bluuebunny/crossref_metadata_2025 huggingface dataset:
Integration of rotational angiography enables better dose planning in Gamma Knife radiosurgery for brain arteriovenous malformations
Authors: Hasegawa Hirotaka , Hanakita Shunya , Shin Masahiro , Kawashima Mariko , Kin Taichi , Takahashi Wataru , Suzuki Yuichi , Shinya Yuki , Ono Hideaki , Shojima Masaaki , Nakatomi Hirofumi , Saito Nobuhito
Published: February 2019

OBJECTIVE

In Gamma Knife radiosurgery (GKS) for arteriovenous malformations (AVMs), CT angiography (CTA), MRI, and digital subtraction angiography (DSA) are generally used to define the nidus. Although the AVM angioarchitecture can be visualized with superior resolution using rotational angiography (RA), the efficacy of integrating RA into the GKS treatment planning process has not been elucidated.

METHODS

Using data collected from 25 consecutive patients with AVMs who were treated with GKS at the authors’ institution, two neurosurgeons independently created treatment plans for each patient before and after RA integration. For all patients, MR angiography, contrasted T1 imaging, CTA, DSA, and RA were performed before treatment. The prescription isodose volume before (PIVB) and after (PIVA) RA integration was measured. For reference purposes, a reference target volume (RTV) for each nidus was determined by two other physicians independent of the planning surgeons, and the RTV covered by the PIV (RTVPIV) was established. The undertreated volume ratio (UVR), overtreated volume ratio (OVR), and Paddick’s conformal index (CI), which were calculated as RTVPIV/RTV, RTVPIV/PIV, and (RTVPIV)2/(RTV × PIV), respectively, were measured by each neurosurgeon before and after RA integration, and the surgeons’ values at each point were averaged. Wilcoxon signed-rank tests were used to compare the values obtained before and after RA integration. The percentage change from before to after RA integration was calculated for the average UVR (%ΔUVRave), OVR (%ΔOVRave), and CI (%ΔCIave) in each patient, as ([value after RA integration]/[value before RA integration] − 1) × 100. The relationships between prior histories and these percentage change values were examined using Wilcoxon signed-rank tests.

RESULTS

The average values obtained by the two surgeons for the median UVR, OVR, and CI were 0.854, 0.445, and 0.367 before RA integration and 0.882, 0.478, and 0.463 after RA integration, respectively. All variables significantly improved after compared with before RA integration (UVR, p = 0.009; OVR, p < 0.001; CI, p < 0.001). Prior hemorrhage was significantly associated with larger %ΔOVRave (median 20.8% vs 7.2%; p = 0.023) and %ΔCIave (median 33.9% vs 13.8%; p = 0.014), but not %ΔUVRave (median 4.7% vs 4.0%; p = 0.449).

CONCLUSIONS

Integrating RA into GKS treatment planning may permit better dose planning owing to clearer visualization of the nidus and, as such, may reduce undertreatment and waste irradiation. Further studies examining whether the observed RA-related improvement in dose planning also improves the radiosurgical outcome are needed.
A robustness check procedure for hypofractionated Gamma Knife radiosurgery
Authors: Chiu Joshua , Braunstein Steve , Nakamura Jean , Theodosopoulos Philip , Sneed Penny , McDermott Michael , Ma Lijun
Published: February 2019

OBJECTIVE

Interfractional residual patient shifts are often observed during the delivery of hypofractionated brain radiosurgery. In this study, the authors developed a robustness treatment planning check procedure to assess the dosimetric effects of residual target shifts on hypofractionated Gamma Knife radiosurgery (GKRS).

METHODS

The residual patient shifts were determined during the simulation process immediately after patient immobilization. To mimic incorporation of residual target shifts during treatment delivery, a quality assurance procedure was developed to sample and shift individual shots according to the residual uncertainties in the prescribed treatment plan. This procedure was tested and demonstrated for 10 hypofractionated GKRS cases.

RESULTS

The maximum residual target shifts were less than 1 mm for the studied cases. When incorporating such shifts, the target coverage varied by 1.9% ± 2.2% (range 0.0%–7.1%) and selectivity varied by 3.6% ± 2.5% (range 1.1%–9.3%). Furthermore, when incorporating extra random shifts on the order of 0.5 mm, the target coverage decreased by as much as 7%, and nonisocentric variation in the dose distributions was noted for the studied cases.

CONCLUSIONS

A pretreatment robustness check procedure was developed and demonstrated for hypofractionated GKRS. Further studies are underway to implement this procedure to assess maximum tolerance levels for individual patient cases.
Impactful publishing: the Journal of Neurosurgery and its diamond anniversary (1944–2019)
Authors: Rutka James T.
Published: February 2019

With this landmark issue of the Journal of Neurosurgery (JNS), we celebrate the 75th anniversary of continuous publication of articles in neurosurgery. It is likely not a coincidence that the diamond anniversary of the JNS coincides precisely with the 150th anniversary of the birth of Harvey Cushing. It is possible that some events in life are inextricably and cosmically tied together, such as the birth of the founding father of our specialty, the society named after him that ultimately became the American Association of Neurological Surgeons (AANS), and the journal of this organization—the JNS.
Gamma knife radiosurgery as a primary treatment for prolactinomas
Authors: Pan Li , Zhang Nan , Wang En Ming , Wang Bin Jiang , Dai Jia Zhong , Cai Pei Wu
Published: February 2019

Object. The purpose of this study was to estimate the efficacy of gamma knife radiosurgery (GKS) in controlling tumor growth and endocrinopathy associated with prolactinomas.

Methods. Between 1993 and 1997, 164 of 469 patients with pituitary adenomas treated by GKS harbored prolactinomas. The dose to the tumor margin ranged from 9 to 35 Gy (mean 31.2 Gy), and the visual pathways were exposed to a dose of less than 10 Gy. The mean tumor diameter was 13.4 mm. The mean follow-up time for 128 cases was 33.2 months (range 6–72 months). Tumor control was observed in all but two patients who underwent surgery 18 and 36 months, respectively, after GKS. Clinical cure was achieved in 67 cases.

Clinical improvement was noted with a decrease in the hyperprolactinemia after GKS. Nonetheless, in 31 (29%) of 108 patients who were followed for more than 2 years no improvement in serum prolactin levels was demonstrated, although this could be normalized by bromocriptine administration after treatment. Nine infertile women became pregnant 2 to 13 months after GKS and all gave birth to normal children.

There was no visual deterioration related to GKS. Five women experienced premature menopause. In these patients there was subtotal disappearance of the tumor and an empty sella developed.

Conclusions. Gamma knife radiosurgery as a primary treatment for prolactinomas can be safe and effective both for controlling tumor growth and for normalization of prolactin hypersecretion. A higher margin dose (≥ 30 Gy) seemed to be associated with a better clinical outcome. Gamma knife radiosurgery may make prolactinomas more sensitive to the bromocriptine.
Gamma knife radiosurgery for prolactinomas
Authors: Landolt Alex M. , Lomax Nicoletta
Published: February 2019

Object. In this retrospective investigation the authors examined the results of gamma knife radiosurgery (GKS) for tumor remnants after unsuccessful open surgery and medical treatment in 20 patients with prolactinomas. Particular attention is paid to a possible radioprotective action of dopamine agonists similar to the action of octreotide in acromegaly.

Methods. Twenty patients with prolactinomas were followed after GKS. Five patients were treated successfully; their prolactin (PRL) levels dropped into the normal range and dopaminergic drugs could be discontinued. Two spontaneous pregnancies were observed and 11 patients experienced improvement. Improvement was defined as normal PRL levels with the continued possibility of reduced medical treatment or a substantially reduced medical treatment dose with some degree of hyperprolactinemia maintained. The treatment failed in three patients who experienced no improvement. Patients treated with dopaminergic drugs during GKS did significantly less well in comparison with the untreated group when a cumulative distribution function (Kaplan—Meier estimate) was used.

Conclusions. The results of GKS for prolactinomas in this investigation are better than the results published by others. This may be an effect of case selection because there were no “salvage cases” in our group of patients. Because a dopamine agonist seemed to induce radioprotection in this series, it is suggested that GKS be performed during an intermission in drug therapy when the dopamine agonist is discontinued.
Gamma knife radiosurgery for brain metastases: prognostic factors for survival and local control
Authors: Kim Dong Gyu , Chung Hyun-Tai , Gwak Ho-Shin , Paek Sun Ha , Jung Hee-Won , Han Dae Hee
Published: February 2019

Object. The authors conducted an analysis of prognostic factors for patient survival and local control of brain metastases after gamma knife radiosurgery.

Methods. In the survival analysis, 53 consecutive patients with 121 lesions treated in the last 2 years were examined. Common primary sites were lung (26 patients), kidney (seven), breast (three), and colon (three). Patient age ranged from 28 to 75 years (median 58 years) and the female/male ratio was 1:0.9. The median tumor volume was 2.1 cm3 (range 0.02–45.5cm3) and the average prescription dose was 15.4 Gy to the 50% isodose. The median follow up was 12 months (range 1–23 months) and the median survival was 46 weeks.

Six-month and 1-year survival rates were 63% and 39%, respectively. Karnofsky Performance Scale score, tumor volume, and presence of extracranial disease were statistically significant prognostic factors (p < 0.05) for survival in multivariate analysis. Number of lesions, patient age, and adjuvant whole-brain radiation therapy were not statistically significant. Ninety-one of 121 lesions with follow-up images were included in the local control analysis. The 1-year actuarial local control rate was 48%. In multivariate analysis smaller volume was associated with better control (p = 0.0043), and, control period of renal cell carcinoma was shorter than that of the other tumor types (p = 0.0070).

Conclusions. Karnofsky Performance Scale score, tumor volume, controlled primary cancer, and absence of extracranial metastases were associated with longer survival in the present study. For local control, tumor volume was a statistically significant factor.
Combined stereotactic split-course fractionated gamma knife radiosurgery and conventional radiation therapy for unfavorable gliomas: a phase I study
Authors: Regine William F. , Patchell Roy A. , Strottmann James M. , Meigooni Ali , Sanders Michael , Young Byron
Published: February 2019

Object. This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT).

Methods. Eighteen patients with previously unirradiated, gliomas treated between March 1995 and January 2000 form the substrate of this report. These included 11 patients with malignant gliomas, six with low-grade gliomas, and one with a recurrent glioma. They were stratified into three groups according to tumor volume (TV). Fifteen were treated using the initial FSRS dose schedule and form the subject of this report. Group A (four patients), had TV of 5 cm3 or less (7 Gy twice pre- and twice post-CEBRT); Group B (six patients), TV greater than 5 cm3 but less than or equal to 15 cm3 (7 Gy twice pre-CEBRT and once post-CEBRT); and Group C (five patients), TV greater than 15 cm3 but less than or equal to 30 cm3 (7 Gy once pre- and once post-CEBRT). All patients received CEBRT to 59.4 Gy in 1.8-Gy fractions. Dose escalation was planned, provided the level of toxicity was acceptable. All patients were able to complete CEBRT without interruption or experiencing disease progression. Unacceptable toxicity was observed in two Grade 4/Group B patients and two Grade 4/Group C patients. Eight patients required reoperation. In three (38%) there was necrosis without evidence of tumor. Neuroimaging studies were available for evaluation in 14 patients. Two had a partial (≥ 50%) reduction in volume and nine had a minor (> 20%) reduction in size. The median follow-up period was 15 months (range 9–60 months). Six patients remained alive for 3 to 60 months.

Conclusions. The imaging responses and the ability of these patients with intracranial gliomas to complete therapy without interruption or experiencing disease progression is encouraging. Excessive toxicity derived from combined FSRS and CEBRT treatment, as evaluated thus far in this study, was seen in patients with Group B and C lesions at the 7-Gy dose level. Evaluation of this novel treatment strategy with dose modification is ongoing.
Gamma knife radiosurgery for low-grade astrocytomas: results of long-term follow up
Authors: Kida Yoshihisa , Kobayashi Tatsuya , Mori Yoshimasa
Published: February 2019

Object. The purpose of this paper is to report the long-term results of gamma knife radiosurgery (GKS) for low-grade astrocytomas.

Methods. Fifty-one patients with low-grade astrocytomas treated with GKS and followed for more than 24 months are reported. Of the 51 patients, 12 harbored Grade I astrocytomas in and around the visual pathways and hypothalamus. The remaining 39 harbored Grade II astrocytomas. The mean patient age at time of GKS was 9.8 years for patient with Grade I and 30.9 years for those with Grade II astrocytomas. The mean tumor diameter was 25.4 mm for Grade I and 23.7 mm for Grade II tumors. The mean margin dose was 12.5 Gy for Grade I and 15.7 Gy for Grade II tumors.

In the mean follow-up period of 27.6 months, both Grade I and Grade II astrocytomas responded well to GKS. Grade I astrocytomas had a response rate of 50% and a control rate of 91.7%. Grade II astrocytomas had a 46.2% response rate and an 87.2% control rate. Statistical analyses concerning the efficacy and related factors showed a significantly better response for patients 10 years of age or older with Grade I and those with a follow-up period of more than 24 months. Complications included radiation-induced edema in 18 (35.3%) of 51 cases, cyst formation or enlargement in five (9.8%), and transient tumor enlargement in three (5.9%).

Conclusions. Radiosurgery can play an important role in the treatment of low-grade astrocytomas, and complete cure of these tumors is expected in at least some of the cases.
Gamma knife radiosurgery for craniopharyngiomas
Authors: Chung Wen-Yuh , Pan David Hung-Chi , Shiau Cheng-Ying , Guo Wan-Yuo , Wang Ling-Wei
Published: February 2019

Object. The goal of this study was to elucidate the role of gamma knife radiosurgery (GKS) and adjuvant stereotactic procedures by assessing the outcome of 31 consecutive patients harboring craniopharyngiomas treated between March 1993 and December 1999.

Methods. There were 31 consecutive patients with craniopharyngiomas: 18 were men and 13 were women. The mean age was 32 years (range 3–69 years). The mean tumor volume was 9 cm3 (range 0.3–28 cm3). The prescription dose to the tumor margin varied from 9.5 to 16 Gy. The visual pathways received 8 Gy or less. Three patients underwent stereotactic aspiration to decompress the cystic component before GKS. The tumor response was classified by percentage reduction of tumor volume as calculated based on magnetic resonance imaging studies. Clinical outcome was evaluated according to improvement and dependence on replacement therapy.

An initial postoperative volume increase with enlargement of a cystic component was found in three patients. They were treated by adjuvant stereotactic aspiration and/or Ommaya reservoir implantation. Tumor control was achieved in 87% of patients and 84% had fair to excellent clinical outcome in an average follow-up period of 36 months. Treatment failure due to uncontrolled tumor progression was seen in four patients at 26, 33, 49, and 55 months, respectively, after GKS. Only one patient was found to have a mildly restricted visual field; no additional endocrinological impairment or neurological deterioration could be attributed to the treatment. There was no treatment-related mortality.

Conclusions. Multimodality management of patients with craniopharyngiomas seemed to provide a better quality of patient survival and greater long-term tumor control. It is suggested that GKS accompanied by adjuvant stereotactic procedures should be used as an alternative in treating recurrent or residual craniopharyngiomas if further microsurgical excision cannot promise a cure.
Gamma knife radiosurgery for cavernous hemangiomas
Authors: Zhang Nan , Pan Li , Wang Bin Jiang , Wang En Min , Dai Jia Zhong , Cai Pei Wu
Published: February 2019

Object. The authors analyzed the outcome of 53 patients with cavernous hemangiomas who underwent gamma knife radiosurgery (GKS) and evaluated the benefit of the treatment.

Methods. From 1994 to 1995, 57 patients were treated with GKS for cavernous hemangiomas. The mean margin dose to the lesions was 20.3 Gy (range 14.5–25.2 Gy) and the prescription isodose was 50 to 80%. The mean follow-up period was 4.2 years. Four patients were lost to follow up. In 18 of 28 patients whose chief complaint was seizures, there was a decrease in seizure frequency. Five of 23 patients with hemorrhage suffered rebleeding 4 to 39 months after GKS. Seventeen patients in whom the hemangiomas were located at the frontal or parietal lobe had neurological disability and in five this was severe. Two patients underwent resection of their hemangioma after GKS. Three experienced visual problems. Follow-up imaging demonstrated shrinkage of the lesion in 19 patients.

Conclusions. A higher margin dose (> 16 Gy) may be associated with a reduction in the incidence of rebleeding after GKS. Higher dosage and severe brain edema after GKS may decrease the frequency and intensity of seizures at least temporarily. Gamma knife radiosurgery may play a role in protection against hemorrhage and in reduction of the rate of seizure in selected cases with the appropriate dose.
Sequential volume mapping for confirmation of negative growth in vestibular schwannomas treated by gamma knife radiosurgery
Authors: Yu Chung Ping , Cheung Joel Yiu Chung , Leung Samuel , Ho Robert
Published: February 2019

Object. The purpose of this study was to confirm, by using a sequential volume mapping (SVM) technique, that gamma knife radiosurgery (GKS) induces negative growth in vestibular schwannomas (VS).

Methods. Over a period of 5 years, 126 small- to medium-sized (< 15 cm3) VSs were treated using microradiosurgical techniques within a standard protocol. All patient data were collected prospectively. Sequential magnetic resonance imaging was performed every 6 months to assess the volume of the tumor, based on specially developed GammaPlan software. The mean follow-up duration was 22 months. At least three SVM measurements were obtained in 91 patients and at least four were obtained in 62 patients. The mean number of SVM measurements for each patient was 2.54. After GKS, the following patterns of volume change were seen: 1) 57 VSs showed transient increase in volume with a peak at 6 months, followed by shrinkage. Four VSs exhibited prolonged swelling beyond 24 months. Transient swelling and eventual shrinkage were independent of the initial VS volume; 2) 29 VSs showed direct volume shri6nkage without swelling; and 3) five VSs showed persistent volume increase. All volume changes were greater than 10%. The overall mean volume reduction was 46.8% at 30 months.

Conclusions. Sequential volume mapping appears to be superior to conventional two-dimensional measurements in monitoring volume changes in VS after GKS. It confirms that transient swelling is common. Ninety-two percent of tumors responded by showing significant volume shrinkage (mean 46.8%). It would seem that GKS can induce volume reduction in VS.
Gamma knife thalamotomy for treatment of tremor: long-term results
Authors: Young Ronald F. , Jacques Skip , Mark Rufus , Kopyov Oleg , Copcutt Brian , Posewitz Allen , Li Francisco
Published: February 2019

Object. The purpose of this study was to investigate the long-term effects of gamma knife thalamotomy for treatment of disabling tremor.

Methods. One hundred fifty-eight patients underwent magnetic resonance imaging—guided radiosurgical nucleus ventralis intermedius (VIM) thalamotomy for the treatment of parkinsonian tremor (102 patients), essential tremor (52 patients), or tremor due to stroke, encephalitis, or cerebral trauma (four patients). Preoperative and postoperative blinded assessments were performed by a team of independent examiners skilled in the evolution of movement disorders. A single isocenter exposure with the 4-mm collimator helmet of the Leksell gamma knife unit was used to make the lesions.

In patients with Parkinson's disease 88.3% became fully or nearly tremor free, with a mean follow up of 52.5 months. Statistically significant improvements were seen in Unified Parkinson's Disease Rating Scale tremor scores and rigidity scores, and these improvements were maintained in 74 patients followed 4 years or longer.

In patients with essential tremor, 92.1% were fully or nearly tremor free postoperatively, but only 88.2% remained tremor free by 4 years or more post-GKS. Statistically significant improvements were seen in the Clinical Rating Scale for tremor in essential tremor patients and these improvements were well maintained in the 17 patients, followed 4 years or longer. Only 50% of patients with tremor of other origins improved significantly.

One patient sustained a transient complication and two patients sustained mild permanent side effects from the treatments.

Conclusions. Gamma knife VIM thalamotomy provides relief from tremor equivalent to that provided by radiofrequency thalamotomy or deep brain stimulation, but it is safer than either of these alternatives. Long-term follow up indicates that relief of tremor is well maintained. No long-term radiation-induced complications have been observed.
Gamma knife radiosurgery for primary management for trigeminal neuralgia
Authors: Brisman Ronald
Published: February 2019

Object. The purpose of this study was to assess the efficacy of gamma knife radiosurgery (GKS) as the primary rather than secondary management for trigeminal neuralgia.

Methods. Eighty-two patients underwent GKS as their first neurosurgical intervention (Group A), and 90 patients underwent GKS following a different procedure (Group B). All GKS patients were treated with a maximum dose of 75 Gy. The single 4-mm isocenter was placed close to the junction of the trigeminal nerve and the brainstem. Six-month follow up was available for 126 patients and 12-month follow up for 84 patients.

Excellent (no pain and no medicine) or good (at least 50% reduction in pain and less medicine) relief was more likely to occur in Group A than in Group B patients 6 and 12 months following GKS for trigeminal neuralgia (p = 0.058). Excellent or good results were also more likely in patients with trigeminal neuralgia without multiple sclerosis (MS) (p = 0.042). The number and type of procedures performed prior to GKS, the interval between the last procedure and GKS, and the interval from first symptom to GKS (within Groups A and B) did not affect 6-month outcome. The interval between first symptom and GKS was shorter in Group A patients without MS (87 months) than in Group B (148 months; p < 0.004). There were no significant differences between Group A and B patients with regard to sex, age, or laterality.

Conclusions. Patients with trigeminal neuralgia who are treated with GKS as primary management have better pain relief than those treated with GKS as secondary management. Patients are more likely to have pain relief if they do not have MS.
Treatment of trigeminal neuralgia with linear accelerator radiosurgery: initial results
Authors: Chen Joseph C. T. , Girvigian Michael , Greathouse Hugh , Miller Michael , Rahimian Javad
Published: February 2019

Object. Radiosurgery has emerged as an important treatment of trigeminal neuralgia. Substantial advantages have been demonstrated in safety and comfort over other modalities. Radiosurgical treatment of trigeminal neuralgia has been well investigated with gamma knife devices involving fixed cobalt sources. Few reports exist concerning trigeminal neuralgia treated using linear accelerator (LINAC)—based devices. In recent years these devices have reached the level of mechanical precision that is required for such functional treatments. The authors describe their initial experience with radiosurgical treatment of trigeminal neuralgia when using a BrainLAB Novalis LINAC device equipped with the commercially available 4-mm collimator.

Methods. A total of 32 patients were treated in a 12-month period between November 2002 and November 2003. The median patient age was 67 years (range 38–84 years). Facial pain was graded using the Barrow Neurological Institute (BNI) scoring system. All patients' pain was BNI Grade IV or V prior to treatment. Of these patients, 22 were undergoing initial treatment, and 10 were undergoing retreatment for recurrent pain following various treatments including percutaneous procedures, gamma knife surgery (GKS), or microvascular decompression. Two patients had multiple sclerosis. In patients undergoing initial radiosurgery, the most proximal segment of the cisternal portion of the trigeminal nerve received 85 to 90 Gy administered in a 5— or 7—noncoplanar arc single-isocenter plan with a 4-mm circular collimator. In patients undergoing repeated radiosurgery, the target received 60 Gy.

Overall good and excellent results (BNI Grade I, II, or III) were achieved in 25 (78%) of 32 patients. The median time to pain relief was 6 weeks. Fair results (improvement in pain with BNI Grade IV) were achieved in three patients (9%), and poor results (no improvement in pain and BNI Grade IV or V) were seen in four (13%). Two patients demonstrated new trigeminal dysfunction following treatment. No other complications occurred.

Conclusions. High-precision imaging and LINAC instrumentation have allowed for treatment of trigeminal neuralgia with results and safety comparable to those achieved using GKS. Linear accelerator—based radiosurgery with the Novalis device is a safe and effective method of managing trigeminal neuralgia and may become the preferred means at centers where the technology is available.
A methodology for verification of radiotherapy dose calculation
Authors: Agazaryan Nzhde , Ullrich Wolfgang , Lee Steve P. , Solberg Timothy D.
Published: February 2019

Object. A methodology for dosimetric verification of radiation therapy plans was developed and implemented. Dosimetric accuracy of clinically active intensity-modulated radiotherapy (IMRT) and intensity-modulated radiosurgery (IMRS) programs was assessed using this methodology.

Methods. The methodology included several dosimetric tasks that were performed to assess the dosimetric accuracy of a treatment plan. Absolute dosimetry of the composite plan was performed using an ionization chamber. Film dosimetry was performed for each individual field and for the multifield composite plan. Calculated dose distributions and film measurements were compared using software developed for the specific tasks. Two-dimensional maps of gamma index, dose difference, and distance-to-agreement were calculated and displayed.

To date, good agreement between measurements and calculations has been observed in 160 clinical IMRT and IMRS plans. The largest observed absolute dose disagreement was −4.79%. The mean absolute dose difference was 0.26%, with a standard deviation of 1.75%. The authors specify a 3% dose difference and 3-mm distance as the scaling acceptability criteria for the gamma index calculations of the film measurement analysis. The planning and delivery system in clinical use has proven consistently to satisfy these criteria.

Conclusions. The dosimetric verification methods and the software tools developed were both quantitative and clinically practical. The measurements and the analysis demonstrated that the IMRT and IMRS planning and delivery system in use was sufficiently accurate for highly conformal treatments.
Stereotactic radiotherapy for the treatment of acoustic neuromas
Authors: Selch Michael T. , Pedroso Alessandro , Lee Steve P. , Solberg Timothy D. , Agazaryan Nzhde , Cabatan-Awang Cynthia , Desalles Antonio A. F.
Published: February 2019

Object. The authors sought to assess the safety and efficacy of stereotactic radiotherapy when using a linear accelerator equipped with a micromultileaf collimator for the treatment of patients with acoustic neuromas.

Methods. Fifty patients harboring acoustic neuromas were treated with stereotactic radiotherapy between September 1997 and June 2003. Two patients were lost to follow-up review. Patient age ranged from 20 to 76 years (median 59 years), and none had neurofibromatosis. Forty-two patients had useful hearing prior to stereotactic radiotherapy. The fifth and seventh cranial nerve functions were normal in 44 and 46 patients, respectively. Tumor volume ranged from 0.3 to 19.25 ml (median 2.51 ml). The largest tumor dimension varied from 0.6 to 4 cm (median 2.2 cm). Treatment planning in all patients included computerized tomography and magnetic resonance image fusion and beam shaping by using a micromultileaf collimator. The planning target volume included the contrast-enhancing tumor mass and a margin of normal tissue varying from 1 to 3 mm (median 2 mm). All tumors were treated with 6-MV photons and received 54 Gy prescribed at the 90% isodose line encompassing the planning target volume. A sustained increase greater than 2 mm in any tumor dimension was defined as local relapse. The follow-up duration varied from 6 to 74 months (median 36 months).

The local tumor control rate in the 48 patients available for follow up was 100%. Central tumor hypodensity occurred in 32 patients (67%) at a median of 6 months following stereotactic radiotherapy. In 12 patients (25%), tumor size increased 1 to 2 mm at a median of 6 months following stereotactic radiotherapy. Increased tumor size in six of these patients was transient. In 13 patients (27%), tumor size decreased 1 to 14 mm at a median of 6 months after treatment. Useful hearing was preserved in 39 patients (93%). New facial numbness occurred in one patient (2.2%) with normal fifth cranial nerve function prior to stereotactic radiotherapy. New facial palsy occurred in one patient (2.1%) with normal seventh cranial nerve function prior to treatment. No patient's pretreatment dysfunction of the fifth or seventh cranial nerve worsened after stereotactic radiotherapy. Tinnitus improved in six patients and worsened in two.

Conclusions. Stereotactic radiotherapy using field shaping for the treatment of acoustic neuromas achieves high rates of tumor control and preservation of useful hearing. The technique produces low rates of damage to the fifth and seventh cranial nerves. Long-term follow-up studies are necessary to confirm these findings.
KAJIAN INDEKS ERODIBILITAS TANAH PADA BEBERAPA SISTEM POLA TANAM
Authors: Muliatiningsih Muliatiningsih , Zulaeha Zulaeha
Published: February 2019

Penelitian ini bertujuan untuk mengetahui kepekaan tanah atau tingkat erodibilitas tanah pada beberapa sistem pola tanam. Penelitian dilakukan di lapangan dengan pengambilan sampel tanah di desa Malaka kecamatan Pemenang Lombok Utara pada lahan dengan kemiringan ≥ 6° dan analisis sifat fisika dan kimia tanah dilakukan di laboratorium Ilmu Tanah Fakultas Pertanian Universitas Mataram. Metode penelitian yang digunakan adalah metode deskriptif dengan pendekatan survei. Hasil penelitian menunjukkan bahwa sistem pola tanam yang berbeda yaitu lahan yang ditanami tanaman semusim (P1), lahan yang ditanami tanaman tahunan (P2) dan lahan yang ditanami secara tumpang sari (P3) pada lokasi penelitian menunjukkan nilai erodibilitas yang berbeda. Nilai erodibilitas tanah tertinggi terdapat pada P3 yaitu sebesar 0,70 sedangkan P2 dan P1 masing-masing sebesar 0,62 dan 0,69. Nilai permeabilitas pada P2 yang relatif lebih rendah jika dibandingkan dengan P1 dan P3
ISOLASI MIKROALGA LAUT DARI PANTAI MAPAK PULAU LOMBOK
Authors: Putri Dina Soes , Marianah Marianah , Ihromi Syirril
Published: February 2019

Mikroalga merupakan mikroorganisme fotosintetik yang hidup di lingkungan berair, baik di air tawar maupun air laut. Potensi aplikasinya yang sangat beragam dan meluas menyebabkan mikroalga menjadi salah satu fokus penelitian di berbagai negara dengan berbagai tujuan tertentu. Beberapa aplikasi dari mikroalga antara lain sebagai biofuel dan bioetanol, pewarna dan pengawet alami, suplemen makanan, komponen obat atau vaksin, komponen sel surya berpemeka pigmen, sel inang pada rekayasa genetika, dan lain-lain. Adapun tujuan dari penelitian ini adalah mengisolasi beberapa spesies mikroalga laut yang berasal dari Pantai Mapak Pulau Lombok. Target luaran penelitian ini adalah artikel ilmiah yang dipublikasikan pada jurnal nasional. Metode yang digunakan pada penelitian ini adalah streak platting dan pour platting. Medium yang digunakan untuk pertumbuhan mikroalga terdiri dari dua jenis, yaitu medium Walne dan Guillard. Sedangkan konsentrasi air laut yang digunakan terdiri dari dua jenis, yaitu salinitas 25 ppt dan 35 ppt. Hasil dari beberapa kali platting dengan variasi teknik maupun medium tetap menghasilkan isolat yang terkontaminasi bakteria dan jamur. Oleh karena itu, perlu dilakukan isolasi ulang dengan merubah metode dan teknik yang digunakan untuk mendapatkan isolat murni.
Re-politicising the Gender-Security Nexus: Sweden’s Feminist Foreign Policy
Authors: Aggestam Karin , Rosamond Annika Bergman
Published: February 2019

Sweden’s feminist foreign policy is founded on the broad idea that gender equality is central to security. This article focuses on how the politicisation of this gender-security nexus is discursively articulated and practiced in the case of feminist foreign policy. The problematic is unpacked by analysing the politicisation of the women, peace and security agenda and global gender mainstreaming. To empirically illustrate the gender-security nexus more specifically, we analyse how these politicisation processes are reflected in Sweden’s support for global peace diplomacy and gender protection. The article concludes by offering three final remarks. First, Sweden’s feminist foreign policy is an expression of several, at times competing, forms of political rationality. Second, while the fluctuation between de-politicisation and re-politicisation of security may seem productive in terms of policy outcome it can also create contradictions and ambiguities in regards to feminist foreign policy practice. One such outcome is the tendency to conflate gender and women across a number of de-politicised policy initiatives launched by the Swedish government. Third, the re-politicisation and contestation of the gender-security nexus is likely to increase in the coming decades because of shifting global power configurations in the global world order.
Politicising Security at the Boundaries: Privacy in Surveillance and Cybersecurity
Authors: Cavelty Myriam Dunn , Leese Matthias
Published: February 2019

This article looks into the politicisation of security. Politicisation, in contrast to securitisation, presupposes that security issues are controversially debated in a public arena without foregone conclusions as to how they are going to be handled. In order to locate and observe politicisation processes empirically, we suggest to look at privacy, a key notion and main tool for resistance vis-à-vis security logics. By examining two issue areas (video surveillance and cybersecurity), we highlight different tactics through which privacy is mobilised as a boundary object to politicise security. The invocation of privacy offers an alternative viewpoint on security, one where the human (digital) body and a human centred notion of security is at the centre. The value of its integrity and the need for its protection is a weighty counter to the abstract and often absolute claims of ‘more security’ through technological means.
Association between parental feeding practices and later body mass index in children and adolescents: The Weight disorder survey of the CASPIAN-IV Study
Authors: Bahreynian Maryam , Mozafarian Nafiseh , Motlagh Mohammad Esmaeil , Qorbani Mostafa , Heshmat Ramin , Kelishadi Roya
Published: February 2019

OBJECTIVE:

Parental eating behavior and feeding practices have an important influence on child eating style and weight status. The aim of this study is to explore the association of parental feeding practices with later body mass index(BMI) in children and adolescents.

METHODS:

This cross-sectional nationwide study was conducted on 23183 Iranian students aged 6–18 years,living in 30 provinces of Iran. They were selected randomly through cluster sampling method.Trained interviewers gathered data on demographic, anthropometric and dietary behaviors related to weight disorders. The questions were about anorexia,overeating and parental pressure to eat, family history of chronic diseases, student’s history on birth weight and breastfeeding duration, as well as the children and parents’ body image.

RESULTS:

The mean (standard deviation, SD) of age was 12.53(3.31) years. Of 22841 participants, 50.7% were boys and 73.48% were from urban areas. We found significant association between gender, living area, birth weight, parental BMI, parental education, socio-economic status (SES), screen time,and student’s weight in the one-way analysis. Students who had usually experienced forced eating were more underweight than other students (OR = 1.7, CI = 1.01–1.36, P = 0.03); moreover, they were significantly less obese (OR = 0.82,CI = 0.68–0.99, P = 0.04). Students who rarely had anorexia, were more overweight than those who never had anorexia(OR = 1.16,CI = 1.02–1.32, P = 0.02). The odds of being obese was lower among students who usually were forced to eat in recent months compared to those who had never experienced forced eating (OR = 0.76,CI = 0.61–0.96, P = 0.01).

CONCLUSION:

We found that parental feeding practices and parental perception of child weight might affect child weight status later in life.These results underscore the importance of focusing on the behaviors of both children and parents to prevent and/or treat unhealthy child weight.
Analysis of Cash Buying and Murabahah Financing (Case Study on Green Mutiara Housing Tambaksogra PT Graha Perwira Pratama, Kembaran Sub-District, Banyumas Regency)
Authors: Wahyuni Shinta
Published: February 2019

The results of research conducted that in the process of purchasing cash housing Mutiara Hijau Tambaksogra At PT. Graha Perwira Pratama there are two that is credit and cash, home purchase in cash applied by PT. Graha Perwira Pratama branch of Housing Mutiara Hijau Tambaksogra Kembaran Sub-district of Banyumas Regency, there are two ways, namely: hard cash and gradually, while crediting in the application of payment with credit in green pearl housing Tambaksogra involves the bank through mortgage loan program and Financing Murabaha in Sharia Bank. In the murabaha method, the bank pays the home repayment to the developer. Comparison Purchase home in cash cheaper price, easier process, no administrative fees, free from the rules and more secure, while home purchase on credit does not need to save large amounts to buy a house, enough money to pay the down payment only and the greater the down payment or the longer the repayment period, the installment will become cheaper.
The Implementation of Ijarah Muntahiya Bittamlik and Mudharabah Products in the Sharia Economic Law Perspective
Authors: Mu’minah Mimin
Published: February 2019

This article is motivated by the rapid development of the Islamic banking world, especially in Indonesia where the majority of the population is Muslims. When other countries have given birth to Islamic-based banks, as well as Indonesia, in 1992 was the establishment of Bank Muamalat Indonesia. Islamic banks use applications that are different from conventional banks, where the term on conventional banks is interest, whereas in Islamic banks use the profit sharing application. One application of Islamic banks that is very helpful to customers is the Mudharabah and Ijarah Muntahiya Bittamlik (IMBT) application. Although these two applications exist in Islamic banks or Islamic-based banks, it is possible that the two applications are not in accordance with Islamic economic law. Therefore, this paper tries to analyze the mudharabah and IMBT applications in the perspective of sharia economic law.
ASSESSMENT OF CORONARY ARTERY DOMINANCE IN THE INDIAN CADAVERS
Authors: Sinha Dr Urmila , Kumar Dr Sanjay , Sinha Dr Sanjeev , Devadas Dr Deepa
Published: February 2019

As Coronary artery disease is one of the most common heart diseases and also the major cause of death in developing countries. The aim of the present study is to evaluate the coronary dominance pattern which will help the cardiac physicians and surgeons for better diagnosis and management of coronary artery diseases.

The study was planned on 30 heart subjects. These selected hearts are without any obvious pathology referred with cardiac conditions was enrolled into the study in Andaman and Nicobar Islands Institute of Medical Science (ANIIMS) from July 2016 to July 2017.The coronary arteries were dissected and analysed for the origin of sinoatrial Nodal artery and Observations were noted. The approval of the Institutional ethical committee was taken for the present study. The hearts identified with the congenital anomalies were excluded from study.

From the above study it can be concluded that the most common is the right coronary dominance compared to left and balanced dominance as seen in this study. The present study is in comparison with the data generated by previous authors. This knowledge of normal anatomy and variations of coronary dominance will help interventional cardiologist, cardio-thoracic surgeons and radiologist to plan and provide proper management to patients.

Keywords: coronary artery, dominance, Coronary artery disease, left, right, both, etc.
ДОСЛІДЖЕННЯ ВПЛИВУ ЛЕГУВАННЯ НА ТЕМПЕРАТУРНИЙ КОЕФІЦІЄНТ ЛІНІЙНОГО РОЗШИРЕННЯ ПОКРИТТІВ
Authors: Грешта Виктор Леонидович , Ткач Дарья Владимировна , Климов Александр Владимирович , Сотников Евгений Георгиевич , Леховицер Зоя Васильевна
Published: February 2019

The effect of doping with yttrium-containing ligatures on the thermal coefficient of the linear expansion of sealing coatings is studied. KHA-82 coating was taken as the base material for the research. It is used in the aircraft engines produced by Motor Sich JSC. This coating contains nickel (base), silicon, aluminium, and solid lubricants (graphite and boron nitride). To enhance the physical-mechanical properties of the coating, an yttrium-containing ligature was added to the size prepared by the serial process. Three different compositions of the ligature with varying content of yttrium were studied, namely Ni-Y is composition No.1, Y is composition No. 2, Co-Ni-Cr-Al-Y is composition No. 3, and KHA-82 is composition No. 4. The coatings were applied onto specially prepared samples by a gas-flame technique. Analysis of the volumetric and possible structural phase changes in the material of the coatings under consideration was carried out on the Shevenar differential dilatometer. It was found out that during the first heating within 650-700° C, there is a change in the shape of the dilatometric curve. Recurring heating also causes the change in the trajectory of the dilatometric curve. The obtained result is probably related to the development of the oxidization processes, appearance of intermetallide phases, and changes in the porosity of the coatings during the first and recurring heating. Reduction of the pore space is beneficial in terms of energy as it is accompanied by the reduction of free surface, which in its turn can trigger the development of phase changes that are connected with the formation of oxide, nitride, and intermetallide inclusions. The smallest difference in the shape of dilatometric curves is observed in the coating of composition No. 3, which is presumably due to the fact that double spinels with a more compact structure are formed in the structure of the material obtained. The estimation of the difference in the temperature coefficient of the linear expansion of the base and coating materials indicates an insignificant difference in these values that can be reduced if the suggested yttrium-containing ligatures are added.
Simultaneous UV Spectrophotometric Estimation
of Amlodipine and Chlorthalidone in Bulk and Combined Tablet Dosage Form
Authors: More Sunil , Tamboli Ashpak , Patil Snehal , Vhanmane Amol
Published: February 2019

There is not a single analytical methods appeared in the literature for combined estimation of Amlodipine and Chlorthalidone in tablets dosage form. Attempts were made to develop a simple, precise and accurate Simultaneous UV spectroscopic method of Amlodipine and Chlorthalidone in bulk and Amlodac CH tablet dosage form by using simultaneous equation method. UV spectrophotometric method was developed and validated as per ICH guidelines using methanol as mobile phase. Amlodipine and Chlorthalidone individually follows the Beer-Lamberts law over concentration range 2.5-12.5μg/ml and 6.25-31.5μg/ml, Regression of coefficient was found to be r2=0.999 and r2=0.999 respectively. The percentage recovery was found in the range of 98% to 102% at three different levels. The proposed method was successfully applied for the determination of Amlodipine and Chlorthalidone in tablets dosage form as per ICH guidelines the result of the analysis were validated statistically and were found to be satisfactory.
PERAN MAHASISWA DALAM MENSUKSESKAN PEMILU 1997
Authors: Tandjung Akbar
Published: February 2019

Peran Mahasiswa dalam Mensukseskan Pemilu 1997
MAUDUDI’S AND ASH-SHIDDIEQY’S THEORY OF IJTIHAD IN THE ISLAMIC LAW
Authors: Ma'mur Ilzamuddin
Published: February 2019

Maududi’s and Ash-Shiddieqy’s Theory of Ijtihad in The Islamic Law
DARI ISLAMISASI PSIKOLOGI KE PSIKOLOGI ISLAM
Authors: Habudin Habudin
Published: February 2019

Dari Islamisasi Psikologi ke Psikologi Islam
SILATURAHMI MUI - MENPEN HARTONO
Authors: Siregar Bismar
Published: February 2019

Silaturahmi MUI - Menpen Hartono
A afetividade e ludicidade nos estudos étnico-raciais nas escolas municipais de Beberibe-CE: uma desconstrução do preconceito racial
Authors: Moura Rayssa da Silva , Souza Flávio Melo de , Rocha Alexandre dos Santos
Published: February 2019

Este artigo tem como objetivo discutir o preconceito étnico-racial por meio da afetividade e ludicidade no contexto educativo do teatro. Ao participarem da encenação das peças teatrais, os alunos ficam motivados a aprender, o que lhes permitem construir seus próprios conhecimentos, e, ao mesmo tempo, se identificarem com a história e cultura da população negra. As escolas municipais incentivadas pelo Projeto Beberibe Multicor desenvolvem o teatro como uma ferramenta educativa, que tem contribuído com a autoafirmação das identidades dos sujeitos e melhoria da autoestima, e, por conseguinte, da aprendizagem. Acredita-se que seja possível desconstruir por meio da afetividade e ludicidade as práticas racistas e preconceituosas nas escolas. Por fim, é necessário que tomemos consciência dessa triste realidade que ainda vivenciam os negros e afro-brasileiros nessa sociedade que exclui pela diferença.