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Use of intraoperative MRI adds time but care-changing information to neurosurgery, study shows

Although the use of intraoperative MRI can add time to surgical procedures, it can help surgeons detect residual disease and, if needed, modify their plan for surgery while the patient is on the operating room table, according to a study conducted by researchers at the University Hospitals of Cleveland/Case Western Reserve University in Cleveland, Ohio, and Johns Hopkins University in Baltimore, Md.

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Keywords: intraoperative, mri, adds, time, care-changing, information, neurosurgery, study, shows, add, care, changing, show

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1. Advance in understanding of blood pressure gene could lead to new treatments
   02-04-2007 · EurekAlert!
   Research by scientists at UCL (University College London) has clearly demonstrated for the first time the structure and function of a gene crucial to the regulation of blood pressure. The discovery could be important in the search for new treatments for illnesses such as heart disease, the UK's biggest killer. In a paper published online today in Nature Medicine, the team, led by Professor Patrick Vallance and Dr James Leiper, UCL Department of Medicine, reveal the role of the human gene dimethylarginine dimethylaminohydrolase (DDAH), showing that loss of DDAH activity disrupts nitric oxide (NO) production. NO is critical in the regulation of blood pressure, nervous system functions and the immune system. The role of DDAH is to break down modified amino acids (Asymmetric dimethylarginine (ADMA) and monomethyl arginine (L-NMMA)) that are produced by the body and have been shown to inhibit NO synthase. These molecules accumulate in various disease states including diabetes, renal failure and pulmonary and systemic hypertension, and their concentration in plasma (the fluid component of blood) is strongly predicative of cardiovascular disease and death. In a healthy human body, the majority of ADMA is eliminated through active metabolism by DDAH. Scientists have hypothesised that if DDAH function is impaired, NO production is reduced, and that this could be an important feature of increased cardiovascular risk. To examine this pathway in more detail, the researchers deleted the DDAH gene in mice. These mice went on to develop hypertension, or high blood pressure. They also designed specific inhibitors (small molecules) which bind to the active site of human DDAH. These small molecule inhibitors also induced hypertension in mice, confirming the importance of DDAH in the regulation of blood pressure. Dr Leiper, UCL Medicine, said: “These genetic and chemical approaches to disrupt DDAH showed remarkably consistent results, and provide compelling evidence that loss of DDAH function increases the concentration of ADMA and thereby disrupts vascular NO signalling. “There has been considerable scientific interest in this pathway and the role of ADMA as a novel risk factor, but so far there's been little evidence to support the idea that it's a cause of disease, rather than just a marker. Genes and their pathways are crucial to our understanding of cardiovascular disease and a better understanding of DDAH-1 could lead to important new treatments. “It could help us to establish if genetic variation predisposes certain people to these diseases, or whether environmental factors exert some of their effects through modulation of DDAH activity. “Our research also shows that this pathway could be harnessed therapeutically to limit production of NO in certain situations where too much nitric oxide is a bad thing; for example, hypotension and septic shock. These are some of the biggest problems in intensive care medicine and there is a huge unmet need for drug treatments.” The study, which was carried out at UCL's Rayne Institute, was funded by grants from the British Heart Foundation, the Wellcome Trust and the Medical Research Council. Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, said: "The unexpected finding in the 1980s that a simple gas, nitric oxide (NO), is made by cells in the blood vessel wall and is a powerful control of blood vessel relaxation led to the award of the Nobel Prize in 1998 to its discoverers. "More recently, there has been increasing evidence that impairment of NO production is likely to be an important factor in the development of heart and circulatory disease, but the mechanisms responsible are not fully understood. "This study suggests for the first time that the loss of the activity of the enzyme DDAH-1 leads to reduced NO production and may cause heart and circulatory disease. These findings are likely to be important in the search for new ways to optimise the health of our blood vessels." ### Notes for Editors 1. For more information, please contact Ruth Metcalfe in the UCL Media Relations Office on tel: +44 (0)20 7679 9739, mobile: +44 (0)7990 675 947, out of hours: +44 (0)7917 271 364, e-mail: r.metcalfe@ucl.ac.uk2. 'Disruption of methylarginine metabolism impairs vascular homeostasis' is published in the February issue of the journal Nature Medicine. Advance online publication is embargoed to 18.00 GMT (13.00 US Eastern) Sunday 4 February 2007. Journalists can obtain copies of the paper by contacting the UCL Media Relations Office.3. The study was funded by the British Heart Foundation, the Wellcome Trust and the Medical Research Council. About UCL Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. In the government's most recent Research Assessment Exercise, 59 UCL departments achieved top ratings of 5* and 5, indicating research quality of international excellence. UCL is the fourth-ranked UK university in the 2006 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Mahatma Gandhi (Laws 1889, Indian political and spiritual leader); Jonathan Dimbleby (Philosophy 1969, writer and television presenter); Junichiro Koizumi (Economics 1969, Prime Minister of Japan); Lord Woolf (Laws 1954, Lord Chief Justice of England & Wales); Alexander Graham Bell (Phonetics 1860s, inventor of the telephone), and members of the band Coldplay.
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2. Dialysis patients with metabolic syndrome show increased risk for heart disease
   03-07-2007 · EurekAlert!
   A study of kidney dialysis patients found that nearly 70 percent had metabolic syndrome, a set of symptoms that is a predictor of cardiovascular disease, at the time they initiated maintenance dialysis. This information further illuminates the relationship between heart and kidney disease, as dialysis patients are already known to have an elevated risk of cardiovascular problems.
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3. OHSU Cancer Institute shows findings of immunotherapy vaccine in prostate cancer patients
   06-02-2007 · EurekAlert!
   The study showed that sipuleucel-T did not significantly delay the time it took for a patient's PSA to reach a value of 3 ng/ml, the primary endpoint of the study, but it did show a prolongation in prostate-specific antigen doubling time (PSADT).
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4. Center-based care yields more behavior problems; in other types of care, problems short-lived
   03-26-2007 · EurekAlert!
   New data from a federally-funded longitudinal study show that that children who spent more time in center-based childcare exhibited more problem behavior through sixth grade. Quality of parenting was found to be a stronger and more consistent predictor of social functioning and achievement than early childcare experiences. Higher quality early childcare was also associated with better vocabularies through fifth grade. The study highlights some of the potential enduring effects of childcare and the implications.
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5. Changing fashions govern mating success in lark buntings, study finds
   01-24-2008 · EurekAlert!
   A study of how female lark buntings choose their mates adds a surprising new twist to the evolutionary theory of sexual selection. Researchers at UC Santa Cruz discovered that female lark buntings show strong preferences for certain traits in the males, but those preferences change from year to year.
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6. Jefferson oncologists show breast cancers to be more aggressive in African-American women
   07-09-2007 · EurekAlert!
   A study of more than 2,200 women shows that African-Americans have more advanced breast cancer at the time of diagnosis than Caucasians. African-American women tend to have breast cancer tumor types that are more aggressive and have poorer prognoses. The findings are in line with other recent studies, and provide more evidence of the continuing need for early breast cancer screening for African-American women and the development of individual treatment strategies.
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7. First-ever study: lack of critical lubricant causes wear in joints
   11-06-2007 · EurekAlert!
   For the first time, researchers have linked increased friction with early wear in the joints of animals. Work led by Brown University physician and engineer Gregory Jay, MD, shows mice that do not produce the protein lubricin begin to show wear in their joints less than two weeks after birth. This finding not only points up the protective power of lubricin but also suggests that it could be used to prevent joint wear after an injury.
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8. Kaiser Permanente study shows electronic medical records and outreach improve osteoporosis care
   10-22-2007 · EurekAlert!
   New Kaiser Permanente study in Journal of the American Geriatrics Association is largest study to show electronic medical records and outreach programs of e-mails, letters and phone calls to patients and primary care providers after a bone fracture dramatically improve the diagnosis and management of osteoporosis.
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9. Personal disclosures by physicians are common, may disrupt patient care
   06-25-2007 · EurekAlert!
   In a study involving unannounced visits by actors portraying new patients, primary care physicians shared personal information about one-third of the time, according to a report in the June 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Only 10 (14 percent) of these disclosures were in response to a patient question, and most (62, or 85 percent) appeared not to be useful to the patient.
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10. Older patients with major depression live longer with appropriate treatment, Penn study shows
    05-14-2007 · EurekAlert!
    Older patients with major depression whose primary care physicians team with depression care managers are 45 percent less likely to die within a five-year time period than older adults with major depression who receive their care in primary care practices where there are no depression care managers. This study, conducted by researchers at the University of Pennsylvania School of Medicine, appears in the current issue of the Annals of Internal Medicine.
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