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Sample records for radiotherapy radio neurosurgery

  1. Chinese herbal medicines as adjuvant treatment during chemo- or radio-therapy for cancer.

    PubMed

    Qi, Fanghua; Li, Anyuan; Inagaki, Yoshinori; Gao, Jianjun; Li, Jijun; Kokudo, Norihiro; Li, Xiao-Kang; Tang, Wei

    2010-12-01

    Numerous studies have indicated that in cancer treatment Chinese herbal medicines in combination with chemo- or radio-therapy can be used to enhance the efficacy of and diminish the side effects and complications caused by chemo- and radio-therapy. Therefore, an understanding of Chinese herbal medicines is needed by physicians and other health care providers. This review provides evidence for use of Chinese herbal medicines as adjuvant cancer treatment during chemo- or radio-therapy. First, Chinese herbal medicines (e.g. Astragalus, Turmeric, Ginseng, TJ-41, PHY906, Huachansu injection, and Kanglaite injection) that are commonly used by cancer patients for treating the cancer and/or reducing the toxicity induced by chemo- or radio-therapy are discussed. Preclinical and clinical studies have shown that these Chinese herbal medicines possess great advantages in terms of suppressing tumor progression, increasing the sensitivity of chemo- and radio-therapeutics, improving an organism's immune system function, and lessening the damage caused by chemo- and radio-therapeutics. Second, clinical trials of Chinese herbal medicines as adjuvant cancer treatment are reviewed. By reducing side effects and complications during chemo- and radio-therapy, these Chinese herbal medicines have a significant effect on reducing cancer-related fatigue and pain, improving respiratory tract infections and gastrointestinal side effects including diarrhea, nausea, and vomiting, protecting liver function, and even ameliorating the symptoms of cachexia. This review should contribute to an understanding of Chinese herbal medicines as adjuvant treatment for cancer and provide useful information for the development of more effective anti-cancer drugs.

  2. Benefit of Carbon Ion Radiotherapy in the Treatment of Radio-resistant Tumors

    SciTech Connect

    Kamada, Tadashi; Tsujii, Hirohiko; Tsuji, Hiroshi; Yanagi, Tsuyoshi; Imai, Reiko; Mizoe, Jun-etsu; Miyamoto, Tadaaki; Kato, Hirotoshi; Yamada, Shigeru; Kato, Shingo; Yoshikawa, Kyousan; Kandatsu, Susumu

    2003-08-26

    The Heavy Ion Medical Accelerator in Chiba (HIMAC) is the world's first heavy ion accelerator complex dedicated to medical use in a hospital environment. Heavy ions have superior depth-dose distribution and greater cell-killing ability. In June 1994, clinical research for the treatment of cancer was begun using carbon ions generated by HIMAC. Until August 2002, a total of 1,297 patients were enrolled in clinical trials. Most of the patients had locally advanced and/or medically inoperable tumors. Tumors radio-resistant and/or located near critical organs were also included. The clinical trials revealed that carbon ion radiotherapy provided definite local control and offered a survival advantage without unacceptable morbidity in a variety of tumors that were hard to cure by other modalities.

  3. Computers and neurosurgery.

    PubMed

    Shaikhouni, Ammar; Elder, J Bradley

    2012-11-01

    At the turn of the twentieth century, the only computational device used in neurosurgical procedures was the brain of the surgeon. Today, most neurosurgical procedures rely at least in part on the use of a computer to help perform surgeries accurately and safely. The techniques that revolutionized neurosurgery were mostly developed after the 1950s. Just before that era, the transistor was invented in the late 1940s, and the integrated circuit was invented in the late 1950s. During this time, the first automated, programmable computational machines were introduced. The rapid progress in the field of neurosurgery not only occurred hand in hand with the development of modern computers, but one also can state that modern neurosurgery would not exist without computers. The focus of this article is the impact modern computers have had on the practice of neurosurgery. Neuroimaging, neuronavigation, and neuromodulation are examples of tools in the armamentarium of the modern neurosurgeon that owe each step in their evolution to progress made in computer technology. Advances in computer technology central to innovations in these fields are highlighted, with particular attention to neuroimaging. Developments over the last 10 years in areas of sensors and robotics that promise to transform the practice of neurosurgery further are discussed. Potential impacts of advances in computers related to neurosurgery in developing countries and underserved regions are also discussed. As this article illustrates, the computer, with its underlying and related technologies, is central to advances in neurosurgery over the last half century.

  4. [Stereotactic radiosurgery and radiotherapy for brain metastases].

    PubMed

    Tanguy, Ronan; Métellus, Philippe; Mornex, Françoise; Mazeron, Jean-Jacques

    2013-01-01

    Brain metastases management is still controversial even though many trials are trying to define the respective roles of neurosurgery, whole-brain radiotherapy, single-dose stereotactic radiotherapy and fractionated stereotactic radiotherapy. In this article, we review data from trials that examine the role of radiosurgery and fractionated stereotactic radiotherapy in the management of brain metastases.

  5. Pediatric neurosurgery: pride and prejudice.

    PubMed

    Winston, K R

    2000-02-01

    Pediatric neurosurgery now exists as a member of the family of neurosurgery with its own training programs, process of accreditation, national and international conferences and scientific journals. The relentless expansion of science relevant to the practice of neurosurgery and the changing patterns of neurosurgical practice have driven and continue to drive the juggernaut of evolutionary process which sometimes necessitates the birth of new specialties of practice. The history and the development of neurosurgery as they relate to children are presented. There is no more reason to think that the established specialty of pediatric neurosurgery or the patients under the care of pediatric neurosurgeons would benefit from the collapsing of pediatric neurosurgery back into the general neurosurgical fold than to think that all of neurosurgery, and hence all patients cared for by neurosurgeons, would benefit from the return of organized neurosurgery to its general surgical parent. Just as mankind benefits from the steady advancement of all aspects of neurosurgery, children benefit from the existence and steady advancement of pediatric neurosurgery.

  6. Evidence-based neurosurgery

    PubMed Central

    Esene, Ignatius N.; Baeesa, Saleh S.; Ammar, Ahmed

    2016-01-01

    Medical evidence is obtainable from approaches, which might be descriptive, analytic and integrative and ranked into levels of evidence, graded according to quality and summarized into strengths of recommendation. Sources of evidence range from expert opinions through well-randomized control trials to meta-analyses. The conscientious, explicit, and judicious use of current best evidence in making decisions related to the care of individual patients defines the concept of evidence-based neurosurgery (EBN). We reviewed reference books of clinical epidemiology, evidence-based practice and other previously related articles addressing principles of evidence-based practice in neurosurgery. Based on existing theories and models and our cumulative years of experience and expertise conducting research and promoting EBN, we have synthesized and presented a holistic overview of the concept of EBN. We have also underscored the importance of clinical research and its relationship to EBN. Useful electronic resources are provided. The concept of critical appraisal is introduced. PMID:27356649

  7. NASA Robotic Neurosurgery Testbed

    NASA Technical Reports Server (NTRS)

    Mah, Robert

    1997-01-01

    The detection of tissue interface (e.g., normal tissue, cancer, tumor) has been limited clinically to tactile feedback, temperature monitoring, and the use of a miniature ultrasound probe for tissue differentiation during surgical operations, In neurosurgery, the needle used in the standard stereotactic CT or MRI guided brain biopsy provides no information about the tissue being sampled. The tissue sampled depends entirely upon the accuracy with which the localization provided by the preoperative CT or MRI scan is translated to the intracranial biopsy site. In addition, no information about the tissue being traversed by the needle (e.g., a blood vessel) is provided. Hemorrhage due to the biopsy needle tearing a blood vessel within the brain is the most devastating complication of stereotactic CT/MRI guided brain biopsy. A robotic neurosurgery testbed has been developed at NASA Ames Research Center as a spin-off of technologies from space, aeronautics and medical programs. The invention entitled "Robotic Neurosurgery Leading to Multimodality Devices for Tissue Identification" is nearing a state ready for commercialization. The devices will: 1) improve diagnostic accuracy and precision of general surgery, with near term emphasis on stereotactic brain biopsy, 2) automate tissue identification, with near term emphasis on stereotactic brain biopsy, to permit remote control of the procedure, and 3) reduce morbidity for stereotactic brain biopsy. The commercial impact from this work is the potential development of a whole new generation of smart surgical tools to increase the safety, accuracy and efficiency of surgical procedures. Other potential markets include smart surgical tools for tumor ablation in neurosurgery, general exploratory surgery, prostate cancer surgery, and breast cancer surgery.

  8. NASA Robotic Neurosurgery Testbed

    NASA Technical Reports Server (NTRS)

    Mah, Robert

    1997-01-01

    The detection of tissue interface (e.g., normal tissue, cancer, tumor) has been limited clinically to tactile feedback, temperature monitoring, and the use of a miniature ultrasound probe for tissue differentiation during surgical operations. In neurosurgery, the needle used in the standard stereotactic CT (Computational Tomography) or MRI (Magnetic Resonance Imaging) guided brain biopsy provides no information about the tissue being sampled. The tissue sampled depends entirely upon the accuracy with which the localization provided by the preoperative CT or MRI scan is translated to the intracranial biopsy site. In addition, no information about the tissue being traversed by the needle (e.g., a blood vessel) is provided. Hemorrhage due to the biopsy needle tearing a blood vessel within the brain is the most devastating complication of stereotactic CT/MRI guided brain biopsy. A robotic neurosurgery testbed has been developed at NASA Ames Research Center as a spin-off of technologies from space, aeronautics and medical programs. The invention entitled 'Robotic Neurosurgery Leading to Multimodality Devices for Tissue Identification' is nearing a state ready for commercialization. The devices will: 1) improve diagnostic accuracy and precision of general surgery, with near term emphasis on stereotactic brain biopsy, 2) automate tissue identification, with near term emphasis on stereotactic brain biopsy, to permit remote control of the procedure, and 3) reduce morbidity for stereotactic brain biopsy. The commercial impact from this work is the potential development of a whole new generation of smart surgical tools to increase the safety, accuracy and efficiency of surgical procedures. Other potential markets include smart surgical tools for tumor ablation in neurosurgery, general exploratory surgery, prostate cancer surgery, and breast cancer surgery.

  9. Discovering neurosurgery: new frontiers.

    PubMed

    Rutka, James T

    2011-12-01

    Over the centuries, discoveries of lands unknown, treasures lost and buried, and formulas to delineate physicochemical processes have led to advancements in our understanding of how the world is structured and governed. In science and medicine, discoveries are frequently made following deliberate periods of observation and experimentation to test hypotheses. However, in some instances, discoveries may arise either following a "eureka moment" that transcends rigorous scientific experimentation or following a serendipitous observation. In many instances, scientific discoveries will lead to new inventions that are aimed at improving the manner in which tasks or operations are performed. In this address, some of the key discoveries in science and medicine that have impacted significantly on the field of neurosurgery are described. Some of these include discoveries in neuroanatomy, anesthesiology, infectious diseases, antisepsis, and radiology. Discoveries in the field of molecular science, from the discovery of DNA to next-generation DNA sequencing, which have helped improve the diagnosis and prognosis of neurosurgical patients with conditions such as brain tumors, are also described. In the end, these discoveries have led us to new frontiers in the subspecialty practice of neurosurgery. Navigating our way through these new frontiers will undoubtedly lead to additional discoveries that are unimaginable at present but bound to improve the future care of neurosurgical patients.

  10. Laser applications in neurosurgery

    NASA Astrophysics Data System (ADS)

    Cerullo, Leonard J.

    1985-09-01

    The "false start" of the laser in neurosurgery should not be misconstrued as a denial of the inherent advantages of precision and gentleness in dealing with neural tissue. Rather, early investigators were frustrated by unrealistic expectations, cumbersome equipment, and a general ignorance of microtechnique. By the early 70s, microneurosurgery was well established, surgical laser equipment for free hand and microlinked application had been developed, and a more realistic view of the limitations of the laser had been established. Consequently, the late 70s really heralded the renaissance of the laser in neurosurgery. Since then, there has been an overwhelming acceptance of the tool in a variety of clinical situations, broadly categorized in five groups. 1)|Perhaps the most generally accepted area is in the removal of extra-axial tumors of the brain and spinal cord. These tumors, benign by histology but treacherous by location, do not present until a significant amount of neurological compensation has already occurred. The application of additional trauma to the neural tissue, whether by further tumor growth or surgical manipulation, frequently results in irreversible damage. Here, the ability of the laser to vaporize tissue, in a fairly hemostatic fashion, without mechanical or thermal damage to sensitive surrounding tissues, is essential. 2)|The ability to incise delicate neural tissue with minimal spread of thermal destruction to adjacent functioning tissue makes the laser the ideal instrument when tumors deep under the surface are encountered in the brain or spinal cord. Thus, the second group of applications is in the transgression of normal neural structures to arrive at deeper pathological tissue. 3)|The third area of benefit for the laser in neurosurgery has been in the performance of neuroablative procedures, calling for deliberate destruction of functioning neural tissue in a controlled fashion. Again, the precision and shape confinement of the destructive

  11. Actualities and Perspectives in Neurosurgery

    PubMed Central

    Iencean, SM; Brehar, FM

    2008-01-01

    In the field of neurosurgery, like in other surgical specialties, the last decades have brought major achievements. The series of revolutionary discoveries has started during the last century in the fifties, with stereotactic radiosurgery, then continued with the implementation of operative microscope (during the seventies), the endovascular embolisation in the nineties and finally with the major improvement in robotic neurosurgery and molecular neurosurgery at the beginning of this century. The major innovation has been brought not only in the field of therapeutical measures but also in the field of neuro– imaging. Thus, the modern MRI with more than 3 Tesla, can reveal to the neurosurgeon the most intimate structures of the nervous system. Several important areas in neurosurgery like: vascular neurosurgery, functional neurosurgery and brain tumors pathology, benefit from the modern technology and from the latest discoveries from genetic and molecular biology. In conclusion, summarizing the discoveries of the last decade, we emphasize that the related areas like genetics, molecular biology, computer technology become more and more important in the future progress of the neurosurgery. PMID:20108475

  12. Single Agent Nanoparticle for Radiotherapy and Radio-Photothermal Therapy in Anaplastic Thyroid Cancer

    PubMed Central

    Zhou, Min; Chen, Yunyun; Adachi, Makoto; Wen, Xiaoxia; Erwin, Bill; Mawlawi, Osama; Lai, Stephen Y.; Li, Chun

    2015-01-01

    Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies. The aggressive behavior of ATC and its resistance to traditional treatment limit the efficacy of radiotherapy, chemotherapy, and surgery. The purpose of this study is aimed at enhancing the therapeutic efficacy of radiotherapy (RT) combined with photothermal therapy (PTT) in murine orthotopic model of ATC, based on our developed single radioactive copper sulfide (CuS) nanoparticle platform. We prepare a new dual-modality therapy for ATC consisting of a single-compartment nanoplatform, polyethylene glycol-coated [64Cu]CuS NPs, in which the radiotherapeutic property of 64Cu is combined with the plasmonic properties of CuS NPs. Mice with Hth83 ATC were treated with PEG[64Cu]CuS NPs and/or near infrared laser. Antitumor effects were assessed by tumor growth and animal survival. We found that in mice bearing orthotopic human Hth83 ATC tumors, micro-PET/CT imaging and biodistribution studies showed that about 50% of the injected dose of PEG-[64Cu]CuS NPs was retained in tumor 48 h after intratumoral injection. Human absorbed doses were calculated from biodistribution data. In antitumor experiments, tumor growth was delayed by PEG-[64Cu]CuS NP-mediated RT, PTT, and combined RT/PTT, with combined RT/PTT being most effective. In addition, combined RT/PTT significantly prolonged the survival of Hth83 tumor-bearing mice compared to no treatment, laser treatment alone, or NP treatment alone without producing acute toxic effects. These findings indicate that this single-compartment multifunctional NPs platform merits further development as a novel therapeutic agent for ATC. PMID:25913249

  13. Single agent nanoparticle for radiotherapy and radio-photothermal therapy in anaplastic thyroid cancer.

    PubMed

    Zhou, Min; Chen, Yunyun; Adachi, Makoto; Wen, Xiaoxia; Erwin, Bill; Mawlawi, Osama; Lai, Stephen Y; Li, Chun

    2015-07-01

    Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies. The aggressive behavior of ATC and its resistance to traditional treatment limit the efficacy of radiotherapy, chemotherapy, and surgery. The purpose of this study is aimed at enhancing the therapeutic efficacy of radiotherapy (RT) combined with photothermal therapy (PTT) in murine orthotopic model of ATC, based on our developed single radioactive copper sulfide (CuS) nanoparticle platform. We prepare a new dual-modality therapy for ATC consisting of a single-compartment nanoplatform, polyethylene glycol-coated [(64)Cu]CuS NPs, in which the radiotherapeutic property of (64)Cu is combined with the plasmonic properties of CuS NPs. Mice with Hth83 ATC were treated with PEG-[(64)Cu]CuS NPs and/or near infrared laser. Antitumor effects were assessed by tumor growth and animal survival. We found that in mice bearing orthotopic human Hth83 ATC tumors, micro-PET/CT imaging and biodistribution studies showed that about 50% of the injected dose of PEG-[(64)Cu]CuS NPs was retained in tumor 48 h after intratumoral injection. Human absorbed doses were calculated from biodistribution data. In antitumor experiments, tumor growth was delayed by PEG-[(64)Cu]CuS NP-mediated RT, PTT, and combined RT/PTT, with combined RT/PTT being most effective. In addition, combined RT/PTT significantly prolonged the survival of Hth83 tumor-bearing mice compared to no treatment, laser treatment alone, or NP treatment alone without producing acute toxic effects. These findings indicate that this single-compartment multifunctional NPs platform merits further development as a novel therapeutic agent for ATC.

  14. Mythology and Neurosurgery.

    PubMed

    Ökten, Ali İhsan

    2016-06-01

    Myths are the keystone of mythology. They are interpretations of events that have been told as stories and legends for thousands of years, inherited from generation to generation, and have reached the present day. Although most myths are considered figments of the imagination or fictitious legends, all of them contain references to facts from the time they occurred. Mythology, which is a collection of figments of imagination concerning nature and human beings, is a product of human effort to perceive, explain, and interpret the universe and the world, much like science. The interaction between mythology and science dates back to the early days of civilization. Mythology, a reflection of human creativity, is extensively used in modern science, particularly in a terminological context. This article aims to reveal the texture of mythology in neurosurgery, by analyzing the birth of medicine in mythology; heroes such as Apollo and Asklepios, the gods of healing and medicine, as well as Hygieia, the goddess of health and hygiene; and mythological terms and phrases such as Achilles tendon, atlas vertebra, gigantism, priapism syndrome, hippocampus, lethargy, syrinx, and arachnoid. Through the use of symbols, mythology has attempted to explain several subjects, such as human nature, disease, birth, and death. In this respect, mythology and medicine dance arm in arm, and this dance has been going on for centuries. As a result, mythology has manifested itself in many fields within medicine, either anatomically or by giving names to various diseases.

  15. Neurosurgery and clinical engineering.

    PubMed

    Salcman, M; Samaras, G M

    1978-01-01

    Modern technology has profoundly altered the clinical practice of neurosurgery. For a wide variety of conditions, patients are being implanted with active and passive devices or treated with advanced microsurgical instrumentation. After surgery, such patients are sent to modern intensive-care units employing the latest advances in patient monitoring and computer technology. We contend that the responsibilities of the Clinical Engineer extend beyond simple installation and maintenance of equipment and systems. It is essential that he take part in the continuing education of non-technical personnel who must make use of the equipment in ways that are meaningful in the care of the patient and to the progress of clinical science. This point is illustrated by our experience with a neurosurgical intensive-care unit. It is also the thesis of this paper that the design and maintenance of increasingly sophisticated biomedical systems will benefit from the use of an interdisciplinary approach at the very inception of a project. This approach is illustrated by our current development of a multibeam microwave hyperthermia system for possible use in the treatment of brain tumors.

  16. [New simulation technologies in neurosurgery].

    PubMed

    Byvaltsev, V A; Belykh, E G; Konovalov, N A

    2016-01-01

    The article presents a literature review on the current state of simulation technologies in neurosurgery, a brief description of the basic technology and the classification of simulation models, and examples of simulation models and skills simulators used in neurosurgery. Basic models for the development of physical skills, the spectrum of available computer virtual simulators, and their main characteristics are described. It would be instructive to include microneurosurgical training and a cadaver course of neurosurgical approaches in neurosurgery training programs and to extend the use of three-dimensional imaging. Technologies for producing three-dimensional anatomical models and patient-specific computer simulators as well as improvement of tactile feedback systems and display quality of virtual models are promising areas. Continued professional education necessitates further research for assessing the validity and practical use of simulators and physical models.

  17. Progress of women in neurosurgery.

    PubMed

    Spetzler, Robert F

    2011-01-01

    Despite advances in issues related to gender equity, barriers to recruiting and retaining women in neurosurgery continue to exist. At the same time, the overall projected shortage of neurosurgeons suggests that women will be vital to the long-term success of the field. Attracting women to neurosurgery can capitalize on strategies, such as mentoring, teaching leadership and negotiating skills, and job sharing or dual training tracks to name a few, that would benefit both men and women passionate about pursuing neurosurgery. Ultimately, personal and institutional accountability must be evaluated to ensure that the best and brightest candidates, regardless of gender, are recruited to neurosurgical programs to promote the health of our challenging but most satisfying profession.

  18. Progress of women in neurosurgery

    PubMed Central

    Spetzler, Robert F.

    2011-01-01

    Despite advances in issues related to gender equity, barriers to recruiting and retaining women in neurosurgery continue to exist. At the same time, the overall projected shortage of neurosurgeons suggests that women will be vital to the long-term success of the field. Attracting women to neurosurgery can capitalize on strategies, such as mentoring, teaching leadership and negotiating skills, and job sharing or dual training tracks to name a few, that would benefit both men and women passionate about pursuing neurosurgery. Ultimately, personal and institutional accountability must be evaluated to ensure that the best and brightest candidates, regardless of gender, are recruited to neurosurgical programs to promote the health of our challenging but most satisfying profession. PMID:22059098

  19. History of Neurosurgery in Malaysia

    PubMed Central

    RAFFIQ, Azman; ABDULLAH, Jafri Malin; HASPANI, Saffari; ADNAN, Johari Siregar

    2015-01-01

    The development of neurosurgical services and training in Malaysia began in 1963, with the first centre established in its capital city at Hospital Kuala Lumpur, aimed to provide much needed neurosurgical services and training in the field of neurology and neurosurgery. This center subsequently expanded in 1975 with the establishment of the Tunku Abdul Rahman Neuroscience Institute (IKTAR); which integrated the three allied interdependent disciplines of neurosurgery, neurology and psychiatry. The establishment of this institute catalysed the rapid expansion of neurosurgical services in Malaysia and paved the way for development of comprehensive training for doctors, nurses, and paramedics. This culminated in the establishments of a local comprehensive neurosurgery training program for doctors in 2001; followed by a training program for nurses and paramedics in 2006. To date, there are more than 60 neurosurgeons providing expert care in 11 centers across Malaysia, along with trained personnel in the field of neurosciences. PMID:27006632

  20. SU-E-T-206: Comparison of EBT and EBT3 RadioChromic Films in Radiation Field of Parotid Cancer Radiotherapy

    SciTech Connect

    Toosi, T Bahreyni; Mianaei, F Khorshidi; Ghorbani, M; Khabbaz Kazemi, N Mohammadian; Mohammadi, M; Meigooni, A Soleimani

    2015-06-15

    Purpose: The aim of the current study is to compare EBT and EBT3 RadioChromic films in dosimetry of radiotherapy fields for treatment of parotid cancer. Methods: The calibrations of EBT and EBT3 films were performed with the same setups for doses ranging from 0.2 Gy to 5 Gy using 6 MV photon beam of a Siemens Primus linac. These films were scanned in color mode (RGB) by a Microtek (1000XL) scanner and the red color channel data was extracted. Treatment planning for parotid cancer radiation therapy was performed on a RANDO phantom. Skin dose was measured at different points in the right anterior oblique (RAO) and right posterior oblique (RPO) fields by EBT and EBT3 films. Results: Dosimetry was performed with the same conditions for the two film types for calibration and in-phantom in parotid cancer radiotherapy. The measured net optical density (NOD) in EBT film was in some extent higher than that from EBT3 film. The minimum difference between these two films under calibration conditions was about 2.9% (for 0.2 Gy). However, the maximum difference was 35.5% (for 0.5 Gy). In the therapeutic fields of parotid cancer radiotherapy at different points, the measured dose from EBT film was higher than the EBT3 film. In these fields the minimum and maximum measured dose differences were 16.0% and 25.5%, respectively. Conclusion: With the same irradiation and reading conditions, EBT film demonstrates higher NOD than the EBT3 film. This effect may be related to the higher sensitivity of EBT film over EBT3 film. However, the obtained dose differences between these two films in low dose range can be due to the differences in fitting functions applied following the calibration process.

  1. Challenges in contemporary academic neurosurgery.

    PubMed

    Black, Peter M

    2006-03-01

    Traditionally, the ideal academic neurosurgeon has been a "quadruple threat," with excellence in clinical work, teaching, research, and administration. This tradition was best exemplified in Harvey Cushing, who developed the field of neurosurgery 90 years ago. This paradigm will probably have to change as academic neurosurgeons face major challenges. In patient care, these include increasing regulatory control, increasing malpractice costs, consolidation of expensive care in academic centers, and decreasing reimbursement; in resident teaching, work hour limitations and a changing resident culture; in research, the increasing dominance of basic scientists in governmental funding decisions and decreased involvement of neurosurgeons in scientific review committees; and in administration, problems of relationships in the workplace, patient safety, and employment compliance in an increasingly bureaucratic system. To meet these challenges, the new academic neurosurgeon will probably not be a quadruple threat personally but will be part of a quadruple threat in a department and institution. Neurosurgeons in such a setting will have to work with hospital, medical school, and national and international groups to address malpractice, reimbursement, subspecialization, and training problems; find supplemental sources of income through grants, development funds, and hospital support; lead in the development of multidisciplinary centers for neuroscience, brain tumor, spine, and other initiatives; and focus on training leaders for hospital, regional, and national groups to reconfigure neurosurgery. Collaboration, flexibility, and leadership will be characteristic of the academic neurosurgeon in this new era.

  2. Renaissance Neurosurgery: Italy's Iconic Contributions.

    PubMed

    Nanda, Anil; Khan, Imad Saeed; Apuzzo, Michael L

    2016-03-01

    Various changes in the sociopolitical milieu of Italy led to the increasing tolerance of the study of cadavers in the late Middle Ages. The efforts of Mondino de Liuzzi (1276-1326) and Guido da Vigevano (1280-1349) led to an explosion of cadaver-centric studies in centers such as Bologna, Florence, and Padua during the Renaissance period. Legendary scientists from this era, including Leonardo Da Vinci, Andreas Vesalius, Bartolomeo Eustachio, and Costanzo Varolio, furthered the study of neuroanatomy. The various texts produced during this period not only helped increase the understanding of neuroanatomy and neurophysiology but also led to the formalization of medical education. With increased understanding came new techniques to address various neurosurgical problems from skull fractures to severed peripheral nerves. The present study aims to review the major developments in Italy during the vibrant Renaissance period that led to major progress in the field of neurosurgery.

  3. An international randomised controlled trial to compare TARGeted Intraoperative radioTherapy (TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer (the TARGIT-A trial).

    PubMed Central

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max; Tobias, Jeffrey S; Joseph, David J; Saunders, Christobel; Brew-Graves, Chris; Potyka, Ingrid; Morris, Stephen; Vaidya, Hrisheekesh J; Williams, Norman R; Baum, Michael

    2016-01-01

    BACKGROUND Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies. OBJECTIVE To compare TARGIT within a risk-adapted approach with whole-breast external beam radiotherapy (EBRT) over several weeks. DESIGN The TARGeted Intraoperative radioTherapy Alone (TARGIT-A) trial was a pragmatic, prospective, international, multicentre, non-inferiority, non-blinded, randomised (1 : 1 ratio) clinical trial. Originally, randomisation occurred before initial lumpectomy (prepathology) and, if allocated TARGIT, the patient received it during the lumpectomy. Subsequently, the postpathology stratum was added in which randomisation occurred after initial lumpectomy, allowing potentially easier logistics and a more stringent case selection, but which needed a reoperation to reopen the wound to give TARGIT as a delayed procedure. The risk-adapted approach meant that, in the experimental arm, if pre-specified unsuspected adverse factors were found postoperatively after receiving TARGIT, EBRT was recommended. Pragmatically, this reflected how TARGIT would be practised in the real world. SETTING Thirty-three centres in 11 countries. PARTICIPANTS Women who were aged ≥ 45 years with unifocal invasive ductal carcinoma preferably ≤ 3.5 cm in size. INTERVENTIONS TARGIT within a risk-adapted approach and whole-breast EBRT. MAIN OUTCOME MEASURES The primary outcome measure was absolute difference in local recurrence, with a non-inferiority margin of 2.5%. Secondary outcome measures included toxicity and breast cancer-specific and non

  4. Treatment Outcomes of Locally Advanced Oropharyngeal Cancer: A Comparison Between Combined Modality Radio-Chemotherapy and Two Variants of Single Modality Altered Fractionation Radiotherapy

    SciTech Connect

    Kader, Hosam A.; Mydin, Aminudin R.; Wilson, Matthew; Alexander, Cheryl; Shahi, Jeevin; Pathak, Irvin; Wu, Jonn S.; Truong, Pauline T.

    2011-07-15

    Purpose: To compare outcomes in patients with locally advanced oropharyngeal cancer treated with radio-chemotherapy (RT-CT), accelerated fractionation radiotherapy (AccRT), or hypofractionated radiotherapy (HypoRT). Methods and Materials: Subjects were 321 consecutive patients with newly diagnosed oropharyngeal cancer, Stage III or IVA/B, treated between January 2001 and December 2005 at the BC Cancer Agency with RT-CT (n = 157), AccRT (n = 57), or HypoRT (n = 107). Outcomes examined were disease-specific survival (DSS), locoregional control (LRC), overall survival (OS), rate of G-tube use, and rate of hospitalization for acute complications. Results: Median follow-up was 3.4 years. Three-year Kaplan-Meier DSS with RT-CT, AccRT, and HypoRT were 80%, 81%, and 74%, respectively (p = 0.219). Cox regression analysis identified treatment modality as a significant factor affecting DSS (p = 0.038). Compared with RT-CT, the hazard ratio (HR) for DSS was 1.0 with AccRT and 2.0 with HypoRT (p = 0.021). Kaplan-Meier pairwise comparisons found no significant difference in LRC and OS between RT-CT and AccRT. HypoRT was associated with significantly lower LRC (p = 0.005) and OS (p = 0.008) compared with RT-CT. There were significant differences in the rates of G-tube use (p < 0.001) and of hospitalization (p = 0.036) among the three treatment groups, with the most frequent rates observed in the RT-CT group. Conclusions: In patients with locally advanced oropharyngeal cancer, AccRT conferred DSS, LRC, and OS comparable to that of RT-CT. Patients treated with RT-CT experienced higher rates of treatment-related acute toxicities. HypoRT was associated with the least favorable outcomes.

  5. Clovis Vincent (1879-1947): founder of French neurosurgery and promoter of oncologic neurosurgery.

    PubMed

    Karamanou, M; Androutsos, G; Lymperi, M; Stamboulis, E; Liappas, I; Lykouras, E

    2012-01-01

    The eminent neurologist Clovis Vincent decided to become neurosurgeon at an advanced age. His is considered the founder of French neurosurgery and the Europe's first neurosurgeon. He was mainly interested in pituitary tumors and his work on oncologic neurosurgery remains valuable.

  6. Global Neurosurgery: The Unmet Need.

    PubMed

    Park, Kee B; Johnson, Walter D; Dempsey, Robert J

    2016-04-01

    Globally, the lack of access to basic surgical care causes 3 times as much deaths as HIV/AIDS, tuberculosis, and malaria combined. The magnitude of this unmet need has been described recently, and the numbers are startling. Major shifts in global health agenda have highlighted access to essential and emergency surgery as a high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths, particularly in the realm of training; however, the demand grossly outstrips the supply; most people in low-income countries do not have access to basic surgical care, either due to lack of availability or affordability. Projects that help create a robust and resilient health system within low- and middle-income countries require urgent implementation. In this context, concurrent scale-up of human resources, investments in capacity building, local data collection, and analysis for accurate assessment are essential. In addition, through process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever.

  7. Simulation and resident education in spinal neurosurgery

    PubMed Central

    Bohm, Parker E.; Arnold, Paul M.

    2015-01-01

    Background: A host of factors have contributed to the increasing use of simulation in neurosurgical resident education. Although the number of simulation-related publications has increased exponentially over the past two decades, no studies have specifically examined the role of simulation in resident education in spinal neurosurgery. Methods: We performed a structured search of several databases to identify articles detailing the use of simulation in spinal neurosurgery education in an attempt to catalogue potential applications for its use. Results: A brief history of simulation in medicine is given, followed by current trends of spinal simulation utilization in residency programs. General themes from the literature are identified that are integral for implementing simulation into neurosurgical residency curriculum. Finally, various applications are reported. Conclusion: The use of simulation in spinal neurosurgery education is not as ubiquitous in comparison to other neurosurgical subspecialties, but many promising methods of simulation are available for augmenting resident education. PMID:25745588

  8. Fetal neurosurgery: current state of the art

    PubMed Central

    Saadai, Payam; Runyon, Timothy; Farmer, Diana L

    2011-01-01

    Congenital CNS abnormalities have been targets for prenatal intervention since the founding of fetal surgery 30 years ago, but with historically variable results. Open fetal neurosurgery for myelomenigocele has demonstrated the most promising results of any CNS malformation. Improvements in the understanding of congenital diseases and in fetal surgical techniques have reopened the door to applying fetal surgery to other congenital CNS abnormalities. Advances in gene therapy, bioengineering and neonatal neuroprotection will aid in the future expansion of fetal neurosurgery to other CNS disorders. PMID:21709818

  9. Modernity and the emerging futurism in neurosurgery.

    PubMed

    Apuzzo, M L

    2000-03-01

    This article discusses the emergence of neurosurgery in its 'modern' form during the second half of the 20th century and presents the apertures to the 21st century that are apparent in establishing an evolving futurism in the field. Factors of primary positive impetus and challenges are discussed.

  10. Use of ADCON in neurosurgery: preclinical review.

    PubMed

    Lo, H; Frederickson, R C

    1999-01-01

    ADCON-L and ADCON-T/N are two bioabsorbable adhesion barrier gels designed to inhibit post-operative fibrosis around the dura and nerve structure. Two ADCON products were evaluated in animal models emulating their use in neurosurgery. In all studies ADCON-L and ADCON-T/N were safe and effective barriers to post-operative peridural and perineural fibrosis.

  11. Neurosurgery: A profession or a technical trade?

    PubMed Central

    Watts, Clark

    2014-01-01

    The American Association of Neurological Surgeons (AANS), 11 years ago converted its Internal Revenue Code (IRC) tax status from a 501 (c) (3) to a 501 (c) (6) entity. By doing so, the professional medical association, now a trade association, was able to more aggressively lobby, support political campaigns, and pursue business opportunities for its members. In the following decade, major changes were seen in the practice of neurosurgery, especially as it relates to spine surgery. With the majority of neurosurgeons limiting themselves to a spine practice, an increased number of spinal procedures, most noted in the Medicare population, was recorded. For example, a 15-fold increase in complex spinal fusions for spinal stenosis was seen between 2002 and 2007. While the basis for this increase was not readily apparent, it was associated with a reduction in reimbursement per case of about 50%, fueling the belief that the increase in complexity of surgery permitted recovery of fees in complex cases to off-set the loss of reimbursement for simpler cases. Considering the growth of spinal surgery within neurosurgery, and decrease funding for spine surgery, in the future there may be too many surgeons chasing too few dollars. There appears to be within neurosurgery a crisis developing where future manpower projections do not realistically match future anticipated specialty funding. PMID:25558426

  12. [The origins of the French neurosurgery].

    PubMed

    Brunon, J

    2016-06-01

    Modern French neurosurgery starts at the beginning of the XXth century under the motivation of Joseph Babinski. He submitted his patients to Thierry de Martel who had learned this new specialized area of medicine with H. Cushing in the États-Unis and V. Horsey in Great Britain. His first successfully treated case of an intracranial tumor was published in 1909. But the true founding father was Clovis Vincent, initially a neurologist and collaborator of de Martel, who became the first chairman in 1933 of the neurosurgical department at the Pitié hospital of Paris and the first professor of neurosurgery in 1938. After the Second World War, many departments were created outside of Paris. Neurosurgery was definitively recognized as a specialized area in medicine in 1948. Currently, more than 400 neurosurgeons work in France. Because I had the very great privilege to be present at the birth of this society in 1970 and to still be in contact with some of the second and third generation of French neurosurgeons who led it to its high international recognition, the Chairman of the French Neurosurgical Society asked me to write this short historical vignette.

  13. Photodynamic application in neurosurgery: present and future

    NASA Astrophysics Data System (ADS)

    Kostron, Herwig

    2009-06-01

    Photodynamic techniques such as photodynamic diagnosis (PDD), fluorescence guided tumor resection (FGR) and photodynamic therapy (PDT) are currently undergoing intensive clinical investigations as adjunctive treatment for malignant brain tumours. This review provides an overview on the current clinical data and trials as well as on photosensitisers, technical developments and indications for photodynamic application in Neurosurgery. Furthermore new developments and clinical significance of FGR for neurosurgery will be discussed. Over 1000 patients were enrolled in various clinical phase I/II trials for PDT for malignant brain tumours. Despite various treatment protocols, variation of photosensitisers and light dose there is a clear trend towards prolonging median survival after one single PDT as compared to conventional therapeutic modalities. The median survival after PDT for primary glioblastoma multiforme WHO IV was 19 months and for recurrent GBM 9 months as compared to standard convential treatment which is 15 months and 3 months, respectively. FGR in combination with adjunctive radiation was significantly superior to standard surgical resection followed by radiation. The combination of FGR/PDD and intraoperative PDT increased significantly survival in recurrent glioblastoma patients. The combination of PDD/ FGR and PDT offers an exciting approach to the treatment of malignant brain tumours "to see and to treat." PDT was generally well tolerated and side effects consisted of occasionally increased intracranial pressure and prolonged skin sensitivity against direct sunlight. This review covers the current available data and draws the future potential of PDD and PDT for its application in neurosurgery.

  14. Neurosurgery: A profession or a technical trade?

    PubMed

    Watts, Clark

    2014-01-01

    The American Association of Neurological Surgeons (AANS), 11 years ago converted its Internal Revenue Code (IRC) tax status from a 501 (c) (3) to a 501 (c) (6) entity. By doing so, the professional medical association, now a trade association, was able to more aggressively lobby, support political campaigns, and pursue business opportunities for its members. In the following decade, major changes were seen in the practice of neurosurgery, especially as it relates to spine surgery. With the majority of neurosurgeons limiting themselves to a spine practice, an increased number of spinal procedures, most noted in the Medicare population, was recorded. For example, a 15-fold increase in complex spinal fusions for spinal stenosis was seen between 2002 and 2007. While the basis for this increase was not readily apparent, it was associated with a reduction in reimbursement per case of about 50%, fueling the belief that the increase in complexity of surgery permitted recovery of fees in complex cases to off-set the loss of reimbursement for simpler cases. Considering the growth of spinal surgery within neurosurgery, and decrease funding for spine surgery, in the future there may be too many surgeons chasing too few dollars. There appears to be within neurosurgery a crisis developing where future manpower projections do not realistically match future anticipated specialty funding.

  15. Molecular neurosurgery: vectors and vector delivery strategies.

    PubMed

    White, Edward

    2012-12-01

    Molecular neurosurgery involves the use of vector-mediated gene therapy and gene knockdown to manipulate in vivo gene expression for the treatment of neurological diseases. These techniques have the potential to revolutionise the practice of neurosurgery. However, significant challenges remain to be overcome before these techniques enter routine clinical practice. These challenges have been the subject of intensive research in recent years and include the development of strategies to facilitate effective vector delivery to the brain and the development of both viral and non-viral vectors that are capable of efficient cell transduction without excessive toxicity. This review provides an update on the practice of molecular neurosurgery with particular focus on the practical neurosurgical aspects of vector delivery to the brain. In addition, an introduction to the key vectors employed in clinical trials and a brief overview of previous gene therapy clinical trials is provided. Finally, key areas for future research aimed at increasing the likelihood of the successful translation of gene therapy into clinical trials are highlighted.

  16. Socioeconomic issues of United States military neurosurgery.

    PubMed

    Moquin, Ross R; Ecklund, James M

    2002-04-15

    Although the practice of neurosurgery in the United States (US) Armed Forces is in many ways similar to the civilian practice of neurosurgery, there are many differences as well. The unique challenges, duties, and opportunities US military neurosurgeons are given, both in peacetime and in times of conflict, are discussed, as are pathways for entering into service. The advantages of military service for neurosurgeons include sponsored training, decreased direct exposure to tort actions, little involvement with third-party payers, significant opportunities for travel, and military specific experiences. The most appealing aspect of military practice is serving fellow members of the US Armed Forces. Disadvantages include the extreme gap between the military and civilian pay scales, lack of support personnel, and in some areas low surgery-related case volume. The greatest concern faced by the military neurosurgical community is the failure to retain experienced neurosurgeons after their obligated service time has been completed, for which several possible solutions are described. It is hoped that future changes will make the practice of military neurosurgery attractive enough so that it will be seen as a career in itself and not an obligation to endure before starting practice in the "real world."

  17. Art, passion, and neurosurgery: the role of the Society of Neurological Surgeons in academic neurosurgery.

    PubMed

    Dempsey, Robert J

    2011-11-01

    Neurosurgery is at a crossroads in a time of economic uncertainty. It is also a time of remarkable potential for innovation resulting in dramatic improvement in the way neurosurgeons care for patients and the quality of outcomes. Analysis of this key time point of neurosurgical history is drawn from reflections for a presidential address to the Society of Neurological Surgeons. It is the author's opinion that the best of academic neurosurgery must and will accept this challenge by developing not only the research but also the creativity and art of what neurosurgeons do for maximal patient benefit in research, educational, and clinical missions.

  18. Smartphone use in neurosurgery? APP-solutely!

    PubMed Central

    Zaki, Michael; Drazin, Doniel

    2014-01-01

    Background: A number of smartphone medical apps have recently emerged that may be helpful for the neurosurgical patient, practitioner, and trainee. This study aims to review the current neurosurgery-focused apps available for the iPhone, iPad, and Android platforms as of December 2013. Methods: Two of the most popular smartphone app stores (Apple Store and Android Google Play Store) were surveyed for neurosurgery-focused apps in December 2013. Search results were categorized based on their description page. Data were collected on price, rating, app release date, target audience, and medical professional involvement in app design. A review of the top apps in each category was performed. Results: The search resulted in 111 unique apps, divided into these 7 categories: 16 (14%) clinical tools, 17 (15%) conference adjunct, 27 (24%) education, 18 (16%) literature, 15 (14%) marketing, 10 (9%) patient information, and 8 (7%) reference. The average cost of paid apps was $23.06 (range: $0.99-89.99). Out of the 111 apps, 71 (64%) were free, 48 (43%) had reviews, and 14 (13%) had more than 10 reviews. Seventy-three (66%) apps showed evidence of medical professional involvement. The number of apps being released every year has been increasing since 2009. Conclusions: There are a number of neurosurgery-themed apps available to all audiences. There was a lack of patient information apps for nonspinal procedures. Most apps did not have enough reviews to evaluate their quality. There was also a lack of oversight to validate the accuracy of medical information provided in these apps. PMID:25101208

  19. Mythological and Prehistorical Origins of Neurosurgery.

    PubMed

    Nanda, Anil; Filis, Andreas; Kalakoti, Piyush

    2016-05-01

    Mythology has a cultural appeal, and the description of some neurosurgical procedures in the Hindu, Greek, Egyptian, and Chinese mythology has a bearing to the origins of our professions. The traces to some of our modern-day practices also can be linked back to the ancient prehistoric eras of the Siberian, Persian, and the Andean region. In this historical perspective, we briefly dwell into individual accounts through the prism of different cultures to highlight the development of neurosurgery in mythology and prehistoric era.

  20. Genealogy of training in vascular neurosurgery.

    PubMed

    Chowdhry, Shakeel A; Spetzler, Robert F

    2014-02-01

    Remarkable advances and changes in the landscape of neurovascular disease have occurred recently. Concurrently, a paradigm shift in training and resident education is underway. This crossroad of unique opportunities and pressures necessitates creative change in the training of future vascular neurosurgeons to allow incorporation of surgical advances, new technology, and supplementary treatment modalities in a setting of reduced work hours and increased public scrutiny. This article discusses the changing landscape in neurovascular disease treatment, followed by the recent changes in resident training, and concludes with our view of the future of training in vascular neurosurgery.

  1. Current Status and Future Prospect of Endovascular Neurosurgery

    PubMed Central

    Jeon, Young Il

    2008-01-01

    Recently, due to the evolution of technology, the field of neurosurgery is receiving spotlight. In particular endovascular neurosurgery has gained a great interest along with the advancement of the modern neurosurgery. The most remarkable advances were made in embolization of the cerebral aneurysms, arteriovenous malformations and intracranial stenosis during the past 10 years. These advances will further change the role of neurosurgeons in treating cerebrovascular disease. Because interventional neuroradiologists have performed most of procedures in the past, neurosurgeons have been deprived of chances to learn endovascular procedure. This article discusses the development of technological aspect of endovascular neurosurgery in chronological order. By understanding the history and current status of the endovascular surgery, the future of neurosurgery will be promising. PMID:19096608

  2. Virtual endoscopy in neurosurgery: a review.

    PubMed

    Neubauer, André; Wolfsberger, Stefan

    2013-01-01

    Virtual endoscopy is the computerized creation of images depicting the inside of patient anatomy reconstructed in a virtual reality environment. It permits interactive, noninvasive, 3-dimensional visual inspection of anatomical cavities or vessels. This can aid in diagnostics, potentially replacing an actual endoscopic procedure, and help in the preparation of a surgical intervention by bridging the gap between plain 2-dimensional radiologic images and the 3-dimensional depiction of anatomy during actual endoscopy. If not only the endoscopic vision but also endoscopic handling, including realistic haptic feedback, is simulated, virtual endoscopy can be an effective training tool for novice surgeons. In neurosurgery, the main fields of the application of virtual endoscopy are third ventriculostomy, endonasal surgery, and the evaluation of pathologies in cerebral blood vessels. Progress in this very active field of research is achieved through cooperation between the technical and the medical communities. While the technology advances and new methods for modeling, reconstruction, and simulation are being developed, clinicians evaluate existing simulators, steer the development of new ones, and explore new fields of application. This review introduces some of the most interesting virtual reality systems for endoscopic neurosurgery developed in recent years and presents clinical studies conducted either on areas of application or specific systems. In addition, benefits and limitations of single products and simulated neuroendoscopy in general are pointed out.

  3. Minimalism in Art, Medical Science and Neurosurgery.

    PubMed

    Ökten, Ali İhsan

    2016-12-21

    The word ''minimalism'' is a word derived from French the word ''minimum''. Whereas the lexical meaning of minimum is ''the least or the smallest quantity necessary for something'', its expression in mathematics can be described as ''the lowest step a variable number can descend, least, minimal''. Minimalism, which advocates an extreme simplicity of the artistic form, is a current in modern art and music whose origins go to 1960s and which features simplicity and objectivity. Although art, science and philosophy are different disciplines, they support each other from time to time, sometimes they intertwine and sometimes they copy each other. A periodic schools or teaching in one of them can take the others into itself, so, they proceed on their ways empowering each other. It is also true for the minimalism in art and the minimal invasive surgical approaches in science. Concepts like doing with less, avoiding unnecessary materials and reducing the number of the elements in order to increase the effect in the expression which are the main elements of the minimalism in art found their equivalents in medicine and neurosurgery. Their equivalents in medicine or neurosurgery have been to protect the physical integrity of the patient with less iatrogenic injury, minimum damage and the same therapeutic effect in the most effective way and to enable the patient to regain his health in the shortest span of time.

  4. Particle radiotherapy for prostate cancer.

    PubMed

    Shioyama, Yoshiyuki; Tsuji, Hiroshi; Suefuji, Hiroaki; Sinoto, Makoto; Matsunobu, Akira; Toyama, Shingo; Nakamura, Katsumasa; Kudo, Sho

    2015-01-01

    Recent advances in external beam radiotherapy have allowed us to deliver higher doses to the tumors while decreasing doses to the surrounding tissues. Dose escalation using high-precision radiotherapy has improved the treatment outcomes of prostate cancer. Intensity-modulated radiation therapy has been widely used throughout the world as the most advanced form of photon radiotherapy. In contrast, particle radiotherapy has also been under development, and has been used as an effective and non-invasive radiation modality for prostate and other cancers. Among the particles used in such treatments, protons and carbon ions have the physical advantage that the dose can be focused on the tumor with only minimal exposure of the surrounding normal tissues. Furthermore, carbon ions also have radiobiological advantages that include higher killing effects on intrinsic radio-resistant tumors, hypoxic tumor cells and tumor cells in the G0 or S phase. However, the degree of clinical benefit derived from these theoretical advantages in the treatment of prostate cancer has not been adequately determined. The present article reviews the available literature on the use of particle radiotherapy for prostate cancer as well as the literature on the physical and radiobiological properties of this treatment, and discusses the role and the relative merits of particle radiotherapy compared with current photon-based radiotherapy, with a focus on proton beam therapy and carbon ion radiotherapy.

  5. Comprehensive review on rhino-neurosurgery

    PubMed Central

    Hosemann, Werner; Schroeder, Henry W.S.

    2015-01-01

    In the past 2 decades, an innovative and active field of surgical collaboration has been evolved and established combining the expertise of neurosurgery and rhinosurgery in the endonasal treatment of different lesions affecting the anterior skull base together with the adjacent intranasal and intradural areas. Important prerequisites for this development were improvements of technical devices, definitions of transnasal surgical corridors, and approvements in endonasal reconstructions, e.g. by use of pedicled nasal mucosal flaps. Due to these improvements, the rate of perioperative infectious complications remained acceptable. Interdisciplinary surgical teams (4-hands-2-minds) have been established constituting specialized centers of “rhino-neurosurgery”. With growing expertise of these groups, it could be shown that oncological results and perioperative complications were comparable to traditional surgery while at the same time the patients’ morbidity could be reduced. The present review encompasses the recent literature focusing on the development, technical details, results, and complications of “rhino-neurosurgery”. PMID:26770276

  6. Options for perioperative pain management in neurosurgery

    PubMed Central

    Vadivelu, Nalini; Kai, Alice M; Tran, Daniel; Kodumudi, Gopal; Legler, Aron; Ayrian, Eugenia

    2016-01-01

    Moderate-to-severe pain following neurosurgery is common but often does not get attention and is therefore underdiagnosed and undertreated. Compounding this problem is the traditional belief that neurosurgical pain is inconsequential and even dangerous to treat. Concerns about problematic effects associated with opioid analgesics such as nausea, vomiting, oversedation, and increased intracranial pressure secondary to elevated carbon dioxide tension from respiratory depression have often led to suboptimal postoperative analgesic strategies in caring for neurosurgical patients. Neurosurgical patients may have difficulty or be incapable of communicating their need for analgesics due to neurologic deficits, which poses an additional challenge. Postoperative pain control should be a priority, because pain adversely affects recovery and patient outcomes. Inconsistent practices and the quality of current analgesic strategies for neurosurgical patients still leave room for improvement. Given the complexity of postoperative pain management for these patients, multimodal strategies are often required to optimize pain control and at the same time limit undesired side effects. PMID:26929661

  7. Virtual neurosurgery, training for the future.

    PubMed

    Vloeberghs, M; Glover, A; Benford, S; Jones, A; Wang, P; Becker, Adib

    2007-06-01

    Virtual reality (VR) simulators have been created for various surgical specialties. The common theme is extensive use of graphics, confined spaces, limited functionality and limited tactile feedback. A development team at the University of Nottingham, UK, consisting of computer scientists, mechanical engineers, graphic designers and a neurosurgeon, set out to develop a haptic, e.g. tactile simulator for neurosurgery making use of boundary elements (BE). The relative homogeneity of the brain, allows boundary elements, e.g. 'surface only' rendering, to simulate the brain structure. A boundary element simplifies the computing equations saves computing time, by assuming the properties of the surface equal the properties of the body. A limited audit was done by neurosurgical users confirming the potential of the simulator as a training tool. This paper focuses on the application of the computational method and refers to the underlying mathematical structure. Full references are included regarding the mathematical methodology.

  8. Life and Medical Ethics in Pediatric Neurosurgery

    PubMed Central

    YAMASAKI, Mami

    2017-01-01

    Ethical issues in the field of pediatric neurosurgery, including prenatal diagnosis, palliative care for children with an intractable serious disease, and medical neglect, are discussed. An important role of medicine is to offer every possible treatment to a patient. However, it also is the responsibility of medicine to be conscious of its limitations, and to help parents love and respect a child who suffers from an incurable disease. When dealing with cases of medical neglect and palliative care for an incurable disease, it is critical to diagnose the child’s condition accurately and evaluate the outcome. However, to treat or not to treat also depends on the medical resources and social-economic status of the community, the parents’ religion and philosophy, the policies of the institutions involved, and the limits of medical science. Moral dilemmas will continue to be addressed as medical progress yields treatments for untreatable diseases in the future. PMID:28025426

  9. Medieval neurosurgery: contributions from the Middle East, Spain, and Persia.

    PubMed

    Rahimi, Scott Y; McDonnell, Dennis E; Ahmadian, Amir; Vender, John R

    2007-01-01

    Modern neurological and spinal surgical techniques have been developed on the foundations established by predecessors. Modern 21st century neurosurgery begins in the Babylonian period, with the Edwin Smith papyrus. Throughout history, periods of enlightenment have resulted in advances in knowledge and understanding that have served as stepping stones for generations to come. As in other fields, in neurosurgery these periods of "enlightenment" have occurred in a variety of civilizations and time periods.

  10. Introduction: military neurosurgery, past and present.

    PubMed

    Klimo, Paul; Ragel, Brian T

    2010-05-01

    For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldier's body from the weapons of war. The Iliad portrays the pivotal 10th year of the legendary Trojan War, during which a schism in the Greek leadership prolongs the extended siege of the city of Troy. In the midst of this martial epic come the lines quoted above, quietly attesting to the value of the military physician, even under the crude conditions of the Greek Dark Age. They are uttered by Idomeneus, one of the foremost Greeks, when he is enjoining one of his comrades, Nestor, to rescue the injured Greek physician Machaon and take him back from the line to treat his wounds. He is afraid that Machaon will be captured by the Trojans, a loss far greater than that of any other single warrior. Duty to country has helped shape the careers of many neurosurgeons, including iconic US figures such as Harvey Cushing and Donald Matson. This issue of Neurosurgical Focus celebrates the rich history of military neurosurgery from the wars of yesterday to the conflicts of today. We have been humbled by the tremendous response to this topic. The 25 articles within this issue will provide the reader with both a broad and an in-depth look at the many facets of military neurosurgery. We have attempted to group articles based on their predominant topic. We also encourage our audience to read other recently published articles. The first 8 articles relate to the current conflicts in Afghanistan and Iraq. The lead article, written by Randy Bell and colleagues from the National Naval Medical Center and Walter Reed Army Medical Center, discusses what is arguably one of the most important contributions by military neurosurgeons from these 2 conflicts: the rapid and aggressive

  11. Neurosurgery in rural Nigeria: A prospective study

    PubMed Central

    Rabiu, Taopheeq Bamidele; Komolafe, Edward Oluwole

    2016-01-01

    Background: Africa has very few neurosurgeons. These are almost exclusively in urban centers. Consequently, people in rural areas, most of the African population, have poor or no access to neurosurgical care. We have recently pioneered rural neurosurgery in Nigeria. Objectives: This report details our initial experiences and the profile of neurosurgical admissions in our center. Methods: A prospective observational study of all neurosurgical patients managed at a rural tertiary health institution in Nigeria from December 2010 to May 2012 was done. Simple descriptive data analysis was performed. Results: A total of 249 males (75.2%) and 82 females (24.8%) were managed. The median age was 37 years (range: Day of birth – 94 years). Trauma was the leading cause of presentation with 225 (68.0%) and 35 (10.6%) having sustained head and spinal injuries, respectively. Operative intervention was performed in 54 (16.3%). Twenty-four (7.2%) patients discharged against medical advice, mostly for economic reasons. Most patients (208, 63.4%) had satisfactory outcome while 30 (9.1%) died. Conclusion: Trauma is the leading cause of rural neurosurgical presentations. There is an urgent need to improve access to adequate neurosurgical care in the rural communities. PMID:27695224

  12. Prophylactic antibiotics and anticonvulsants in neurosurgery.

    PubMed

    Ratilal, B; Sampaio, C

    2011-01-01

    The prophylactic administration of antibiotics to prevent infection and the prophylactic administration of anticonvulsants to prevent first seizure episodes are common practice in neurosurgery. If prophylactic medication therapy is not indicated, the patient not only incurs the discomfort and the inconvenience resulting from drug treatment but is also unnecessarily exposed to adverse drug reactions, and incurs extra costs. The main situations in which prophylactic anticonvulsants and antibiotics are used are described and those situations we found controversial in the literature and lack further investigation are identified: anticonvulsants for preventing seizures in patients with chronic subdural hematomas, antiepileptic drugs for preventing seizures in those suffering from brain tumors, antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures, and antibiotic prophylaxis for the surgical introduction of intracranial ventricular shunts.In the following we present systematic reviews of the literature in accordance with the standard protocol of The Cochrane Collaboration to evaluate the effectiveness of the use of these prophylactic medications in the situations mentioned. Our goal was to efficiently integrate valid information and provide a basis for rational decision-making.

  13. Registration in neurosurgery and neuroradiotherapy applications.

    PubMed

    Cuchet, E; Knoplioch, J; Dormont, D; Marsault, C

    1995-01-01

    Because of the high level of accuracy needed in neurosurgery, many computer-assisted surgery (CAS) and augmented reality techniques have been developed in this field. A common issue with all of these techniques is registration between preoperative three-dimensional images (computed tomography and magnetic resonance imaging) and the patient in the operating room. We present, in the first part of this paper, a survey of the latest CAS technologies, using fully automatic registration without fiducial landmarks. All of the registration algorithms described are based on minimization of a cost function. We then describe our approach. Our cost function is simply the mean square error (MSE), minimized by the iterative closest point algorithm (ICP). Because the weak point of the ICP algorithm is the closest point computational cost, we precalculate it by a "closest point map," inspired from classical distance map. We finally perturb the found solution to eliminate local minima close to the global minimum. This paper summarizes the various methods presented. We study the shape of the different cost functions and show that there is no need for a complex cost function. MSE has sufficiently good convergence properties to reach a position very close to the global minimum. We also demonstrate the influence of a final perturbation of the found solution to improve registration. Finally, we test the registration on different regions of the patient's head.

  14. Augmented reality in neurosurgery: a systematic review.

    PubMed

    Meola, Antonio; Cutolo, Fabrizio; Carbone, Marina; Cagnazzo, Federico; Ferrari, Mauro; Ferrari, Vincenzo

    2016-05-07

    Neuronavigation has become an essential neurosurgical tool in pursuing minimal invasiveness and maximal safety, even though it has several technical limitations. Augmented reality (AR) neuronavigation is a significant advance, providing a real-time updated 3D virtual model of anatomical details, overlaid on the real surgical field. Currently, only a few AR systems have been tested in a clinical setting. The aim is to review such devices. We performed a PubMed search of reports restricted to human studies of in vivo applications of AR in any neurosurgical procedure using the search terms "Augmented reality" and "Neurosurgery." Eligibility assessment was performed independently by two reviewers in an unblinded standardized manner. The systems were qualitatively evaluated on the basis of the following: neurosurgical subspecialty of application, pathology of treated lesions and lesion locations, real data source, virtual data source, tracking modality, registration technique, visualization processing, display type, and perception location. Eighteen studies were included during the period 1996 to September 30, 2015. The AR systems were grouped by the real data source: microscope (8), hand- or head-held cameras (4), direct patient view (2), endoscope (1), and X-ray fluoroscopy (1) head-mounted display (1). A total of 195 lesions were treated: 75 (38.46 %) were neoplastic, 77 (39.48 %) neurovascular, and 1 (0.51 %) hydrocephalus, and 42 (21.53 %) were undetermined. Current literature confirms that AR is a reliable and versatile tool when performing minimally invasive approaches in a wide range of neurosurgical diseases, although prospective randomized studies are not yet available and technical improvements are needed.

  15. Neurosurgery in the realm of 10(-9), Part 2: applications of nanotechnology to neurosurgery--present and future.

    PubMed

    Elder, James B; Liu, Charles Y; Apuzzo, Michael L J

    2008-02-01

    Neurosurgery in the future will witness an increasing influx of novel technologies, many of which will be based on developments in the emerging science of nanotechnology. Additionally, the continued trend in medicine toward minimally invasive diagnostic and surgical techniques will be aided by incorporation of applications of nanotechnology. Neurosurgeons of the future must facilitate the development of nanotechnology and nanomedicine in their clinical practice and research efforts to optimize patient benefit and facilitate scientific advancement. The fields of nanotechnology and nanomedicine remain in their infancy. Recently, however, the literature regarding nanoscience has rapidly expanded. This article is the second of two and provides a review of recent nanotechnology research relevant to clinical neurosurgery and neurology. The first article reviewed recent developments and issues in nanotechnology with a particular focus on applications to the neurosciences. This article also discusses current developments in nanotechnology and nanomedicine that may yield applications in neurosurgery in the future. Additional attention is given to other emerging technologies that are not truly nanotechnology, such as microelectromechanical systems, which will influence the future of medicine and neurosurgery. The goal is to provide the reader with a brief outline and description of some of the new developments in nanotechnology that may affect the clinical practice or operative experience of neurosurgeons. Continued innovation in nanotechnology presents novel opportunities for translation to the clinical arena. Neuroscience, neurology, and neurosurgery will be greatly affected by the influx of nanoscience and its applications. Through continued collaboration, physicians, scientists, and engineers will shape the futures of nanomedicine and nanoneurosurgery.

  16. Fast forwarding: the evolution of neurosurgery. The 2005 presidential address.

    PubMed

    Ratcheson, Robert A

    2005-10-01

    Despite the major social and economic reorganization of medical practice that has taken place during the past 40 years, neurosurgery-the most fascinating specialty in all of clinical medicine-has grown and prospered. Today, this specialty is poised for an era of spectacular advancement and improvement in care; however, significant problems with the potential to retard this growth face neurosurgery. Among these problems is the medical liability situation, which has the potential to destabilize neurosurgical practices and the current health care delivery system. Other issues facing neurosurgery include the potential for loss of the unique nature of the specialty through a conversion to shift-worker surgeons and increasing reliance on profit-seeking institutions for financial stability and liability protection. Lifestyle choices are of growing importance and currently discourage women from entering the field. With a growing knowledge base, there is the recognition that it may not be possible for most individuals to master all aspects of the specialty. There is continued confusion about manpower needs. In addition, some neurosurgeons are choosing to practice in ways that fail to meet the neurosurgeon's obligations to society. There is a growing number of neurosurgeons who dislike providing trauma coverage and there is the potential for some neurosurgeons to give up intracranial neurosurgery. The author believes that it is not competition that will improve the delivery of neurosurgical care and allow for continued growth, but cooperation, and that it will be possible to alleviate many of our problems through increased regionalization of neurosurgical care delivery. This proposal has the potential to promote the formation of neurosurgical teams, ameliorate the problem of physician fatigue, allow greater development of subspecialty skills, and ease the burden of trauma call. It should allow satisfactory solutions to lifestyle considerations and encourage more women to

  17. Government Medical College Trivandrum - Fifty years of Neurosurgery in Kerala state.

    PubMed

    Peethambaran, Anil Kumar; Chandran, Raj S

    2017-01-01

    The Department of Neurosurgery founded in the Trivandrum Medical College, Kerala, the first teaching hospital in Kerala state, is celebrating its 50th anniversary. The history of Neurosurgery in this Institute is synonymous with the history of Neurosurgery in the state as this was the first medical college to start a Neurosurgery department within the state.The students after undergoing their rigorous training in the department, went on to establish advanced neurosurgical centres throughout Kerala and in several other parts of the country. This article traces the illustrious history of the Department of Neurosurgery, Trivandrum Medical College and also of the eminent faculty members and residents, who helped in advancing the standards of Neurosurgery in the region as well as the rest of India. The Department of Neurosurgery was founded in the Trivandrum Medical College, Kerala, the first teaching hospital in Kerala state, in the year 1951, and is celebrating its 50th anniversary. The history of Neurosurgery in this Institute is synonymous with the history of Neurosurgery in the state as this was the first medical college to start a Neurosurgery department within the state.The students after undergoing their rigorous training in the department, went on to establish advanced neurosurgical centres throughout Kerala and in several other parts of the country. This article traces the illustrious history of the Department of Neurosurgery, Trivandrum Medical College and also of the eminent faculty members and residents, who helped in advancing the standards of Neurosurgery in the region as well as the rest of India.

  18. Development of a new microsurgical robot for stereotactic neurosurgery.

    PubMed

    Koyama, H; Uchida, T; Funakubo, H; Takakura, K; Fankhauser, H

    1990-01-01

    The robot technology was introduced into a new stereotactic neurosurgery system for applications to biopsy, blind surgery, and functional neurosurgery. The authors have developed a newly designed prototype microsurgical robot, designed to allow a biopsy needle to reach the target such as a cerebral tumor within a brain automatically on the basis of the X, Y, and Z coordinates obtained by CT scanner. This robot is so small that it can be driven in a CT scanner gantry. It consists mainly of the link mechanism and the insertion mechanism. We constructed the link mechanism and investigated its working space.

  19. Functional neurosurgery. The modulation of neural and mind circuits.

    PubMed

    Al-Otaibi, Faisal; Al-Khairallah, Thamer

    2012-01-01

    Different complex neuroanatomical and neurochemical circuits regulate a variety of neuronal behaviors and brain functions. Any disturbance in these circuits can generate functional disorders such as movement disorders, epilepsy, pain, memory disorders, and psychiatric disorders. Functional neurosurgery aims to restore these functions, either by removing or isolating the abnormally behaving neurons or by modulating the disturbed circuits. Neuromodulation is a fast-growing field, powered by the recent advances in neuroimaging and technology. Here, we discuss recent advances and new horizons in functional neurosurgery.

  20. Radio Galaxies.

    ERIC Educational Resources Information Center

    Downes, Ann

    1986-01-01

    Provides background information on radio galaxies. Topic areas addressed include: what produces the radio emission; radio telescopes; locating radio galaxies; how distances to radio galaxies are found; physics of radio galaxies; computer simulations of radio galaxies; and the evolution of radio galaxies with cosmic time. (JN)

  1. The Co-evolution of Neuroimaging and Psychiatric Neurosurgery

    PubMed Central

    Dyster, Timothy G.; Mikell, Charles B.; Sheth, Sameer A.

    2016-01-01

    The role of neuroimaging in psychiatric neurosurgery has evolved significantly throughout the field’s history. Psychiatric neurosurgery initially developed without the benefit of information provided by modern imaging modalities, and thus lesion targets were selected based on contemporary theories of frontal lobe dysfunction in psychiatric disease. However, by the end of the 20th century, the availability of structural and functional magnetic resonance imaging (fMRI) allowed for the development of mechanistic theories attempting to explain the anatamofunctional basis of these disorders, as well as the efficacy of stereotactic neuromodulatory treatments. Neuroimaging now plays a central and ever-expanding role in the neurosurgical management of psychiatric disorders, by influencing the determination of surgical candidates, allowing individualized surgical targeting and planning, and identifying network-level changes in the brain following surgery. In this review, we aim to describe the coevolution of psychiatric neurosurgery and neuroimaging, including ways in which neuroimaging has proved useful in elucidating the therapeutic mechanisms of neuromodulatory procedures. We focus on ablative over stimulation-based procedures given their historical precedence and the greater opportunity they afford for post-operative re-imaging, but also discuss important contributions from the deep brain stimulation (DBS) literature. We conclude with a discussion of how neuroimaging will transition the field of psychiatric neurosurgery into the era of precision medicine. PMID:27445706

  2. 3D printing in neurosurgery: A systematic review

    PubMed Central

    Randazzo, Michael; Pisapia, Jared M.; Singh, Nickpreet; Thawani, Jayesh P.

    2016-01-01

    Background: The recent expansion of three-dimensional (3D) printing technology into the field of neurosurgery has prompted a widespread investigation of its utility. In this article, we review the current body of literature describing rapid prototyping techniques with applications to the practice of neurosurgery. Methods: An extensive and systematic search of the Compendex, Scopus, and PubMed medical databases was conducted using keywords relating to 3D printing and neurosurgery. Results were manually screened for relevance to applications within the field. Results: Of the search results, 36 articles were identified and included in this review. The articles spanned the various subspecialties of the field including cerebrovascular, neuro-oncologic, spinal, functional, and endoscopic neurosurgery. Conclusions: We conclude that 3D printing techniques are practical and anatomically accurate methods of producing patient-specific models for surgical planning, simulation and training, tissue-engineered implants, and secondary devices. Expansion of this technology may, therefore, contribute to advancing the neurosurgical field from several standpoints. PMID:27920940

  3. In touch with robotics: neurosurgery for the future.

    PubMed

    Nathoo, Narendra; Cavuşoğlu, M Cenk; Vogelbaum, Michael A; Barnett, Gene H

    2005-03-01

    The introduction of multiple front-end technologies during the past quarter century has generated an emerging futurism for the discipline of neurological surgery. Driven primarily by synergistic developments in science and engineering, neurosurgery has always managed to harness the potential of the latest technical developments. Robotics represents one such technology. Progress in development of this technology has resulted in new uses for robotic devices in our discipline, which are accompanied by new potential dangers and inherent risks. The recent surge in robot-assisted interventions in other disciplines suggests that this technology may be considered one of a spectrum of frontier technologies poised to fuel the development of neurosurgery and consolidate the era of minimalism. On a more practical level, if the introduction of robotics in neurosurgery proves beneficial, neurosurgeons will need to become facile with this technology and learn to harness its potential so that the best surgical results may be achieved in the least invasive manner. This article reviews the role of robotic technology in the context of neurosurgery.

  4. Protocol for the CONVERT trial—Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status

    PubMed Central

    Falk, Sally; Ashcroft, Linda; Bewley, Michelle; Lorigan, Paul; Wilson, Elena; Groom, Nicki; Snee, Michael; Fournel, Pierre; Cardenal, Felipe; Bezjak, Andrea; Blackhall, Fiona

    2016-01-01

    Introduction Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) is the only multicentre, international, randomised, phase III trial open in Europe and Canada looking at optimisation of chemoradiotherapy (RT) in limited stage small cell lung cancer (LS-SCLC). Following on from the Turrisi trial of once-daily versus twice-daily (BD) concurrent chemoradiotherapy, there is a real need for a new phase III trial using modern conformal RT techniques and investigating higher once-daily radiation dose. This trial has the potential to define a new standard chemo-RT regimen for patients with LS-SCLC and good performance status. Methods and analysis 447 patients with histologically or cytologically proven diagnosis of SCLC were recruited from 74 centres in eight countries between 2008 and 2013. Patients were randomised to receive either concurrent twice-daily RT(45 Gy in 30 twice-daily fractions over 3 weeks) or concurrent once-daily RT(66 Gy in 33 once-daily fractions over 6.5 weeks) both starting on day 22 of cycle 1. Patients are followed up until death. The primary end point of the study is overall survival and secondary end points include local progression-free survival, metastasis-free survival, acute and late toxicity based on the Common Terminology Criteria for Adverse Events V.3.0, chemotherapy and RTdose intensity. Ethics and dissemination The trial received ethical approval from NRES Committee North West—Greater Manchester Central (07/H1008/229). There is a trial steering committee, including independent members and an independent data monitoring committee. Results will be published in a peer-reviewed journal and presented at international conferences. Trial registration number ISRCTN91927162; Pre-results. PMID:26792218

  5. Bystander effects and radiotherapy.

    PubMed

    Marín, Alicia; Martín, Margarita; Liñán, Olga; Alvarenga, Felipe; López, Mario; Fernández, Laura; Büchser, David; Cerezo, Laura

    2015-01-01

    Radiation-induced bystander effects are defined as biological effects expressed after irradiation by cells whose nuclei have not been directly irradiated. These effects include DNA damage, chromosomal instability, mutation, and apoptosis. There is considerable evidence that ionizing radiation affects cells located near the site of irradiation, which respond individually and collectively as part of a large interconnected web. These bystander signals can alter the dynamic equilibrium between proliferation, apoptosis, quiescence or differentiation. The aim of this review is to examine the most important biological effects of this phenomenon with regard to areas of major interest in radiotherapy. Such aspects include radiation-induced bystander effects during the cell cycle under hypoxic conditions when administering fractionated modalities or combined radio-chemotherapy. Other relevant aspects include individual variation and genetics in toxicity of bystander factors and normal tissue collateral damage. In advanced radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), the high degree of dose conformity to the target volume reduces the dose and, therefore, the risk of complications, to normal tissues. However, significant doses can accumulate out-of-field due to photon scattering and this may impact cellular response in these regions. Protons may offer a solution to reduce out-of-field doses. The bystander effect has numerous associated phenomena, including adaptive response, genomic instability, and abscopal effects. Also, the bystander effect can influence radiation protection and oxidative stress. It is essential that we understand the mechanisms underlying the bystander effect in order to more accurately assess radiation risk and to evaluate protocols for cancer radiotherapy.

  6. Cerenkov and radioluminescence imaging of brain tumor specimens during neurosurgery

    NASA Astrophysics Data System (ADS)

    Spinelli, Antonello Enrico; Schiariti, Marco P.; Grana, Chiara M.; Ferrari, Mahila; Cremonesi, Marta; Boschi, Federico

    2016-05-01

    We presented the first example of Cerenkov luminescence imaging (CLI) and radioluminescence imaging (RLI) of human tumor specimens. A patient with a brain meningioma localized in the left parietal region was injected with 166 MBq of Y90-DOTATOC the day before neurosurgery. The specimens of the tumor removed during surgery were imaged using both CLI and RLI using an optical imager prototype developed in our laboratory. The system is based on a cooled electron multiplied charge coupled device coupled with an f/0.95 17-mm C-mount lens. We showed for the first time the possibility of obtaining CLI and RLI images of fresh human brain tumor specimens removed during neurosurgery.

  7. A Bosphorus submarine passage and the reinvention of neurosurgery.

    PubMed

    Apuzzo, Michael L J; Pagán, Veronica M; Faccio, Rodrick; Liu, Charles Y

    2013-01-01

    One of the major themes characterizing the emergence of modern neurosurgery has been the concept of technology transfer and the application of a broad spectrum of revolutionary elements of technology from both physical and biological science. These transference applications are now apparent in modern neurosurgery as it is practiced on all continents of the globe. More than 3 decades ago, these ideas that now have come to fruition were in states of formulation. This article describes and further documents one such fertile cauldron of ideas and practical realities--the United States Navy Nuclear Submarine Service and its role and affect on the life and professional career of an academic neurosurgeon who was active in areas of progress as modernity was established for the early 21st century.

  8. Analysis of Electronic Densities and Integrated Doses in Multiform Glioblastomas Stereotactic Radiotherapy

    SciTech Connect

    Baron-Aznar, C.; Moreno-Jimenez, S.; Celis, M. A.; Ballesteros-Zebadua, P.; Larraga-Gutierrez, J. M.

    2008-08-11

    Integrated dose is the total energy delivered in a radiotherapy target. This physical parameter could be a predictor for complications such as brain edema and radionecrosis after stereotactic radiotherapy treatments for brain tumors. Integrated Dose depends on the tissue density and volume. Using CT patients images from the National Institute of Neurology and Neurosurgery and BrainScan(c) software, this work presents the mean density of 21 multiform glioblastomas, comparative results for normal tissue and estimated integrated dose for each case. The relationship between integrated dose and the probability of complications is discussed.

  9. Analysis of Electronic Densities and Integrated Doses in Multiform Glioblastomas Stereotactic Radiotherapy

    NASA Astrophysics Data System (ADS)

    Barón-Aznar, C.; Moreno-Jiménez, S.; Celis, M. A.; Lárraga-Gutiérrez, J. M.; Ballesteros-Zebadúa, P.

    2008-08-01

    Integrated dose is the total energy delivered in a radiotherapy target. This physical parameter could be a predictor for complications such as brain edema and radionecrosis after stereotactic radiotherapy treatments for brain tumors. Integrated Dose depends on the tissue density and volume. Using CT patients images from the National Institute of Neurology and Neurosurgery and BrainScansoftware, this work presents the mean density of 21 multiform glioblastomas, comparative results for normal tissue and estimated integrated dose for each case. The relationship between integrated dose and the probability of complications is discussed.

  10. [Changing the teaching of neurosurgery with information technology].

    PubMed

    Moreau, Jean-Jacques; Caire, François; Kalamarides, Michel; Mireau, Etienne; Dauger, Frédéric; Coignac, Marie-Jo; Charlin, Bernard

    2009-10-01

    A digital campus is a distance learning site that uses the potential of information and communication technologies to disseminate and improve educational services. This website, with open and free access, is built from free software with Web 2.0 technology. It is hosted at the University of Limoges. It functions as a digital library, containing scanned books, slide shows, more than 200 hours of recorded courses and round tables accessible by streaming video. The site is indexed according to the users' needs, by level of knowledge, specialty, keywords, and supplementary MeSH terms. The campus is organized as the College of Neurosurgery (http://college.neurochirurgie.fr). The durability of this type of training (in existence for 9 years now) is made possible by a powerful and committed consortium: the French Society of Neurosurgery, which has created high-quality intellectual and scientific resources, the University of Limoges, the Dupuytren University Hospital Center in Limoges, the region of Limousin, and the French-language Virtual Medical University, which have provided logistic and financial support. To target appropriate levels at various users, we distinguished four groups: medical students, neurosurgery students, neurosurgeons (continuing medical education), and students in allied health fields. All areas of neurosurgery are concerned. All the courses, including tests for self-evaluation and scientific meetings (organized with information and communication technologies) are digitally recorded for the site. The principles that make it possible for a medical discipline to organize around an online project are: a pedagogical conception of projects built in the form of models reusable by other health specialties; a stronghold within professional societies of the relevant specialties able to create high-quality intellectual and scientific resources; an organization by educational levels that can be extended transversally to other health disciplines; and free

  11. New developments in intracranial stereotactic radiotherapy for metastases.

    PubMed

    Pinkham, M B; Whitfield, G A; Brada, M

    2015-05-01

    Brain metastases are common and the prognosis for patients with multiple brain metastases treated with whole brain radiotherapy is limited. As systemic disease control continues to improve, the expectations of radiotherapy for brain metastases are growing. Stereotactic radiosurgery (SRS) as a high precision localised irradiation given in a single fraction prolongs survival in patients with a single brain metastasis and functional independence in those with up to three brain metastases. SRS technology has become commonplace and is available in many radiation oncology and neurosurgery departments. With increasing use there is a need for appropriate patient selection, refinement of dose-fractionation and safe integration of SRS with other treatment modalities. We review the evidence for current practice and new developments in the field, with a specific focus on patient-relevant outcomes.

  12. Highly cited publications in pediatric neurosurgery: part 2

    PubMed Central

    Khan, Nickalus R.; Auschwitz, Tyler; McAbee, Joseph H.; Boop, Frederick A.; Klimo, Paul

    2015-01-01

    Purpose Citation counting can be used to evaluate the impact an article has made on its discipline. This study characterizes the most cited articles related to clinical pediatric neurosurgery as of July 2013. Methods A list of search terms was computed using Thomson Reuters Web of Science® (WOS) to capture the 100 most cited articles in the overall literature and the top 50 articles from 2002 to 2012 related to clinical pediatric neurosurgery from non-dedicated pediatric neurosurgical journals. The following information was recorded for each article: number of authors, country of origin, citation count adjusted for number of years in print, topic, and level of evidence. Results The 100 most cited articles appeared in 44 journals. Publication dates ranged from 1986 to 2008; two were class 1 evidence, nine class 2, 26 class 3, and 52 class 4. Citations ranged from 90 to 321 (mean=131); average time-adjusted citation count was 10. The 50 most cited articles from 2002 to 2012 appeared in 31 journals; four were class 2 evidence, 15 class 3, and 21 class 4. Citations ranged from 68 to 245 (mean=103); average time-adjusted citation count was 13. Conclusion Overall, papers from non-pediatric neurosurgical journals had higher citation counts and improved level of evidence grades compared to articles from pediatric neurosurgical periodicals. An original paper related to clinical pediatric neurosurgery in a non-pediatric neurosurgical journal having a total citation count of 100–150 or more and an average citation count of 10–15 per year or more can be considered a high-impact publication. PMID:24113776

  13. Publication misrepresentation among neurosurgery residency applicants: an increasing problem.

    PubMed

    Kistka, Heather M; Nayeri, Arash; Wang, Li; Dow, Jamie; Chandrasekhar, Rameela; Chambless, Lola B

    2016-01-01

    OBJECT Misrepresentation of scholarly achievements is a recognized phenomenon, well documented in numerous fields, yet the accuracy of reporting remains dependent on the honor principle. Therefore, honest self-reporting is of paramount importance to maintain scientific integrity in neurosurgery. The authors had observed a trend toward increasing numbers of publications among applicants for neurosurgery residency at Vanderbilt University and undertook this study to determine whether this change was a result of increased academic productivity, inflated reporting, or both. They also aimed to identify application variables associated with inaccurate citations. METHODS The authors retrospectively reviewed the residency applications submitted to their neurosurgery department in 2006 (n = 148) and 2012 (n = 194). The applications from 2006 were made via SF Match and those from 2012 were made using the Electronic Residency Application Service. Publications reported as "accepted" or "in press" were verified via online search of Google Scholar, PubMed, journal websites, and direct journal contact. Works were considered misrepresented if they did not exist, incorrectly listed the applicant as first author, or were incorrectly listed as peer reviewed or published in a printed journal rather than an online only or non-peer-reviewed publication. Demographic data were collected, including applicant sex, medical school ranking and country, advanced degrees, Alpha Omega Alpha membership, and USMLE Step 1 score. Zero-inflated negative binomial regression was used to identify predictors of misrepresentation. RESULTS Using univariate analysis, between 2006 and 2012 the percentage of applicants reporting published works increased significantly (47% vs 97%, p < 0.001). However, the percentage of applicants with misrepresentations (33% vs 45%) also increased. In 2012, applicants with a greater total of reported works (p < 0.001) and applicants from unranked US medical schools (those not

  14. 3D localization of ferromagnetic probes for small animal neurosurgery.

    PubMed

    Heinig, Maximilian; Schlaefer, Alexander; Schweikard, Achim

    2010-01-01

    We present the design, setup and results for a magnetic navigation system for small animal stereotactic neurosurgery. Our system tracks the position of thin (diameter 0.5 mm), magnetized ferromagnetic probes inserted into brains of small animals, e.g. rats, for electrophysiological recordings. It is used in combination with the spherical assistant for stereotactic surgery (SASSU) robot to obtain online feedback of the probe's position. Navigation is based only on the static magnetic field generated by the probes thus no external excitation or wires are needed.

  15. [From stone trephine to robots, 5000 years of neurosurgery].

    PubMed

    Reinhardt, H F

    1990-01-16

    Only a century has elapsed since the first serious surgical interventions on the human brain were undertaken; man has however sought to understand its structure and function for several thousand years in order to reach therapeutic consequences. A few highlights of brain research and neurosurgery from the neolithic to current times are described along with the prevailing views and technologies. Parallels are drawn with examples from clock making. An outlook to computer aided surgery (CAS) combining modern imaging techniques with data processing and technical operative innovation is given.

  16. Dr. Lenke Horvath (1917-1991): Creator of Pediatric Neurosurgery in Romania.

    PubMed

    Mohan, Dumitru; Moisa, Horatiu Alexandru; Nica, Dan Aurel; Ciurea, Alexandru Vlad

    2016-04-01

    The development of neurosurgery as an independent specialty took place with great difficulty in Romania. In this respect, the most revered personalities are those of Professor Alexandru Moruzzi (1900-1957) (in Iasi) and Professor Dimitrie Bagdasar (1893-1946) (in Bucharest), who are the fathers of modern neurosurgery in Romania. Professor Bagdasar was schooled in Professor Harvey Cushing's clinic in Boston and is credited with creating the first completely independent neurosurgical unit in Romania. His legacy was carried on with honor by Professor Constantin Arseni (1912-1994), who, in 1975, tasked Dr. Lenke Horvath (1917-1991) with creating the first autonomous pediatric neurosurgery unit in Bucharest. This article is a small tribute to the founder of pediatric neurosurgery in Romania and one of the female pioneer neurosurgeons, who, by personal example of dedication and hard work, radically changed medical thinking and neurosurgery in Romania.

  17. Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training.

    PubMed

    Piquer, José; Qureshi, Mubashir Mahmood; Young, Paul H; Dempsey, Robert J

    2015-06-01

    OBJECT A shortage of neurosurgeons and a lack of knowledge of neuroendoscopic management of hydrocephalus limits modern care in sub-Saharan Africa. Hence, a mobile teaching project for endoscopic third ventriculostomy (ETV) procedures and a subsequent program to develop neurosurgery as a permanent specialty in Kenya and Zanzibar were created and sponsored by the Neurosurgery Education and Development (NED) Foundation and the Foundation for International Education in Neurological Surgery. The objective of this work was to evaluate the results of surgical training and medical care in both projects from 2006 to 2013. METHODS Two portable neuroendoscopy systems were purchased and a total of 38 ETV workshops were organized in 21 hospitals in 7 different countries. Additionally, 49 medical expeditions were dispatched to the Coast General Hospital in Mombasa, Kenya, and to the Mnazi Moja Hospital in Zanzibar. RESULTS From the first project, a total of 376 infants with hydrocephalus received surgery. Six-month follow-up was achieved in 22%. In those who received follow-up, ETV efficacy was 51%. The best success rates were achieved with patients 1 year of age or older with aqueductal stenosis (73%). The main causes of hydrocephalus were infection (56%) and spina bifida (23%). The mobile education program interacted with 72 local surgeons and 122 nurses who were trained in ETV procedures. The second project involved 49 volunteer neurosurgeons who performed a total of 360 nonhydrocephalus neurosurgical operations since 2009. Furthermore, an agreement with the local government was signed to create the Mnazi Mmoja NED Institute in Zanzibar. CONCLUSIONS Mobile endoscopic treatment of hydrocephalus in East Africa results in reasonable success rates and has also led to major developments in medicine, particularly in the development of neurosurgery specialty care sites.

  18. Position statement from the Italian Society of Neurosurgery on the ARUBA Study.

    PubMed

    Cenzato, Marco; Delitala, Alberto; Delfini, Roberto; Pasqualin, Alberto; Maira, Giulio; Esposito, Vincenzo; Tomasello, Francesco; Boccardi, Edoardo

    2016-03-01

    As the conclusions of the ARUBA Study are strongly oriented towards therapeutic abstention, we think it is appropriate to express the concern of the Italian Society of Neurosurgery for the impact that this study might have on the health of patients, if not properly evaluated. The vast majority of patients (76-81%) included in the study was treated with endovascular or radiotherapy treatments, alone or in combination. Only 18 patients (19%) had surgery. It is well known that a partial treatment of arteriovenous malformations (AVMs), as is often the case with endovascular therapy, may increase the risk of bleeding. The primary endpoint (death or symptomatic stroke) in the treated group was reached in 30.7%, i.e. almost one-third of the subjects. This has no comparison in the current surgical literature. Considering permanent and transient neurological deficits along with headaches and seizures all together in the same outcome evaluation parameter may be inappropriate and misleading. The graph with all results from the ARUBA Study, which claims to be the demonstration that natural history is better that treatment, clearly shows that what is assumed to be treated has not actually been treated. If death or stroke occur a few years from treatment, it only means that the disease was not cured and patients received a partial - therefore ineffective, if not dangerous - treatment. An effective treatment, as surgery is, must have a flat follow-up curve. The ARUBA Study shows that incomplete treatment leads to negative outcome, confirming that an integrated multidisciplinary strategy has to be plotted out before starting any treatment and that a complete exclusion of the AVM must be achieved.

  19. [Robotics in neurosurgery: current status and future prospects].

    PubMed

    Benabid, A L; Hoffmann, D; Ashraf, A; Koudsie, A; Esteve, F; Le Bas, J F

    1998-02-01

    Neurosurgery is in essence a field of application development for robots, based on multimodal image guidance. Specific motorized tools have already been developed and routinely applied in stereotaxy to position a probe holder or in conventional neurosurgery to hold a microscope oriented towards a given target. The potentialities of these approaches have triggered industrial developments which are now commercially available. These systems use databases, primarily coming from multimodal numerical images from X-ray radiology to magnetic resonance imaging. These spatially encoded data are transferred through digital networks to workstations where images can be processed and surgical procedures are pre-planned, then transferred to the robotic systems to which they are connected. We have been using a stereotaxic robot since 1989 and a microscope robot since 1995 in various surgical routine procedures. The future of these applications rely mainly on the technical progress in informatics, about image recognition to adapt the pre-planning to the actual surgical situation, to correct brain shifts (for instance), about image fusion, integrated knowledge such as brain atlases, as well as virtual reality. The future developments, covering surgical procedure, research and teaching, are sure to be far beyond our wildest expectations.

  20. Virtual reality simulation in neurosurgery: technologies and evolution.

    PubMed

    Chan, Sonny; Conti, François; Salisbury, Kenneth; Blevins, Nikolas H

    2013-01-01

    Neurosurgeons are faced with the challenge of learning, planning, and performing increasingly complex surgical procedures in which there is little room for error. With improvements in computational power and advances in visual and haptic display technologies, virtual surgical environments can now offer potential benefits for surgical training, planning, and rehearsal in a safe, simulated setting. This article introduces the various classes of surgical simulators and their respective purposes through a brief survey of representative simulation systems in the context of neurosurgery. Many technical challenges currently limit the application of virtual surgical environments. Although we cannot yet expect a digital patient to be indistinguishable from reality, new developments in computational methods and related technology bring us closer every day. We recognize that the design and implementation of an immersive virtual reality surgical simulator require expert knowledge from many disciplines. This article highlights a selection of recent developments in research areas related to virtual reality simulation, including anatomic modeling, computer graphics and visualization, haptics, and physics simulation, and discusses their implication for the simulation of neurosurgery.

  1. Interrupted time-series analysis: studying trends in neurosurgery.

    PubMed

    Wong, Ricky H; Smieliauskas, Fabrice; Pan, I-Wen; Lam, Sandi K

    2015-12-01

    OBJECT Neurosurgery studies traditionally have evaluated the effects of interventions on health care outcomes by studying overall changes in measured outcomes over time. Yet, this type of linear analysis is limited due to lack of consideration of the trend's effects both pre- and postintervention and the potential for confounding influences. The aim of this study was to illustrate interrupted time-series analysis (ITSA) as applied to an example in the neurosurgical literature and highlight ITSA's potential for future applications. METHODS The methods used in previous neurosurgical studies were analyzed and then compared with the methodology of ITSA. RESULTS The ITSA method was identified in the neurosurgical literature as an important technique for isolating the effect of an intervention (such as a policy change or a quality and safety initiative) on a health outcome independent of other factors driving trends in the outcome. The authors determined that ITSA allows for analysis of the intervention's immediate impact on outcome level and on subsequent trends and enables a more careful measure of the causal effects of interventions on health care outcomes. CONCLUSIONS ITSA represents a significant improvement over traditional observational study designs in quantifying the impact of an intervention. ITSA is a useful statistical procedure to understand, consider, and implement as the field of neurosurgery evolves in sophistication in big-data analytics, economics, and health services research.

  2. [Endocrine function following cranial radiotherapy of neoplasms in children].

    PubMed

    Couselo Sánchez, J M; Fernández Bujía, M L; Pombo Arias, M; Devesa Múgiga, J; Tojo Sierra, R; Peña Guitán, J

    1984-01-01

    The effect of radiotherapy upon the diencephalo-hypophyseal axis was studied in 14 children that had received cranial radio-therapy (2,400 to 6,000 R) to treat different intracranial tumors. Several hormones were evaluated between 2 months and 3 years after radiotherapy was performed. 35.7 per 100 of the patients were deficient in growth hormone, 37.5 per 100 showed an alteration of prolactin secretion, and 28 per 100 an abnormal response to thyroid-stimulating hormone.

  3. Radiation transport in a radiotherapy room

    SciTech Connect

    Agosteo, S.; Para, A.F.; Maggioni, B.

    1995-01-01

    The photoneutron dose equivalent in a linac radio-therapy room and its entrance maze was investigated by means of Monte Carlo simulations under different conditions. Particularly, the effect of neutron absorbers and moderator layers placed on the maze walls was considered. The contribution of prompt gamma rays emitted in absorption reactions of thermal neutrons was also taken into account. The simulation results are compared with some experimental measurements in the therapy room and in the maze. 13 refs., 5 figs., 5 tabs.

  4. Experimental and clinical standards, and evolution of lasers in neurosurgery.

    PubMed

    Devaux, B C; Roux, F X

    1996-01-01

    From initial experiments of ruby, argon and CO2 lasers on the nervous system so far, dramatic progress was made in delivery systems technology as well as in knowledge of laser-tissue interaction effects and hazards through various animal experiments and clinical experience. Most surgical effects of laser light on neural tissue and the central nervous system (CNS) are thermal lesions. Haemostasis, cutting and vaporization depend on laser emission parameters--wavelength, fluence and mode--and on the exposed tissues optical and thermal properties--water and haemoglobin content, thermal conductivity and specific heat. CO2 and Nd-YAG lasers have today a large place in the neurosurgical armamentarium, while new laser sources such as high power diode lasers will have one in the near future. Current applications of these lasers derive from their respective characteristics, and include CNS tumour and vascular malformation surgery, and stereotactic neurosurgery. Intracranial, spinal cord and intra-orbital meningiomas are the best lesions for laser use for haemostasis, dissection and tissue vaporization. Resection of acoustic neuromas, pituitary tumours, spinal cord neuromas, intracerebral gliomas and metastases may also benefit from lasers as accurate, haemostatic, non-contact instruments which reduce surgical trauma to the brain and eloquent structures such as brain stem and cranial nerves. Coagulative lasers (1.06 microns and 1.32 microns Nd-YAG, argon, or diode laser) will find an application for arteriovenous malformations and cavernomas. Any fiberoptic-guided laser will find a use during stereotactic neurosurgical procedures, including image-guided resection of tumours and vascular malformations and endoscopic tumour resection and cysts or entry into a ventricle. Besides these routine applications of lasers, laser interstitial thermotherapy (LITT) and photodynamic therapy (PDT) of brain tumours are still in the experimental stage. The choice of a laser in a

  5. [Radiotherapy of bone metastases].

    PubMed

    Thureau, S; Vieillard, M-H; Supiot, S; Lagrange, J-L

    2016-09-01

    Radiotherapy plays a major role in palliative treatment of bone metastases. Recent developments of stereotactic radiotherapy and intensity modulated radiation therapy give the possibility to treat oligometastatic diseases. The objective of this paper is to report indications and treatment modalities of radiotherapy in these situations.

  6. Inauguration of pediatric neurosurgery by Harvey W. Cushing: his contributions to the surgery of posterior fossa tumors in children. Historical vignette.

    PubMed

    Cohen-Gadol, Aaron A; Spencer, Dennis D

    2004-02-01

    Development of posterior fossa surgery remains Harvey Cushing's hallmark contribution to pediatric neurosurgery. During the era before Cushing, posterior fossa lesions were considered inoperable, and only osseous decompressive surgery was offered. The evolution of Cushing's surgical expertise from subtemporal decompressions to total extirpation of vascular fourth ventricular tumors, combined with a dramatic decrease in his operative mortality rate, reflects the maturation of modern neurosurgical techniques. A comprehensive review of the medical records of Cushing's pediatric patients treated between 1912 and 1932 revealed that procedures such as lateral ventricular puncture (to decrease cerebellar herniation), transvermian approach to midline tumors, and electrocoagulation were the key factors punctuating the path to his pioneering achievements in posterior fossa surgery. The outcome of such operations was improved by his recognition of the importance of tumor mural nodule in cyst recurrence, as well as elucidation of the histogenesis of pediatric posterior fossa tumors to tailor treatment including radiotherapy.

  7. The development of neurosurgery at the University of Utah, 1955-2009.

    PubMed

    House, Paul A; Heilbrun, M Peter; Apfelbaum, Ronald I; Kraus, Kristin L; Couldwell, William T

    2010-09-01

    Located in the geographic Intermountain West, the Department of Neurosurgery at the University of Utah has undergone remarkable growth and transformation since the appointment of the first full-time clinical faculty member in 1955. The Department has provided broad neurosurgical services to an expanding community while fulfilling its academic mission of pushing the frontiers within neurosurgical subspecialties. The history of neurosurgery in the Salt Lake Valley and the achievements of the Department of Neurosurgery, including the seminal development of early cranial stereotactic devices, are reviewed in this article.

  8. Neurosurgery in Würzburg until World War II.

    PubMed

    Arnold, H; Collmann, H

    2012-01-01

    The institution of German neurosurgery as an autonomous surgical specialty, starting in Würzburg in 1934, is closely linked to the names of Fritz König and Wilhelm Tönnis. They were acting at a time when the global economic crisis and a consolidating Nazi dictatorship caused a cascade of alarming changes in political and social life. On the one hand it is fascinating to see how the restless work and energy of Tönnis managed to build up the first independent neurosurgical unit in Germany and to tighten efficient international connections all over the world within a few years. On the other hand-from a present-day perspective-it is difficult to understand how his strive towards a specialist's success, in contrast to that of Otfrid Foerster, was barely affected by the threatening political development, until the Second World War stopped his plans and ideas for many years.

  9. [Intraoperative monitoring of oxygen tissue pressure: Applications in vascular neurosurgery].

    PubMed

    Arikan, Fuat; Vilalta, Jordi; Torne, Ramon; Chocron, Ivette; Rodriguez-Tesouro, Ana; Sahuquillo, Juan

    2014-01-01

    Ischemic lesions related to surgical procedures are a major cause of postoperative morbidity in patients with cerebral vascular disease. There are different systems of neuromonitoring to detect intraoperative ischemic events, including intraoperative monitoring of oxygen tissue pressure (PtiO2). The aim of this article was to describe, through the discussion of 4 cases, the usefulness of intraoperative PtiO2 monitoring during vascular neurosurgery. In presenting these cases, we demonstrate that monitoring PtiO2 is a reliable way to detect early ischemic events during surgical procedures. Continuous monitoring of PtiO2 in an area at risk allows the surgeon to resolve the cause of the ischemic event before it evolves to an established cerebral infarction.

  10. The incidentaloma of the pituitary gland: Is neurosurgery required

    SciTech Connect

    Reincke, M.; Allolio, B.; Saeger, W.; Menzel, J.; Winkelmann, W. )

    1990-05-23

    The authors describe a series of 18 patients with an intrasellar mass incidentally discovered by computed tomography or magnetic resonance imaging. The average size of the mass was 13 mm, with a range from 5 to 25 mm. Initial ophthalmologic examination revealed bitemporal hemianopia in 2 patients. Results of routine endocrine testing showed partial hypopituitarism in 5 patients and growth hormone hypersecretion without signs and symptoms of acromegaly in 1 patient. Four patients underwent neurosurgery. Histologically, one chondroid chordoma and three pituitary adenomas were found. In the remaining 14 patients treated conservatively, repeated computed tomography and magnetic resonance imaging revealed no significant change in tumor size at the time of follow-up. The results suggest that the incidentaloma of the pituitary gland is a benign condition that does not necessarily require neurosurgical intervention.

  11. Simulation and augmented reality in endovascular neurosurgery: lessons from aviation.

    PubMed

    Mitha, Alim P; Almekhlafi, Mohammed A; Janjua, Major Jameel J; Albuquerque, Felipe C; McDougall, Cameron G

    2013-01-01

    Endovascular neurosurgery is a discipline strongly dependent on imaging. Therefore, technology that improves how much useful information we can garner from a single image has the potential to dramatically assist decision making during endovascular procedures. Furthermore, education in an image-enhanced environment, especially with the incorporation of simulation, can improve the safety of the procedures and give interventionalists and trainees the opportunity to study or perform simulated procedures before the intervention, much like what is practiced in the field of aviation. Here, we examine the use of simulators in the training of fighter pilots and discuss how similar benefits can compensate for current deficiencies in endovascular training. We describe the types of simulation used for endovascular procedures, including virtual reality, and discuss the relevant data on its utility in training. Finally, the benefit of augmented reality during endovascular procedures is discussed, along with future computerized image enhancement techniques.

  12. Balloons in endovascular neurosurgery: history and current applications.

    PubMed

    Alaraj, Ali; Wallace, Adam; Dashti, Reza; Patel, Prasad; Aletich, Victor

    2014-02-01

    The use of balloons in the field of neurosurgery is currently an essential part of our clinical practice. The field has evolved over the last 40 years since Serbinenko used balloons to test the feasibility of occluding cervical vessels for intracranial pathologies. Since that time, indications have expanded to include sacrificing cervical and intracranial vessels with detachable balloons, supporting the coil mass in wide-necked aneurysms (balloon remodeling technique), and performing intracranial and cervical angioplasty for atherosclerotic disease, as well as an adjunct to treat arteriovenous malformations. With the rapid expansion of endovascular technologies, it appears that the indications and uses for balloons will continue to expand. In this article, we review the history of balloons, the initial applications, the types of balloons available, and the current applications available for endovascular neurosurgeons.

  13. Numerical simulations of clinical focused ultrasound functional neurosurgery

    PubMed Central

    Pulkkinen, Aki; Werner, Beat; Martin, Ernst; Hynynen, Kullervo

    2014-01-01

    A computational model utilizing grid and finite difference methods was developed to simulate focused ultrasound functional neurosurgery interventions. The model couples the propagation of ultrasound in fluids (soft tissues) and solids (skull) with acoustic and visco-elastic wave equations. The computational model was applied to simulate clinical focused ultrasound functional neurosurgery treatments performed in patients suffering from therapy resistant chronic neuropathic pain. Datasets of five patients were used to derive the treatment geometry. Eight sonications performed in the treatments were then simulated with the developed model. Computations were performed by driving the simulated phased array ultrasound transducer with the acoustic parameters used in the treatments. Resulting focal temperatures and size of the thermal foci were compared quantitatively, in addition to qualitative inspection of the simulated pressure and temperature fields. This study found that the computational model and the simulation parameters predicted an average of 24 ± 13 % lower focal temperature elevations than observed in the treatments. The size of the simulated thermal focus was found to be 40 ± 13 % smaller in the anterior–posterior direction and 22 ± 14% smaller in the inferior–superior direction than in the treatments. The location of the simulated thermal focus was off from the prescribed target by 0.3 ± 0.1 mm, while the peak focal temperature elevation observed in the measurements was off by 1.6 ± 0.6 mm. Although the results of the simulations suggest that there could be some inaccuracies in either the tissue parameters used, or in the simulation methods, the simulations were able to predict the focal spot locations and temperature elevations adequately for initial treatment planning performed to assess, for example, the feasibility of sonication. The accuracy of the simulations could be improved if more precise ultrasound tissue properties (especially of the

  14. In vivo porcine training model for cranial neurosurgery.

    PubMed

    Regelsberger, Jan; Eicker, Sven; Siasios, Ioannis; Hänggi, Daniel; Kirsch, Matthias; Horn, Peter; Winkler, Peter; Signoretti, Stefano; Fountas, Kostas; Dufour, Henry; Barcia, Juan A; Sakowitz, Oliver; Westermaier, Thomas; Sabel, Michael; Heese, Oliver

    2015-01-01

    Supplemental education is desirable for neurosurgical training, and the use of human cadaver specimen and virtual reality models is routine. An in vivo porcine training model for cranial neurosurgery was introduced in 2005, and our recent experience with this unique model is outlined here. For the first time, porcine anatomy is illustrated with particular respect to neurosurgical procedures. The pros and cons of this model are described. The aim of the course was to set up a laboratory scenery imitating an almost realistic operating room in which anatomy of the brain and neurosurgical techniques in a mentored environment free from time constraints could be trained. Learning objectives of the course were to learn about the microsurgical techniques in cranial neurosurgery and the management of complications. Participants were asked to evaluate the quality and utility of the programme via standardized questionnaires by a grading scale from A (best) to E (worst). In total, 154 residents have been trained on the porcine model to date. None of the participants regarded his own residency programme as structured. The bleeding and complication management (97%), the realistic laboratory set-up (89%) and the working environment (94%) were favoured by the vast majority of trainees and confirmed our previous findings. After finishing the course, the participants graded that their skills in bone drilling, dissecting the brain and preserving cerebral vessels under microscopic magnification had improved to level A and B. In vivo hands-on courses, fully equipped with microsurgical instruments, offer an outstanding training opportunity in which bleeding management on a pulsating, vital brain represents a unique training approach. Our results have shown that education programmes still lack practical training facilities in which in vivo models may act as a complementary approach in surgical training.

  15. Numerical simulations of clinical focused ultrasound functional neurosurgery

    NASA Astrophysics Data System (ADS)

    Pulkkinen, Aki; Werner, Beat; Martin, Ernst; Hynynen, Kullervo

    2014-04-01

    A computational model utilizing grid and finite difference methods were developed to simulate focused ultrasound functional neurosurgery interventions. The model couples the propagation of ultrasound in fluids (soft tissues) and solids (skull) with acoustic and visco-elastic wave equations. The computational model was applied to simulate clinical focused ultrasound functional neurosurgery treatments performed in patients suffering from therapy resistant chronic neuropathic pain. Datasets of five patients were used to derive the treatment geometry. Eight sonications performed in the treatments were then simulated with the developed model. Computations were performed by driving the simulated phased array ultrasound transducer with the acoustic parameters used in the treatments. Resulting focal temperatures and size of the thermal foci were compared quantitatively, in addition to qualitative inspection of the simulated pressure and temperature fields. This study found that the computational model and the simulation parameters predicted an average of 24 ± 13% lower focal temperature elevations than observed in the treatments. The size of the simulated thermal focus was found to be 40 ± 13% smaller in the anterior-posterior direction and 22 ± 14% smaller in the inferior-superior direction than in the treatments. The location of the simulated thermal focus was off from the prescribed target by 0.3 ± 0.1 mm, while the peak focal temperature elevation observed in the measurements was off by 1.6 ± 0.6 mm. Although the results of the simulations suggest that there could be some inaccuracies in either the tissue parameters used, or in the simulation methods, the simulations were able to predict the focal spot locations and temperature elevations adequately for initial treatment planning performed to assess, for example, the feasibility of sonication. The accuracy of the simulations could be improved if more precise ultrasound tissue properties (especially of the

  16. Radio Days.

    ERIC Educational Resources Information Center

    Sanderson, Neil

    1998-01-01

    Thousands of today's high school students run FM radio stations at school, carrying on a tradition that began 50 years ago. Radio helps students learn to work with others and develop a strong sense of responsibility. A sidebar gives advice on starting a high school radio station. (MLF)

  17. Utilizing virtual and augmented reality for educational and clinical enhancements in neurosurgery.

    PubMed

    Pelargos, Panayiotis E; Nagasawa, Daniel T; Lagman, Carlito; Tenn, Stephen; Demos, Joanna V; Lee, Seung J; Bui, Timothy T; Barnette, Natalie E; Bhatt, Nikhilesh S; Ung, Nolan; Bari, Ausaf; Martin, Neil A; Yang, Isaac

    2017-01-01

    Neurosurgery has undergone a technological revolution over the past several decades, from trephination to image-guided navigation. Advancements in virtual reality (VR) and augmented reality (AR) represent some of the newest modalities being integrated into neurosurgical practice and resident education. In this review, we present a historical perspective of the development of VR and AR technologies, analyze its current uses, and discuss its emerging applications in the field of neurosurgery.

  18. Firefighters' Radios

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Public Technology Inc. asked for NASA assistance to devise the original firefighter's radio. Good short-range radio communications are essential during a fire to coordinate hose lines, rescue victims, and otherwise increase efficiency. Useful firefighting tool is lower cost, more rugged short range two-way radio. Inductorless electronic circuit replaced inductances and coils in radio circuits with combination of transistors and other low-cost components. Substitution promises reduced circuit size and cost. Enhanced electrical performance made radio more durable and improved maintainability by incorporating modular construction.

  19. The history of neurosurgery in Anatolia and Turkey: the Turkish Neurosurgical Society.

    PubMed

    Solaroglu, Ihsan; Acar, Feridun; Bavbek, Murad; Ture, Ugur; Beskonakli, Ethem

    2013-01-01

    Although the history of neurosurgery in Anatolia goes back ten thousand years, modern surgery began in Turkey in 1890. Neurosurgery in Turkey began in the first half of the 20th century. However, general surgeons began applying neurosurgical techniques back in the late 19th century. Most of these applications included procedures for craniocerebral traumas and infections. Dr. Cemil Topuzlu (1868-1958) is the founder of modern surgery in Turkey. Dr. Abdulkadir Cahit Tuner became the first neurosurgeon with a degree in Turkey in 1923. The first neurosurgery department was established in Istanbul in 1923, and the first training program began in the late 1940s. Currently there are almost 1200 neurosurgeons in Turkey and 75 training clinics at university hospitals and Training and Research Hospitals of the Ministry of Health provide neurosurgery training. The current state of neurosurgery in Turkey is parallel to that of the advanced Western countries. Apart from the application of neurosurgical procedures, there have been many scientific studies from Turkish neurosurgeons contributing to the total body of literature in neurosurgery.

  20. [Radiotherapy of hypopharynx cancers].

    PubMed

    Pointreau, Y; Lafond, C; Trémolières, P; Legouté, F; Servagi-Vernat, S; Giraud, P; Maingon, P; Calais, G; Lapeyre, M

    2016-09-01

    The intensity-modulated radiotherapy is the gold standard in the treatment of hypopharynx cancers. Early T1 and T2 tumours could be treated by exclusive radiotherapy or surgery. For tumours requiring total pharyngolaryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy are possible. For T4 tumours, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, curative dose is 70Gy and prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used for locally advanced cancers with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation is based on guidelines.

  1. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

    PubMed Central

    Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.

    2014-01-01

    Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P < 0.001) and an increased 30-day morbidity rate of 25.9% versus 14.14% in non-anemic patients (P < 0.001). The 30-day morbidity rates for all patients undergoing cranial procedures were stratified by diagnosis: 26.5% aneurysm, 24.7% sellar tumor, 19.7% extra-axial tumor, 14.8% intra-axial tumor, 14.4% arteriovenous malformation, and 5.6% pain. Following multivariable regression, the 30-day mortality in anemic patients was threefold higher than in non-anemic patients (4.1% vs 1.3%; OR = 2.77; 95% CI: 1.65-4.66). The odds of postoperative morbidity in anemic patients were significantly higher than in non-anemic patients (OR = 1.29; 95% CI: 1.03-1.61). There was a significant difference in postoperative morbidity event odds with a hematocrit level above (OR = 1.07; 95% CI: 0.78-1.48) and below (OR = 2.30; 95% CI: 1.55-3.42) 33% [hemoglobin (Hgb) 11 g/dl]. Conclusions: Preoperative anemia in elective cranial neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID

  2. Heavy-ion radiotherapy

    NASA Astrophysics Data System (ADS)

    Kanai, Tatsuaki

    2000-11-01

    Heavy-ion radiotherapy using high-energy carbon beams has been performed at the National Institute of Radiological Sciences, Japan. The physical frame works for heavy-ion radiotherapy are established using physical understandings of radiation physics. In order to increase the accuracy of heavy-ion radiotherapy, many physical problems should be solved. Unsolved problems, such as the depth dose distributions, range of heavy-ion in patients and heavy-ion dosimetry in the radiation therapy, are discussed. .

  3. [Radiotherapy of oropharynx carcinoma].

    PubMed

    Servagi Vernat, S; Tochet, F; Vieillevigne, L; Pointreau, Y; Maingon, P; Giraud, P

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  4. Shining light on neurosurgery diagnostics using Raman spectroscopy.

    PubMed

    Broadbent, Brandy; Tseng, James; Kast, Rachel; Noh, Thomas; Brusatori, Michelle; Kalkanis, Steven N; Auner, Gregory W

    2016-10-01

    Surgical excision of brain tumors provides a means of cytoreduction and diagnosis while minimizing neurologic deficit and improving overall survival. Despite advances in functional and three-dimensional stereotactic navigation and intraoperative magnetic resonance imaging, delineating tissue in real time with physiological confirmation is challenging. Raman spectroscopy is a promising investigative and diagnostic tool for neurosurgery, which provides rapid, non-destructive molecular characterization in vivo or in vitro for biopsy, margin assessment, or laboratory uses. The Raman Effect occurs when light temporarily changes a bond's polarizability, causing change in the vibrational frequency, with a corresponding change in energy/wavelength of the scattered photon. The recorded inelastic scattering results in a "fingerprint" or Raman spectrum of the constituent under investigation. The amount, location, and intensity of peaks in the fingerprint vary based on the amount of vibrational bonds in a molecule and their ensemble interactions with each other. Distinct differences between various pathologic conditions are shown as different intensities of the same peak, or shifting of a peak based on the binding conformation. Raman spectroscopy has potential for integration into clinical practice, particularly in distinguishing normal and diseased tissue as an adjunct to standard pathologic diagnosis. Further, development of fiber-optic Raman probes that fit through the instrument port of a standard endoscope now allows researchers and clinicians to utilize spectroscopic information for evaluation of in vivo tissue. This review highlights the need for such an instrument, summarizes neurosurgical Raman work performed to date, and discusses the future applications of neurosurgical Raman spectroscopy.

  5. Dynamic hub load predicts cognitive decline after resective neurosurgery

    PubMed Central

    Carbo, Ellen W. S.; Hillebrand, Arjan; van Dellen, Edwin; Tewarie, Prejaas; de Witt Hamer, Philip C.; Baayen, Johannes C.; Klein, Martin; Geurts, Jeroen J. G.; Reijneveld, Jaap C.; Stam, Cornelis J.; Douw, Linda

    2017-01-01

    Resective neurosurgery carries the risk of postoperative cognitive deterioration. The concept of ‘hub (over)load’, caused by (over)use of the most important brain regions, has been theoretically postulated in relation to symptomatology and neurological disease course, but lacks experimental confirmation. We investigated functional hub load and postsurgical cognitive deterioration in patients undergoing lesion resection. Patients (n = 28) underwent resting-state magnetoencephalography and neuropsychological assessments preoperatively and 1-year after lesion resection. We calculated stationary hub load score (SHub) indicating to what extent brain regions linked different subsystems; high SHub indicates larger processing pressure on hub regions. Dynamic hub load score (DHub) assessed its variability over time; low values, particularly in combination with high SHub values, indicate increased load, because of consistently high usage of hub regions. Hypothetically, increased SHub and decreased DHub relate to hub overload and thus poorer/deteriorating cognition. Between time points, deteriorating verbal memory performance correlated with decreasing upper alpha DHub. Moreover, preoperatively low DHub values accurately predicted declining verbal memory performance. In summary, dynamic hub load relates to cognitive functioning in patients undergoing lesion resection: postoperative cognitive decline can be tracked and even predicted using dynamic hub load, suggesting it may be used as a prognostic marker for tailored treatment planning. PMID:28169349

  6. Using Electronic Noses to Detect Tumors During Neurosurgery

    NASA Technical Reports Server (NTRS)

    Homer, Margie L.; Ryan, Margaret A.; Lara, Liana M.; Kateb, Babak; Chen, Mike

    2008-01-01

    It has been proposed to develop special-purpose electronic noses and algorithms for processing the digitized outputs of the electronic noses for determining whether tissue exposed during neurosurgery is cancerous. At present, visual inspection by a surgeon is the only available intraoperative technique for detecting cancerous tissue. Implementation of the proposal would help to satisfy a desire, expressed by some neurosurgeons, for an intraoperative technique for determining whether all of a brain tumor has been removed. The electronic-nose technique could complement multimodal imaging techniques, which have also been proposed as means of detecting cancerous tissue. There are also other potential applications of the electronic-nose technique in general diagnosis of abnormal tissue. In preliminary experiments performed to assess the viability of the proposal, the problem of distinguishing between different types of cultured cells was substituted for the problem of distinguishing between normal and abnormal specimens of the same type of tissue. The figure presents data from one experiment, illustrating differences between patterns that could be used to distinguish between two types of cultured cancer cells. Further development can be expected to include studies directed toward answering questions concerning not only the possibility of distinguishing among various types of normal and abnormal tissue but also distinguishing between tissues of interest and other odorous substances that may be present in medical settings.

  7. Neurosurgery of the future: Deep brain stimulations and manipulations.

    PubMed

    Nicolaidis, Stylianos

    2017-04-01

    Important advances are afoot in the field of neurosurgery-particularly in the realms of deep brain stimulation (DBS), deep brain manipulation (DBM), and the newly introduced refinement "closed-loop" deep brain stimulation (CLDBS). Use of closed-loop technology will make both DBS and DBM more precise as procedures and will broaden their indications. CLDBS utilizes as feedback a variety of sources of electrophysiological and neurochemical afferent information about the function of the brain structures to be treated or studied. The efferent actions will be either electric, i.e. the classic excitatory or inhibitory ones, or micro-injection of such things as neural proteins and transmitters, neural grafts, implants of pluripotent stem cells or mesenchymal stem cells, and some variants of gene therapy. The pathologies to be treated, beside Parkinson's disease and movement disorders, include repair of neural tissues, neurodegenerative pathologies, psychiatric and behavioral dysfunctions, i.e. schizophrenia in its various guises, bipolar disorders, obesity, anorexia, drug addiction, and alcoholism. The possibility of using these new modalities to treat a number of cognitive dysfunctions is also under consideration. Because the DBS-CLDBS technology brings about a cross-fertilization between scientific investigation and surgical practice, it will also contribute to an enhanced understanding of brain function.

  8. Dynamic hub load predicts cognitive decline after resective neurosurgery.

    PubMed

    Carbo, Ellen W S; Hillebrand, Arjan; van Dellen, Edwin; Tewarie, Prejaas; de Witt Hamer, Philip C; Baayen, Johannes C; Klein, Martin; Geurts, Jeroen J G; Reijneveld, Jaap C; Stam, Cornelis J; Douw, Linda

    2017-02-07

    Resective neurosurgery carries the risk of postoperative cognitive deterioration. The concept of 'hub (over)load', caused by (over)use of the most important brain regions, has been theoretically postulated in relation to symptomatology and neurological disease course, but lacks experimental confirmation. We investigated functional hub load and postsurgical cognitive deterioration in patients undergoing lesion resection. Patients (n = 28) underwent resting-state magnetoencephalography and neuropsychological assessments preoperatively and 1-year after lesion resection. We calculated stationary hub load score (SHub) indicating to what extent brain regions linked different subsystems; high SHub indicates larger processing pressure on hub regions. Dynamic hub load score (DHub) assessed its variability over time; low values, particularly in combination with high SHub values, indicate increased load, because of consistently high usage of hub regions. Hypothetically, increased SHub and decreased DHub relate to hub overload and thus poorer/deteriorating cognition. Between time points, deteriorating verbal memory performance correlated with decreasing upper alpha DHub. Moreover, preoperatively low DHub values accurately predicted declining verbal memory performance. In summary, dynamic hub load relates to cognitive functioning in patients undergoing lesion resection: postoperative cognitive decline can be tracked and even predicted using dynamic hub load, suggesting it may be used as a prognostic marker for tailored treatment planning.

  9. Clinical Characteristics of Patients with Trigeminal Neuralgia Referred to Neurosurgery

    PubMed Central

    Siqueira, Silvia RDT; Teixeira, Manoel J; Siqueira, José TT

    2009-01-01

    Objectives To investigate the clinical characteristics of patients with trigeminal neuralgia referred to surgery in a center of reference. Methods We evaluated the general characteristics of 395 patients with trigeminal neuralgia referred to neurosurgery as treatment. They corresponded to 2 samples of 1984 and 2004. The EDOF-HC protocol (Orofacial Pain Questionnaire) and the medical profile were used. Results In the first study (1984), with 290 patients, the higher prevalence was: women (57.3%), white (95.5%), with mean age of 62.5. The most affected trigeminal branches were the maxillary and/or mandibular branches (65.5%), and the right side was the most affected (57.6%). From the second study (2004), with 105 patients, 57.1% were women, 75.2% white, with a mean age of 60.8. The maxillary and/or mandibular branches (79.0%) and the right side (69.5%) were the most affected. Both samples had neurological abnormalities and systemic diseases (mainly cardiovascular). Conclusions General characteristics of these patients were similar to other samples of trigeminal neuralgia. Neurological findings were also present in patients with no previous surgical treatment for TN. Hypertension and cardiac diseases were also frequent and make the monitoring of the patients during crises necessary. PMID:19756195

  10. Nonlinear optical imaging: toward chemical imaging during neurosurgery

    NASA Astrophysics Data System (ADS)

    Meyer, Tobias; Dietzek, Benjamin; Krafft, Christoph; Romeike, Bernd F. M.; Reichart, Rupert; Kalff, Rolf; Popp, Jürgen

    2011-03-01

    Tumor recognition and precise tumor margin detection presents a central challenge during neurosurgery. In this contribution we present our recent all-optical approach to tackle this problem. We introduce various nonlinear optical techniques, such as coherent anti-Stokes Raman scattering (CARS), second-harmonic generation (SHG) and two-photon fluorescence (TPEF), to study the morphology and chemical composition of (ex vivo) brain tissue. As the experimental techniques presented are contact-free all-optical techniques, which do not rely on the administration of external (fluorescence) labels, we anticipate that their implementation into surgical microscopes will provide significant advantages of intraoperative tumor diagnosis. In this contribution an introduction to the different optical spectroscopic methods will be presented and their implementation into a multimodal microscopic setup will be discussed. Furthermore, we will exemplify their application to brain tissue, i.e. both pig brain as a model for healthy brain tissue and human brain samples taken from surgical procedures. The data to be discussed show the capability of a joint CARS/SHG/TPEF multimodal imaging approach in highlighting various aspects of tissue morphochemistry. The consequences of this microspectroscopic potential, when combined with the existing technology of surgical microscopes, will be discussed.

  11. Nanotube Radio

    NASA Astrophysics Data System (ADS)

    Jensen, Kenneth; Weldon, Jeff; Garcia, Henry; Zettl, Alex

    2008-03-01

    We have constructed a fully functional, fully integrated radio receiver from a single carbon nanotube. The nanotube serves simultaneously as all essential components of a radio: antenna, tunable band-pass filter, amplifier, and demodulator. A direct current voltage source, as supplied by a battery, powers the radio. Using carrier waves in the commercially relevant 40-400 MHz range and both frequency and amplitude modulation techniques, we demonstrate successful music and voice reception.

  12. Radio Science

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Radio science experiments use electromagnetic waves to probe or study the solar system. Three major research areas were identified within this discipline: radio astronomy, radar astronomy, and celestial mechanics. Radio astronomy (or radiometry) is the detection and measurement of naturally produced radio frequency emissions. Sources include surfaces, atmospheres, rings, and plasmas. Radar astronomy is the observation of man-made signals after their interaction with a target. Both imaging and non-imaging results. Celestial mechanics includes all studies related to the motions of (and gravity fields of) bodies within the solar system. These should not be considered rigid separations, but aid in the discussion of the data sets.

  13. [Radiotherapy of skin cancers].

    PubMed

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules.

  14. College Radio.

    ERIC Educational Resources Information Center

    Sauls, Samuel J.

    As with commercial stations, the underlying premise of the college radio station is to serve the community, whether it be the campus community or the community at large, but in unique ways often geared to underserved niches of the population. Much of college radio's charm lies in its unpredictable nature and constant mutations. The stations give…

  15. Radio astronomy

    NASA Technical Reports Server (NTRS)

    Taylor, R. M.; Manchester, R. N.

    1980-01-01

    The activities of the Deep Space Network in support of radio and radar astronomy operations during July and August 1980 are reported. A brief update on the OSS-sponsored planetary radio astronomy experiment is provided. Also included are two updates, one each from Spain and Australia on current host country activities.

  16. Radio stars.

    PubMed

    Hjellming, R M; Wade, C M

    1971-09-17

    Up to the present time six classes of radio stars have been established. The signals are almost always very faint and drastically variable. Hence their discovery has owed as much to serendipity as to the highly sophisticated equipment and techniques that have been used. When the variations are regular, as with the pulsars, this characteristic can be exploited very successfully in the search for new objects as well as in the detailed study of those that are already known. The detection of the most erratically variable radio stars, the flare stars and the x-ray stars, is primarily a matter of luck and patience. In the case of the novas, one at least knows where and oughly when to look for radio emission. A very sensitive interferometer is clearly the best instrument to use in the initial detection of a radio star. The fact that weak background sources are frequently present makes it essential to prove that the position of a radio source agrees with that of a star to within a few arc seconds. The potential of radio astronomy for the study of radio stars will not be realized until more powerful instruments than those that are available today can be utilized. So far, we have been able to see only the most luminous of the radio stars.

  17. History of the Neurosurgery Department of Pontificia Universidad Catolica, Santiago, Chile.

    PubMed

    Sfeir, Felipe; Villanueva, Pablo; Tagle, Patricio

    2017-01-01

    Pontificia Universidad Católica de Chile's medical school was founded in 1929. An interest in neurosurgical development arose in the minds of the Dean, Dr. Cristobal Espíldora, and the Chief of Surgery, Dr. Rodolfo Rencoret, in 1946. They encouraged and supported Dr. J. Ricardo Olivares to specialize in Neurosurgery with Professor H. Olivecrona in Stockholm, Sweden. The first neurosurgical procedure in the Hospital Clínico de la Universidad Católica was performed in 1950. Since then, intensive efforts have been made to develop neurosurgery and its science. As a result, it is now a center capable of achieving high-quality standards in vascular, oncologic, and endoscopic neurosurgery; stereotactic and radiosurgery; complex spine surgery; pediatric neurosurgery; and epilepsy surgery. This article tells the story of a university hospital neurosurgery service in a country at the southern end of the world and how it became one of the most important neurosurgical centers in Chile and South America.

  18. Neurosurgery value and quality in the context of the Affordable Care Act: a policy perspective.

    PubMed

    Menger, Richard P; Guthikonda, Bharat; Storey, Christopher M; Nanda, Anil; McGirt, Matthew; Asher, Anthony

    2015-12-01

    Neurosurgeons provide direct individualized care to patients. However, the majority of regulations affecting the relative value of patient-related care are drafted by policy experts whose focus is typically system- and population-based. A central, prospectively gathered, national outcomes-related database serves as neurosurgery's best opportunity to bring patient-centered outcomes to the policy arena. In this study the authors analyze the impact of the Affordable Care Act (ACA) on the determination of quality and value in neurosurgery care through the scope, language, and terminology of policy experts. The methods by which the ACA came into law and the subsequent quality implications this legislation has for neurosurgery will be discussed. The necessity of neurosurgical patient-oriented clinical registries will be discussed in the context of imminent and dramatic reforms related to medical cost containment. In the policy debate moving forward, the strength of neurosurgery's argument will rest on data, unity, and proactiveness. The National Neurosurgery Quality and Outcomes Database (N(2)QOD) allows neurosurgeons to generate objective data on specialty-specific value and quality determinations; it allows neurosurgeons to bring the patient-physician interaction to the policy debate.

  19. Magnetic resonance susceptibility weighted imaging in neurosurgery: current applications and future perspectives.

    PubMed

    Di Ieva, Antonio; Lam, Timothy; Alcaide-Leon, Paula; Bharatha, Aditya; Montanera, Walter; Cusimano, Michael D

    2015-12-01

    Susceptibility weighted imaging (SWI) is a relatively new imaging technique. Its high sensitivity to hemorrhagic components and ability to depict microvasculature by means of susceptibility effects within the veins allow for the accurate detection, grading, and monitoring of brain tumors. This imaging modality can also detect changes in blood flow to monitor stroke recovery and reveal specific subtypes of vascular malformations. In addition, small punctate lesions can be demonstrated with SWI, suggesting diffuse axonal injury, and the location of these lesions can help predict neurological outcome in patients. This imaging technique is also beneficial for applications in functional neurosurgery given its ability to clearly depict and differentiate deep midbrain nuclei and close submillimeter veins, both of which are necessary for presurgical planning of deep brain stimulation. By exploiting the magnetic susceptibilities of substances within the body, such as deoxyhemoglobin, calcium, and iron, SWI can clearly visualize the vasculature and hemorrhagic components even without the use of contrast agents. The high sensitivity of SWI relative to other imaging techniques in showing tumor vasculature and microhemorrhages suggests that it is an effective imaging modality that provides additional information not shown using conventional MRI. Despite SWI's clinical advantages, its implementation in MRI protocols is still far from consistent in clinical usage. To develop a deeper appreciation for SWI, the authors here review the clinical applications in 4 major fields of neurosurgery: neurooncology, vascular neurosurgery, neurotraumatology, and functional neurosurgery. Finally, they address the limitations of and future perspectives on SWI in neurosurgery.

  20. Robotics in neurosurgery: state of the art and future technological challenges.

    PubMed

    Zamorano, L; Li, Q; Jain, S; Kaur, G

    2004-06-01

    The use of robotic technologies to assist surgeons was conceptually described almost thirty years ago but has only recently become feasible. In Neurosurgery, medical robots have been applied to neurosurgery for over 19 years. Nevertheless this field remains unknown to most neurosurgeons. The intrinsic characteristics of robots, such as high precision, repeatability and endurance make them ideal surgeon's assistants. Unfortunately, limitations in the current available systems make its use limited to very few centers in the world. During the last decade, important efforts have been made between academic and industry partnerships to develop robots suitable for use in the operating room environment. Although some applications have been successful in areas of laparoscopic surgery and orthopaedics, Neurosurgery has presented a major challenge due to the eloquence of the surrounding anatomy. This review focuses on the application of medical robotics in neurosurgery. The paper begins with an overview of the development of the medical robotics, followed by the current clinical applications in neurosurgery and an analysis of current limitations. We discuss robotic applications based in our own experience in the field. Next, we discuss the technological challenges and research areas to overcome those limitations, including some of our current research approaches for future progress in the field.

  1. Sensors management in robotic neurosurgery: the ROBOCAST project.

    PubMed

    Vaccarella, Alberto; Comparetti, Mirko Daniele; Enquobahrie, Andinet; Ferrigno, Giancarlo; De Momi, Elena

    2011-01-01

    Robot and computer-aided surgery platforms bring a variety of sensors into the operating room. These sensors generate information to be synchronized and merged for improving the accuracy and the safety of the surgical procedure for both patients and operators. In this paper, we present our work on the development of a sensor management architecture that is used is to gather and fuse data from localization systems, such as optical and electromagnetic trackers and ultrasound imaging devices. The architecture follows a modular client-server approach and was implemented within the EU-funded project ROBOCAST (FP7 ICT 215190). Furthermore it is based on very well-maintained open-source libraries such as OpenCV and Image-Guided Surgery Toolkit (IGSTK), which are supported from a worldwide community of developers and allow a significant reduction of software costs. We conducted experiments to evaluate the performance of the sensor manager module. We computed the response time needed for a client to receive tracking data or video images, and the time lag between synchronous acquisition with an optical tracker and ultrasound machine. Results showed a median delay of 1.9 ms for a client request of tracking data and about 40 ms for US images; these values are compatible with the data generation rate (20-30 Hz for tracking system and 25 fps for PAL video). Simultaneous acquisitions have been performed with an optical tracking system and US imaging device: data was aligned according to the timestamp associated with each sample and the delay was estimated with a cross-correlation study. A median value of 230 ms delay was calculated showing that realtime 3D reconstruction is not feasible (an offline temporal calibration is needed), although a slow exploration is possible. In conclusion, as far as asleep patient neurosurgery is concerned, the proposed setup is indeed useful for registration error correction because the brain shift occurs with a time constant of few tens of minutes.

  2. Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders

    PubMed Central

    Nuttin, Bart; Wu, Hemmings; Mayberg, Helen; Hariz, Marwan; Gabriëls, Loes; Galert, Thorsten; Merkel, Reinhard; Kubu, Cynthia; Vilela-Filho, Osvaldo; Matthews, Keith; Taira, Takaomi; Lozano, Andres M; Schechtmann, Gastón; Doshi, Paresh; Broggi, Giovanni; Régis, Jean; Alkhani, Ahmed; Sun, Bomin; Eljamel, Sam; Schulder, Michael; Kaplitt, Michael; Eskandar, Emad; Rezai, Ali; Krauss, Joachim K; Hilven, Paulien; Schuurman, Rick; Ruiz, Pedro; Chang, Jin Woo; Cosyns, Paul; Lipsman, Nir; Voges, Juergen; Cosgrove, Rees; Li, Yongjie; Schlaepfer, Thomas

    2014-01-01

    Background For patients with psychiatric illnesses remaining refractory to ‘standard’ therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environments. Findings The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered ‘established’ in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients. Interpretation This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety. PMID:24444853

  3. Spinal neurosurgery with the head-mounted "Varioscope" microscope.

    PubMed

    Kuchta, J; Simons, P

    2009-05-01

    We present a preliminary report on the intra-operative use of a head-mounted microscope ("Varioscope" Leica HM500) in spinal neurosurgery. The Varioscope is a dynamic microscope mounted on a head-set. It weights 297 g and measures 73 x 120 x 63 mm (length x width x height). It offers an infinitely variable range of magnification from 3.6x to 7.2x. The working distance ranges from 300 to 600 mm. The field of view varies between 30-144 mm, depending on the selected enlargement factor and the working distance. In addition to the zoom function, the device offers a focus function (automatic or on demand). The optical elements for focus and zoom are located in two separate tubes which are mounted on a middle section containing the mechanical components as well as the receiver unit for the focussing elements. The lenses are adjusted by means of motor-driven push/pull cables. The autofocus works well in larger operative fields and a working distance between 30 and 60 cm. Nevertheless, when used in today's "keyhole" approaches, the autofocus is not helpful when operating in deep structures. Based on the satisfactory results achieved in our series, we can recommend the Varioscope, especially when no stationary microscope is available. The portable device can be packed in a suitcase and can travel with the consultant microsurgeon to different hospitals and distant units. The built-in video camera is ideal for patients, staff, assistant surgeons, and student education with real-time video monitoring of procedures from the microsurgeon's perspective. For daily microsurgery, we felt more comfortable with fixed, stationary operating microscopes.

  4. Robotic System for MRI-Guided Stereotactic Neurosurgery

    PubMed Central

    Li, Gang; Cole, Gregory A.; Shang, Weijian; Harrington, Kevin; Camilo, Alex; Pilitsis, Julie G.; Fischer, Gregory S.

    2015-01-01

    Stereotaxy is a neurosurgical technique that can take several hours to reach a specific target, typically utilizing a mechanical frame and guided by preoperative imaging. An error in any one of the numerous steps or deviations of the target anatomy from the preoperative plan such as brain shift (up to 20 mm), may affect the targeting accuracy and thus the treatment effectiveness. Moreover, because the procedure is typically performed through a small burr hole opening in the skull that prevents tissue visualization, the intervention is basically “blind” for the operator with limited means of intraoperative confirmation that may result in reduced accuracy and safety. The presented system is intended to address the clinical needs for enhanced efficiency, accuracy, and safety of image-guided stereotactic neurosurgery for Deep Brain Stimulation (DBS) lead placement. The work describes a magnetic resonance imaging (MRI)-guided, robotically actuated stereotactic neural intervention system for deep brain stimulation procedure, which offers the potential of reducing procedure duration while improving targeting accuracy and enhancing safety. This is achieved through simultaneous robotic manipulation of the instrument and interactively updated in situ MRI guidance that enables visualization of the anatomy and interventional instrument. During simultaneous actuation and imaging, the system has demonstrated less than 15% signal-to-noise ratio (SNR) variation and less than 0.20% geometric distortion artifact without affecting the imaging usability to visualize and guide the procedure. Optical tracking and MRI phantom experiments streamline the clinical workflow of the prototype system, corroborating targeting accuracy with 3-axis root mean square error 1.38 ± 0.45 mm in tip position and 2.03 ± 0.58° in insertion angle. PMID:25376035

  5. Simulation of brain tumor resection in image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Fan, Xiaoyao; Ji, Songbai; Fontaine, Kathryn; Hartov, Alex; Roberts, David; Paulsen, Keith

    2011-03-01

    Preoperative magnetic resonance images are typically used for neuronavigation in image-guided neurosurgery. However, intraoperative brain deformation (e.g., as a result of gravitation, loss of cerebrospinal fluid, retraction, resection, etc.) significantly degrades the accuracy in image guidance, and must be compensated for in order to maintain sufficient accuracy for navigation. Biomechanical finite element models are effective techniques that assimilate intraoperative data and compute whole-brain deformation from which to generate model-updated MR images (uMR) to improve accuracy in intraoperative guidance. To date, most studies have focused on early surgical stages (i.e., after craniotomy and durotomy), whereas simulation of more complex events at later surgical stages has remained to be a challenge using biomechanical models. We have developed a method to simulate partial or complete tumor resection that incorporates intraoperative volumetric ultrasound (US) and stereovision (SV), and the resulting whole-brain deformation was used to generate uMR. The 3D ultrasound and stereovision systems are complimentary to each other because they capture features deeper in the brain beneath the craniotomy and at the exposed cortical surface, respectively. In this paper, we illustrate the application of the proposed method to simulate brain tumor resection at three temporally distinct surgical stages throughout a clinical surgery case using sparse displacement data obtained from both the US and SV systems. We demonstrate that our technique is feasible to produce uMR that agrees well with intraoperative US and SV images after dural opening, after partial tumor resection, and after complete tumor resection. Currently, the computational cost to simulate tumor resection can be up to 30 min because of the need for re-meshing and the trial-and-error approach to refine the amount of tissue resection. However, this approach introduces minimal interruption to the surgical workflow

  6. [Prostate cancer external beam radiotherapy].

    PubMed

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy.

  7. Neurosurgery in Turkish poetry: three poets, two poems and two neurosurgeons.

    PubMed

    Kahilogullari, Gokmen

    2015-01-01

    Poems are essential in art and vital organs in literature. Similarly, surgery (and neurosurgery) is also regarded to be an art in medicine. From Hippocrates to nowadays, there is a debate on whether medicine -especially surgery- is a kind of an art or a field of science or a combination of both. This close relation becomes clearer during the practice of surgery, especially in neurosurgery. Herein, the relation between Turkish poetry and Turkish neurosurgery is being presented by researching the interesting and exciting stories about three poets (Can Yücel, Hasan Hüseyin Korkmazgil, Nazım Hikmet), their poems; and two Turkish neurosurgeons (Gazi Yaşargil, Yücel Kanpolat).

  8. Perioperative posterior reversible encephalopathy syndrome in 2 pediatric neurosurgery patients with brainstem ependymoma.

    PubMed

    Gephart, Melanie G Hayden; Taft, Bonnie P; Giese, Anne-Katrin; Guzman, Raphael; Edwards, Michael S B

    2011-03-01

    Posterior reversible encephalopathy syndrome (PRES) has been described in pediatric neurooncology patients, although it has not been documented perioperatively in pediatric neurosurgery patients not actively receiving chemotherapy. Recently at the authors' facility, 2 cases of PRES were diagnosed perioperatively in children with brainstem ependymoma. Both patients had presented with hypertension, altered mental status, and seizures and demonstrated MR imaging features consistent with PRES. The patients were treated with antiseizure and antihypertension medications, leading to improvement in both clinical symptoms and neuroimaging findings. These cases are the first to document PRES in perioperative pediatric neurosurgery patients not actively receiving chemotherapy. Both patients had ependymoma involving the brainstem, which may have led to intra- and perioperative hemodynamic instability (including hypertension) and predisposed them to this syndrome. An awareness of PRES in similar scenarios will aid in the prevention, diagnosis, and treatment of pediatric neurosurgery patients with this syndrome.

  9. Statement of Ethics in Neurosurgery of the World Federation of Neurosurgical Societies.

    PubMed

    Umansky, Felix; Black, Peter L; DiRocco, Concenzio; Ferrer, Enrique; Goel, Atul; Malik, Ghaus M; Mathiesen, Tiit; Mendez, Ivar; Palmer, James D; Juanotena, Jorge Rodriguez; Fraifeld, Shifra; Rosenfeld, Jeffrey V

    2011-01-01

    This Statement of Ethics in Neurosurgery was developed by the Committee for Ethics and Medico-Legal Affairs of the World Federation of Neurosurgical Societies to help neurosurgeons resolve problems in the treatment of individual patients and meet obligations to the larger society. This document is intended as a framework rather than a set of rules. It cannot cover every situation and should be used with flexibility. However, it is our intent that the fundamental principles enunciated here should serve as a guide in the day-to-day practice of neurosurgery.

  10. [Characteristics of perioperative period in Xenon-based combined general anaesthesia in neurosurgery].

    PubMed

    Viatkin, A A; Petrosian, L G; Mizikov, V M; Vasil'ev, S A

    2013-01-01

    Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. Xe in concentration 65% was used to maintenance of anesthesia, other medication was avoided. As a resuIt there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n = 3), hyperdynamic reaction (n = 8), PONV (n = 8) were detected in early postoperative period. An analysis of this study suggests a conclusion that studied method of Xenon-based anesthesia is inexpedient for neurosurgery.

  11. Radio Pulsars

    NASA Astrophysics Data System (ADS)

    Beskin, V. S.; Chernov, S. V.; Gwinn, C. R.; Tchekhovskoy, A. A.

    2015-10-01

    Almost 50 years after radio pulsars were discovered in 1967, our understanding of these objects remains incomplete. On the one hand, within a few years it became clear that neutron star rotation gives rise to the extremely stable sequence of radio pulses, that the kinetic energy of rotation provides the reservoir of energy, and that electromagnetic fields are the braking mechanism. On the other hand, no consensus regarding the mechanism of coherent radio emission or the conversion of electromagnetic energy to particle energy yet exists. In this review, we report on three aspects of pulsar structure that have seen recent progress: the self-consistent theory of the magnetosphere of an oblique magnetic rotator; the location, geometry, and optics of radio emission; and evolution of the angle between spin and magnetic axes. These allow us to take the next step in understanding the physical nature of the pulsar activity.

  12. Radio Astronomy

    NASA Technical Reports Server (NTRS)

    Wolken, P. R.; Shaffer, R. D.

    1983-01-01

    Deep Space Network (DSN) 26- and 64-meter antenna stations were utilized in support of Radio Astronomy Experiment Selection Panel experiments. Within a time span of 10 days, in May 1983 (267.75 hours total), nine RAES experiments were supported. Most of these experiments involved multifacility interferometry using Mark 3 data recording terminals and as many as six non-DSN observatories. Investigations of black holes, quasars, galaxies, and radio sources are discussed.

  13. [Operative neurosurgery: personal view and historical backgrounds (2) acoustic neurinoma].

    PubMed

    Yonekawa, Yasuhiro

    2006-12-01

    Microsurgical removal of acoustic neurinoma is still one of the challenging topics in neurosurgery in spite of the development of Gamma-knife or radiosurgery, with which small and moderate sized tumors can be treated. Surgical technique necessitates more expertise in dealing with larger tumors. In this report ongoing microsurgical standard technique for removal of acoustic neurinomas of approx. 3 cm (extrameatal) in diameter is presented along with its historical backgrounds and literature review with reported techniques used by experienced neurosurgeons. 1) Standard sitting position with head turned (30) and flexed (20) head, and not semisitting position. 2) retromastoid retrosigmoid osteoplastic craniotomy following a linear incision. Special mention is made on how to manage the air embolism inherent to the sitting position in which the use of fibrin glue to seal the air entrance is presented along with early detection. 3) Intracapsular enucleation after the dural incision and retraction of the biventer lobule with special emphasis on the infrequent anatomical course of the facial and vestibulocochlear nerves on the posterior wall of neurinomas. 4) Localizing the facial nerve and vestibulocochlear nerve at the pontine side, so that decision of preserving or sacrificing the latter in the course of surgery can be made from the viewpoint of hearing preservation and concentrate on facial nerve function. 5) Drilling away of the posterior meatal lip in which sufficient drilling away should be performed to minimize opening of the posterior semicircular canal and that of mastoid cells. Complete sealing of either is necessary to prevent hearing loss or CSF rhinorrhoe. 6) Reduction of remaining tumor-capsule volume by sharp dissection or bipolar cutting, using intraoperative EMG-stimulation which identifies the presence of flattened facial nerve fibers on the capsule. Presence tiny remnant of the tumor capsule attached to the nerve bundles just before the entrance of

  14. Recruitment in Radiotherapy

    ERIC Educational Resources Information Center

    Deeley, T. J.; And Others

    1976-01-01

    The Faculty Board of Radiotherapy and Oncology of the Royal College of Radiobiologists surveyed the factors thought to influence recruitment into the specialty. Possible factors listed in replies of 36 questionnaires are offered. (LBH)

  15. Fedor Krause: the first systematic use of X-rays in neurosurgery.

    PubMed

    Elhadi, Ali M; Kalb, Samuel; Martirosyan, Nikolay L; Agrawal, Abhishek; Preul, Mark C

    2012-08-01

    Within a few months of Wilhelm Conrad Röntgen's discovery of x-rays in 1895, Fedor Krause acquired an x-ray apparatus and began to use it in his daily interactions with patients and for diagnosis. He was the first neurosurgeon to use x-rays methodically and systematically. In 1908 Krause published the first volume of text on neurosurgery, Chirurgie des Gehirns und Rückenmarks (Surgery of the Brain and Spinal Cord), which was translated into English in 1909. The second volume followed in 1911. This was the first published multivolume text totally devoted to neurosurgery. Although Krause excelled in and promoted neurosurgery, he believed that surgeons should excel at general surgery. Importantly, Krause was inclined to adopt technology that he believed could be helpful in surgery. His 1908 text was the first neurosurgical text to contain a specific chapter on x-rays ("Radiographie") that showed roentgenograms of neurosurgical procedures and pathology. After the revolutionary discovery of x-rays by Röntgen, many prominent neurosurgeons seemed pessimistic about the use of x-rays for anything more than trauma or fractures. Krause immediately seized on its use to guide and monitor ventricular drainage and especially for the diagnosis of tumors of the skull base. The x-ray images contained in Krause's "Radiographie" chapter provide a seminal view into the adoption of new technology and the development of neurosurgical technique and are part of neurosurgery's heritage.

  16. History of the Department of Neurosurgery at Thomas Jefferson University Hospital.

    PubMed

    Chalouhi, Nohra; Osterholm, Jewell; Jabbour, Pascal; Dumont, Aaron S; Gonzalez, L Fernando; Harrop, James; Sharan, Ashwini; Rosenwasser, Robert; Tjoumakaris, Stavropoula

    2013-10-01

    The neurosurgical tradition at Jefferson Medical College began in the 19th century with Samuel Gross. In his textbook entitled A System of Surgery, Gross revealed his knowledge of the disorders of the nervous system at a time when innovations were practically inexistent. Gross' work paved the way for William Williams Keen, "America's first brain surgeon." In 1887, Keen became the first surgeon in the nation to successfully remove a primary brain tumor. In 1893, Keen operated secretly on President Grover Cleveland for removal of an intraoral sarcoma and later served as a consultant to Franklin Roosevelt after he contracted poliomyelitis. The neurosurgery division was established in 1943 by J. Rudolph Jaeger. It was Philip Gordy who created a distinct Department of Neurosurgery in 1969. Jewell L. Osterholm became chairman of the Department of Neurosurgery in 1974. Since 2004, Robert Rosenwasser has served as chairman, and the Department of Neurosurgery at Jefferson has grown to include 26 faculty members. The residency has expanded to include 3 residents per academic year since 2007.

  17. 21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Self-retaining retractor for neurosurgery. 882.4800 Section 882.4800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4800...

  18. 21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Self-retaining retractor for neurosurgery. 882.4800 Section 882.4800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4800...

  19. 21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Self-retaining retractor for neurosurgery. 882.4800 Section 882.4800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4800...

  20. 21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Self-retaining retractor for neurosurgery. 882.4800 Section 882.4800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4800...

  1. 21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Self-retaining retractor for neurosurgery. 882.4800 Section 882.4800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4800...

  2. Roots of neuroanatomy, neurology, and neurosurgery as found in the Bible and Talmud.

    PubMed

    Tubbs, R Shane; Loukas, Marios; Shoja, Mohammadali M; Cohen-Gadol, Aaron A; Wellons, John C; Oakes, W Jerry

    2008-07-01

    Historical observations and interpretations regarding the treatment of components of the nervous system can be found in the writings of the Bible and Talmud. A review of topics germane to modern neuroanatomy, neurology, and neurosurgery from these early, rich writings is presented herein. These historic writings provide a glimpse into the early understanding, description, and treatment of pathologies of the nervous system.

  3. Integration of patient specific modeling and advanced image processing techniques for image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Archip, Neculai; Fedorov, Andriy; Lloyd, Bryn; Chrisochoides, Nikos; Golby, Alexandra; Black, Peter M.; Warfield, Simon K.

    2006-03-01

    A major challenge in neurosurgery oncology is to achieve maximal tumor removal while avoiding postoperative neurological deficits. Therefore, estimation of the brain deformation during the image guided tumor resection process is necessary. While anatomic MRI is highly sensitive for intracranial pathology, its specificity is limited. Different pathologies may have a very similar appearance on anatomic MRI. Moreover, since fMRI and diffusion tensor imaging are not currently available during the surgery, non-rigid registration of preoperative MR with intra-operative MR is necessary. This article presents a translational research effort that aims to integrate a number of state-of-the-art technologies for MRI-guided neurosurgery at the Brigham and Women's Hospital (BWH). Our ultimate goal is to routinely provide the neurosurgeons with accurate information about brain deformation during the surgery. The current system is tested during the weekly neurosurgeries in the open magnet at the BWH. The preoperative data is processed, prior to the surgery, while both rigid and non-rigid registration algorithms are run in the vicinity of the operating room. The system is tested on 9 image datasets from 3 neurosurgery cases. A method based on edge detection is used to quantitatively validate the results. 95% Hausdorff distance between points of the edges is used to estimate the accuracy of the registration. Overall, the minimum error is 1.4 mm, the mean error 2.23 mm, and the maximum error 3.1 mm. The mean ratio between brain deformation estimation and rigid alignment is 2.07. It demonstrates that our results can be 2.07 times more precise then the current technology. The major contribution of the presented work is the rigid and non-rigid alignment of the pre-operative fMRI with intra-operative 0.5T MRI achieved during the neurosurgery.

  4. Radio astronomy

    NASA Technical Reports Server (NTRS)

    Kellermann, Kenneth I.; Heeschen, David; Backer, Donald C.; Cohen, Marshall H.; Davis, Michael; Depater, Imke; Deyoung, David; Dulk, George A.; Fisher, J. R.; Goss, W. Miller

    1991-01-01

    The following subject areas are covered: (1) scientific opportunities (millimeter and sub-millimeter wavelength astronomy; meter to hectometer astronomy; the Sun, stars, pulsars, interstellar masers, and extrasolar planets; the planets, asteroids, and comets; radio galaxies, quasars, and cosmology; and challenges for radio astronomy in the 1990's); (2) recommendations for new facilities (the millimeter arrays, medium scale instruments, and small-scale projects); (3) continuing activities and maintenance, upgrading of telescopes and instrumentation; (4) long range programs and technology development; and (5) social, political, and organizational considerations.

  5. [Radiotherapy of larynx cancers].

    PubMed

    Pointreau, Y; Lafond, C; Legouté, F; Trémolières, P; Servagi-Vernat, S; Giraud, P; Maingon, P; Calais, G; Lapeyre, M

    2016-09-01

    Intensity-modulated radiotherapy is the gold standard in the treatment of larynx cancers (except T1 glottic tumour). Early T1 and T2 tumours may be treated by exclusive radiation or surgery. For tumours requiring total laryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy is possible. For T4 tumour, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, the curative dose is 70Gy and the prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used in locally advanced cancer with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation was based on guidelines.

  6. [Radiotherapy for retroperitoneal sarcomas].

    PubMed

    Sargos, P; Stoeckle, E; Henriques de Figueiredo, B; Antoine, M; Delannes, M; Mervoyer, A; Kantor, G

    2016-10-01

    The management of retroperitoneal sarcoma can be very challenging, and the quality of initial treatment strategy appears to be a crucial prognostic factor. En bloc surgery is currently the standard of care for these rare tumours and perioperative treatments such as chemotherapy or radiotherapy have not been validated yet. However, local-regional relapse constitutes the most common disease course. While adjuvant radiotherapy is less and less common due to gastrointestinal toxicities, preoperative radiation therapy offers numerous advantages and is being evaluated as part of a national multicentre phase II study (TOMOREP trial) and is the subject of a European randomized phase III study (STRASS trial). The objective of this article is to present data on preoperative irradiation in terms of dose, volumes and optimal radiotherapy techniques for the treatment of this rare disease.

  7. Radiotherapy for lung cancer

    SciTech Connect

    Bleehen, N.M.; Cox, J.D.

    1985-05-01

    The role of radiation therapy in the management of lung cancer was reviewed at a workshop held in Cambridge, England, in June 1984. It was concluded that there was a continuing role for radiation therapy in the primary management of small cell lung cancer, including the loco-regional treatment for patients with limited disease. Radical radiotherapy for patients with non-small cell carcinoma could be curative for a proportion of patients with limited disease. Careful planning and quality control was essential. Palliative radiotherapy provided useful treatment for many other patients. Other related aspects of treatment are also presented.

  8. The Radio JOVE Project - Shoestring Radio Astronomy

    NASA Technical Reports Server (NTRS)

    Thieman, J.; Flagg, R.; Greenman, W.; Higgins, C.; Reyes, F.; Sky, J.

    2010-01-01

    Radio JOVE is an education and outreach project intended to give students and other interested individuals hands-on experience in learning radio astronomy. They can do this through building a radio telescope from a relatively inexpensive kit that includes the parts for a receiver and an antenna as well as software for a computer chart recorder emulator (Radio Skypipe) and other reference materials

  9. Precision radiotherapy for brain tumors

    PubMed Central

    Yan, Ying; Guo, Zhanwen; Zhang, Haibo; Wang, Ning; Xu, Ying

    2012-01-01

    OBJECTIVE: Precision radiotherapy plays an important role in the management of brain tumors. This study aimed to identify global research trends in precision radiotherapy for brain tumors using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for precision radiotherapy for brain tumors containing the key words cerebral tumor, brain tumor, intensity-modulated radiotherapy, stereotactic body radiation therapy, stereotactic ablative radiotherapy, imaging-guided radiotherapy, dose-guided radiotherapy, stereotactic brachytherapy, and stereotactic radiotherapy using the Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed articles on precision radiotherapy for brain tumors which were published and indexed in the Web of Science; (b) type of articles: original research articles and reviews; (c) year of publication: 2002-2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) Corrected papers or book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on precision radiotherapy for brain tumors. RESULTS: The stereotactic radiotherapy, intensity-modulated radiotherapy, and imaging-guided radiotherapy are three major methods of precision radiotherapy for brain tumors. There were 260 research articles addressing precision radiotherapy for brain tumors found within the Web of Science. The USA published the most papers on precision radiotherapy for brain tumors, followed by Germany and France. European Synchrotron Radiation Facility, German Cancer Research Center and Heidelberg University were the most prolific research institutes for publications on precision radiotherapy for brain tumors. Among the top 13 research institutes publishing in this field, seven

  10. Problems with phenytoin administration in neurology/neurosurgery ITU patients receiving enteral feeding.

    PubMed

    Kitchen, D; Smith, D

    2001-06-01

    Our objective was to investigate the relationship between phenytoin bioavailability, enteral feeding and serum albumin levels in patients admitted to neurology/neurosurgery ITU, via case studies of three patients. The research was performed at the Walton centre for Neurology and Neurosurgery NHS Trust, Liverpool, England, and our subjects consisted of three cases admitted to ITU (1 status epilepticus, 1 post-trauma and 1 post-subarachnoid haemorrhage (SAH)). Phenytoin levels were assessed in relation to the type of feeding and serum albumin levels. We found evidence of a complex relationship between phenytoin levels, enteral feeding and serum albumin in patients in the neuro ITU setting. We conclude that, in this setting the patient's phenytoin needs to be closely monitored and treated aggressively to maintain therapeutic levels. They should also be followed up during rehabilitation to avoid toxicity.

  11. Neurosurgery in Rwanda during a United Nations peace-keeping mission.

    PubMed

    Rosenfeld, J V

    1997-05-01

    An analysis of the neurosurgical component of the medical support provided by a United Nations peace-keeping mission in Rwanda is presented. The Australian Defence Force contingent provided medical support to the United Nations and the civilian population. Eight hundred thirty-eight procedures were performed during 12 months. A wide range of surgery was encompassed, with neurosurgery accounting for 17 (2%) of the total operations: compound depressed fractured skull, 5; intracranial pressure monitor, 2; burr holes for acute head injury and chronic subdural hematoma, 2; skull osteomyelitis debridement, 1; rib-graft cranioplasty, 2; scalp rotation flap, 1; congenital myelomeningocele, 2; occipital meningocele, 1; craniofacial approach to Le Fort III fracture, 1. A broad range of neurosurgical procedures have been performed. The overall numbers of neurosurgical operations were small, but they were successfully performed by general surgeons. Familiarity with neurosurgery is necessary in predeployment training of military surgeons working in a remote location with limited resources.

  12. Development and Evaluation of a Registration Methodology for Information-Guided Precision Robotic Laser Neurosurgery System

    NASA Astrophysics Data System (ADS)

    Nakamura, Ryoichi; Hara, Mikiko; Omori, Shigeru; Uematsu, Miyuki; Umezu, Mitsuo; Muragaki, Yoshihiro; Iseki, Hiroshi

    To establish safe, precise, and minimally invasive surgery, Computer Aided Surgery (CAS) systems, such as intra-operative imaging and navigation system to detect the location of the target of therapy, and surgical robot system, are very powerful tools. There is strong need to combine these CAS systems for fusion of advanced diagnosis and treatment technologies. In this paper, we introduce our new method to register the intraoperative imaging information, robotic surgery system, and patient using surgical navigation system. Using our Open-MRI navigation system and laser surgery system for neurosurgery, we can make registration between these system and patient precisely. The experimental result shows that the error on the registration between image data and the laser surgery system is low enough to fulfill the requirement of laser surgery system in the use of high-resolution image data. This system realizes the safe, precise and minimally invasive neurosurgery by the combination of intra-operative diagnosis and advanced therapeutic device.

  13. Graph theory analysis of complex brain networks: new concepts in brain mapping applied to neurosurgery.

    PubMed

    Hart, Michael G; Ypma, Rolf J F; Romero-Garcia, Rafael; Price, Stephen J; Suckling, John

    2016-06-01

    Neuroanatomy has entered a new era, culminating in the search for the connectome, otherwise known as the brain's wiring diagram. While this approach has led to landmark discoveries in neuroscience, potential neurosurgical applications and collaborations have been lagging. In this article, the authors describe the ideas and concepts behind the connectome and its analysis with graph theory. Following this they then describe how to form a connectome using resting state functional MRI data as an example. Next they highlight selected insights into healthy brain function that have been derived from connectome analysis and illustrate how studies into normal development, cognitive function, and the effects of synthetic lesioning can be relevant to neurosurgery. Finally, they provide a précis of early applications of the connectome and related techniques to traumatic brain injury, functional neurosurgery, and neurooncology.

  14. [The history of Spanish neurosurgery: the Valencian school: J.J. Barcia Goyanes].

    PubMed

    Barcia-Mariño, Carlos; Rodríguez-Mena, Ruben

    2013-01-01

    Professor Juan José Barcia-Goyanes started neurosurgical practice from anatomy and neuropsychiatry in response to a vacancy at a department known as "Nervous diseases", in 1931 at Hospital General in Valencia, Spain. Since the first intervention, based on the methods and surgical instruments already used in Europe and the U.S.A., the neurosurgical practice became the mainstay of the department, from which other auxiliary specialties emerged, such as neuroradiology, neurophysiology, neuropathology and also new techniques such as stereotactic surgery, functional neurosurgery and palencephalography. This year, the department celebrates its 80th anniversary. The broad spectrum of Prof. Barcia's scientific work included fields like neurology, neurosurgery and psychiatry, as well as anthropology, medical thought, history of medicine, morphology and history of anatomical language in his work "Onomatologica anatomica nova", in addition to an interesting poetic work. He was a founding member of the Luso-Spanish Neurosurgical Society and the Neurosurgical Society of Levante.

  15. [Radiotherapy of breast cancer].

    PubMed

    Hennequin, C; Barillot, I; Azria, D; Belkacémi, Y; Bollet, M; Chauvet, B; Cowen, D; Cutuli, B; Fourquet, A; Hannoun-Lévi, J M; Leblanc, M; Mahé, M A

    2016-09-01

    In breast cancer, radiotherapy is an essential component of the treatment. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. Partial breast irradiation could not be proposed routinely but only in very selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neo-adjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra and infra-clavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit/risk ratio (cardiac toxicity). Dose to the chest wall or the breast must be between 45-50Gy with a conventional fractionation. A boost dose over the tumour bed is required if the patient is younger than 60 years old. Hypofractionation (42.5 Gy in 16 fractions, or 41.6 Gy en 13 or 40 Gy en 15) is possible after tumorectomy and if a nodal irradiation is not mandatory. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in case of specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with

  16. Space Telecommunications Radio System STRS Cognitive Radio

    NASA Technical Reports Server (NTRS)

    Briones, Janette C.; Handler, Louis M.

    2013-01-01

    Radios today are evolving from awareness toward cognition. A software defined radio (SDR) provides the most capability for integrating autonomic decision making ability and allows the incremental evolution toward a cognitive radio. This cognitive radio technology will impact NASA space communications in areas such as spectrum utilization, interoperability, network operations, and radio resource management over a wide range of operating conditions. NASAs cognitive radio will build upon the infrastructure being developed by Space Telecommunication Radio System (STRS) SDR technology. This paper explores the feasibility of inserting cognitive capabilities in the NASA STRS architecture and the interfaces between the cognitive engine and the STRS radio. The STRS architecture defines methods that can inform the cognitive engine about the radio environment so that the cognitive engine can learn autonomously from experience, and take appropriate actions to adapt the radio operating characteristics and optimize performance.

  17. Neurosurgery in the realm of 10(-9), part 1: stardust and nanotechnology in neuroscience.

    PubMed

    Elder, James B; Liu, Charles Y; Apuzzo, Michael L J

    2008-01-01

    Nanotechnology as a science has evolved from notions and speculation to emerge as a prominent combination of science and engineering that stands to impact innumerable aspects of technology. Medicine in general and neurosurgery in particular will benefit greatly in terms of improved diagnostic and therapeutic capabilities. The recent explosion in nanotechnology products, including diverse applications such as beauty products and medical contrast agents, has been accompanied by an ever increasing volume of literature. Recent articles from our institution provided an historical and scientific background of nanotechnology, with a purposeful focus on nanomedicine. Future applications of nanotechnology to neuroscience and neurosurgery were briefly addressed. The present article is the first of two that will further this discussion by providing specific details of current nanotechnology applications and research related to neuroscience and clinical neurosurgery. This article also provides relevant perspective in scale, history, economics, and toxicology. Topics of specific importance to developments or advances of technologies used by neuroscientists and neurosurgeons are presented. In addition, advances in the field of microelectromechanical systems technology are discussed. Although larger than nanoscale, microelectromechanical systems technologies will play an important role in the future of medicine and neurosurgery. The second article will discuss current nanotechnologies that are being, or will be in the near future, incorporated into the armamentarium of the neurosurgeon. The goal of these articles is to keep the neuroscience community abreast of current developments in nanotechnology, nanomedicine, and, in particular, nanoneurosurgery, and to present possibilities for future applications of nanotechnology. As applications of nanotechnology permeate all forms of scientific and medical research, clinical applications will continue to emerge. Physicians of the

  18. Neurosurgery in Egypt: past, present, and future-from pyramids to radiosurgery.

    PubMed

    El Gindi, Sayed

    2002-09-01

    THE CONTEMPORARY DEVELOPMENT of neurosurgery in Egypt is described, with reference to the ancient past and recent American and European influences. This article traces the steps taken by several leading Egyptian pioneers. Egypt, one of the key countries in the Middle East, has led the development of the specialty in the region and has maintained close ties with the international body of neurological surgeons and surgical societies.

  19. The present and future of quality measures and public reporting in neurosurgery.

    PubMed

    Bekelis, Kimon; McGirt, Matthew J; Parker, Scott L; Holland, Christopher M; Davies, Jason; Devin, Clinton J; Atkins, Tyler; Knightly, Jack; Groman, Rachel; Zyung, Irene; Asher, Anthony L

    2015-12-01

    Quality measurement and public reporting are intended to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. However, regulatory implementation has created a complex network of reporting requirements for physicians and medical practices. These include Medicare's Physician Quality Reporting System, Electronic Health Records Meaningful Use, and Value-Based Payment Modifier programs. The common denominator of all these initiatives is that to avoid penalties, physicians must meet "generic" quality standards that, in the case of neurosurgery and many other specialties, are not pertinent to everyday clinical practice and hold specialists accountable for care decisions outside of their direct control. The Centers for Medicare and Medicaid Services has recently authorized alternative quality reporting mechanisms for the Physician Quality Reporting System, which allow registries to become subspecialty-reporting mechanisms under the Qualified Clinical Data Registry (QCDR) program. These programs further give subspecialties latitude to develop measures of health care quality that are relevant to the care provided. As such, these programs amplify the power of clinical registries by allowing more accurate assessment of practice patterns, patient experiences, and overall health care value. Neurosurgery has been at the forefront of these developments, leveraging the experience of the National Neurosurgery Quality and Outcomes Database to create one of the first specialty-specific QCDRs. Recent legislative reform has continued to change this landscape and has fueled optimism that registries (including QCDRs) and other specialty-driven quality measures will be a prominent feature of federal and private sector quality improvement initiatives. These physician- and patient-driven methods will allow neurosurgery to underscore the value of interventions, contribute to the development of sustainable health care

  20. Virtual reality training in neurosurgery: Review of current status and future applications

    PubMed Central

    Alaraj, Ali; Lemole, Michael G.; Finkle, Joshua H.; Yudkowsky, Rachel; Wallace, Adam; Luciano, Cristian; Banerjee, P. Pat; Rizzi, Silvio H.; Charbel, Fady T.

    2011-01-01

    Background: Over years, surgical training is changing and years of tradition are being challenged by legal and ethical concerns for patient safety, work hour restrictions, and the cost of operating room time. Surgical simulation and skill training offer an opportunity to teach and practice advanced techniques before attempting them on patients. Simulation training can be as straightforward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced virtual reality (VR) simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. Methods: A PubMed review of the literature was performed for the MESH words “Virtual reality, “Augmented Reality”, “Simulation”, “Training”, and “Neurosurgery”. Relevant articles were retrieved and reviewed. A review of the literature was performed for the history, current status of VR simulation in neurosurgery. Results: Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and credential surgeons as technically competent. The number of published literature discussing the application of VR simulation in neurosurgery training has evolved over the last decade from data visualization, including stereoscopic evaluation to more complex augmented reality models. With the revolution of computational analysis abilities, fully immersive VR models are currently available in neurosurgery training. Ventriculostomy catheters insertion, endoscopic and endovascular simulations are used in neurosurgical residency training centers across the world. Recent studies have shown the coloration of proficiency with those simulators and levels of experience in the real world. Conclusion: Fully immersive technology is starting to be applied to the practice of

  1. The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale.

    PubMed

    Parker, Scott L; McGirt, Matthew J; Bekelis, Kimon; Holland, Christopher M; Davies, Jason; Devin, Clinton J; Atkins, Tyler; Knightly, Jack; Groman, Rachel; Zyung, Irene; Asher, Anthony L

    2015-12-01

    Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N(2)QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N(2)QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N(2)QOD QCDR is further evidence of neurosurgery's commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N(2)QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure.

  2. Application of Predictive Nursing Reduces Psychiatric Complications in ICU Patients after Neurosurgery

    PubMed Central

    LIU, Qiong; ZHU, Hui

    2016-01-01

    Background: Our aim was to investigate the effects of clinical application of perioperative predictive nursing on reducing psychiatric complications in Intensive Care Unit (ICU) patients after neurosurgery. Methods: A total of 129 patients who underwent neurosurgery and received intensive care were enrolled in our study from February 2013 to February 2014. These patients were divided into two groups: the experimental group (n=68) receiving predictive nursing before and after operation, and the control group (n=61) with general nursing. Clinical data including length of ICU stay, duration of the patients’ psychiatric symptoms, form and incidence of adverse events, and patient satisfaction ratings were recorded, and their differences between the two groups were analyzed. Results: The duration of psychiatric symptoms and the length of ICU stay for patients in the experimental group were significantly shorter than those in the control group (P<0.05). The incidence of adverse events and psychiatric symptoms, such as sensory and intuition disturbance, thought disturbance, emotional disorder, and consciousness disorder, in the experimental group was significantly lower than that in the control group (P<0.05). Patient satisfaction ratings were significantly higher in the experimental group than those in the control group (P<0.05). Conclusion: Application of predictive nursing on ICU patients who undergo neurosurgery could effectively reduce the incidence of psychiatric symptoms as well as other adverse events. Our study provided clinical evidences to encourage predictive nursing in routine settings for patients in critical conditions. PMID:27252916

  3. Bulgarian military neurosurgery: from Warsaw Pact to the North Atlantic Treaty Organization.

    PubMed

    Enchev, Yavor; Eftimov, Tihomir

    2010-05-01

    After 45 years as a closest ally of the Soviet Union in the Warsaw Pact, founded mainly against the US and the Western Europe countries, and 15 years of democratic changes, since 2004 Bulgaria has been a full member of NATO and an equal and trusted partner of its former enemies. The unprecedented transformation has affected all aspects of the Bulgarian society. As a function of the Bulgarian Armed Forces, Bulgarian military medicine and in particular Bulgarian military neurosurgery is indivisibly connected with their development. The history of Bulgarian military neurosurgery is the history of the transition from the Union of Soviet Socialist Republics military system and military medicine to NATO standards in every aspect. The career of the military neurosurgeon in Bulgaria is in many ways similar to that of the civilian neurosurgeon, but there are also many peculiarities. The purpose of this study was to outline the background and the history of Bulgarian military neurosurgery as well as its future trends in the conditions of world globalization.

  4. Laser neurosurgery: A systematic analysis of magnetic resonance-guided laser interstitial thermal therapies.

    PubMed

    Lagman, Carlito; Chung, Lawrance K; Pelargos, Panayiotis E; Ung, Nolan; Bui, Timothy T; Lee, Seung J; Voth, Brittany L; Yang, Isaac

    2017-02-01

    Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel minimally invasive modality that uses heat from laser probes to destroy tissue. Advances in probe design, cooling mechanisms, and real-time MR thermography have increased laser utilization in neurosurgery. The authors perform a systematic analysis of two commercially available MRgLITT systems used in neurosurgery: the Visualase® thermal therapy and NeuroBlate® Systems. Data extraction was performed in a blinded fashion. Twenty-two articles were included in the quantitative synthesis. A total of 223 patients were identified with the majority having undergone treatment with Visualase (n=154, 69%). Epilepsy was the most common indication for Visualase therapy (n=8 studies, 47%). Brain mass was the most common indication for NeuroBlate therapy (n=3 studies, 60%). There were no significant differences, except in age, wherein the NeuroBlate group was nearly twice as old as the Visualase group (p<0.001). Frame, total complications, and length-of-stay (LOS) were non-significant when adjusted for age and number of patients. Laser neurosurgery has evolved over recent decades. Clinical indications are currently being defined and will continue to emerge as laser technologies become more sophisticated. Head-to-head comparison of these systems was difficult given the variance in indications (and therefore patient population) and disparate literature.

  5. Aura of technology and the cutting edge: a history of lasers in neurosurgery.

    PubMed

    Ryan, Robert W; Spetzler, Robert F; Preul, Mark C

    2009-09-01

    In this historical review the authors examine the important developments that have led to the availability of laser energy to neurosurgeons as a unique and sometimes invaluable tool. They review the physical science behind the function of lasers, as well as how and when various lasers based on different lasing mediums were discovered. They also follow the close association between advances in laser technology and their application in biomedicine, from early laboratory experiments to the first clinical experiences. Because opinions on the appropriate role of lasers in neurosurgery vary widely, the historical basis for some of these views is explored. Initial enthusiasm for a technology that appears to have innate advantages for safe resections has often given way to the strict limitations and demands of the neurosurgical operating theater. However, numerous creative solutions to improve laser delivery, power, safety, and ergonomics demonstrate the important role that technological advances in related scientific fields continue to offer neurosurgery. Benefiting from the most recent developments in materials science, current CO(2) laser delivery systems provide a useful addition to the neurosurgical armamentarium when applied in the correct circumstances and reflect the important historical advances that come about from the interplay between neurosurgery and technology.

  6. [Radiotherapy for Graves' ophthalmopathy].

    PubMed

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J

    2004-11-01

    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  7. RADIO ALTIMETERS

    DOEpatents

    Bogle, R.W.

    1960-11-22

    A radio ranging device is described which utilizes a superregenerative oscillator having alternate sending and receiving phases with an intervening ranging interval between said phases, means for varying said ranging interval, means responsive to an on-range noise reduction condition for stopping said means for varying the ranging interval and indicating means coupled to the ranging interval varying means and calibrated in accordance with one-half the product of the ranging interval times the velocity of light whereby the range is indicated.

  8. Radiotherapy for bone pain.

    PubMed Central

    Needham, P R; Mithal, N P; Hoskin, P J

    1994-01-01

    Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). Thirty-one per cent of the patients were aged 70 or over. The treatment of 97 of these patients was assessed. They had a total of 280 sites treated over the course of their disease. Fifty-nine per cent of sites treated received a fractionated course of radiotherapy. Site significantly influenced fractionation. Overall response rates of 82% were achieved. Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation. PMID:7523672

  9. Melanoma: Last call for radiotherapy.

    PubMed

    Espenel, Sophie; Vallard, Alexis; Rancoule, Chloé; Garcia, Max-Adrien; Guy, Jean-Baptiste; Chargari, Cyrus; Deutsch, Eric; Magné, Nicolas

    2017-02-01

    Melanoma is traditionally considered to be a radioresistant tumor. However, radiotherapy and immunotherapy latest developments might upset this radiobiological dogma. Stereotactic radiotherapy allows high dose per fraction delivery, with high dose rate. More DNA lethal damages, less sublethal damages reparation, endothelial cell apoptosis, and finally clonogenic cell dysfunction are produced, resulting in improved local control. Radiotherapy can also enhance immune responses, inducing neoantigens formation, tumor antigen presentation, and cytokines release. A synergic effect of radiotherapy with immunotherapy is expected, and might lead to abscopal effects. If hadrontherapy biological properties seem able to suppress hypoxia-induced radioresistance and increase biological efficacy, ballistic advantages over photon radiations might also improve radiotherapy outcomes on usually poor prognosis locations. The present review addresses biological and clinical effects of high fraction dose, bystander effect, abscopal effect, and hadrontherapy features in melanoma. Clinical trials results are warranted to establish indications of innovative radiotherapy in melanoma.

  10. Accident prevention in radiotherapy

    PubMed Central

    Holmberg, O

    2007-01-01

    In order to prevent accidents in radiotherapy, it is important to learn from accidents that have occurred previously. Lessons learned from a number of accidents are summarised and underlying patterns are looked for in this paper. Accidents can be prevented by applying several safety layers of preventive actions. Categories of these preventive actions are discussed together with specific actions belonging to each category of safety layer. PMID:21614274

  11. [Radiotherapy of bladder cancer].

    PubMed

    Riou, O; Chauvet, B; Lagrange, J-L; Martin, P; Llacer Moscardo, C; Charissoux, M; Lauche, O; Aillères, N; Fenoglietto, P; Azria, D

    2016-09-01

    Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.

  12. Radiotherapy DICOM packet sniffing.

    PubMed

    Ackerly, T; Gesoand, M; Smith, R

    2008-09-01

    The Digital Imaging and Communications in Medicine (DICOM) standard is meant to allow communication of medical images between equipment provided by different vendors, but when two applications do not interact correctly in a multi-vendor environment it is often first necessary to demonstrate non-compliance of either the sender or the receiver before a resolution to the problem can be progressed. Sometimes the only way to do this is to monitor the network communication between the two applications to find out which one is not complying with the DICOM standard. Packet sniffing is a technique of network traffic analysis by passive observation of all information transiting a point on the network, regardless of the specified sender or receiver. DICOM packet sniffing traps and interprets the network communication between two DICOM applications to determine which is non compliant. This is illustrated with reference to three examples, a radiotherapy planning system unable to receive CT data from a particular CT scanner, a radiotherapy simulator unable to print correctly on a DICOM printer, and a PACS unable to respond when queried about what images it has in its archive by a radiotherapy treatment planning system. Additionally in this work it has been proven that it is feasible to extract DICOM images from the intercepted network data. This process can be applied to determine the cause of a DICOM image being rendered differently by the sender and the receiver.

  13. Imaging in radiotherapy.

    PubMed

    Van den Berge, D L; De Ridder, M; Storme, G A

    2000-10-01

    Radiotherapy, more then any other treatment modality, relies heavily and often exclusively on medical imaging to determine the extent of disease and the spatial relation between target region and neighbouring healthy tissues. Radically new approaches to radiation delivery are inspired on CT scanning and treat patients in a slice-by-slice fashion using intensity modulated megavoltage fan beams. For quality assurance of complex 3-D dose distributions, MR based 3-D verificative dosimetry on irradiated phantoms has been described. As treatment delivery becomes increasingly refined, the need for accurate target definition increases as well and sophisticated imaging tools like image fusion and 3-D reconstruction are routinely used for treatment planning. While in the past patients were positioned on the treatment machines based exclusively on surface topography and the well-known skin marks, such approach is no longer sufficient for high-accuracy radiotherapy and special imaging tools like on-line portal imaging are used to verify and correct target positioning. Much of these applications rely on digital image processing, transmission and storage, and the development of standards, like DICOM and PACS have greatly contributed to these applications. Digital imaging plays an increasing role in many areas in radiotherapy and has been fundamental in new developments that have demonstrated impact on patient care.

  14. [Radiotherapy for primary lung carcinoma].

    PubMed

    Giraud, P; Lacornerie, T; Mornex, F

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy, for primary lung carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  15. Radio Jove: Jupiter Radio Astronomy for Citizens

    NASA Astrophysics Data System (ADS)

    Higgins, Charles; Thieman, J. R.; Flagg, R.; Reyes, F. J.; Sky, J.; Greenman, W.; Brown, J.; Typinski, D.; Ashcraft, T.; Mount, A.

    2014-01-01

    Radio JOVE is a hands-on educational activity that brings the radio sounds of the Sun, Jupiter, the Milky Way Galaxy, and terrestrial radio noise to students, teachers, and the general public. Participants may build a simple radio telescope kit, make scientific observations, and interact with professional radio observatories in real-time over the Internet. Our website (http://radiojove.gsfc.nasa.gov) includes science information, construction manuals, observing guides, and education resources for teachers and students. Radio Jove is continually expanding its participants with over 1800 kits sold to more than 70 countries worldwide. Recently some of our most dedicated observers have upgraded their Radio Jove antennas to semi-professional observatories. We have spectrographs and wide band antennas, some with 8 MHz bandwidth and some with dual polarization capabilities. In an effort to add to the science literature, these observers are coordinating their efforts to pursue some basic questions about Jupiter’s radio emissions (radio source locations, spectral structure, long term changes, etc.). We can compare signal and ionosphere variations using the many Radio Jove observers at different locations. Observers are also working with members of the Long Wavelength Array Station 1 (LWA1) radio telescope to coordinate observations of Jupiter; Radio Jove is planning to make coordinated observations while the Juno Mission is active beginning in 2015. The Radio Jove program is overviewed, its hardware and software are highlighted, recent sample observations are shown, and we demonstrate that we are capable of real citizen science.

  16. Intensified autophagy compromises the efficacy of radiotherapy against prostate cancer

    SciTech Connect

    Koukourakis, Michael I.

    2015-05-29

    Introduction: Radiotherapy is an equivalent alternative or complement to radical prostatectomy, with high therapeutic efficacy. High risk patients, however, experience high relapse rates, so that research on radio-sensitization is the most evident route to improve curability of this common disease. Materials and methods: In the current study we investigated the autophagic activity in a series of patients with localized prostate tumors treated with radical radiotherapy, using the LC3A and the LAMP2a proteins as markers of autophagosome and lysosome cellular content, respectively. The role of autophagy on prostate cancer cell line resistance to radiation was also examined. Results: Using confocal microscopy on tissue biopsies, we showed that prostate cancer cells have, overall, high levels of LC3A and low levels of LAMP2a compared to normal prostate glands. Tumors with a ‘highLC3A/lowLAMP2a’ phenotype, suggestive of intensified lysosomal consumption, had a significantly poorer biochemical relapse free survival. The PC3 radioresistant cell line sustained remarkably its autophagic flux ability after radiation, while the DU145 radiosensitive one experiences a prolonged blockage of the autophagic process. This was assessed with aggresome accumulation detection and LC3A/LAMP2a double immunofluorescence, as well as with sequestrosome/p62 protein detection. By silencing the LC3A or LAMP2a expression, both cell lines became more sensitive to escalated doses of radiation. Conclusions: High base line autophagy activity and cell ability to sustain functional autophagy define resistance of prostate cancer cells to radiotherapy. This can be reversed by blocking up-regulated components of the autophagy pathway, which may prove of importance in the field of clinical radiotherapy. - Highlights: • High LC3A and low LAMP2a levels is a frequent expression pattern of prostate carcinoma. • This pattern of intensified autophagic flux relates with high relapse rates after

  17. Learning radio astronomy by doing radio astronomy

    NASA Astrophysics Data System (ADS)

    Vaquerizo Gallego, J. A.

    2011-11-01

    PARTNeR (Proyecto Académico con el Radio Telescopio de NASA en Robledo, Academic Project with the NASA Radio Telescope at Robledo) is an educational program that allows high school and undergraduate students to control a 34 meter radio telescope and conduct radio astronomical observations via the internet. High-school teachers who join the project take a course to learn about the science of radio astronomy and how to use the antenna as an educational resource. Also, teachers are provided with learning activities they can do with their students and focused on the classroom implementation of the project within an interdisciplinary framework. PARTNeR provides students with firsthand experience in radio astronomy science. Thus, remote radio astronomical observations allow students to learn with a first rate scientific equipment the basics of radio astronomy research, aiming to arouse scientific careers and positive attitudes toward science. In this contribution we show the current observational programs and some recent results.

  18. [Proposal for radio-oncologic needs planning].

    PubMed

    Sauer, R

    1986-10-01

    The demand planning for radio-oncologic treatment considers the population density and structure of the region served by the hospital, the geographic conditions of this region, the medical prescriptions of the hospital institution, the incidence of cancer, the part of radiotherapy in the treatment of the tumor, hospital-specific factors and, finally, the minimum requirements for technical equipment and staff of a radiotherapeutic functional unit. The most important factors are certainly the incidence of cancer and the number of tumor patients actually receiving a radiotherapy. For the Federal Republic of Germany, an incidence of annually 300 to 320 new cancers per 100,000 inhabitants is determined, based on the mortality statistics of the Federal Republic of Germany, England, Wales and Norway as well as the cancer incidence statistics of Hamburg, Baden-Württemberg, Saarland and the very reliable registers of Scandinavia and the German Democratic Republic. The part of radiotherapy is probably between 32 and 35% of primary treatments, repeated treatments must be added. With respect to technical equipment and staff, some minimum requirements have to be fulfilled by a radiotherapeutic functional unit if its work shall be satisfactory in the medical and economical domain. A concentration of radiotherapeutic resources is recommended. The number of beds required for a radio-oncologic hospital applying modern techniques and combined methods is 40 to 45% of the number of patients irradiated per day. A three-category system for radio-oncologic treatment is presented. Future planning, however, should only be based on two categories.

  19. German Emergency Care in Neurosurgery and Military Neurology during World War II, 1939-1945.

    PubMed

    Stahnisch, Frank W

    2016-01-01

    A critical analysis of the historical involvement of neurology and neurosurgery in military emergency care services enables us to better contextualize and appreciate the development of modern neurology at large. Wartime neurosurgery and civil brain science during the German Nazi period tightly coalesced in examining the specific injury types, which military neurosurgeons such as Wilhelm Toennis, Klaus Joachim Zuelch, and Georg Merrem encountered and treated based on their neurophysiological understanding gained from earlier peacetime research. Collaborative associations with Dr. Toennis in particular proved to be highly beneficial to other military neurologists and neurosurgeons during World War II and beyond. This article also discusses the prewar developments and considers the fate of German neurosurgeons and military neurologists after the war. The envisaged dynamic concepts of fast action, reaction, and recycling, which contemporary physicians had intensively studied in the preceding scientific experiments in their neurophysiological laboratories, had already been introduced into neurological surgery during the interwar period. In retrospect, World War II emergency rescue units greatly strengthened military operations through an active process of 'recycling' indispensable army personnel. Neurosurgical emergency chains thereby introduced another decisive step in the modernization of warfare, in that they increased the momentum of military mobility in the field. Notwithstanding the violence of warfare and the often inhumane ways in which such knowledge in the field of emergency neurology was gained, the protagonists among the group of experts in military neurology and neurosurgery strongly contributed to the postwar clinical neuroscience community in Germany. In differing political pretexts, this became visible in both East Germany and West Germany after the war, while the specific military and political conditions under which this knowledge of emergency medicine

  20. Hand-tool-tissue interaction forces in neurosurgery for haptic rendering.

    PubMed

    Aggravi, Marco; De Momi, Elena; DiMeco, Francesco; Cardinale, Francesco; Casaceli, Giuseppe; Riva, Marco; Ferrigno, Giancarlo; Prattichizzo, Domenico

    2016-08-01

    Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives. This work focuses on checking whether the interaction forces during a bench model neurosurgery operation can lie in the solely cutaneous perception of the human finger pads. If this assumption is found true, it would be possible to exploit sensory subtraction techniques for providing surgeons with feedback from neurosurgery. We measured the forces exerted to surgical tools by three neurosurgeons performing typical actions on a brain phantom, using contact force sensors, while the forces exerted by the tools to the phantom tissue were recorded using a load cell placed under the brain phantom box. The measured surgeon-tool contact forces were 0.01-3.49 N for the thumb and 0.01-6.6 N for index and middle finger, whereas the measured tool-tissue interaction forces were from six to 11 times smaller than the contact forces, i.e., 0.01-0.59 N. The measurements for the contact forces fit the range of the cutaneous sensitivity for the human finger pad; thus, we can say that, in a tele-operated robotic neurosurgery scenario, it would possible to render forces at the fingertip level by conveying haptic cues solely through the cutaneous channel of the surgeon's finger pads. This approach would allow high transparency and high stability of the haptic feedback loop in a tele-operation system.

  1. Radiotherapy in the UK

    SciTech Connect

    Ramsay, S.

    1993-10-09

    What is wrong with radiation treatment in the UK Is it bad practice or merely bad publicity Between 1982 and 1991, 1,000 patients receiving isocentric radiation therapy at the North Staffordshire Royal Infirmary received a substantial underdose of radiation; the clinical report on this incident was published last week. The operator had been using a correction factor for tumor-to-skin distance, unaware that this factor had already been applied by the computer system. Although the report pointed out that it is not surprising that the clinicians were not alerted to the undertreatment, is also noted that there were no resources at the hospital to audit the outcome of radiotherapy.

  2. [Radiotherapy during pregnancy].

    PubMed

    Mazeron, R; Barillot, I; Mornex, F; Giraud, P

    2016-09-01

    The diagnostic of cancer during pregnancy is a rare and delicate situation. As the developments of the embryo and the human fetus are extremely sensitive to ionizing radiations, the treatment of these tumors should be discussed. The studies - preclinical and clinical - based mostly on exposure accidents show that subdiaphragmatic treatments are possible during pregnancy. When radiotherapy is used, phantom estimations of the dose to the fetus, confirmed by in vivo measurements are required. Irradiation and imaging techniques should be arranged to decrease as much as possible the dose delivered to the fetus and hold below the threshold of 0.1Gy.

  3. Computational Modeling for Enhancing Soft Tissue Image Guided Surgery: An Application in Neurosurgery

    PubMed Central

    Miga, Michael I.

    2016-01-01

    With the recent advances in computing, the opportunities to translate computational models to more integrated roles in patient treatment are expanding at an exciting rate. One area of considerable development has been directed towards correcting soft tissue deformation within image guided neurosurgery applications. This review captures the efforts that have been undertaken towards enhancing neuronavigation by the integration of soft tissue biomechanical models, imaging and sensing technologies, and algorithmic developments. In addition, the review speaks to the evolving role of modeling frameworks within surgery and concludes with some future directions beyond neurosurgical applications. PMID:26354118

  4. Trends and importance of radiosurgery for the development of functional neurosurgery

    PubMed Central

    Kondziolka, Douglas; Flickinger, John C.; Niranjan, Ajay; Lunsford, L. Dade

    2012-01-01

    Functional neurosurgery includes surgery conducted to ablate, augment, or modulate targets that lead to improvement in neurological function or behavior. Surgical approaches for this purpose include destructive lesioning with different mechanical or biologic agents or energy sources, non-destructive electrical modulation, and cellular or chemical augmentation. Our purpose was to review the role of stereotactic radiosurgery used for functional indications and to discuss future applications and potential techniques. Imaging and neurophysiological research will enable surgeons to consider new targets and circuits that may be clinically important. Radiosurgery is one minimal access approach to those targets. PMID:22826808

  5. Innovation in Neurosurgery: Intellectual Property Strategy and Academia/Industrial Collaboration.

    PubMed

    Murayama, Yuichi

    2016-09-15

    Neurosurgery has tremendous possibilities for development of innovative medical devices. However, most of the neurosurgical devices used in Japan are imported products. Promotion and development of domestic medical devices is highly encouraged and it is one of the pillars of Prime Minister Shinzo Abe's growth strategy of Japanese economy. Innovative "Made in Japan" medical devices can be developed by interdisciplinary collaboration between industries and academic institutions. Proper orientation of medical and engineering education, social and administrative awareness of the need of facilitating the medical devices creative process with corresponding regulatory changes, and appropriate medical and technological infrastructure establishment are needed for stimulating medical device innovation.

  6. History of Neurosurgery at Postgraduate Institute of Medical Education and Research, Chandigarh.

    PubMed

    Gupta, Sunil K; Mukherjee, Kanchan K; Chhabra, Rajesh; Tripathi, Manjul

    2017-01-01

    The Department of Neurosurgery started functioning at the Postgraduate Institute of Medical Education and Research, Chandigarh in 1962 with the joining of Dr. Gulati. The department provides neurosurgical services primarily to the people of Chandigarh, Punjab, Haryana, Himachal Pradesh, Jammu and Kashmir as well as the neighbouring areas of Rajasthan, Uttar Pradesh and Uttarakhand. The infrastructure and subspecialties have been developed over the last 5 decades by the dedicated and tireless efforts of the faculty and residents. We attempt to chronicle the contributions of those who have served the department in the past.

  7. Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.

    PubMed

    Hansen, Daniel; Vedantam, Aditya; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

    2016-10-01

    OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1

  8. Innovation in Neurosurgery: Intellectual Property Strategy and Academia/Industrial Collaboration

    PubMed Central

    MURAYAMA, Yuichi

    2016-01-01

    Neurosurgery has tremendous possibilities for development of innovative medical devices. However, most of the neurosurgical devices used in Japan are imported products. Promotion and development of domestic medical devices is highly encouraged and it is one of the pillars of Prime Minister Shinzo Abe’s growth strategy of Japanese economy. Innovative “Made in Japan” medical devices can be developed by interdisciplinary collaboration between industries and academic institutions. Proper orientation of medical and engineering education, social and administrative awareness of the need of facilitating the medical devices creative process with corresponding regulatory changes, and appropriate medical and technological infrastructure establishment are needed for stimulating medical device innovation. PMID:27298262

  9. [The processing of point clouds for brain deformation existing in image guided neurosurgery system].

    PubMed

    Yao, Xufeng; Lin, Yixun; Song, Zhijian

    2008-08-01

    The finite element method (FEM) plays an important role in solving the brain deformation problem in the image guided neurosurgery system. The position of the brain cortex during the surgery provides the boundary condition for the FEM model. In this paper, the information of brain cortex is represented by the unstructured points and the boundary condition is achieved by the processing of unstructured points. The processing includes the mapping of texture, segmentation, simplification and denoising. The method of k-nearest clustering based on local surface properties is used to simplify and denoise the unstructured point clouds. The results of experiment prove the efficiency of point clouds processing.

  10. Objective skill analysis and assessment in neurosurgery by using an ultra-miniaturized inertial measurement unit WB-3--pilot tests.

    PubMed

    Lin, Z; Zecca, M; Sessa, S; Sasaki, T; Suzuki, T; Itoh, K; Iseki, H; Takanishi, A

    2009-01-01

    In recent years there has been an ever increasing amount of research and development of technologies and methods to improve the quality and the performance of advanced surgery. In several fields, such as laparoscopy, various training methods and metrics have been proposed, both to improve the surgeon's abilities and also to assess her/his skills. For neurosurgery, however, the extremely small movements and target operating space involved have prevented until now the development of similar methodologies and systems. In this paper we present the development of an ultra-miniaturized Inertial Measurement Unit (IMU) and its application for neurosurgery skill assessment in a simple pick and place scenario. This analysis is a preliminary yet fundamental step to realize a better training/evaluation system for neurosurgeons, and to objectively evaluate and understand how the neurosurgery is performed.

  11. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery.

    PubMed

    Baskaran, Vivek; Štrkalj, Goran; Štrkalj, Mirjana; Di Ieva, Antonio

    2016-01-01

    3D printing is a form of rapid prototyping technology, which has led to innovative new applications in biomedicine. It facilitates the production of highly accurate three dimensional objects from substrate materials. The inherent accuracy and other properties of 3D printing have allowed it to have exciting applications in anatomy education and surgery, with the specialty of neurosurgery having benefited particularly well. This article presents the findings of a literature review of the Pubmed and Web of Science databases investigating the applications of 3D printing in anatomy and surgical education, and neurosurgery. A number of applications within these fields were found, with many significantly improving the quality of anatomy and surgical education, and the practice of neurosurgery. They also offered advantages over existing approaches and practices. It is envisaged that the number of useful applications will rise in the coming years, particularly as the costs of this technology decrease and its uptake rises.

  12. Current Applications and Future Perspectives of the Use of 3D Printing in Anatomical Training and Neurosurgery

    PubMed Central

    Baskaran, Vivek; Štrkalj, Goran; Štrkalj, Mirjana; Di Ieva, Antonio

    2016-01-01

    3D printing is a form of rapid prototyping technology, which has led to innovative new applications in biomedicine. It facilitates the production of highly accurate three dimensional objects from substrate materials. The inherent accuracy and other properties of 3D printing have allowed it to have exciting applications in anatomy education and surgery, with the specialty of neurosurgery having benefited particularly well. This article presents the findings of a literature review of the Pubmed and Web of Science databases investigating the applications of 3D printing in anatomy and surgical education, and neurosurgery. A number of applications within these fields were found, with many significantly improving the quality of anatomy and surgical education, and the practice of neurosurgery. They also offered advantages over existing approaches and practices. It is envisaged that the number of useful applications will rise in the coming years, particularly as the costs of this technology decrease and its uptake rises. PMID:27445707

  13. The Radio Amateur's Handbook.

    ERIC Educational Resources Information Center

    Blakeslee, Douglas, Ed.

    The objectives of this basic reference work for the radio amateur are to present radio theory and practice in terms of application and to reflect both the fundamentals and the rapidly-advancing technology of radio communications so that the radio amateur will have a guide to what is practical, meaningful, proven, and useful. Twenty-three chapters…

  14. The Frequency Spectrum Radio.

    ERIC Educational Resources Information Center

    Howkins, John, Ed.

    1979-01-01

    This journal issue focuses on the frequency spectrum used in radio communication and on the World Administrative Radio Conference, sponsored by the International Telecommunication Union, held in Geneva, Switzerland, in the fall of 1979. Articles describe the World Administrative Radio Conference as the most important radio communication conference…

  15. Imaging in radiotherapy

    NASA Astrophysics Data System (ADS)

    Calandrino, R.; Del Maschio, A.; Cattaneo, G. M.; Castiglioni, I.

    2009-09-01

    The diagnostic methodologies used for the radiotherapy planning have undergone great developments in the last 30 years. Since the 1980s, after the introduction of the CT scanner, the modality for the planning moved beyond the planar 2D assessment to approach a real and more realistic volumetric 3D definition. Consequently the dose distribution, previously obtained by means of an overly simple approximation, became increasingly complex, better tailoring the true shape of the tumour. The final therapeutic improvement has been obtained by a parallel increase in the complexity of the irradiating units: the Linacs for therapy have, in fact, been equipped with a full accessory set capable to modulate the fluence (IMRT) and to check the correct target position continuously during the therapy session (IMRT-IGRT). The multimodal diagnostic approach, which integrates diagnostic information, from images of the patient taken with CT, NMR, PET and US, further improves the data for a biological and topological optimization of the radiotherapy plan and consequently of the dose distribution in the Planning Target Volume. Proteomic and genomic analysis will be the next step in tumour diagnosis. These methods will provide the planners with further information, for a true personalization of the treatment regimen and the assessment of the predictive essays for each tumour and each patient.

  16. Fertility impairment in radiotherapy

    PubMed Central

    Kuźba-Kryszak, Tamara; Nowikiewicz, Tomasz; Żyromska, Agnieszka

    2016-01-01

    Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patient's sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning. PMID:27647982

  17. [Hodgkin's lymphoma and radiotherapy].

    PubMed

    Datsenko, P V; Panshin, G A

    2015-01-01

    After a median observation time of 4,5 years, 440 patients with Hodgkin's lymphoma stage I-IV to the Ann Arbor classification were treated with radiotherapy (2200 lymph areas) and ABVD (n=204) or BEACOPP (n=117) or CEA/ABVD (lomustine, etoposide, adriamycine, bleomycine, vinblastine and dacarbacine; n=119) regimens in 1995-2012. Correct allocation of groups with "CR or PR ≥80%" and "PR: 0-79%", after first-line chemotherapy, is extremely important for following RT planning. Adaptation of patients with Hodgkin's lymphoma can take place only after successful treatment, the probability of relapse and fear of repeated courses strongly interfere with this process, especially in the first years after its closure. Duration of remission period, especially in young people, is no less important than the criteria for overall survival. It is impossible to build recommendations for treatment for Hodgkin's lymphoma, based only on long-term survival rates. Importance of radiotherapy in reducing the number of relapses is undeniable, so the idea that the development of the role of chemotherapy in the treatment of the ray method Hodgkin's lymphoma gradually becomes secondary is in serious doubt. Our findings suggest the importance of both maintaining a high disease-free survival and reducing long-term complications in designing treatments of Hodgkin's lymphoma.

  18. From the Idea to Its Realization: The Evolution of Minimally Invasive Techniques in Neurosurgery

    PubMed Central

    Grunert, P.

    2013-01-01

    Minimally invasive techniques in neurosurgery evolved in two steps. Many minimally invasive concepts like neuronavigation, endoscopy, or frame based stereotaxy were developed by the pioneers of neurosurgery, but it took decades till further technical developments made the realization and broad clinical application of these early ideas safe and possible. This thesis will be demonstrated by giving examples of the evolution of four minimally invasive techiques: neuronavigation, transsphenoidal pituitary surgery, neuroendoscopy and stereotaxy. The reasons for their early failure and also the crucial steps for the rediscovery of these minimally invasive techniques will be analysed. In the 80th of the 20th century endoscopy became increasingly applied in different surgical fields. The abdominal surgeons coined as first for their endoscopic procedures the term minimally invasive surgery in contrast to open surgery. In neurrosurgery the term minimally invasive surgery stood not in opposiotion to open procedures but was understood as a general concept and philosophy using the modern technology such as neuronavigation, endoscopy and planing computer workstations with the aim to make the procedures less traumatic. PMID:24455231

  19. Schizophrenia and neurosurgery: A dark past with hope of a brighter future.

    PubMed

    Agarwal, Prateek; Sarris, Christina E; Herschman, Yehuda; Agarwal, Nitin; Mammis, Antonios

    2016-12-01

    Schizophrenia is a chronic and progressive psychiatric disease that remains difficult to manage in the 21st century. Current medical therapies have been able to give reprieve and decrease incidence of psychotic episodes. However, as the disease progresses, patients can become ever more refractory to current pharmaceutical agents and the polypharmacy that is attempted in treatment. Additionally, many of these drugs have significant adverse effects, leaving the practitioner in a difficult predicament for treating these patients. The history of neurosurgery for schizophrenia, among other psychiatric diseases, has a very dark past. Therefore, this review examines peer-reviewed studies on the history of schizophrenia, its medical and surgical therapies, financial costs, and future directions for disease management. We highlight the historically poor relationship between neurosurgery and psychiatric disease and discuss current research in the understandings of schizophrenia. Guided by a strong code of ethics and new technology, including the use of stereotaxis and deep brain stimulation (DBS), the medical communities treating psychiatric disease are beginning to overcome the horrors of the past. DBS is currently being used with moderate success in the treatment of depression, obsessive compulsive disorder, Tourette's syndrome, and anorexia nervosa. With greater understanding of the neural circuitry of schizophrenia and the evolving role for DBS in psychiatric disease, the authors believe that schizophrenia, like other psychiatric diseases, can be treated with DBS.

  20. Josef Klingler's models of white matter tracts: influences on neuroanatomy, neurosurgery, and neuroimaging.

    PubMed

    Agrawal, Abhishek; Kapfhammer, Josef P; Kress, Annetrudi; Wichers, Hermann; Deep, Aman; Feindel, William; Sonntag, Volker K H; Spetzler, Robert F; Preul, Mark C

    2011-08-01

    During the 1930s, white matter tracts began to assume relevance for neurosurgery, especially after Cajal's work. In many reviews of white matter neurobiology, the seminal contributions of Josef Klingler (1888-1963) and their neurological applications have been overlooked. In 1934 at the University of Basel under Eugen Ludwig, Klingler developed a new method of dissection based on a freezing technique for brain tissue that eloquently revealed the white matter tracts. Klingler worked with anatomists, surgeons, and other scientists, and his models and dissections of white matter tracts remain arguably the most elegant ever created. He stressed 3-dimensional anatomic relationships and laid the foundation for defining mesial temporal, limbic, insular, and thalamic fiber and functional relationships and contributed to the potential of stereotactic neurosurgery. Around 1947, Klingler was part of a Swiss-German group that independently performed the first stereotactic thalamotomies, basing their targeting and logic on Klingler's white matter studies, describing various applications of stereotaxy and showing Klingler's work integrated into a craniocerebral topographic system for targeting with external localization of eloquent brain structures and stimulation of deep thalamic nuclei. Klingler's work has received renewed interest because it is applicable for correlating the results of the fiber-mapping paradigms from diffusion tensor imaging to actual anatomic evidence. Although others have described white matter tracts, none have had as much practical impact on neuroscience as Klinger's work. More importantly, Josef Klingler was an encouraging mentor, influencing neurosurgeons, neuroscientists, and brain imaging for more than three quarters of a century.

  1. Preventable and Potentially Preventable Traumatic Death Rates in Neurosurgery Department: A Single Center Experience

    PubMed Central

    Ha, Mahnjeong; Kim, Byung Chul; Choi, Seonuoo; Cho, Won Ho

    2016-01-01

    Objective Preventable and potentially preventable traumatic death rates is a method to evaluate the preventability of the traumatic deaths in emergency medical department. To evaluate the preventability of the traumatic deaths in patients who were admitted to neurosurgery department, we performed this study. Methods A retrospective review identified 52 patients who admitted to neurosurgery department with severe traumatic brain injuries between 2013 and 2014. Based on radiologic and clinical state at emergency room, each preventability of death was estimated by professional panel discussion. And the final death rates were calculated. Results The preventable and potentially preventable traumatic death rates was 19.2% in this study. This result is lower than that of the research of 2012, Korean preventable and potentially preventable traumatic death rates. The rate of preventable and potentially preventable traumatic death of operation group is lower than that of conservative treatment group. Also, we confirmed that direct transfer and the time to operation are important to reduce the preventability. Conclusion We report the preventable and potentially preventable traumatic death rates of our institute for evaluation of preventability in severe traumatic brain injuries during the last 2 years. For decrease of preventable death, we suggest that continuous survey of the death rate of traumatic brain injury patients is required. PMID:27857910

  2. Assessing residents' operative skills for external ventricular drain placement and shunt surgery in pediatric neurosurgery.

    PubMed

    Aldave, Guillermo; Hansen, Daniel; Briceño, Valentina; Luerssen, Thomas G; Jea, Andrew

    2017-01-27

    OBJECTIVE The authors previously demonstrated the use of a validated Objective Structured Assessment of Technical Skills (OSATS) tool for evaluating residents' operative skills in pediatric neurosurgery. However, no benchmarks have been established for specific pediatric procedures despite an increased need for meaningful assessments that can either allow for early intervention for underperforming trainees or allow for proficient residents to progress to conducting operations independently with more passive supervision. This validated methodology and tool for assessment of operative skills for common pediatric neurosurgical procedures-external ventricular drain (EVD) placement and shunt surgery- was applied to establish its procedure-based feasibility and reliability, and to document the effect of repetition on achieving surgical skill proficiency in pediatric EVD placement and shunt surgery. METHODS A procedure-based technical skills assessment for EVD placements and shunt surgeries in pediatric neurosurgery was established through the use of task analysis. The authors enrolled all residents from 3 training programs (Baylor College of Medicine, Houston Methodist Hospital, and University of Texas-Medical Branch) who rotated through pediatric neurosurgery at Texas Children's Hospital over a 26-month period. For each EVD placement or shunt procedure performed with a resident, the faculty and resident (for self-assessment) completed an evaluation form (OSATS) based on a 5-point Likert scale with 7 categories. Data forms were then grouped according to faculty versus resident (self) assessment, length of pediatric neurosurgery rotation, postgraduate year level, and date of evaluation ("beginning of rotation," within 1 month of start date; "end of rotation," within 1 month of completion date; or "middle of rotation"). Descriptive statistical analyses were performed with the commercially available SPSS statistical software package. A p value < 0.05 was considered

  3. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Plus Sufentanil Infusion during Neurosurgery: A Retrospective Study

    PubMed Central

    Su, Shiyu; Ren, Chunguang; Zhang, Hongquan; Liu, Zhong; Zhang, Zongwang

    2016-01-01

    Background: Approximately 60% of patients experience moderate-to-severe pain after neurosurgery, which primarily occurs in the first 24–72 h. Despite this, improved postoperative analgesia solutions after neurosurgery have not yet been devised. This retrospective study was conducted to evaluate the effect of intra- and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the quality of postoperative analgesia in patients undergoing neurosurgery. Methods: One hundred and sixty-three post-neurosurgery patients were divided into two groups: Group D (DEX infusion at 0.5 μg·kg−1 for 10 min, then adjusted to 0.3 μg·kg−1·h−1 until incision suturing) and Group ND (no DEX infusion during surgery). Patient-controlled analgesia was administered for 72 h after surgery (Group D: sufentanil 0.02 μg·kg−1·h−1 plus DEX 0.02 μg·kg−1·h−1, Group ND: sufentanil 0.02 μg·kg−1·h−1) in this retrospective study. The primary outcome measure was postoperative sufentanil consumption. Hemodynamics, requirement of narcotic, and vasoactive drugs, recovery time and the incidence of concerning adverse effects were recorded. Pain intensity [Visual Analogue Scale (VAS)], Ramsay sedation scale (RSS) and Bruggemann comfort scale (BCS) were also evaluated at 1, 4, 8, 12, 24, 48, and 72 h after surgery. Results: Postoperative sufentanil consumption was significantly lower in Group D during the first 72 h after surgery (P < 0.05). Compared with Group ND, heart rate (HR) in Group D was significantly decreased from intubation to 20 min after arriving at post anesthesia care unit (PACU), while mean arterial pressure (MAP) in Group D was significantly decreased from intubation to 5 min after arriving at PACU (P < 0.05). The intraoperative requirements for sevoflurane, remifentanil, and fentanyl were approximately 35% less in Group D compared with Group ND. VAS at rest at 1, 4, and 8 h and with cough at 12, 24, 48, and 72 h after surgery were significantly

  4. Radiotherapy in Phyllodes Tumour

    PubMed Central

    Sasidharan, Balukrishna; Manipadam, Marie Therese; Paul, M J; Backianathan, Selvamani

    2017-01-01

    Introduction Phyllodes Tumour (PT) of the breast is a relatively rare breast neoplasm (<1%) with diverse range of pathology and biological behaviour. Aim To describe the clinical course of PT and to define the role of Radiotherapy (RT) in PT of the breast. Materials and Methods Retrospective analysis of hospital data of patients with PT presented from 2005 to 2014 was done. Descriptive statistics was used to analyze the results. Simple description of data was done in this study. Age and duration of symptoms were expressed in median and range. Percentages, tables and general discussions were used to understand the meaning of the data analyzed. Results Out of the 98 patients, 92 were eligible for analysis. The median age of presentation was 43 years. A total of 64/92 patients were premenopausal. There was no side predilection for this tumour but 57/92 patients presented as an upper outer quadrant lump. Fifty percent of the patients presented as giant (10 cm) PT. The median duration of symptoms was 12 months (range: 1-168 months). A 60% of patients had Benign (B), 23% had Borderline (BL) and 17% had malignant (M) tumours. The surgical treatment for benign histology included Lumpectomy (L) for 15%, Wide Local Excision (WLE) for 48%, and Simple Mastectomy (SM) for 37%. All BL and M tumours were treated with WLE or SM. There was no recurrence in B and BL group when the margin was ≥1 cm. All non-metastatic M tumours received adjuvant RT irrespective of their margin status. Total 3/16 patients with M developed local recurrence. Total 6/16 M patients had distant metastases (lung or bone). Our median duration of follow up was 20 months (range: 1-120 months). Conclusion Surgical resection with adequate margins (>1 cm) gave excellent local control in B and BL tumours. For patients with BL PT, local radiotherapy is useful, if margins are close or positive even after the best surgical resection. There is a trend towards improved local control with adjuvant radiotherapy for

  5. [Respiratory synchronization and breast radiotherapy].

    PubMed

    Mège, A; Ziouèche-Mottet, A; Bodez, V; Garcia, R; Arnaud, A; de Rauglaudre, G; Pourel, N; Chauvet, B

    2016-10-01

    Adjuvant radiation therapy following breast cancer surgery continues to improve locoregional control and overall survival. But the success of highly targeted-conformal radiotherapy such as intensity-modulated techniques, can be compromised by respiratory motion. The intrafraction motion can potentially result in significant under- or overdose, and also expose organs at risk. This article summarizes the respiratory motion and its effects on imaging, dose calculation and dose delivery by radiotherapy for breast cancer. We will review the methods of respiratory synchronization available for breast radiotherapy to minimize the respiratory impact and to spare organs such as heart and lung.

  6. [Task sharing with radiotherapy technicians in image-guided radiotherapy].

    PubMed

    Diaz, O; Lorchel, F; Revault, C; Mornex, F

    2013-10-01

    The development of accelerators with on-board imaging systems now allows better target volumes reset at the time of irradiation (image-guided radiotherapy [IGRT]). However, these technological advances in the control of repositioning led to a multiplication of tasks for each actor in radiotherapy and increase the time available for the treatment, whether for radiotherapy technicians or radiation oncologists. As there is currently no explicit regulatory framework governing the use of IGRT, some institutional experiments show that a transfer is possible between radiation oncologists and radiotherapy technicians for on-line verification of image positioning. Initial training for every technical and drafting procedures within institutions will improve audit quality by reducing interindividual variability.

  7. Radio frequency detection assembly and method for detecting radio frequencies

    SciTech Connect

    Cown, Steven H.; Derr, Kurt Warren

    2010-03-16

    A radio frequency detection assembly is described and which includes a radio frequency detector which detects a radio frequency emission produced by a radio frequency emitter from a given location which is remote relative to the radio frequency detector; a location assembly electrically coupled with the radio frequency detector and which is operable to estimate the location of the radio frequency emitter from the radio frequency emission which has been received; and a radio frequency transmitter electrically coupled with the radio frequency detector and the location assembly, and which transmits a radio frequency signal which reports the presence of the radio frequency emitter.

  8. Radiotherapy Planning using MRI

    PubMed Central

    Schmidt, Maria A; Payne, Geoffrey S

    2016-01-01

    The use of Magnetic Resonance Imaging (MRI) in Radiotherapy (RT) planning is rapidly expanding. We review the wide range of image contrast mechanisms available to MRI and the way they are exploited for RT planning. However a number of challenges are also considered: the requirements that MR images are acquired in the RT treatment position, that they are geometrically accurate, that effects of patient motion during the scan are minimised, that tissue markers are clearly demonstrated, that an estimate of electron density can be obtained. These issues are discussed in detail, prior to the consideration of a number of specific clinical applications. This is followed by a brief discussion on the development of real-time MRI-guided RT. PMID:26509844

  9. Radiotherapy on hidradenocarcinoma

    PubMed Central

    Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

    2011-01-01

    Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

  10. [Hepatic tumors and radiotherapy].

    PubMed

    Rio, E; Mornex, F; Peiffert, D; Huertas, A

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT.

  11. [Radiotherapy for nasopharyngeal carcinoma].

    PubMed

    Maingon, P; Blanchard, P; Bidault, F; Calmels, L

    2016-09-01

    Nasapharyngeal carcinoma is a rare disease. Oftenly, the diagnostic is made for advanced disease. Localized tumors, T1 or T2 NO observed a good prognosis and are locally controlled in more than 90 % of the cases by radiotherapy alone. The standard treatment of locally advanced disease is combined chemoradiation. A special vigilance of fast decrease of the volume of the pathological lymph nodes, sometimes associated to loss of weight might indicate an adaptive dosimetric revision. The treatment of recurrent disease is of great importance. Surgical indications are limited but should be discussed in multidisciplinary tumor board when possible. Surgical nodal sampling has to be proposed for nodal recurrence as well as reirradiation, which could be indicated according to the technical issues.

  12. Pion radiotherapy at LAMPF

    SciTech Connect

    Bush, S.E.; Smith, A.R.; Zink, S.

    1982-12-01

    Clinical investigations of pi meson radiotherapy were conducted by the Cancer Research and Treatment Center of the University of New Mexico and the Los Alamos National Laboratory from 1974 until 1982. Two hundred and thirty patients have been treated for a variety of locally advanced primary and metastatic neoplasms. One hundred and ninety-six patients have been followed for a minimum of 18 months. Crude survival data range from 11% for unresectable pancreatic carcinoma to 82% for Stages C and D1 adenocarcinoma of the prostate. Acute tolerance of normal tissues is approximately 4500 pion rad in 36 fractions over 7 weeks. Severe chronic reactions have appeared with increasing frequency after doses in excess of 4000 pion rad.

  13. South Asian Medicinal Compounds as Modulators of Resistance to Chemotherapy and Radiotherapy

    PubMed Central

    Prasad, N. Rajendra; Muthusamy, Ganesan; Shanmugam, Mohana; Ambudkar, Suresh V.

    2016-01-01

    Cancer is a hyperproliferative disorder that involves transformation, dysregulation of apoptosis, proliferation, invasion, angiogenesis and metastasis. During the last 30 years, extensive research has revealed much about the biology of cancer. Chemotherapy and radiotherapy are the mainstays of cancer treatment, particularly for patients who do not respond to surgical resection. However, cancer treatment with drugs or radiation is seriously limited by chemoresistance and radioresistance. Various approaches and strategies are employed to overcome resistance to chemotherapy and radiation treatment. Many plant-derived phytochemicals have been investigated for their chemo- and radio-sensitizing properties. The peoples of South Asian countries such as India, Pakistan, Sri Lanka, Nepal, Bangladesh and Bhutan have a large number of medicinal plants from which they produce various pharmacologically potent secondary metabolites. The medicinal properties of these compounds have been extensively investigated and many of them have been found to sensitize cancer cells to chemo- and radio-therapy. This review focuses on the role of South Asian medicinal compounds in chemo- and radio-sensitizing properties in drug- and radio-resistant cancer cells. Also discussed is the role of South Asian medicinal plants in protecting normal cells from radiation, which may be useful during radiotherapy of tumors to spare surrounding normal cells. PMID:26959063

  14. A neurologist in the origin of European and International neurosurgery: Clovis-Julien-Désiré Vincent (1879-1947).

    PubMed

    Androutsos, G; Karamanou, M; Lymberi, M; Zambelis, T; Stamboulis, E

    2011-01-01

    Vincent Clovis began his carrier as a neurologist and finally became neurosurgeon at an advanced age. He is considered the founder of French neurosurgery, and after Harvey Williams Cushing, Europe's first neurosurgeon. He was mainly interested in pituitary tumors, in cerebral abscesses and in cerebral oedema.

  15. The genesis of neurosurgery and the evolution of the neurosurgical operative environment: part I-prehistory to 2003.

    PubMed

    Liu, Charles Y; Apuzzo, Michael L J

    2003-01-01

    Despite its singular importance, little attention has been given to the neurosurgical operative environment in the scientific and medical literature. This article focuses attention on the development of neurosurgery and the parallel emergence of its operative setting. The operative environment has, to a large extent, defined the "state of the art and science" of neurosurgery, which is now undergoing rapid reinvention. During the course of its initial invention, major milestones in the development of neurosurgery have included the definition of anatomy, consolidation of a scientific basis, and incorporation of the practicalities of anesthesia and antisepsis and later operative technical adjuvants for further refinement of action and minimalism. The progress, previously long and laborious in emergence, is currently undergoing rapid evolution. Throughout its evolution, the discipline has assimilated the most effective tools of modernity into the operative environment, leading eventually to the entity known as the operating room. In the decades leading to the present, progressive minimalization of manipulation and the emergence of more refined operative definition with increasing precision are evident, with concurrent miniaturization of attendant computerized support systems, sensors, robotic interfaces, and imaging devices. These developments over time have led to the invention of neurosurgery and the establishment of the current state-of-the-art neurosurgical operating room as we understand it, and indeed, to a broader definition of the entity itself. To remain current, each neurosurgeon should periodically reconsider his or her personal operative environment and its functional design with reference to modernity of practice as currently defined.

  16. VERO® radiotherapy for low burden cancer: 789 patients with 957 lesions

    PubMed Central

    Orecchia, R; Surgo, A; Muto, M; Ferrari, A; Piperno, G; Gerardi, MA; Comi, S; Garibaldi, C; Ciardo, D; Bazani, A; Golino, F; Pansini, F; Fodor, C; Romanelli, P; Maestri, D; Scroffi, V; Mazza, S; Jereczek-Fossa, BA

    2016-01-01

    Purpose The aim of this retrospective study is to evaluate patient profile, feasibility, and acute toxicity of RadioTherapy (RT) delivered by VERO® in the first 20 months of clinical activity. Methods Inclusion criteria: 1) adult patients; 2) limited volume cancer (M0 or oligometastatic); 3) small extracranial lesions; 4) treatment between April 2012 and December 2013 and 5) written informed consent. Two techniques were employed: intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT). Toxicity was evaluated using Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer (RTOG/EORTC) criteria. Results Between April 2012 and December 2013, 789 consecutive patients (957 lesions) were treated. In 84% of them one lesion was treated and in 16% more than one lesion were treated synchronously/metachronously; first radiotherapy course in 85%, re-irradiation in 13%, and boost in 2% of cases. The treated region included pelvis 46%, thorax 38%, upper abdomen 15%, and neck 1%. Radiotherapy schedules included <5 and >5 fractions in 75% and 25% respectively. All patients completed the planned treatment and an acceptable acute toxicity was observed. Conclusions RT delivered by VERO® was administrated predominantly to thoracic and pelvic lesions (lung and urologic tumours) using hypofractionation. It is a feasible approach for limited burden cancer offering short and well accepted treatment with favourable acute toxicity profile. Further investigation including dose escalation and other available VERO® functionalities such as real-time dynamic tumour tracking is warranted in order to fully evaluate this innovative radiotherapy system. PMID:27729942

  17. Bone Health and Pelvic Radiotherapy.

    PubMed

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice.

  18. From Structure to Circuits: The Contribution of MEG Connectivity Studies to Functional Neurosurgery

    PubMed Central

    Pang, Elizabeth W.; Snead III, O. C.

    2016-01-01

    New advances in structural neuroimaging have revealed the intricate and extensive connections within the brain, data which have informed a number of ambitious projects such as the mapping of the human connectome. Elucidation of the structural connections of the brain, at both the macro and micro levels, promises new perspectives on brain structure and function that could translate into improved outcomes in functional neurosurgery. The understanding of neuronal structural connectivity afforded by these data now offers a vista on the brain, in both healthy and diseased states, that could not be seen with traditional neuroimaging. Concurrent with these developments in structural imaging, a complementary modality called magnetoencephalography (MEG) has been garnering great attention because it too holds promise for being able to shed light on the intricacies of functional brain connectivity. MEG is based upon the elemental principle of physics that an electrical current generates a magnetic field. Hence, MEG uses highly sensitive biomagnetometers to measure extracranial magnetic fields produced by intracellular neuronal currents. Put simply then, MEG is a measure of neurophysiological activity, which captures the magnetic fields generated by synchronized intraneuronal electrical activity. As such, MEG recordings offer exquisite resolution in the time and oscillatory domain and, as well, when co-registered with magnetic resonance imaging (MRI), offer excellent resolution in the spatial domain. Recent advances in MEG computational and graph theoretical methods have led to studies of connectivity in the time-frequency domain. As such, MEG can elucidate a neurophysiological-based functional circuitry that may enhance what is seen with MRI connectivity studies. In particular, MEG may offer additional insight not possible by MRI when used to study complex eloquent function, where the precise timing and coordination of brain areas is critical. This article will review the

  19. The impact of several craniotomies on transcranial motor evoked potential monitoring during neurosurgery.

    PubMed

    Tomio, Ryosuke; Akiyama, Takenori; Toda, Masahiro; Ohira, Takayuki; Yoshida, Kazunari

    2016-10-07

    OBJECTIVE Transcranial motor evoked potential (tMEP) monitoring is popular in neurosurgery; however, the accuracy of tMEP can be impaired by craniotomy. Each craniotomy procedure and changes in the CSF levels affects the current spread. The aim of this study was to investigate the influence of several craniotomies on tMEP monitoring by using C3-4 transcranial electrical stimulation (TES). METHODS The authors used the finite element method to visualize the electric field in the brain, which was generated by TES, using realistic 3D head models developed from T1-weighted MR images. Surfaces of 5 layers of the head (brain, CSF, skull, subcutaneous fat, and skin layer) were separated as accurately as possible. The authors created 5 models of the head, as follows: normal head; frontotemporal craniotomy; parietal craniotomy; temporal craniotomy; and occipital craniotomy. The computer simulation was investigated by finite element methods, and clinical recordings of the stimulation threshold level of upper-extremity tMEP (UE-tMEP) during neurosurgery were also studied in 30 patients to validate the simulation study. RESULTS Bone removal during the craniotomy positively affected the generation of the electric field in the motor cortex if the motor cortex was just under the bone at the margin of the craniotomy window. This finding from the authors' simulation study was consistent with clinical reports of frontotemporal craniotomy cases. A major decrease in CSF levels during an operation had a significantly negative impact on the electric field when the motor cortex was exposed to air. The CSF surface level during neurosurgery depends on the body position and location of the craniotomy. The parietal craniotomy and temporal craniotomy were susceptible to the effect of the changing CSF level, based on the simulation study. A marked increase in the threshold following a decrease in CSF was actually recorded in clinical reports of the UE-tMEP threshold from a temporal craniotomy

  20. The historical origin of the term "meningioma" and the rise of nationalistic neurosurgery.

    PubMed

    Barthélemy, Ernest Joseph; Sarkiss, Christopher A; Lee, James; Shrivastava, Raj K

    2016-11-01

    The historical origin of the meningioma nomenclature unravels interesting social and political aspects about the development of neurosurgery in the late 19th century. The meningioma terminology itself was the subject of nationalistic pride and coincided with the advancement in the rise of medicine in Continental Europe as a professional social enterprise. Progress in naming and understanding these types of tumor was most evident in the nations that successively assumed global leadership in medicine and biomedical science throughout the 19th and 20th centuries, that is, France, Germany, and the United States. In this vignette, the authors delineate the uniqueness of the term "meningioma" as it developed within the historical framework of Continental European concepts of tumor genesis, disease states, and neurosurgery as an emerging discipline culminating in Cushing's Meningiomas text. During the intellectual apogee of the French Enlightenment, Antoine Louis published the first known scientific treatise on meningiomas. Like his father, Jean-Baptiste Louis, Antoine Louis was a renowned military surgeon whose accomplishments were honored with an admission to the Académie royale de chirurgie in 1749. His treatise, Sur les tumeurs fongueuses de la duremère, appeared in 1774. Following this era, growing economic depression affecting a frustrated bourgeoisie triggered a tumultuous revolutionary period that destroyed France's Ancien Régime and abolished its university and medical systems. The resulting anarchy was eventually quelled through legislation aiming to satisfy Napoleon's need for qualified military professionals, including physicians and surgeons. These laws laid the foundations for the subsequent flourishing of French medicine throughout the mid-19th century. Subsequent changes to the meningioma nomenclature were authored by intellectual giants of this postrevolutionary period, for example, by the Limogesborn pathologist Jean Cruveilhier known for the term

  1. Pediatric neurosurgery telemedicine clinics: a model to provide care to geographically underserved areas of the United States and its territories.

    PubMed

    James, Hector E

    2016-12-01

    OBJECTIVE The author describes the creation, structuring, and development of a pediatric neurosurgery telemedicine clinic (TMC) to provide telehealth across geographical, time, social, and cultural barriers. METHODS In July 2009 the University of Florida (UF) Division of Pediatric Neurosurgery received a request from the Southeast Georgia Health District (Area 9-2) to provide a TMC to meet regional needs. The Children's Medical Services (CMS) of the State of Georgia installed telemedicine equipment and site-to-site connectivity. Audiovisual connectivity was performed in the UF Pediatric Neurosurgery office, maintaining privacy and HIPAA (Health Insurance Portability and Accountability Act) requirements. Administrative steps were taken with documentation of onsite training of the secretarial and nursing personnel of the CMS clinic. Patient preregistration and documentation were performed as required by the UF College of Medicine-Jacksonville. Monthly clinics are held with the CMS nursing personnel presenting the pertinent clinical history and findings to the pediatric neurosurgeon in the presence of the patient/parents. Physical findings and diagnostic studies are discussed, and management decisions are made. RESULTS The first TMC was held in August 2011. A total of 40 TMC sessions have been held through January 2016, with a total of 43 patients seen: 13 patients once; 13 patients twice; 8 patients for 3 visits; 2 for 4 visits; 2 for 6 visits; 2 for 5 visits; 2 for 7 visits; and 1 patient has been seen 8 times. CONCLUSIONS Pediatric patients in areas of the continental US and its territories with limited access to pediatric neurosurgery services could benefit from this model, if other pediatric neurosurgery centers provide telehealth services.

  2. Resonance and Radio

    ERIC Educational Resources Information Center

    Starrett, Malin J.

    2008-01-01

    The science and technology of radio receives little attention in contemporary education. This article discusses ways to explore the basic operating principles of radio. (Contains 4 figures, 3 footnotes, and 2 notes.)

  3. Automatic trajectory planning of DBS neurosurgery from multi-modal MRI datasets.

    PubMed

    Bériault, Silvain; Al Subaie, Fahd; Mok, Kelvin; Sadikot, Abbas F; Pike, G Bruce

    2011-01-01

    We propose an automated method for preoperative trajectory planning of deep brain stimulation image-guided neurosurgery. Our framework integrates multi-modal MRI analysis (T1w, SWI, TOF-MRA) to determine an optimal trajectory to DBS targets (subthalamic nuclei and globus pallidus interna) while avoiding critical brain structures for prevention of hemorrhages, loss of function and other complications. Results show that our method is well suited to aggregate many surgical constraints and allows the analysis of thousands of trajectories in less than 1/10th of the time for manual planning. Finally, a qualitative evaluation of computed trajectories resulted in the identification of potential new constraints, which are not addressed in the current literature, to better mimic the decision-making of the neurosurgeon during DBS planning.

  4. A novel registration method for image-guided neurosurgery system based on stereo vision.

    PubMed

    An, Yong; Wang, Manning; Song, Zhijian

    2015-01-01

    This study presents a novel spatial registration method of Image-guided neurosurgery system (IGNS) based on stereo-vision. Images of the patient's head are captured by a video camera, which is calibrated and tracked by an optical tracking system. Then, a set of sparse facial data points are reconstructed from them by stereo vision in the patient space. Surface matching method is utilized to register the reconstructed sparse points and the facial surface reconstructed from preoperative images of the patient. Simulation experiments verified the feasibility of the proposed method. The proposed method it is a new low-cost and easy-to-use spatial registration method for IGNS, with good prospects for clinical application.

  5. An Intelligent Robotic Hospital Bed for Safe Transportation of Critical Neurosurgery Patients Along Crowded Hospital Corridors.

    PubMed

    Wang, Chao; Savkin, Andrey V; Clout, Ray; Nguyen, Hung T

    2015-09-01

    We present a novel design of an intelligent robotic hospital bed, named Flexbed, with autonomous navigation ability. The robotic bed is developed for fast and safe transportation of critical neurosurgery patients without changing beds. Flexbed is more efficient and safe during the transportation process comparing to the conventional hospital beds. Flexbed is able to avoid en-route obstacles with an efficient easy-to-implement collision avoidance strategy when an obstacle is nearby and to move towards its destination at maximum speed when there is no threat of collision. We present extensive simulation results of navigation of Flexbed in the crowded hospital corridor environments with moving obstacles. Moreover, results of experiments with Flexbed in the real world scenarios are also presented and discussed.

  6. Commercial Radio as Communication.

    ERIC Educational Resources Information Center

    Rothenbuhler, Eric W.

    1996-01-01

    Compares the day-to-day work routines of commercial radio with the principles of a theoretical communication model. Illuminates peculiarities of the conduct of communication by commercial radio. Discusses the application of theoretical models to the evaluation of practicing institutions. Offers assessments of commercial radio deriving from…

  7. Extragalactic Radio Sources

    ERIC Educational Resources Information Center

    Kellerman, Kenneth I.

    1973-01-01

    Discusses new problems arising from the growing observational data through radio telescope arrays, involving the origin of radio sources, apparent superluminal velocities, conversion of radio sources to relativistic particles, and the nature of compact opaque and extended transparent sources. New physics may be needed to answer these cosmological…

  8. Severe head injury in children: emergency access to neurosurgery in the United Kingdom

    PubMed Central

    Tasker, R C; Morris, K P; Forsyth, R J; Hawley, C A; Parslow, R C

    2006-01-01

    Objective To determine the scale of acute neurosurgery for severe traumatic brain injury (TBI) in childhood, and whether surgical evacuation for haematoma is achieved within four hours of presentation to an emergency department. Methods A 12 month audit of emergency access to all specialist neurosurgical and intensive care services in the UK. Severe TBI in a child was defined as that necessitating admission to intensive care. Results Of 448 children with severe head injuries, 91 (20.3%) underwent emergency neurosurgery, and 37% of these surgical patients had at least one non‐reactive and dilated pupil. An acute subdural or epidural haematoma was present in 143/448 (31.9%) children, of whom 66 (46.2%) underwent surgery. Children needing surgical evacuation of haematoma were at a median distance of 29 km (interquartile range (IQR) 11.8–45.7) from their neurosurgical centre. One in four children took longer than one hour to reach hospital after injury. Once in an accident and emergency department, 41% took longer than fours hours to arrive at the regional centre. The median interval between time of accident and arrival at the surgical centre was 4.5 hours (IQR 2.23–7.73), and 79% of inter‐hospital transfers were undertaken by the referring hospital rather than the regional centre. In cases where the regional centre undertook the transfer, none were completed within four hours of presentation—the median interval was 6.3 hours (IQR 5.1–8.12). Conclusions The system of care for severely head injured children in the UK does not achieve surgical evacuation of a significant haematoma within four hours. The recommendation to use specialist regional paediatric transfer teams delays rather than expedites the emergency service. PMID:16794092

  9. Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

    PubMed Central

    Owojuyigbe, Afolabi Muyiwa; Komolafe, Edward O.; Adenekan, Anthony T.; Dada, Muyiwa A.; Onyia, Chiazor U.; Ogunbameru, Ibironke O.; Owagbemi, Oluwafemi F.; Talabi, Ademola O.; Faponle, Fola A.

    2016-01-01

    Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved. PMID:27251657

  10. A Patient Registry to Improve Patient Safety: Recording General Neurosurgery Complications

    PubMed Central

    Sarnthein, Johannes; Stieglitz, Lennart; Clavien, Pierre-Alain; Regli, Luca

    2016-01-01

    Background To improve the transparency of the local health care system, treatment cost was recently referenced to disease related groups. Treatment quality must be legally documented in a patient registry, in particular for the highly specialized treatments provided by neurosurgery departments. Methods In 2013 we have installed a patient registry focused on cranial neurosurgery. Surgeries are characterized by indication, treatment, location and other specific neurosurgical parameters. Preoperative state and postoperative outcome are recorded prospectively using neurological and sociological scales. Complications are graded by their severity in a therapy-oriented complication score system (Clavien-Dindo-Grading system, CDG). Results are presented at the monthly clinical staff meeting. Results Data acquisition compatible with the clinic workflow permitted to include all eligible patients into the registry. Until December 2015, we have registered 2880 patients that were treated in 3959 surgeries and 8528 consultations. Since the registry is fully operational (August 2014), we have registered 325 complications on 1341 patient discharge forms (24%). In 64% of these complications, no or only pharmacological treatment was required. At discharge, there was a clear correlation of the severity of the complication and the Karnofsky Performance Status (KPS, ρ = -0.3, slope -6 KPS percentage points per increment of CDG) and the length of stay (ρ = 0.4, slope 1.5 days per increment of CDG). Conclusions While the therapy-oriented complication scores correlate reasonably well with outcome and length of stay, they do not account for new deficits that cannot be treated. Outcome grading and complication severity grading thus serve a complimentary purpose. Overall, the registry serves to streamline and to complete information flow in the clinic, to identify complication rates and trends early for the internal quality monitoring and communication with patients. Conversely, the

  11. Application of underwater shock wave and laser-induced liquid jet to neurosurgery

    NASA Astrophysics Data System (ADS)

    Tominaga, T.; Nakagawa, A.; Hirano, T.; Sato, J.; Kato, K.; Hosseini, S. H. R.; Takayama, K.

    2006-03-01

    Paper deals with applications of underwater shock waves to medicine. A historical development of underwater shock wave generation by using pulsed Ho:YAG laser beam irradiation in water is briefly described and an overview is given regarding potential applications of shock waves to neuro-surgery. The laser beam irradiation in a liquid-filled catheter produces water vapor bubble and shock waves intermittently produces micro-liquid jets in a controlled fashion from the exit of the catheter. Correlations between shock dynamics and bubble dynamics are emphasized. To optimize the jet motion, results of basic parametric studies are briefly presented. The liquid jet discharged from the catheter exit has an impulse high enough to clearly exhibit effectiveness for various medical purposes. In liquid jets we observed reasonably strong shock waves and hence invented a compact shock generator aiming to apply to microsurgery. We applied it to a rat's bone window and developed an effective method of brain protection against shock loading. The insertion of Gore-Tex® sheet is found to attenuate shock waves drastically even for very short stand off distance and its physical mechanism is clarified. The laser-induced liquid jet (LILJ) is successfully applied to soft tissue dissection. Animal experiments were performed and results of histological observations are presented in details. Results of animal experiments revealed that LILJ can sharply dissect soft tissue with a minimum amount of liquid consumption, while blood vessels larger than 0.2 mm in diameter are preserved. Shock waves and LILJ have a potential to be indispensable tools in neuro-surgery.

  12. Integrating risk management data in quality improvement initiatives within an academic neurosurgery department.

    PubMed

    McLaughlin, Nancy; Garrett, Matthew C; Emami, Leila; Foss, Sarah K; Klohn, Johanna L; Martin, Neil A

    2016-01-01

    OBJECT While malpractice litigation has had many negative impacts on health care delivery systems, information extracted from lawsuits could potentially guide toward venues to improve care. The authors present a comprehensive review of lawsuits within a tertiary academic neurosurgical department and report institutional and departmental strategies to mitigate liability by integrating risk management data with quality improvement initiatives. METHODS The Comprehensive Risk Intelligence Tool database was interrogated to extract claims/suits abstracts concerning neurosurgical cases that were closed from January 2008 to December 2012. Variables included demographics of the claimant, type of procedure performed (if any), claim description, insured information, case outcome, clinical summary, contributing factors and subfactors, amount incurred for indemnity and expenses, and independent expert opinion in regard to whether the standard of care was met. RESULTS During the study period, the Department of Neurosurgery received the most lawsuits of all surgical specialties (30 of 172), leading to a total incurred payment of $4,949,867. Of these lawsuits, 21 involved spinal pathologies and 9 cranial pathologies. The largest group of suits was from patients with challenging medical conditions who underwent uneventful surgeries and postoperative courses but filed lawsuits when they did not see the benefits for which they were hoping; 85% of these claims were withdrawn by the plaintiffs. The most commonly cited contributing factors included clinical judgment (20 of 30), technical skill (19 of 30), and communication (6 of 30). CONCLUSIONS While all medical and surgical subspecialties must deal with the issue of malpractice and liability, neurosurgery is most affected both in terms of the number of suits filed as well as monetary amounts awarded. To use the suits as learning tools for the faculty and residents and minimize the associated costs, quality initiatives addressing the

  13. Future directions in 3-dimensional imaging and neurosurgery: stereoscopy and autostereoscopy.

    PubMed

    Christopher, Lauren A; William, Albert; Cohen-Gadol, Aaron A

    2013-01-01

    Recent advances in 3-dimensional (3-D) stereoscopic imaging have enabled 3-D display technologies in the operating room. We find 2 beneficial applications for the inclusion of 3-D imaging in clinical practice. The first is the real-time 3-D display in the surgical theater, which is useful for the neurosurgeon and observers. In surgery, a 3-D display can include a cutting-edge mixed-mode graphic overlay for image-guided surgery. The second application is to improve the training of residents and observers in neurosurgical techniques. This article documents the requirements of both applications for a 3-D system in the operating room and for clinical neurosurgical training, followed by a discussion of the strengths and weaknesses of the current and emerging 3-D display technologies. An important comparison between a new autostereoscopic display without glasses and current stereo display with glasses improves our understanding of the best applications for 3-D in neurosurgery. Today's multiview autostereoscopic display has 3 major benefits: It does not require glasses for viewing; it allows multiple views; and it improves the workflow for image-guided surgery registration and overlay tasks because of its depth-rendering format and tools. Two current limitations of the autostereoscopic display are that resolution is reduced and depth can be perceived as too shallow in some cases. Higher-resolution displays will be available soon, and the algorithms for depth inference from stereo can be improved. The stereoscopic and autostereoscopic systems from microscope cameras to displays were compared by the use of recorded and live content from surgery. To the best of our knowledge, this is the first report of application of autostereoscopy in neurosurgery.

  14. Surgical Management of Combined Intramedullary Arteriovenous Malformation and Perimedullary Arteriovenous Fistula within the Hybrid Operating Room after Five Years of Performing Focus Fractionated Radiotherapy: Case Report

    PubMed Central

    GEKKA, Masayuki; SEKI, Toshitaka; HIDA, Kazutoshi; OSANAI, Toshiya; HOUKIN, Kiyohiro

    2014-01-01

    Perimedullary arteriovenous fistula (AVF) shunts occur on the spinal cord surface and can be treated surgically or by endovascular embolization. In contrast, the nidus of an intramedullary arteriovenous malformation (AVM) is located in the spinal cord and is difficult to treat surgically or by endovascular techniques. The benefits of radiotherapy for treating intramedullary AVM have been published, but are anecdotal and consist largely of case reports. We present a case of combined cervical intramedullary AVM and perimedullary AVF which received surgical treatment within a hybrid operating room (OR) after 5 years of focus fractionated radiotherapy. A 37-year-old male presented with stepwise worsening myelopathy. Magnetic resonance imaging and spinal angiography revealed intramedullary AVM and perimedullary AVF at the C3 to C5 levels. In order to reduce nidus size and blood flow, we first performed focal fractionated radiotherapy. Five years later, the lesion volume was reduced. Following this, direct surgery was performed by an anterior approach using corpectomy in the hybrid OR. The spinal cord was monitored by motor-evoked potential throughout the surgery. Complete obliteration of the fistulous connection was confirmed by intraoperative indocyanine green video-angiography and intraoperative angiography, preserving the anterior spinal artery. We conclude that surgical treatment following focal fractionated radiotherapy may become one strategy for patients who are initially deemed ineligible for endovascular embolization and surgical treatment. Furthermore, the hybrid OR enables safe and precise treatment for spinal vascular disorders in the fields of endovascular treatment and neurosurgery. PMID:25367581

  15. [Adaptative radiotherapy: The case for MRI-guided radiotherapy].

    PubMed

    Maingon, P

    2016-10-01

    The concept of image-guided radiotherapy benefits from the development of magnetic resonance imaging (MRI) associated with different capacities of tissue analyses such as spectroscopy or diffusion analysis. The production of devices allowing the repositioning of patients through MRI represents a strong added value without delivering any additional dose to the patient while the optimization of the adaptative strategies are facilitated by a better contrast of the soft tissues compared to the scanner. The advantages of MRI are well demonstrated for brain tumours, head and neck carcinomas, pelvic tumors, mediastinal malignancies, gastrointestinal tract diseases. Adaptative radiotherapy inaugurates a new area of radiotherapy with different modalities. Several technological solutions are provided or discussed allowing the patients to benefit from thses new technologies as soon as possible.

  16. [Postoperative radiotherapy of prostate cancer].

    PubMed

    Guérif, S; Latorzeff, I; Lagrange, J-L; Hennequin, C; Supiot, S; Garcia, A; François, P; Soulié, M; Richaud, P; Salomon, L

    2014-10-01

    Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery.

  17. Dedicated Linac for Radioneurosurgery at the National Institute of Neurology and Neurosurgery of Mexico

    NASA Astrophysics Data System (ADS)

    Celis-López, Miguel A.; Lárraga-Gutiérrez, José M.

    2003-09-01

    The objective is to present a description and the main clinical applications of this dedicated Linac for benign and malignant tumors in the central nervous system. The Novalis (BrainLab, Germany) is a 6 MV dedicated linac for a single high dose Radiosurgery (RS) and for fractionated doses in Stereotactic Radiotherapy with a high level of precision at the isocenter.

  18. Expanding global access to radiotherapy.

    PubMed

    Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

    2015-09-01

    Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

  19. [Head and neck adaptive radiotherapy].

    PubMed

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven.

  20. Inflammatory Skin Conditions Associated With Radiotherapy.

    PubMed

    Hernández Aragüés, I; Pulido Pérez, A; Suárez Fernández, R

    2017-04-01

    Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized.

  1. Radiotherapy supports protective tumor-specific immunity

    PubMed Central

    Gupta, Anurag; Sharma, Anu; von Boehmer, Lotta; Surace, Laura; Knuth, Alexander; van den Broek, Maries

    2012-01-01

    Radiotherapy is an important therapeutic option for the treatment of cancer. Growing evidence indicates that, besides inducing an irreversible DNA damage, radiotherapy promotes tumor-specific immune response, which significantly contribute to therapeutic efficacy. We postulate that radiotherapy activates tumor-associated dendritic cells, thus changing the tolerogenic tumor environment into an immunogenic one. PMID:23264910

  2. Clinical quality standards for radiotherapy

    PubMed Central

    2012-01-01

    Aim of the study The technological progress that is currently being witnessed in the areas of diagnostic imaging, treatment planning systems and therapeutic equipment has caused radiotherapy to become a high-tech and interdisciplinary domain involving staff of various backgrounds. This allows steady improvement in therapy results, but at the same time makes the diagnostic, imaging and therapeutic processes more complex and complicated, requiring every stage of those processes to be planned, organized, controlled and improved so as to assure high quality of services provided. The aim of this paper is to present clinical quality standards for radiotherapy as developed by the author. Material and methods In order to develop the quality standards, a comparative analysis was performed between European and Polish legal acts adopted in the period of 1980-2006 and the universal industrial ISO 9001:2008 standard, defining requirements for quality management systems, and relevant articles published in 1984-2009 were reviewed, including applicable guidelines and recommendations of American, international, European and Polish bodies, such as the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy & Oncology (ESTRO), the International Atomic Energy Agency (IAEA), and the Organisation of European Cancer Institutes (OECI) on quality assurance and management in radiotherapy. Results As a result, 352 quality standards for radiotherapy were developed and categorized into the following three groups: 1 – organizational standards; 2 – physico-technical standards and 3 – clinical standards. Conclusion Proposed clinical quality standards for radiotherapy can be used by any institution using ionizing radiation for medical purposes. However, standards are of value only if they are implemented, reviewed, audited and improved, and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:23788854

  3. Second Malignant Neoplasms Following Radiotherapy

    PubMed Central

    Kumar, Sanath

    2012-01-01

    More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy. PMID:23249860

  4. Review of the potential of optical technologies for cancer diagnosis in neurosurgery: a step toward intraoperative neurophotonics.

    PubMed

    Vasefi, Fartash; MacKinnon, Nicholas; Farkas, Daniel L; Kateb, Babak

    2017-01-01

    Advances in image-guided therapy enable physicians to obtain real-time information on neurological disorders such as brain tumors to improve resection accuracy. Image guidance data include the location, size, shape, type, and extent of tumors. Recent technological advances in neurophotonic engineering have enabled the development of techniques for minimally invasive neurosurgery. Incorporation of these methods in intraoperative imaging decreases surgical procedure time and allows neurosurgeons to find remaining or hidden tumor or epileptic lesions. This facilitates more complete resection and improved topology information for postsurgical therapy (i.e., radiation). We review the clinical application of recent advances in neurophotonic technologies including Raman spectroscopy, thermal imaging, optical coherence tomography, and fluorescence spectroscopy, highlighting the importance of these technologies in live intraoperative tissue mapping during neurosurgery. While these technologies need further validation in larger clinical trials, they show remarkable promise in their ability to help surgeons to better visualize the areas of abnormality and enable safe and successful removal of malignancies.

  5. Neurosurgery at the crossroads: leadership role of the American Association of Neurological Surgeons. The 1979 AANS presidential address.

    PubMed

    Dohn, D F

    1979-10-01

    The President of the American Association of Neurological Surgeons (AANS) reviews the formative history of the major neurosurgical societies, together with their agreement to consolidate their efforts in the joint AANS. As a united group, the Association has been effective in carrying out relations with other professional organizations and with government. Long-range planning is being pursued steadily to increase the role of organized neurosurgery in maintenance of, and improvement in, patient care, education, and research.

  6. [Which rules apply to hypofractionated radiotherapy?].

    PubMed

    Supiot, S; Clément-Colmou, K; Paris, F; Corre, I; Chiavassa, S; Delpon, G

    2015-10-01

    Hypofractionated radiotherapy is now more widely prescribed due to improved targeting techniques (intensity modulated radiotherapy, image-guided radiotherapy and stereotactic radiotherapy). Low dose hypofractionated radiotherapy is routinely administered mostly for palliative purposes. High or very high dose hypofractionated irradiation must be delivered according to very strict procedures since every minor deviation can lead to major changes in dose delivery to the tumor volume and organs at risk. Thus, each stage of the processing must be carefully monitored starting from the limitations and the choice of the hypofractionation technique, tumour contouring and dose constraints prescription, planning and finally dose calculation and patient positioning verification.

  7. Improvement of patient satisfaction with the neurosurgery service at a large tertiary care, London-based hospital

    PubMed Central

    Khan, Amad; Naushad Chaudhry, Mohammad; Khalid, Salema; Nandi, Dipankar

    2014-01-01

    Patient satisfaction is central to healthcare provision and the effective running of any surgical unit. Following on from both formal and informal feedback, we decided to look objectively at patient satisfaction with the neurosurgery service at a large tertiary care hospital in London and identify areas that needed improvement within the unit. Patient satisfaction was looked at with respect to four different aspects of the neurosurgery service: the surgeons, ward doctors, nurses, and hospital services. A questionnaire-based cross-sectional study was conducted and once the data were collected a plan of action to improve service provision was put into place. Data were collected from 150 patients over a 3 month period from September to November 2012. Interventions were made and data re-collected from 150 patients from January to March 2013. With regards to satisfaction with the neurosurgery service, 76.7% (n=115) were satisfied; following implementation of our measures for improvement, which included staff education, meetings and posters, this figure increased to 90.6% (n=136, p<0.001 on Chi-square testing). In conclusion, patient satisfaction should be at the crux of patient care, with a strong focus on effective communication skills, and can be improved by identification of issues by direct patient feedback and subsequent action based on this. PMID:26733061

  8. Morbidity associated with 30-day surgical site infection following nonshunt pediatric neurosurgery.

    PubMed

    Sherrod, Brandon A; Rocque, Brandon G

    2017-04-01

    OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients. Procedures were categorized by Current Procedural Terminology (CPT) codes. CSF shunts were excluded. Deep and superficial SSIs occurring within 30 days of an index procedure were identified. Deep SSIs included deep wound infections, intracranial abscesses, meningitis, osteomyelitis, and ventriculitis. The following outcomes occurring within 30 days of an index procedure were analyzed, along with postoperative time to complication development: sepsis, wound disruption, length of postoperative stay, readmission, reoperation, and death. RESULTS A total of 251 procedures associated with a 30-day SSI were identified (2.7% of 9296 procedures). Superficial SSIs were more common than deep SSIs (57.4% versus 42.6%). Deep SSIs occurred more frequently after epilepsy or intracranial tumor procedures. Superficial SSIs occurred more frequently after skin lesion, spine, Chiari decompression, craniofacial, and myelomeningocele closure procedures. The mean (± SD) postoperative length of stay for patients with any SSI was 9.6 ± 14.8 days (median 4 days). Post-SSI outcomes significantly associated with previous SSI included wound disruption (12.4%), sepsis (15.5%), readmission (36.7%), and reoperation (43.4%) (p < 0.001 for each). Post-SSI sepsis rates (6.3% vs 28.0% for superficial versus deep SSI, respectively; p < 0.001), wound disruption rates (4.9% vs 22.4%, p < 0.001), and reoperation rates (23.6% vs 70.1%, p < 0.001) were significantly greater for patients

  9. Parental Evaluation of a Nurse Practitioner-Developed Pediatric Neurosurgery Website

    PubMed Central

    Vogel, Tina Kovacs; Kleib, Manal; Davidson, Sandra J

    2016-01-01

    Background Parents often turn to the Internet to seek health information about their child’s diagnosis and condition. Information, support, and resources regarding pediatric neurosurgery are scarce, hard to find, and difficult to comprehend. To address this gap, a pediatric nurse practitioner designed a website called the Neurosurgery Kids Fund (NKF). Analyzing the legitimacy of the NKF website for parents seeking health information and fulfilling their social and resource needs is critical to the website’s future development and success. Objective To explore parental usage of the NKF website, track visitor behavior, evaluate usability and design, establish ways to improve user experience, and identify ways to redesign the website. The aim of this study was to assess and evaluate whether a custom-designed health website could meet parents’ health information, support, and resource needs. Methods A multimethod approach was used. Google Analytic usage reports were collected and analyzed for the period of April 23, 2013, to November 30, 2013. Fifty-two online questionnaires that targeted the website’s usability were collected between June 18, 2014, and July 30, 2014. Finally, a focus group was conducted on August 20, 2014, to explore parents’ perceptions and user experiences. Findings were analyzed using an inductive content analysis approach. Results There were a total of 2998 sessions and 8818 page views, with 2.94 pages viewed per session, a 56.20% bounce rate, an average session duration of 2 minutes 24 seconds, and a 56.24% new sessions rate. Results from 52 eligible surveys included that the majority of NKF users were Caucasian (90%), females (92%), aged 36-45 years (48%), with a university or college degree or diploma (69%). Half plan to use the health information. Over half reported turning to the Internet for health information and spending 2 to 4 hours a day online. The most common reasons for using the NKF website were to (1) gather information

  10. Radiotherapy dose enhancement using BNCT in conventional LINACs high-energy treatment: Simulation and experiment

    PubMed Central

    Alikaniotis, Katia; Borla, Oscar; Monti, Valeria; Vivaldo, Gianna; Zanini, Alba; Giannini, Gianrossano

    2016-01-01

    Aim To employ the thermal neutron background that affects the patient during a traditional high-energy radiotherapy treatment for BNCT (Boron Neutron Capture Therapy) in order to enhance radiotherapy effectiveness. Background Conventional high-energy (15–25 MV) linear accelerators (LINACs) for radiotherapy produce fast secondary neutrons in the gantry with a mean energy of about 1 MeV due to (γ, n) reaction. This neutron flux, isotropically distributed, is considered as an unavoidable undesired dose during the treatment. Considering the moderating effect of human body, a thermal neutron fluence is localized in the tumour area: this neutron background could be employed for BNCT by previously administering 10B-Phenyl-Alanine (10BPA) to the patient. Materials and methods Monte Carlo simulations (MCNP4B-GN code) were performed to estimate the total amount of neutrons outside and inside human body during a traditional X-ray radiotherapy treatment. Moreover, a simplified tissue equivalent anthropomorphic phantom was used together with bubble detectors for thermal and fast neutron to evaluate the moderation effect of human body. Results Simulation and experimental results confirm the thermal neutron background during radiotherapy of 1.55E07 cm−2 Gy−1. The BNCT equivalent dose delivered at 4 cm depth in phantom is 1.5 mGy-eq/Gy, that is about 3 Gy-eq (4% of X-rays dose) for a 70 Gy IMRT treatment. Conclusions The thermal neutron component during a traditional high-energy radiotherapy treatment could produce a localized BNCT effect, with a localized therapeutic dose enhancement, corresponding to 4% or more of photon dose, following tumour characteristics. This BNCT additional dose could thus improve radiotherapy, acting as a localized radio-sensitizer. PMID:26933394

  11. Dominion Radio Astrophysical Observatory

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    The Dominion Radio Astrophysical Observatory began operating in 1959, and joined the NATIONAL RESEARCH COUNCIL in 1970. It became part of the Herzberg Institute of Astrophysics in 1975. The site near Penticton, BC has a 26 m radio telescope, a seven-antenna synthesis telescope on a 600 m baseline and two telescopes dedicated to monitoring the solar radio flux at 10.7 cm. This part of the Institu...

  12. Radio determination satellite service

    NASA Astrophysics Data System (ADS)

    Briskman, Robert D.

    1990-07-01

    The capabilities and measured performance of a geosynchronous satellite-based service called the radio determination satellite service (RDSS), which operates at radio frequencies allocated by the International Telecommunications Union (ITU) and is licensed in the United States by the Federal Communications Commission (FCC), are discussed. Plans for both improvement in capability and expansion to nearly global coverage are described. Since RDSS can also provide radio navigation, some comparisons of this service with the Global Positioning System (GPS) are made.

  13. Radiotherapy T1 glottic carcinoma

    SciTech Connect

    Zablow, A.I.; Erba, P.S.; Sanfillippo, L.J.

    1989-11-01

    From 1970 to 1985, curative radiotherapy was administered to 63 patients with stage I carcinoma of the true vocal cords. Precision radiotherapeutic technique yields cure rates comparable to surgical results. Good voice quality was preserved in a high percentage of patients.

  14. Radio data transmission for SCADA

    SciTech Connect

    Frasier, W.E. )

    1989-09-01

    Enron has used such wireless systems as meteor burst radio, 952 MHz multiple address radio, VSAT and L-band satellite, cellular radio and ACSB radio. The company's experience with meteor burst radio communications is discussed in this paper. It indicates good system reliability and consequently all back-up telephone lines have been removed from sites using this system.

  15. Rivaling paradigms in psychiatric neurosurgery: adjustability versus quick fix versus minimal-invasiveness

    PubMed Central

    Müller, Sabine; Riedmüller, Rita; van Oosterhout, Ansel

    2015-01-01

    In the wake of deep brain stimulation (DBS) development, ablative neurosurgical procedures are seeing a comeback, although they had been discredited and nearly completely abandoned in the 1970s because of their unethical practice. Modern stereotactic ablative procedures as thermal or radiofrequency ablation, and particularly radiosurgery (e.g., Gamma Knife) are much safer than the historical procedures, so that a re-evaluation of this technique is required. The different approaches of modern psychiatric neurosurgery refer to different paradigms: microsurgical ablative procedures is based on the paradigm ‘quick fix,’ radiosurgery on the paradigm ‘minimal-invasiveness,’ and DBS on the paradigm ‘adjustability.’ From a mere medical perspective, none of the procedures is absolutely superior; rather, they have different profiles of advantages and disadvantages. Therefore, individual factors are crucial in decision-making, particularly the patients’ social situation, individual preferences, and individual attitudes. The different approaches are not only rivals, but also enriching mutually. DBS is preferable for exploring new targets, which may become candidates for ablative microsurgery or radiosurgery. PMID:25883557

  16. "Extremely minimally invasive": recent advances in nanotechnology research and future applications in neurosurgery.

    PubMed

    Mattei, Tobias A; Rehman, Azeem A

    2015-01-01

    The term "nanotechnology" refers to the development of materials and devices that have been designed with specific properties at the nanometer scale (10(-9) m), usually being less than 100 nm in size. Recent advances in nanotechnology have promised to enable visualization and intervention at the subcellular level, and its incorporation to future medical therapeutics is expected to bring new avenues for molecular imaging, targeted drug delivery, and personalized interventions. Although the central nervous system presents unique challenges to the implementation of new therapeutic strategies involving nanotechnology (such as the heterogeneous molecular environment of different CNS regions, the existence of multiple processing centers with different cytoarchitecture, and the presence of the blood-brain barrier), numerous studies have demonstrated that the incorporation of nanotechnology resources into the armamentarium of neurosurgery may lead to breakthrough advances in the near future. In this article, the authors present a critical review on the current 'state-of-the-art' of basic research in nanotechnology with special attention to those issues which present the greatest potential to generate major therapeutic progresses in the neurosurgical field, including nanoelectromechanical systems, nano-scaffolds for neural regeneration, sutureless anastomosis, molecular imaging, targeted drug delivery, and theranostic strategies.

  17. Theoretical and In-Vivo Investigation of Optical Reflectance from Human Brain to Assist Neurosurgery

    NASA Astrophysics Data System (ADS)

    Johns, Maureen; Giller, Cole A.; Liu, Hanli

    1998-10-01

    Parkinson's disease (PD) is a chronic, progressive disease involving the globus pallidus (GP), which is a gray matter mass, surrounded by white matter deep within the brain. During a neurosurgery procedure, a thin probe is inserted into the GP to create a lesion that often relieves the cardinal symptoms of PD. The goal of this study is to develop an optical method to accurately locate the GP border. In theory, Monte Carlo simulations were performed to predict the optical reflectance from brain tissue. In experiment, a portable, real-time display spectrometer with a fiber optic reflectance probe was developed and used during human surgery. Optical reflectance values were recorded at 1 mm intervals to obtain a spatial profile of the tissue as the probe passed through regions of gray and white matter. The simulation and in vivo studies of the reflectance from the brain are in good agreement with one another. The clinical data show that the reflectance from gray matter is approximately 50% or less than that from white matter between 650 and 800 nm. A slope algorithm is developed to distinguish gray and white matter in vivo. This study provides previously unknown optical reflectance of the human brain.

  18. Rivaling paradigms in psychiatric neurosurgery: adjustability versus quick fix versus minimal-invasiveness.

    PubMed

    Müller, Sabine; Riedmüller, Rita; van Oosterhout, Ansel

    2015-01-01

    In the wake of deep brain stimulation (DBS) development, ablative neurosurgical procedures are seeing a comeback, although they had been discredited and nearly completely abandoned in the 1970s because of their unethical practice. Modern stereotactic ablative procedures as thermal or radiofrequency ablation, and particularly radiosurgery (e.g., Gamma Knife) are much safer than the historical procedures, so that a re-evaluation of this technique is required. The different approaches of modern psychiatric neurosurgery refer to different paradigms: microsurgical ablative procedures is based on the paradigm 'quick fix,' radiosurgery on the paradigm 'minimal-invasiveness,' and DBS on the paradigm 'adjustability.' From a mere medical perspective, none of the procedures is absolutely superior; rather, they have different profiles of advantages and disadvantages. Therefore, individual factors are crucial in decision-making, particularly the patients' social situation, individual preferences, and individual attitudes. The different approaches are not only rivals, but also enriching mutually. DBS is preferable for exploring new targets, which may become candidates for ablative microsurgery or radiosurgery.

  19. A rare case of symmetrical four limb gangrene following emergency neurosurgery

    PubMed Central

    Phan, Pho NH; Acharya, Vikas; Parikh, Dhruv; Shad, Amjad

    2015-01-01

    Introduction The authors report a case of symmetrical peripheral gangrene (SPG) following emergency neurosurgery. Presentation of case A 35-year-old female presented to hospital in Thailand with nausea, headache, and subsequent seizures. She was found to have a large intracranial space-occupying lesion with mass effect. Following emergency surgical debulking and decompression, she suffered from severe sepsis with multiple organ failure, treated with high dose intravenous vasopressors and developed secondary gangrene in all four limbs. She was repatriated to the UK with a baseline GCS of 8 and multiple postoperative medical complications. With initial conservative management, the patient made a prolonged but satisfactory progression to recovery prior to semi-elective debridement and selected digit amputation of the gangrene. Discussion This is the first reported case of four limb symmetrical peripheral gangrene following an emergency craniotomy. Conclusion Although rare, SPG is a substantial complication with high mortality and morbidity and therefore should be especially taken into account for emergency intracranial pathologies in neurosurgical patients, particularly if they require emergency surgery. PMID:26406313

  20. Thermal model to investigate the temperature in bone grinding for skull base neurosurgery.

    PubMed

    Zhang, Lihui; Tai, Bruce L; Wang, Guangjun; Zhang, Kuibang; Sullivan, Stephen; Shih, Albert J

    2013-10-01

    This study develops a thermal model utilizing the inverse heat transfer method (IHTM) to investigate the bone grinding temperature created by a spherical diamond tool used for skull base neurosurgery. Bone grinding is a critical procedure in the expanded endonasal approach to remove the cranial bone and access to the skull base tumor via nasal corridor. The heat is generated during grinding and could damage the nerve or coagulate the blood in the carotid artery adjacent to the bone. The finite element analysis is adopted to investigate the grinding-induced bone temperature rise. The heat source distribution is defined by the thermal model, and the temperature distribution is solved using the IHTM with experimental inputs. Grinding experiments were conducted on a bovine cortical bone with embedded thermocouples. Results show significant temperature rise in bone grinding. Using 50°C as the threshold, the thermal injury can propagate about 3mm in the traverse direction, and 3mm below the ground surface under the dry grinding condition. The presented methodology demonstrated the capability of being a thermal analysis tool for bone grinding study.

  1. Computational and in vivo investigation of optical reflectance from human brain to assist neurosurgery.

    PubMed

    Johns, M; Giller, C; Liu, H

    1998-10-01

    Parkinson's disease (PD) is a chronic, progressive disease involving the globus pallidus (GP), which is a gray matter mass, surrounded by white matter deep within the brain. During a neurosurgery procedure, a thin probe is inserted into the GP to create a lesion that often relieves the cardinal symptoms of PD. The goal of this study is to develop an optical method to accurately locate the GP border. In theory, Monte Carlo simulations were performed to predict the optical reflectance from brain tissue. In experiment, a portable, real-time display spectrometer with a fiber optic reflectance probe was developed and used during human surgery. Optical reflectance values were recorded at 1 mm intervals to obtain a spatial profile of the tissue as the probe passed through regions of gray and white matter. The simulation and in vivo studies of the reflectance from the brain are in good agreement with one another. The clinical data show that the reflectance from gray matter is approximately 50% or less than that from white matter between 650 and 800 nm. A slope algorithm is developed to distinguish gray and white matter in vivo. This study provides previously unknown optical reflectance of the human brain. © 1998 Society of Photo-Optical Instrumentation Engineers.

  2. Automated rejection of contaminated surface measurements for improved surface registration in image guided neurosurgery.

    PubMed

    Bucholz, R; Macneil, W; Fewings, P; Ravindra, A; McDurmont, L; Baumann, C

    2000-01-01

    Most image guided Neurosurgery employs adhesively mounted external fiducials for registration of medical images to the surgical workspace. Due to high logistical costs associated with these artificial landmarks, we strive to eliminate the need for these markers. At our institution, we developed a handheld laser stripe triangulation device to capture the surface contours of the patient's head while oriented for surgery. Anatomical surface registration algorithms rely on the assumption that the patient's anatomy bears the same geometry as the 3D model of the patient constructed from the imaging modality employed. During the time interval from which the patient is imaged and placed in the Mayfield head clamp in the operating room, the skin of the head bulges at the pinsite and the skull fixation equipment itself optically interferes with the image capture laser. We have developed software to reject points belonging to objects of known geometry while calculating the registration. During the course of development of the laser scanning unit, we have acquired surface contours of 13 patients and 2 cadavers. Initial analysis revealed that this automated rejection of points improved the registrations in all cases, but the accuracy of the fiducial method was not surpassed. Only points belonging to the offending instrument are removed. Skin bulges caused by the clamps and instruments remain in the data. We anticipate that careful removal of the points in these skin bulges will yield registrations that at least match the accuracy of the fiducial method.

  3. Fiber-based tissue identification for electrode placement in deep brain stimulation neurosurgery (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    DePaoli, Damon T.; Lapointe, Nicolas; Goetz, Laurent; Parent, Martin; Prudhomme, Michel; Cantin, Léo.; Galstian, Tigran; Messaddeq, Younès.; Côté, Daniel C.

    2016-03-01

    Deep brain stimulation's effectiveness relies on the ability of the stimulating electrode to be properly placed within a specific target area of the brain. Optical guidance techniques that can increase the accuracy of the procedure, without causing any additional harm, are therefore of great interest. We have designed a cheap optical fiber-based device that is small enough to be placed within commercially available DBS stimulating electrodes' hollow cores and that is capable of sensing biological information from the surrounding tissue, using low power white light. With this probe we have shown the ability to distinguish white and grey matter as well as blood vessels, in vitro, in human brain samples and in vivo, in rats. We have also repeated the in vitro procedure with the probe inserted in a DBS stimulating electrode and found the results were in good agreement. We are currently validating a second fiber optic device, with micro-optical components, that will result in label free, molecular level sensing capabilities, using CARS spectroscopy. The final objective will be to use this data in real time, during deep brain stimulation neurosurgery, to increase the safety and accuracy of the procedure.

  4. Low end interactive image-directed neurosurgery. Update on rudimentary augmented reality used in epilepsy surgery.

    PubMed

    Doyle, W K

    1996-01-01

    Our experience with a very low end interactive image-directed (IIDS) neurosurgical system is presented. The system was developed by the author and consists of a personal desktop computer and a magnetic field digitizer. This low cost solution was pursued as an alternative to available commercial devices which were expensive and not readily modifiable for novel ideas and new applications targeted for Epilepsy surgery. The rationale and description of the system was presented last year at Medicine Meets Virtual Reality III. Included in that detailed report were the fundamental mathematics forming the basics of transformation between the surgical and the digital data spaces. Since then the system has been used in an additional 20 cases now totaling 40 in all. Its advantages and short comings will be described. The theoretical advantages of magnetic field technology over other localization methods is reviewed. Also, our experience with alternative low cost off-the-shelf interfacing devices and other related modifications are described. We have accumulated clinical data to suggest that craniotomy sizes have been reduced, electrode placement has been improved, and that interactive image-directed techniques offer advantages over other common intra-operative localization modalities such as ultrasound. Our conclusion is that interactive image-directed techniques improve neurosurgery and that inexpensive enabling technology is already available providing the technological substrate for low cost devices using virtual reality notions for surgery and medicine. This particular technology offers advantages to traditional surgical techniques demonstrating the attractiveness of rudimentary virtual reality medical applications.

  5. Cost analysis of a project to digitize classic articles in neurosurgery*

    PubMed Central

    Bauer, Kathleen

    2002-01-01

    In summer 2000, the Cushing/Whitney Medical Library at Yale University began a demonstration project to digitize classic articles in neurosurgery from the late 1800s and early 1900s. The objective of the first phase of the project was to measure the time and costs involved in digitization, and those results are reported here. In the second phase, metadata will be added to the digitized articles, and the project will be publicized. Thirteen articles were scanned using optical character recognition (OCR) software, and the resulting text files were carefully proofread. Time for photocopying, scanning, and proofreading were recorded. This project achieved an average cost per item (total pages plus images) of $4.12, a figure at the high end of average costs found in other studies. This project experienced high costs for two reasons. First, the articles contained many images, which required extra processing. Second, the older fonts and the poor condition of many of these articles complicated the OCR process. The average article cost $84.46 to digitize. Although costs were high, the selection of historically important articles maximized the benefit gained from the investment in digitization. PMID:11999182

  6. Use of hydrogen peroxide in neurosurgery: case series of cardiovascular complications

    PubMed Central

    Spiriev, Toma; Prabhakar, Hemanshu; Sandu, Nora; Tzekov, Christo; Kondoff, Slavomir; Laleva, Lili; Schaller, Bernhard

    2012-01-01

    Objectives Postoperative complications induced by hydrogen peroxide (H2O2) are described in the neurosurgical literature and mainly involve oxygen venous emboli, postoperative pneumocephalus; some of them even fatal. However, recently there are more and more published case reports for significant cardiac dysrhythmia related to the use of this chemical agent during routine neurosurgical interventions. Design Retrospective, two-centre study. Setting Retrospective review of clinical/radiological documentation (including preoperative medical history, operation report and intraoperative anesthesiology data charts). Participants Patients scheduled for cranial neurosurgical interventions. Main outcome measures Intraoperative occurrence of trigeminocardiac reflex (TCR), according the earlier defined by our group criteria, or other severe cardiovascular complications related to the intraoperative use of H2O2. Results Five cases were included in the study fulfilling the strict inclusion/exclusion criteria. Two of the cases were recognized as intraoperative TCR, in the other three cases the cardiovascular effects were possibly due to TCR in one, mechanical stimulation of vital centre in anterior hypothalamus, brainstem, or either mechanical or thermal action of H2O2. Conclusions According to this two-centre study, we can give, for the first time, evidence that cardiovascular complications according to the intraoperative use of H2O2 in neurosurgery are not rare with an incidence of 3%. Special reference is given to the occurrence of the TCR in this context. PMID:22299072

  7. Classification of the EEG during neurosurgery. Parametric identification and Kalman filtering compared.

    PubMed

    Cerutti, S; Liberati, D; Avanzini, G; Franceschetti, S; Panzica, F

    1986-07-01

    A procedure is described which aims to classify an EEG recorded during neurosurgery, for example intracerebral aneurysm clipping. A parametric approach is used; it employs auto-regressive (AR) modelling and Kalman filtering to quantify directly the dynamics of the EEG generating mechanism, supposing it to be a linear, time-invariant system driven by white noise. The results of this EEG processing are analysed together with simultaneous values of arterial blood pressure (ABP) as surgery of this kind is carried out under conditions of controlled hypotension. The object is to compare the sensitivity of ABP data with that obtained from the EEG and so provide an early warning of a potentially dangerous non-physiological state induced by the hypotensive drug (in this case sodium nitroprusside). Some methodological comments on the correct implementation of these algorithms are given and the procedure is compared with similar approaches which have appeared in the literature during the last few years. Particular emphasis is placed on the power spectral analysis of the signal by pointing out a method for spectral decomposition, related to AR power density estimation, which permits the separation of single spectral components in terms of central frequencies and their associated power. Other potential applications of this method are in long term EEG monitoring for the detection of changes due for example to drug infusion, to fast transient events, or to changes in the stationary condition.

  8. Stabilized radio frequency quadrupole

    DOEpatents

    Lancaster, Henry D.; Fugitt, Jock A.; Howard, Donald R.

    1984-01-01

    A long-vane stabilized radio frequency resonator for accelerating charged particles and including means defining a radio frequency resonator cavity, a plurality of long vanes mounted in the defining means for dividing the cavity into sections, and means interconnecting opposing ones of the plurality of vanes for stabilizing the resonator.

  9. Stabilized radio frequency quadrupole

    DOEpatents

    Lancaster, H.D.; Fugitt, J.A.; Howard, D.R.

    1984-12-25

    Disclosed is a long-vane stabilized radio frequency resonator for accelerating charged particles and including means defining a radio frequency resonator cavity, a plurality of long vanes mounted in the defining means for dividing the cavity into sections, and means interconnecting opposing ones of the plurality of vanes for stabilizing the resonator. 5 figs.

  10. Amateur Radio Satellite Communications.

    ERIC Educational Resources Information Center

    Koch, David P.

    The Amateur Radio Satellite Communications project had, as its goal, the assembly of an amateur radio satellite station in a high school physics classroom. Specific objectives were to provide: (1) a special source of interest as a motivator for attracting students and building public relations; (2) a center of interest as a motivator for the study…

  11. Planetary foreshock radio emissions

    NASA Astrophysics Data System (ADS)

    Kuncic, Zdenka; Cairns, Iver H.

    2005-07-01

    The electron foreshock regions upstream of Earth's bow shock and upstream of traveling interplanetary shocks are known to be propitious sites for a variety of energetic particle and plasma wave phenomena, including radio emissions. A quantitative theoretical model has been developed for radio emissions associated with the terrestrial foreshock and for type II radio bursts associated with interplanetary shocks. Here, we generalize this model and apply it to other planetary foreshocks. We present predictions for the levels of planetary foreshock radio emissions and compare these with observations by past and present space missions. One key result is that Mercury can be a strong source of foreshock radio emissions, and this prediction may be testable with the anticipated BepiColombo space mission. Although the terrestrial foreshock radio emissions are the most detectable with existing instruments, our results predict that they are the second strongest in absolute terms, following the Jovian foreshock emissions. Indeed, we predict that the radio instrument on board Ulysses should have detected Jovian foreshock radio emissions, and we suggest that there is some evidence in the data to support this. We also suggest that Cassini was potentially capable of detecting foreshock emissions from Venus during its gravity-assist flybys and may possibly be capable of detecting foreshock emissions from Saturn under favorable solar wind conditions.

  12. Radio Astronomy for Amateurs

    NASA Astrophysics Data System (ADS)

    Quinn, N.; Murdin, P.

    2003-04-01

    Karl Jansky is considered the father of RADIOASTRONOMY. During the 1930s, Jansky worked for the Bell Telephone Laboratories studying the origin of static noise from thunderstorms. During the course of this work he discovered that some signals had an extraterrestrial origin. However, it was Grote Reber, a professional radio engineer and radio amateur, who carried out further investigations. In 1937...

  13. The Radio Jove Project

    NASA Technical Reports Server (NTRS)

    Thieman, J. R.

    2010-01-01

    The Radio love Project is a hands-on education and outreach project in which students, or any other interested individuals or groups build a radio telescope from a kit, operate the radio telescope, transmit the resulting signals through the internet if desired, analyze the results, and share the results with others through archives or general discussions among the observers. Radio love is intended to provide an introduction to radio astronomy for the observer. The equipment allows the user to observe radio signals from Jupiter, the Sun, the galaxy, and Earth-based radiation both natural and man-made. The project was started through a NASA Director's Discretionary Fund grant more than ten years ago. it has continued to be carried out through the dedicated efforts of a group of mainly volunteers. Dearly 1500 kits have been distributed throughout the world. Participation can also be done without building a kit. Pre-built kits are available. Users can also monitor remote radio telescopes through the internet using free downloadable software available through the radiosky.com website. There have been many stories of prize-winning projects, inspirational results, collaborative efforts, etc. We continue to build the community of observers and are always open to new thoughts about how to inspire the observers to still greater involvement in the science and technology associated with Radio Jove.

  14. Writing for Radio.

    ERIC Educational Resources Information Center

    Tupper, Marianna S.

    1995-01-01

    Describes a 24-hour commercial radio station simulation class project for eighth-grade language arts. Students wrote their own scripts, chose music and were disc jockeys on their own music and talk shows, and prepared news and traffic reports. Guest speakers from actual commercial radio came in to discuss issues such as advertising, censorship,…

  15. Film, Radio, and Television.

    ERIC Educational Resources Information Center

    Hardesty, Carolyn, Ed.

    1990-01-01

    This journal issue covers the history of film, radio, and television in Iowa. The first article, "When Pictures and Sound Came to Iowa," summarizes the origin of movies and radio and their early beginnings in Iowa. Using old photographs and measurement charts, the viewing, reading, and listening habits of young people in 1950 and 1958…

  16. Long-Term Results of Targeted Intraoperative Radiotherapy (Targit) Boost During Breast-Conserving Surgery

    SciTech Connect

    Vaidya, Jayant S.; Baum, Michael; Tobias, Jeffrey S.; Wenz, Frederik; Massarut, Samuele; Keshtgar, Mohammed; Hilaris, Basil; Saunders, Christobel; Williams, Norman R.; Brew-Graves, Chris; Corica, Tammy; Roncadin, Mario; Kraus-Tiefenbacher, Uta; Suetterlin, Marc; Bulsara, Max; Joseph, David

    2011-11-15

    Purpose: We have previously shown that delivering targeted radiotherapy to the tumour bed intraoperatively is feasible and desirable. In this study, we report on the feasibility, safety, and long-term efficacy of TARGeted Intraoperative radioTherapy (Targit), using the Intrabeam system. Methods and Materials: A total of 300 cancers in 299 unselected patients underwent breast-conserving surgery and Targit as a boost to the tumor bed. After lumpectomy, a single dose of 20 Gy was delivered intraoperatively. Postoperative external beam whole-breast radiotherapy excluded the usual boost. We also performed a novel individualized case control (ICC) analysis that computed the expected recurrences for the cohort by estimating the risk of recurrence for each patient using their characteristics and follow-up period. Results: The treatment was well tolerated. The median follow up was 60.5 months (range, 10-122 months). Eight patients have had ipsilateral recurrence: 5-year Kaplan Meier estimate for ipsilateral recurrence is 1.73% (SE 0.77), which compares well with that seen in the boosted patients in the European Organization for Research and Treatment of Cancer study (4.3%) and the UK STAndardisation of breast RadioTherapy study (2.8%). In a novel ICC analysis of 242 of the patients, we estimated that there should be 11.4 recurrences; in this group, only 6 recurrences were observed. Conclusions: Lumpectomy and Targit boost combined with external beam radiotherapy results in a low local recurrence rate in a standard risk patient population. Accurate localization and the immediacy of the treatment that has a favorable effect on tumour microenvironment may contribute to this effect. These long-term data establish the long-term safety and efficacy of the Targit technique and generate the hypothesis that Targit boost might be superior to an external beam boost in its efficacy and justifies a randomized trial.

  17. Radio efficiency of pulsars

    SciTech Connect

    Szary, Andrzej; Melikidze, George I.; Gil, Janusz; Zhang, Bing; Xu, Ren-Xin E-mail: zhang@physics.unlv.edu

    2014-03-20

    We investigate radio emission efficiency, ξ, of pulsars and report a near-linear inverse correlation between ξ and the spin-down power, E-dot , as well as a near-linear correlation between ξ and pulsar age, τ. This is a consequence of very weak, if any, dependences of radio luminosity, L, on pulsar period, P, and the period derivative, P-dot , in contrast to X-ray or γ-ray emission luminosities. The analysis of radio fluxes suggests that these correlations are not due to a selection effect, but are intrinsic to the pulsar radio emission physics. We have found that, although with a large variance, the radio luminosity of pulsars is ≈10{sup 29} erg s{sup –1}, regardless of the position in the P-- P-dot diagram. Within such a picture, a model-independent statement can be made that the death line of radio pulsars corresponds to an upper limit in the efficiency of radio emission. If we introduce the maximum value for radio efficiency into the Monte Carlo-based population syntheses we can reproduce the observed sample using the random luminosity model. Using the Kolmogorov-Smirnov test on a synthetic flux distribution reveals a high probability of reproducing the observed distribution. Our results suggest that the plasma responsible for generating radio emission is produced under similar conditions regardless of pulsar age, dipolar magnetic field strength, and spin-down rate. The magnetic fields near the pulsar surface are likely dominated by crust-anchored, magnetic anomalies, which do not significantly differ among pulsars, leading to similar conditions for generating electron-positron pairs necessary to power radio emission.

  18. [Report of the World Federation of Neurosurgical Societies (WFNS) international course and Cameroon Neurosurgery Society Congress (CNS) Yaoundé (Cameroon), 1st--4th October 2007].

    PubMed

    Eyenga, V C; Ndoumbe, A; Eloundou, N J

    2008-04-01

    Neurosurgery remains a very marginal activity in sub-Saharan Africa. In this part of the world which counts nearly 40 countries, some do not have a single neurosurgeon, some have one to five, the number of ten neurosurgeons per country remaining an exception! In its concern of popularizing and of developing neurosurgery worldwide, the WFNS organized an international course in Africa, October 2007 2nd-3rd in Yaoundé (Cameroon). The Cameroon Neurosurgery Society (CNS) took this opportunity to organize its very first congress in the presence of the WFNS delegation from October 1st to 4th, 2007. The joint meeting with the WFNS was baptized the "African Week of Neurosurgery". This special event was a first in sub-Saharan Africa. The delegation of the WFNS, led by Professor J. Brotchi (Belgium) President of the WFNS, was made up of Professors A. Sousa (Brazil), Mr. Choux (France), N. Tribolet (Swiss), M. Arraez (Spain), A. Bricolo (Italy), A. Kamlichi (Morocco), G. Dechambenoit (France), K. Kalangu (Zimbabwe). Twenty three neurosurgeons coming from nine African countries (Cameroon, Nigeria, Gabon, Congo, Niger, Burkina Faso, Ivory Coast, Senegal, and Guinea) took an active part in work. The scientific success of this event led to the creation of the "Association of Neurological Surgeons of Africa (ANSA)" which will be the WFNS-Africa interface in order to insure the development of neurosurgery in Africa.

  19. [Stereotactic radiotherapy for pelvic tumors].

    PubMed

    Mazeron, R; Fumagalli, I

    2014-01-01

    Extracranial stereotactic radiotherapy is booming. The development and spread of dedicated accelerators coupled with efficient methods of repositioning can now allow treatments of mobile lesions with moderate size, with high doses per fraction. Intuitively, except for the prostate, pelvic tumours, often requiring irradiation of regional lymph node drainage, lend little to this type of treatment. However, in some difficult circumstances, such as boost or re-radiation, stereotactic irradiation condition is promising and clinical experiences have already been reported.

  20. Intraoperative radiotherapy for breast cancer

    PubMed Central

    Williams, Norman R.; Pigott, Katharine H.; Brew-Graves, Chris

    2014-01-01

    Intra-operative radiotherapy (IORT) as a treatment for breast cancer is a relatively new technique that is designed to be a replacement for whole breast external beam radiotherapy (EBRT) in selected women suitable for breast-conserving therapy. This article reviews twelve reasons for the use of the technique, with a particular emphasis on targeted intra-operative radiotherapy (TARGIT) which uses X-rays generated from a portable device within the operating theatre immediately after the breast tumour (and surrounding margin of healthy tissue) has been removed. The delivery of a single fraction of radiotherapy directly to the tumour bed at the time of surgery, with the capability of adding EBRT at a later date if required (risk-adaptive technique) is discussed in light of recent results from a large multinational randomised controlled trial comparing TARGIT with EBRT. The technique avoids irradiation of normal tissues such as skin, heart, lungs, ribs and spine, and has been shown to improve cosmetic outcome when compared with EBRT. Beneficial aspects to both institutional and societal economics are discussed, together with evidence demonstrating excellent patient satisfaction and quality of life. There is a discussion of the published evidence regarding the use of IORT twice in the same breast (for new primary cancers) and in patients who would never be considered for EBRT because of their special circumstances (such as the frail, the elderly, or those with collagen vascular disease). Finally, there is a discussion of the role of the TARGIT Academy in developing and sustaining high standards in the use of the technique. PMID:25083504

  1. 75 FR 10439 - Cognitive Radio Technologies and Software Defined Radios

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... COMMISSION 47 CFR Part 2 Cognitive Radio Technologies and Software Defined Radios AGENCY: Federal... implement security features in software defined radios (SDRs). While, the Commission dismisses this petition... Order 1. On March 17, 2005, the Commission adopted the Cognitive Radio Report and Order, 70 FR...

  2. New insights into the synergism of nucleoside analogs with radiotherapy.

    PubMed

    Lee, Michael W; Parker, William B; Xu, Bo

    2013-09-26

    Nucleoside analogs have been frequently used in combination with radiotherapy in the clinical setting, as it has long been understood that inhibition of DNA repair pathways is an important means by which many nucleoside analogs synergize. Recent advances in our understanding of the structure and function of deoxycytidine kinase (dCK), a critical enzyme required for the anti-tumor activity for many nucleoside analogs, have clarified the mechanistic role this kinase plays in chemo- and radio-sensitization. A heretofore unrecognized role of dCK in the DNA damage response and cell cycle machinery has helped explain the synergistic effect of these agents with radiotherapy. Since most currently employed nucleoside analogs are primarily activated by dCK, these findings lend fresh impetus to efforts focused on profiling and modulating dCK expression and activity in tumors. In this review we will briefly review the pharmacology and biochemistry of the major nucleoside analogs in clinical use that are activated by dCK. This will be followed by discussions of recent advances in our understanding of dCK activation via post-translational modifications in response to radiation and current strategies aimed at enhancing this activity in cancer cells.

  3. The DTI Challenge: Towards Standardized Evaluation of Diffusion Tensor Imaging Tractography for Neurosurgery

    PubMed Central

    Pujol, Sonia; Wells, William; Pierpaoli, Carlo; Brun, Caroline; Gee, James; Cheng, Guang; Vemuri, Baba; Commowick, Olivier; Prima, Sylvain; Stamm, Aymeric; Goubran, Maged; Khan, Ali; Peters, Terry; Neher, Peter; Maier-Hein, Klaus H.; Shi, Yundi; Tristan-Vega, Antonio; Veni, Gopalkrishna; Whitaker, Ross; Styner, Martin; Westin, Carl-Fredrik; Gouttard, Sylvain; Norton, Isaiah; Chauvin, Laurent; Mamata, Hatsuho; Gerig, Guido; Nabavi, Arya; Golby, Alexandra; Kikinis, Ron

    2015-01-01

    Background and Purpose Diffusion tensor imaging tractography reconstruction of white matter pathways can help guide brain tumor resection. However, DTI tracts are complex mathematical objects and the validity of tractography-derived information in clinical settings has yet to be fully established. To address this issue, we initiated the DTI Challenge, an international working group of clinicians and scientists whose goal was to provide standardized evaluation of tractography methods for neurosurgery. The purpose of this empirical study was to evaluate different tractography techniques in the first DTI Challenge workshop. Methods Eight international teams from leading institutions reconstructed the pyramidal tract in four neurosurgical cases presenting with a glioma near the motor cortex. Tractography methods included deterministic, probabilistic, filtered, and global approaches. Standardized evaluation of the tracts consisted in the qualitative review of the pyramidal pathways by a panel of neurosurgeons and DTI experts and the quantitative evaluation of the degree of agreement among methods. Results The evaluation of tractography reconstructions showed a great inter-algorithm variability. Although most methods found projections of the pyramidal tract from the medial portion of the motor strip, only a few algorithms could trace the lateral projections from the hand, face, and tongue area. In addition, the structure of disagreement among methods was similar across hemispheres despite the anatomical distortions caused by pathological tissues. Conclusions The DTI Challenge provides a benchmark for the standardized evaluation of tractography methods on neurosurgical data. This study suggests that there are still limitations to the clinical use of tractography for neurosurgical decision-making. PMID:26259925

  4. Max Brödel: his art, legacy, and contributions to neurosurgery through medical illustration.

    PubMed

    Patel, Smruti K; Couldwell, William T; Liu, James K

    2011-07-01

    Max Brödel is considered the father of modern medical illustration. This report reviews his contributions to neurosurgery as a medical illustrator. Max Brödel, a young artist from Leipzig, Germany, was hired at Johns Hopkins Hospital in 1894, where he illustrated an operative textbook of gynecology for Howard A. Kelly. Although Brödel did not have any formal medical training, he quickly acquired knowledge of anatomy, pathology, physiology, and surgery. Brödel's extraordinary illustrations were characterized by an aerial perspective that conveyed the surgeon's operative viewpoint and precise surgical anatomy. He masterfully incorporated tissue realism with cross-sectional anatomy to accentuate concepts while maintaining topographical accuracy. Brödel's reputation spread quickly and resulted in collaborations with prominent surgeons, such as Cushing, Halsted, and Dandy. Cushing, who also possessed artistic talent, became a pupil of Brödel and remained a very close friend. In 1911, Brödel was appointed the director of the Department of Art as Applied to Medicine at Johns Hopkins, the first academic department of its kind in the world. For the next several decades, he trained generations of renowned medical illustrators. Just as Osler, Halsted, and Cushing passed their skills and knowledge to future leaders of medicine and surgery, Brödel did the same for the field of medical illustration. The advancement of neurosurgical education has been greatly facilitated by Max Brödel's artistic contributions. His unique ability to synthesize art and medicine resulted in timeless illustrations that remain indispensable to surgeons. The art produced by his legacy of illustrators continues to flourish in neurosurgical literature today.

  5. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    NASA Astrophysics Data System (ADS)

    Alva-Sánchez, Héctor; Reynoso-Mejía, Alberto; Casares-Cruz, Katiuzka; Taboada-Barajas, Jesús

    2014-11-01

    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  6. Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?

    PubMed

    Davies, B M; Patel, H C

    2016-07-01

    Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination. Results SSIs were detected in 2.6% of 1146 cases. Antisepsis with PVI alone was performed in 654 (57%) procedures, while 276 (24%) had CHG alone and 216 (19%) CHG and PVI together. SSIs were associated with longer operating time (p<0.001) and younger age (p=0.03). Surgery type (p<0.001) and length of operation (p<0.001) were significantly different between antisepsis groups. In a binary logistic regression model, CHG and PVI was associated with a significant reduction in the likelihood of developing an SSI (adjusted odds ratio [AOR] 0.12, 95% confidence interval [CI] 0.02-0.63) than either agent alone. There was no difference in SSI rates between CHG and PVI alone (AOR 0.60, 95% CI 0.24-1.5). Conclusions Combination skin preparation with CHG and PVI significantly reduced SSI rates compared to CHG or PVI alone. A prospective, randomized study validating these findings is now warranted.

  7. Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?

    PubMed Central

    Davies, BM; Patel, HC

    2016-01-01

    Introduction Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. Effective preoperative antisepsis is a recognised prophylactic, with commonly used agents including chlorhexidine (CHG) and povidone-iodine (PVI). However, there is emerging evidence to suggest an additional benefit when they are used in combination. Methods We analysed data from our prospective SSI database on patients undergoing clean cranial neurosurgery between October 2011 and April 2014. We compared the case-mix adjusted odds of developing a SSI in patients undergoing skin preparation with CGH or PVI alone or in combination. Results SSIs were detected in 2.6% of 1146 cases. Antisepsis with PVI alone was performed in 654 (57%) procedures, while 276 (24%) had CHG alone and 216 (19%) CHG and PVI together. SSIs were associated with longer operating time (p<0.001) and younger age (p=0.03). Surgery type (p<0.001) and length of operation (p<0.001) were significantly different between antisepsis groups. In a binary logistic regression model, CHG and PVI was associated with a significant reduction in the likelihood of developing an SSI (adjusted odds ratio [AOR] 0.12, 95% confidence interval [CI] 0.02–0.63) than either agent alone. There was no difference in SSI rates between CHG and PVI alone (AOR 0.60, 95% CI 0.24–1.5). Conclusions Combination skin preparation with CHG and PVI significantly reduced SSI rates compared to CHG or PVI alone. A prospective, randomized study validating these findings is now warranted. PMID:27055411

  8. The 2009 devaluation of radiosurgery and its impact on the neurosurgery-radiation oncology partnership.

    PubMed

    Heilbrun, M Peter; Adler, John R

    2010-07-01

    Neurosurgeons, radiation oncologists, and, increasingly, other surgical specialists recognize that radiosurgery is an important tool for managing selected disorders throughout the body. The partnership between neurosurgeons and radiation oncologists has resulted in collaborative studies that have established the clinical benefits of radiosurgery. Today, however, a range of political and financial issues is straining this relationship and thereby undermining the practice of radiosurgery. Neurosurgeons and radiation oncologists recently restricted the definition of radiosurgery to include only cranial- and spine-focused radiation treatments. Meanwhile, organized radiation oncology decided unilaterally that radiosurgery administered to other parts of the body would be termed stereotactic body radiation therapy. Finally, neurosurgical and radiation oncology coding experts developed new Current Procedural Terminology codes for cranial vault and spine radiosurgery, which were approved for use by the Relative Value Scale Update Committee as of 2009. The authors suggest that the neurosurgery strategy-which included 1) reasserting that all of the tasks of a radiosurgery procedure remain bundled, and 2) agreeing to limit the definition of radiosurgery to cranial vault and spine-has failed neurosurgeons who perform radiosurgery, and it may jeopardize patient access to this procedure in the future. The authors propose that all of the involved medical specialties recognize that the application of image-guided, focused radiation therapy throughout the body requires a partnership between radiation and surgical disciplines. They also urge surgeons to reexamine their coding methods, and they maintain that Current Procedural Terminology codes should be consistent across all of the different specialties involved in these procedures. Finally, surgeons should consider appropriate training in medical physics and radiobiology to perform the tasks involved in these specific procedures

  9. Graphical user interfaces for simulation of brain deformation in image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Fan, Xiaoyao; Ji, Songbai; Valdes, Pablo; Roberts, David W.; Hartov, Alex; Paulsen, Keith D.

    2010-02-01

    In image-guided neurosurgery, preoperative images are typically used for surgical planning and intraoperative guidance. The accuracy of preoperative images can be significantly compromised by intraoperative brain deformation. To compensate for brain shift, biomechanical finite element models have been used to assimilate intraoperative data to simulate brain deformation. The clinical feasibility of the approach strongly depends on its accuracy and efficiency. In order to facilitate and streamline data flow, we have developed graphical user interfaces (GUIs) to provide efficient image updates in the operating room (OR). The GUIs are organized in a top-down hierarchy with a main control panel that invokes and monitors a series of sub-GUIs dedicated to perform tasks involved in various aspects of computations of whole-brain deformation. These GUIs are used to segment brain, generate case-specific brain meshes, and assign and visualize case-specific boundary conditions (BC). Registration between intraoperative ultrasound (iUS) images acquired pre- and post-durotomy is also facilitated by a dedicated GUI to extract sparse displacement data used to drive a biomechanical model. Computed whole-brain deformation is then used to morph preoperative MR images (pMR) to generate a model-updated image set (i.e., uMR) for intraoperative guidance (accuracy of 1-2 mm). These task-driven GUIs have been designed to be fault-tolerant, user-friendly, and with sufficient automation. In this paper, we present the modular components of the GUIs and demonstrate the typical workflow through a clinical patient case.

  10. Financial and clinical governance implications of clinical coding accuracy in neurosurgery: a multidisciplinary audit.

    PubMed

    Haliasos, N; Rezajooi, K; O'neill, K S; Van Dellen, J; Hudovsky, Anita; Nouraei, Sar

    2010-04-01

    Clinical coding is the translation of documented clinical activities during an admission to a codified language. Healthcare Resource Groupings (HRGs) are derived from coding data and are used to calculate payment to hospitals in England, Wales and Scotland and to conduct national audit and benchmarking exercises. Coding is an error-prone process and an understanding of its accuracy within neurosurgery is critical for financial, organizational and clinical governance purposes. We undertook a multidisciplinary audit of neurosurgical clinical coding accuracy. Neurosurgeons trained in coding assessed the accuracy of 386 patient episodes. Where clinicians felt a coding error was present, the case was discussed with an experienced clinical coder. Concordance between the initial coder-only clinical coding and the final clinician-coder multidisciplinary coding was assessed. At least one coding error occurred in 71/386 patients (18.4%). There were 36 diagnosis and 93 procedure errors and in 40 cases, the initial HRG changed (10.4%). Financially, this translated to pound111 revenue-loss per patient episode and projected to pound171,452 of annual loss to the department. 85% of all coding errors were due to accumulation of coding changes that occurred only once in the whole data set. Neurosurgical clinical coding is error-prone. This is financially disadvantageous and with the coding data being the source of comparisons within and between departments, coding inaccuracies paint a distorted picture of departmental activity and subspecialism in audit and benchmarking. Clinical engagement improves accuracy and is encouraged within a clinical governance framework.

  11. New technologies in neurosurgery: Effects on the conventional techniques and anaesthesiological considerations

    NASA Astrophysics Data System (ADS)

    Fasano, V. A.; Lombard, G. F.; Urciuoli, R.; Benech, F.; Ponzio, R. M.

    1985-09-01

    New technologies have been recently introduced into neurosurgery: laser sources, ultrasonic aspiration, intraoperative echotomography and intraoperative Doppler flowmeter. The aim of this work, showing the use of these instruments in different neurosurgical operations, is to discuss the effective improvements of the surgical techniques when comparing new and traditional technologies. The laser is able to concentrate high energies in restricted areas allowing a maximum selectivity. Having a superficial destructive effect with associated hemostasis, CO 2 and argon are suitable in dissection maneuvers. Nd:YAG produces a high thermal diffusion, consenting a deeper and extended tissue removal and a considerable reduction of intraoperative blood loss also in vascularized tumors. A promising field of application of the laser is the treatment of cerebral vascular malformations. In arterio-venous malformations the irradiation of the nidus with Nd:YAG produces a rapid obliteration of the pathologic vessels. This technique avoids the isolation of the feeding arteries and reduces the manipulation of the surrounding tissue. In small saccular aneurysms an argon laser is used to produce a shrinkage of the dilatation with consequent occlusion of the malformation. The ultrasonic aspirator is used in the tumoral surgery to obtain a more rapid demolition of the mass by fragmentation and suction. Intraoperative echotomography consents a sharp topographic localization of the lesion, particularly in deeper cerebral areas, providing data on the nature of solid tumors. The intraoperative Doppler flowmeter is useful for identification of the feeding arteries and the shunt of the small deep-seated arterio-venous malformations consenting a dynamic evaluation of the operation. General anaesthesia in neurosurgical procedures is favourably influenced by laser use. Conventional anaesthetic techniques, however, must be modified to avoid the harmful effect of the laser, depending on the movements

  12. Towards the development of a spring-based continuum robot for neurosurgery

    NASA Astrophysics Data System (ADS)

    Kim, Yeongjin; Cheng, Shing Shin; Desai, Jaydev P.

    2015-03-01

    Brain tumor is usually life threatening due to the uncontrolled growth of abnormal cells native to the brain or the spread of tumor cells from outside the central nervous system to the brain. The risks involved in carrying out surgery within such a complex organ can cause severe anxiety in cancer patients. However, neurosurgery, which remains one of the more effective ways of treating brain tumors focused in a confined volume, can have a tremendously increased success rate if the appropriate imaging modality is used for complete tumor removal. Magnetic resonance imaging (MRI) provides excellent soft-tissue contrast and is the imaging modality of choice for brain tumor imaging. MRI combined with continuum soft robotics has immense potential to be the revolutionary treatment technique in the field of brain cancer. It eliminates the concern of hand tremor and guarantees a more precise procedure. One of the prototypes of Minimally Invasive Neurosurgical Intracranial Robot (MINIR-II), which can be classified as a continuum soft robot, consists of a snake-like body made of three segments of rapid prototyped plastic springs. It provides improved dexterity with higher degrees of freedom and independent joint control. It is MRI-compatible, allowing surgeons to track and determine the real-time location of the robot relative to the brain tumor target. The robot was manufactured in a single piece using rapid prototyping technology at a low cost, allowing it to disposable after each use. MINIR-II has two DOFs at each segment with both joints controlled by two pairs of MRI-compatible SMA spring actuators. Preliminary motion tests have been carried out using vision-tracking method and the robot was able to move to different positions based on user commands.

  13. The impact of a patient education bundle on neurosurgery patient satisfaction

    PubMed Central

    Kliot, Tamara; Zygourakis, Corinna C.; Imershein, Sarah; Lau, Catherine; Kliot, Michel

    2015-01-01

    Background: As reimbursements and hospital/physician performance become ever more reliant on Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) and other quality metrics, physicians are increasingly incentivized to improve patient satisfaction. Methods: A faculty and resident team at the University of California, San Francisco (UCSF) Department of Neurological Surgery developed and implemented a Patient Education Bundle. This consisted of two parts: The first was preoperative expectation letters (designed to inform patients of what to expect before, during, and after their hospitalization for a neurosurgical procedure); the second was a trifold brochure with names, photographs, and specialty/training information about the attending surgeons, resident physicians, and nurse practitioners on the neurosurgical service. We assessed patient satisfaction, as measured by HCAHPS scores and a brief survey tailored to our specific intervention, both before and after our Patient Education Bundle intervention. Results: Prior to our intervention, 74.6% of patients responded that the MD always explained information in a way that was easy to understand. After our intervention, 78.7% of patients responded that the MD always explained information in a way that was easy to understand. “Neurosurgery Patient Satisfaction survey” results showed that 83% remembered receiving the preoperative letter; of those received the letter, 93% found the letter helpful; and 100% thought that the letter should be continued. Conclusion: Although effects were modest, we believe that patient education strategies, as modeled in our bundle, can improve patients’ hospital experiences and have a positive impact on physician performance scores and hospital ratings. PMID:26664909

  14. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    SciTech Connect

    Alva-Sánchez, Héctor

    2014-11-07

    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  15. Automatic deformable MR-ultrasound registration for image-guided neurosurgery.

    PubMed

    Rivaz, Hassan; Chen, Sean Jy-Shyang; Collins, D Louis

    2015-02-01

    In this work, we present a novel algorithm for registration of 3-D volumetric ultrasound (US) and MR using Robust PaTch-based cOrrelation Ratio (RaPTOR). RaPTOR computes local correlation ratio (CR) values on small patches and adds the CR values to form a global cost function. It is therefore invariant to large amounts of spatial intensity inhomogeneity. We also propose a novel outlier suppression technique based on the orientations of the RaPTOR gradients. Our deformation is modeled with free-form cubic B-splines. We analytically derive the derivatives of RaPTOR with respect to the transformation, i.e., the displacement of the B-spline nodes, and optimize RaPTOR using a stochastic gradient descent approach. RaPTOR is validated on MR and tracked US images of neurosurgery. Deformable registration of the US and MR images acquired, respectively, preoperation and postresection is of significant clinical significance, but challenging due to, among others, the large amount of missing correspondences between the two images. This work is also novel in that it performs automatic registration of this challenging dataset. To validate the results, we manually locate corresponding anatomical landmarks in the US and MR images of tumor resection in brain surgery. Compared to rigid registration based on the tracking system alone, RaPTOR reduces the mean initial mTRE over 13 patients from 5.9 to 2.9 mm, and the maximum initial TRE from 17.0 to 5.9 mm. Each volumetric registration using RaPTOR takes about 30 sec on a single CPU core. An important challenge in the field of medical image analysis is the shortage of publicly available dataset, which can both facilitate the advancement of new algorithms to clinical settings and provide a benchmark for comparison. To address this problem, we will make our manually located landmarks available online.

  16. Retractor-induced brain shift compensation in image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Fan, Xiaoyao; Ji, Songbai; Hartov, Alex; Roberts, David; Paulsen, Keith

    2013-03-01

    In image-guided neurosurgery, intraoperative brain shift significantly degrades the accuracy of neuronavigation that is solely based on preoperative magnetic resonance images (pMR). To compensate for brain deformation and to maintain the accuracy in image guidance achieved at the start of surgery, biomechanical models have been developed to simulate brain deformation and to produce model-updated MR images (uMR) to compensate for brain shift. To-date, most studies have focused on shift compensation at early stages of surgery (i.e., updated images are only produced after craniotomy and durotomy). Simulating surgical events at later stages such as retraction and tissue resection are, perhaps, clinically more relevant because of the typically much larger magnitudes of brain deformation. However, these surgical events are substantially more complex in nature, thereby posing significant challenges in model-based brain shift compensation strategies. In this study, we present results from an initial investigation to simulate retractor-induced brain deformation through a biomechanical finite element (FE) model where whole-brain deformation assimilated from intraoperative data was used produce uMR for improved accuracy in image guidance. Specifically, intensity-encoded 3D surface profiles at the exposed cortical area were reconstructed from intraoperative stereovision (iSV) images before and after tissue retraction. Retractor-induced surface displacements were then derived by coregistering the surfaces and served as sparse displacement data to drive the FE model. With one patient case, we show that our technique is able to produce uMR that agrees well with the reconstructed iSV surface after retraction. The computational cost to simulate retractor-induced brain deformation was approximately 10 min. In addition, our approach introduces minimal interruption to the surgical workflow, suggesting the potential for its clinical application.

  17. Radio broadcasting via satellite

    NASA Astrophysics Data System (ADS)

    Helm, Neil R.; Pritchard, Wilbur L.

    1990-10-01

    Market areas offering potential for future narrowband broadcast satellites are examined, including international public diplomacy, government- and advertising-supported, and business-application usages. Technical issues such as frequency allocation, spacecraft types, transmission parameters, and radio receiver characteristics are outlined. Service and system requirements, advertising revenue, and business communications services are among the economic issues discussed. The institutional framework required to provide an operational radio broadcast service is studied, and new initiatives in direct broadcast audio radio systems, encompassing studies, tests, in-orbit demonstrations of, and proposals for national and international commercial broadcast services are considered.

  18. Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma

    SciTech Connect

    Sabolch, Aaron; Feng, Mary; Griffith, Kent; Hammer, Gary; Doherty, Gerard; Ben-Josef, Edgar

    2011-08-01

    Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.

  19. Postoperative Intensity-Modulated Radiotherapy in Low-Risk Endometrial Cancers: Final Results of a Phase I Study

    SciTech Connect

    Macchia, Gabriella; Cilla, Savino M.P.; Ferrandina, Gabriella; Padula, Gilbert D.A.; Deodato, Francesco; Digesu, Cinzia; Caravatta, Luciana; Picardi, Vincenzo; Corrado, Giacomo; Piermattei, Angelo; Valentini, Vincenzo; Cellini, Numa; Scambia, Giovanni; Morganti, Alessio Giuseppe

    2010-04-15

    Purpose: To determine the maximum tolerated dose of short-course radiotherapy (intensity-modulated radiotherapy technique) to the upper two thirds of the vagina in endometrial cancers with low risk of local recurrence. Patients and Methods: A Phase I clinical trial was performed. Eligible patients had low-risk resected primary endometrial adenocarcinomas. Radiotherapy was delivered in 5 fractions over 1 week. The planning target volume was the clinical target volume plus 5 mm. The clinical target volume was defined as the upper two thirds of the vagina as evidenced at CT simulation by a vaginal radio-opaque device. The planning target volume was irradiated by a seven-field intensity-modulated radiotherapy technique, planned by the Plato Sunrise inverse planning system. A first cohort of 6 patients received 25 Gy (5-Gy fractions), and a subsequent cohort received 30 Gy (6-Gy fractions). The Common Toxicity Criteria scale, version 3.0, was used to score toxicity. Results: Twelve patients with endometrial cancer were enrolled. Median age was 58 years (range, 49-74 years). Pathologic stage was IB (83.3%) and IC (16.7%). Median tumor size was 30 mm (range, 15-50 mm). All patients completed the prescribed radiotherapy. No patient experienced a dose-limiting toxicity at the first level, and the radiotherapy dose was escalated from 25 to 30 Gy. No patients at the second dose level experienced dose-limiting toxicity. The most common Grade 2 toxicity was gastrointestinal, which was tolerable and manageable. Conclusions: The maximum tolerated dose of short-course radiotherapy was 30 Gy at 6 Gy per fraction. On the basis of this result, we are conducting a Phase II study with radiotherapy delivered at 30 Gy.

  20. A comparative cost analysis of polytrauma and neurosurgery Intensive Care Units at an apex trauma care facility in India

    PubMed Central

    Kumar, Parmeshwar; Jithesh, V.; Gupta, Shakti Kumar

    2016-01-01

    Context: Although Intensive Care Units (ICUs) only account for 10% of the hospital beds, they consume nearly 22% of the hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: The aim of this study was to evaluate and compare the cost of intensive care delivery between multispecialty and neurosurgery ICUs at an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203-bedded Level IV trauma care facility in New Delhi, India, from May 1, 2012 to June 30, 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in the study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Statistical analysis was performed by Fisher's two tailed t-test. Results: Total cost/bed/day for the multispecialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU, it was Rs. 14,306.7/-, workforce constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist health-care decision makers in better allocation of resources. Although multispecialty ICUs are more cost-effective, other factors will also play a role in defining the kind of ICU that needs to be designed. PMID:27555693

  1. Academic Productivity of US Neurosurgery Residents as Measured by H-Index: Program Ranking with Correlation to Faculty Productivity.

    PubMed

    Sarkiss, Christopher A; Riley, Kyle J; Hernandez, Christopher M; Oermann, Eric K; Ladner, Travis R; Bederson, Joshua B; Shrivastava, Raj K

    2017-03-29

    Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P < .001). Increasing program size leads to a clear increase in academic productivity on both the

  2. First Experiences in Intensity Modulated Radiation Surgery at the National Institute of Neurology and Neurosurgery: A Dosimetric Point of View

    NASA Astrophysics Data System (ADS)

    Lárraga-Gutiérrez, José M.; Celis-López, Miguel A.

    2003-09-01

    The National Institute of Neurology and Neurosurgery in Mexico City has acquired a Novalis® shaped beam radiosurgery unit. The institute is pioneer in the use of new technologies for neuroscience. The Novalis® unit allows the use of conformal beam radiosurgery/therapy and the more advanced modality of conformal therapy: Intensity Modulated Radiation Therapy (IMRT). In the present work we present the first cases of treatments that use the IMRT technique and show its ability to protect organs at risk, such as brainstem and optical vias.

  3. Eratosthenes via Ham Radio

    ERIC Educational Resources Information Center

    Koser, John F.

    1975-01-01

    A secondary geology class used Eratosthenes' method for measuring the circumference of the earth by comparing their measurements of the shadow of a vertical rod to the measurements made by another person contacted by ham radio. (MLH)

  4. Unveiling the radio cosmos

    NASA Astrophysics Data System (ADS)

    Vanderlinde, Keith

    2017-02-01

    Using a radio telescope with no moving parts, the dark energy speeding up the expansion of the Universe can be probed in unprecedented detail, says Keith Vanderlinde, on behalf of the CHIME collaboration.

  5. Fast Radio Bursts

    NASA Astrophysics Data System (ADS)

    Kaspi, Victoria M.

    2017-01-01

    Fast Radio Bursts (FRBs) are a recently discovered phenomenon consisting of short (few ms) bursts of radio waves that have dispersion measures that strongly suggest an extragalactic and possibly cosmological origin. Current best estimates for the rate of FRBs is several thousand per sky per day at radio frequencies near 1.4 GHz. Even with so high a rate, to date, fewer than 20 FRBs have been reported, with one source showing repeated bursts. In this talk I will describe known FRB properties including what is known about the lone repeating source, as well as models for the origin of these mysterious events. I will also describe the CHIME radio telescope, currently under construction in Canada. Thanks to its great sensitivity and unprecedented field-of-view, CHIME promises major progress on FRBs.

  6. Packet Radio for Library Automation.

    ERIC Educational Resources Information Center

    Brownrigg, Edwin B.; And Others

    1984-01-01

    This tutorial on packet radio (communication system using radio and digital packet-switching technology) highlights radio transmission of data, brief history, special considerations in applying packet radio to library online catalogs, technology, defining protocol at physical and network levels, security, geographic coverage, and components. (A…

  7. Soldier’s Radio

    DTIC Science & Technology

    1992-02-14

    individual soldier. "t’s primary use is by individuals in squads or small units, but may also be used to interconnect into local and wide area...Velopilnq the concept for the Soldier’s Radio. The operation of the SR can be partitioned into two areas. The architecture required to provide intra- squad ... SQUAD CONMECTrVITY The basic radio ccmmunications architectures suitable for :cnsideration for the SR intra- squad operations include the Net, .tar

  8. The Radio JOVE Project

    NASA Astrophysics Data System (ADS)

    Garcia, L.; Thieman, J.; Higgins, C.

    1999-09-01

    Radio JOVE is an interactive educational activity which brings the radio sounds of Jupiter and the Sun to students, teachers, and the general public. This is accomplished through the construction of a simple radio telescope kit and the use of a real-time radio observatory on the Internet. Our website (http://radiojove.gsfc.nasa.gov/) will contain science information, instruction manuals, observing guides, and education resources for students and teachers. Our target audience is high school science classes, but subjects can be tailored to college undergraduate physics and astronomy courses or even to middle school science classes. The goals of the project are: 1) Educate people about planetary and solar radio astronomy, space physics, and the scientific method 2) Provide teachers and students with a hands-on radio astronomy exercise as a science curriculum support activity by building and using a simple radio telescope receiver/antenna kit 3) Create the first ever online radio observatory which provides real-time data for those with internet access 4) Allow interactions among participating schools by facilitating exchanges of ideas, data, and observing experiences. Our current funding will allow us to impact 100 schools by partially subsidizing their participation in the program. We expect to expand well beyond this number as publicity and general interest increase. Additional schools are welcome to fully participate, but we will not be able to subsidize their kit purchases. We hope to make a wide impact among the schools by advertising through appropriate newsletters, space grant consortia, the INSPIRE project (http://image.gsfc.nasa.gov/poetry/inspire/), electronic links, and science and education meetings. We would like to acknoledge support from the NASA/GSFC Director's Discretionary Fund, the STScI IDEAS grant program and the NASA/GSFC Space Science Data Operations Office.

  9. Radio spectrum surveillance station

    NASA Technical Reports Server (NTRS)

    Hersey, D. R.

    1979-01-01

    The paper presents a general and functional description of a low-cost surveillance station designed as the first phase of NASA's program to develop a radio spectrum surveillance capability for deep space stations for identifying radio frequency interference sources. The station described has identified several particular interferences and is yielding spectral signature data which, after cataloging, will serve as a library for rapid identification of frequently observed interference. Findings from the use of the station are discussed.

  10. Radio observations of solar eclipse.

    NASA Astrophysics Data System (ADS)

    Liu, Yuying; Fu, Qijun

    1998-09-01

    For radio astronomy, a solar eclipse provides an opportunity for making solar radio observations with high one-dimension spatial resolution. The radio observation of a solar eclipse has played an important role in solar radio physics. Some important factors for radio observation of a solar eclipse are introduced and analysed. Solar eclipse radio observation has also played an important role in the progress of solar radio atronomy in China. The solar eclipses of 1958, 1968, 1980 and 1987, which were observed in China, are introduced, and the main results of these observations are briefly shown.

  11. Stevens-Johnson Syndrome and toxic epidermal necrolysis overlap due to oral temozolomide and cranial radiotherapy.

    PubMed

    Sarma, Nilendu

    2009-01-01

    A 46-year-old man developed Stevens-Johnson syndrome and toxic epidermal necrolysis overlap, with severe localized denudation of the skin on the head and neck, following radiotherapy and oral temozolomide therapy for cranial glioblastoma multiforme. He also had a primary malignant fibrous histiocytoma of the thigh that was amputated 5 years earlier. A rash developed after 7 days of radio- and chemotherapy. It was an extensive maculopapular rash that started over the temporal area of the head and rapidly spread, sparing only the distal limbs. Radiotherapy and temozolomide were stopped on the tenth day but the rash rapidly progressed for the next 4-6 days. Following this, the spread halted and complete recovery was observed within the next 2 weeks. The peculiarity of the presentation in this case was that the brunt of the disease with severe skin denudation was localized to the surrounding areas of cranial radiotherapy. The patient was also receiving oral phenytoin, diclofenac, and parenteral dexamethasone before chemotherapy was started. These medications were continued, even after development of the skin rash, until well after full recovery from the skin lesions. After critical evaluation of disease onset, progression, and recovery, and their relationship to the introduction and withdrawal of different medicines, it appeared that either temozolomide alone or in combination with radiotherapy most probably triggered the condition.

  12. Astrometry of southern radio sources.

    PubMed

    White, G L; Jauncey, D L; Harvey, B R; Savage, A; Gulkis, S; Preston, R A; Peterson, B A; Reynolds, J E; Nicolson, G D; Malin, D F

    1991-01-01

    An overview is presented of a number of astrometry and astrophysics programs based on radio sources from the Parkes 2.7 GHz catalogues. The programs cover the optical identification and spectroscopy of flat-spectrum Parkes sources and the determination of their milliarc-second radio structures and positions. Work is also in progress to tie together the radio and Hipparcos positional reference frames. A parallel program of radio and optical astrometry of southern radio stars is also under way.

  13. Radiotherapy in patients with connective tissue diseases.

    PubMed

    Giaj-Levra, Niccolò; Sciascia, Savino; Fiorentino, Alba; Fersino, Sergio; Mazzola, Rosario; Ricchetti, Francesco; Roccatello, Dario; Alongi, Filippo

    2016-03-01

    The decision to offer radiotherapy in patients with connective tissue diseases continues to be challenging. Radiotherapy might trigger the onset of connective tissue diseases by increasing the expression of self-antigens, diminishing regulatory T-cell activity, and activating effectors of innate immunity (dendritic cells) through Toll-like receptor-dependent mechanisms, all of which could potentially lead to breaks of immune tolerance. This potential risk has raised some debate among radiation oncologists about whether patients with connective tissue diseases can tolerate radiation as well as people without connective tissue diseases. Because the number of patients with cancer and connective tissue diseases needing radiotherapy will probably increase due to improvements in medical treatment and longer life expectancy, the issue of interactions between radiotherapy and connective tissue diseases needs to be clearer. In this Review, we discuss available data and evidence for patients with connective tissue diseases treated with radiotherapy.

  14. Sensitization of radio-resistant prostate cancer cells with a unique cytolethal distending toxin

    PubMed Central

    Lai, Chih-Ho; Chang, Chia-Shuo; Liu, Hsin-Ho; Tsai, Yuh-Shyan; Hsu, Feng-Ming; Yu, Yung-Luen; Lai, Cheng-Kuo; Gandee, Leah; Pong, Rey-Chen; Hsu, Heng-Wei; Yu, Lan; Saha, Debabrata; Hsieh, Jer-Tsong

    2014-01-01

    Cytolethal distending toxin (CDT) produced by Campylobacter jejuni is a genotoxin that induces cell-cycle arrest and apoptosis in mammalian cells. Recent studies have demonstrated that prostate cancer (PCa) cells can acquire radio-resistance when DOC-2/DAB2 interactive protein (DAB2IP) is downregulated. In this study, we showed that CDT could induce cell death in DAB2IP-deficient PCa cells. A combination of CDT and radiotherapy significantly elicited cell death in DAB2IP-deficient PCa cells by inhibiting the repair of ionizing radiation (IR)-induced DNA double-strand break (DSB) during G2/M arrest, which is triggered by ataxia telangiectasia mutated (ATM)-dependent DNA damage checkpoint responses. We also found that CDT administration significantly increased the efficacy of radiotherapy in a xenograft mouse model. These results indicate that CDT can be a potent therapeutic agent for radio-resistant PCa. PMID:25015118

  15. Comparison between skin-mounted fiducials and bone-implanted fiducials for image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Rost, Jennifer; Harris, Steven S.; Stefansic, James D.; Sillay, Karl; Galloway, Robert L., Jr.

    2004-05-01

    Point-based registration for image-guided neurosurgery has become the industry standard. While the use of intrinsic points is appealing because of its retrospective nature, affixing extrinsic objects to the head prior to scanning has been demonstrated to provide much more accurate registrations. Points of reference between image space and physical space are called fiducials. The extrinsic objects which generate those points are fiducial markers. The markers can be broken down into two classifications: skin-mounted and bone-implanted. Each has distinct advantages and disadvantages. Skin-mounted fiducials require simply sticking them on the patient in locations suggested by the manufacturer, however, they can move with tractions placed on the skin, fall off and perhaps the most dangerous problem, they can be replaced by the patient. Bone implanted markers being rigidly affixed to the skull do not present such problems. However, a minor surgical intervention (analogous to dental work) must be performed to implant the markers prior to surgery. Therefore marker type and use has become a decision point for image-guided surgery. We have performed a series of experiments in an attempt to better quantify aspects of the two types of markers so that better informed decisions can be made. We have created a phantom composed of a full-size plastic skull [Wards Scientific Supply] with a 500 ml bag of saline placed in the brain cavity. The skull was then sealed. A skin mimicking material, DragonSkinTM [SmoothOn Company] was painted onto the surface and allowed to dry. Skin mounted fiducials [Medtronic-SNT] and bone-implanted markers [Z-Kat]were placed on the phantom. In addition, three additional bone-implanted markers were placed (two on the base of the skull and one in the eye socket for use as targets). The markers were imaged in CT and 4 MRI sequences (T1-weighted, T2 weighted, SPGR, and a functional series.) The markers were also located in physical space using an Optotrak

  16. Radiotherapy by particle beams (hadrontherapy) of intracranial tumours: a survey on pathology.

    PubMed

    Schiffer, D

    2005-04-01

    A review of the principal contributions of radio-therapy of brain tumours by beam particles is carried out. Neutrons, protons and light ions are considered along with their pros and cons in relation to types and locations of brain tumours. A particular emphasis is given to the pathologic studies of their effects directly o n tumours and on the normal nervous tissue, considering mainly the relevant action mechanisms of the radiation types and the requirements of the clinical therapeutic strategies. For comparison the main features of the pathologic effects of radiotherapy by photons are described. From the review it emerges that the new modality of radiation by protons and light ions, because of their peculiar physical characteristics, may represent a new way of destroying the tumour and sparing normal nervous tissue, especially when deeply located and irregularly shaped tumours are concerned. More neuropathological studies are needed in order to better understand the potentiality of the new treatment of modalities.

  17. Radio data archiving system

    NASA Astrophysics Data System (ADS)

    Knapic, C.; Zanichelli, A.; Dovgan, E.; Nanni, M.; Stagni, M.; Righini, S.; Sponza, M.; Bedosti, F.; Orlati, A.; Smareglia, R.

    2016-07-01

    Radio Astronomical Data models are becoming very complex since the huge possible range of instrumental configurations available with the modern Radio Telescopes. What in the past was the last frontiers of data formats in terms of efficiency and flexibility is now evolving with new strategies and methodologies enabling the persistence of a very complex, hierarchical and multi-purpose information. Such an evolution of data models and data formats require new data archiving techniques in order to guarantee data preservation following the directives of Open Archival Information System and the International Virtual Observatory Alliance for data sharing and publication. Currently, various formats (FITS, MBFITS, VLBI's XML description files and ancillary files) of data acquired with the Medicina and Noto Radio Telescopes can be stored and handled by a common Radio Archive, that is planned to be released to the (inter)national community by the end of 2016. This state-of-the-art archiving system for radio astronomical data aims at delegating as much as possible to the software setting how and where the descriptors (metadata) are saved, while the users perform user-friendly queries translated by the web interface into complex interrogations on the database to retrieve data. In such a way, the Archive is ready to be Virtual Observatory compliant and as much as possible user-friendly.

  18. Thioridazine Sensitizes Esophageal Carcinoma Cell Lines to Radiotherapy-Induced Apoptosis In Vitro and In Vivo

    PubMed Central

    Li, Hongxia; Juan, Li; Xia, Leiming; Wang, Yi; Bao, Yangyi; Sun, Guoping

    2016-01-01

    Background Radiotherapy is one of the primary treatments for esophageal squamous cell carcinoma (ESCC). Identification of novel radio-sensitizing agents will improve the therapeutic outcome of radiotherapy. This study aimed to determine the radio-sensitizing effect of the antipsychotic agent thioridazine in ESCC and explored the underlying mechanisms. Material/Methods ECA-109 and TE-1 ESCC cells were treated with thioridazine and radiotherapy alone and in combination. Cell survival was measured by MTT assay. Cell cycle and apoptosis were monitored by flow cytometry. Western blot analysis was used to analyze the expression of phospho-PI3K, phosphor-AKT, phospho-mTOR, Caspase-3, Caspase-9, Bax, Bcl-2, Bal-xl, Bak, and p53. The xenograft mouse model was used to study the in vivo anticancer effect of thioridazine and irradiation. Results Combined treatment with thioridazine and irradiation significantly reduced viability of ESCC cells compared with thioridazine or irradiation treatment alone. Thioridazine and irradiation treatment induced G0/G1 phases cell cycle arrest through down-regulation of CDK4 and cyclinD1. In addition, thioridazine and irradiation treatment induced apoptosis through up-regulation of cleaved capase-3 and 9, as well as an increase in the expression of Bax and Bak and a decrease in the expression of Bcl-2 and Bcl-xl. Furthermore, thioridazine and irradiation treatment inhibited the PI3K-AKT-mTOR pathway and up-regulated the expression of p53. In xenograft mice, thioridazine and irradiation reduced ESCC tumor growth. Conclusions Thioridazine sensitizes ESCC cells to radiotherapy. Thioridazine may play a role in ESCC radiation therapy as a promising radiosensitizer. PMID:27453171

  19. Thioridazine Sensitizes Esophageal Carcinoma Cell Lines to Radiotherapy-Induced Apoptosis In Vitro and In Vivo.

    PubMed

    Li, Hongxia; Juan, Li; Xia, Leiming; Wang, Yi; Bao, Yangyi; Sun, Guoping

    2016-07-25

    BACKGROUND Radiotherapy is one of the primary treatments for esophageal squamous cell carcinoma (ESCC). Identification of novel radio-sensitizing agents will improve the therapeutic outcome of radiotherapy. This study aimed to determine the radio-sensitizing effect of the antipsychotic agent thioridazine in ESCC and explored the underlying mechanisms. MATERIAL AND METHODS ECA-109 and TE-1 ESCC cells were treated with thioridazine and radiotherapy alone and in combination. Cell survival was measured by MTT assay. Cell cycle and apoptosis were monitored by flow cytometry. Western blot analysis was used to analyze the expression of phospho-PI3K, phosphor-AKT, phospho-mTOR, Caspase-3, Caspase-9, Bax, Bcl-2, Bal-xl, Bak, and p53. The xenograft mouse model was used to study the in vivo anticancer effect of thioridazine and irradiation. RESULTS Combined treatment with thioridazine and irradiation significantly reduced viability of ESCC cells compared with thioridazine or irradiation treatment alone. Thioridazine and irradiation treatment induced G0/G1 phases cell cycle arrest through down-regulation of CDK4 and cyclinD1. In addition, thioridazine and irradiation treatment induced apoptosis through up-regulation of cleaved capase-3 and 9, as well as an increase in the expression of Bax and Bak and a decrease in the expression of Bcl-2 and Bcl-xl. Furthermore, thioridazine and irradiation treatment inhibited the PI3K-AKT-mTOR pathway and up-regulated the expression of p53. In xenograft mice, thioridazine and irradiation reduced ESCC tumor growth. CONCLUSIONS Thioridazine sensitizes ESCC cells to radiotherapy. Thioridazine may play a role in ESCC radiation therapy as a promising radiosensitizer.

  20. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, Kevin M.; Doyle, Barney L.

    1996-01-01

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue.

  1. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, K.M.; Doyle, B.L.

    1996-08-20

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue. 25 figs.

  2. Comets at radio wavelengths

    NASA Astrophysics Data System (ADS)

    Crovisier, Jacques; Bockelée-Morvan, Dominique; Colom, Pierre; Biver, Nicolas

    2016-11-01

    Comets are considered as the most primitive objects in the Solar System. Their composition provides information on the composition of the primitive solar nebula, 4.6 Gyr ago. The radio domain is a privileged tool to study the composition of cometary ices. Observations of the OH radical at 18 cm wavelength allow us to measure the water production rate. A wealth of molecules (and some of their isotopologues) coming from the sublimation of ices in the nucleus have been identified by observations in the millimetre and submillimetre domains. We present an historical review on radio observations of comets, focusing on the results from our group, and including recent observations with the Nançay radio telescope, the IRAM antennas, the Odin satellite, the Herschel space observatory, ALMA, and the MIRO instrument aboard the Rosetta space probe.

  3. High redshift radio galaxies

    NASA Technical Reports Server (NTRS)

    Mccarthy, Patrick J.

    1993-01-01

    High redshift galaxies that host powerful radio sources are examined. An overview is presented of the content of radio surveys: 3CR and 3CRR, 4C and 4C/USS, B2/1 Jy, MG, MRC/1Jy, Parkes/PSR, B3, and ESO Key-Project. Narrow-line radio galaxies in the visible and UV, the source of ionization and excitation of the emission lines, emission-line luminosities, morphology of the line-emitting gas, physical properties and energetics, kinematics of the line-emitting gas, and implications from the emission lines are discussed. The morphologies and environments of the host galaxies, the alignment effect, and spectral energy distributions and ages are also examined.

  4. Radio coverage statistics.

    PubMed

    Lynn, W

    1984-01-01

    The Clearinghouse on Development Communication surveyed 135 countries in Asia, Africa, Europe, North and South America, for U.S.A.I.D., to determine the number of radio and television broadcast stations and receivers. Some of the data were obtained from the World Factbook, the World Radio and TV Handbook, and the World Radio and T.V. Facts and Figures, from 1979 to 1981. In those countries where stations are privately owned, audience surveys are often available. In 2 out of 3 developing countries, however, stations are government owned, and no such information is available. Numbers of receivers can sometimes be ascertained from receiver license applications. There is a need for more complete information on broadcast demographics, listening and viewing patterns by the community of world development program personnel.

  5. Radio frequency spectrum management

    NASA Astrophysics Data System (ADS)

    Sujdak, E. J., Jr.

    1980-03-01

    This thesis is a study of radio frequency spectrum management as practiced by agencies and departments of the Federal Government. After a brief introduction to the international agency involved in radio frequency spectrum management, the author concentrates on Federal agencies engaged in frequency management. These agencies include the National Telecommunications and Information Administration (NTIA), the Interdepartment Radio Advisory Committee (IRAC), and the Department of Defense (DoD). Based on an analysis of Department of Defense frequency assignment procedures, recommendations are given concerning decentralizing military frequency assignment by delegating broader authority to unified commanders. This proposal includes a recommendation to colocate the individual Service frequency management offices at the Washington level. This would result in reduced travel costs, lower manpower requirements, and a common tri-Service frequency management data base.

  6. Planetary radio waves

    NASA Technical Reports Server (NTRS)

    Goertz, C. K.

    1986-01-01

    Three planets, the earth, Jupiter and Saturn are known to emit nonthermal radio waves which require coherent radiation processes. The characteristic features (frequency spectrum, polarization, occurrence probability, radiation pattern) are discussed. Radiation which is externally controlled by the solar wind is distinguished from internally controlled radiation which only originates from Jupiter. The efficiency of the externally controlled radiation is roughly the same at all three planets (5 x 10 to the -6th) suggesting that similar processes are active there. The maser radiation mechanism for the generation of the radio waves and general requirements for the mechanism which couples the power generator to the region where the radio waves are generated are briefly discussed.

  7. Radio Emission from Supernovae

    SciTech Connect

    Weiler, Kurt W.; Panagia, Nino; Sramek, Richard A.; Van Dyk, Schuyler D.; Stockdale, Christopher J.; Kelley, Matthew T.

    2009-05-03

    Study of radio supernovae over the past 27 years includes more than three dozen detected objects and more than 150 upper limits. From this work it is possible to identify classes of radio properties, demonstrate conformance to and deviations from existing models, estimate the density and structure of the circumstellar material and, by inference, the evolution of the presupernova stellar wind, and reveal the last stages of stellar evolution before explosion. It is also possible to detect ionized hydrogen along the line of sight, to demonstrate binary properties of the presupernova stellar system, and to detect dumpiness of the circumstellar material.

  8. Radio Observations of Meteors.

    PubMed

    Millman, P M

    1954-08-27

    To summarize, we find that the radio technique of meteor observation enables us to extend the systematic recording of meteor rates down to the 9th or 10th magnitude; to determine satisfactory heights and velocities on a scale previously impossible; to calculate the orbits of meteor showers and individual meteors, in particular those that appear only in the daytime; and to study wind drift and fine structure in the ionosphere. The radio observations have quite definitely indicated that down to the 9th magnitude, corresponding to particles approximately 1 mm in diameter, meteors are members of the solar system and do not come from interstellar space.

  9. Sensors Locate Radio Interference

    NASA Technical Reports Server (NTRS)

    2009-01-01

    After receiving a NASA Small Business Innovation Research (SBIR) contract from Kennedy Space Center, Soneticom Inc., based in West Melbourne, Florida, created algorithms for time difference of arrival and radio interferometry, which it used in its Lynx Location System (LLS) to locate electromagnetic interference that can disrupt radio communications. Soneticom is collaborating with the Federal Aviation Administration (FAA) to install and test the LLS at its field test center in New Jersey in preparation for deploying the LLS at commercial airports. The software collects data from each sensor in order to compute the location of the interfering emitter.

  10. Radio astronomy with microspacecraft

    NASA Technical Reports Server (NTRS)

    Collins, D.

    2001-01-01

    A dynamic constellation of microspacecraft in lunar orbit can carry out valuable radio astronomy investigations in the frequency range of 30kHz--30MHz, a range that is difficult to explore from Earth. In contrast to the radio astronomy ivestigations that have flown on individual spacecraft, the four microspacecraft together with a carrier spacecraft, which transported them to lunar orbit, form an interferometer with far superior angular resolution. Use of microspacecraft allows the entire constellation to be launched with a Taurus-class vehicle. Also distinguishing this approach is that the Moon is used as needed to shield the constellation from RF interference from the Earth and Sun.

  11. e-POP Radio Science Using Amateur Radio Transmissions

    NASA Astrophysics Data System (ADS)

    Frissell, N. A.; Perry, G. W.; Miller, E. S.; Shovkoplyas, A.; Moses, M. L.; James, H. G.; Yau, A. W.

    2015-12-01

    A major component of the enhanced Polar Outflow Probe (e-POP) Radio Receiver Instrument (RRI) mission is to utilize artificially generated radio emissions to study High Frequency (HF) radio wave propagation in the ionosphere. In the North American and European sectors, communications between amateur radio operators are a persistent and abundant source source of HF transmissions. We present the results of HF radio wave propagation experiments using amateur radio transmissions as an HF source for e-POP RRI. We detail how a distributed and autonomously operated amateur radio network can be leveraged to study HF radio wave propagation as well as the structuring and dynamics of the ionosphere over a large geographic region. In one case, the sudden disappearance of nearly two-dozen amateur radio HF sources located in the midwestern United States was used to detect a enhancement in foF2 in that same region. We compare our results to those from other more conventional radio instruments and models of the ionosphere to demonstrate the scientific merit of incorporating amateur radio networks for radio science at HF.

  12. Smoking during radiotherapy for head and neck cancer and acute mucosal reaction

    PubMed Central

    Szeszko, Beata; Osowiecka, Karolina; Rucińska, Monika; Wasilewska-Teśluk, Ewa; Gliński, Krzysztof; Kępka, Lucyna

    2015-01-01

    Aim We compared the incidence of RTOG/EORTC grade III and higher acute mucositis in patients with head and neck cancer who continued to smoke during radiotherapy with those who quit smoking. Background There are conflicting data on the relationship between smoking during radiotherapy and the severity of acute mucosal reaction. More studies dealing with this issue are needed. Materials and methods Among 136 patients receiving curative radio(chemo)therapy, 37 (27%) declared that they had not quit smoking during radiotherapy. The intensity of mucositis was scored daily by a nurse and weekly by a physician using the RTOG/EORTC scale. The main end-point of the study was the highest observed RTOG/EORTC grade of mucositis. Results Patients who smoked during radiotherapy (smokers) were younger than their counterparts who quit smoking (non-smokers), p = 0.06. There were no other differences in the baseline characteristics between smokers and non-smokers. Grade III/IV acute mucositis was observed in 43.5% of all patients. The percentage of patients with grade III/IV acute mucositis was similar in smokers and non-smokers (46% vs. 42%, p = 0.71). Nine patients (smokers [13.5%]; non-smokers [4%], p = 0.05) required prolonged hospitalization to heal mucositis. Conclusions In the whole group, smoking during radiotherapy was not related to acute mucosal toxicity evaluated as the rate of the highest observed grade of mucositis. PMID:26109918

  13. Prism beamswitch for radio telescopes.

    PubMed

    Payne, J M; Ulich, B L

    1978-12-01

    A dielectric prism and switching mechanism have been constructed for beamswitching a Cassegrain radio telescope. Spatially extended radio sources may be mapped without significant confusion utilizing the sensitivity and stability inherent in the conventional Dicke radiometer.

  14. Svetloe Radio Astronomical Observatory

    NASA Technical Reports Server (NTRS)

    Smolentsev, Sergey; Rahimov, Ismail

    2013-01-01

    This report summarizes information about the Svetloe Radio Astronomical Observatory activities in 2012. Last year, a number of changes took place in the observatory to improve some technical characteristics and to upgrade some units to their required status. The report provides an overview of current geodetic VLBI activities and gives an outlook for the future.

  15. Zelenchukskaya Radio Astronomical Observatory

    NASA Technical Reports Server (NTRS)

    Smolentsev, Sergey; Dyakov, Andrei

    2013-01-01

    This report summarizes information about Zelenchukskaya Radio Astronomical Observatory activities in 2012. Last year a number of changes took place in the observatory to improve some technical characteristics and to upgrade some units to the required status. The report provides an overview of current geodetic VLBI activities and gives an outlook for the future.

  16. RADIO RANGING DEVICE

    DOEpatents

    Nieset, R.T.

    1961-05-16

    A radio ranging device is described. It utilizes a super regenerative detector-oscillator in which echoes of transmitted pulses are received in proper phase to reduce noise energy at a selected range and also at multiples of the selected range.

  17. Community Radio in Canada.

    ERIC Educational Resources Information Center

    Canadian Broadcasting Corp., Ottawa (Ontario).

    Results are presented of a survey of 20 community radio organizations operating in Canada. For each of the 20 agencies, information is provided relating to: (1) the name and address of the organization; (2) the name and population of the community served; (3) the station's call letters, frequency, and power; (4) the date of the station's license;…

  18. Radio Channel Simulator (RCSM)

    SciTech Connect

    2007-01-31

    This is a simulation package for making site specific predictions of radio signal strength. The software computes received power at discrete grid points as a function of the transmitter location and propagation environment. It is intended for use with wireless network simulation packages and to support wireless network deployments.

  19. Albanian: Basic Radio Communications.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This volume has been designed as a supplement to a course in Albanian developed by the Defense Language Institute. The emphasis in this text is placed on radio communications instruction. The volume is divided into five exercises, each of which contains a vocabulary, dictation, and an air-to-ground communications procedure conducted in Albanian…

  20. Torun Radio Astronomy Observatory

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    Torun Center for Astronomy is located at Piwnice, 15 km north of Torun, Poland. A part of the Faculty of Physics and Astronomy of the Nicolaus Copernicus University, it was created by the union of Torun Radio Astronomy Observatory (TRAO) and the Institute of Astronomy on 1 January 1997....

  1. Educational Broadcasting--Radio.

    ERIC Educational Resources Information Center

    Ahamed, Uvais; Grimmett, George

    This manual is intended for those who must conduct educational radio broadcasting training courses in Asia-Pacific countries without the resources of experienced personnel, as well as for individuals to use in self-learning situations. The selection of material has been influenced by the need to use broadcasting resources effectively in programs…

  2. [Radiotherapy of benign intracranial tumors].

    PubMed

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects.

  3. Radiotherapy for Pancreatic Neuroendocrine Tumors

    SciTech Connect

    Contessa, Joseph N.; Griffith, Kent A.; Wolff, Elizabeth; Ensminger, William; Zalupski, Mark; Ben-Josef, Edgar

    2009-11-15

    Purpose: Pancreatic neuroendocrine tumors (PNTs) are rare malignant neoplasms considered to be resistant to radiotherapy (RT), although data on efficacy are scarce. We reviewed our institutional experience to further delineate the role of RT for patients with PNTs. Methods and Materials: Between 1986 and 2006, 36 patients with PNTs were treated with RT to 49 sites. Of these 36 patients, 23 had radiographic follow-up data, which were used to determine the tumor response rate and freedom from local progression. Long-term toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Results: The overall response rate to RT was 39% (13% complete response, 26% partial response, 56% stable disease, and 4% progressive disease). A significant difference in the freedom from local progression between the groups receiving either greater than or less than the median 2 Gy/fraction biologically equivalent dose of 49.6 Gy was found, with all radiographic progression occurring in patients who had received <=32 Gy. The actuarial 3-year local freedom from progression rate was 49%. Palliation was achieved in 90% of patients, with either improvement or resolution of symptoms after RT. Of 35 patients, 33 had metastatic disease at their referral for RT, and the median overall survival for this patient population was 2 years. Three long-term Grade 3 or greater toxicities were recorded. Conclusion: RT is an effective modality for achieving local control in patients with PNTs. RT produces high rates of symptomatic palliation and freedom from local progression. Prospective trials of radiotherapy for PNTs are warranted.

  4. The study of the relation of DNA repair pathway genes SNPs and the sensitivity to radiotherapy and chemotherapy of NSCLC

    PubMed Central

    Wang, Chunbo; Nie, Huan; Li, Yiqun; Liu, Guiyou; Wang, Xu; Xing, Shijie; Zhang, Liping; Chen, Xin; Chen, Yue; Li, Yu

    2016-01-01

    To analyze the relation between SNPs in DNA repair pathway-related genes and sensitivity of tumor radio-chemotherapy, 26 SNPs in 20 DNA repair genes were genotyped on 176 patients of NSCLC undertaking radio-chemotherapy treatment. In squamous cell carcinoma (SCC), as the rs2228000, rs2228001 (XPC), rs2273953 (TP73), rs2279744 (MDM2), rs2299939 (PTEN) and rs8178085, rs12334811 (DNA-PKcs) affected the sensitivity to chemotherapy, so did the rs8178085, rs12334811 to radiotherapy. Moreover rs344781, rs2273953 and rs12334811 were related with the survival time of SCC. In general, the “good” genotype GG (rs12334811) showed greater efficacy of radio-chemotherapy and MSF (24 months) on SCC. In adenocarcinoma, as the rs2699887 (PIK3), rs12334811 (DNA-PKcs) influenced the sensitivity to chemotherapy, so did the rs2299939, rs2735343 (PTEN) to radiotherapy. And rs402710, rs80270, rs2279744 and rs2909430 impacted the survival time of the adenocarcinoma patients. Both GG (rs2279744) and AG (rs2909430) showed a shorter survival time (MFS = 6). Additionally, some SNPs such as rs2228000, rs2228001 and rs344781 were found to regulate the expression of DNA repair pathway genes through eQTLs dataset analysis. These results indicate that SNPs in DNA repair pathway genes might regulate the expression and affect the DNA damage repair, and thereby impact the efficacy of radio-chemotherapy and the survival time of NSCLC. PMID:27246533

  5. Community Control of Local Radio.

    ERIC Educational Resources Information Center

    Lewis, Peter M.

    This study was designed to determine to what extent local communities control the local radio which serves them, by what formal mechanisms their control is secured, and the underlying assumptions and goals which govern the practice of the professionals who have charge of the facilities. Two British radio stations, BBC Radio Bristol and the…

  6. Ham Radio is Mir Magic.

    ERIC Educational Resources Information Center

    Evans, Gary

    1997-01-01

    Presents a classroom activity in which students communicated with U.S. and Russian astronauts via ham radio while they were in orbit on the space station Mir. Gives suggestions for other ham radio classroom activities as well as names of organizations, publications, and grant programs that teachers can access to help in bring ham radio into their…

  7. Radio: Your Publics Are Listening!

    ERIC Educational Resources Information Center

    Marx, Gary

    The purpose of this booklet is to provide school board members, administrators, teachers, and others interested in education with an understanding of radio, how it works, and how school systems can take advantage of the communications possibilities offered by radio. After providing background information on radio as a mass communications medium…

  8. Collaborative Beamfocusing Radio (COBRA)

    NASA Astrophysics Data System (ADS)

    Rode, Jeremy P.; Hsu, Mark J.; Smith, David; Husain, Anis

    2013-05-01

    A Ziva team has recently demonstrated a novel technique called Collaborative Beamfocusing Radios (COBRA) which enables an ad-hoc collection of distributed commercial off-the-shelf software defined radios to coherently align and beamform to a remote radio. COBRA promises to operate even in high multipath and non-line-of-sight environments as well as mobile applications without resorting to computationally expensive closed loop techniques that are currently unable to operate with significant movement. COBRA exploits two key technologies to achieve coherent beamforming. The first is Time Reversal (TR) which compensates for multipath and automatically discovers the optimal spatio-temporal matched filter to enable peak signal gains (up to 20 dB) and diffraction-limited focusing at the intended receiver in NLOS and severe multipath environments. The second is time-aligned buffering which enables TR to synchronize distributed transmitters into a collaborative array. This time alignment algorithm avoids causality violations through the use of reciprocal buffering. Preserving spatio-temporal reciprocity through the TR capture and retransmission process achieves coherent alignment across multiple radios at ~GHz carriers using only standard quartz-oscillators. COBRA has been demonstrated in the lab, aligning two off-the-shelf software defined radios over-the-air to an accuracy of better than 2 degrees of carrier alignment at 450 MHz. The COBRA algorithms are lightweight, with computation in 5 ms on a smartphone class microprocessor. COBRA also has low start-up latency, achieving high accuracy from a cold-start in 30 ms. The COBRA technique opens up a large number of new capabilities in communications, and electronic warfare including selective spatial jamming, geolocation and anti-geolocation.

  9. The importance of Radio Quiet Zone (RQZ) for radio astronomy

    NASA Astrophysics Data System (ADS)

    Umar, Roslan; Abidin, Zamri Zainal; Ibrahim, Zainol Abidin

    2013-05-01

    Most of radio observatories are located in isolated areas. Since radio sources from the universe is very weak, astronomer need to avoid radio frequency interference (RFI) from active spectrum users and radio noise produced by human made (telecommunication, mobile phone, microwave user and many more. There are many observatories around the world are surrounded by a Radio Quiet Zone (RQZ), which is it was set up using public or state laws. A Radio Quiet Zone normally consists of two areas: an exclusive area in which totally radio emissions are forbidden, with restrictions for residents and business developments, and a larger (radius up to 100 km above) coordination area where the power of radio transmission limits to threshold levels. Geographical Information System (GIS) can be used as a powerful tool in mapping large areas with varying RQZ profiles. In this paper, we report the initial testing of the usage of this system in order to identify the areas were suitable for Radio Quiet Zone. Among the important parameters used to develop the database for our GIS are population density, information on TV and telecommunication (mobile phones) transmitters, road networks (highway), and contour shielding. We will also use other information gathered from on-site RFI level measurements on selected 'best' areas generated by the GIS. The intention is to find the best site for the purpose of establishing first radio quiet zones for radio telescope in Malaysia.

  10. Intraoperative Radiotherapy in Childhood Malignant Astrocytoma

    PubMed Central

    Rana, Sohail R.; Haddy, Theresa B.; Ashayeri, Ebrahim; Goldson, Alfred L.

    1984-01-01

    A 12-year-old black male patient with glioblastoma multiforme was treated with intraoperative radiotherapy followed by conventional external beam radiation and chemotherapy. The authors' clinical experience with these therapeutic measures is discussed. PMID:6330375

  11. Historical aspects of heavy ion radiotherapy

    SciTech Connect

    Raju, M.R.

    1995-03-01

    This paper presents historical developments of heavy-ion radiotherapy including discussion of HILAC and HIMAC and discussion of cooperation between Japan and the United States, along with personal reflections.

  12. Imaging Instrumentation and Techniques for Precision Radiotherapy

    NASA Astrophysics Data System (ADS)

    Parodi, Katia; Parodi, Katia; Thieke, Christian; Thieke, Christian

    Over the last decade, several technological advances have considerably improved the achievable precision of dose delivery in radiation therapy. Clinical exploitation of the superior tumor-dose conformality offered by modern radiotherapy techniques like intensity-modulated radiotherapy and ion beam therapy requires morphological and functional assessment of the tumor during the entire therapy chain from treatment planning to beam application and treatment response evaluation. This chapter will address the main rationale and role of imaging in state-of-the-art external beam radiotherapy. Moreover, it will present the status of novel imaging instrumentation and techniques being nowadays introduced in clinical use or still under development for image guidance and, ultimately, dose guidance of precision radiotherapy.

  13. [Conformal radiotherapy for vertebral bone metastasis].

    PubMed

    Faivre, J C; Py, J F; Vogin, G; Martinage, G; Salleron, J; Royer, P; Grandgirard, N; Pasquier, D; Thureau, S

    2016-10-01

    Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication. Analgesic re-irradiation is possible in the case of insufficient response or recurrent pain after radiotherapy. Metabolic radiation, bisphosphonates or denosumab do not dissuade external radiation therapy for pain relief. Systemic oncological treatments can be suspended with a period of wash out given the risk of radiosensitization or recall phenomenon. Better yet, the intensity modulated radiotherapy and stereotactic radiotherapy can be part of a curative strategy for oligometastatic patients and suggest new treatment prospects.

  14. [Hopes of high dose-rate radiotherapy].

    PubMed

    Fouillade, Charles; Favaudon, Vincent; Vozenin, Marie-Catherine; Romeo, Paul-Henri; Bourhis, Jean; Verrelle, Pierre; Devauchelle, Patrick; Patriarca, Annalisa; Heinrich, Sophie; Mazal, Alejandro; Dutreix, Marie

    2017-03-07

    In this review, we present the synthesis of the newly acquired knowledge concerning high dose-rate irradiations and the hopes that these new radiotherapy modalities give rise to. The results were presented at a recent symposium on the subject.

  15. [Radiotherapy of carcinoma of the salivary glands].

    PubMed

    Servagi-Vernat, S; Tochet, F

    2016-09-01

    Indication, doses, and technique of radiotherapy for salivary glands carcinoma are presented, and the contribution of neutrons and carbon ions. The recommendations for delineation of the target volumes and organs at risk are detailed.

  16. Heavy particle radiotherapy: prospects and pitfalls

    SciTech Connect

    Faju, M.R.

    1980-01-01

    The use of heavy particles in radiotherapy of tumor volumes is examined. Particles considered are protons, helium ions, heavy ions, negative pions, and fast neutrons. Advantages and disadvantages are discussed. (ACR)

  17. Intracranial aneurysm formation after radiotherapy for medulloblastoma

    PubMed Central

    Kamide, Tomoya; Mohri, Masanao; Misaki, Kouichi; Uchiyama, Naoyuki; Nakada, Mitsutoshi

    2016-01-01

    Background: The development of an intracranial aneurysm after radiotherapy is rare but secondary effect of cranial irradiation in a primary disease treatment. Case Description: The patient was a 17-year-old male adolescent who was diagnosed as having a posterior fossa medulloblastoma when he was 8 years old. He had undergone tumor resection with radiotherapy and chemotherapy. A distal posterior inferior cerebellar artery aneurysm was identified by magnetic resonance imaging 8 years after radiotherapy and grew rapidly throughout the next 1 year. The patient underwent microsurgical clipping and was discharged without deficit. Conclusion: This experience demonstrates that physicians caring for patients who have undergone intracranial radiotherapy should carefully consider the possibility of an aneurysmal formation when conducting follow-up imaging. PMID:27999713

  18. Laser Nano-Neurosurgery from Gentle Manipulation to Nano-Incision of Neuronal Cells and Scaffolds: An Advanced Neurotechnology Tool

    PubMed Central

    Soloperto, Alessandro; Palazzolo, Gemma; Tsushima, Hanako; Chieregatti, Evelina; Vassalli, Massimo; Difato, Francesco

    2016-01-01

    Current optical approaches are progressing far beyond the scope of monitoring the structure and function of living matter, and they are becoming widely recognized as extremely precise, minimally-invasive, contact-free handling tools. Laser manipulation of living tissues, single cells, or even single-molecules is becoming a well-established methodology, thus founding the onset of new experimental paradigms and research fields. Indeed, a tightly focused pulsed laser source permits complex tasks such as developing engineered bioscaffolds, applying calibrated forces, transfecting, stimulating, or even ablating single cells with subcellular precision, and operating intracellular surgical protocols at the level of single organelles. In the present review, we report the state of the art of laser manipulation in neuroscience, to inspire future applications of light-assisted tools in nano-neurosurgery. PMID:27013962

  19. Systematic reviews and meta-analyses in spine surgery, neurosurgery and orthopedics: guidelines for the surgeon scientist.

    PubMed

    Phan, Kevin; Mobbs, Ralph J

    2015-12-01

    The research evidence in the realm of surgery is expanding at a rapid pace, and thus corresponds with an increasing need to critically appraise and synthesize the available literature. Particularly in fields such as spine surgery, neurosurgery and orthopedics which traditionally have little Class I randomized clinical data, reviews are important to pool the available evidence on clinical questions which are otherwise difficult to answer. Whilst systematic reviews and meta-analyses have the potential to provide critical and updated surgical evidence to guide clinical decisions, poorly performed analyses and misinterpretation of such reviews may have a detrimental effect on patient care and outcomes. We present a summary of the critical steps in performing a systematic review and meta-analysis, allowing the surgeon scientist to better interpret and perform their own systematic reviews and meta-analyses.

  20. What is New and Innovative in Emergency Neurosurgery? Emerging Diagnostic Technologies Provide Better Care and Influence Outcome: A Specialist Review.

    PubMed

    Zisakis, Athanasios K; Varsos, Vassilios; Exadaktylos, Aristomenis

    2013-01-01

    The development of emergency medical services and especially neurosurgical emergencies during recent decades has necessitated the development of novel tools. Although the gadgets that the neurosurgeon uses today in emergencies give him important help in diagnosis and treatment, we still need new technology, which has rapidly developed. This review presents the latest diagnostic tools, which offer precious help in everyday emergency neurosurgery practice. New ultrasound devices make the diagnosis of haematomas easier. In stroke, the introduction of noninvasive new gadgets aims to provide better treatment to the patient. Finally, the entire development of computed tomography and progress in radiology have resulted in innovative CT scans and angiographic devices that advance the diagnosis, treatment, and outcome of the patent. The pressure on physicians to be quick and effective and to avoid any misjudgement of the patient has been transferred to the technology, with the emphasis on developing new systems that will provide our patients with a better outcome and quality of life.

  1. A fantastic voyage: a personal perspective on involvement in the development of modern stereotactic and functional neurosurgery (1974-2004).

    PubMed

    Apuzzo, Michael L J

    2005-05-01

    Stressing environments, individuals, ideas, and global events, this historical stereotactic and functional neurosurgical vignette initially presents a review of factors in the genesis of personal interest and the foundations of involvement in the discipline of neurological surgery. The vignette then traces the development of concepts and instrumentation and their ultimate practical utilization in patient care on the neurosurgical services at the Keck School of Medicine at the University of Southern California over the course of a 3-decade period (1974-2004). The article summarizes and elaborates details of contributions to the literature and complex involvement on the national and international levels as the refinements and capabilities of stereotactic and functional neurosurgery have been reinvented over a generation through the emergence of new technology, ideas, individual ingenuity, and active collegial exchange.

  2. Laser Nano-Neurosurgery from Gentle Manipulation to Nano-Incision of Neuronal Cells and Scaffolds: An Advanced Neurotechnology Tool.

    PubMed

    Soloperto, Alessandro; Palazzolo, Gemma; Tsushima, Hanako; Chieregatti, Evelina; Vassalli, Massimo; Difato, Francesco

    2016-01-01

    Current optical approaches are progressing far beyond the scope of monitoring the structure and function of living matter, and they are becoming widely recognized as extremely precise, minimally-invasive, contact-free handling tools. Laser manipulation of living tissues, single cells, or even single-molecules is becoming a well-established methodology, thus founding the onset of new experimental paradigms and research fields. Indeed, a tightly focused pulsed laser source permits complex tasks such as developing engineered bioscaffolds, applying calibrated forces, transfecting, stimulating, or even ablating single cells with subcellular precision, and operating intracellular surgical protocols at the level of single organelles. In the present review, we report the state of the art of laser manipulation in neuroscience, to inspire future applications of light-assisted tools in nano-neurosurgery.

  3. Accurate radio and optical positions for southern radio sources

    NASA Technical Reports Server (NTRS)

    Harvey, Bruce R.; Jauncey, David L.; White, Graeme L.; Nothnagel, Axel; Nicolson, George D.; Reynolds, John E.; Morabito, David D.; Bartel, Norbert

    1992-01-01

    Accurate radio positions with a precision of about 0.01 arcsec are reported for eight compact extragalactic radio sources south of -45-deg declination. The radio positions were determined using VLBI at 8.4 GHz on the 9589 km Tidbinbilla (Australia) to Hartebeesthoek (South Africa) baseline. The sources were selected from the Parkes Catalogue to be strong, flat-spectrum radio sources with bright optical QSO counterparts. Optical positions of the QSOs were also measured from the ESO B Sky Survey plates with respect to stars from the Perth 70 Catalogue, to an accuracy of about 0.19 arcsec rms. These radio and optical positions are as precise as any presently available in the far southern sky. A comparison of the radio and optical positions confirms the estimated optical position errors and shows that there is overall agreement at the 0.1-arcsec level between the radio and Perth 70 optical reference frames in the far south.

  4. Clinical Outcomes of Wulingsan Subtraction Decoction Treatment of Postoperative Brain Edema and Fever as a Complication of Glioma Neurosurgery

    PubMed Central

    Jin, Wei-rong; Zhang, Feng-e; Diao, Bao-zhong; Zhang, Yue-ying

    2016-01-01

    Objective. To evaluate the efficacy of Wulingsan subtraction (五苓散加减 WLSS) decoction in the treatment of postoperative brain edema and fever as a complication of glioma neurosurgery. Methods. This retrospective study was conducted at the Department of Neurosurgery of Liaocheng People's Hospital. Patients hospitalized between March 2011 and December 2014 were divided into three groups: Group A received WLSS oral liquid (50 mL), twice a day; Group B received an intravenous infusion of mannitol; and Group C received WLSS combined with mannitol (n = 30 patients per group). All patients were treated for 10 days continuously. Therapeutic efficacy was evaluated by measuring body temperature and indicators of renal function before and 3, 5, and 10 days after treatment. Results. Compared to the other two groups, significantly greater clinical efficacy was observed in the patients treated with mannitol (Group B; P < 0.05), although marked clinical efficacy was also observed over time in patients treated with WLSS (Group A). After 5 days, the quantifiable effects of the WLSS and mannitol combination group (Group C) were substantial (P < 0.05). The renal damage in Group B was more obvious after 5 days and 10 days. Conclusion. Compared with mannitol treatment alone, WLSS combined with mannitol induced a more rapid reduction in body temperature. Our findings suggest that patients should be started on mannitol for 3 days and then switched to WLSS to achieve obvious antipyretic effects and protect renal function. This method of treatment should be considered for clinical applications. PMID:27019661

  5. Versatile utilization of real-time intraoperative contrast-enhanced ultrasound in cranial neurosurgery: technical note and retrospective case series

    PubMed Central

    Lekht, Ilya; Brauner, Noah; Bakhsheshian, Joshua; Chang, Ki-Eun; Gulati, Mittul; Shiroishi, Mark S.; Grant, Edward G.; Christian, Eisha; Zada, Gabriel

    2016-01-01

    OBJECTIVE Intraoperative contrast-enhanced ultrasound (iCEUS) offers dynamic imaging and provides functional data in real time. However, no standardized protocols or validated quantitative data exist to guide its routine use in neurosurgery. The authors aimed to provide further clinical data on the versatile application of iCEUS through a technical note and illustrative case series. METHODS Five patients undergoing craniotomies for suspected tumors were included. iCEUS was performed using a contrast agent composed of lipid shell microspheres enclosing perflutren (octafluoropropane) gas. Perfusion data were acquired through a time-intensity curve analysis protocol obtained using iCEUS prior to biopsy and/or resection of all lesions. RESULTS Three primary tumors (gemistocytic astrocytoma, glioblastoma multiforme, and meningioma), 1 metastatic lesion (melanoma), and 1 tumefactive demyelinating lesion (multiple sclerosis) were assessed using real-time iCEUS. No intraoperative complications occurred following multiple administrations of contrast agent in all cases. In all neoplastic cases, iCEUS replicated enhancement patterns observed on preoperative Gd-enhanced MRI, facilitated safe tumor de-bulking by differentiating neoplastic tissue from normal brain parenchyma, and helped identify arterial feeders and draining veins in and around the surgical cavity. Intraoperative CEUS was also useful in guiding a successful intraoperative needle biopsy of a cerebellar tumefactive demyelinating lesion obtained during real-time perfusion analysis. CONCLUSIONS Intraoperative CEUS has potential for safe, real-time, dynamic contrast-based imaging for routine use in neurooncological surgery and image-guided biopsy. Intraoperative CEUS eliminates the effect of anatomical distortions associated with standard neuronavigation and provides quantitative perfusion data in real time, which may hold major implications for intraoperative diagnosis, tissue differentiation, and quantification of

  6. MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery.

    PubMed

    Siewerdsen, J

    2016-06-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: (1) Keyvan Farahani, "Image-guided focused ultrasound surgery and therapy" (2) Jeffrey H. Siewerdsen, "Advances in image registration and reconstruction for image-guided neurosurgery" (3) Tina Kapur, "Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite" (4) Raj Shekhar, "Multimodality image-guided interventions: Multimodality for the rest of us" Learning Objectives: 1. Understand the principles and applications of HIFU in surgical ablation. 2. Learn about recent advances in 3D-2D and 3D deformable image registration in support of surgical safety and precision. 3. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. 4. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. 5. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and

  7. [Radiotherapy for small cell lung carcinoma].

    PubMed

    Pourel, N

    2016-10-01

    Radiotherapy for small cell lung carcinoma has known significant improvements over the past 10 years especially through routine use of PET-CT in the initial work-up and contouring before treatment. Prophylactic cranial irradiation remains a standard of care for locally advanced disease and is a subject of controversy for metastatic disease. A new indication for thoracic radiotherapy may soon arise for metastatic disease, still confirmation studies are ongoing.

  8. Blisters - an unusual effect during radiotherapy.

    PubMed

    Höller, U; Schubert, T; Budach, V; Trefzer, U; Beyer, M

    2013-11-01

    The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described.

  9. Radiotherapy in the treatment of vertebral hemangiomas

    SciTech Connect

    Faria, S.L.; Schlupp, W.R.; Chiminazzo, H. Jr.

    1985-02-01

    Symptomatic vertebral hemangiomas are not common. Although radiotherapy has been used as treatment, the data are sparse concerning total dose, fractionation and results. The authors report nine patients with vertebral hemangioma treated with 3000-4000 rad, 200 rad/day, 5 fractions per week, followed from 6 to 62 months. Seventy-seven percent had complete or almost complete disappearance of the symptoms. Radiotherapy schedules are discussed.

  10. Radiotherapy for Vestibular Schwannomas: A Critical Review

    SciTech Connect

    Murphy, Erin S.; Suh, John H.

    2011-03-15

    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  11. AIDS radio triggers.

    PubMed

    Elias, A M

    1991-07-01

    In April 1991, the Ethnic Communities' Council of NSW was granted funding under the Community AIDS Prevention and Education Program through the Department of Community Services and Health, to produce a series of 6x50 second AIDS radio triggers with a 10-second tag line for further information. The triggers are designed to disseminate culturally-sensitive information about HIV/AIDS in English, Italian, Greek, Spanish, Khmer, Turkish, Macedonian, Serbo-Croatian, Arabic, Cantonese, and Vietnamese, with the goal of increasing awareness and decreasing the degree of misinformation about HIV/AIDS among people of non-English-speaking backgrounds through radio and sound. The 6 triggers cover the denial that AIDS exists in the community, beliefs that words and feelings do not protect one from catching HIV, encouraging friends to be compassionate, compassion within the family, AIDS information for a young audience, and the provision of accurate and honest information on HIV/AIDS. The triggers are slated to be completed by the end of July 1991 and will be broadcast on all possible community, ethnic, and commercial radio networks across Australia. They will be available upon request in composite form with an information kit for use by health care professionals and community workers.

  12. MULTIMOMENT RADIO TRANSIENT DETECTION

    SciTech Connect

    Spitler, L. G.; Cordes, J. M.; Chatterjee, S.; Stone, J.

    2012-04-01

    We present a multimoment technique for signal classification and apply it to the detection of fast radio transients in incoherently dedispersed data. Specifically, we define a spectral modulation index in terms of the fractional variation in intensity across a spectrum. A signal whose intensity is distributed evenly across the entire band has a lower modulation index than a spectrum whose intensity is localized in a single channel. We are interested in broadband pulses and use the modulation index to excise narrowband radio frequency interference by applying a modulation index threshold above which candidate events are removed. The technique is tested both with simulations and using data from known sources of radio pulses (RRAT J1928+15 and giant pulses from the Crab pulsar). The method is generalized to coherent dedispersion, image cubes, and astrophysical narrowband signals that are steady in time. We suggest that the modulation index, along with other statistics using higher order moments, should be incorporated into signal detection pipelines to characterize and classify signals.

  13. The Askaryan Radio Array

    NASA Astrophysics Data System (ADS)

    Hoffman, Kara D.

    2013-01-01

    Ultra high energy cosmogenic neutrinos could be most efficiently detected in dense, radio frequency (RF) transparent media via the Askaryan effect. Building on the expertise gained by RICE, ANITA and IceCube's radio extension in the use of the Askaryan effect in cold Antarctic ice, we are currently developing an antenna array known as ARA (The Askaryan Radio Array) to be installed in boreholes extending 200 m below the surface of the ice near the geographic South Pole. The unprecedented scale of ARA, which will cover a fiducial area of ~ 100 square kilometers, was chosen to ensure the detection of the flux of neutrinos suggested by the observation of a drop in high energy cosmic ray flux consistent with the GZK cutoff by HiRes and the Pierre Auger Observatory. Funding to develop the instrumentation and install the first prototypes has been granted, and the first components of ARA were installed during the austral summer of 2010-2011. Within 3 years of commencing operation, the full ARA will exceed the sensitivity of any other instrument in the 0.1-10 EeV energy range by an order of magnitude. The primary goal of the ARA array is to establish the absolute cosmogenic neutrino flux through a modest number of events. This information would frame the performance requirements needed to expand the array in the future to measure a larger number of neutrinos with greater angular precision in order to study their spectrum and origins.

  14. Adapting radiotherapy to hypoxic tumours

    NASA Astrophysics Data System (ADS)

    Malinen, Eirik; Søvik, Åste; Hristov, Dimitre; Bruland, Øyvind S.; Rune Olsen, Dag

    2006-10-01

    In the current work, the concepts of biologically adapted radiotherapy of hypoxic tumours in a framework encompassing functional tumour imaging, tumour control predictions, inverse treatment planning and intensity modulated radiotherapy (IMRT) were presented. Dynamic contrast enhanced magnetic resonance imaging (DCEMRI) of a spontaneous sarcoma in the nasal region of a dog was employed. The tracer concentration in the tumour was assumed related to the oxygen tension and compared to Eppendorf histograph measurements. Based on the pO2-related images derived from the MR analysis, the tumour was divided into four compartments by a segmentation procedure. DICOM structure sets for IMRT planning could be derived thereof. In order to display the possible advantages of non-uniform tumour doses, dose redistribution among the four tumour compartments was introduced. The dose redistribution was constrained by keeping the average dose to the tumour equal to a conventional target dose. The compartmental doses yielding optimum tumour control probability (TCP) were used as input in an inverse planning system, where the planning basis was the pO2-related tumour images from the MR analysis. Uniform (conventional) and non-uniform IMRT plans were scored both physically and biologically. The consequences of random and systematic errors in the compartmental images were evaluated. The normalized frequency distributions of the tracer concentration and the pO2 Eppendorf measurements were not significantly different. 28% of the tumour had, according to the MR analysis, pO2 values of less than 5 mm Hg. The optimum TCP following a non-uniform dose prescription was about four times higher than that following a uniform dose prescription. The non-uniform IMRT dose distribution resulting from the inverse planning gave a three times higher TCP than that of the uniform distribution. The TCP and the dose-based plan quality depended on IMRT parameters defined in the inverse planning procedure (fields

  15. The use of low energy, ion induced nuclear reactions for proton radiotherapy applications

    SciTech Connect

    Horn, K.M.; Doyle, B.; Segal, M.N.; Hamm, R.W.; Adler, R.J.; Glatstein, E.

    1995-04-01

    Medical radiotherapy has traditionally relied upon the use of external photon beams and internally implanted radioisotopes as the chief means of irradiating tumors. However, advances in accelerator technology and the exploitation of novel means of producing radiation may provide useful alternatives to some current modes of medical radiation delivery with reduced total dose to surrounding healthy tissue, reduced expense, or increased treatment accessibility. This paper will briefly overview currently established modes of radiation therapy, techniques still considered experimental but in clinical use, innovative concepts under study that may enable new forms of treatment or enhance existing ones. The potential role of low energy, ion-induced nuclear reactions in radiotherapy applications is examined specifically for the 650 keV d({sup 3}He,p){sup 4}He nuclear reaction. This examination will describe the basic physics associated with this reaction`s production of 17.4 MeV protons and the processes used to fabricate the necessary materials used in the technique. Calculations of the delivered radiation dose, heat generation, and required exposure times are presented. Experimental data are also presented validating the dose calculations. The design of small, lower cost ion accelerators, as embodied in `nested`-tandem and radio frequency quadrupole accelerators is examined, as is the potential use of high-output {sup 3}He and deuterium ion sources. Finally, potential clinical applications are discussed in terms of the advantages and disadvantages of this technique with respect to current radiotherapy methods and equipment.

  16. A Simulation Study of a Radiofrequency Localization System for Tracking Patient Motion in Radiotherapy.

    PubMed

    Ostyn, Mark; Kim, Siyong; Yeo, Woon-Hong

    2016-04-13

    One of the most widely used tools in cancer treatment is external beam radiotherapy. However, the major risk involved in radiotherapy is excess radiation dose to healthy tissue, exacerbated by patient motion. Here, we present a simulation study of a potential radiofrequency (RF) localization system designed to track intrafraction motion (target motion during the radiation treatment). This system includes skin-wearable RF beacons and an external tracking system. We develop an analytical model for direction of arrival measurement with radio frequencies (GHz range) for use in a localization estimate. We use a Monte Carlo simulation to investigate the relationship between a localization estimate and angular resolution of sensors (signal receivers) in a simulated room. The results indicate that the external sensor needs an angular resolution of about 0.03 degrees to achieve millimeter-level localization accuracy in a treatment room. This fundamental study of a novel RF localization system offers the groundwork to design a radiotherapy-compatible patient positioning system for active motion compensation.

  17. A Simulation Study of a Radiofrequency Localization System for Tracking Patient Motion in Radiotherapy

    PubMed Central

    Ostyn, Mark; Kim, Siyong; Yeo, Woon-Hong

    2016-01-01

    One of the most widely used tools in cancer treatment is external beam radiotherapy. However, the major risk involved in radiotherapy is excess radiation dose to healthy tissue, exacerbated by patient motion. Here, we present a simulation study of a potential radiofrequency (RF) localization system designed to track intrafraction motion (target motion during the radiation treatment). This system includes skin-wearable RF beacons and an external tracking system. We develop an analytical model for direction of arrival measurement with radio frequencies (GHz range) for use in a localization estimate. We use a Monte Carlo simulation to investigate the relationship between a localization estimate and angular resolution of sensors (signal receivers) in a simulated room. The results indicate that the external sensor needs an angular resolution of about 0.03 degrees to achieve millimeter-level localization accuracy in a treatment room. This fundamental study of a novel RF localization system offers the groundwork to design a radiotherapy-compatible patient positioning system for active motion compensation. PMID:27089342

  18. Workshop on Radio Transients

    NASA Astrophysics Data System (ADS)

    Croft, Steve; Gaensler, Bryan

    2012-04-01

    abstract-type="normal">SummaryWe are entering a new era in the study of variable and transient radio sources. This workshop discussed the instruments and the strategies employed to study those sources, how they are identified and classified, how results from different surveys can be compared, and how radio observations tie in with those at other wavelengths. The emphasis was on learning what common ground there is between the plethora of on-going projects, how methods and code can be shared, and how best practices regarding survey strategy could be adopted. The workshop featured the four topics below. Each topic commenced with a fairly brief introductory talk, which then developed into discussion. By way of preparation, participants had been invited to upload and discuss one slide per topic to a wiki ahead of the workshop. 1. Telescopes, instrumentation and survey strategy. New radio facilities and on-going projects (including upgrades) are both studying the variability of the radio sky, and searching for transients. The discussion first centred on the status of those facilities, and on projects with a time-domain focus, both ongoing and planned, before turning to factors driving choices of instrumentation, such as phased array versus single pixel feeds, the field of view, spatial and time resolution, frequency and bandwidth, depth, area, and cadence of the surveys. 2. Detection, pipelines, and classification. The workshop debated (a) the factors that influence decisions to study variability in the (u,v) plane, in images, or in catalogues, (b) whether, and how much, pipeline code could potentially be shared between one project and another, and which software packages are best for different approaches, (c) how data are stored and later accessed, and (d) how transients and variables are defined and classified. 3. Statistics, interpretation, and synthesis. It then discussed how (i) the choice of facility and strategy and (ii) detection and classification schemes

  19. Radiotherapy Treatment Planning for Testicular Seminoma

    SciTech Connect

    Wilder, Richard B.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Beard, Clair J.

    2012-07-15

    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

  20. Radio quiet, please! - protecting radio astronomy from interference

    NASA Astrophysics Data System (ADS)

    van Driel, W.

    2011-06-01

    The radio spectrum is a finite and increasingly precious resource for astronomical research, as well as for other spectrum users. Keeping the frequency bands used for radio astronomy as free as possible of unwanted Radio Frequency Interference (RFI) is crucial. The aim of spectrum management, one of the tools used towards achieving this goal, includes setting regulatory limits on RFI levels emitted by other spectrum users into the radio astronomy frequency bands. This involves discussions with regulatory bodies and other spectrum users at several levels - national, regional and worldwide. The global framework for spectrum management is set by the Radio Regulations of the International Telecommunication Union, which has defined that interference is detrimental to radio astronomy if it increases the uncertainty of a measurement by 10%. The Radio Regulations are revised every three to four years, a process in which four organisations representing the interests of the radio astronomical community in matters of spectrum management (IUCAF, CORF, CRAF and RAFCAP) participate actively. The current interests and activities of these four organisations range from preserving what has been achieved through regulatory measures, to looking far into the future of high frequency use and giant radio telescope use.

  1. Development of the ultra-miniaturized Inertial Measurement Unit WB3 for objective skill analysis and assessment in neurosurgery: preliminary results.

    PubMed

    Zecca, Massimiliano; Sessa, Salvatore; Lin, Zhuohua; Suzuki, Takashi; Sasaki, Tomoya; Itoh, Kazuko; Iseki, Hiroshi; Takanishi, Atsuo

    2009-01-01

    In recent years there has been an ever increasing amount of research and development of technologies and methodologies aimed at improving the safety of advanced surgery. In this context, several training methods and metrics have been proposed, in particular for laparoscopy, both to improve the surgeon's abilities and also to assess her/his skills. For neurosurgery, however, the extremely small movements and sizes involved have prevented until now the development of similar methodologies and systems. In this paper we present the development of the ultra-miniaturized Inertial Measurement Unit WB3 (at present the smallest, lightest, and best performing in the world) for practical application in neurosurgery as skill assessment tool. This paper presents the feasibility study for quantitative discrimination of movements of experienced surgeons and beginners in a simple pick and place scenario.

  2. Management of Subarachnoid Hemorrhage in Two Important Italian Political Leaders: A Paradigm of Ethical and Technological Evolution of Neurosurgery During the Past Half-Century.

    PubMed

    Longatti, Pierluigi; Giombelli, Ermanno; Pavesi, Giacomo; Carteri, Alessandro; Feletti, Alberto

    2016-08-01

    For a curious and extraordinary coincidence, 5 of the 7 most relevant leaders of the Italian Communist Party (Partito Comunista Italiano, which was established in 1921, has been the biggest Communist Party in Western Countries) suffered a cerebral stroke. Cerebrovascular diseases afflicted also Stalin and Lenin, and a number of Presidents of the United States. We present the stories of 2 important Italian political leaders who shared both the leadership role of the major left Italian Party and the dramatic experience of a subarachnoid hemorrhage. Retracing their medical incidents, separated by 50 years of history, we show how a fatal medical disease has become neurosurgical and successfully cured thanks to the advances of neurosurgery, neuroradiology, and hospital organization. A neurologic disease that was disgraceful 50 years ago has lost any disquieting and embarrassing significance in the present time to the light of evolution of vascular neurosurgery.

  3. Essentials of research methods in neurosurgery and allied sciences for research, appraisal and application of scientific information to patient care (Part I)

    PubMed Central

    Esene, Ignatius N.; El-Shehaby, Amr M.; Baeesa, Saleh S.

    2016-01-01

    Every neurosurgeon ought to be acquainted with the basics of research methods to enhance the comprehension of the research process and critical appraisal procedures of a scientific write-up. This in turn will ensure the appropriate application of scientific knowledge to patient care. Recent publications reveal that a significant proportion of articles published in neurosurgery are mislabeled with dire consequences on the sorting and indexing of evidence. Furthermore, many clinicians report that they feel unqualified to read the medical literature critically hence, it is for this reason that we conducted this review. Herein, we present a simple algorithm to facilitate the comprehension of research methods, as well as elucidate on the anatomy of common study designs in neurosurgery. Illustrative examples are provided when necessary. Understanding research methods and the critical analysis of published reports of clinical investigation is a fundamental skill of the physician to enable the incorporation of new clinical knowledge to practice PMID:27094519

  4. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2013-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  5. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2014-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  6. Fiducial marker guided prostate radiotherapy: a review.

    PubMed

    O'Neill, Angela G M; Jain, Suneil; Hounsell, Alan R; O'Sullivan, Joe M

    2016-12-01

    Image-guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogeneous whole-pelvic radiotherapy dose, but these surrogates are not reliable when using reduced margins, dose escalation or hypofractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990s. They require surgical implantation and provide a surrogate for the position of the prostate gland. A variety of FMs are available and they can be used in a number of ways. This review aimed to establish the evidence for using prostate FMs in terms of feasibility, implantation procedures, types of FMs used, FM migration, imaging modalities used and the clinical impact of FMs. A search strategy was defined and a literature search was carried out in Medline. Inclusion and exclusion criteria were applied, which resulted in 50 articles being included in this review. The evidence demonstrates that FMs provide a more accurate surrogate for the position of the prostate than either external skin marks or bony anatomy. A combination of FM alignment and soft-tissue analysis is currently the most effective and widely available approach to ensuring accuracy in prostate IGRT. FM implantation is safe and well tolerated. FM migration is possible but minimal. Standardization of all techniques and procedures in relation to the use of prostate FMs is required. Finally, a clinical trial investigating a non-surgical alternative to prostate FMs is introduced.

  7. Radio emision from supernova remnants

    NASA Astrophysics Data System (ADS)

    Dubner, G.

    2016-06-01

    The vast majority of supernova remnants (SNRs) in our Galaxy and nearby galaxies have been discovered through radio observations, and only a very small number of the SNRs catalogued in the Milky Way have not been detected in the radio band, or are poorly defined by current radio observations. The study of the radio emission from SNRs is an excellent tool to investigate morphological characteristics, marking the location of shock fronts and contact discontinuities; the presence, orientation and intensity of the magnetic field; the energy spectrum of the emitting particles; and the dynamical consequences of the interaction with the circumstellar and interstellar medium. I will review the present knowledge of different important aspects of radio remnants and their impact on the interstellar gas. Also, new radio studies of the Crab Nebula carried out with the Karl Jansky Very Large Array (JVLA) at 3 GHz and with ALMA at 100 GHz, will be presented.

  8. Low-dose magnetic-field-immune biplanar fluoroscopy for neurosurgery

    NASA Astrophysics Data System (ADS)

    Ramos, P. A.; Lawson, Michael A.; Wika, Kevin G.; Allison, Stephen W.; Quate, E. G.; Molloy, J. A.; Ritter, Rogers C.; Gilles, George T.

    1991-07-01

    The imaging chain of a bi-planar fluoroscopic system is described for a new neurosurgical technique: the Video Tumor Fighter (VTF). The VTF manipulates a small intracranially implanted magnet, called a thermoseed, by a large external magnetic field gradient. The thermoseed is heated by rf-induction to kill proximal tumor cells. For accurately guiding the seed through the brain, the x-ray tubes are alternately pulsed up to four times per second, each for as much as two hours. Radio-opaque reference markers, attached to the skull, enable the thermoseed's three dimensional position to be determined and then projected onto a displayed MRI brain scan. The imaging approach, similar to systems at the University of Arizona and the Mayo Clinic, includes a 20 cm diameter phosphor screen viewed by a proximity focused microchannel plate image intensifier coupled via fiberoptic taper to a solid state camera. The most important performance specifications are magnetic field immunity and, due to the procedure duration, low dosage per image. A preliminary arrangement designed in the laboratories yielded usable images at approximately 100 (mu) R exposure per frame. In this paper, the results of a series of studies of the effects of magnetic fields on microchannel plate image intensifiers used in the image detection chain are presented.

  9. Uzaybimer Radio Telescope Control System

    NASA Astrophysics Data System (ADS)

    Balbay, R.; Öz, G. K.; Arslan, Ö.; Özeren, F. F.; Küçük, İ.

    2016-12-01

    A 13 meters former NATO radar is being converted into a radio telescope. The radio telescope is controlled by a system which has been developed at UZAYBİMER. The Telescope Control System(TCS) has been designed using modern industrial systems. TCS has been developed in LabView platform in which works Windows embedded OS. The position feedback used on radio telescopes is an industrial EtherCAT standard. ASCOM library is used for astronomical calculations.

  10. Radio Emission from Binary Stars

    NASA Astrophysics Data System (ADS)

    Hjellming, R.; Murdin, P.

    2000-11-01

    Stellar radio emission is most common in double star systems where each star provides something essential in producing the large amounts of radio radiation needed for it to be detectable by RADIO TELESCOPES. They transfer mass, supply energy or, when one of the stars is a NEUTRON STAR or BLACK HOLE, have the strong gravitational fields needed for the energetic particles and magnetic fields needed...

  11. The properties of radio ellipticals

    NASA Astrophysics Data System (ADS)

    Sparks, W. B.; Disney, M. J.; Wall, J. V.; Rodgers, A. W.

    1984-03-01

    The authors present optical and additional radio data for the bright galaxies of the Disney & Wall survey. These data form the basis of a statistical comparison of the properties of radio elliptical galaxies to radio-quiet ellipticals. The correlations may be explained by the depth of the gravitational potential well in which the galaxy resides governing the circumstances under which an elliptical galaxy rids itself of internally produced gas.

  12. The Richard C. Schneider Lecture. New dimensions of neurosurgery in the realm of high technology: possibilities, practicalities, realities.

    PubMed

    Apuzzo, M L

    1996-04-01

    Fueled by a buoyant economy, popular attitudes and demands, and parallel progress in transferable technical and biological areas, neurosurgery has enjoyed a remarkable quarter of a century of progress. Developmental trends in the discipline have included the following: 1) a refinement of preoperative definition of the structural substrate, 2) miniaturization of operative corridors, 3) reduction of operative trauma, 4) increased effectiveness at the target site, and 5) incorporation of improved technical adjuvants and physical operative tools into treatment protocols. In particular, the computer has become a formidable ally in diagnostic and surgical events. Trends in technical development indicate that we are entering an exciting era of advanced surgery of the human cerebrum, which is heralded by the following: 1) current developments in areas of imaging, sensors, and visualization; 2) new devices for localization and navigation; 3) new capabilities for action at the target point; and 4) innovative concepts related to advanced operative venues. Imaging has provided structurally based surgical maps, which now are being given the new dimension of function in complex and integrated formats for preoperative planning and intraoperative tactical direction. Cerebral localization and navigation based on these advances promise to provide further refinement to the field of stereotactic neurosurgery, as linked systems are superseded by more flexible nonlinked methodologies in functionally defined volume-oriented navigational databases. Target point action now includes not only ablative capabilities through micro-operative methods and the use of stereotactically directed high-energy forms but also the emergence of restorative capabilities through applications of principles of genetic engineering in the areas of molecular and cellular neurosurgery. Complex, dedicated, and self-contained operative venues will be required to optimize the emergence and development of these

  13. A dose comparison of proton radiotherapy and photon radiotherapy for pediatric brain tumor

    NASA Astrophysics Data System (ADS)

    Kim, S. Y.; Cho, J. H.

    2014-12-01

    The purpose of this study was to investigate the effectiveness of photon radiotherapy and to compare the dose of treatment planning between proton radiotherapy and 3D conformal radiation therapy (3D-CRT) for pediatric brain tumor patients. This study was conducted in five pediatric brain tumor patients who underwent craniospinal irradiation treatment from October 2013 to April 2014 in the hospital. The study compared organs at risk (OARs) by assessing the dose distribution of normal tissue from the proton plan and 3D-CRT. Furthermore, this study assessed the treatment plans by looking at the homogeneity index (HI) and conformity index (CI). As a result, the study revealed OARs due to the small volume proton radiotherapy dose distribution in the normal tissue. Also, by comparing HI and CI between the 3D-CRT and proton radiotherapy plan, the study found that the dose of proton radiotherapy plan was homogenized. When conducting 3D-CRT and proton radiotherapy in a dose-volume histogram comparison, the dose of distribution turned out to be low. Consequently, proton radiotherapy is used for protecting the normal tissue, and is used in tumor tissue as a homogenized dose for effective treatment.

  14. miR-25 modulates NSCLC cell radio-sensitivity through directly inhibiting BTG2 expression

    SciTech Connect

    He, Zhiwei Liu, Yi Xiao, Bing Qian, Xiaosen

    2015-02-13

    A large proportion of the NSCLC patients were insensitive to radiotherapy, but the exact mechanism is still unclear. This study explored the role of miR-25 in regulating sensitivity of NSCLC cells to ionizing radiation (IR) and its downstream targets. Based on measurement in tumor samples from NSCLC patients, this study found that miR-25 expression is upregulated in both NSCLC and radio-resistant NSCLC patients compared the healthy and radio-sensitive controls. In addition, BTG expression was found negatively correlated with miR-25a expression in the both tissues and cells. By applying luciferase reporter assay, we verified two putative binding sites between miR-25 and BTG2. Therefore, BTG2 is a directly target of miR-25 in NSCLC cancer. By applying loss-and-gain function analysis in NSCLC cell lines, we demonstrated that miR-25-BTG2 axis could directly regulated BTG2 expression and affect radiotherapy sensitivity of NSCLC cells. - Highlights: • miR-25 is upregulated, while BTG2 is downregulated in radioresistant NSCLC patients. • miR-25 modulates sensitivity to radiation induced apoptosis. • miR-25 directly targets BTG2 and suppresses its expression. • miR-25 modulates sensitivity to radiotherapy through inhibiting BTG2 expression.

  15. Radio-loud and Radio-quiet QSOs

    NASA Astrophysics Data System (ADS)

    Kellermann, K. I.; Condon, J. J.; Kimball, A. E.; Perley, R. A.; Ivezić, Željko

    2016-11-01

    We discuss 6 GHz JVLA observations covering a volume-limited sample of 178 low-redshift (0.2< z< 0.3) optically selected quasi-stellar objects (QSOs). Our 176 radio detections fall into two clear categories: (1) about 20% are radio-loud QSOs (RLQs) with spectral luminosities of {L}6≳ {10}23.2 {{W}} {{Hz}}-1 that are primarily generated in the active galactic nucleus (AGN) responsible for the excess optical luminosity that defines a bona fide QSO; and (2) the remaining 80% that are radio-quiet QSOs (RQQs) that have {10}21≲ {L}6≲ {10}23.2 {{W}} {{Hz}}-1 and radio sizes ≲ 10 {kpc}, and we suggest that the bulk of their radio emission is powered by star formation in their host galaxies. “Radio-silent” QSOs ({L}6≲ {10}21 {{W}} {{Hz}}-1) are rare, so most RQQ host galaxies form stars faster than the Milky Way; they are not “red and dead” ellipticals. Earlier radio observations did not have the luminosity sensitivity of {L}6≲ {10}21 {{W}} {{Hz}}-1 that is needed to distinguish between such RLQs and RQQs. Strong, generally double-sided radio emission spanning \\gg 10 {kpc} was found to be associated with 13 of the 18 RLQ cores with peak flux densities of {S}{{p}}> 5 {mJy} {{beam}}-1 ({log}(L)≳ 24). The radio luminosity function of optically selected QSOs and the extended radio emission associated with RLQs are both inconsistent with simple “unified” models that invoke relativistic beaming from randomly oriented QSOs to explain the difference between RLQs and RQQs. Some intrinsic property of the AGNs or their host galaxies must also determine whether or not a QSO appears radio-loud.

  16. RADIO FREQUENCY ATTENUATOR

    DOEpatents

    Giordano, S.

    1963-11-12

    A high peak power level r-f attenuator that is readily and easily insertable along a coaxial cable having an inner conductor and an outer annular conductor without breaking the ends thereof is presented. Spaced first and second flares in the outer conductor face each other with a slidable cylindrical outer conductor portion therebetween. Dielectric means, such as water, contact the cable between the flares to attenuate the radio-frequency energy received thereby. The cylindrical outer conductor portion is slidable to adjust the voltage standing wave ratio to a low level, and one of the flares is slidable to adjust the attenuation level. An integral dielectric container is also provided. (AFC)

  17. Packet Radio Communications Project

    DTIC Science & Technology

    1974-12-01

    init.ate any pending DMA channel I/O now possible as a result of the completed DMA I/O operation. For example, if the packet transmision has been...keyboard and printer b. Binary data record I/O fo/from the tape media c. Scan for unsolicited keyboard input 2-12 Software description of experimental...the station and transmit to the station packets input on the radio receivers. The goal is to provide a transparent packet transfer media to

  18. Radio frequency strain monitor

    NASA Technical Reports Server (NTRS)

    Heyman, Joseph S. (Inventor); Rogowski, Robert S. (Inventor); Holben, Jr., Milford S. (Inventor)

    1989-01-01

    A radio frequency strain monitor includes a voltage controlled oscillator for generating an oscillating signal that is input into a propagation path. The propagation path is preferably bonded to the surface of a structure to be monitored and produces a propagated signal. A phase difference between the oscillating and propagated signals is detected and maintained at a substantially constant value which is preferably a multiple of 90.degree. by changing the frequency of the oscillating signal. Any change in frequency of the oscillating signal provides an indication of strain in the structure to which the propagation path is bonded.

  19. Lunar Farside Radio Lab

    NASA Astrophysics Data System (ADS)

    Maccone, Claudio

    2005-03-01

    It is proposed that the Farside of the Moon should be protected legally against man-made radio pollution and uncontrolled exploitation. In fact, only by establishing a radiotelescope on the Farside of the Moon it will finally be possible to cope with the Radio Frequency Interference (RFI) that is now increasingly plaguing all of Radioastronomy, Bioastronomy and Search for Extraterrestrial Intelligence (SETI) Searches done from the surface of the Earth. It is suggested to partition the Farside into 3 sectors, each 60°wide, to ensurethe creation of a future “Lunar Farside Radio Lab” inside crater Daedalus (at 180°E) with our planned Radiotelescope (in practice a Phased Array),complete freedom to exploit the Nearside as well as the four Lagrangian points L1, L3, L4 and L5 of the Earth Moon system by allowing even some International Space Stations to be located there. It is also claimed, however, thatthe “opposite” Lagrangian point L2 should possibly be kept free of spacecrafts that would flood the Farside by the RFI they produce. Realistically, it might be difficult to comply with the latter request in view of the far-future development of a Space Base located there in order to depart towards the Asteroids and the Outer Planets at very reduced fuel consumption. A more reasonable request about any future space station located at the Earth Moon L2 point is thus that this future space station should be shielded to prevent its RFI from reaching the Farside of the Moon.A number of further astrophysical, astronautical and technical issues could just be highlighted in this study and deserve much more elaboration. To mention a few:the precise size of the “Quiet Cone” extending into space above the Farside of the Moon. Also, the experimental measurement of how quiet this Cone actually is by letting a radiometer orbit the Moon (see the web site www.rli.it);the mathematical modelling of the weak ionosphere of the Moon and its possible diffraction effects at very

  20. Solar radio emission

    NASA Technical Reports Server (NTRS)

    Goldman, M. V.; Smith, D. F.

    1981-01-01

    Active areas of both observational and theoretical research in which rapid progress is being made are discussed. These include: (1) the dynamic spectrum or frequency versus time plot; (2) physical mechanisms in the development of various types of bursts; (3) microwave type 1, 2, 3, and moving type 4 bursts; (4) bursts caused by trapped electrons; (5) physics of type 3bursts; (6) the physics of type 2 bursts and their related shocks; (7) the physics of both stationary and moving traps and associated type 1 and moving type 4 bursts; and (8) the status of the field of solar radio emission.

  1. Observations of Solar Radio Transients

    NASA Astrophysics Data System (ADS)

    Paige, Giorla

    2011-05-01

    A low frequency radio telescope has been recently been constructed on the campus of the The College of New Jersey (TCNJ) and has begun conducting observations at 20MHz as part of NASA'a Radio Jove program. This instrument is capable of observations of solar radio emission including strong prompt radio emission associated with solar burst events. We will discuss solar observations conducted with this instrument as well as an effort to conduct coincident observations with the Eight-meter-wavelength Transient Array (ETA) and the Long Wavelength Array (LWA).

  2. Internet Resources for Radio Astronomy

    NASA Astrophysics Data System (ADS)

    Andernach, H.

    A subjective overview of Internet resources for radio-astronomical information is presented. Basic observing techniques and their implications for the interpretation of publicly available radio data are described, followed by a discussion of existing radio surveys, their level of optical identification, and nomenclature of radio sources. Various collections of source catalogues and databases for integrated radio source parameters are reviewed and compared, as well as the web interfaces to interrogate the current and ongoing large-area surveys. Links to radio observatories with archives of raw (uv-) data are presented, as well as services providing images, both of individual objects or extracts (``cutouts'') from large-scale surveys. While the emphasis is on radio continuum data, a brief list of sites providing spectral line data, and atomic or molecular information is included. The major radio telescopes and surveys under construction or planning are outlined. A summary is given of a search for previously unknown optically bright radio sources, as performed by the students as an exercise, using Internet resources only. Over 200 different links are mentioned and were verified, but despite the attempt to make this report up-to-date, it can only provide a snapshot of the situation as of mid-1998.

  3. [Radiotherapy for sarcoma: hadrontherapy, for whom and what for?].

    PubMed

    Pommier, P; Sunyach, M-P; Hu, Yi; Amsalem, E; Claude, L; Moncort-Boulch, D; Toutenu, P; Balosso, J

    2010-06-01

    The radiobiological properties of the hadrons (neutrons, protons, carbon ions) led to their therapeutic use in sarcomas, as a referent therapy or as an alternative to photon therapy. An extensive review of the literature has been conducted to assess the present indications and the perspectives for hadrontherapy. Compared to photons, neutrons are characterized by a higher biological efficiency that is on particular importance for these tumours usually considered as radio-resistant. Neutrons have been considered as a standard therapy for sarcoma' patients, contra-indicated for surgery or with a definitive R2 resection, but their indications and use have been restricted due to the occurrence of late severe toxicities related to their poor ballistic' properties. Thanks to their physical properties (Bragg Peak), protons are characterized by a higher conformity index compared to photons (and neutrons) with optimal organs at risk preservation that permits a dose escalation. Protontherapy is to date the standard of care for base of skull, spinal and paraspinal sarcomas. Carbon ions combined both advantages from protons and neutrons. Literature data permits to consider this radiation modality as a referent therapy for unresectable sarcomas. The ongoing diffusions of protons and carbon ions radiotherapy facilities will permit to offer these therapies to more patients and to conduct studies that are warranted to determine their indications and their results.

  4. [Hyperbaric oxygen and radiotherapy: From myth to reality].

    PubMed

    Espenel, S; Raffoux, C; Vallard, A; Garcia, M-A; Guy, J-B; Rancoule, C; Ben Mrad, M; Langrand-Escure, J; Trone, J-C; Pigne, G; Diao, P; Magné, N

    2016-07-01

    Worldwide, more than a million people receive each year a curative radiotherapy. While local control and overall survival are steadily increasing, 5 to 15% of patients still develop above grade 2 late toxicities. Late toxicities treatments are complex. Hyperbaric oxygenation was shown to induce revascularization and healing of injured tissues, but indications are still debated. Through a literature review, we summarized the hyperbaric oxygenation indications in radiation-induced late toxicities. We also studied the knowledge and practice of French local radiation therapists. It seems that hyperbaric oxygen therapy can be a conservative treatment of haemorrhagic cystitis and radiation-induced pain, in case of drug therapies failure. Often associated with a significant morbidity and mortality, surgery could be avoided. The risk of complications in case of tooth extraction in irradiated tissues is also reduced. However, the role of hyperbaric oxygenation for mandibular osteoradionecrosis, radiation-induced proctitis, enteritis, lymphoedema, brachial plexopathy, skin and neurological sequelae seems more questionable since studies results are conflicting. Future outcomes of phase III studies are expected to clarify the role of hyperbaric oxygenation in the management of radio-induced toxicities, including for head and necks complications.

  5. Differences in breast tissue oxygenation following radiotherapy.

    PubMed

    Dornfeld, Ken; Gessert, Charles E; Renier, Colleen M; McNaney, David D; Urias, Rodolfo E; Knowles, Denise M; Beauduy, Jean L; Widell, Sherry L; McDonald, Bonita L

    2011-08-01

    Tissue perfusion and oxygenation changes following radiotherapy may result from and/or contribute to the toxicity of treatment. Breast tissue oxygenation levels were determined in the treated and non-treated breast 1 year after radiotherapy for breast conserving treatment. Transcutaneous oxygenation varied between subjects in both treated and non-treated breast. Subjects without diabetes mellitus (n=16) had an average oxygenation level of 64.8 ± 19.9mmHg in the irradiated breast and an average of 72.3 ± 18.1mmHg (p=0.018) at the corresponding location in the control breast. Patients with diabetes (n=4) showed a different oxygenation pattern, with lower oxygenation levels in control tissue and no decrease in the irradiated breast. This study suggests oxygenation levels in normal tissues vary between patients and may respond differently after radiotherapy.

  6. Oral verrucous carcinoma. Treatment with radiotherapy

    SciTech Connect

    Nair, M.K.; Sankaranarayanan, R.; Padmanabhan, T.K.; Madhu, C.S.

    1988-02-01

    Fifty-two cases of oral verrucous carcinoma treated with radiotherapy at the Regional Cancer Centre, Trivandrum, Kerala, India in 1982 were evaluated to determine the distribution within the oral cavity, clinical extent, and effectiveness of radiotherapy in controlling the disease. The most common site was the buccal mucosa. Fifty percent of the patients had clinically negative regional lymph nodes and 33% were in earlier stages (T1, T2, N0, and M0). The overall 3-year no evidence of disease (NED) survival rate was 44%. The 3-year NED survival rate with radium implant was 86%. We cannot comment on anaplastic transformation after radiotherapy because our treatment failures have not been subjected for biopsy concerning this matter. Because the results are comparable with those of well-differentiated squamous cell carcinoma, we think that the treatment policies advocated for oral squamous cell carcinoma are also applicable to oral verrucous carcinoma.

  7. [Good practice of image-guided radiotherapy].

    PubMed

    de Crevoisier, R; Créhange, G; Castelli, J; Lafond, C; Delpon, G

    2015-10-01

    Image-guided radiotherapy (IGRT) aims to take into account the anatomical variations occurring during the course of radiotherapy, by direct or indirect visualization of the target volume followed by a corrective action. The movements of the target, or at least the set-up errors are corrected by moving the treatment table, corresponding to the simplest and most validated IGRT modality in a standard practice. The deformations of the target volume and organs at risk are however much more common, and unfortunately much more complicated to consider, requiring multiple planning before or during the treatment, corresponding to the adaptive radiotherapy strategies. The planning target volume must be carefully chosen according to these anatomic variations. This article reviews the modalities of IGRT, standard or under evaluation, according to the different tumour sites.

  8. Radiotherapy-induced hypopituitarism: a review.

    PubMed

    Sathyapalan, Thozhukat; Dixit, Sanjay

    2012-05-01

    Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic-pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic-pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic-pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

  9. One hundred years of radiotherapy in Turkey.

    PubMed

    Dincer, M; Kuter, S

    2001-10-01

    The study and practice of radiology in Turkey began in 1897, only 2 years after the discovery of X-rays. A simple X-ray machine was constructed in Istanbul, consisting of a Crookes tube, a Ruhmkorff coil, and a home-made battery. This machine was first used on wounded soldiers, for diagnostic purposes. The first report of X-rays being used therapeutically in Turkey was published in a national journal in 1904. By 1933, the most up-to-date radiotherapy equipment of the time had been installed in every major city in the country. Innovative radiotherapy techniques, such as rotational treatment, were also being tried in 1930s. Today, there are 45 radiotherapy centres in Turkey, and 400 radiation oncologists and 80 medical physicists practise there.

  10. Optical emission in the radio lobes of radio galaxies. II - New observations of 21 radio lobes

    NASA Astrophysics Data System (ADS)

    Crane, P.; Tyson, J. A.; Saslaw, W. C.

    1983-02-01

    The authors report new identifications of optical emission associated with the radio lobes of double radio galaxies. Optical emission is present in the outer radio structure of the sources 3C 219, 3C 244.1, 3C 247, 3C 252, 3C 268.2, 3C 321, 3C 319, 3C 337, and possibly in 3C 330. The authors have not found emission to the detection limit of V ≡ 24 in the sources 3C 79, 3C 173.1, 3C 223, 3C 325, and 3C 381. Of the 21 separate sources in optical studies of extended lobes of radio galaxies reported to date, 16 radio sources observed so far show significant optical emission within one or both lobes, while in 11 of these the optical object is within 2arcsec of the radio peak.

  11. The Extragalactic Radio Background

    NASA Technical Reports Server (NTRS)

    Kogut, A.; Fixsen, D. J.; Levin, S. M.; Limon, M.; Lubin, P. M.; Seiffert, M.; Singal, J.; Villela, T.; Wollack, E.; Wuensche, C. A.

    2011-01-01

    The existence of an isotropic component of the high-latitude radio sky has been recognized for nearly fifty years, but has typically been assumed to be Galactic in origin. We use recent radio observations to test whether the observed high-latitude component could originate within either an extended Galactic halo or a more local "bubble" structure. The lack of significant polarization from the isotropic component, combined with the lack of significant correlation with the Galactic far-infrared emission, rule out an origin within the Galaxy. We conclude that an extragalactic origin is the only viable alternative for the bulk of the isotropic high-latitude emission. The extragalactic component is 2-3 times brighter than local (Galactic) emission towards the Galactic poles and is consistent with a power law in frequency with amplitude T(sub r) = 24.1 plus or minus 2.1 K and spectral index beta = -2.599 plus or minus 0.036 evaluated at reference frequency 310 MHz.

  12. Pelvic radiotherapy and sexual function in women

    PubMed Central

    Froeding, Ligita Paskeviciute

    2015-01-01

    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. Methods An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. Results The literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  13. Meningioma after radiotherapy for Hodgkin's disease.

    PubMed

    Deutsch, M; Rosenstein, M; Figura, J H

    1999-08-01

    The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.

  14. Robotic and artificial intelligence for keyhole neurosurgery: the ROBOCAST project, a multi-modal autonomous path planner.

    PubMed

    De Momi, E; Ferrigno, G

    2010-01-01

    The robot and sensors integration for computer-assisted surgery and therapy (ROBOCAST) project (FP7-ICT-2007-215190) is co-funded by the European Union within the Seventh Framework Programme in the field of information and communication technologies. The ROBOCAST project focuses on robot- and artificial-intelligence-assisted keyhole neurosurgery (tumour biopsy and local drug delivery along straight or turning paths). The goal of this project is to assist surgeons with a robotic system controlled by an intelligent high-level controller (HLC) able to gather and integrate information from the surgeon, from diagnostic images, and from an array of on-field sensors. The HLC integrates pre-operative and intra-operative diagnostics data and measurements, intelligence augmentation, multiple-robot dexterity, and multiple sensory inputs in a closed-loop cooperating scheme including a smart interface for improved haptic immersion and integration. This paper, after the overall architecture description, focuses on the intelligent trajectory planner based on risk estimation and human criticism. The current status of development is reported, and first tests on the planner are shown by using a real image stack and risk descriptor phantom. The advantages of using a fuzzy risk description are given by the possibility of upgrading the knowledge on-field without the intervention of a knowledge engineer.

  15. [A new human machine interface in neurosurgery: The Leap Motion(®). Technical note regarding a new touchless interface].

    PubMed

    Di Tommaso, L; Aubry, S; Godard, J; Katranji, H; Pauchot, J

    2016-06-01

    Currently, cross-sectional imaging viewing is used in routine practice whereas the surgical procedure requires physical contact with an interface (mouse or touch-sensitive screen). This type of contact results in a risk of lack of aseptic control and causes loss of time. The recent appearance of devices such as the Leap Motion(®) (Leap Motion society, San Francisco, USA) a sensor which enables to interact with the computer without any physical contact is of major interest in the field of surgery. However, its configuration and ergonomics produce key challenges in order to adapt to the practitioner's requirements, the imaging software as well as the surgical environment. This article aims to suggest an easy configuration of the Leap Motion(®) in neurosurgery on a PC for an optimized utilization with Carestream(®) Vue PACS v11.3.4 (Carestream Health, Inc., Rochester, USA) using a plug-in (to download at: https://drive.google.com/?usp=chrome_app#folders/0B_F4eBeBQc3ybElEeEhqME5DQkU) and a video tutorial (https://www.youtube.com/watch?v=yVPTgxg-SIk).

  16. Real-time correction scheme for calibration and implementation of microscope-based image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Sun, Hai; Farid, Hany; Hartov, Alex; Lunn, Karen E.; Roberts, David W.; Paulsen, Keith D.

    2002-05-01

    Microscope-based image-guided neurosurgery can be divided into three steps: calibration of the microscope optics; registration of the pre-operative images to the operating space; and tracking of the patient and microscope over time. Critical to this overall system is the temporal retention of accurate camera calibration. Classic calibration algorithms are routinely employed to find both intrinsic and extrinsic camera parameters. The accuracy of this calibration, however, is quickly compromised due to the complexity of the operating room, the long duration of a surgical procedure, and the inaccuracies in the tracking system. To compensate for the changing conditions, we have developed an adaptive procedure which responds to accruing registration error. The approach utilizes miniature fiducial markers implanted on the bony rim of the craniotomy site, which remain in the field of view of the operating microscope. A simple error function that enforces the registration of the known fiducial markers is used to update the extrinsic camera parameters. The error function is minimized using a gradient descent. This correction procedure reduces RMS registration errors for cortical features on the surface of the brain by an average of 72%, or 1.5 mm. These errors were reduced to less than 0.6 mm after each correction during the entire surgical procedure.

  17. Space Telecommunications Radio Architecture (STRS)

    NASA Technical Reports Server (NTRS)

    Reinhart, Richard C.

    2006-01-01

    A software defined radio (SDR) architecture used in space-based platforms proposes to standardize certain aspects of radio development such as interface definitions, functional control and execution, and application software and firmware development. NASA has charted a team to develop an open software defined radio hardware and software architecture to support NASA missions and determine the viability of an Agency-wide Standard. A draft concept of the proposed standard has been released and discussed among organizations in the SDR community. Appropriate leveraging of the JTRS SCA, OMG's SWRadio Architecture and other aspects are considered. A standard radio architecture offers potential value by employing common waveform software instantiation, operation, testing and software maintenance. While software defined radios offer greater flexibility, they also poses challenges to the radio development for the space environment in terms of size, mass and power consumption and available technology. An SDR architecture for space must recognize and address the constraints of space flight hardware, and systems along with flight heritage and culture. NASA is actively participating in the development of technology and standards related to software defined radios. As NASA considers a standard radio architecture for space communications, input and coordination from government agencies, the industry, academia, and standards bodies is key to a successful architecture. The unique aspects of space require thorough investigation of relevant terrestrial technologies properly adapted to space. The talk will describe NASA s current effort to investigate SDR applications to space missions and a brief overview of a candidate architecture under consideration for space based platforms.

  18. Safety and Special Radio Services.

    ERIC Educational Resources Information Center

    Federal Communications Commission, Washington, DC.

    Numerous radio stations across the nation perform nonbroadcast services in areas ranging from aviation, forestry protection, and telephone maintenance to amateur and citizen radio. These services can be grouped in four general categories: (1) safety, (2) industry, (3) land transportation, and (4) miscellaneous purposes. This bulletin briefly…

  19. Frequency Allocation; The Radio Spectrum.

    ERIC Educational Resources Information Center

    Federal Communications Commission, Washington, DC.

    The Federal Communications Commission (FCC) assigns segments of the radio spectrum to categories of users, and specific frequencies within each segment to individual users. Since demand for channel space exceeds supply, the process is complex. The radio spectrum can be compared to a long ruler: the portion from 10-540 kiloHertz has been set aside…

  20. Stabilized radio-frequency quadrupole

    DOEpatents

    Lancaster, H.D.; Fugitt, J.A.; Howard, D.R.

    1982-09-29

    A long-vane stabilized radio frequency resonator for accelerating charged particles and including means defining a radio frequency resonator cavity, a plurality of long vanes mounted in the defining means for dividing the cavity into sections, and means interconnecting opposing ones of the plurality of vanes for stabilizing the resonator.

  1. The future for radio astronomy

    NASA Astrophysics Data System (ADS)

    Breton, Rene P.; Hassall, Tom

    2013-12-01

    THE TRANSIENT UNIVERSE Rene P Breton and Tom Hassall argue that, while radio astronomy has always involved transient phenomena, exploration of this part of the electromagnetic spectrum has been falling behind because of the lack of data. But the advent of a new generation of radio telescopes such as LOFAR, could change that.

  2. Audiences for Contemporary Radio Formats.

    ERIC Educational Resources Information Center

    Lull, James T.; And Others

    A radio audience survey of 110 sample geographic clusters in the Santa Barbara, California, area served a twofold purpose: the construction of a demographic profile of audience types according to radio format choices, and the identification and analysis of various audience subgroups. A skip interval technique of these geographic clusters resulted…

  3. The Radio Phenomenon in Italy.

    ERIC Educational Resources Information Center

    Faenza, Roberto

    One in a series of studies of experiments in new audiovisual techniques in Europe and the situations in some member countries, this paper traces the development of radio in Italy. Opposing views about radio broadcasting (public monopoly vs. freedom of broadcasting) are examined, and the various political and legal aspects of communications in…

  4. 78 FR 32165 - Commercial Radio Operators; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... COMMISSION 47 CFR Part 0 Commercial Radio Operators; Correction AGENCY: Federal Communication Commission... rules concerning radio operator licenses for maritime and aviation in order to reduce administrative...) Administers the Commission's commercial radio operator program (part 13 of this chapter); the...

  5. Galaxy clusters: Radio relics from fossil electrons

    NASA Astrophysics Data System (ADS)

    Johnston-Hollitt, Melanie

    2017-01-01

    The detection of a tailed radio galaxy in a galaxy cluster conjoined to a region of diffuse radio emission confirms that radio galaxies provide the energetic electrons needed to explain the origin of this enigmatic emission.

  6. Radiotherapy in the management of early breast cancer

    SciTech Connect

    Wang, Wei

    2013-03-15

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.

  7. Radio characteristics of galactic nuclei

    NASA Astrophysics Data System (ADS)

    Condon, J. J.

    1986-02-01

    Radio characteristics of galactic nuclei, providing such unique information as spectral data on source variability, and the long-term history of the central engine and its duration of activity and total energy, are reviewed. The compact radio source characteristics are complicated by orientation-dependent relativistic beaming and by refractive focusing in the interstellar medium. Incoherent synchrotron radiation is thought to be the emission mechanism, with the result that synchrotron self-absorption in compact sources hides the central engine from direct radio observation. However, the history revealed by the extended jets and lobes of radio galaxies and quasars favors a single massive object not supported by radiation pressure, either a spinar or a black hole, as the energy source in radio-galaxy nuclei.

  8. Radio outburst of BL Lacertae

    NASA Astrophysics Data System (ADS)

    Buemi, C. S.; Leto, P.; Trigilio, C.; Umana, G.; Giroletti, M.; Orienti, M.; Raiteri, C. M.; Villata, M.; Bach, U.

    2013-04-01

    We report on extremely high radio flux of BL Lacertae at 43 and 8 GHz. Observations at 43 GHz with the 32 m radio telescope in Noto (Italy) revealed a flux density of 10.5 +/- 0.2 Jy on 2013 April 10.65, while observations at 8 GHz with the 32 m radio telescope in Medicina (Italy) detected a flux density of 8.2 +/- 0.7 Jy on April 12.22. These extremely high radio fluxes show that the radio activity likely correlated to the strong optical, near-infrared, and gamma-ray activity of 2011-2012 (see ATels #4028, #4031, #4155, #4271, #4277, #4349, #4565, #4600), and X-ray activity of late 2012 (ATels #4557, #4627), is far to be exhausted.

  9. The Leicester radiotherapy bite block: an aid to head and neck radiotherapy.

    PubMed

    Hollows, P; Hayter, J P; Vasanthan, S

    2001-02-01

    We describe the construction of a custom-made bite block to be used during external beam radiotherapy to the oral cavity. The bite block is made with standard maxillofacial prosthetic techniques and materials. The design allows accurate and reproducible positioning of the perioral tissues to aid planning of radiotherapy and treatment. The compressibility of this device improves comfort for the patient, while it is in use.

  10. Exploring the Dynamic Radio Sky

    NASA Astrophysics Data System (ADS)

    Mooley, Kunal P.; Hallinan, Gregg; Frail, Dale A.; Myers, Steven T.; Kulkarni, Shrinivas R.; Bourke, Stephen; Horesh, Assaf

    2015-01-01

    Most of what is currently known about slow radio transients (supernovae, gamma-ray bursts, tidal disruption events, stellar flares, etc.) has come via radio follow-up of objects identified by synoptic telescopes at optical, X-ray or gamma-ray wavelengths. However, with the ability to capture obscured, unbeamed and magnetically-driven phenomena, radio surveys offer unique discovery strong diagnostic for cosmic transients. For the first time, we are systematically exploring the dynamic radio sky on timescales between one day to several years using multi-epoch large surveys with the Karl G. Jansky Array (VLA). We have carried out surveys in the COSMOS deep field as well as wide fields like Stripe 82. I have developed a unique infrastructure for near-real-time calibration, imaging, transient search, transient vetting, rapid multiwavelength follow-up, and contemporaneous optical surveys to better characterize radio transient phenomena. A large part of my thesis includes the commissioning of a new observing mode at the VLA: On-The-Fly Mosaicking. This mode has significantly improved the survey efficiency of the VLA, and it is a driver for VLASS, the future all-sky survey planned with this telescope. Through our radio surveys we have discovered several fascinating transients that are unique to the radio. These surveys have established the VLA as an efficient transient discovery machine. My thesis has enormous implications for how to design efficient transient surveys for the next generation of radio interferometer facilities like ASKAP, MeerKAT, WSRT/Apertif and LOFAR. My work has also provided answers to key problems such as the rates of transients, demographics of variability of radio sources including AGN, and false-positive foreground for future searches for the radio counterparts of gravitational-wave (GW) sources.

  11. Post-radiotherapy hypothyroidism in dogs treated for thyroid carcinomas.

    PubMed

    Amores-Fuster, I; Cripps, P; Blackwood, L

    2017-03-01

    Hypothyroidism is a common adverse event after head and neck radiotherapy in human medicine, but uncommonly reported in canine patients. Records of 21 dogs with histologically or cytologically confirmed thyroid carcinoma receiving definitive or hypofractionated radiotherapy were reviewed. Nine cases received 48 Gy in 12 fractions, 10 received 36 Gy in 4 fractions and 2 received 32 Gy in 4 fractions. Seventeen cases had radiotherapy in a post-operative setting. Ten cases developed hypothyroidism (47.6%) after radiotherapy. The development of hypothyroidism was not associated with the radiotherapy protocol used. Median time to diagnosis of hypothyroidism was 6 months (range, 1-13 months). Hypothyroidism is a common side effect following radiotherapy for thyroid carcinomas. Monitoring of thyroid function following radiotherapy is recommended. No specific risk factors have been identified.

  12. Breast Cancer Patients’ Experience of External-Beam Radiotherapy

    PubMed Central

    Schnur, Julie B.; Ouellette, Suzanne C.; Bovbjerg, Dana H.; Montgomery, Guy H.

    2013-01-01

    Radiotherapy is a critical component of treatment for the majority of women with breast cancer, particularly those who receive breast conserving surgery. Although medically beneficial, radiotherapy can take a physical and psychological toll on patients. However, little is known about the specific thoughts and feelings experienced by women undergoing breast cancer radiotherapy. Therefore, the study aim was to use qualitative research methods to develop an understanding of these thoughts and feelings based on 180 diary entries, completed during radiotherapy by 15 women with Stage 0-III breast cancer. Thematic analysis identified four primary participant concerns: (a) a preoccupation with time; (b) fantasies (both optimistic and pessimistic) about life following radiotherapy; (c) the toll their side-effect experience takes on their self-esteem; and (d) feeling mystified by radiotherapy. These themes are consistent with previous literature on illness and identity. These findings have implications for the treatment and care of women undergoing breast cancer radiotherapy. PMID:19380502

  13. The Radio Language Arts Project: adapting the radio mathematics model.

    PubMed

    Christensen, P R

    1985-01-01

    Kenya's Radio Language Arts Project, directed by the Academy for Educational Development in cooperation with the Kenya Institute of Education in 1980-85, sought to teach English to rural school children in grades 1-3 through use of an intensive, radio-based instructional system. Daily 1/2 hour lessons are broadcast throughout the school year and supported by teachers and print materials. The project further was aimed at testing the feasibility of adaptation of the successful Nicaraguan Radio Math Project to a new subject area. Difficulties were encountered in articulating a language curriculum with the precision required for a media-based instructional system. Also a challenge was defining the acceptable regional standard for pronunciation and grammar; British English was finally selected. An important modification of the Radio Math model concerned the role of the teacher. While Radio Math sought to reduce the teacher's responsibilities during the broadcast, Radio Language Arts teachers played an important instructional role during the English lesson broadcasts by providing translation and checks on work. Evaluations of the Radio language Arts Project suggest significant gains in speaking, listening, and reading skills as well as high levels of satisfaction on the part of parents and teachers.

  14. Radio frequency coaxial feedthrough

    DOEpatents

    Owens, Thomas L.

    1989-01-17

    An improved radio frequency coaxial transmission line vacuum feed-through provided based on the use of a half-wavelength annular dielectric pressure barrier disk, or multiple disks comprising an effective half wavelength structure to eliminate reflections from the barrier surfaces. Gas-tight seals are formed about the outer and inner diameter surfaces of the barrier disk using a sealing technique which generates radial forces sufficient to form seals by forcing the conductor walls against the surfaces of the barrier disks in a manner which does not deform the radii of the inner and outer conductors, thereby preventing enhancement of the electric field at the barrier faces which limits voltage and power handling capabilities of a feedthrough.

  15. Radio Seeing Monitor Interferometer

    NASA Astrophysics Data System (ADS)

    Hiriart, David; Valdez, Jorge; Zaca, Placido; Medina, José L.

    2002-10-01

    A two-element interferometer for monitoring atmospheric phase fluctuations (radio seeing) is presented; this uses the unmodulated beacon signal at 11.715 GHz from a geostationary satellite. The system measures phase differences on the signal received by two small antennas separated by 50 m. The system incorporates the best features from previous designs: a heterodyne phase-lock receiver and an IQ demodulator system. Phase fluctuations measured at this frequency may be extrapolated to millimetric and submillimetric wavelengths since the atmosphere is not dispersive at these frequencies. The instrument has been tested at the Observatory San Pedro Martir (Mexico) at 2800 m above sea level. The final destination of the instrument is Cerro la Negra (Mexico), where the Large Millimeter Telescope is under construction, at an altitude of 4600 m.

  16. Radio pulsar disk electrodynamics

    NASA Technical Reports Server (NTRS)

    Michel, F. C.

    1983-01-01

    Macroscopic physics are discussed for the case of a disk close to an isolated, magnetized, rotating neutron star that acts as a Faraday disk dynamo, while the disk acts as both a load and a neutral sheet. This sheet allows the polar cap current to return to the neutron star, splitting a dipolar field into two monopolar halves. The dominant energy loss is from the stellar wind torque, and the next contribution is dissipation in the auroral zones, where the current returns to the star in a 5 cm-thick sheet. The disk itself may be a source of visible radiation comparable to that in pulsed radio frequency emission. As the pulsar ages, the disk expands and narrows into a ring which, it is suggested, may lead to a cessation of pulsed emission at periods of a few sec.

  17. Gold Nanoparticle Hyperthermia Reduces Radiotherapy Dose

    PubMed Central

    Lin, Lynn; Slatkin, Daniel N.; Dilmanian, F. Avraham; Vadas, Timothy M.; Smilowitz, Henry M.

    2014-01-01

    Gold nanoparticles can absorb near infrared light, resulting in heating and ablation of tumors. Gold nanoparticles have also been used for enhancing the dose of X-rays in tumors during radiotherapy. The combination of hyperthermia and radiotherapy is synergistic, importantly allowing a reduction in X-ray dose with improved therapeutic results. Here we intratumorally infused small 15 nm gold nanoparticles engineered to be transformed from infrared-transparent to infrared-absorptive by the tumor, which were then heated by infrared followed by X-ray treatment. Synergy was studied using a very radioresistant subcutaneous squamous cell carcinoma (SCCVII) in mice. It was found that the dose required to control 50% of the tumors, normally 55 Gy, could be reduced to <15 Gy (a factor of >3.7). Gold nanoparticles therefore provide a method to combine hyperthermia and radiotherapy to drastically reduce the X-ray radiation needed, thus sparing normal tissue, reducing the side effects, and making radiotherapy more effective. PMID:24990355

  18. Radiotherapy for inverted papilloma: a case report.

    PubMed

    Levendag, P C; Annyas, A A; Escajadillo, J R; Elema, J D

    1984-06-01

    Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore, we present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy.

  19. Results of radiotherapy for Peyronie's disease

    SciTech Connect

    Niewald, Marcus . E-mail: ramnie@uniklinikum-saarland.de; Wenzlawowicz, Knut v.; Fleckenstein, Jochen; Wisser, Lothar; Derouet, Harry; Ruebe, Christian

    2006-01-01

    Purpose: To retrospectively review the results of radiotherapy for Peyronie's disease. Patients and Methods: In the time interval 1983-2000, 154 patients in our clinic were irradiated for Peyronie's disease. Of those, 101 had at least one complete follow-up data set and are the subject of this study. In the majority of patients, penis deviation was between 30 and 50{sup o}, there were one or two indurated foci with a diameter between 5 and 15 mm. Pain was recorded in 48/92 patients. Seventy-two of the 101 patients received radiotherapy with a total dose of 30 Gy, and 25 received 36 Gy in daily fractions of 2.0 Gy. The remaining patients received the following dosage: 34 Gy (1 patient), 38-40 Gy (3 patients). Mean duration of follow-up was 5 years. Results: The best results ever at any time during follow-up were an improvement of deviation in 47%, reduction of number of foci in 32%, reduction of size of foci in 49%, and less induration in 52%. Approximately 50% reported pain relief after radiotherapy. There were 28 patients with mild acute dermatitis and only 4 patients with mild urethritis. There were no long-term side effects. Conclusion: Our results compare well with those of other studies in the literature. In our patient cohort, radiotherapy was an effective therapy option with only very rare and mild side effects.

  20. Radio Astronomy Explorer /RAE/. I - Observations of terrestrial radio noise.

    NASA Technical Reports Server (NTRS)

    Herman, J. R.; Caruso, J. A.; Stone, R. G.

    1973-01-01

    Radio Astronomy Explorer (RAE) I data are analyzed to establish characteristics of HF terrestrial radio noise at an altitude of about 6000 km. Time and frequency variations in amplitude of the observed noise well above cosmic noise background are explained on the basis of temporal and spatial variations in ionospheric critical frequency coupled with those in noise source distributions. It is shown that terrestrial radio noise regularly breaks through the ionosphere and reaches RAE with magnitudes 15 dB and more above cosmic noise background, on frequencies above the F-layer critical frequency.

  1. Radiation dosimetry in radiotherapy: a model for an extrinsic optical fiber sensor

    NASA Astrophysics Data System (ADS)

    Mignani, Anna G.; Romano, Salvatore; Fusi, Franco; Mencaglia, Andrea A.

    1998-06-01

    The success of radiotherapy relies on the on-line monitoring of the dose of radiation to which the tumor and its adjacent tissues are exposed. Conventional thermoluminescence dosimeters provide only off-line monitoring, since they determine the radiation dosage after completion of the exposure. In order to overcome this limitation, optical fiber sensors have been proposed, which allow for a minimally invasive, real time and continuous monitoring of the delivered which allow for a minimally invasive, real time and continuous monitoring of the delivered dosage. These sensors make use of radio-transducers which are coupled at the end of a radiation-resistant fiber link, so as to obtain a radiation-induced intensity modulation. Typical radio-transducers are: (1) phosphors, which are stimulated to produce a visible luminescence linearly related to the radiation exposure; (2) heavy-metal-doped fiber sections, which undergo an intensity attenuation in the presence of radiation; (3) radiochromic dyes, which exhibit radiation-modulated optical absorption spectra. This paper presents preliminary test of radiation dosimetry performed by means of an extrinsic optical fiber sensor which makes use of a radiochromic film as radio-transducer. The spectral behavior of the transducer allows for two- wavelength differential measurements, so as to obtain a reference intensity-based sensor output.

  2. Neo-adjuvant radiotherapy in rectal cancer

    PubMed Central

    Glimelius, Bengt

    2013-01-01

    In rectal cancer treatment, attention has focused on the local primary tumour and the regional tumour cell deposits to diminish the risk of a loco-regional recurrence. Several large randomized trials have also shown that combinations of surgery, radiotherapy and chemotherapy have markedly reduced the risk of a loco-regional recurrence, but this has not yet had any major influence on overall survival. The best results have been achieved when the radiotherapy has been given preoperatively. Preoperative radiotherapy improves loco-regional control even when surgery has been optimized to improve lateral clearance, i.e., when a total mesorectal excision has been performed. The relative reduction is then 50%-70%. The value of radiotherapy has not been tested in combination with more extensive surgery including lateral lymph node clearance, as practised in some Asian countries. Many details about how the radiotherapy is performed are still open for discussion, and practice varies between countries. A highly fractionated radiation schedule (5 Gy × 5), proven efficacious in many trials, has gained much popularity in some countries, whereas a conventionally fractionated regimen (1.8-2.0 Gy × 25-28), often combined with chemotherapy, is used in other countries. The additional therapy adds morbidity to the morbidity that surgery causes, and should therefore be administered only when the risk of loco-regional recurrence is sufficiently high. The best integration of the weakest modality, to date the drugs (conventional cytotoxics and biologicals) is not known. A new generation of trials exploring the best sequence of treatments is required. Furthermore, there is a great need to develop predictors of response, so that treatment can be further individualized and not solely based upon clinical factors and anatomic imaging. PMID:24379566

  3. Radio studies of extragalactic supernovae.

    PubMed

    Weiler, K W; Sramek, R A; Panagia, N

    1986-03-14

    Some exploding stars (supernovae) are powerful emitters of centimeter radio radiation. Detailed observations have shown that these supernovae quickly become detectable in the radio range, first at shorter wavelengths (higher frequencies) and later at progressively longer and longer wavelengths (lower frequencies). This part of the phenomenon appears to be well explained by a monotonic decrease in the amount of ionized material surrounding the radio-emitting regions as the shock from the explosion travels outward. The radio emission itself is of a nonthermal, synchrotron origin, as is the case in most bright cosmic radio sources. Once the absorption effects become negligible, the radio intensity declines with time until reaching the detection limit of the telescope. Models suggest that the absorbing material originates in a dense wind of matter lost by the supernova progenitor star, or by its companion if it is in a binary system, in the last stages of evolution before the explosion. The synchrotron radio emission can be generated either externally by the shock wave from the explosion propagating through this same high density stellar wind or internally by a rapidly rotating neutron star, which is the collapsed core of the exploded star. Present results appear to favor the former model for at least the first several years after the supernova explosion, although the latter model remains viable.

  4. Radio emission in Mercury magnetosphere

    NASA Astrophysics Data System (ADS)

    Varela, J.; Reville, V.; Brun, A. S.; Pantellini, F.; Zarka, P.

    2016-10-01

    Context. Active stars possess magnetized wind that has a direct impact on planets that can lead to radio emission. Mercury is a good test case to study the effect of the solar wind and interplanetary magnetic field (IMF) on radio emission driven in the planet magnetosphere. Such studies could be used as proxies to characterize the magnetic field topology and intensity of exoplanets. Aims: The aim of this study is to quantify the radio emission in the Hermean magnetosphere. Methods: We use the magnetohydrodynamic code PLUTO in spherical coordinates with an axisymmetric multipolar expansion for the Hermean magnetic field, to analyze the effect of the IMF orientation and intensity, as well as the hydrodynamic parameters of the solar wind (velocity, density and temperature), on the net power dissipated on the Hermean day and night side. We apply the formalism derived by Zarka et al. (2001, Astrophys. Space Sci., 277, 293), Zarka (2007, Planet. Space Sci., 55, 598) to infer the radio emission level from the net dissipated power. We perform a set of simulations with different hydrodynamic parameters of the solar wind, IMF orientations and intensities, that allow us to calculate the dissipated power distribution and infer the existence of radio emission hot spots on the planet day side, and to calculate the integrated radio emission of the Hermean magnetosphere. Results: The obtained radio emission distribution of dissipated power is determined by the IMF orientation (associated with the reconnection regions in the magnetosphere), although the radio emission strength is dependent on the IMF intensity and solar wind hydro parameters. The calculated total radio emission level is in agreement with the one estimated in Zarka et al. (2001, Astrophys. Space Sci., 277, 293) , between 5 × 105 and 2 × 106 W.

  5. Radio protection zone evaluation at the Dominion Radio Astrophysical Observatory

    NASA Astrophysics Data System (ADS)

    Tapping, Ken

    Increasing use of the radio spectrum by licensed and unlicensed devices, together with the encroachment of housing developments are an issue facing many radio observatories, including the Dominion Radio Astrophysical Observatory (DRAO), located near Penticton in Southern British Columbia. A joint study by Industry Canada (Canada's national spectrum manager), and the National Research Council (Operator of DRAO) is currently in progress to examine protection zone needs and the reliability of the definitions of the zone, and the general level of background noise from growing local communities. The objectives are to produce a definition of a protection zone that is useful in spectrum management to protect the observatory, and to establish how much local community development is acceptable if the observatory is to remain a viable location for radio astronomical observations. This presentation will summarize the results so far in this ongoing study.

  6. Radio Search For Extrasolar Planets

    NASA Astrophysics Data System (ADS)

    Zarka, P.

    Theoretical justification and ongoing observational efforts in view of detecting radio emissions from extrasolar planets will be presented. On the "prediction" side, a heuris- tic scaling law has been established relating the radio output of any magnetized flow- obstacle system to the incident magnetic energy flux on the obstacle. Its confirmation by the observation of radio emission from extrasolar planets would help to understand the energy budget of such a system. On the "detection" side, specific procedures have been developed for interference mitigation and weak burst detection.

  7. Recurrent Activity in Radio Galaxies

    SciTech Connect

    Jamrozy, Marek; Konar, Chiranjib; Machalski, Jerzy; Mack, Karl-Heinz; Saikia, Dhruba; Siemiginowska, Aneta; Stawarz, Lukasz; /KIPAC, Menlo Park /Jagiellonian U.

    2007-10-15

    One of the outstanding issues concerning extragalactic radio sources is the total duration of their active phase and the possible existence of duty cycles of their nuclear activity. A duty cycle can be recognized if there is a mechanism which preserves the information of past activity for a sufficiently long time after a new activity has started up. If a new cycle starts before the radio lobes created during a former activity period have faded, we can recognize this by the observations of a young radio source embedded in an old relic structure.

  8. Searches for Fast Radio Transients

    NASA Astrophysics Data System (ADS)

    Cordes, J. M.; McLaughlin, M. A.

    2003-10-01

    We discuss optimal detection of fast radio transients from astrophysical objects while taking into account the effects of propagation through intervening ionized media, including dispersion, scattering, and scintillation. Our analysis applies to the giant-pulse phenomenon exhibited by some pulsars, for which we show examples, and to radio pulses from other astrophysical sources, such as prompt radio emission from gamma-ray burst sources and modulated signals from extraterrestrial civilizations. We estimate scintillation parameters for extragalactic sources that take into account scattering both in the host galaxy and in foreground Galactic plasma.

  9. The Helios radio astronomy experiment

    NASA Technical Reports Server (NTRS)

    Kayser, S.; Stone, R.

    1984-01-01

    Radio bursts traveling between the Sun and the Earth were tracked by radio astronomy experiments on Helios 1 and 2. A relatively short dipole antenna with a well-defined toroidal reception pattern was flown. The antenna spins in the ecliptic at 60.3 rpm and 2 frequencies are measured in each revolution. The signal analysis determines the strength of the signal, the direction of the source in the ecliptic, and the degree of modulation, and estimates source size. The experiments provide three-dimensional direction finding in space. They extend the radio frequency window beyond what is observable on Earth, and offer a long triangulation baseline.

  10. Technical advances in external radiotherapy for hepatocellular carcinoma

    PubMed Central

    Park, Shin-Hyung; Kim, Jae-Chul; Kang, Min Kyu

    2016-01-01

    Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma (HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs. SABR can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates of 84%-100%. Various advanced imaging modalities are used for radiotherapy planning and delivery to improve the precision of radiotherapy. These advanced techniques enable the delivery of high dose radiotherapy for early to advanced HCCs without increasing the radiation-induced toxicities. However, as there have been no effective tools for the prediction of the response to radiotherapy or recurrences within or outside the radiation field, future studies should focus on selecting the patients who will benefit from radiotherapy. PMID:27621577

  11. The excess radio background and fast radio transients

    SciTech Connect

    Kehayias, John; Kephart, Thomas W.; Weiler, Thomas J. E-mail: thomas.w.kephart@vanderbilt.edu

    2015-10-01

    In the last few years ARCADE 2, combined with older experiments, has detected an additional radio background, measured as a temperature and ranging in frequency from 22 MHz to 10 GHz, not accounted for by known radio sources and the cosmic microwave background. One type of source which has not been considered in the radio background is that of fast transients (those with event times much less than the observing time). We present a simple estimate, and a more detailed calculation, for the contribution of radio transients to the diffuse background. As a timely example, we estimate the contribution from the recently-discovered fast radio bursts (FRBs). Although their contribution is likely 6 or 7 orders of magnitude too small (though there are large uncertainties in FRB parameters) to account for the ARCADE 2 excess, our development is general and so can be applied to any fast transient sources, discovered or yet to be discovered. We estimate parameter values necessary for transient sources to noticeably contribute to the radio background.

  12. Implant supported overdenture in the patients with history of radio and chemotherapy for the prostate malignancy

    PubMed Central

    Aeran, Himanshu; Nautiyal, Vijay; Kumar, Varun; Uniyal, Shashank

    2015-01-01

    The success of dental implants in patients that have undergone chemo and radiotherapy for a region other than head and neck remain unclear, although some local and systemic factors could be contraindications to dental implant treatment. As there are very few absolute medical contraindications to dental implant treatment, but a number of conditions may increase the risk of treatment failure or complications. The case report describes the successful survival of dental implants placed in maxilla and mandible of a patient who had undergone radio and chemotherapy for prostate cancer. PMID:27390497

  13. Evaluation of Conoscopic Holography for Estimating Tumor Resection Cavities in Model-Based Image-Guided Neurosurgery

    PubMed Central

    Sun, Kay; Pheiffer, Thomas S.; Rucker, D. Caleb; Sills, Allen K.; Thompson, Reid C.; Miga, Michael I.

    2014-01-01

    Surgical navigation relies on accurately mapping the intraoperative state of the patient to models derived from preoperative images. In image-guided neurosurgery, soft tissue deformations are common and have been shown to compromise the accuracy of guidance systems. In lieu of whole-brain intraoperative imaging, some advocate the use of intraoperatively acquired sparse data from laser-range scans, ultrasound imaging, or stereo reconstruction coupled with a computational model to drive subsurface deformations. Some authors have reported on compensating for brain sag, swelling, retraction, and the application of pharmaceuticals such as mannitol with these models. To date, strategies for modeling tissue resection have been limited. In this paper, we report our experiences with a novel digitization approach, called a conoprobe, to document tissue resection cavities and assess the impact of resection on model-based guidance systems. Specifically, the conoprobe was used to digitize the interior of the resection cavity during eight brain tumor resection surgeries and then compared against model prediction results of tumor locations. We should note that no effort was made to incorporate resection into the model but rather the objective was to determine if measurement was possible to study the impact on modeling tissue resection. In addition, the digitized resection cavity was compared with early postoperative MRI scans to determine whether these scans can further inform tissue resection. The results demonstrate benefit in model correction despite not having resection explicitly modeled. However, results also indicate the challenge that resection provides for model-correction approaches. With respect to the digitization technology, it is clear that the conoprobe provides important real-time data regarding resection and adds another dimension to our noncontact instrumentation framework for soft-tissue deformation compensation in guidance systems. PMID:24845293

  14. National healthcare spending in the U.S. and Japan: national economic policy and implications for neurosurgery.

    PubMed

    Bean, James R

    2005-01-01

    Growth of national healthcare spending is a problem confronting national governments of all industrially advanced countries. Healthcare spending in the U.S. reached 13.9% of the Gross Domestic Product (GDP) in 2003, compared to only 8% in Japan. In the U.S., health insurance is voluntary, with 15% of the population uninsured. In Japan, health insurance is mandatory and virtually universal, with growth in national health costs about half the rate of growth in the U.S. U.S. healthcare costs are projected to reach 18.4% of GDP 2013. The predicted growth in health care costs is expected to cause strain on the federal budget and a growing inability of employers and employees to pay for private insurance. Different national policies are the reason for different national health care costs in the U.S. and Japan. The U.S. has higher healthcare prices for salaries, equipment, supplies, and pharmaceuticals as compared to Japan. Higher prices, higher service intensity and volume during hospitalization create higher total cost in the U.S. Price controls in Japan kept medical inflation low at 0.46%/yr from 1980-2000. Market-pricing mechanisms in the U.S. have proven ineffective in controlling national healthcare costs, while Japan's national fee and price control policies have kept national costs among the lowest within the Organization for Economic Cooperation and Development. To guide insurance coverage policy, neurosurgery and other highly technical specialties should better define the comparative health benefit of high price technical services by prospective outcome studies.

  15. The Business of Radio Promotion.

    ERIC Educational Resources Information Center

    Hall, Jonathan

    This speech suggests that public radio stations should examine and use the techniques employed by commercial stations to increase their listening audience--creative promotion based on community involvement and participation. Some examples are included. (SC)

  16. Radio astronomy - The next decade

    NASA Astrophysics Data System (ADS)

    Kellermann, Kenneth I.

    1991-09-01

    Discoveries made over the past several decades by radio astronomers include radio galaxies, quasars, pulsars, gravitational lenses, energetic bursts from the sun and Jupiter, the greenhouse effect on Venus, the rotation of Mercury, giant molecular clouds, violent activity in galactic nuclei, and cosmic background radiation. This paper discusses the development of ever more powerful radio telescopes, which include the VLA operated by NRAO near Socorro (New Mexico); the new NRAO's 100-m Green Bank Telescope being constructed in Green Bank (West Virginia); and the proposed Millimeter Array, which will consist of 40 antennas, each 8-m across, arranged in any of four different ways depending on the size of the region under study. Consideration is also given to methods for increasing the resolving power and image quality of radio telescopes, with special attention given to very-long-baseline interferometry.

  17. Facilities for radio-iodination.

    PubMed

    Ramsey, N W; Bhattacharyya, A K; Dunn, M J

    1980-02-01

    A fume cabinet with a sloping front, fitted with a chemical absorbing filter and extractor fan, but without exhaust ducting, appears to possess considerable advantages for radio-iodination work compared with standard fume cupboards.

  18. EVA Radio DRATS 2011 Report

    NASA Technical Reports Server (NTRS)

    Swank, Aaron J.; Bakula, Casey J.

    2012-01-01

    In the Fall of 2011, National Aeronautics and Space Administration (NASA) Glenn Research Center (GRC) participated in the Desert Research and Technology Studies (DRATS) field experiments held near Flagstaff, Arizona. The objective of the DRATS outing is to provide analog mission testing of candidate technologies for space exploration, especially those technologies applicable to human exploration of extra- terrestrial rocky bodies. These activities are performed at locations with similarities to extra-terrestrial conditions. This report describes the Extravehicular Activity (EVA) Dual-Band Radio Communication System which was demonstrated during the 2011 outing. The EVA radio system is designed to transport both voice and telemetry data through a mobile ad hoc wireless network and employs a dual-band radio configuration. Some key characteristics of this system include: 1. Dual-band radio configuration. 2. Intelligent switching between two different capability wireless networks. 3. Self-healing network. 4. Simultaneous data and voice communication.

  19. 46 CFR 15.830 - Radio officers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Radio officers. 15.830 Section 15.830 Shipping COAST... Computations § 15.830 Radio officers. Radio officers are required on certain merchant vessels of the United States. The determination of when a radio officer is required is based on the Federal...

  20. 75 FR 66709 - Commercial Radio Operators Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... COMMISSION 47 CFR Parts 0, 1, 13, 80, and 87 Commercial Radio Operators Rules AGENCY: Federal Communications... radio operator licenses for maritime and aviation radio stations who perform certain functions performed within the commercial radio operators service, to determine which rules can be clarified, streamlined,...

  1. 46 CFR 15.830 - Radio officers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Radio officers. 15.830 Section 15.830 Shipping COAST... Computations § 15.830 Radio officers. Radio officers are required on certain merchant vessels of the United States. The determination of when a radio officer is required is based on the Federal...

  2. 46 CFR 15.830 - Radio officers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Radio officers. 15.830 Section 15.830 Shipping COAST... Computations § 15.830 Radio officers. Radio officers are required on certain merchant vessels of the United States. The determination of when a radio officer is required is based on the Federal...

  3. 46 CFR 15.830 - Radio officers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Radio officers. 15.830 Section 15.830 Shipping COAST... Computations § 15.830 Radio officers. Radio officers are required on certain merchant vessels of the United States. The determination of when a radio officer is required is based on the Federal...

  4. 46 CFR 15.830 - Radio officers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Radio officers. 15.830 Section 15.830 Shipping COAST... Computations § 15.830 Radio officers. Radio officers are required on certain merchant vessels of the United States. The determination of when a radio officer is required is based on the Federal...

  5. PARTNeR: Radio astromony for students

    NASA Astrophysics Data System (ADS)

    Blasco, C.; Vaquerizo, J. A.

    2008-06-01

    PARTNeR stands for Proyecto Academico con el Radiotelescopio de NASA en Robledo (the Academic Project with NASA's radio telescope at Robledo), and allows students to perform radio astronomy observations. High school and university students can access the PARTNeR radio telescope via the internet. The students can operate the antenna from their own school or university and perform radio astronomy observations.

  6. Innovativeness and the Public Radio Audience.

    ERIC Educational Resources Information Center

    Williams, Wenmouth, Jr.; Krugman, Dean M.

    1981-01-01

    A public radio audience was surveyed to test the hypothesis that a relationship exists between innovativeness and public radio listening. Rather than supporting the hypothesis, findings indicate that the entertainment and information elements of public radio are the primary attractions for the public radio audience. (MER)

  7. Radio Implementation of a Testbed For Cognitive Radio Source Localization Using USRPS and GNU Radio

    DTIC Science & Technology

    2014-09-01

    pp. 116–130, 2009. [4] R.A. Rashid , M.A. Sarijari, N. Fisal, S.K.S. Yusof and N.H. Mahalin, “Spectrum sensing measurement using GNU Radio and...USRP software radio platform,” in Proc. 7th Int. Conf. Wireless and Mobile Commun., Luxembourg, 2011. [5] R.A. Rashid , M.A. Sarijari, N. Fisal...Sarijari, A. Marwanto, N. Fisal, S.K.S. Yusof and R.A Rashid , “Energy detection sensing based on GNU Radio and USRP: An analysis study,” in Proc

  8. The role of Harvey Cushing and Walter Dandy in the evolution of modern neurosurgery in the Netherlands, illustrated by their correspondence.

    PubMed

    Groen, Rob J M; Koehler, Peter J; Kloet, Alfred

    2013-03-01

    The development of modern neurosurgery in the Netherlands, which took place in the 1920s, was highly influenced by the personal involvement of both Harvey Cushing and Walter Dandy, each in his own way. For the present article, the authors consulted the correspondence (kept at the Cushing/Whitney Medical Library in New Haven and the Alan Mason Chesney Medical Archives in Baltimore) of Cushing and Dandy with their Dutch disciples. The correspondence provides a unique inside view into the minds of both neurosurgical giants. After the neurologist Bernard Brouwer had paved the way for sending the Dutch surgeon Ignaz Oljenick overseas, Cushing personally took the responsibility to train him (1927-1929). On his return to Amsterdam, Oljenick and Brouwer established the first neurosurgical department in the country. Encouraged by Oljenick's favorable results, a number of Dutch general surgeons started asking Cushing for support. Cushing strategically managed and deflected these requests, probably aiming to increase the advantage of Oljenick and Brouwer. However, the University Hospital in Groningen persisted in the plans to establish its own neurosurgical unit and sent Ferdinand Verbeek to the US in 1932. Although staying at Cushing's department initially, Verbeek ultimately applied to Walter Dandy for a position of visiting voluntary assistant, staying until the end of 1934. Verbeek and Dandy became lifelong friends. On his return to Groningen, Verbeek started practicing neurosurgery, isolated in the northern part of the country. He relied on the support of Dandy, with whom he kept up a regular correspondence, discussing cases and seeking advice. Dandy, on his part, used Verbeek as the ambassador in Europe for his operative innovations. At the beginning of World War II, Oljenick had to flee the country, which concluded the direct line with the Cushing school in the Netherlands. After Dandy's death (1946), Verbeek continued practicing neurosurgery following his style and

  9. Ondvrejov solar radio WWW page

    NASA Astrophysics Data System (ADS)

    Jivrivcka, Karel; Meszarosova, Hana

    Since mid 1997 the Solar Radio Astronomy Group of the Astronomical Institute in Ondvrejov has been running a new WWW page. You can find us at the address --- http://sunkl.asu.cas.cz/radio/ --- where information about our instruments, observed frequencies, as well as about our data archive is available. The home page includes four main topics: 1. Observation & Instrumentation --- here you can find information about which instruments are currently in use, observed frequencies, time resolutions etc. Presently we use for solar radio observations three dedicated instruments: RT3 -- single frequency 3 GHz receiver with 10 ms time resolution RT4 -- radio spectrograph 2.0--4.5 GHz with 100 ms time resolution RT5 -- radio spectrograph 0.8--2.0 GHz with 100 ms time resolution The observations are run daily, while the Sun is higher then 5 degrees above the horizon. Because of the tremendous amount of data, only chosen time intervals with radio events are archived. Event Archive Info: --- here you can find information about archived data (date, time interval) as well as overall images of individual events in GIF format (the image names are at the same time hyperlinks for direct loading) sorted by date and time of observation. Gallery: --- here you can find some representative examples of spectra of solar radio events, recorded by our instruments. Anonymous FTP Server: --- enables direct FTP access to our image archive. This WWW page should give you an insight, what data are available and what the events look roughly like. The uncalibrated rough data from our archive can be processed only by special programs and are not generally free. But if you are interested in a particular event from our archive, you can contact us via e-mail address: radio@asu.cas.cz This work has been supported by the Czech Academy of Sciences through grant no.A3003707.

  10. Populations of extragalactic radio sources

    NASA Astrophysics Data System (ADS)

    Wall, J. V.

    In the late 1950s and early 1960s, radio sky surveys were the center of an intense and public debate -- Big-Bang versus Steady-State cosmology -- the arguments revolving about source counts and statistical interpretations in the face of instrumental complications. The 1965 discovery of the microwave background took the fire from the debate, but left the momentum in place for large-area radio surveys at different frequencies, and for extensive identification/redshift-measurement programs. By the 1970s the data enabled us to start disentangling the different populations of extragalactic radio sources. We could refine our taxonomy, and we could view the possibility of delineating individual cosmic histories and evolutions. We could at least describe a goal to elucidate the birth-life-death cycles of the objects involved 1quasi-stellar objects (QSOs) and radio galaxies: together the 'active galactic nuclei' (AGNs)1 whose unaccountably prodigious energies somehow produce the beautifully aligned radio structures with which we are now familiar. One part of John Bolton's vision was to see how distorted a view of the AGN universe the original long-wavelength surveys provided. One legacy is thus the 'short-wavelength survey' for extragalactic radio sources, which has done so much to balance our picture of the radio sky. And indeed the legacy continues in the form of the immense sky surveys at present under way, complete with their sub-industries of radio-positioning and identification. From these, yet further results are emerging on spatial distribution and the skeleton structure of the universe. It is the purpose of this paper to outline something of this current view of the populations, their differences, similarities and unifying concepts.

  11. National Centre for Radio Astrophysics

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    India's National Centre for Radio Astrophysics (NCRA), located on the Pune University Campus, is part of the TATA INSTITUTE OF FUNDAMENTAL RESEARCH. At Khodad, 80 km from Pune, NCRA has set up the Giant Metrewave Radio Telescope (GMRT), the world's largest telescope operating at meter wavelengths. GMRT consists of 30 fully steerable dishes of 45 m diameter, spread over a 25 km area. Another meter...

  12. Historic Radio Astronomy Working Group

    NASA Astrophysics Data System (ADS)

    2007-06-01

    This special issue of Astronomische Nachrichten contains the proceedings of a session of the Historic Radio Astronomy Working Group of the International Astronomical Union that took place during the 26th General Assembly of the IAU in Prague on 17th August 2006. In addition to the talks presented in Prague some contributions were solicited to give a more complete overview of `The Early History of European Radio Astronomy'.

  13. Radio emission from supernova remnants

    NASA Astrophysics Data System (ADS)

    Dubner, Gloria; Giacani, Elsa

    2015-09-01

    The explosion of a supernova releases almost instantaneously about 10^{51} ergs of mechanic energy, changing irreversibly the physical and chemical properties of large regions in the galaxies. The stellar ejecta, the nebula resulting from the powerful shock waves, and sometimes a compact stellar remnant, constitute a supernova remnant (SNR). They can radiate their energy across the whole electromagnetic spectrum, but the great majority are radio sources. Almost 70 years after the first detection of radio emission coming from an SNR, great progress has been achieved in the comprehension of their physical characteristics and evolution. We review the present knowledge of different aspects of radio remnants, focusing on sources of the Milky Way and the Magellanic Clouds, where the SNRs can be spatially resolved. We present a brief overview of theoretical background, analyze morphology and polarization properties, and review and critically discuss different methods applied to determine the radio spectrum and distances. The consequences of the interaction between the SNR shocks and the surrounding medium are examined, including the question of whether SNRs can trigger the formation of new stars. Cases of multispectral comparison are presented. A section is devoted to reviewing recent results of radio SNRs in the Magellanic Clouds, with particular emphasis on the radio properties of SN 1987A, an ideal laboratory to investigate dynamical evolution of an SNR in near real time. The review concludes with a summary of issues on radio SNRs that deserve further study, and analysis of the prospects for future research with the latest-generation radio telescopes.

  14. A zero-power radio receiver.

    SciTech Connect

    Brocato, Robert Wesley

    2004-09-01

    This report describes both a general methodology and some specific examples of passive radio receivers. A passive radio receiver uses no direct electrical power but makes sole use of the power available in the radio spectrum. These radio receivers are suitable as low data-rate receivers or passive alerting devices for standard, high power radio receivers. Some zero-power radio architectures exhibit significant improvements in range with the addition of very low power amplifiers or signal processing electronics. These ultra-low power radios are also discussed and compared to the purely zero-power approaches.

  15. ERK/p38 MAPK inhibition reduces radio-resistance to a pulsed proton beam in breast cancer stem cells

    NASA Astrophysics Data System (ADS)

    Jung, Myung-Hwan; Park, Jeong Chan

    2015-10-01

    Recent studies have identified highly tumorigenic cells with stem cell-like characteristics, termed cancer stem cells (CSCs) in human cancers. CSCs are resistant to conventional radiotherapy and chemotherapy owing to their high DNA repair ability and oncogene overexpression. However, the mechanisms regulating CSC radio-resistance, particularly proton beam resistance, remain unclear. We isolated CSCs from the breast cancer cell lines MCF-7 and MDA-MB-231, which expressed the characteristic breast CSC membrane protein markers CD44+/CD24-/ low , and irradiated the CSCs with pulsed proton beams. We confirmed that CSCs were resistant to pulsed proton beams and showed that treatment with p38 and ERK inhibitors reduced CSC radio-resistance. Based on these results, BCSC radio-resistance can be reduced during proton beam therapy by co-treatment with ERK1/2 or p38 inhibitors, a novel approach to breast cancer therapy.

  16. Natural radio lasing at Jupiter

    NASA Technical Reports Server (NTRS)

    Calvert, W.; Leblanc, Y.; Ellis, G. R. A.

    1988-01-01

    Like the comparable AKR radio emissions from earth's magnetosphere, the well-known decametric radio S-bursts from Jupiter, observed in France and Australia at frequencies from 10 to 26 MHz, have been found to exhibit equally spaced discrete spectral components which can be attributed to the adjacent longitudinal oscillation modes of natural radio lasers. Implying sizes of only a few kilometers for the individual radio lasers producing the S-bursts, the frequency spacing of these modes was roughly constant with frequency and about 30 to 50 kHz. Their corresponding temporal spacings, however, varied inversely proportional to the observing frequency, suggesting that the radio lasers producing the S-bursts were expanding uniformly at a rate of about 4 km/s. Presumably caused by the projected motion of Io with respect to the planet, this expansion of the S-burst radio lasers would account for the downward frequency drifts of the S-bursts without the energetic electron bunches which have heretofore always been assumed necessary to account for such behavior.

  17. Radio galaxies and their environment

    SciTech Connect

    van Breugel, W.

    1993-02-24

    The relationships between radio galaxies and their environment are varied, complex, and evolve with cosmic epoch. Basic questions are what role the environment plays in triggering and fuelling (radio) galaxy activity what the effects of this activity are on its environment, and how radio galaxies and environment evolve. Clearly, this could be the topic of a workshop all in itself and the scope of this review will necessarily be limited. A review of the connections between environment and galaxy activity in general has been given by Heckman. First, I will briefly summarize the relationships between parent galaxy and cluster environments, and radio galaxies. A more detailed discussion of various aspects of this will be given elsewhere by F. Owen, J.0. Burns and R. Perley. I will then discuss the current status of investigations of extended emission-line regions in radio galaxies, again referring elsewhere in this volume for more detailed discussions of some particular aspects (kinematics and ionization mechanisms by K. Meisenheimer; polarization and spectral index lobe asymmetries by G. Pooley). I will conclude with a brief discussion of the current status of observations of high redshift radio galaxies.

  18. Flare stars at radio wavelengths

    NASA Technical Reports Server (NTRS)

    Lang, Kenneth R.

    1990-01-01

    The radio emission from dMe flare stars is discussed using Very Large Array and Arecibo observations as examples. Active flare stars emit weak, unpolarized, quiescent radio radiation that may be always present. Although thermal bremsstrahlung and/or thermal gyroresonance radiation account for the slowly-varying, quiescent radio radiation of solar active regions, these processes cannot account for the long-wavelength quiescent radiation observed from nearby dMe flare stars. It has been attributed to nonthermal gyrosynchrotron radiation, but some as yet unexplained mechanism must be continually producing the energetic electrons. Long duration, narrow-band radiation is also emitted from some nearby dMe stars at 20 cm wavelength. Such radiation may be attributed to coherent plasma radiation or to coherent electron-cyclotron masers. Impulsive stellar flares exhibit rapid variations that require radio sources that are smaller than the star in size, and high brightness temperatures greater than 10(exp 15) K that are also explained by coherent radiation processes. Quasi-periodic temporal fluctuations suggest pulsations during some radio flares. Evidence for frequency structure and positive or negative frequency drifts during radio flares from dMe stars is also presented.

  19. Flare stars at radio wavelengths

    NASA Technical Reports Server (NTRS)

    Lang, Kenneth R.

    1989-01-01

    The radio emission from dMe flare stars is discussed using Very Large Array and Arecibo observations as examples. Active flare stars emit weak, unpolarized, quiescent radio radiation that may be always present. Although thermal bremsstrahlung and/or thermal gyroresonance radiation account for the slowly-varying, quiescent radio radiation of solar active regions, these processes cannot account for the long-wavelength quiescent radiation observed from nearby dMe flare stars. It has been attributed to nonthermal gyrosynchrotron radiation, but some as yet unexplained mechanism must be continually producing the energetic electrons. Long duration, narrow-band radiation is also emitted from some nearby dMe stars at 20 cm wavelength. Such radiation may be attributed to coherent plasma radiation or to coherent electron-cyclotron masers. Impulsive stellar flares exhibit rapid variations that require radio sources that are smaller than the star in size, and high brightness temperatures greater than 10(exp 15) K that are also explained by coherent radiation processes. Quasi-periodic temporal fluctuations suggest pulsations during some radio flares. Evidence for frequency structure and positive or negative frequency drifts during radio flares from dMe stars is also presented.

  20. Second cancers following radiotherapy for cancer

    SciTech Connect

    Curtis, R.E.

    1997-03-01

    The study of second cancer risk after radiotherapy provides a unique opportunity to study carcinogenesis since large groups of humans are deliberately exposed to substantial doses of radiation in order to cure disease. Detailed radiotherapy records for cancer patients allow precise quantification of organ dose, and population-based cancer registries are frequently available to provide access to large groups of patients who are closely followed for long periods. Moreover, cancer patients treated with surgery alone (no radiation) are frequently available to serve as a non-irradiated comparison group. New information can be provided on relatively insensitive organs, and low dose exposures in the range of scientific interest are received by organs outside the radiation treatment fields. This paper will review several recently completed studies that characterize the risk of radiation-induced second cancers. Emphasis will be given to studies providing new information on the dose-response relationship of radiation-induced leukemia, breast cancer and lung cancer.

  1. [Radiotherapy as primary treatment for chemodectoma?].

    PubMed

    Verniers, D; Van Limbergen, E; Leysen, J; Ostyn, F; Segers, A

    1990-01-01

    Chemodectomas are slowly growing tumours originating in the chemoreceptor bodies. The diagnosis is based on typical clinical symptoms and radiological investigation. CT scanning with contrast enhancement permits to establish diagnosis in most cases and gives a correct idea of tumour size, tumour extension, displacement of arteries and bone destruction. Small tympanic chemodectomas are successfully managed by surgery, without causing additional cranial nerve palsies. Surgery of larger lesions is frequently followed by a high percentage of local recurrence (greater than 50%) and important morbidity (neurologic sequelae). Our present series confirms that these tumours can successfully be treated by radiotherapy. Persisting local control rates can be obtained in more than 90% of cases with moderate doses (45-50 Gy in 5 weeks) of carefully planned radiotherapy.

  2. [Radiotherapy and targeted therapy/immunotherapy].

    PubMed

    Antoni, D; Bockel, S; Deutsch, E; Mornex, F

    2016-10-01

    Thanks to recent advances achieved in oncologic systemic and local ablative treatment, the treatments become more and more efficient in term of local control and overall survival. Thus, the targeted therapies, immunotherapy or stereotactic radiotherapy have modified the management of patients, especially in case of oligometastatic disease. Many questions are raised by these innovations, particularly the diagnosis and management of new side effects or that of the combination of these different treatments, depending on the type of primary tumor. Fundamental data are available, while clinical data are still limited. Ongoing trials should help to clarify the clinical management protocols. This manuscript is a review of the combination of radiotherapy and targeted therapy/immunotherapy.

  3. Perianal Paget disease treated definitively with radiotherapy.

    PubMed

    Mann, J; Lavaf, A; Tejwani, A; Ross, P; Ashamalla, H

    2012-12-01

    Extramammary Paget disease (empd) is a relatively rare cutaneous disorder described as an apocrine gland tumour occurring in both a benign and a malignant form with metastatic potential. The areas of the body affected are the vulva, perianal region, penis, scrotum, perineum, and axilla, all of which contain apocrine glands. When empd affects the perianal region, it is called perianal Paget disease (ppd). All forms of empd, including ppd, are typically treated by wide surgical excision. Perianal Paget disease usually occurs later in life in patients who are often poor surgical candidates, but the available literature is scarce regarding other treatment modalities, including definitive radiotherapy. We contend that ppd can be safely and effectively treated with radiotherapy, and here, we present the case of a 75-year-old woman with ppd who was successfully so treated. A brief review of the literature concerning the diagnosis, natural history, and treatment of ppd is also included.

  4. Proton Radiotherapy for Solid Tumors of Childhood

    PubMed Central

    Cotter, Shane E.; McBride, Sean M.; Yock, Torunn I.

    2012-01-01

    The increasing efficacy of pediatric cancer therapy over the past four decades has produced many long-term survivors that now struggle with serious treatment related morbidities affecting their quality of life. Radiation therapy is responsible for a significant proportion of these late effects, but a relatively new and emerging modality, proton radiotherapy hold great promise to drastically reduce these treatment related late effects in long term survivors by sparing dose to normal tissues. Dosimetric studies of proton radiotherapy compared with best available photon based treatment show significant dose sparing to developing normal tissues. Furthermore, clinical data are now emerging that begin to quantify the benefit in decreased late treatment effects while maintaining excellent cancer control rates. PMID:22417062

  5. Status of radiotherapy in a multidisciplinary cancer board.

    PubMed

    Ichikawa, Mayumi; Nemoto, Kenji; Miwa, Misako; Ohta, Ibuki; Nomiya, Takuma; Yamakawa, Mayumi; Itho, Yuriko; Fukui, Tadahisa; Yoshioka, Takashi

    2014-03-01

    Multidisciplinary cancer boards (CBs) for making cancer treatment decisions have become popular in many countries; however, the status of radiotherapy in CBs and the influence of CBs on radiotherapy decisions have not been studied. To clarify these issues, we reviewed the minutes of our CBs from February 2010 to March 2012, and we classified planned treatments discussed at the CBs into five categories and analyzed decisions concerning radiotherapy in each category. The fraction of cases for which radiotherapy was recommended was 536/757 (71%). These cases included 478 cases (63%) for which radiation therapy was planned and four cases (0.5%) for which radiation therapy was unexpectedly recommended. On the other hand, radiation therapy was canceled in 21 cases (4%) for which radiation therapy had been planned. This study showed that radiotherapy was discussed in many cases at CBs and that CBs have a great influence on decisions concerning radiotherapy.

  6. The radio properties of infrared-faint radio sources

    NASA Astrophysics Data System (ADS)

    Middelberg, E.; Norris, R. P.; Hales, C. A.; Seymour, N.; Johnston-Hollitt, M.; Huynh, M. T.; Lenc, E.; Mao, M. Y.

    2011-02-01

    Context. Infrared-faint radio sources (IFRS) are objects that have flux densities of several mJy at 1.4 GHz, but that are invisible at 3.6 μm when using sensitive Spitzer observations with μJy sensitivities. Their nature is unclear and difficult to investigate since they are only visible in the radio. Aims: High-resolution radio images and comprehensive spectral coverage can yield constraints on the emission mechanisms of IFRS and can give hints to similarities with known objects. Methods: We imaged a sample of 17 IFRS at 4.8 GHz and 8.6 GHz with the Australia Telescope Compact Array to determine the structures on arcsecond scales. We added radio data from other observing projects and from the literature to obtain broad-band radio spectra. Results: We find that the sources in our sample are either resolved out at the higher frequencies or are compact at resolutions of a few arcsec, which implies that they are smaller than a typical galaxy. The spectra of IFRS are remarkably steep, with a median spectral index of -1.4 and a prominent lack of spectral indices larger than -0.7. We also find that, given the IR non-detections, the ratio of 1.4 GHz flux density to 3.6 μm flux density is very high, and this puts them into the same regime as high-redshift radio galaxies. Conclusions: The evidence that IFRS are predominantly high-redshift sources driven by active galactic nuclei (AGN) is strong, even though not all IFRS may be caused by the same phenomenon. Compared to the rare and painstakingly collected high-redshift radio galaxies, IFRS appear to be much more abundant, but less luminous, AGN-driven galaxies at similar cosmological distances.

  7. Brown University Radio Student Telescope (BURST)

    NASA Astrophysics Data System (ADS)

    Miller, Michelle

    2017-01-01

    The Brown University Radio Student Telescope (BURST) is a rooftop low frequency radio interferometer that we hope to potentially use to observe radio transients, non-thermal radio emission from Galactic synchrotron and supernova remnants, and extragalactic radio sources. It was built by a group of Brown undergraduates this past summer. An overview of the design, ultimate installation, challenges in implementation and data acquisition will be covered in the poster.

  8. Postoperative radiotherapy in the management of keloids

    PubMed Central

    Carvajal, Claudia C; Ibarra, Carla M; Arbulo, Douglas L; Russo, Moisés N; Solé, Claudio P

    2016-01-01

    Background The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. Objective This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. Methods Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. Results Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. Conclusions The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes. PMID:27994646

  9. Radiotherapy equipment--purchase or lease?

    PubMed

    Nisbet, A; Ward, A

    2001-08-01

    Against a background of increasing demand for radiotherapy equipment, this study was undertaken to investigate options for equipment procurement, in particular to compare purchase with lease. The perceived advantages of lease are that equipment can be acquired within budget and cashflow constraints, with relatively low amounts of cash leaving the NHS in the first year, avoiding the necessity of capitalizing the equipment and providing protection against the risk of obsolescence associated with high technology equipment. The perceived disadvantages of leasing are that the Trust does not own the equipment, leasing can be more expensive in revenue terms, the tender process is extended and there may be lease conditions to be met, which may be costly and/or restrictive. There are also a number of technical considerations involved in the leasing of radiotherapy equipment that influence the financial analysis and practical operation of the radiotherapy service. The technical considerations include servicing and planned preventative maintenance, upgrades, spare parts, subsequent purchase of "add ons", modification of equipment, research and development work, commencement of the lease period, return of equipment at the end of the lease period and negotiations at the end of the lease period. A study from Raigmore Hospital, Inverness is described, which involves the procurement of new, state-of-the-art radiotherapy equipment. This provides an overview of the procurement process, including a summary of the advantages and disadvantages of leasing, with the figures from the financial analysis presented and explained. In addition, a detailed description is given of the technical considerations to be taken into account in the financial analysis and negotiation of any lease contract.

  10. Low-Dose Radiotherapy in Indolent Lymphoma

    SciTech Connect

    Rossier, Christine; Schick, Ulrike; Miralbell, Raymond; Mirimanoff, Rene O.; Weber, Damien C.; Ozsahin, Mahmut

    2011-11-01

    Purpose: To assess the response rate, duration of response, and overall survival after low-dose involved-field radiotherapy in patients with recurrent low-grade lymphoma or chronic lymphocytic leukemia (CLL). Methods and Materials: Forty-three (24 women, 19 men) consecutive patients with indolent lymphoma or CLL were treated with a total dose of 4 Gy (2 x 2 Gy) using 6- 18-MV photons. The median age was 73 years (range, 39-88). Radiotherapy was given either after (n = 32; 75%) or before (n = 11; 25%) chemotherapy. The median time from diagnosis was 48 months (range, 1-249). The median follow-up period was 20 months (range, 1-56). Results: The overall response rate was 90%. Twelve patients (28%) had a complete response, 15 (35%) had a partial response, 11 (26%) had stable disease, and 5 (11%) had progressive disease. The median overall survival for patients with a positive response (complete response/partial response/stable disease) was 41 months; for patients with progressive disease it was 6 months (p = 0.001). The median time to in-field progression was 21 months (range, 0-24), and the median time to out-field progression was 8 months (range, 0-40). The 3-year in-field control was 92% in patients with complete response (median was not reached). The median time to in-field progression was 9 months (range, 0.5-24) in patients with partial response and 6 months (range, 0.6-6) in those with stable disease (p < 0.05). Younger age, positive response to radiotherapy, and no previous chemotherapy were the best factors influencing the outcome. Conclusions: Low-dose involved-field radiotherapy is an effective treatment in the management of patients with recurrent low-grade lymphoma or CLL.

  11. Partial breast radiotherapy with simple teletherapy techniques.

    PubMed

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  12. Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

    SciTech Connect

    Wu, Y.-H.; Wang, H-M.; Chen, Hellen Hi-Wen; Lin, C.-Y.; Chen, Eric Yen-Chao; Fan, K.-H.; Huang, S.-F.; Chen, I-How; Liao, C.-T.; Cheng, Ann-Joy; Chang, Joseph Tung-Chieh

    2010-03-15

    Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

  13. Targeting Radiotherapy to Cancer by Gene Transfer

    PubMed Central

    2003-01-01

    Targeted radionuclide therapy is an alternative method of radiation treatment which uses a tumor-seeking agent carrying a radioactive atom to deposits of tumor, wherever in the body they may be located. Recent experimental data signifies promise for the amalgamation of gene transfer with radionuclide targeting. This review encompasses aspects of the integration of gene manipulation and targeted radiotherapy, highlighting the possibilities of gene transfer to assist the targeting of cancer with low molecular weight radiopharmaceuticals. PMID:12721515

  14. Partial breast radiotherapy with simple teletherapy techniques

    SciTech Connect

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  15. Current concepts on imaging in radiotherapy.

    PubMed

    Lecchi, Michela; Fossati, Piero; Elisei, Federica; Orecchia, Roberto; Lucignani, Giovanni

    2008-04-01

    New high-precision radiotherapy (RT) techniques, such as intensity-modulated radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within the target and spare a larger portion of normal tissue than conventional RT. These techniques require accurate tumour volume delineation and intrinsic characterization, as well as verification of target localisation and monitoring of organ motion and response assessment during treatment. These tasks are strongly dependent on imaging technologies. Among these, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron emission tomography (PET) have been applied in high-precision RT. For tumour volume delineation and characterization, PET has brought an additional dimension to the management of cancer patients by allowing the incorporation of crucial functional and molecular images in RT treatment planning, i.e. direct evaluation of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis. The combination of PET and CT in a single imaging system (PET/CT) to obtain a fused anatomical and functional dataset is now emerging as a promising tool in radiotherapy departments for delineation of tumour volumes and optimization of treatment plans. Another exciting new area is image-guided radiotherapy (IGRT), which focuses on the potential benefit of advanced imaging and image registration to improve precision, daily target localization and monitoring during treatment, thus reducing morbidity and potentially allowing the safe delivery of higher doses. The variety of IGRT systems is rapidly expanding, including cone beam CT and US. This article examines the increasing role of imaging techniques in the entire process of high-precision radiotherapy.

  16. The role of radiotherapy in veterinary practice.

    PubMed

    Owen, L N

    1975-11-01

    It is common knowledge today that cancer is by no means an incurable disease and therefore it is no longer necessary to propose euthanasia for all inoperable cases of malignant neoplasia. The veterinary surgeon has a duty to inform his client of current methods of treatment, particularly radiotherapy, which may possibly provide a cure or prolong life without pain for several months. This article outlines the availability and usefulness of this important line of treatment.

  17. Glioblastoma multiforme after radiotherapy for acromegaly

    SciTech Connect

    Piatt, J.H. Jr.; Blue, J.M.; Schold, S.C. Jr.; Burger, P.C.

    1983-07-01

    A case of glioblastoma multiforme that occurred 14 years after radiotherapy for acromegaly is presented. The striking correspondence between the anatomy of the tumor and the geometry of the radiation ports is suggestive of a causal relationship. Previously reported cases of radiation-associated glioma are reviewed, and a brief appraisal of the evidence for induction of these lesions by radiation is presented. The differentiation of radiation-associated neoplasms from radionecrosis is also discussed.

  18. Adaptive Radiotherapy for an Uncommon Chloroma

    PubMed Central

    Majdoul, Soufya; Colson-Durand, Laurianne; To, Nu Hanh; Belkacemi, Yazid

    2016-01-01

    Granulocytic sarcomas, also referred to as chloromas or myeloid sarcomas, are extramedullary neoplasms that are composed of immature myeloid cells. This uncommon disease is known to be radiosensitive. However, the total dose and dose per fraction are not standardized. In addition, during the course of radiation therapy, significant reduction of the tumor is usually obtained. Thus, target volume reduction may require an intermediate radiotherapy plan evaluation for an adaptive treatment. A second plan at mid-dose is highly recommended. PMID:27920690

  19. Development of C6+ laser ion source and RFQ linac for carbon ion radiotherapy

    NASA Astrophysics Data System (ADS)

    Sako, T.; Yamaguchi, A.; Sato, K.; Goto, A.; Iwai, T.; Nayuki, T.; Nemoto, K.; Kayama, T.; Takeuchi, T.

    2016-02-01

    A prototype C6+ injector using a laser ion source has been developed for a compact synchrotron dedicated to carbon ion radiotherapy. The injector consists of a laser ion source and a 4-vane radio-frequency quadrupole (RFQ) linac. Ion beams are extracted from plasma and directly injected into the RFQ. A solenoid guides the low-energy beams into the RFQ. The RFQ is designed to accelerate high-intensity pulsed beams. A structure of monolithic vanes and cavities is adopted to reduce its power consumption. In beam acceleration tests, a solenoidal magnetic field set between the laser ion source and the RFQ helped increase both the peak currents before and after the RFQ by a factor of 4.

  20. Development of C⁶⁺ laser ion source and RFQ linac for carbon ion radiotherapy.

    PubMed

    Sako, T; Yamaguchi, A; Sato, K; Goto, A; Iwai, T; Nayuki, T; Nemoto, K; Kayama, T; Takeuchi, T

    2016-02-01

    A prototype C(6+) injector using a laser ion source has been developed for a compact synchrotron dedicated to carbon ion radiotherapy. The injector consists of a laser ion source and a 4-vane radio-frequency quadrupole (RFQ) linac. Ion beams are extracted from plasma and directly injected into the RFQ. A solenoid guides the low-energy beams into the RFQ. The RFQ is designed to accelerate high-intensity pulsed beams. A structure of monolithic vanes and cavities is adopted to reduce its power consumption. In beam acceleration tests, a solenoidal magnetic field set between the laser ion source and the RFQ helped increase both the peak currents before and after the RFQ by a factor of 4.