Changing the face of London's healthcare.

Europe's newest hospital, and the UK's largest ever PPP-funded and operated healthcare facility--the 650 pounds sterling million Royal London in Whitechapel--opened its doors on 1 March--following years of hard work and planning which has seen doctors and nurses involved throughout, working under the guidance of a 30-strong Barts and the London NHS Trust New Hospitals Programme team to create an optimal healing environment. HEJ editor, Jonathan Baillie, discussed with New Hospitals Programme director, Matthew Tulley, the challenges of overseeing the design, planning, and construction, of the 'new' Royal London as part of a wider 1 billion pounds sterling PFI project to transform and modernise facilities at both the Barts and the Royal London sites, and of smoothly moving over 3,000 staff and patients from old to new accommodation.

A simple stereotactic method for frameless deep brain stimulation.

Background: Deep brain stimulation (DBS) is widely used to treat advanced Parkinson's disease, other movement and psychiatric disorders. DBS implantation requires application of a stereotactic frame throughout a lengthy procedure, making it uncomfortable and tiring. We designed a stereotactic cube to stage the operation, perform frameless microelectrode recording (MER) and fix the DBS.

Staged functional neurosurgery using image fusion: electronic atlas and microelectrode recording at Dundee.

The unforgiving nature of the thalamus, the globus pallidus and the subthalamic nucleus necessitates precise localization of functional targets. This requires the total attention of both the patient and the surgeon. To maximize the concentration of the patient and provide the most accurate localization, we performed staged stereotactic functional procedures.

Audit of neurophysiological recording during movement disorder surgery.

Sixty-two cases of thalamic pallidal and subthalamic surgery in Dundee were audited to assess the influence of physiological localisation on the procedure. Methods included microelectrode recording, evoked potential and stimulation techniques. Although anatomical localisation is improving with modern techniques, the physiological information is still modifying the surgery in 67% of cases.

Development of a novel system for assessing tooth and restoration wear.

Objectives: This investigation sought to develop a mapping apparatus for use in the assessment of both tooth and restoration wear.

Methods: A computer controlled mapping device, capable of scanning a suitably prepared electroconductive tooth replica by means of an electrical feedback mechanism, was constructed and its accuracy assessed by measuring the thicknesses of four engineers' slip gauges 12 times each. The reproducibility of three potential methods of rendering a die stone replica electroconductive was also investigated.