bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
Mixed Method Strategies to DevelopThe Acquisition of ESP Students’ Skills of on Line Marketing
Authors: Amal Bakhrul Khair , Natsir Muhammad , Supsiloani Supsiloani , Suswati Rita 
Published: February 2019

English for Spesific purposes is one of the topicthat hold a great deal of advantages for students in Literature program. It aims to give a chance to the students to feel the working environment and see how it will be when they want to get involve into the bussiness. The variety jobs have been offered to youngsters but the most current opportunity is on line bussiness. It opens a wide range of chance for students to achieve. In order to do so, students should master some skills, not only pedagogic skills but also marketing skills. This research tries to answer the question of how to acquire ESP students’ skillsof online marketing using mixed method, consist of qualitative, quantitative into a mixed method research approaches. The population is the senior students who are going to do field observations in several offices, consists of 30 students of english literature department program. The results show that; (1) Mixed Methods has a significat impact on the acquisition of ESP students’ skills ofon line marketing, (2) online marketing is still a prosperous bussiness for the future. Further it is suggested to do more research on this area to enrich the knowledge of online bussiness as one of the new option of profession for students of english literature department program in FBS Universitas Negeri Medan (UNIMED).
Surgical Management of Oral Squamous Cell Carcinoma in Dhaka Dental College Hospital; 31 patients
Authors: Sultana Farjana , Karim Md Rezaul , Haider Ismat Ara 
Published: February 2019

Cancer is a major cause of death throughout the world. Oral cancer is one of the six most frequently occurring cancer.1 In Bangladesh, the number of new cancer cases of whole body per year is about 200000 of which oral cancer is about 20%.2 In our neighboring country India, accounts for thirty-five percent of all newly diagnosed cancers in men. The etiology of oral cancer is well established in most instances with consumption of tobacco in any form and alcohol being the most common etiologic agents. Recently, however, exposure to the human papilloma virus has been implicated in young patients with oral carcinoma. The exact mechanism of carcinogenesis in this setting remains to be elucidated .3 Surgery is the most well established mode of initial definitive treatment for a majority of oral cancers. The factors that affect the choice of treatment are related to the tumor and the patient. Primary site, location, proximity to bone and depth of infiltration are factors, which influence particular surgical approach. Advanced reconstructive techniques that allow free transfer of soft tissue and bone improve the functional and aesthetic outcomes following major ablative surgery .Over the course of the past thirty years there has been improvement in the overall survival of patients with oral carcinoma largely due to the improved understanding of the biology of local progression, early identification and treatment of metastatic lymph nodes in the neck and employment of adjuvant post-operative radiotherapy or chemotherapy. Either the role of surgery in oral cancer has evolved with integration of multidisciplinary treatment approaches employing chemotherapy and radiotherapy sequentially or concurrently .Surgical expertise is required for rehabilitation of functional and aesthetic defects created by initial treatment of cancer. Thus, surgery and services of a surgeon remain central to the management of oral cancer.4 A cross sectional study of 31patients undergoing surgery for the treatment of oral squamous cell carcinoma was carried out at Department of Oral & Maxillofacial Surgery ,Dhaka Dental college & hospital from May 2016 to July2017. Here 31 patients, of them male 13 and female 18 having 31 to 80years age ranges of oral squamous cell carcinoma who underwent surgery and reconstruction were included in this study. All patients were referred to oncologist after surgery. Aim of this study was to assess the status of disease, to provide the patient surgical treatment as a first line therapy, to find out any post-operative complications.
Update Dent. Coll. j: 2018; 8 (2): 10-13
Cone-Beam Computed Tomography to Assess Mandibular Invasion in Oral Squamous Cell Carcinoma
Authors: Islam Md Ariful , Uddin Md Nasir , Ali Md Shahjahan , Hossain Md Mahfuz 
Published: February 2019

Background: Oral squamous cell carcinoma which occurs closely to the mandible has a tendency to invade mandible. An accurate preoperative evaluation of mandibular invasion is important for optimum treatment planning. Aim of this study is to determine the accuracy of CBCT in detection of mandibular invasion in oral squamous cell carcinoma.
Study design: In this prospective observational study 35 patients of histologically proven squamous cell carcinoma which was close proximity to the mandible were selected. The results of preoperative CBCT scan of mandible were compared with that of post operative histopathology of bone and thus sensitivity, specificity, negative predictive value, positive predictive value were calculated.
Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CBCT were 96%, 90.90%, 96%, 90.90%, 97.14% respectively (Chi squared with Yates correction equals 21.844 with 1 degrees of freedom, p value < o.oooo1).
Conclusion: Cone beam computed tomography is a sensitive test and has an acceptable range of specificity.
Update Dent. Coll. j: 2018; 8 (2): 18-22
Educação e jogos: análise educomunicativa sobre a implementação de jogos em ambientes de ensino
Authors: Bürger Carlos Alberto Coletto , Ghisleni Taís Steffenello 
Published: February 2019

A escola tradicional encontra, na atualidade, dificuldades para manter a concentração do aluno e fomentar seu desejo por aprender. Diante dessa realidade o uso de jogos educativos é uma das formas de motivar o aluno a participar ativamente das atividades. O objetivo principal deste artigo é analisar, a partir de premissas educomunicativas, como é feita a utilização de jogos em sala de aula. Como objetivos específicos ficou definido: Caracterizar o que são jogos e jogos educativos; fazer um levantamento bibliográfico dos estudos de caso de aplicação de jogos em salas de aula; enfatizar como utilizar jogos em sala de aula pode melhorar a aprendizagem; refletir sobre possibilidades de aplicação desses jogos a partir da visão da educomunicação. Esta é uma pesquisa qualitativa, de levantamento bibliográfico e análise de conteúdo que investigou os artigos de estudo de caso publicados em periódicos científicos, através de uma ótica educomunicativa. Contatamos que a utilização de jogos em sala de aula auxilia a aprendizagem.