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1.
J Pharmacol Sci ; 153(3): 104-112, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37770151

ABSTRACT

Statins, which are cholesterol synthesis inhibitors, are well-known therapeutics for dyslipidemia; however, some studies have anticipated their use as anticancer agents. However, epithelial cancer cells show strong resistance to statins through an increased expression of HMG-CoA reductase (HMGCR), an inhibitory target of statins. Castration-resistant prostate cancer (CRPC) cells synthesize androgens from cholesterol on their own. We performed suppression of CYP11A1, a rate-limiting enzyme in androgen synthesis from cholesterol, using siRNA or inhibitors, to examine the effect of steroidogenesis inhibition on statin sensitivity in CRPC cells. Here, we suggested that CYP11A1 silencing sensitized the statin-resistant CRPC cell line DU-145 to atorvastatin via HMGCR downregulation by an increase in intracellular free cholesterol. We further demonstrated that CYP11A1 silencing induced epithelial-mesenchymal transition, which converted DU-145 cells into a statin-sensitive phenotype. This suggests that concomitant use of CYP11A1 inhibitors could be an effective approach for overcoming statin resistance in CRPC. Moreover, we showed that ketoconazole, a CYP11A1 inhibitor, sensitized DU-145 cells to atorvastatin, although not all the molecular events observed in CYP11A1 silencing were reproducible. Although further studies are necessary to clarify the detailed mechanisms, ketoconazole may be effective as a concomitant drug that potentiates the anticancer effect of atorvastatin.


Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors , Prostatic Neoplasms, Castration-Resistant , Male , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Atorvastatin/pharmacology , Cholesterol Side-Chain Cleavage Enzyme , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostatic Neoplasms, Castration-Resistant/genetics , Ketoconazole , Cholesterol , Cell Line, Tumor , Hydroxymethylglutaryl CoA Reductases/genetics
2.
Life Sci ; 312: 121249, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36455649

ABSTRACT

AIMS: Statins, cholesterol-lowering drugs, are potential therapeutic agents for inhibiting cancer proliferation. However, the mechanisms that mediate the effects of statins, the homeostatic responses of tumor cells to statin therapy, and the modes underlying the antitumor effects of statins remain unclear. MAIN METHODS: To uncover the effects of statins on cancer cells in vitro, we performed transcriptome and metabolome analyses on atorvastatin-treated statin-resistant and statin-sensitive lung cancer cells. KEY FINDINGS: The results of Gene Ontology terms and pathway enrichment analyses showed that after 24 h of atorvastatin treatment, the expression of cell cycle- and DNA replication-related genes was significantly decreased in the statin-sensitive cancer cells. The results of metabolome analysis showed that the components of polyamine metabolism and purine metabolism, glycolysis, and pentose phosphate pathway were decreased in the statin-sensitive cancer cells. SIGNIFICANCE: Differences in cellular properties between statin-sensitive and statin-resistant cancer cells revealed additional candidates for therapeutic targets in statin-treated cancer cells and suggested that inhibiting these metabolic pathways could improve efficacy. In conclusion, combining statins with inhibitors of polyamine metabolism (cell proliferation and protein translation), purine metabolism (DNA synthesis), glycolytic system (energy production), and pentose phosphate pathway (antioxidant stress) might enhance the anticancer effects of statins.


Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors , Neoplasms , Mevalonic Acid , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Atorvastatin/pharmacology , Polyamines , Purines , Neoplasms/drug therapy , Neoplasms/genetics
3.
Article in Japanese | MEDLINE | ID: mdl-35314573

ABSTRACT

In this article, we present the following: a background of visually induced motion sickness (VIMS), the goal of our study, and descriptions of three recent studies conducted by our group on the measurement and analysis of eye movement while viewing movies and the relationship of eye movement with VIMS. First, this study focuses on the relationship between eye movement and motion sickness susceptibility. We investigated the relationship between the motion sickness susceptibility and the frequency of optokinetic nystagmus (OKN) with peripheral viewing. It was revealed that susceptible participants showed a lower OKN frequency under conditions that strongly support the occurrence of OKN than insusceptible participants. Second, this study focuses on the relationship between visual information and postural variation such as visually evoked postural responses (VEPRs). In this study, both eye movement and the center of gravity while viewing a movie were measured. Additionally, we evaluated the difference in the transfer gain of the transfer function (vision as input and equilibrium function as output) due to the type of movie content or way of viewing. The gain for the three-dimensional movie with peripheral viewing exceeded that for the two-dimensional movie with central viewing. Third, this study focuses on eye movement and the application of deep-learning technology. In this study, we classified the eye movement as peripheral or central using a convolutional deep neural network with supervised learning. Then, cross validation was performed to test the classification accuracy. The use of >1-s eye movement data yielded an accuracy of >90%.


Subject(s)
Motion Pictures , Motion Sickness , Humans , Motion Sickness/etiology , Nystagmus, Optokinetic
4.
J Vet Med Sci ; 84(4): 494-501, 2022 Apr 13.
Article in English | MEDLINE | ID: mdl-35173094

ABSTRACT

Myogenesis, the formation of muscle fibers, is affected by certain glycoproteins, including chondroitin sulfate (CS), which are involved in various cellular processes. We aimed to investigate the mechanism underlying CS-E-induced suppression of myotube formation using the myoblast cell line C2C12. Differentiated cells treated with 0.1 mg/ml CS-E for nine days showed multinucleated and rounded myotubes with myosin heavy chain positivity. No difference was found between the CS-E-treated group with rounded myotubes and CS (-) controls with elongated myotubes in the levels of phospho-cofilin, a protein involved in the dynamics of actin cytoskeleton. Interestingly, N-cadherin, which is involved in the gene expression of myoblast fusion factors (myomaker and myomixer), was significantly downregulated at both the mRNA and protein levels following CS-E treatment. These results suggest that N-cadherin downregulation is one of the mechanisms underlying the CS-E-induced suppression of myotube formation.


Subject(s)
Cadherins , Chondroitin Sulfates , Animals , Cadherins/metabolism , Cell Differentiation , Cell Fusion/veterinary , Chondroitin Sulfates/metabolism , Chondroitin Sulfates/pharmacology , Muscle Development , Muscle Fibers, Skeletal
5.
Vet Comp Oncol ; 20(1): 313-323, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34657361

ABSTRACT

The epithelial-to-mesenchymal transition (EMT) is fundamental in cancer progression and contributes to the acquisition of malignant properties. The statin class of cholesterol-lowering drugs exhibits pleiotropic anticancer effects in vitro and in vivo, and many epidemiologic studies have reported a correlation between statin use and reduced cancer mortality. We have shown previously that sensitivity to the anti-proliferative effect of statins varies among human cancer cells and statins are more effective against mesenchymal-like cells than epithelial-like ones in human cancers. There have only been few reports on the application of statins to cancer therapy in veterinary medicine, and differences in statin sensitivity among canine cancer cells have not been examined. In this study, we aimed to clarify the correlation between sensitivity to atorvastatin and epithelial/mesenchymal states in 11 canine cancer cell lines derived from mammary gland, squamous cell carcinoma, lung, and melanoma. Sensitivity to atorvastatin varied among canine cancer cells, with IC50 values ranging from 5.92 to 71.5 µM at 48 h, which were higher than the plasma concentrations clinically achieved with statin therapy. Atorvastatin preferentially attenuated the proliferation of mesenchymal-like cells. In particular, highly statin-sensitive cells were characterized by aberrant expression of the ZEB family of EMT-inducing transcription factors. However, ZEB2 silencing in highly sensitive cells did not induce resistance to atorvastatin. Taken together, these results suggest that high expression of ZEB is a characteristic of highly statin-sensitive cells and could be a molecular marker for predicting whether cancers are sensitive to statins, though ZEB itself does not confer statin sensitivity.


Subject(s)
Dog Diseases , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Melanoma , Animals , Atorvastatin/pharmacology , Atorvastatin/therapeutic use , Cell Line, Tumor , Cell Proliferation/drug effects , Dog Diseases/drug therapy , Dogs , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Melanoma/veterinary
6.
J Vet Med Sci ; 83(12): 1812-1819, 2021 Dec 02.
Article in English | MEDLINE | ID: mdl-34670921

ABSTRACT

The purpose of this study was to elucidate the functions of estrogen and two estrogen receptors (ERs; ERα and ERß) in the myoregeneration process and morphogenesis. Cardiotoxin (CTX) was injected into the tibialis anterior (TA) muscles of ovariectomized (OVX) mice to induce muscle injury, and subsequent myoregeneration was morphologically assessed. The diameter of regenerated myotubes in OVX mice was significantly smaller than that in intact mice at all time points of measurement. OVX mice also showed lower muscle recovery rates and slower speeds than did intact mice. ER protein levels showed a predominance of ERß over ERα in both intact and OVX states. The ERß level was increased significantly at 7 days after CTX injection in OVX mice and remained at a high level until 14 days. In addition, continuous administration of E2 to OVX mice in which muscle injury was induced resulted in a significantly larger diameter of regenerated myotubes than that in mice that did not receive estrogen. The results indicate that estrogen is an essential factor in the myoregeneration process since estrogen depletion delayed myoregeneration in injured muscles and administration of estrogen under the condition of a low estrogen status rescued delayed myoregeneration. The results strongly suggested that ERß may be a factor that promotes myoregeneration more than does ERα.


Subject(s)
Estrogens , Muscle Fibers, Skeletal , Animals , Estrogens/pharmacology , Female , Mice , Morphogenesis , Muscle, Skeletal , Ovariectomy/veterinary , Regeneration
7.
Sci Rep ; 11(1): 12763, 2021 06 17.
Article in English | MEDLINE | ID: mdl-34140545

ABSTRACT

Epithelial-mesenchymal transition (EMT) in primary tumor cells is a key prerequisite for metastasis initiation. Statins, cholesterol-lowering drugs, can delay metastasis formation in vivo and attenuate the growth and proliferation of tumor cells in vitro. The latter effect is stronger in tumor cells with a mesenchymal-like phenotype than in those with an epithelial one. However, the effect of statins on epithelial cancer cells treated with EMT-inducing growth factors such as transforming growth factor-ß (TGF-ß) remains unclear. Here, we examined the effect of atorvastatin on two epithelial cancer cell lines following TGF-ß treatment. Atorvastatin-induced growth inhibition was stronger in TGF-ß-treated cells than in cells not thusly treated. Moreover, treatment of cells with atorvastatin prior to TGF-ß treatment enhanced this effect, which was further potentiated by the simultaneous reduction in the expression of the statin target enzyme, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR). Dual pharmacological targeting of HMGCR can thus strongly inhibit the growth and proliferation of epithelial cancer cells treated with TGF-ß and may also improve statin therapy-mediated attenuation of metastasis formation in vivo.


Subject(s)
Atorvastatin/pharmacology , Hydroxymethylglutaryl CoA Reductases/metabolism , Neoplasms/pathology , Transforming Growth Factor beta/pharmacology , Biomarkers, Tumor/metabolism , Cell Count , Cell Line, Tumor , Cell Proliferation/drug effects , Cell Size/drug effects , Epithelial-Mesenchymal Transition/drug effects , Gene Expression Regulation, Neoplastic/drug effects , Humans , Models, Biological , RNA, Messenger/genetics , RNA, Messenger/metabolism
8.
Nihon Eiseigaku Zasshi ; 73(1): 39-45, 2018.
Article in Japanese | MEDLINE | ID: mdl-29386445

ABSTRACT

OBJECTIVES: By measuring cerebral blood flow in the prefrontal cortex, we aimed to determine how reading a book on a tablet computer affects sleep. METHODS: Seven students (7 men age range, 21-32 years) participated in this study. In a controlled illuminance environment, the subjects read a novel in printed form or on a tablet computer from any distance. As the subjects were reading, the cerebral blood flow in their prefrontal cortex was measured by near-infrared spectroscopy. The study protocol was as follows. 1) Subjects mentally counted a sequence of numbers for 30 s as a pretest to standardized thinking and then 2) read the novel for 10 min, using the printed book or tablet computer. In step 2), the use of the book or tablet computer was in a random sequence. Subjects rested between the two tasks. RESULTS: Significantly increased brain activity (increase in regional cerebral blood flow) was observed following reading a novel on a tablet computer compared with that after reading a printed book. Furthermore, the region around Broca's area was more active when reading on a tablet computer than when reading a printed book. CONCLUSIONS: Considering the results of this study and previous studies on physiological characteristics during nonrapid eye movement sleep, we concluded that reading a book on a tablet computer before the onset of sleep leads to the potential inhibition of sound sleep through mechanisms other than the suppression of melatonin secretion.


Subject(s)
Cerebrovascular Circulation/physiology , Computers, Handheld , Prefrontal Cortex/blood supply , Reading , Sleep Wake Disorders/etiology , Sleep/physiology , Adult , Books , Humans , Male , Melatonin/metabolism , Spectroscopy, Near-Infrared , Time Factors , Young Adult
9.
Nihon Eiseigaku Zasshi ; 72(1): 87-92, 2017.
Article in Japanese | MEDLINE | ID: mdl-28154366

ABSTRACT

OBJECTIVES: The purpose of this study was to identify and clarify the requirements for 3D stereoscopic images that do not cause viewing discomfort to the human eye even when the protrusion distance is large. METHODS: A total of 140 healthy men and women aged 14 to 79 years participated in this study. We first measured the fusion limits in these participants using two 3D stereoscopic images. We then measured the expansion of the fusion limit by inserting a middle image in a region located equally parallax from the two images. RESULTS: The results showed that the fusion limits were significantly expanded (p<0.01) after inserting the middle image. CONCLUSIONS: Insertion of middle images with parallax can extend the fusion limit. This method was shown to be an effective for viewing 3D stereoscopic images without causing discomfort.


Subject(s)
Accommodation, Ocular/physiology , Convergence, Ocular/physiology , Depth Perception/physiology , Imaging, Three-Dimensional/methods , Vision Disparity/physiology , Adolescent , Adult , Aged , Aging/physiology , Female , Humans , Lens, Crystalline/physiology , Male , Middle Aged , Young Adult
10.
Nihon Eiseigaku Zasshi ; 71(1): 19-29, 2016.
Article in Japanese | MEDLINE | ID: mdl-26832613

ABSTRACT

OBJECTIVES: We aimed to investigate the effect of stereoscopic viewing and the degree of awareness of motion sickness on posture by measuring body sway during motion movie viewing. METHODS: Nineteen students (12 men and 7 women; age range, 21-24 years) participated in this study. The movie, which showed several balls randomly positioned, was projected on a white wall 2 m in front of the subjects through a two-dimensional (2-D)/three-dimensional (3-D) convertible projector. To measure body sway during movie viewing, the subjects stood statically erect on a Wii balance board, with the toe opening at 18 degrees. The study protocol was as follows: The subjects watched (1) a nonmoving movie for 1 minute as the pretest and then (2) a round-trip sinusoidally moving-in-depth-direction movie for 3 minutes. (3) The initial static movie was shown again for 1 minute. Steps (2) and (3) were treated as one trial, after which two trials (2-D and 3-D movies) were performed in a random sequence. RESULTS: In this study, we found that posture changed according to the motion in the movie and that the longer the viewing time, the higher the synchronization accuracy. These tendencies depended on the level of awareness of motion sickness or the 3-D movie viewed. CONCLUSIONS: The mechanism of postural change in movie viewing was not vection but self-defense to resolve sensory conflict between visual information (spatial swing) and equilibrium sense (motionlessness).


Subject(s)
Posture , Audiovisual Aids , Female , Humans , Male , Motion , Young Adult
11.
Nihon Eiseigaku Zasshi ; 71(1): 30-6, 2016.
Article in Japanese | MEDLINE | ID: mdl-26832614

ABSTRACT

OBJECTIVES: Owing to the recent rapid advancements in image processing and three-dimensional (3-D) technologies, stereoscopic images can now be viewed on television as well as in theaters and on gaming consoles among others. However, with these advancements, there have also been reports on motion sickness and asthenopia induced by viewing stereoscopic films. Human equilibrium function deteriorates when viewing stereoscopic films, which may lead to motion sickness; however, the exact cause of such motion sickness remains unknown. Therefore, as part of hygiene research that contributes to society, it is important to consider the safety of viewing virtual 3D contents. METHODS: In this study, we investigated the effects of viewing 2-D/3-D video clips on the human body by stabilometry, electrogastrography (EGG), and subjective assessments. Seven subjects aged 22 to 24 viewed 2-D/3-D video clips for 60 min. RESULTS: A comparison of time series data obtained at rest shows a significant change in the EGG patterns 20 min after the start of viewing the video clips. Furthermore, sway values while viewing the 3-D video clips were considerably higher than those while viewing the 2-D video clips 60 min after the start of viewing. CONCLUSIONS: These findings show that the autonomic nervous system is affected first by long-term viewing of stereoscopic films, and the equilibrium function deteriorates gradually over the course of the exposure.


Subject(s)
Autonomic Nervous System , Audiovisual Aids , Digestion , Eating , Electrophysiological Phenomena , Humans , Imaging, Three-Dimensional , Male , Stomach/physiology , Time Factors , Vision, Ocular , Young Adult
12.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 70(2): 135-42, 2014 Feb.
Article in Japanese | MEDLINE | ID: mdl-24573227

ABSTRACT

Plaque imaging using computed tomography (CT) is an important diagnostic method for predicting the risk of vascular events. However, the CT value variability of plaques, which depends on the scan parameters, remains a key challenge. The aim of this study was to evaluate the effect of reconstruction properties on the CT value, area, and shape reproducibility of plaques. In general, the types of reconstruction kernels in a CT system are limited, thus impeding the acquisition of the necessary resolution properties (modulation transfer functions: MTFs). We therefore obtained images with eight types (smoothed to edge-enhanced) of resolution property by applying frequency processing to the original CT images. We made phantoms of simulated 6-mm-diameter vessels with plaque and scanned them at different doses. The CT values, areas, and shape reproducibility of plaques were measured from each processed image. Enhanced-type resolution with no edge enhancement (not exceeding 1.0) effectively raised the CT value and shape reproducibility accuracies. However, edge-enhancement type resolution caused errors in the CT value, area and shape reproducibility.


Subject(s)
Plaque, Atherosclerotic/diagnostic imaging , Tomography, X-Ray Computed/methods , Phantoms, Imaging , Reproducibility of Results
13.
Article in English | MEDLINE | ID: mdl-24111402

ABSTRACT

The purpose of this study is to develop method for improvement of low-contrast signal detectability of general X-ray images used for observing overviews, included noise reduction technique and signal amplification technique, that are difficult to detect in the observing overview. The proposal method consists signal amplification part and noise reduction part. The noise reduction part first identifies and mathematizes the characteristics of the noise attributed to the X-ray imaging system before the subject is imaged. The noise information derived from mathematization is used to remove the noise representing the system noise from the subject image. After noise reduction, all the signals on the subject image with sufficiently reduced noise are amplified by multiplication with an arbitrary coefficient. The feasibility of the proposed method was indicated by three evaluations that were performed vision assessment using the image including the virtual low-contrast signals by four radiological technologists. That of the proposed method was confirmed from results of the evaluations. That of the proposed method was confirmed from results of the evaluations.


Subject(s)
Signal-To-Noise Ratio , Algorithms , Humans , Image Processing, Computer-Assisted , Neoplasms/diagnostic imaging , Radiography
14.
Int J Comput Assist Radiol Surg ; 8(4): 621-33, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23263885

ABSTRACT

PURPOSE: Liquid crystal display (LCD) of mammograms provides soft-copy results that differ in conventional and phase contrast mammography (PCM). PCM potentially offers the highest quality of sharpness and graininess, an edge emphasis effect on the object, and the highest image resolution. However, when the image is displayed on an LCD, the resolution depends on the pixel pitch and the PCM image data must be diminished. We investigated the observed effect on spatial resolution and contrast when conventional or phase contrast mammograms are viewed on an LCD. METHODS: Using the tissue-equivalent phantom (Model 1011A), a conventional mammogram and a magnification radiography image were obtained with a PCM system. This phantom contains simulated fibers, microcalcifications, and masses. The PCM image was reduced 1/1.75 to render it consistent with life size mammography using the nearest neighbor, bilinear, and bicubic interpolation methods. The images were displayed on a five million (5M)-pixel LCD with 100 % magnification. Ten mammography technicians observed the reduction images displayed on LCDs and reported their results. RESULTS: In the detectability of the microcalcifications, there was no significant difference between conventional mammograms and reduced PCM images. Regarding fibers and masses, detectability using reduced images was higher than those of conventional images. The detectability using images reduced by the nearest-neighbor method was lower than those of images reduced by two other interpolation methods. Bilinear interpolation was affected by the smoothing effect, while CNR was increased. In addition, since the noise of PCM image was reduced by an air gap effect, high detectability of key image features was found. CONCLUSIONS: Soft-copy display of phase-contrast mammograms is feasible with LCDs, while detectability of fibers and masses was best with bilinear interpolation and use of an air gap.


Subject(s)
Breast Neoplasms/diagnostic imaging , Data Display , Mammography/methods , Phantoms, Imaging , Radiographic Image Interpretation, Computer-Assisted/instrumentation , Female , Humans , Liquid Crystals
15.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 66(2): 131-6, 2010 Feb 20.
Article in Japanese | MEDLINE | ID: mdl-20203426

ABSTRACT

An image-guided neurosurgery and neuronavigation system based on magnetic resonance imaging has been used as an indispensable tool for resection of brain tumors. Therefore, accuracy of the neuronavigation system, provided by periodic quality assurance (QA), is essential for image-guided neurosurgery. Two types of accuracy index, fiducial registration error (FRE) and target registration error (TRE), have been used to evaluate navigation accuracy. FRE shows navigation accuracy on points that have been registered. On the other hand, TRE shows navigation accuracy on points such as tumor, skin, and fiducial markers. This study shows that TRE is more reliable than FRE. However, calculation of TRE is a time-consuming, subjective task. Software for QA was developed to compute TRE. This software calculates TRE automatically by an image processing technique, such as automatic template matching. TRE was calculated by the software and compared with the results obtained by manual calculation. Using the software made it possible to achieve a reliable QA system.


Subject(s)
Magnetic Resonance Imaging , Neuronavigation/instrumentation , Neurosurgical Procedures/instrumentation , Software , Surgery, Computer-Assisted/instrumentation , Humans , Phantoms, Imaging
16.
Radiol Phys Technol ; 2(2): 120-5, 2009 Jul.
Article in English | MEDLINE | ID: mdl-20821109

ABSTRACT

Neurosurgeons sometimes find it difficult to locate tumors precisely during microsurgery, particularly tumors located in the brain parenchyma because of the absence of boundaries in this region. Image-guided neurosurgical techniques conducted with the help of neuronavigation systems have been developed and have gained importance recently. Accuracy is vital during image-guided neurosurgery. We used a phantom to evaluate the errors introduced during navigation. The three errors evaluated were skin-shift, marker-gap, and table-rotation errors. The skin-shift error occurs if the fiducial markers positioned on the scalp move when the head is fixed to a head holder with head pins. The marker-gap error occurs when the marker ball is positioned incorrectly in the marker socket. The table-rotation error occurs when the operating table is rotated for obtaining an intraoperative MR image and then returned to its original position. Our results indicated that skin shift decreased the navigation accuracy by an error of more than 4 mm, and the gap between the marker ball and the socket resulted in a decrease in navigation accuracy by an error of more than 5 mm. The table-rotation error was found to be negligible. The errors can be avoided by ensuring that the fiducial markers are positioned appropriately on the scalp and the marker ball is fitted well in the marker socket. A phantom is useful for evaluating accuracy, particularly for evaluating errors intrinsic to different operating rooms. Periodic quality assurance by use of a phantom in each operating room might aid in maintaining the accuracy of neuronavigation.


Subject(s)
Medical Errors , Neurosurgery , Surgery, Computer-Assisted , Fiducial Markers , Humans , Medical Errors/prevention & control , Neurosurgery/instrumentation , Neurosurgery/standards , Operating Tables , Phantoms, Imaging , Rotation , Skin , Surgery, Computer-Assisted/instrumentation , Surgery, Computer-Assisted/standards
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