The maps of the human immunoglobulin heavy-chain and kappa light-chain loci have recently been completed. We have now completed a map of the human lambda locus (IGL) located on chromosome 22q11.2. We mapped 52 V lambda genes from 10 V lambda families and 7 J lambda and C lambda genes on a 1140 kb contig constructed from eight YACs and 129 cosmid clones. The V lambda genes are arranged within 800 kb. Genes of the different V lambda families are organized in three clusters, V lambda II and III families (cluster A); V lambda I, V, VII and IX families (cluster B); V lambda IV, VI, VIII and X families (cluster C), in contrast to the dispersed organization of the different VH and V kappa families within the human VH and V kappa loci. We note that the most frequently used V lambda families (V lambda II and III) are proximal to the J lambda and C lambda genes. The VpreB gene, encoding part of the surrogate light chain, the GGT2 gene and the BCRL4 pseudogene were also mapped within the lambda locus.

OBJECT Stereotactic biopsy procedures are an everyday part of neurosurgery. The procedure provides an accurate histological diagnosis with the least possible morbidity. Robotic stereotactic biopsy needs to be an accurate, safe, frameless, and rapid technique. This article reports the clinical results of a series of 100 frameless robotic biopsies using a Medtech ROSA device. METHODS The authors retrospectively analyzed their first 100 frameless stereotactic biopsies performed with the robotic ROSA device: 84 biopsies were performed by frameless robotic surface registration, 7 were performed by robotic bone fiducial marker registration, and 9 were performed by scalp fiducial marker registration. Intraoperative flat-panel CT scanning was performed concomitantly in 25 cases. The operative details of the robotic biopsies, the diagnostic yield, and mortality and morbidity data observed in this series are reported. RESULTS A histological diagnosis was established in 97 patients. No deaths or permanent morbidity related to surgery were observed. Six patients experienced transient neurological worsening. Six cases of bleeding within the lesion or along the biopsy trajectory were observed on postoperative CT scans but were associated with transient clinical symptoms in only 2 cases. Stereotactic surgery was performed with patients in the supine position in 93 cases and in the prone position in 7 cases. The use of fiducial markers was reserved for posterior fossa biopsy via a transcerebellar approach, via an occipital approach, or for pediatric biopsy. CONCLUSIONS ROSA frameless stereotactic biopsies appear to be accurate and safe robotized frameless procedures.

Objective: To establish the impact of the imaging modality, registration method and use of intraoperative computed tomography (CT) scan on the accuracy of the ROSA® stereotactic robot. Methods: Using a dedicated phantom device, we measured the accuracy of the stereotactic robot for 20 targets as a function of the registration method (frameless, FL, or frame-based, FB) and the reference imaging modality (3T magnetic resonance imaging, MRI, CT scanner or flat-panel CT, fpCT). We performed a retrospective study of the accuracy of the first 26 FB and 31 FL robotized stereotactic surgeries performed in our department. Results: In a phantom study, the mean target accuracy was 1.59 mm for 3T MRI-guided FL surgery, 0.3 mm for fpCT-guided FL surgery and 0.3 mm for CT-guided FB surgery. In our retrospective series, the mean accuracy was 0.81 mm for FB stereotactic surgery, 1.22 mm for our 24 stereotactic surgery procedures with FL (surface recognition) registration and 0.7 mm for our 7 stereotactic surgery procedures with FL fiducial marker registration. Intraoperative fpCT fully corrected all the registration errors. Conclusions: The ROSA stereotactic robot is highly accurate. Robotized FB stereotactic surgery is more accurate than robotized FL stereotactic surgery.

IMGT expertly annotated data and tools described in this paper are particularly useful for the analysis of the IG and TR rearrangements in leukemia, lymphoma and myeloma, and in translocations involving the antigen receptor loci. IMGT is freely available at http://imgt.cines.fr.