements by DICOM PACS software for data input from Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). We plan to utilize this software as a guide and as a replacement for far more advanced neuronavigation systems. We have designed and launched the pilot version of this software and tested and compared it by DICOM PACS and also in an artificial skull for accuracy assessment. Our evaluation confirmed high accuracy performance of this smartphone application compared with DICOM PACS software for initial surgical approach to candidates for EVD placement or other emergency setting procedures which require neurotargeting interventions. Also, our neurotargeting device's accuracy was tested using provided angles by the application, which results in acceptable performance. CONCLUSIONS: This smartphone application coupled with targeting device can be used in various settings such as EVD placement in hydrocephalus and in other brain targeting candidates in emergency settings. Also, it may be used in any emergency or neurosurgery department centers with no access to advanced neuro-imaging facilities, only using patient's simple cranial measures to achieve acceptable and highly accurate brain targeting compared with conventional, time consuming and costly techniques. We plan to expand this study to clinical trials for further evaluation.

Toward knowledge-based liver surgery: holistic information processing for surgical decision support.

PURPOSE: Malignant neoplasms of the liver are among the most frequent cancers worldwide. Given the diversity of options for liver cancer therapy, the choice of treatment depends on various parameters including patient condition, tumor size and location, liver function, and previous interventions. To address this issue, we present the first approach to treatment strategy planning based on holistic processing of patient-individual data, practical knowledge (i.e., case knowledge), and factual knowledge (e.g., clinical guidelines and studies). METHODS: The contributions of this paper are as follows: (1) a formalized dynamic patient model that incorporates all the heterogeneous data acquired for a specific patient in the whole course of disease treatment; (2) a concept for formalizing factual knowledge; and (3) a technical infrastructure that enables storing, accessing, and processing of heterogeneous data to support clinical decision making. RESULTS: Our patient model, which currently covers 602 patient-individual parameters, was successfully instantiated for 184 patients. It was sufficiently comprehensive to serve as the basis for the formalization of a total of 72 rules extracted from studies on patients with colorectal liver metastases or hepatocellular carcinoma. For a subset of 70 patients with these diagnoses, the system derived an average of [Formula: see text] assertions per patient. CONCLUSION: The proposed concept paves the way for holistic treatment strategy planning by enabling joint storing and processing of heterogeneous data from various information sources.

The Effect of Human Mesenchymal Stem Cells-Conditioned Media on Glioblastoma Cells Viability In Vitro.

A novel target for cancer treatment is based on the effects of non-tumor cells, including hMSCs on tumor growth. However, the results are controversial: some studies showed that hMSCs inhibit tumor progression, while others found they promote tumor cell proliferation. In this study, we analyse the effect of human mesenchymal cells derived from umbilical cord tissue (hUC-MSCs) and bone-marrow- mesenchymal stem cells (hBM-MSCs) on glioblastoma cells viability in vitro. GB cell cultures were established from fresh sample tissues provided by "Bagdasar-Arseni" Hospital, Bucharest, from consented GB patients. hUC-MSCs, HUC-1 and HUC-2 cell lines, were established from human umbilical cord tissue collected after delivery from natural term births at the Emergency Hospital of Craiova, Romania. hBM-MSCs cell line was purchased from Life Technologies. Conditioned media (CM) from MSCs was used to treat GB cells for 24, 48, 72 and 96 hours. To determine GB cell viability was used MTT cell proliferation assay. Statistical analyses were performed using Students t-test. hUC-MSCs CM displayed the potential to be cytotoxic to GB cells, while the treatment with hBM-MSCs CM significantly stimulated GB cell growth 24 hours after the treatment and showed minor growth cell inhibition 48, 72 and 96 hours after the treatment. This report proved that hUC-MSCsCM inhibited GB cell proliferation, while little inhibitory effect was exerted by hBM-MSCs CM.