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Biomedical subjects

R Sweeney

Publications and source records attributed to R Sweeney.

At least 19 recordsLinked to original sources
PubMed2003

Neuroendoscopy based on computer assisted adjustment of the endoscope holder in the laboratory.

OBJECTIVE: We present our initial clinical experience with a novel technique of frameless stereotactic neuroendoscopy using a neuronavigation system, a specially designed aiming device (endoscope holder/targeting device) combined with a vacuum-mouthpiece based head holder. Due to the reproducibility of patient immobilization in the fixation system, the endoscope holder can be adjusted in the laboratory in the absence of the patient. METHODS: An individual vacuum-mouthpiece was fabricated. The patients were scanned with an external reference frame attached to this mouthpiece and the images were transferred to the neuronavigation system. Determination of the path, mouthpiece-based registration and adjustment of the targeting device were performed the day before surgery in the absence of the patient. In the OR the patient was repositioned and the endoscope was introduced through the preadjusted aiming device to the precalculated depth. RESULTS: The novel technique was successfully used for frameless endoscopic navigation in five patients. Three endoscopic third ventriculostomies in adults, one endoscopic septostomy due to unilateral hydrocephalus in an adult female patient and one endoscopic ventriculo-cysto cisternostomy in a 20-month-old girl with a suprasellar arachnoid cyst, were performed with excellent clinical results and without technical complications. CONCLUSION: Our initial experience indicates that frameless stereotaxy, in combination with a relocatable head holder and a special targeting device, allows for precise and preplanned advancement of the neuroendoscope, reducing or even eliminating intraoperative registration and endoscope trajectory adjustments, thus substantially reducing OR time. Due to the non-invasive but rigid immobilization method, neuronavigation can also be performed in children under 2 years of age.

Adult↗
PubMed2002

Use of neuronavigation and electrophysiology in surgery of subcortically located lesions in the sensorimotor strip.

OBJECTIVES: Subcortical lesions in the sensorimotor strip are often considered to be inoperable. The purpose of this study was to evaluate the usefulness of a combined approach for surgery in this region, aided by a robotic neuronavigation system under electrophysiological control. METHODS: In a prospective study on 10 patients, space occupying lesions in the sensorimotor central area were removed using the Surgiscope robotic navigation system and the Nicolet Viking IV electrophysiological system. RESULTS: Precise tumour localisation with the neuronavigation system and the information on the patient's cortical motor distribution obtained by bipolar cortical stimulation led to postoperative improvement in motor function in all but one patient. Seven of the patients had focal, defined pathology (four metastases; two cavernoma; one aspergilloma). CONCLUSION: Due to the implementation of two recent technologies, surgery of lesions in the subcortical sensorimotor region can be performed with greater confidence.

Adult↗
PubMed2001

MRI appearance of radiation-induced changes of normal cervical tissues.

Irradiation causes specific MRI changes in anatomic morphology and signal intensity. To avoid misinterpretation, it is important to consider the potential radiation changes of normal tissue in MRI. The aim of this study was to describe the detected radiation effects on normal cervical tissues in MRI. Pretreatment and posttreatment MRI of 52 patients with primary neck tumors were evaluated retrospectively. The MR imaging was performed before initiating radiotherapy and at the end of the treatment period. Patients underwent follow-up studies within 24 months after the end of irradiation. Edema was the main radiation-induced effect. It was detected in the epiglottis, larynx, pharynx wall, retro- and parapharyngeal space, salivary glands, muscles, and subcutaneous tissue. In some cases the bone marrow of the mandible showed edema, due to osteonecrosis. We additionally detected fluid accumulation in the mastoid cells. Radiation caused volume reduction of the parotid gland, thickening of the pharynx wall, and fatty degeneration of bone marrow. Magnetic resonance imaging is an excellent method of depicting radiation-induced changes of normal tissue. Especially T2-weighted sequences allow the detection of even slight edema. It is important to be aware of the most common radiation-induced changes in MRI and to take them into account when assessing an examination.

Adult↗
PubMed2001

Effect of HIPping, stress and surface finish on the environmental degradation of Y-TZP ceramics.

Hot isostatically pressed (HIPped) and hot pressed (designated unHIPped) bar samples of yttria stabilized tetragonal zirconia polycrystalline ceramic (3Y-TZP) were subjected to three point bend testing in water at 90 degrees C. HIPped femoral heads with three different surface finishes were also aged in 90 degrees C water. The early stages of the environment induced tetragonal to monoclinic transformation was monitored as a function of time by X-ray diffraction, white light interferometry and scanning electron microscopy. HIPped samples were found to transform less readily than unHIPped samples and have a longer incubation period prior to transformation. There was an increase in the amount of monoclinic phase detected following the application of stress, particularly on the compression surface. Microcraters, believed to result from the expulsion of transformed grains when stress was applied, were observed on tension surfaces, particularly of unHIPped samples. There was no effect of surface roughness on the environment induced transformation for the range of surface finishes investigated.

Journal Article↗
PubMed2000

Comparison of standard and individually planned infradiaphragmatic fields in irradiation of retroperitoneal lymph nodes.

PURPOSE: In prophylactic irradiation of infradiaphragmatic lymphatic nodes (LN), the width of the paraaortic and pelvic field is given by a line joining the tips of the transverse processes of the 11th thoracic to the 4th lumbar vertebrae. Then the field boundary follows a straight line to the most lateral point of the acetabulum seen on the simulation film. Another method of setting the field border is to project the lateral contours of the large abdominal vessels from T(1)-weighted coronal MR images of the abdomen onto the simulator radiographs and add a 2-cm margin along the so delineated vessels. In our study, we compared both methods as to full enclosure of paraaortic and pelvic lymphatics or nodal miss. MATERIAL AND METHODS: Abdominal CT scans of 81 patients with involvement of paraaortic lymph node regions with LN sizes not exceeding 2.5 cm were examined. The distance from the center of the appropriate vertebra to the center of the most lateral lymph node was referred to the transverse process as well as to the outside contour of the aorta on the left and the vena cava on the right side. Respectively, the LN were measured referenced to the iliac vessels from the 5th lumbar through to the 2nd sacral vertebra. At the level of the hip joint the distance was measured from the midline as determined by a line through the center of the sacrum, perpendicular to a line connecting center of both femoral heads. RESULTS: Our measurements showed that lymph nodes do occur (1) lateral to the transverse processes of the thoracic and lumbar vertebrae as well as (2) outside the 2-cm safety margin from the lateral contour of the large abdominal vessels. CONCLUSION: These data clearly show that the traditional fields for radiation of infradiaphragmatic lymphatic nodes have not been large enough to enclose almost all retroperitoneal and pelvic lymph nodes with certainty. We recommend an expansion of the fields.

Aorta, Abdominal↗
PubMed1998

Repositioning accuracy: comparison of a noninvasive head holder with thermoplastic mask for fractionated radiotherapy and a case report.

PURPOSE: To compare accuracy, clinical feasibility, and subjective patient impression between a noninvasive head holder (Vogele Bale Hohner [VBH]; Wellhoefer Dosimetry, Schwarzenbruck, Germany) developed at the University of Innsbruck and the thermoplastic mask fixation system for use in fractionated external radiotherapy. We present a case report of an actual patient fixated in the VBH head holder during radiation therapy. MATERIALS AND METHODS: The VBH head holder consists of an individualized vacuum dental cast connected to a head plate via two hydraulic arms allowing noninvasive, reproducible head fixation of even uncooperative patients. Accuracy was tested and compared with that of the thermoplastic mask using the Phillips EasyGuide navigation system on five volunteers. Specific external registration points served as landmarks and their positions were compared after each repositioning. System and operator inaccuracy were also taken into account. The times taken for production and repositioning of the respective fixation devices were compared, and subjective impressions were noted. RESULTS: Mean VBH head holder repositioning accuracy was 1.02 mm while that of the thermoplastic mask was 3.05 mm. 69% of mask repositionings showed a deviation > 2 mm and 41% > 3 mm (as opposed to 8% and 1% respectively for the VBH head holder) Those points located farthest away from the respective plane of fixation showed the largest deviations. Both production and repositioning times were similar between the systems; depending upon the patient, the VBH head holder was generally better tolerated than the mask system. CONCLUSION: Due to its significantly better repositioning accuracy compared to that of the thermoplastic mask, the VBH head holder is especially suited for external radiation requiring precise repositioning due to critical tissues in immediate surrounding of the area to be irradiated.

Adult↗
PubMed1998

Antisense in abundance: the ribosome as a vehicle for antisense RNA.

Insertions at some sites within rRNA variable regions can be tolerated without affecting rRNA function. Antisense RNAs inserted at such sites in the T. thermophila rRNA can eliminate phenotypically or immunologically detectable gene expression of three genes tested. This unusually effective antisense activity is probably due to the abundance, stability and favourable intracellular localization of these antisense rRNAs with respect to mRNAs. Since antisense RNAs function very well as a part of the rRNA, rRNA might also be useful as a vehicle for other RNAs that might affect cell function such as protein binding sites or trans-acting ribozymes. The robust function of the antisense ribosome system in T. thermophila should allow the use of this system to specifically suppress gene expression and to clone genes by their null or hypomorphic phenotypes. The use of the antisense ribosome in other eukaryotes has yet to be explored, but the realization of this goal is well within the realm of possibility.

Animals↗
PubMed1998

[Noninvasive head fixation for external irradiation of tumors of the head-neck area].

PURPOSE: To fully utilize the technical capabilities of radiation diagnostics and planning, a precise and reproducible method of head fixation is a prerequisite. METHOD: We have adapted the Vogele-Bale-Hohner (VBH) head holder (Wellhöfer Dosimetrie, Schwarzenbruck, Germany), originally designed for frameless stereotactic operations, to the requirements of external beam radiotherapy. A precise and reproducible head fixation is attained by an individualized vacuum upper-dental cast which is connected over 2 hydraulic arms to an adjustable head- and rigid base-plate. Radiation field and patient alignment lasers are marked on a relocatable clear PVC localization box. RESULTS: The possibility of craniocaudal adjustment of the head plate on the base plate allows the system to adapt to the actual position of the patient on the radiotherapy couch granting tensionless repositioning. The VBH head holder has proven itself to be a precise yet practicable method of head fixation. Duration of mouthpiece production and daily repositioning is comparable to that of the thermoplastic mask. CONCLUSION: The new head holder is in routine use at our hospital and quite suitable for external beam radiation of patients with tumors of the head and neck.

Equipment Design↗
PubMed1998

An intragenic suppressor of cold sensitivity identifies potentially interacting bases in the peptidyl transferase center of Tetrahymena rRNA.

Peptidyl transfer of a growing peptide on a ribosome-bound transfer RNA (tRNA) to an incoming amino acyl tRNA is the central step in translation, and it may be catalyzed primarily by the large subunit (LSU) ribosomal RNA (rRNA). Genetic and biochemical evidence suggests that the central loop of domain V of the LSU rRNA plays a direct role in peptidyl transfer. It was previously found that a single base change at a universally conserved site in this region of the Tetrahymena thermophila LSU rRNA confers anisomycin resistance (an-r) as well as extremely slow growth, cold sensitivity, and aberrant cell morphology. Because anisomycin specifically inhibits peptidyl transfer, possibly by interfering with tRNA binding, it is likely that this mutant rRNA is defective in efficiently completing one of these steps. In the present study, we have isolated an intragenic suppressor mutation located only three bases away from the original mutation that partially reverses the slow growth and cold-sensitive phenotypes. These data imply that the functional interaction of these two bases is necessary for normal rRNA function, perhaps for peptidyl transfer or tRNA binding. These data provide the first demonstration of a functional interaction between bases within this rRNA region.

Animals↗