NEWS UPDATE-MINIMALLY INVASIVE SURGERY-THE IKNIFE SURGERY

IKNIFE SURGERY

If anybody thought of going into the operation theater fills with trauma and fear of surgical instruments, the needles and knife's cutting edges. General anesthesia or partial anesthesia may minimize the pain but still they are problematic.

Whenever surgery is advised by the doctor the patient gets naturally the presurgical trauma and fear.

The history of surgery dates back to dark and more invasive methods. Ancient Egyptians drill holes into the living person's skull to cure a headache, migraine, convulsions, and to correct a fracture.

In ancient times a cataract surgery was carried out by passing a hook through the pupil without an anesthetic. Leeches were used to suck the blood which lets out during the surgery. Now these gruesome and invasive surgical operations become past history. Thank God as at present the surgery becomes mostly noninvasive by the inventions of most modern instruments such as Laparoscopy, and laser instruments. Even a heart transplant is now relatively routine. A gallbladder can easily be removed through a keyhole surgery by using a laparoscope.

A laparoscope is a small tube with a light source and camera which is inserted through a keyhole into the body until it reaches the relevant part. The areas that to be operated, show up on the screen.

Minimally invasive surgery involves, small incision, less scar, lower risk of infections, a reduced period of convalescence, and a shorter stay in hospitals.

ARTEMIS OR ROBOTIC OPERATIONS

In July 2000 a team of scientists in Germany developed an operating system with two robotic arms which are controlled by a surgeon at a control console. They called it Artemis.

In the same 2000, the first Robotic Surgical System was approved in the US by the FDA. They called it by the name The Da Vinci System.

The system contains three components.

1.A vision cart with a light source and cameras

2.A master console where the surgeon sits

3.A movable cart with two instrument arms and the camera arm.

The camera provides a true 3-D image displayed above the surgeon's hands so that the tips of the instruments seem like an extension of the control grips.

Foot pedals control extra cautionary, camera focus, instrument and camera arm clutches, and master control grips that drive the servant robotic arms at the patient side.

But still, there are drawbacks in the robotic surgery with reports of malfunctions, and errors which sometimes fatal. Hence these methods to not satisfied by everyone else.

ELECTROSURGICAL KNIVES

As days are passing the surgical science improves with higher technology to minimize the complications of surgery.

Electrosurgical knives are invented in 1920 and are used to remove cancerous tumors. The electrical knives are working by using an electric current it rapidly heats the body tissue and cutting it by minimal blood loss. Yet the instrument needs to be improved as the older electrical knives and the doctors' eyes cannot many times differentiate the cancerous cells from the noncancerous healthy cells.

In 2013 a continuous research on this has given the fruit by the finding of an Iknife with the expected result.

The Iknife by using mass spectrometry can enable the surgeon to examine biological tissue by pairing up electrosurgery.

In mass spectrometry electrically charged ions are passed through the electric or magnetic fields. These processes can distinguish between tissues of different combinations by the calculation of mass to charge measurements. The method is known as chemical profiling.

By analizing the chemical composition of different tissues, it can easily identify which tissues are healthy and which are not.

Mechanisms of the Iknife

Cutting with the electrical knife causes the tissue to vaporize and produce smoke. This smoke is sucked and passed through connected a mass spectrometer which analyzes the vapor to its chemical mass. By matching the results to a reference index, the surgeon can identify the type of tissue within 3 seconds.

The reference index has been made by Dr.Takas and his team by taking and comparing thousands of cancerous and non-cancerous tissues. From these samples they created the data index of 1624 cancerous and 1309 non-cancerous entries for matching samples in the future.

In future the Iknife can be used to analyze mucous membranes, and the respiratory, urinogenital, and gastrointestinal systems.

NEWS UPDATE-A NEW MILESTONE IN THE DIAGNOSIS OF PD

MILESTONES IN THE DIAGNOSIS OF PARKINSON DISEASE

A new hope has emerged for the early accurate diagnosis for Parkinson's Disease after research finding that an abnormal protein associated with PD can be detected from the patient's spinal fluid in clumps.

Though it is too early to say about a conclusive result for the test as it has been done with a small batch of the patients only but the researches say in future the test would be conducted through large batches of patients to bring up to surface.

As we all from a previous post in this blog about Parkinson's Disease PD, that PD is an incurable disease. It is a kind of nerve disorder in which dopamine production in the brain is impaired over time due to the damage and death of dopamine-producing neurons in the nigrostriatal pathway and substantia nigra.For details please refer to the article-Parkinson's Disease in this blog.

At present there is no proper diagnosis for PD to give a definitive result. Nowadays the diagnosis by a simple assessment through the patient's medical history, medical examination, physical and neurological tests. But the results are not immediate and may take years to conclude.

Dr.Allison Green and his colleagues of the National CJD Research and Surveillance Unit at the University of Edinburgh in the UK revealed that the diagnostic which they devised for detecting Creutzfeldt-Jacob Disease(CJD) rare serious dementia with complicated brain disorders, can be successfully used to diagnose and detect early development of PD. In CJD and PD the same clumpings of proteins are seen in the CNS fluids.

Dr.Allison Green called the test as Real-Time Quaking Induced Conversion(RT-QuIC). The test accurately detected the accumulation and clumping of Alpha Synuclein in the spinal fluid of PD patients.

Alpha-Synuclein 

This is a kind of protein found in all normal individuals but is believed to trigger PD and Lewy body Dementia by the formation of clumps in the spinal fluid. The clumps are known as Lewy Bodies.

These clumps are detected in the spinal fluid to determine and indicate the presence of these clumps present in the neurons of the nigrostriatal and substantia nigra and block them not to produce dopamine.

Also they block the dopamine production at the neurons situated in the region of cognitive abilities and cause the disease Lewy body Dementia and CJD.

At present the test by Dr. Green et.al has been applied to 20 samples of spinal fluid taken from PD patients and 15 samples from healthy patients.

The test however has the ability to measure the stickiness and clumping up of proteins an indicator of whether they are likely to cause the disease or not.

They found that the test was with 95% accuracy and 100% specificity.

THE NEWS

 

Early Parkinson's diagnosis moves closer with new protein test

Written by Honor Whiteman

Published: Tuesday 30 August 2016 Published: Tue 30 Aug 2016

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Researchers may be one step closer to a diagnostic test for Parkinson's disease, after finding that an abnormal protein associated with the illness can be detected in patients' spinal fluid.

Researchers are closer to a much-needed diagnostic test for Parkinson's disease.

While it is early days for the test, the team's results - published in the journal Annals of Clinical and Translational Neurology - have been hailed "hugely promising."
Parkinson's disease is a neurological condition whereby the production of dopamine in the brain is reduced over time, due to the damage and death of neurons that produce it. Dopamine is a neurotransmitter involved in the regulation of movement and coordination.
As a result, patients with the disease may experience tremors of the hands, arms, legs, jaws, and face, slowed movement, muscle rigidity, impaired posture and balance, and speech problems.
There is currently no definitive test for Parkinson's. The disease is normally diagnosed thorough assessment of the patient's medical history, a medical examination, and physical and neurological tests, but this can take years.
Now, Dr. Alison Green, of the National CJD Research & Surveillance Unit at the University of Edinburgh in the United Kingdom, and colleagues reveal how a test originally developed to detect Creutzfeldt-Jakob disease (CJD) could be adapted to detect Parkinson's.

The test detected Parkinson's with 95 percent accuracy

In their study, Dr. Green and the team report how the test - called the real-time quaking-induced conversion (RT-QuIC) - accurately detected accumulation of the protein alpha-synuclein in the spinal fluid of patients with the disease.

Fast facts about Parkinson's

• Almost 1 million Americans are living with Parkinson's
• The precise cause of Parkinson's remains unclear
• There is no cure for Parkinson's, only treatments to help manage symptoms.

Learn more about Parkinson's

Alpha-synuclein is a protein believed to be associated with the onset of both Parkinson's disease and Lewy body dementia.
In people with Parkinson's, the protein has been found to form clumps - called Lewy bodies - in neurons that produce dopamine, while in patients with Lewy body dementia, the clumps form in neurons associated with cognitive abilities.
While previous studies have attempted to develop a test to detect alpha-synuclein, these have produced conflicting results. This is because the protein is present in the brains of healthy individuals, only causing problems when it clumps together.
The test from Dr. Green and colleagues, however, has the ability to measure the stickiness and buildup of proteins, an indicator of whether they are likely to cause disease.
For their study, the researchers applied the test to 20 samples of spinal fluid taken from patients with Parkinson's disease, alongside samples of 15 healthy controls.
They found the test was able to identify 19 out of 20 samples with 95 percent accuracy and 100 percent specificity. It was also able to detect the buildup of the protein in three spinal fluid samples of individuals at high risk for Parkinson's.
The team also applied the test to samples of patients with Lewy body dementia. Compared with control samples, the test was able to detect the disease with 92 percent accuracy and 100 percent specificity.

A 'significant development' toward early test for Parkinson's

While these results need to be validated in a larger sample of patients, the researchers are hopeful that their findings could lead to much-needed diagnostic tests for both Parkinson's and Lewy body dementia.
Dr. Green says earlier diagnosis for these patients may mean greater participation in clinical trials of new drugs to prevent disease or slow progression.
Dr. Beckie Port, senior research communications officer at Parkinson's UK, says the team's findings could one day meet the need for a simple, accurate test for Parkinson's.

"Although early days, the fact that researchers have developed a new test that is able to detect abnormal alpha-synuclein in the spinal fluid of people with Parkinson's with remarkable specificity and sensitivity, is hugely promising.
Further research is needed to test more samples to see if the results continue to hold true, but this could be a significant development towards a future early diagnostic test for Parkinson's."

Dr. Beckie Port

Read about the discovery of a mutant gene interaction that could lead to new treatments for Parkinson's.

Written by Honor Whiteman