4,321 research outputs found
Biologically effective dose correlates with linear tumor volume changes after upfront single-fraction stereotactic radiosurgery for vestibular schwannomas.
Vestibular schwannomas (VSs) are benign, slow-growing tumors. Management options include observation, surgery, and radiation. In this retrospective trial, we aimed at evaluating whether biologically effective dose (BED) plays a role in tumor volume changes after single-fraction first intention stereotactic radiosurgery (SRS) for VS. We compiled a single-institution experience (n = 159, Lausanne University Hospital, Switzerland). The indication for SRS was decided after multidisciplinary discussion. Only cases with minimum 3 years follow-up were included. The Koos grading, a reliable method for tumor classification was used. Radiosurgery was performed using Gamma Knife (GK) and a uniform marginal prescription dose of 12 Gy. Mean BED was 66.3 Gy (standard deviation 3.8, range 54.1-73.9). The mean follow-up period was 5.1 years (standard deviation 1.7, range 3-9.2). The primary outcome was changes in 3D volumes after SRS as function of BED and of integral dose received by the VS. Random-effect linear regression model showed that tumor volume significantly and linearly decreased over time with higher BED (p < 0.0001). Changes in tumor volume were also significantly associated with age, sex, number of isocenters, gradient index, and Koos grade. However, the effect of BED on tumor volume change was moderated by time after SRS and Koos grade. Lower integral doses received by the VSs were inversely correlated with BED in relationship with tumor volume changes (p < 0.0001). Six (3.4%) patients needed further intervention. For patients having uniformly received the same marginal dose prescription, higher BED linearly and significantly correlated with tumor volume changes after SRS for VSs. BED could represent a potential new treatment paradigm for patients with benign tumors, such as VSs, for attaining a desired radiobiological effect. This could further increase the efficacy and decrease the toxicity of SRS not only in benign tumors but also in other SRS indications
Proposal of a timing strategy for cholesteatoma surgery during the COVID-19 pandemic.
The COVID-19 infection is an aggressive viral illness with high risk of transmission during otolaryngology examination and surgery. Cholesteatoma is known for its potential to cause complications and scheduling of surgery during the pandemic must be done carefully. The majority of otological surgeries may be classified as elective and postponed at this time (e.g., stapedotomy, tympanoplasty); whereas, others are emergencies (e.g., complicated acute otitis media, complicated cholesteatoma with cerebral or Bezold's abscess, meningitis, sinus thrombosis) and require immediate intervention. What is the ideal time for the surgical management of Cholesteatoma during the COVID-19 pandemic?
Senior otologic surgeons from six teaching hospitals from various countries affected by the COVID-19 from around the world met remotely to make recommendations on reorganizing schedules for the treatment of cholesteatoma which has a risk of severe morbidity and mortality. The recommendations are based on their experiences and on available literature.
Due to the high risk of infecting the surgical staff it is prudent to stop all elective ear surgeries and plan cholesteatoma surgery after careful selection of patients, based on the extent of the disease and available resources. Specific precautions including use of appropriate personal protection equipment should be followed when operating on all patients during the pandemic. To facilitate the decision-making in the management of cholesteatoma, timing for surgery can be divided into two categories with 3 and 2 sub-groups based on disease severity.
Evidence on the timing of surgery of patients with cholesteatoma during the COVID-19 pandemic is lacking. This manuscript contains practical tips on how cholesteatoma surgery can be reorganized during this pandemic
The SPHERE data center: a reference for high contrast imaging processing
The objective of the SPHERE Data Center is to optimize the scientific return
of SPHERE at the VLT, by providing optimized reduction procedures, services to
users and publicly available reduced data. This paper describes our motivation,
the implementation of the service (partners, infrastructure and developments),
services, description of the on-line data, and future developments. The SPHERE
Data Center is operational and has already provided reduced data with a good
reactivity to many observers. The first public reduced data have been made
available in 2017. The SPHERE Data Center is gathering a strong expertise on
SPHERE data and is in a very good position to propose new reduced data in the
future, as well as improved reduction procedures.Comment: SF2A proceeding
Shadows cast on the transition disk of HD 135344B. Multiwavelength VLT/SPHERE polarimetric differential imaging
The protoplanetary disk around the F-type star HD 135344B (SAO 206462) is in
a transition stage and shows many intriguing structures both in scattered light
and thermal (sub-)millimeter emission which are possibly related to planet
formation processes. We study the morphology and surface brightness of the disk
in scattered light to gain insight into the innermost disk regions, the
formation of protoplanets, planet-disk interactions traced in the surface and
midplane layers, and the dust grain properties of the disk surface. We have
carried out high-contrast polarimetric differential imaging (PDI) observations
with VLT/SPHERE and obtained polarized scattered light images with ZIMPOL in R-
and I-band and with IRDIS in Y- and J-band. The scattered light images reveal
with unprecedented angular resolution and sensitivity the spiral arms as well
as the 25 au cavity of the disk. Multiple shadow features are discovered on the
outer disk with one shadow only being present during the second observation
epoch. A positive surface brightness gradient is observed in the stellar
irradiation corrected images in southwest direction possibly due to an
azimuthally asymmetric perturbation of the temperature and/or surface density
by the passing spiral arms. The disk integrated polarized flux, normalized to
the stellar flux, shows a positive trend towards longer wavelengths which we
attribute to large aggregate dust grains in the disk surface. Part of the the
non-azimuthal polarization signal in the Uphi image of the J-band observation
could be the result of multiple scattering in the disk. The detected shadow
features and their possible variability have the potential to provide insight
into the structure of and processes occurring in the innermost disk regions.Comment: Accepted for publication in A&A, 20 pages, 15 figure
Partitioning of on-demand electron pairs
We demonstrate the high fidelity splitting of electron pairs emitted on
demand from a dynamic quantum dot by an electronic beam splitter. The fidelity
of pair splitting is inferred from the coincidence of arrival in two detector
paths probed by a measurement of the partitioning noise. The emission
characteristic of the on-demand electron source is tunable from electrons being
partitioned equally and independently to electron pairs being split with a
fidelity of 90%. For low beam splitter transmittance we further find evidence
of pair bunching violating statistical expectations for independent fermions
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