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Transcranial MR-Guided Focused Ultrasound Used to Treat Patients with Functional Brain Disorders

By MedImaging International staff writers
Posted on 06 Aug 2009

A feasibility study has been completed assessing the use of noninvasive transcranial MR-guided focused ultrasound surgery (MRgFUS) for the treatment of neuropathic pain. Ten adult patients diagnosed with chronic neuropathic pain successfully underwent noninvasive deep brain ablation surgery (central lateral thalamotomy) with transcranial MRgFUS and showed improvement in pain scores and reduction of pain medication with no adverse effects at three months follow-up. This is the first study in the world to evaluate noninvasive transcranial focused ultrasound as a treatment modality for functional brain disorders.

InSightec, Ltd. (Tirat Carmel, Israel) developed the technology and the study was performed by a team at the University Children's Hospital Zurich (Switzerland). "This study showed that we can perform successful operations in the depth of the brain without opening the cranium or physically penetrating the brain with medical tools, something that appeared to be unimaginable only a few years ago,” said Daniel Jeanmonod, neurosurgeon at the University of Zurich. "By eliminating any physical penetration into the brain, we hope to duplicate the therapeutic effects of invasive deep brain ablation without the side effects for a wider group of patients.”

Neurosurgeons currently treat patients with functional neurologic disorders such as neuropathic pain or Parkinson's disease by inserting a tiny probe through the cranium and brain to reach and ablate damaged tissue. The more traditional invasive treatment works to alleviate pain and other symptoms, however, it exposes the patient to complications, including infections, bleeding, and damage to surrounding brain tissue, Dr. Jeanmonod explained. Moreover, only patients whose target tissue lies in the clear path of the probe are eligible for the invasive procedure, he said.

"We now have early clinical evidence suggesting that transcranial MRgFUS provides a safe and effective way to noninvasively ablate tissue deep within the brain,” said Ernst Martin, M.D., director of the Magnetic Resonance Center at the University Children's Hospital Zurich. "While we need to monitor these patients further, we are very encouraged by the results to date and look forward to continuing our research. A noninvasive treatment that reduces the risk of infection and bleeding will fill an unmet need for many patients who currently have run out of treatment options or are unwilling to undergo invasive brain surgery because of the risks associated with it.”

One patient in the study suffered nerve damage from a spinal tumor that led to severe pain and cramps in his right arm. The pain persisted for years and the patient ultimately reported depression and suicidal thoughts because of his condition. Immediately after receiving transcranial MRgFUS treatment on his brain, he reported that the pain had disappeared. A short time later, he was able to resume normal activities that his neuropathic pain had prevented him from doing, such as gardening and outings in the country with his family.

The Swiss research team is planning a larger study for functional brain disorders and expands its clinical research to movement disorders, such as Parkinson's disease and tremor, and to other functional neurologic disorders later this year. Additional sites in North America are also expected to initiate clinical research programs in functional brain disorders with transcranial MRgFUS later in 2009.

ExAblate is the first system to use the MR guided focused ultrasound technology that combines MRI--to visualize the body anatomy, plan the treatment and monitor treatment outcome in real time--and high intensity focused ultrasound to target brain tissue noninvasively. MR thermometry allows the physician to control and adjust the treatment in real time to ensure that the targeted area is fully treated and surrounding tissue is spared. The ExAblate 4000 is a platform for a variety of transcranial indications, such as brain tumors, functional neurosurgery, stroke, and targeted drug delivery.

The ExAblate 2000, based on the same technology, was approved by the U.S. Food and Drug Administration (FDA) in 2004 as a treatment for symptomatic uterine fibroids; 5,000 women have been treated worldwide to date. ExAblate 2000 received the European CE marking certification for pain palliation of bone metastases in June 2007.

InSightec was founded in 1999 to develop the breakthrough MR-guided focused ultrasound technology and transform it into the next-generation operating room.

Related Links:
InSightec
University Children's Hospital Zurich

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57 (!!!!! 2719.8791503906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

58 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

59 (!!!!! 8665.8000946045): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

60 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

61 (!!!!! 2494.8120117188): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (!!!!! 3868.1030273438): SELECT fid FROM jos_deeppockets WHERE id=294724894 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294724894 AND published='1' LIMIT 1

63 (97.990036010742): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

64 (45.061111450195): select jos_twitters.link from jos_twitters where cat=10

65 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

66 (33.140182495117): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 3351.2115478516): SELECT fid FROM jos_deeppockets WHERE id=294724894 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294724894 AND published='1' LIMIT 1

69 (100.13580322266): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (!!!!! 3666.1624908447): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (440.83595275879): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (48.87580871582): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (49.114227294922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (34.093856811523): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

105 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

106 (!!!!! 5452.8713226318): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 3966.0930633545): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 5374.9084472656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

109 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

110 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (569.10514831543): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (876.18827819824): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 3057.0030212402): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (166.89300537109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

115 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

116 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

117 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

118 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

119 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

120 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

121 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

122 (!!!!! 3346.9200134277): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 64197.778701782): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (849.96223449707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724894 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724894 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 23344.039916992): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (113.01040649414): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (107.0499420166): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (55.074691772461): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (97.036361694336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (57.93571472168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (478.02925109863): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (66.041946411133): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (67.949295043945): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (47.206878662109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (718.83201599121): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (574.82719421387): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (86.069107055664): SELECT name FROM jos_deeppockets WHERE id=215

138 (60.796737670898): SELECT name FROM jos_deeppockets WHERE id=215

139 (902.17590332031): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (650.88272094727): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 4167.0799255371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

142 (!!!!! 3867.8646087646): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

143 (!!!!! 14703.989028931): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 5932.092666626): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (164.03198242188): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294724894 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2563.9533996582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 4070.9972381592): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (231.02760314941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

149 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

150 (!!!!! 1901.1497497559): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (159.97886657715): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

152 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

153 (!!!!! 3237.9627227783): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294724894 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294724894 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (113.96408081055): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

155 (!!!!! 3750.8010864258): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

156 (111.10305786133): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (198.8410949707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

158 (!!!!! 1369.9531555176): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294724894 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294724894 AND published='1' LIMIT 1

159 (86.069107055664): select jos_twitters.link from jos_twitters where cat=10

160 (63.896179199219): select jos_facebook.link from jos_facebook where cat=10

161 (48.87580871582): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 1014.9478912354): select jos_linkedin.link from jos_linkedin where cat=10

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