bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computational model for the estimation of the extracranial doses received during Leksell gamma knife model C treatment
Authors: Majali Mustafa , Novotny Josef , Novotny Josef 
Published: November 2018

Object. Extracranial doses received by patients undergoing Leksell gamma knife surgery (GKS) can be of clinical concern. Therefore, the ability to preestimate peripheral doses received outside the treatment field during the GKS would be beneficial and could be used for the optimization of treatment planning by providing a reference for practitioners to calculate the extracranial dose burden to the body before the start of treatment.
Methods. A dose of 40 Gy was delivered to the Rando phantom in a single fraction to a midline hypothetical target close to the center of the skull. Treatment planning was performed for multiple isocenters with a prescription to the 50% isodose of each collimator. Treatment plans were produced for 1, 5, 10, 15, and 20 shots, keeping the same dose and dose distribution at different target volumes. An automatic positioning system was used for positioning the phantom during the treatment. The doses to different organs were measured during GKS using a thermoluminescent dosimeter. In vivo measurements were also made in 200 patients who underwent GKS with the model C unit for different diagnoses at Na Homolce Hospital.
Conclusions. The peripheral dose depended on the collimator size with a logarithmic dependence on collimator size and a linear dependence on the number of shots. This model can be used for the estimation of peripheral doses with a total error less than 20%. This information can help clinicians with treatment planning optimization, especially in patients with long survival expectancy.
Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation
Authors: Nyáry István , Major Otto , Hanzély Zoltán , Szeifert György T. 
Published: November 2018

✓ Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy.
A hemorrhagic lesion in the posterior part of the thalamus had been diagnosed as a tumor and was treated with 40-Gy fractionated radiotherapy. One year after this treatment the case was reconsidered based on new imaging evidence, and the lesion was removed by conventional craniotomy. Histopathological examination revealed a CH with postirradiation changes. Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion.
The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.
Radiosurgery and the prevention of regrowth of incompletely removed nonfunctioning pituitary adenomas
Authors: Picozzi Piero , Losa Marco , Mortini Pietro , Valle Micol Angela , Franzin Alberto , Attuati Luca , da Passano Camillo Ferrari , Giovanelli Massimo 
Published: November 2018

Object. The authors studied the efficacy of gamma knife radiosurgery (GKS) in the prevention of regrowth of nonfunctioning pituitary adenomas (NPA).
Methods. One hundred nineteen patients were included in this study and were divided into two groups. All patients had undergone surgery in our department and recurrent or residual adenoma was demonstrated on postoperative MR imaging. Group A consisted of 68 patients who were followed without additional treatment. Group B was composed of 51 patients who received GKS within 1 year after microsurgery. There was no significant demographic difference between the two groups. In Group B the mean margin dose was 16.5 ± 0.3 Gy (range 13–21 Gy). Fifty one and one tenth percent of patients in Group A were recurrence free at 5 years and 89.8% in Group B (p < 0.001). In Group B patients, tumor volume decreased from a baseline value of 2.4 ± 0.2 cm3 to 1.6 ± 0.2 cm3 at last follow up (p < 0.001).
Conclusions. The results of this study suggest that GKS is effective in controlling growth of residual NPA for at least 5 years following initial maximal surgical debulking compared with no radiation therapy. Thus, GKS is recommended after microsurgery when visible tumor can be detected on imaging studies.
Stereotactic noninvasive volume measurement compared with geometric measurement for indications and evaluation of gamma knife treatment
Authors: Del Valle Ramiro , Pérez Miguel , Ortiz Juan , Ruiz Salvador , de Anda Salvador , Jaramillo José , Martínez Manuel , Corona Roberto , Vivas Ingrid , Facha M.A. Teresa , Olmos Rosario , Arrieta Arturo , Estrada Josué 
Published: November 2018

Object. Volume estimation is one of the most important criteria in the evaluation and follow up of radiosurgical treatments and outcomes; however, several limitations are involved in the calculation estimation of target volumes.
Methods. Retrospective and prospective studies were conducted to evaluate the efficacy of a new noninvasive stereotactic method when it is compared with geometric volume calculation of intracranial tumors for planning stereotactic radiosurgery treatment as well as for follow up and outcome evaluation.
Two equations were created that permit comparison of the calculated and measured volumes. These equations took linear and quadratic forms, respectively. Volume estimation using the stereotactic approach compared with traditional volume calculation gave more accurate results regardless of the shape and size of the lesion.
Conclusions. The use of stereotactic volume calculation is highly recommended in planning, follow up, and determination of the outcome in patients participating in radiosurgical treatment and should lead to more uniform reports of the response to treatment.
Evaluation of a new concept for the management of skull base chordomas and chondrosarcomas
Authors: Feigl Guenther Christian , Bundschuh Otto , Gharabaghi Alireza , Safavi-Abassi Sam , El Shawarby Amr , Samii Madjid , Horstmann Gerhard A. 
Published: November 2018

Object. Chordomas and chondrosarcomas of the skull base are rare locally invasive tumors associated with high recurrence rates. The aim of this study was to evaluate the concept of microsurgical tumor volume reduction followed by early gamma knife surgery (GKS).
Methods. Thirteen patients with 15 tumors were treated between October 2000 and June 2003. There were three patients (23.1%) with chordomas and 10 (76.9%) with chondrosarcomas. There were nine men and four women who ranged in age between 19 and 69 years. All patients first underwent maximal tumor resection. Within 2 to 10 months after surgery they were treated with GKS. The mean postoperative tumor volume treated with GKS was 9.7 cm3 (range 1.4–20.3 cm3). Follow-up computerized tomography and magnetic resonance imaging examinations with volumetric tumor analysis were performed every 6 months after GKS.
The mean treatment dose was 17 Gy and the mean isodose was 52%. The mean follow-up duration was 17 months during which there was only one tumor recurrence at the margin of the radiation field. The mean volume reduction was 35.4%.
Conclusions. Results of this treatment strategy are encouraging but the efficacy of this multimodal treatment combining surgery and early GKS requires a longer follow up.
Does gamma knife surgery stimulate cellular immune response to metastatic brain tumors? A histopathological and immunohistochemical study
Authors: Szeifert György T. , Salmon Isabelle , Rorive Sandrine , Massager Nicolas , Devriendt Daniel , Simon Stephan , Brotchi Jacques , Levivier Marc 
Published: November 2018

Object. The aim of this study was to analyze the cellular immune response and histopathological changes in secondary brain tumors after gamma knife surgery (GKS).
Methods. Two hundred ten patients with cerebral metastases underwent GKS. Seven patients underwent subsequent craniotomy for tumor removal between 1 and 33 months after GKS. Four of these patients had one tumor, two patients had two tumors, and one patient had three. Histological and immunohistochemical investigations were performed. In addition to routine H & E and Mallory trichrome staining, immunohistochemical reactions were conducted to characterize the phenotypic nature of the cell population contributing to the tissue immune response to neoplastic deposits after radiosurgery.
Light microscopy revealed an intensive lymphocytic infiltration in the parenchyma and stroma of tumor samples obtained in patients in whom surgery was performed over 6 months after GKS. Contrary to this, extensive areas of tissue necrosis with either an absent or scanty lymphoid population were observed in the poorly controlled neoplastic specimens obtained in cases in which surgery was undertaken in patients less than 6 months after GKS. Immunohistochemical characterization demonstrated the predominance of CD3-positive T cells in the lymphoid infiltration.
Conclusions. Histopathological findings of the present study are consistent with a cellular immune response of natural killer cells against metastatic brain tumors, presumably stimulated by the ionizing energy of focused radiation.
Diagnostic value of thallium-201 chloride single-photon emission computerized tomography in differentiating tumor recurrence from radiation injury after gamma knife surgery for metastatic brain tumors
Authors: Serizawa Toru , Saeki Naokatsu , Higuchi Yoshinori , Ono Junichi , Matsuda Shinji , Sato Makoto , Yanagisawa Masamichi , Iuchi Toshihiko , Nagano Osamu , Yamaura Akira 
Published: November 2018

Object. The authors assessed the diagnostic value of 201Tl Cl single-photon emission computerized tomography (SPECT), performed after gamma knife surgery (GKS) for metastatic brain tumors in differentiating tumor recurrence from radiation injury.
Methods. Of 6503 metastatic brain tumors treated with GKS, 201Tl SPECT was required in 72 to differentiate between tumor recurrence and radiation injury. When the Tl index was greater than 5, the lesion was diagnosed as a tumor recurrence. When the index was < 3.0 it was called radiation injury. In cases with a Tl index between 3 and 5, 201Tl SPECT was repeated once per month until the Tl index was greater than 5 or less than 3. If the Tl index fluctuated between 3 and 5 for 2 months, the lesion was diagnosed as radiation injury. The final diagnosis was based on histological examination or clinical course.
The sensitivity of the method was 91%; thus 201Tl SPECT is effective for differentiating between tumor recurrence and radiation injury in metastatic brain tumors treated with GKS. Caution is necessary, however, for the following reasons: 1) simple interinstitutional comparisons of Tl indices are not possible because measurement methods are institute specific; 2) steroid administration decreases the Tl index to a variable degree; and 3) a severe radiation injury lesion, as is often seen after repeated GKS or very high dose GKS, may have a Tl index greater than 5.
Conclusions. Used with critical insight 201Tl Cl SPECT can be useful in distinguishing between tumor regrowth and radiation necrosis in patients with cerebral metastases.
Radiosurgery for trigeminal neuralgia: is sensory disturbance required for pain relief?
Authors: Pollock Bruce E. 
Published: November 2018

ObjectOver the past 15 years stereotactic radiosurgery has become an accepted surgical option for patients with medically unresponsive trigeminal neuralgia (TN). The mechanism whereby radiosurgery causes pain relief remains unclear.MethodsA review of recent papers on the radiosurgical management of TN reveals a correlation between maximum prescription dose and facial pain outcomes (p = 0.03) and between maximum prescription dose and new-onset trigeminal dysfunction (p < 0.01). In five of six studies in which investigators specifically analyzed whether there is any relationship between postradiosurgical trigeminal dysfunction and facial pain outcomes, there was a statistically significant greater chance of patients being pain free without medications if new trigeminal dysfunction developed after radiosurgery. Likewise, combining the results of two small series on repeated radiosurgery for TN also showed a significant correlation between postradiosurgical trigeminal dysfunction and facial pain outcomes (p = 0.02).ConclusionsAlthough the quality of data available does not permit a formal metaanalysis of radiosurgery for TN, the preponderance of information supports an association between the development of facial sensory loss and pain relief after radiosurgery. Consequently, radiosurgery should be considered a destructive technique in which the goal is similar to that in other percutaneous ablative techniques used to manage TN: create sufficient damage to the trigeminal system to achieve pain relief, but not so much injury that the patient is at risk for deafferentation pain syndromes.
Radiosurgery for glomus jugulare tumors: experience treating 16 patients in Iran
Authors: Bitaraf Mohammad Ali , Alikhani Mazdak , Tahsili-Fahadan Pouya , Motiei-Langroudi Rouzbeh , Zahiri Alireza , Allahverdi Mahmoud , Salmanian Soraya 
Published: November 2018

ObjectGlomus jugulare tumors (GJT) have traditionally been treated by surgery or fractionated external-beam radiotherapy. The aim of this retrospective study was to determine the tumor control rate, clinical outcome, and short-term complications of stereotactic radiosurgery in subsets of patients who are poor candidates for these procedures, based on age, medical problems, tumor size, or prior treatment failure.MethodsThe Leksell Gamma Knife was used to treat 16 patients harboring symptomatic, residual, recurrent, or unresectable GJTs. The age of the patients ranged from 12 to 77 years (median 46.5 years). Gamma Knife surgery (GKS) was performed as primary treatment in five patients (31.3%). Microsurgery preceded radiosurgery in 10 patients (62.5%) and fractionated radiotherapy in three patients (18.8%). The median tumor volume was 9.8 cm3 (range 1.7–20.6 cm3). The median marginal dose applied to a mean isodose volume of 50% (range 37–70%) was 18 Gy (range 14–20 Gy).Neurological follow-up examinations revealed improved clinical status in 10 patients (62.5%), a stable neurological status in six (37.5%), and no complications. After radiosurgery, follow-up imaging was conducted in 14 patients; the median interval from GKS to the last follow up was 18.5 months (range 4–28 months). Tumor size had decreased in six patients (42.9%), and the volume remained unchanged in the remaining eight (57.1%). None of the tumors increased in volume during the observation period.Conclusions According to the authors' experience, GKS represents a useful therapeutic option to control symptoms and may be safely conducted in patients with primary or recurrent GJTs with no death and no acute morbidity. Because of the tumor's naturally slow growth rate, however, long-term follow-up data are needed to establish a cure rate after radiosurgery.
Calculation of isoeffective doses and the α /β value by comparing results following radiosurgery and radiotherapy for arteriovenous malformations of the brain
Authors: Karlsson Bengt , Lax Ingmar , Yamamoto Masaaki , Söderman Michael , Jokura Hidefumi , Rosen Charles , Bailes Julian 
Published: November 2018

ObjectThe authors sought to assess the relationship between obliteration rate and different dose parameters following fractionated radiotherapy for arteriovenous malformations (AVMs). A comparison of the results of radiosurgery and radiotherapy for AVMs was made to calculate the best fit α/β value, which would then be used as a model for predicting the treatment outcome, independent of the number of fractions applied.MethodsData from 1453 patients were analyzed: 1154 treated with radiosurgery and 300 with fractionated radiotherapy. The relationships between dose and obliteration rate after 3 years were calculated, and the best fit curve to the empirical results was defined. The higher the dose per fraction, biologically effective dose, and the lower the total dose, the higher the obliteration rate. The isoeffective doses when comparing radiotherapy and radiosurgery independent of the α/β value could not be defined. The dose per fraction had the best predictive value, independent of the number of fractions.Conclusions Dose per fraction seems to be the decisive parameter for the treatment response following both radiotherapy and radiosurgery. A larger number of fractions did not increase the obliteration rate. The data indicate that higher doses per fraction should be used when irradiating AVMs.
Long-term results of Gamma Knife surgery for arteriovenous malformations: 10- to 15-year follow up in patients treated with lower doses
Authors: Inoue Hiroshi K. 
Published: November 2018

ObjectSeveral adverse effects such as brain edema, necrosis, arterial stenosis, hemorrhage after obliteration, and delayed cyst formation have been reported as early and late complications of Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs). These adverse effects seem to be decreased in a lower-dose treatment regimen compared with the classic higher margin doses of 25 Gy because the radiation insult to the surrounding tissue is minimized. Long-term results of lower-dose GKS for AVMs are presented.MethodsOne hundred fourteen patients with AVMs were treated with lower-dose GKS (≤ 20-Gy margin dose). There were 68 male and 46 female patients, aged 10 to 68 years (mean 35.4 years). The evaluation of AVM nidi and dose planning were performed using both angiography and MR imaging in all cases to exclude the surrounding brain tissue. The mean margin dose was 19.5 Gy.Total angiographically documented obliteration was achieved in 65 (85.5%) of 76 patients. Eleven patients underwent a second treatment, including staged treatment for large AVMs; total AVM obliteration has been achieved in six of them to date. Of 38 patients in whom no follow-up examination could be performed, 19 of them were healthy and 10 were lost from follow up. Nine patients experienced bleeding during the latency period, and four of them suffered lethal hemorrhage. Symptomatic early complications were extensive brain edema after repeated GKS in one patient and an adverse effect on the internal capsule in one. Delayed cyst formation was found in one patient as a late complication 10 years after treatment. No treatment-related death has been noted to date.Conclusions Lower-dose GKS is an effective and safe treatment for patients with AVMs and may decrease long-term adverse effects to the surrounding brain.
Pemodelan UML Pada Sistem Pengajuan Dana Anggaran Untuk Peningkatan Produktivitas Perusahaaan
Authors: Liantoni Febri , Yusincha Amalia 
Published: November 2018

Dunia teknologi informasi berkembang pesat dengan dukungan teknologi yang semakin canggih. Unified Modeling Languange salah satu sistem yang bisa digunakan untuk standar pembuatan sistem informasi. Dengan menggunakan Unified Modeling Languange perancangan dan pembuatan sistem dapat dikerjakan lebih cepat. Pada penelitian ini pemodelan Unified Modeling Languange digunakan untuk membuat sistem pengajuan dana anggaran. Pembuatan sistem ini bertujuan untuk meningkatkan produktivitas perusahaaan dalam menangani proyek yang dikerjakan. Berdasarkan analisa dan pengujian sistem diperoleh kesimpulan bahwa sistem yang dibuat dapat mempermudah para karyawan perusahaan dalam proses pengajuan dana anggaran dan pertanggungjawaban dana proyek. Sistem yang dibuat juga memberikan informasi mengenai pengajuan dana yang diterima atau ditolak suatu proyek, sehingga dapat membuat pekerjaan yang dikerjakan lebih efisien dan dapat mengurangi resiko kesalahan terhadap pengajuan dana proyek.

Kata kunci: Teknologi Informasi, Unified Modeling Languange, Sistem, Dana Anggaran

Abstract
The world of information technology is growing rapidly with the support of increasingly sophisticated technology. Unified Modeling Language one of the systems that can be used for the standard of making information systems. Using Unified Modeling Language the design and manufacture of the system can be done faster. In this study Unified Modeling Language modeling is used to create a system for submitting budget funds. The creation of this system aims to improve the productivity of companies in handling the projects being worked on. Based on the analysis and testing of the system, it can be concluded that the system created can make it easier for company employees in the process of submitting budget funds and accountability for project funds. The system created also provides information about the submission of funds received or rejected by a project, so as to make the work done more efficiently and can reduce the risk of errors in the submission of project funds.
Keywords: Information Technology, Unified Modeling Languages, Systems, Budget Funds
Ordre local autour du germanium dans les verres du système SiO2-GeO2-B2O3-Na2O : étude par spectrométrie d'absorption X
Authors: Lapeyre Caroline , Petiau Jacqueline , Calas Georges , Gauthier Francis , Gombert Jean 
Published: November 2018

L'ordre local autour du germanium dans les verres à séparation de phase du système SiO2-GeO2-B2O3-Na2O a été étudié par EXAFS et comparé à celui observé dans des verres plus simples (GeO2 vitreux, binaires GeO2-SiO2 et GeO2-Na2O). Dans GeO2 pur et dans les binaires GeO2-SiO2, la distance Ge-O mesurée prouve que le germanium est uniquement en coordinance 4 et que le tétraèdre GeO4 est rigide. Au contraire, l'accroissement de la distance Ge-O dans le binaire GeO2-Na2O montre qu'une partie des atomes de germanium y est en coordinance 6.
Une deuxième couche atomique n'est observée que dans les verres GeO2 pur et GeO2-Na2O ; elle traduit un angle Ge-Q-Ge bien défini et voisin de celui mesuré dans le cristal a-GeO2 (130°), ce qui indique un ordre tridimensionnel au-delà du tétraèdre de base. Un verre quaternaire étudié à différentes étapes du processus de séparation de phase ne montre qu'une seule couche Ge-O, avec un comportement proche de celui observé dans le binaire GeO2-SiO2.