1. Parkinson’s Disease and NOTES By: Amy Duda

2. What is Parkinson’s? Nerve cells use a brain chemical, dopamine, to help control muscle movement. Parkinson’s disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without this chemical, the brain cannot properly send messages to the cells. This leads to loss of muscle function. Parkinson’s Disease is a potentially fatal disease that often times leads to death.

3. The Cure Exactly why the brain cells waste away is unknown. There is currently no cure for Parkinson's. Medicines are given to patients to relieve the symptoms of Parkinson's, however, they do not cure the disease. A new technique could potentially lead to a drug that could not only cure the symptoms, but cure he disease itself.

4. A New Technique The University College London has taken skin cells from a patient with Parkinson’s disease and generated them into nerve cells. Those nerve cells could then be brought into the laboratory to figure out why certain nerve cells die. Having them in the laboratory allows them to conduct new research and test drugs that they would not have been able to test before.

5. Results There still is not a cure for Parkinson’s but the new technique holds great promise towards not only a cure for Parkinson’s, but for other diseases as well.

6. NOTES What is NOTES? Natural Orifice Translumenal Endoscope Surgery, or NOTES, is a new surgery that involves the removal of organs through a natural orifice (mouth, vagina, or anus). It can remove organs such as the appendix, gallbladder, kidney, along with hernia repair.

7. How does NOTES work? An endoscope is inserted into the body through a natural orifice. The endoscope is equipped with a camera and a light that sends real time signals to the screen so the doctor can watch what he’s doing on screen while he completes the procedure. The doctor can make incisions inside the body to get to the organ.

8. What does an endoscope look like?

9. NOTES Simulator Professor Suvranu De has made a NOTES simulator to help doctors practice this procedure. The doctor holds the controls and watches the simulation on the screen while he does the procedure. During the real procedure, doctors look at a screen while they make incisions inside the patient’s body. The screen has real time user interactions.

10. The Ideal Patient The ideal patient for this procedure would be a person that has a demanding profession and can to afford to take more than a few days off work.

11. Advantages This procedure can reduce pain, recovery time, complications, and hernias even further compared to a traditional laparoscopic surgical approach. Patients will be able to return to normal life within two days without pain medication. No external scarring. NOTES is one of the safest alternatives to traditional laparoscopic surgery.

12. Results This procedure will continue to evolve towards a less invasive surgical approach and holds great promise. Other organs may be able to be removed using NOTES.

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14. Citations http://www.rpi.edu/research/magazine/summer11/health-1.html http://archneur.ama- assn.org/cgi/content/full/59/5/848?maxtoshow=&hits=10&RESULTF ORMAT=&fulltext=fmailial+aggregation+of+parkinson%27s+dieseas e&searchid=1&FIRSTINDEX=0&resourcetype=HWCIThttp://archneur.ama- assn.org/cgi/content/full/59/5/848?maxtoshow=&hits=10&RESULTF ORMAT=&fulltext=fmailial+aggregation+of+parkinson%27s+dieseas e&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT http://www.biologynews.net/archives/2011/03/11/surgery_without_ex ternal_scars_is_gaining_traction.htmlhttp://www.biologynews.net/archives/2011/03/11/surgery_without_ex ternal_scars_is_gaining_traction.html http://www.eurekalert.org/pub_releases/2011-08/uoe- scs082211.phphttp://www.eurekalert.org/pub_releases/2011-08/uoe- scs082211.php

15. Questions?