Hydatid cysts in retroperitoneal region in transit to the thorax

different aging and other skin spots can be treated succesfully with Co2 laser.

Neuroanatomy of CSF Flow

The complex circuitry interconnecting different areas in the brain, known collectively as white matter, is composed of millions of axons organized into fascicles and bundles. Upon macroscopic examination of sections of the brain, it is difficult to discern the orientation of the fibers. The same is true for conventional imaging modalities. However, recent advancements in magnetic resonance imaging (MRI) make such task possible in a live subject. By sensitizing an otherwise typical MRI sequence to the diffusion of water molecules it is possible to measure their diffusion coefficient in a given direction1. Normally, the axonal membrane and myelin sheaths pose barriers to the movement of water molecules and, thus, they diffuse preferentially along the axon2. Therefore, the direction of white matter bundles can be elucidated by determining the principal diffusivity of water. The three-dimensional representation of the diffusion coefficient can be given by a tensor and its mathematical decomposition provides the direction of the tracts3; this MRI technique is known as diffusion tensor imaging (DTI). By connecting the information acquired with DTI, three-dimensional depictions of white matter fascicles are obtained4. The virtual dissection of white matter bundles is rapidly becoming a valuable tool in clinical research.

Our journey begins with a transverse section of tightly packed axons as seen through light microscopy. Although represented as a two-dimensional "slice", we see that these axons in fact resemble tubes. A simulation of water molecules diffusing randomly inside the axons demonstrates how the membranes and myelin hinder their movement across them and shows the preferred diffusion direction --along the axons. The tracts depicted through DTI slowly blend in and we ride along with them. As we zoom out even more, we realize that it is a portion of the corpus callosum connecting the two sides of the brain we were traveling on and the great difference in relative scale of the individual axons becomes evident. The surface of the brain is then shown, as well as the rest of the white matter bundles--a big, apparently chaotic tangle of wires. Finally, the skin covers the brain.

With the exception of the simulated water molecules, all the data presented in the animation is obtained through microscopy and MRI. Computer algorithms for the extraction of the cerebral structures and a custom-built graphics engine make our journey through the brain's anatomy possible in a living person.

Micrograph courtesy of Dr. Christian Beaulieu, University of Alberta.
Music by Mario Mattioli.

References:
1. Stejskal, E.O., et al., J. Chem. Phys., 1965. 42:
2. Beaulieu, C., NMR Biomed., 2002. 15:435-55.
3. Basser, P.J., et al., J. Magn. Reson. B, 1994. 103:247-54.
4. Mori, S., et al., NMR Biomed., 2002. 15:468-80.

Insertion of a CSF shunt

I call this technique deep rendering. I basically stacked graphical cross-sections (in this case, MRI rendering data), using proper increments and clip through them with the camera. This way I am able to explore all internal components in full 3D real-time.

I actually was able to figure out how to colorize different organs to help distinguish them apart from each other but couldn't get the shader to render real-time in Maya.

Credit: MRI scans courtesy of University of Washington Digital Anatomist Program

Endoscopic fenestration of suprasellar cyst in a 4 years old girl

Endoscopic fenestration of arachnoid cyst in middle fossa

brain scans with arachnoid cyst, pre and post operative

Endoscopic Management of Brain Cyst, ForaminoPlasty

Endoscopic Brain Surgery, third Ventriculostomy

Ganglion Cyst Removal

Hydatid Cyst Removal from the brain

Watch as Dr. Benjamin Carson performs risky brain surgery on young Payton to remove a brain tumor. Dr. Carson, director of pediatric neurosurgery, is just one of the many reasons why Johns Hopkins Children's Center was recently ranked #1 in neurology and neurosurgery in America's Best Children's Hospitals 2008

Vanderbilt Medical Center neurosurgeons and neurologists will be online demonstrating their 4-stage innovative technique used for Deep Brain Stimulation (DBS). Deep brain stimulation therapy utilizes an implantable neuro-stimulator to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia.

M. Patrick Lowe, MD, renowned robotic surgeon and gynecologic oncologist at Northwestern Memorial Hospital, will demonstrate the use of robotic surgery to treat endometrial cancer.

Dr. Lowe, director of the robotics and minimally invasive surgical program for the Division of Gynecologic Oncology at Northwestern University's Feinberg School of Medicine, was among the early adopters of robotics to treat gynecologic malignancies, citing precision, improved dexterity and superior patient outcomes among the benefits.

"Women diagnosed with a gynecologic malignancy want the shortest route leading back to a degree of normalcy post treatment," says Lowe. "Robotic surgery offers the path of least resistance, combining shorter recovery times with superior outcomes."

Highlights of a fetal laser surgery for twin-to-twin transfusion syndrome (TTTS) will be shown from Tampa General Hospital

TTTS affects 10 to 15 percent of identical-twin pregnancies and is the result of abnormal blood exchange between identical twins through a common placenta. The larger of the twins, or recipient, is surrounded by too much amniotic fluid and in danger of heart failure as its body tries to pump the overwhelming volume of blood intended for both. The smaller, or donor twin, is encased in a shrinking amniotic sac deprived of blood. Without treatment, both will likely die.

Rubén Quintero, M.D., Medical Director of Maternal Fetal Medicine/Fetal Surgery at Tampa General Hospital and Professor and Director of the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida College of Medicine will narrate the procedure and answer e-mail questions live as taped highlights of the procedure are shown.

On Tuesday May 29th at 3:00pm EDT, University Hospitals Case Medical Center Cleveland, Ohio, will host a live webcast to demonstrate the removal of brain tumor and epileptic focus from an awake patient using intra-operative MRI and brain mapping. See this on OR-Live.com

The patient was a middle-aged gentleman with new onset seizures. An MRI showed what appeared to be a low grade glioma near the motor strip on the right. Studies have shown that complete removal can cure the seizures, improve quality of life and survival, but this is difficult to do with conventional technology without harming the surrounding normal brain because its difficult to determine where tumor ends and normal brain begins.

Cricothyroidotomy NEJM

Arthrocentesis of the Knee