Real-time multiple microsensor tissue recognition and its potential application in the management of prostate cancer.
Explore the source record for details and available documents.
Biopsy↗
Biomedical subjects
Russell J Andrews
Publications and source records attributed to Russell J Andrews.
The future role of intelligent probes in detecting and managing prostate cancer.
Explore the source record for details and available documents.
Cryosurgery↗
Neuroprotection trek--the next generation: the measurement is the message.
Animal trials of many pharmacological neuroprotective agents have been quite successful, whereas trials in humans have been uniformly disappointing. A major difference between laboratory research in animals and clinical research in humans is the amount and/or quality of data obtained. The goal of this presentation is to argue that when clinical studies consist of more valid, objective data--that is, as our measurement capabilities in clinical research become as robust as they are in laboratory research--we are likely to gain new insights into both (1) injury to the nervous system and (2) neuroprotective treatment strategies. Technological advances (in data acquisition and analysis)--often novel even in the laboratory--will be the "scale" that will enable progress in measurement. As examples of such technological advances, two projects initiated at NASA Ames Research Center are cited. The NASA Smart Probe Project, with the goal of combining multiple microsensors and neural networks for real-time tissue identification (e.g., for tumor detection), has recently moved into the clinical realm, with a prototype being used to diagnose breast cancer in women "on the spot". The NASA Nanoelectrode Array Project has fabricated nanoscale devices that can simultaneously monitor electrical activity and neurotransmitter concentrations, while providing electrical stimulation focally and precisely (and potentially in a closed-loop fashion based on the input from the nanosensors). The large amounts of data that such techniques can acquire and analyze--separated spatially and temporally throughout the nervous system, if necessary--will provide insights not only into neuroprotective strategies, but also into the workings of the nervous system itself.
Animals↗
Neuroprotection trek--the next generation: neuromodulation I. Techniques--deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation.
Neuromodulation denotes controlled electrical stimulation of the central or peripheral nervous system. The three forms of neuromodulation described in this paper-deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation-were chosen primarily for their demonstrated or potential clinical usefulness. Deep brain stimulation is a completely implanted technique for improving movement disorders, such as Parkinson's disease, by very focal electrical stimulation of the brain-a technique that employs well-established hardware (electrode and pulse generator/battery). Vagus nerve stimulation is similar to deep brain stimulation in being well-established (for the treatment of refractory epilepsy), completely implanted, and having hardware that can be considered standard at the present time. Vagus nerve stimulation differs from deep brain stimulation, however, in that afferent stimulation of the vagus nerve results in diffuse effects on many regions throughout the brain. Although use of deep brain stimulation for applications beyond movement disorders will no doubt involve placing the stimulating electrode(s) in regions other than the thalamus, subthalamus, or globus pallidus, the use of vagus nerve stimulation for applications beyond epilepsy-for example, depression and eating disorders-is unlikely to require altering the hardware significantly (although stimulation protocols may differ). Transcranial magnetic stimulation is an example of an external or non-implanted, intermittent (at least given the current state of the hardware) stimulation technique, the clinical value of which for neuromodulation and neuroprotection remains to be determined.
Animals↗
Neuroprotection trek--the next generation: neuromodulation II. Applications--epilepsy, nerve regeneration, neurotrophins.
Three examples of neuroprotective applications of electrical stimulation-neuromodulation-are considered: (1) the diagnosis and treatment of epilepsy, (2) the augmentation of peripheral nerve regeneration after transection, and (3) the interaction between electrical stimulation and neurotrophins (notably brain derived neurotrophic factor [BDNF]) in various neuroprotective situations. The research cited demonstrates clear benefit from appropriate electrical stimulation in the treatment of (1) certain patients with medication-refractory epilepsy, and (2) the functional regeneration of peripheral nerves after transection and surgical repair. Furthermore, neuromodulation of peripheral nerve regeneration has been associated with an increase in the neurotrophin BDNF. The roles of BDNF and other neurotrophins in several disorders of the nervous system are discussed in the context of neuromodulation and its augmentation of neurotrophins. Neuromodulation-at least in part through its effect on BDNF and other neurotrophins-will likely play a major role in the treatment (and possibly prevention) of disorders of the nervous system for which neuroproteive pharmacologic agents have traditionally been sought.
Anticonvulsants↗
The NASA Smart Probe Project for real-time multiple microsensor tissue recognition.
BACKGROUND: Remote surgery requires automated sensors, effectors and sensor-effector communication. The NASA Smart Probe Project has focused on the sensor aspect. METHODS: The NASA Smart Probe uses neural networks and data from multiple microsensors for a unique tissue signature in real time. Animal and human trials use several probe configurations: (1) 8-microsensor probe (2.5 mm in diameter) for rodent studies (normal and subcutaneous mammary tumor tissues), and (2) 21-gauge needle probe with 3 spectroscopic fibers and an impedance microelectrode for breast cancer diagnosis in humans. Multisensor data are collected in real time (update 100 times/s) using PCs. RESULTS: Human data (collected by NASA licensee BioLuminate) from 15 women undergoing breast biopsy distinguished normal tissue from both benign tumors and breast carcinoma. Tumor margins and necrosis are rapidly detected. CONCLUSION: Real-time tissue identification is achievable. Potential applications, including probes incorporating nanoelectrode arrays, are presented.
Biopsy↗
Intraventricular neurocysticercosis: 18 consecutive patients and review of the literature.
OBJECT: The prognosis for intraventricular neurocysticercosis (IVNCC) is poorer than that for parenchymal NCC, making prompt diagnosis and treatment especially important. Although active, viable intraventricular cysts produce no reaction in the host; they can cause noncommunicating hydrocephalus, the onset of which is frequently abrupt. With the death of the larva comes a local granulomatous ependymitis, generalized ventriculitis, and meningoencephalitis. The authors report on 18 patients with IVNCC (accrued from a larger case series of 62 patients with NCC treated over an 11-year period), detailing clinical presentation, neuroimaging findings, treatment, and outcome. METHODS: All patients presented with hydrocephalus and/or meningitis. The most valuable diagnostic tests were magnetic resonance imaging of the brain and EITB of serum and/or cerebrospinal fluid. Treatment included albendazole and steroid therapy in all cases, and when necessary in cases requiring urgent or emergency ventriculostomy and/or surgical removal of the obstructing cyst (followed by shunt placement if indicated). CONCLUSIONS: An extensive review of the literature on IVNCC has been prepared, with the goal of providing the reader with the information necessary to diagnose and treat this complex and potentially fatal disease in a timely and effective manner.
Adolescent↗