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1. Optical Characterization of OMT-Coupled TES Bolometers for LiteBIRD

Author

J. Hubmayr, P. A. R. Ade, A. Adler, E. Allys, D. Alonso, K. Arnold, D. Auguste, J. Aumont, R. Aurlien, J. E. Austermann, S. Azzoni, C. Baccigalupi, A. J. Banday, R. Banerji, R. B. Barreiro, N. Bartolo, S. Basak, E. Battistelli, L. Bautista, J. A. Beall, D. Beck, S. Beckman, K. Benabed, J. Bermejo-Ballesteros, M. Bersanelli, J. Bonis, J. Borrill, F. Bouchet, F. Boulanger, S. Bounissou, M. Brilenkov, M. L. Brown, M. Bucher, E. Calabrese, M. Calvo, P. Campeti, A. Carones, F. J. Casas, A. Catalano, A. Challinor, V. Chan, K. Cheung, Y. Chinone, C. Chiocchetta, S. E. Clark, L. Clermont, S. Clesse, J. Cliche, F. Columbro, J. A. Connors, A. Coppolecchia, W. Coulton, J. Cubas, A. Cukierman, D. Curtis, F. Cuttaia, G. D’Alessandro, K. Dachlythra, P. de Bernardis, T. de Haan, E. de la Hoz, M. De Petris, S. Della Torre, J. J. Daz Garca, C. Dickinson, P. Diego-Palazuelos, M. Dobbs, T. Dotani, D. Douillet, E. Doumayrou, L. Duband, A. Ducout, S. M. Duff, J. M. Duval, K. Ebisawa, T. Elleflot, H. K. Eriksen, J. Errard, T. Essinger-Hileman, S. Farrens, F. Finelli, R. Flauger, K. Fleury-Frenette, C. Franceschet, U. Fuskeland, L. Galli, S. Galli, M. Galloway, K. Ganga, J. R. Gao, R. T. Genova-Santos, M. Georges, M. Gerbino, M. Gervasi, T. Ghigna, S. Giardiello, E. Gjerlw, R. Gonzlez Gonzles, M. L. Gradziel, J. Grain, L. Grandsire, F. Grupp, A. Gruppuso, J. E. Gudmundsson, N. W. Halverson, J. Hamilton, P. Hargrave, T. Hasebe, M. Hasegawa, M. Hattori, M. Hazumi, S. Henrot-Versill, B. Hensley, D. Herman, D. Herranz, G. C. Hilton, E. Hivon, R. A. Hlozek, D. Hoang, A. L. Hornsby, Y. Hoshino, K. Ichiki, T. Iida, T. Ikemoto, H. Imada, K. Ishimura, H. Ishino, G. Jaehnig, M. Jones, T. Kaga, S. Kashima, N. Katayama, A. Kato, T. Kawasaki, R. Keskitalo, C. Kintziger, T. Kisner, Y. Kobayashi, N. Kogiso, A. Kogut, K. Kohri, E. Komatsu, K. Komatsu, K. Konishi, N. Krachmalnicoff, I. Kreykenbohm, C. L. Kuo, A. Kushino, L. Lamagna, J. V. Lanen, G. Laquaniello, M. Lattanzi, A. T. Lee, C. Leloup, F. Levrier, E. Linder, M. J. Link, A. I. Lonappan, T. Louis, G. Luzzi, J. Macias-Perez, T. Maciaszek, B. Maffei, D. Maino, M. Maki, S. Mandelli, M. Maris, B. Marquet, E. Martnez-Gonzlez, F. A. Martire, S. Masi, M. Massa, M. Masuzawa, S. Matarrese, F. T. Matsuda, T. Matsumura, L. Mele, A. Mennella, M. Migliaccio, Y. Minami, K. Mitsuda, A. Moggi, M. Monelli, A. Monfardini, J. Montgomery, L. Montier, G. Morgante, B. Mot, Y. Murata, J. A. Murphy, M. Nagai, Y. Nagano, T. Nagasaki, R. Nagata, S. Nakamura, R. Nakano, T. Namikawa, F. Nati, P. Natoli, S. Nerval, N. Neto Godry Farias, T. Nishibori, H. Nishino, F. Noviello, G. C. O’Neil, C. O’Sullivan, K. Odagiri, H. Ochi, H. Ogawa, S. Oguri, H. Ohsaki, I. S. Ohta, N. Okada, L. Pagano, A. Paiella, D. Paoletti, G. Pascual Cisneros, A. Passerini, G. Patanchon, V. Pelgrim, J. Peloton, V. Pettorino, F. Piacentini, M. Piat, G. Piccirilli, F. Pinsard, G. Pisano, J. Plesseria, G. Polenta, D. Poletti, T. Prouv, G. Puglisi, D. Rambaud, C. Raum, S. Realini, M. Reinecke, C. D. Reintsema, M. Remazeilles, A. Ritacco, P. Rosier, G. Roudil, J. Rubino-Martin, M. Russell, H. Sakurai, Y. Sakurai, M. Sandri, M. Sasaki, G. Savini, D. Scott, J. Seibert, Y. Sekimoto, B. Sherwin, K. Shinozaki, M. Shiraishi, P. Shirron, A. Shitvov, G. Signorelli, G. Smecher, F. Spinella, J. Starck, S. Stever, R. Stompor, R. Sudiwala, S. Sugiyama, R. Sullivan, A. Suzuki, J. Suzuki, T. Suzuki, T. L. Svalheim, E. Switzer, R. Takaku, H. Takakura, S. Takakura, Y. Takase, Y. Takeda, A. Tartari, D. Tavagnacco, A. Taylor, E. Taylor, Y. Terao, L. Terenzi, J. Thermeau, H. Thommesen, K. L. Thompson, B. Thorne, T. Toda, M. Tomasi, M. Tominaga, N. Trappe, M. Tristram, M. Tsuji, M. Tsujimoto, C. Tucker, R. Ueki, J. N. Ullom, K. Umemori, L. Vacher, J. Van Lanen, G. Vermeulen, P. Vielva, F. Villa, M. R. Vissers, N. Vittorio, B. Wandelt, W. Wang, I. K. Wehus, J. Weller, B. Westbrook, G. Weymann-Despres, J. Wilms, B. Winter, E. J. Wollack, N. Y. Yamasaki, T. Yoshida, J. Yumoto, K. Watanuki, A. Zacchei, M. Zannoni, A. Zonca, Hubmayr, J, Ade, P, Adler, A, Allys, E, Alonso, D, Arnold, K, Auguste, D, Aumont, J, Aurlien, R, Austermann, J, Azzoni, S, Baccigalupi, C, Banday, A, Banerji, R, Barreiro, R, Bartolo, N, Basak, S, Battistelli, E, Bautista, L, Beall, J, Beck, D, Beckman, S, Benabed, K, Bermejo-Ballesteros, J, Bersanelli, M, Bonis, J, Borrill, J, Bouchet, F, Boulanger, F, Bounissou, S, Brilenkov, M, Brown, M, Bucher, M, Calabrese, E, Calvo, M, Campeti, P, Carones, A, Casas, F, Catalano, A, Challinor, A, Chan, V, Cheung, K, Chinone, Y, Chiocchetta, C, Clark, S, Clermont, L, Clesse, S, Cliche, J, Columbro, F, Connors, J, Coppolecchia, A, Coulton, W, Cubas, J, Cukierman, A, Curtis, D, Cuttaia, F, D’Alessandro, G, Dachlythra, K, de Bernardis, P, de Haan, T, de la Hoz, E, De Petris, M, Della Torre, S, Daz Garca, J, Dickinson, C, Diego-Palazuelos, P, Dobbs, M, Dotani, T, Douillet, D, Doumayrou, E, Duband, L, Ducout, A, Duff, S, Duval, J, Ebisawa, K, Elleflot, T, Eriksen, H, Errard, J, Essinger-Hileman, T, Farrens, S, Finelli, F, Flauger, R, Fleury-Frenette, K, Franceschet, C, Fuskeland, U, Galli, L, Galli, S, Galloway, M, Ganga, K, Gao, J, Genova-Santos, R, Georges, M, Gerbino, M, Gervasi, M, Ghigna, T, Giardiello, S, Gjerlw, E, Gonzles, R, Gradziel, M, Grain, J, Grandsire, L, Grupp, F, Gruppuso, A, Gudmundsson, J, Halverson, N, Hamilton, J, Hargrave, P, Hasebe, T, Hasegawa, M, Hattori, M, Hazumi, M, Henrot-Versill, S, Hensley, B, Herman, D, Herranz, D, Hilton, G, Hivon, E, Hlozek, R, Hoang, D, Hornsby, A, Hoshino, Y, Ichiki, K, Iida, T, Ikemoto, T, Imada, H, Ishimura, K, Ishino, H, Jaehnig, G, Jones, M, Kaga, T, Kashima, S, Katayama, N, Kato, A, Kawasaki, T, Keskitalo, R, Kintziger, C, Kisner, T, Kobayashi, Y, Kogiso, N, Kogut, A, Kohri, K, Komatsu, E, Komatsu, K, Konishi, K, Krachmalnicoff, N, Kreykenbohm, I, Kuo, C, Kushino, A, Lamagna, L, Lanen, J, Laquaniello, G, Lattanzi, M, Lee, A, Leloup, C, Levrier, F, Linder, E, Link, M, Lonappan, A, Louis, T, Luzzi, G, Macias-Perez, J, Maciaszek, T, Maffei, B, Maino, D, Maki, M, Mandelli, S, Maris, M, Marquet, B, Martnez-Gonzlez, E, Martire, F, Masi, S, Massa, M, Masuzawa, M, Matarrese, S, Matsuda, F, Matsumura, T, Mele, L, Mennella, A, Migliaccio, M, Minami, Y, Mitsuda, K, Moggi, A, Monelli, M, Monfardini, A, Montgomery, J, Montier, L, Morgante, G, Mot, B, Murata, Y, Murphy, J, Nagai, M, Nagano, Y, Nagasaki, T, Nagata, R, Nakamura, S, Nakano, R, Namikawa, T, Nati, F, Natoli, P, Nerval, S, Neto Godry Farias, N, Nishibori, T, Nishino, H, Noviello, F, O’Neil, G, O’Sullivan, C, Odagiri, K, Ochi, H, Ogawa, H, Oguri, S, Ohsaki, H, Ohta, I, Okada, N, Pagano, L, Paiella, A, Paoletti, D, Pascual Cisneros, G, Passerini, A, Patanchon, G, Pelgrim, V, Peloton, J, Pettorino, V, Piacentini, F, Piat, M, Piccirilli, G, Pinsard, F, Pisano, G, Plesseria, J, Polenta, G, Poletti, D, Prouv, T, Puglisi, G, Rambaud, D, Raum, C, Realini, S, Reinecke, M, Reintsema, C, Remazeilles, M, Ritacco, A, Rosier, P, Roudil, G, Rubino-Martin, J, Russell, M, Sakurai, H, Sakurai, Y, Sandri, M, Sasaki, M, Savini, G, Scott, D, Seibert, J, Sekimoto, Y, Sherwin, B, Shinozaki, K, Shiraishi, M, Shirron, P, Shitvov, A, Signorelli, G, Smecher, G, Spinella, F, Starck, J, Stever, S, Stompor, R, Sudiwala, R, Sugiyama, S, Sullivan, R, Suzuki, A, Suzuki, J, Suzuki, T, Svalheim, T, Switzer, E, Takaku, R, Takakura, H, Takakura, S, Takase, Y, Takeda, Y, Tartari, A, Tavagnacco, D, Taylor, A, Taylor, E, Terao, Y, Terenzi, L, Thermeau, J, Thommesen, H, Thompson, K, Thorne, B, Toda, T, Tomasi, M, Tominaga, M, Trappe, N, Tristram, M, Tsuji, M, Tsujimoto, M, Tucker, C, Ueki, R, Ullom, J, Umemori, K, Vacher, L, Van Lanen, J, Vermeulen, G, Vielva, P, Villa, F, Vissers, M, Vittorio, N, Wandelt, B, Wang, W, Wehus, I, Weller, J, Westbrook, B, Weymann-Despres, G, Wilms, J, Winter, B, Wollack, E, Yamasaki, N, Yoshida, T, Yumoto, J, Watanuki, K, Zacchei, A, Zannoni, M, Zonca, A, and National Aeronautics and Space Administration (US)

Subjects
CMB, TES, OMT, Low temperature detector, Bolometer, FIS/05 - ASTRONOMIA E ASTROFISICA, Settore FIS/05 - Astronomia e Astrofisica, General Materials Science, Condensed Matter Physics, CMB, TES, OMT, Low temperature detector, Bolometer, Atomic and Molecular Physics, and Optics
Abstract

et al., Feedhorn- and orthomode transducer- (OMT) coupled transition edge sensor (TES) bolometers have been designed and micro-fabricated to meet the optical specifications of the LiteBIRD high frequency telescope (HFT) focal plane. We discuss the design and optical characterization of two LiteBIRD HFT detector types: dual-polarization, dual-frequency-band pixels with 195/280 GHz and 235/337 GHz band centers. Results show well-matched passbands between orthogonal polarization channels and frequency centers within 3% of the design values. The optical efficiency of each frequency channel is conservatively reported to be within the range 0.64−0.72, determined from the response to a cryogenic, temperature-controlled thermal source. These values are in good agreement with expectations and either exceed or are within 10% of the values used in the LiteBIRD sensitivity forecast. Lastly, we report a measurement of loss in Nb/SiNx/Nb microstrip at 100 mK and over the frequency range 200–350 GHz, which is comparable to values previously reported in the literature., This work is supported by NASA under grant no. 80NSSC18K0132.

Published
2022

3. Quantitative Modeling of External Ventricular Drain Output to Predict Shunt Dependency in Aneurysmal Subarachnoid Hemorrhage: Cohort Study

Author

A, Perry, C S, Graffeo, G, Kleinstern, L P, Carlstrom, M J, Link, and A A, Rabinstein

Subjects
Adult, Aged, 80 and over, Male, Rupture, Spontaneous, Intracranial Aneurysm, Cerebral Infarction, Aneurysm, Ruptured, Middle Aged, Models, Theoretical, Subarachnoid Hemorrhage, Risk Assessment, Ventriculoperitoneal Shunt, Brain Ischemia, Ventriculostomy, Cohort Studies, Young Adult, Drainage, Humans, Vasospasm, Intracranial, Female, Aged, Hydrocephalus
Abstract

Acute hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH); however, attempts to predict shunt-dependent chronic hydrocephalus using clinical parameters have been equivocal.Cohort study of aSAH is treated with external ventricular drainage (EVD) placement at our institution, 2001-2016, via logistic regression. EVD-related parameters included mean/total EVD output (days 0-2), EVD days, EVD days ≤ 5 mmHg, and wean/clamp fails. aSAH outcomes assessed included ventriculoperitoneal shunt (VPS) placement, delayed cerebral ischemia (DCI), radiographic infarction (RI), symptomatic vasospasm (SV), age, and aSAH grades.Two hundred and ten aSAH patients underwent EVD treatment for a median 12 days (range 1-54); 85 required VPS (40%). On univariate analysis, EVD output, total EVD days, EVD days ≤ 5 mmHg, and wean/clamp trial failures were significantly associated with VPS placement (p 0.01 for all parameters). No EVD output parameter demonstrated a significant association with DCI, RI, or SV. On multivariate analysis, EVD output was a significant predictor of VPS placement, after adjusting for age and clinical and radiological grades; the optimal threshold for predicting VPS placement was mean daily output 204 ml on days 0-2 (OR 2.59, 95% CI 1.31-5.07). Multiple wean failures were associated with unfavorable functional outcome, after adjusting for age, grade, and VPS placement (OR 1.65, 95% CI 1.10-2.47). We developed a score incorporating age, grade and EVD parameters (MAGE) for predicting VPS placement after aSAH.EVD output parameters and wean/clamp trial failures predicted shunt dependence in an age- and grade-adjusted multivariable model. Early VPS placement may be warranted in patients with MAGE score ≥ 4, particularly following 2 failed wean trials.

Published
2019

4. CLIN-RADIATION THERAPY

Author

W.-S. Yoon, J.-T. Kim, Y.-M. Han, D.-S. Chung, Y.-S. Park, K. J. Lizarraga, M. Allen-Auerbach, A. A. De Salles, W. H. Yong, W. Chen, M. I. Ruge, P. Kickingereder, T. Simon, H. Treuer, V. Sturm, P. R. D'Alessandro, J. Jarrett, S. A. Walling, I. G. Fleetwood, T. G. Kim, D. H. Lim, S. L. McGovern, D. Grosshans, M. F. McAleer, M. Chintagumpala, S. Khatua, T. Vats, A. Mahajan, P. D. Beauchesne, G. Faure, G. Noel, T. Schmitt, L. Martin, E. Jadaud, C. Carnin, A. Astradsson, P. M. a. Rosenschold, A. K. W. Lund, U. Feldt-Rasmussen, H. Roed, M. Juhler, N. Kumar, R. Kumar, S. C. Sharma, K. K. Mukherjee, N. Khandelwal, P. K. Gupta, A. Bansal, R. Kapoor, S. Ghosal, C. L. Barney, A. P. Brown, M. C. Lowe, D. R. Grosshans, J. F. de Groot, V. Puduvalli, M. R. Gilbert, T. S. Vats, P. D. Brown, B. E. Pollock, S. L. Stafford, M. J. Link, Y. I. Garces, R. L. Foote, S. Ryu, E. Y. Kim, R. Yechieli, J. K. Kim, T. Mikkelsen, S. Kalkanis, J. Rock, G. K. Prithviraj, P. Oppelt, L. Arfons, K. C. Cuneo, J. Vredenburgh, A. Desjardins, K. Peters, J. Sampson, Z. Chang, J. Kirkpatrick, S. K. Nath, A. D. Sheridan, P. J. Rauch, J. N. Contessa, J. B. Yu, J. P. Knisely, F. J. Minja, A. O. Vortmeyer, V. L. Chiang, M. Koto, A. Hasegawa, R. Takagi, G. Sasahara, H. Ikawa, T. Kamada, Y. Iwadate, M. Matsutani, A. A. Kanner, G. Sela, E. Gez, D. Matceyevsky, N. Strauss, B. W. Corn, D. G. Brachman, K. A. Smith, P. Nakaji, S. Sorensen, K. J. Redmond, E. M. Mahone, L. Kleinberg, S. Terezakis, T. McNutt, H. Agbahiwe, K. Cohen, M. Lim, M. Wharam, A. Horska, B. Amendola, A. Wolf, S. Coy, L. Blach, F. Mesfin, D. Suki, G. Rao, V. A. R. Palkonda, N. More, P. Ganesan, R. Kesavan, M. Shunmugavel, T. Kasirajan, V. R. Maram, S. Kakkar, P. Upadhyay, S. Das, S. Nigudgi, J. S. Katz, M. Ghaly, M. Schulder, R. B. Taylor, P. E. Schaner, A. F. Dragovic, J. M. Markert, B. L. Guthrie, M. C. Dobelbower, S. A. Spencer, J. B. Fiveash, L. Chen, H. Guerrero-Cazares, E. Ford, A. Quinones-Hinojosa, K. Redmond, A. G. Wernicke, K. C. Chao, D. Nori, B. Parashar, M. Yondorf, J. A. Boockvar, S. Pannullo, P. Stieg, T. H. Schwartz, J. E. Leeman, D. A. Clump, J. C. Flickinger, S. A. Burton, A. H. Mintz, D. E. Heron, S. H. O'Neil, K. Wong, C. Buranahirun, B. Gonzalez-Morkos, R. J. Brown, A. Hamilton, J. Malvar, R. Sposto, G. Dhall, J. Finlay, A. Olch, K. Reddy, D. Damek, L. Gaspar, D. Ney, B. Kavanagh, A. Waziri, K. Lillehei, K. Stuhr, C. Chen, K. Kalakota, O. Offor, R. Patel, R. Dess, A. Schumacher, I. Helenowski, M. Marymont, P. Sperduto, S. J. Chmura, M. Mehta, G. Zadeh, W. Shi, H. Liu, M. Studenski, L. Fu, C. Peng, V. Gunn, S. Rudoler, C. Farrell, D. Andrews, J. Chu, J. Turian, J. W. Rooney, J. A. B. Ramiscal, N. N. Laack, K. Shah, M. Surucu, E. Melian, D. Anderson, V. Prabhu, T. Origitano, A. Sethi, and B. Emami

Subjects
Oncology, Radiation therapy, Abstracts, Cancer Research, medicine.medical_specialty, Text mining, business.industry, Internal medicine, medicine.medical_treatment, medicine, Neurology (clinical), business
Published
2012
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5. Radiation Therapy

Author

A. Charkravarti, M. Wang, I. Robins, A. Guha, W. Curren, D. Brachman, C. Schultz, A. Choucair, M. Dolled-Filhart, J. Christiansen, M. Gustavson, A. Molinaro, P. Mischel, T. Lautenschlaeger, A. Dicker, M. Mehta, C. A. Phillips, S. Dhulibala, D. Hallahan, J. Jaboin, F. S. Cardinale, P. Dickey, I. Goodrich, J. Gorelick, R. Sinha, V. M. Dest, C. Chen, C. Olsen, W. Franklin, B. Kleinschmidt-DeMasters, B. D. Kavanagh, K. Lillehei, A. Waziri, D. Damek, L. E. Gaspar, M. C. Stauder, N. N. Laack, M. J. Link, B. E. Pollock, P. J. Schomberg, J. F. Fraser, S. C. Pannullo, J. Moliterno, W. Cobb, P. E. Stieg, S. Vinchon-Petit, D. Jarnet, S. Michalak, A. Lewis, J.-P. Benoit, P. Menei, G. Desmarais, B. Paquette, R. Bujold, D. Mathieu, D. Fortin, K. C. Cuneo, J. J. Vredenburgh, J. H. Sampson, D. A. Reardon, A. Desjardins, K. L. Peters, J. P. Kirkpatrick, P. N. Patel, R. Vyas, U. Suryanarayan, D. Bhavsar, C. Hayhurst, E. Monsalves, M. Van Prooijen, C. Menard, G. Zadeh, C. Chung, K. Burrell, P. Lindsey, S. H. Burri, A. L. Asher, R. B. Kelly, P. Boltes, R. W. Fraser, F. A. Dilmanian, A. Rusek, N. R. Desnoyers, J. Y. Park, B. Dane, I. Dioszegi, S. D. Hurley, M. K. O'Banion, D. Tomasi, R. Wang, A. G. Meek, L. Sleire, J. Wang, J. Heggdal, P.-H. Pedersen, P. O. Enger, D. A. Clump, R. Srinivas, R. E. Wegner, D. E. Heron, S. A. Burton, A. H. Mintz, S. P. Howard, H. I. Robins, W. A. Tome, A. J. Paravati, P. A. Gardner, C. Snyderman, C. Ozhasoglu, A. Quinn, K. Seelman, J. H. Chang, Y. G. Park, M. J. Mehta, R. K. Vyas, D. C. Bhavsar, J. N. Guarnaschelli, L. Imwalle, J. Ying, C. McPherson, R. Warnick, J. Breneman, S. S. Khwaja, N. M. Wetjen, P. D. Brown, M. Siedow, U. Nestler, J. Perry, A. Huebner, A. Chakravarti, J. Glass, D. Andrews, M. Werner-Wasik, J. Evans, R. Lawrence, N. Martinez, G. Anuradha, M. David, M. Sara, L. Mark, B. Ricardo, J. Jeff, H. Juan, D. Kozono, P. Zinn, K. Ng, E. Melian, V. Prabhu, A. Sethi, K. Barton, D. Anderson, R. C. Rockne, M. Mrugala, J. Rockhill, and K. R. Swanson

Subjects
Cancer Research, Oncology, Neurology (clinical)
Published
2010
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10. Long-Term Quality of Life Following Stereotactic Radiosurgery for Vestibular Schwannoma

Author

M. J. Link, J. J. Thom, Brian A. Neff, Bruce E. Pollock, Matthew L. Carlson, C. L. Driscoll, Nicole M. Tombers, and Jeffrey T. Jacob

Subjects
Vestibular system, medicine.medical_specialty, Quality of life (healthcare), business.industry, medicine.medical_treatment, medicine, Neurology (clinical), Radiology, Schwannoma, medicine.disease, business, Radiosurgery, Term (time)
Published
2012
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14. Results of repeated gamma knife radiosurgery for medically unresponsive trigeminal neuralgia

Author

B E, Pollock, R L, Foote, S L, Stafford, M J, Link, D A, Gorman, and P J, Schomberg

Subjects
Aged, 80 and over, Male, Reoperation, Middle Aged, Trigeminal Neuralgia, Radiosurgery, Postoperative Complications, Recurrence, Humans, Female, Treatment Failure, Facial Nerve Diseases, Aged, Follow-Up Studies, Pain Measurement
Abstract

Gamma knife radiosurgery (GKS) is being increasing performed in the management of patients with medically unresponsive trigeminal neuralgia. The authors report the results of repeated GKS in patients with recurrent facial pain after their initial procedure.Between April 1997 and December 1999, 100 patients with idiopathic trigeminal neuralgia underwent GKS at the authors' center. To date, 26 patients have required additional surgery because GKS provided no significant pain relief (15 patients) or because they had recurrent facial pain (11 patients). Ten of these patients underwent repeated GKS at a median of 13 months (range 4-27 months). All patients undergoing repeated GKS had a significant reduction in their facial pain after the first procedure (eight were pain free); no patient developed facial numbness or paresthesias. Initially, nine of 10 patients became pain free 1 to 4 weeks following repeated GKS. At a median follow up of 15 months (range 3-32 months), eight patients remained pain free and required no medication. All eight patients with persistent pain relief developed minor neurological dysfunction after repeated GKS (six patients had facial numbness and two had paresthesias).Repeated GKS can be associated with a high rate of pain relief for patients with trigeminal neuralgia who experienced a significant reduction in their facial pain after the first operation. However, every patient with sustained pain relief after the second operation also developed some degree of trigeminal dysfunction. These findings of improved pain relief for patients who develop facial numbness after GKS for trigeminal neuralgia support the experimental data currently available.

Published
2001

15. Gamma knife radiosurgery for skull base meningiomas

Author

B E, Pollock, S L, Stafford, and M J, Link

Subjects
Adult, Aged, 80 and over, Male, Middle Aged, Radiosurgery, Magnetic Resonance Imaging, Skull Base Neoplasms, Treatment Outcome, Meningeal Neoplasms, Humans, Female, Meningioma, Aged, Retrospective Studies
Abstract

Radiosurgery has been proven to be a safe and effective management strategy for skull base meningiomas either primarily or for tumor recurrence or progression after prior microsurgical resection. With its steep radiation falloff, radiosurgery provides long-term tumor growth control without the complications associated with conventional fractionated radiation therapy. Stereotactic MR imaging has allowed better definition of the tumor margin for precise multiisocenter conformal dose planning, and our current radiation dose prescription has decreased the incidence of new cranial nerve deficits after radiosurgery to less than 10%. Tumor growth control after radiosurgery remains greater than 90%; patients with subsequent growth typically have tumor outside the irradiated volume or a histologic diagnosis of atypical or malignant meningioma. Still, longer follow-up is needed to ensure that tumor growth control remains permanent after radiosurgery. For patients with large tumors of the skull base, radiosurgery can be part of a staged approach with microsurgery. Initially, the tumor is debulked without an attempt at resection involving the cranial nerves or basal vessels. Radiosurgery can then be performed for the small remaining tumor volume with little risk of cranial nerve deficits. Such multimodality treatment should result in reduced patient morbidity, with long-term tumor control.

Published
2000

18. Efficacy of brief, intense light exposure for treatment of winter depression

Author

J S, Terman, M, Terman, D, Schlager, B, Rafferty, M, Rosofsky, M J, Link, P F, Gallin, and F M, Quitkin

Subjects
Male, Psychiatric Status Rating Scales, Affect, Light, Mood Disorders, Humans, Female, Seasons
Abstract

A high-intensity fluorescent lighting system, tilted downward toward the head, and emitting negligible levels of ultraviolet radiation, was tested under two random crossover protocols in winter-depressed patients: 30-minute sessions at (a) 3,000 lux vs. 10,000 lux in early morning, and (b) morning vs. evening sessions at 10,000 lux. Judgment of clinical remission was based jointly on relative and absolute score improvements on a Structured Interview Guide for the Hamilton Depression Scale--Seasonal Affective Disorder Version (SIGH-SAD) and a set of supplementary atypical-vegetative items. Data are presented for 24 subjects who showed relapse upon withdrawal. An overall remission rate of 75 percent was found for morning light at 10,000 lux. The rates for evening light (25%) and 3,000 lux morning light (19%) were significantly lower. The remission rate for morning light treatment of 10,000 lux for 30 minutes approximately equalled 2,500 lux treatment for 2 hours (data from our earlier studies), suggesting a reciprocity between dosing dimensions of intensity and duration. No pathological changes were revealed by ophthalmological examinations given after 2 to 6 weeks of daily treatment.

Published
1990

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