Saturday, March 28, 2009

Focal therapy and CyberKnife for localised PCa

from the IV MB, post by yyy60:

>>Focal therapy and CyberKnife for localised PCa (UroSource, Netherland)

Friday, 27 March 2009- At the recent 24th Annual EAU Congress held in Stockholm, Dr. Giuseppe Morgia (Messina, Italy) lectured for a European School of Urology (ESU) course regarding emerging treatment procedures for localised prostate cancer such as the Cyberknife, a technique which he said offers several distinct advantages but with a high price tag that hampers the wider use of this new technology.


In his concluding remarks, Morgia summarised the benefits and drawbacks of the Cyberknife system. Benefits include: short treatment course; potent radiation dose within the prostate; less invasive than HDR barchytherapy, and the sharp treatment margin reduces radiation exposure to surrounding tissues.

Amongst the drawbacks are the minimal publications on treatment outcomes; long-term effectiveness has not been confirmed; sharp margin could miss cancer cells if they spread outside the prostate; complications and QoL are not standardised, the high cost of the equipment and the existence of few active centres.

Hypofractionated CyberKnife radiosurgery for perichiasmatic pituitary adenomas: early results

from the IV MB, post by yyy60:

Hypofractionated CyberKnife radiosurgery for perichiasmatic pituitary adenomas: early results

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.

OBJECTIVE: Radiation therapy is recommended for pituitary tumors that are refractory to surgical and medical therapies. The efficacy of single-fraction radiosurgery is established for these lesions, but lesions within 3 mm of the optic pathway cannot be safely treated with doses higher than 8 to 10 Gy. We hypothesized that the optic nerve will tolerate 5 consecutive daily radiosurgery fractions of 500 cGy with effective tumor control.

METHODS: We reviewed our first 20 patients with recurrent or residual pituitary adenomas within 3 mm of the optic chiasm treated with the CyberKnife radiosurgery system (Accuray, Inc., Sunnyvale, CA). Tumors were treated with a mean coverage of 97 +/- 2.2% (range, 89.8-99.7%), a mean conformity index of 1.3 +/- 0.2 (range, 1.1-1.6), and a mean treatment isodose line of 74.5 +/- 6.6% (range, 60-86%). The primary end point was an interim analysis of visual preservation, and secondary end points were radiographic and endocrinological tumor control.

RESULTS: The mean follow-up period for visual field testing was 26.6 +/- 10.5 months (range, 10.6-41 months). The vision of all 14 patients with intact preoperative vision remained intact. Of the 5 patients with impaired vision, 2 remained stable, and 3 improved. No patient's vision deteriorated. The mean radiographic follow-up was 29.3 +/- 8.6 months (range, 10.2-40.5 months). On magnetic resonance imaging, 12 tumors were stable, 8 were smaller, and none enlarged.

CONCLUSION: This preliminary study establishes that the optic nerve and chiasm tolerate CyberKnife hypofractionated radiosurgery of 5 x 500 cGy to perichiasmatic pituitary adenomas. Early data suggest that this dosing paradigm may achieve satisfactory radiographic and endocrinological tumor control for these challenging lesions, but longer follow-up is necessary to confirm these results.

Network neutral colocation Companies

In this article, we will examine and compare some metrics for two different Companies active in the colocation business, Equinix (EQIX) and Switch and Data (SDXC).

Both Companies are network neutral, which means that they offer a wide range of competing bandwidth providers in their centers, that may be seen as secure bunkers where customers keep their servers to store Internet content, data, and interconnect to each other or to the final users, through Telecoms, ISPs.

Going back in time, it's interesting to note that Equinix was funded by Al Avery and Jay Adelson, (now the CEO of, who had previously developed the concept that became the first commercial interconnection point of the Internet, the Palo Alto Internet Exchange, or PAIX®.

PAIX, that was later expanded to other US cities, was acquired in 2003 by Switch and Data, and still represents the foundation of the interconnection side of this Company's activity.

While the two Companies can be compared, as they share a similar model, and almost similar roots, as noted, it's useful to underline a few differences in their business approach:

  • Equinix has become the leader in the colocation sector, with a worldwide presence in all key markets, and revenues in excess of $ 700 Million in 2008 ($ 443 Million in the US), while Switch and Data only operates centers in North America only and has established a partnership in Europe with Interxion (a former Equinix partner) for customer referral, to try to respond to the needs of multinational customers (2008 revenues: $171,5 Million);

  • Equinix data centers are usually larger (an average of 82,500 sqft.), and the Company concentrates its efforts in a few, selected, major markets (only 6 in the USA), while Switch and Data centers are present in 23 North American markets (including Toronto, Canada) and are usually smaller in size (on average less than 31,000 sqft., ranging from 8,000 to 254.300 sqft.);

  • locally, both Companies enjoy leadership in different markets – Switch and Data Palo Alto PAIX is the best interconnected center in the West Coast, while Equinix is the leader in the East Coast with its Ashburn (Washington DC metro) center – but usually both firms offer access to the main bandwidth providers in each of the markets where they do have a presence, as their centers are a “must be” location for Telecoms, ISPs, etc.;

  • Equinix listed on NASDAQ in 2000, and survived through the bubble burst as a public Company, while Switch and Data had its IPO only in February, 2007, taking advantage from the bubble burst through its PAIX acquisition from the AboveNet/Metromedia Fiber Network bankruptcy ;

  • both Companies enjoyed a nice growth rate in the last few years (+25% for Switch and Data and +38% for Equinix, organically, in 2008 ) and their outlook for 2009 is predicting a similar increase, +20% for Switch and Data and slightly in excess of 20% for Equinix.

We will limit our metrics mostly to data for the last 2 years, given Switch and Data recent history as a listed Company, but also because these numbers represent, for both Companies, a maturity level.

To run our comparisons, we will make use of spreadsheets created by Gridstone Research. This Company assembles, analyzes, and structures unstructured company information into operational data, and graphics. What is interesting about their method, is that they do not limit their research to Company filings, but also include conference call transcripts, from Seeking Alpha, and other sources of information, and this does also allow to dig into additional metrics, like in this case churn or cabinets billing or same centers revenues, that usually would require a specific, often time consuming research.

Let's start from some basic analysis - revenue, recurring revenue and gross profit for both Companies (you may click on the charts to enlarge):

Both Companies have been growing steadily, recently, and recurring revenues (a very predictable number, as it is linked to contracts with an average life of about two years) do represent almost 95% of the total turn over. Equinix shows a spike in the 4Q of 2007 due to the first full quarter integrating the European assets derived from the acquisition of IX Europe, that increased revenues but also did impact margins negatively.

Here is a view of total revenues and EBITDA for both Companies (US numbers only for Equinix, for an apple to apple comparison): we may notice that EBITDA is generally growing, in percentage, at a faster pace than revenues, and has reached a very healthy 49.5% of revenues for Equinix in the last quarter (US only, 44.1% in total), while Switch and Data is at 34.6%.

Equinix has also been reporting, in the past, revenues for “same IBX” centers, to give some insight into organic growth excluding the new openings – here is a quick look:

Finally, some sector related metrics like cabinets billing (growing for both Companies) and churn: as to this metric, it is interesting to note that both Companies are forecasting, in spite of the difficult economic climate, a very low churn at about 2% per quarter, and Switch and Data has achieved so far keeping this number well below that level:

Lastly, if we look at 4Q 2008 numbers, we realize that Equinix enjoys a very healthy revenue per employee ratio, having achieved $ 188,000 per employee in that specific quarter, or $ 752,000 on a yearly basis (USA numbers only, it is $171,000 per quarter as a Company, or $ 684,000 yearly), while Switch and Data is at $ 135,100 in the 4Q 2008 ($ 540,400 yearly) – as we noticed Equinix data centers are generally larger and the economy of scale achieved probably contributes to a stronger productivity number.

Akamai Data: Internet, Broadband Still Going & Growing

from GigaOm:

>>The launch of super high-speed DOCSIS 3.0 cable broadband technology, the increased deployment of fiber and faster DSL lines resulted in a sharp increase in the average speed of broadband connections during the fourth quarter of 2008, according to data collected by Akamai for its “State of the Internet” report, expected to be released on Monday.

Just for fun, it's not too difficult to detect Akamai customers even at this end (click to enlarge):

Equinix statistics

Friday, March 27, 2009

Switzerland's lifestyle and fashion magazine Annabelle report on Cyberknife

from the IV MB, by yyy60:

>>Switzerland's lifestyle and fashion magazine Annabelle report on Cyberknife

link to the translated article 1,000 Servers at Equinix

must read from Data Center Knowledge:

>>TechCrunch noted yesterday that (CRM) says it runs its entire operation on just 1,000 servers, of which 500 are used to mirror data. “Think about that for a minute,” Erick Schonfeld writes. “Salesforce has more than 55,000 enterprise customers, 1.5 million individual subscribers, 30 million lines of third-party code, and hundreds of terabytes of data all running on 1,000 machines. … All of Salesforce relies on data stored in only ten databases that run on about 50 servers.”


The company says it is building its first international data center in Singapore, which is expected to go live before the end of fiscal 2010, and will service the rapidly growing international customer base for its Software-as-a-Service (SaaS) applications and hosting. also announced plans to establish a Network Operations Center (NOC) in Singapore to implement 24×7, follow-the-sun monitoring of the company’s data centers in North America and Singapore.

The Singapore facility is likely within a new data center under construction by Equinix, which is scheduled to come online this year.

Wednesday, March 25, 2009

Peering with WV Fiber

Equinix Chicago, IL, US 2001:504:0:4:0:1:9151:1 10GigE Active 20G Q1/09

Equinix Newark, NJ, US 2001:504:0:6:0:1:9151:1 10GigE Pending Ready Q1/09

PAIX Dallas, TX, US TBD TBD 10GigE Pending Ready Q1/09

Tuesday, March 24, 2009

Samsung YP-P3 MP3 Player (8GB, 16GB) Review

from Everything USB:

>>Samsung YP-P3 MP3 Player (8GB, 16GB) Review

Review Verdict

  • The YP-P3 has all of the major ingredients needed to become one of the best portable media players on the market but is hampered by a finicky capacitive touchscreen along with Sammy's implementation of ID3 tags and stereo Bluetooth A2DP.


Of Capacitance and Haptics

The Samsung P3's primary means of control is through a capacitive glass touchscreen similar to the what's used on the iPod Touch and BlackBerry Storm.

The biggest improvement over the YP-P2 in my opinion comes from the addition of Immersion's TouchSense haptics technology, also known as rumble vibration(tm). In essence, when you touch the screen it will rumble a faux "click" as if you're actually depressing a button and then feeling it spring back as you let go. Swiping your finger across the screen to scroll or flip through pages produces a short rolling sensation, and dragging slider bars produces a clicking sensation to indicate continuous movement. I cannot emphasize enough just how well the haptics work for the P3, as it gives you a feeling that you're actually interacting with a functional device and not just a slab of glass. Lastly there is the VibeWoofer gimmick, which will cause the player to vibrate in sync with the bass hits of your music and videos. It was cool for about five minutes before I switched it back off.
erything USBything USB

Stereotactic Radiotherapy ''Promising'' For Early Prostate Cancer

NEW YORK (Reuters Health) - The results of a small phase II trial suggest that stereotactic body radiotherapy (SBRT), which involves a higher dose but shorter course than standard external beam radiotherapy, is a safe and effective treatment for localized prostate cancer.

"There is great enthusiasm in reducing the length of treatment for prostate cancer while also possibly improving its effectiveness, and these early results are very promising for men with early-stage prostate cancer," lead author Dr. Christopher King, from Stanford University School of Medicine, California, said in a statement.

The findings, reported in the International Journal of Radiation, Oncology, Biology, Physics for March 15, come from a study of 41 men who received a 7.25-Gy daily dose of image-guided SBRT for 5 days delivered with the CyberKnife (Accuracy Inc., Sunnyvale, California).


While the findings are encouraging, Dr. King acknowledged that longer follow-up of these patients is needed. "It can often take as long as 10 years to see late side effects and recurrences, so we will have to monitor these men closely and cautiously pursue these treatments further before we can confidently say that SBRT is as good as other proven prostate cancer treatments."

Monday, March 23, 2009


London, 23 March 2009 –

The researchers and organisers of 5th Data Centres Europe, the only regional conference in the sector, have announced a first ever panel of CEOs of the leading data centre operating companies will take place at the conference.

Eric Schwartz, President,Equinix Europe, Mike Tobin, CEO, TelecityGroup, Mike Faust, CEO, Digital Realty, and David Ruberg, CEO, Interxion, will meet together in a unique first ever panel to debate strategies for the enterprise customer, as migration to third party outsourcing continues to accelerate.

Data Centres Europe – which includes the annual industry Awards ceremony – is the brand leading content driven, networking rich event for the region. Attendees from EU countries plus eastern and central Europe will converge on the city of London where the forum is being held 22-23 April 2009 at the America Square Conference centre.

Sunday, March 22, 2009

Immersion Medical granted full Patent for spinal fusion simulation

from the IV MB, post by cellodude:

>>Medical device and procedure simulation


A device is disclosed that includes an interface member including a material and a manipulandum movable in a degree of freedom. The manipulandum is able to penetrate the material. A sensor is configured to output a position signal based on the position of the manipulandum. An actuator is configured to output haptic feedback by applying a compressive force to the material based on the position signal. In other embodiments, a method is disclosed that includes receiving a position signal associated with a position of a manipulandum, where at least a portion of the manipulandum penetrates the interface material. Haptic feedback is output by varying a density of the interface material based on the position signal.

Inventors: Cunningham; Richard L. (Washington, DC), Cohen; Robert (Kensington, MD)
Assignee: Immersion Medical, Inc. (Gaithersburg, MD)
Appl. No.: 10/803,080
Filed: March 18, 2004