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Abstract: Aims: To apply modern mass spectrometry based technology to identify possible CSF peptide markers of glioblastoma multiforme (GBM). Methods: Mass spectrometry based peptidomics® technology enables a systematic and comprehensive screening of cerebrospinal fluid (CSF) with regard to its peptide composition. Differential Peptide Display® (DPD) allows the identification of single marker peptides for a target disease. Using both, we analyzed CSF samples of 11 patients harbouring a glioblastoma multiforme in comparison to 13 normal controls. Results: Four CSF peptides which significantly distinguished GBM from controls in all applied statistic tests could be identified out of more than 2000 detected CSF peptides. They were specific C-terminal fragments of alpha-1-antichymotrypsin, osteopontin, and transthyretin as well as a N-terminal residue of albumin. All molecules are constituents of normal CSF, but none has previously been reported to be significantly elevated in CSF of GBM patients. Conclusion: The study showed that peptidomics technology is able to identify possible biomarkers of neoplastic CNS disease. It remains to be determined if the identified elevated CSF peptides are specific for GBM. With regard to GBM, however, the more important role of CSF peptide biomarkers than aiding initial diagnosis might be early recognition of disease recurrence or monitoring of efficacy of adjuvant therapy protocols. [Copyright &y& Elsevier]

Abstract: Aim: To test the versatility and usefulness of a prototype rigid endoscope with a continuously variable-view-angle tip (Endochamaeleon, Karl Storz, Tuttlingen, Germany) with regard to field of vision and applicability for endoscopic assisted neurosurgery. Methods: In five formaldehyde fixed specimens frontolateral and retrosigmoid approaches were prepared on both sides and five target positions of the endoscopes tip were defined. A rigid 4mm endoscope, which offers in one plane a viewing range of approximately −10° to +120° by turning a proximal knob coupled to fine distal optomechanics was compared to 0°, 45°, and 70° rigid endoscopes. The visualizable neuroanatomical structures were assessed for each position, endoscope angle, and plane of view as well as the over-all visibility of neuroanatomical structures and the time factor. Results: 1905 recorded images of 1800 different views were analyzed. The EC offers a variable angle of view in one plane without need to change the endoscope position. This feature is well suited for inspection of functionally delicate areas at the skull base. The maximum number of visible structures for each position was only seen with the EC. Endoscopic exploration was significantly less time consuming with the EC than with the other endoscopes. Conclusion: The EC provided superior usability and visualization potential compared to standard rigid endoscopes with fixed angulation. It combines the ergonomic and safety advantage of not having to insert endoscopes with different angles with the opportunity to “scan” the surgical field with a variable angle of 0°–120° within one plane of view. [Copyright &y& Elsevier]