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Using nine ALs, a set of three configurations of different combinations of them is proposed. These configurations are defined according to the required positioning of the patient's head during Nutlin-3a in vitro surgery and the resulting distribution of the expected target registration error (TRE). These configurations were first evaluated by simulation experiment using the data of 20 patients from two hospitals, and then testing the applicability of them in eight real clinical surgeries of neuronavigation. The results of the simulation experiment showed that, by incorporating a fiducial registration error (FRE) of 3.5 mm measured in the clinical setting, the expected TRE in the whole skull was less than 2.5 mm, and the expected TRE in the whole brain was less than 1.75 mm when using all selleck products the nine ALs. A small TRE could also be achieved in the corresponding surgical field by using the other three configurations with less ALs. In the clinical experiment, the FLE ranges in the image and the patient space were 1.4�C3.6 mm and 1.6�C5.5 mm, respectively. The measured TRE and FRE were 3.1?��?0.75 mm and 3.5?��?0.17 mm, respectively. The AL configurations proposed in this investigation provide sufficient registration accuracy and can help to avoid the disadvantages of SMs if used clinically. Copyright ? 2013 John Wiley & Sons, Ltd. ""Medullary thyroid carcinomas (MTCs) are mostly aggressive but slowly growing malignant tumours that metastasize early to loco-regional lymph nodes. Desmoplastic stroma reaction is a strong risk factor associated with lymph node metastases. We evaluated immunohistochemically the expression Oxymatrine of two hypoxia-associated proteins, carbonic anhydrase IX (CAIX) and hypoxia-induced factor 1�� (HIF1��), and ki-67, intercellular matrix adhesion molecule E-cadherin and the stroma remodelling marker tenascin C in a series of 100 sporadic MTCs and corresponding lymph node metastases, if present. Moderate to strong expression of CAIX was seen in 53 cases, and of HIF1�� in 51 cases, showing a strong correlation (p