Browsing by Subject "neurosurgery"

Now showing 1 - 10 of 11
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    Acridine Orange as a Novel Photosensitizer for Photodynamic Therapy in Glioblastoma
    (Elsevier, 2018) Osman, Hany; Elsahy, Deena; Saadatzadeh, M. Reza; Pollok, Karen E.; Yocom, Steven; Hattab, Eyas; Georges, Joseph; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Object Photodynamic therapy is an exciting treatment modality that combines the effects of a chemical agent with the physical energy from light or radiation to result in lysis of cells of interest. Acridine orange is a molecule with fluorescence properties that was demonstrated to possess photosensitizing properties. The objective of this study was to investigate the photodynamic effect of acridine orange on glioblastoma cell viability and growth. Methods Glioblastoma cells (n = 8000 cells/well at 0 hours) were exposed to acridine orange followed by white unfiltered light-emitting diodes (LED) light. Cultures were exposed to either 10 or 30 minutes of light. The cell number per well was determined at 0, 24, 48, and 72 hours after exposure. Results A dramatic cytocidal effect of acridine orange after exposure to as little as 10 minutes of white light was observed. There was almost complete eradication of the glioblastoma cells over a 72-hour period. Although acridine orange or light alone exhibited some effect on cell growth, it was not as pronounced as the combination of acridine orange and light. Conclusions This is the first study to demonstrate the photodynamic effect of acridine orange in glioblastoma cells. This data supports the need for further studies to characterize and evaluate whether this striking cytotoxic effect can be achieved in vivo. The combination of acridine orange and exposure to white unfiltered LED light may have potential future applications in management of glioblastoma.
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    Biomechanical Root Cause Analysis of Complications in Head Immobilization Devices for Pediatric Neurosurgery
    (ASME, 2018-06) Abdulhafez, Moataz; Zaazoue, Mohamed; Kadry, Karim; Goumnerova, Liliana C.; Bedewy, Mostafa; Neurological Surgery, School of Medicine
    Precise and firm fixation of the cranium is critical during craniotomy and delicate brain neurosurgery making head immobilization devices (HIDs) a staple instrument in brain neurosurgical operations today. However, despite their popularity, there is no standard procedure for their use and many complications arise from using HIDs in pediatric neurosurgery. In this paper, we identify biomechanical causes of complications and quantify risks in pin-type HIDs including clamping force selection, positioning and age effects. Based on our root cause analysis, we develop a framework to address the biomechanical factors that influence complications and understand the biomechanics of the clamping process. We develop an age-dependent finite element model (FEM) of a single pin on a cranial bone disc with the representative properties and skull thickness depending on age. This model can be utilized to reduce risk of complications by design as well as to provide recommendations for current practices.
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    COMPARISON OF 3D VOLUME REGISTRATION TECHNIQUES APPLIED TO NEUROSURGERY
    (Office of the Vice Chancellor for Research, 2012-04-13) Verma, Romil; Cottingham, Chris; Nguyen, Thanh; Kale, Ashutosh; Catania, Robin; Wright, Jacob; Christopher, Lauren; Tuceryan, Mihan; William, Albert
    Introduction: Image guided surgery requires that the pre-operative da-ta used for planning the surgery should be aligned with the patient during surgery. For this surgical application a fast, effective volume registration al-gorithm is needed. In addition, such an algorithm can also be used to devel-op surgical training presentations. This research tests existing methods of image and volume registration with synthetic 3D models and with 3D skull data. The aim of this research is to find the most promising algorithms in ac-curacy and execution time that best fit the neurosurgery application. Methods: Medical image volumes acquired from MRI or CT medical im-aging scans provided by the Indiana University School of Medicine were used as Test image cases. Additional synthetic data with ground truth was devel-oped by the Informatics students. Each test image was processed through image registration algorithms found in four common medical imaging tools: MATLAB, 3D Slicer, VolView, and VTK/ITK. The resulting registration is com-pared against the ground truth evaluated with mean squared error metrics. Algorithm execution time is measured on standard personal computer (PC) hardware. Results: Data from this extensive set of tests reveal that the current state of the art algorithms all have strengths and weaknesses. These will be categorized and presented both in a poster form and in a 3D video presenta-tion produced by Informatics students in an auto stereoscopic 3D video. Conclusions: Preliminary results show that execution of image registra-tion in real-time is a challenging task for real time neurosurgery applica-tions. Final results will be available at paper presentation. Future research will focus on optimizing registration and also implementing deformable regis-tration in real-time.
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    Developing New Image Registration Techniques and 3D Displays for Neuroimaging and Neurosurgery
    (Office of the Vice Chancellor for Research, 2013-04-05) Zheng, Yuese; Jing, Yici; Nguyen, Thanh; Zajac, Sarah; Wright, Jacob; Catania, Robin
    Image guided surgery requires that the pre-operative data used for planning the surgery should be aligned with the patient during surgery. For this surgical application a fast, effective volume registration algorithm is needed. In addition, such an algorithm can also be used to develop surgical training presentations. This research extends existing methods and techniques to improve convergence and speed of execution. The aim is to find the most promising speed improvements while maintaining accuracy to best fit the neurosurgery application. In the recent phase, we focus on feature extraction and the time-accuracy trade-off. Medical image volumes acquired from MRI or CT medical imaging scans provided by the Indiana University School of Medicine were used as test image cases. Additional synthetic data with ground truth is developed by the Informatics students. The speed-enhancements to the registration are compared against the ground truth evaluated with mean squared error metrics. Algorithm execution time with and without speed improvement is measured on standard personal computer (PC) hardware. Additionally, the informatics students are developing a 3D movie that shows the surgical and preoperative data overlay, which presents the results of the speed improvements from the remaining students’ work. Our testing indicates that an intelligent subset of the data points that are needed for registration should improve the speed significantly. Preliminary results show that even though image registration in real-time is a challenging task for real time neurosurgery applications, intelligent preprocessing provides a promising solution. Final results will be available at paper presentation.
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    Global trends of female representation in neurosurgery
    (AANS, 2022-08-19) Pahwa, Bhavya; Zaazoue, Mohamed A.; Neurological Surgery, School of Medicine
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    In Vivo Microscopy in Neurosurgical Oncology
    (Elsevier, 2018) Osman, Hany; Georges, Joseph; Elsahy, Deena; Hattab, Eyas; Yocom, Steven; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Intraoperative neurosurgical histopathologic diagnoses rely on evaluation of rapid tissue preparations such as frozen sections and smears with conventional light microscopy. Though useful, these techniques are time consuming and therefore unable to provide real-time intraoperative feedback. In vivo molecular imaging techniques are emerging as novel methods for generating real-time diagnostic histopathologic images of tumors and their surrounding tissues. These imaging techniques rely on contrast generated by exogenous fluorescent dyes, autofluorescence of endogenous molecules, fluorescence decay of excited molecules, or light scattering. Large molecular imaging instruments are being miniaturized for clinical in vivo use. This review discusses pertinent imaging systems that have been developed for neurosurgical use and imaging techniques currently under NADPH development for neurosurgical molecular imaging.
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    Measures of Health-Related Quality of Life Outcomes in Pediatric Neurosurgery: Literature Review
    (Elsevier, 2019-02) Desai, Virendra R.; Gadgil, Nisha; Saad, Shahbaz; Raskin, Jeffrey S.; Lam, Sandi K.; Neurological Surgery, School of Medicine
    Background Improving value in healthcare means optimizing outcomes and minimizing costs. The emerging pay-for-performance era requires understanding of the effect of healthcare services on health-related quality of life (HRQoL). Pediatric and surgical subspecialties have yet to fully integrate HRQoL measures into practice. The present study reviewed and characterized the HRQoL outcome measures across various pediatric neurosurgical diagnoses. Methods A literature review was performed by searching PubMed and Google Scholar with search terms such as “health-related quality of life” and “pediatric neurosurgery” and then including the specific pathologies for which a HRQoL instrument was found (e.g., “health-related quality of life” plus “epilepsy”). Each measurement was evaluated by content and purpose, relative strengths and weaknesses, and validity. Results We reviewed 68 reports. Epilepsy, brain tumor, cerebral palsy, spina bifida, hydrocephalus, and scoliosis were diagnoses found in reported studies that had used disease-specific HRQoL instruments. Information using general HRQoL instruments was also reported. Internal, test–retest, and/or interrater reliability varied across the instruments, as did face, content, concurrent, and/or construct validity. Few instruments were tested enough for robust reliability and validity. Significant variability was found in the usage of these instruments in clinical studies within pediatric neurosurgery. Conclusions The HRQoL instruments used in pediatric neurosurgery are currently without standardized guidelines and thus exhibit high variability in use. Clinicians should support the development and application of these methods to optimize these instruments, promote standardization of research, improve performance measures to reflect clinically modifiable and meaningful outcomes, and, ultimately, lead the national discussion in healthcare quality and patient-centered care.
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    Patient Perspective
    (Elsevier, 2019-05) Taylor, Jill Bolte; Medicine, School of Medicine
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    Pediatric neurosurgery along with children’s hospitals’ innovations are rapid and uniform in response to the COVID-19 pandemic
    (AANS, 2020) Weiner, Howard L.; Adelson, P. David; Brockmeyer, Douglas L.; Maher, Cormac O.; Gupta, Nalin; Smyth, Matthew D.; Jea, Andrew; Blount, Jeffrey P.; Riva-Cambrin, Jay; Lam, Sandi K.; Ahn, Edward S.; Albert, Gregory W.; Leonard, Jeffrey R.; Neurological Surgery, School of Medicine
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    Virtual, 3-Dimensional Temporal Bone Model and Its Educational Value for Neurosurgical Trainees
    (Elsevier, 2018) Morone, Peter J.; Shah, Kushal J.; Hendricks, Benjamin K.; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Objective Learning complex neuroanatomy is an arduous yet important task for every neurosurgical trainee. As technology has advanced, various modalities have been created to aid our understanding of anatomy. This study sought to assess the educational value of a virtual, 3-dimensional (3D) temporal bone model. Methods The 3D temporal bone model was created with assistance of computer graphic designers and published online. Its educational value as a teaching was tool was assessed by querying 73 neurosurgery residents at 4 institutions and was compared with that of a standard, 2-dimensional (2D) temporal bone resource. Data were collected via a survey, and significance among responses was analyzed via a univariate chi-square test. Results The survey response rate was 37%. Greater than 90% of residents preferred to study with the 3D model compared with the 2D resource and felt that the 3D model allowed them understand the anatomy more realistically (P = 0.001). Moreover, >90% of residents believed that reviewing the 3D model before an actual surgery could lead to improved operative efficiency and safety (P = 0.001). Conclusions This study demonstrates the utility of a novel, 3D temporal bone model as a teaching tool for neurosurgery residents. The model contains accurate anatomic structures and allows user interaction via a virtual, immersive environment.