The First North American Clinical Gamma Knife Center

2019 ◽  
pp. 9-18 ◽  
Author(s):  
L. Dade Lunsford ◽  
Ajay Niranjan ◽  
John C. Flickinger
Keyword(s):  
Gamma Knife ◽  
North American

scholarly journals Skull base chondrosarcoma radiosurgery: report of the North American Gamma Knife Consortium

2015 ◽  
Vol 123 (5) ◽  
pp. 1268-1275 ◽  
Author(s):  
Hideyuki Kano ◽  
Jason Sheehan ◽  
Penny K. Sneed ◽  
Heyoung L. McBride ◽  
Byron Young ◽  
...  
Keyword(s):  
Overall Survival ◽  
Skull Base ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
North American ◽  
Cranial Nerve ◽  
Team Approach ◽  
Lower Cranial Nerve ◽  
Nerve Paralysis ◽  
The North

OBJECT Stereotactic radiosurgery (SRS) is a potentially important option for patients with skull base chondrosarcomas. The object of this study was to analyze the outcomes of SRS for chondrosarcoma patients who underwent this treatment as a part of multimodality management. METHODS Seven participating centers of the North American Gamma Knife Consortium (NAGKC) identified 46 patients who underwent SRS for skull base chondrosarcomas. Thirty-six patients had previously undergone tumor resections and 5 had been treated with fractionated radiation therapy (RT). The median tumor volume was 8.0 cm3 (range 0.9–28.2 cm3), and the median margin dose was 15 Gy (range 10.5–20 Gy). Kaplan-Meier analysis was used to calculate progression-free and overall survival rates. RESULTS At a median follow-up of 75 months after SRS, 8 patients were dead. The actuarial overall survival after SRS was 89% at 3 years, 86% at 5 years, and 76% at 10 years. Local tumor progression occurred in 10 patients. The rate of progression-free survival (PFS) after SRS was 88% at 3 years, 85% at 5 years, and 70% at 10 years. Prior RT was significantly associated with shorter PFS. Eight patients required salvage resection, and 3 patients (7%) developed adverse radiation effects. Cranial nerve deficits improved in 22 (56%) of the 39 patients who deficits before SRS. Clinical improvement after SRS was noted in patients with abducens nerve paralysis (61%), oculomotor nerve paralysis (50%), lower cranial nerve dysfunction (50%), optic neuropathy (43%), facial neuropathy (38%), trochlear nerve paralysis (33%), trigeminal neuropathy (12%), and hearing loss (10%). CONCLUSIONS Stereotactic radiosurgery for skull base chondrosarcomas is an important adjuvant option for the treatment of these rare tumors, as part of a team approach that includes initial surgical removal of symptomatic larger tumors.

Stereotactic radiosurgery for intractable cluster headache: an initial report from the North American Gamma Knife Consortium

2011 ◽  
Vol 114 (6) ◽  
pp. 1736-1743 ◽  
Author(s):  
Hideyuki Kano ◽  
Douglas Kondziolka ◽  
David Mathieu ◽  
Scott L. Stafford ◽  
Thomas J. Flannery ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Gamma Knife ◽  
Brain Stimulation ◽  
North American ◽  
Microvascular Decompression ◽  
Gamma Knife Surgery ◽  
Initial Report ◽  
The North ◽  
Deep Brain

Object The aim of this study was to evaluate the outcomes of Gamma Knife surgery (GKS) when used for patients with intractable cluster headache (CH). Methods Four participating centers of the North American Gamma Knife Consortium identified 17 patients who underwent GKS for intractable CH between 1996 and 2008. The median patient age was 47 years (range 26–83 years). The median duration of pain before GKS was 10 years (range 1.3–40 years). Seven patients underwent unsuccessful prior surgical procedures, including microvascular decompression (2 patients), microvascular decompression with glycerol rhizotomy (2 patients), deep brain stimulation (1 patient), trigeminal ganglion stimulation (1 patient), and prior GKS (1 patient). Fourteen patients had associated autonomic symptoms. The radiosurgical target was the trigeminal nerve (TN) root and the sphenopalatine ganglion (SPG) in 8 patients, only the TN in 8 patients, and only the SPG in 1 patient. The median maximum TN and SPG dose was 80 Gy. Results Favorable pain relief (Barrow Neurological Institute Grades I–IIIb) was achieved and maintained in 10 (59%) of 17 patients at a median follow-up of 34 months. Three patients required additional procedures (repeat GKS in 2 patients, hypothalamic deep brain stimulation in 1 patient). Eight (50%) of 16 patients who had their TN irradiated developed facial sensory dysfunction after GKS. Conclusions Gamma Knife surgery for intractable, medically refractory CH provided lasting pain reduction in approximately 60% of patients, but was associated with a significantly greater chance of facial sensory disturbances than GKS used for trigeminal neuralgia.

Infection control in North American dental schools

1989 ◽  
Vol 53 (9) ◽  
pp. 532-537 ◽  
Author(s):  
E Sampson ◽  
VB Dhuru
Keyword(s):  
Infection Control ◽  
North American ◽  
Dental Schools

Treatment planning instruction in North American dental schools, 1984-85

1985 ◽  
Vol 49 (10) ◽  
pp. 702-706
Author(s):  
S Kennon ◽  
TF Sleamaker ◽  
AG Farman
Keyword(s):  
Treatment Planning ◽  
North American ◽  
Dental Schools

Adaptation of the Connected Speech Test: Rerecording and Passage Equivalency

2020 ◽  
Vol 29 (2) ◽  
pp. 259-264 ◽  
Author(s):  
Hasan K. Saleh ◽  
Paula Folkeard ◽  
Ewan Macpherson ◽  
Susan Scollie
Keyword(s):  
Speech Perception ◽  
North American ◽  
First Language ◽  
Intraclass Correlation ◽  
Normal Hearing ◽  
Connected Speech ◽  
Internal Reliability ◽  
Speech Test ◽  
The Mean ◽  
Unit Standard

Purpose The original Connected Speech Test (CST; Cox et al., 1987) is a well-regarded and often utilized speech perception test. The aim of this study was to develop a new version of the CST using a neutral North American accent and to assess the use of this updated CST on participants with normal hearing. Method A female English speaker was recruited to read the original CST passages, which were recorded as the new CST stimuli. A study was designed to assess the newly recorded CST passages' equivalence and conduct normalization. The study included 19 Western University students (11 females and eight males) with normal hearing and with English as a first language. Results Raw scores for the 48 tested passages were converted to rationalized arcsine units, and average passage scores more than 1 rationalized arcsine unit standard deviation from the mean were excluded. The internal reliability of the 32 remaining passages was assessed, and the two-way random effects intraclass correlation was .944. Conclusion The aim of our study was to create new CST stimuli with a more general North American accent in order to minimize accent effects on the speech perception scores. The study resulted in 32 passages of equivalent difficulty for listeners with normal hearing.

North American blastomycosis presenting as an acute panniculitis and arthritis

1970 ◽  
Vol 102 (1) ◽  
pp. 92-96 ◽  
Author(s):  
R. P. Maioriello
Keyword(s):  
North American

"TRACHOMA AMONG THE NORTH AMERICAN INDIANS"

JAMA ◽  
1926 ◽  
Vol 86 (13) ◽  
pp. 970
Author(s):  
L. Webster Fox
Keyword(s):  
American Indians ◽  
North American ◽  
North American Indians ◽  
The North

1588: The Bicalutamide Early Prostate Cancer Program: Findings of the North American Trial at 7.7 Years' Median Follow-Up

2006 ◽  
Vol 175 (4S) ◽  
pp. 511-512
Author(s):  
David G. McLeod ◽  
Ira Klimberg ◽  
Donald Gleason ◽  
Gerald Chodak ◽  
Thomas Morris ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
North American ◽  
Early Prostate Cancer ◽  
The North ◽  
Cancer Program

144: Surgical Margin Status in European Versus North American Patients at Radical Prostatectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 46-47
Author(s):  
Daniel J. Lewinshtein ◽  
K.-H. Felix Chun ◽  
Alberto Briganti ◽  
Hendrik Isbarn ◽  
Eike Currlin ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
North American ◽  
Surgical Margin ◽  
Margin Status
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