Neurosurgery
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A significant number of medulloblastomas (MBs) originate from abnormal activation of the sonic hedgehog/patched (SHH/PTC) signaling pathway. Although p53 deficiency enhances tumor formation in mice, inactivation of the p53 gene is seen in a minority of MBs. Wild-type p53-induced phosphatase 1 (WIP1) downregulates p53 expression and has been shown to be overexpressed in MBs. ⋯ We show that ectopic expression of WIP1 cooperates with SHH to enhance formation of MB, although it is insufficient to induce tumors independently. Our results verify the role of WIP1 in MB formation and provide a crucial link to the inactivation of p53 in MBs.
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Innovation in medicine has led to advances directly benefitting patients. Yet recent legislation has created intense scrutiny of the relationship between surgeons and industry. Critics argue that surgeon-held patents and royalties incentivize surgeon loyalty, influencing decision making as to which devices are used intraoperatively. ⋯ The fields in which patents are held include tumor (125), spine (98), vascular (54), trauma (27), stereotaxy/image guidance (88), pain (19), peripheral nerve (2), electrical stimulation (63), and pediatrics (9); surgical instruments (59), drug delivery (17), and other (21) account for the remainder. The total amount of royalties received by neurosurgeons in 2010 is expected to be $13,223,000 (minimum: $7K, maximum: $8.261M). Despite public and legislative perceptions of widespread conflicts of interest, there are relatively few neurosurgeons who hold patents and receive significant royalties.