The high-field-strength MR imager was successfully adapted for intraoperative use with the integrated neuronavigation system. Intraoperative MR imaging provided valuable information that allowed intraoperative modification of the surgical strategy.
Objective: The aim of the study was to evaluate the effect of intraoperative high-field (1.5 Tesla) magnetic resonance imaging (MRI) on the results of transsphenoidal surgery of GH-secreting pituitary macroadenomas. Methods: Twenty-three acromegalic patients (mean tumor size, 25^12 mm; untreated preoperative GH, 4.2-159 mg/l; IGF-I, 349 -1111 mg/l) were investigated by intraoperative high-field MRI. If intraoperative imaging depicted an accessible tumor remnant, resection was continued. Results: In five patients intraoperative MRI led to further tumor removal, two of these met the consensus criteria for endocrine remission after 3 months. In two patients basal GH and oral glucose tolerance test (OGTT) were , 2 mg/l, only IGF-I was slightly elevated, and in one patient GH was , 5 mg/l and OGTT was 2 mg/l, with elevated IGF-I. Final intraoperative MRI showed no tumor remnants in 14 patients; eight of them met the consensus criteria for remission of acromegaly. In the patients with MRI showing incomplete removal (four suspect findings and five patients with intended partial removal) none was normalized. Conclusion: With regard to the patients with a tumor configuration in whom complete tumor removal was considered (n ¼ 18), intraoperative MRI increased the rate of endocrine normalization from 33 to 44% applying the consensus criteria, and improved endocrine outcome to 'nearly normalization' in another 17%. With regard to preoperative GH levels and tumor size, intraoperative MRI can help to achieve endocrine remission in patients who are normally considered not to be curable. However, taking GH as the tumor marker, even intraoperative high-field MRI was not able to detect tumor remnants in every case.
Despite extended resections, introduction of high-field iMRI in conjunction with functional navigation did not translate into an increased risk of postoperative deficits. The use of high-field iMRI increased radicality in glioma surgery without additional morbidity.
Spectral sensitivity functions were measured between 334 nm and 683 nm in Salamandra salamandra by utilizing two behavioral reactions: the negative phototactic response, and the prey catching behavior elicited by a moving worm dummy. The action spectrum of the negative phototactic response revealed 3 pronounced maxima: at 360-400 nm, at 520-540 nm, and at 600-640 nm. In the range around 450 nm, there was a "reaction gap" where sensitivity could not be measured. The action spectrum of the prey catching behavior was entirely different: maximal sensitivity was found at 500 nm and at 570 nm. Between 500 nm and 334 nm sensitivity decreased continuously for about 1 log unit (Fig. 6).Experiments under chromatic adaptation using the prey catching behavior indicate that the relatively high sensitivity in the ultraviolet range is not due to a separate ultraviolet photoreceptor, but is based on the responses of a photoreceptor maximally sensitive at about 500 nm.Color discrimination was tested by moving a colored worm dummy within a differently colored surround of equal subjective brightness. The salamanders were able to discriminate blue from green, and green from red (Fig. 10). The results can be explained by assuming a trichromatic color vision based on 3 photoreceptor types maximally sensitive around 450 nm, 500 nm and 570 nm (Fig. 12).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.