Current algorithm for the surgical treatment of facial pain

<p/> <p>Background</p> <p>Facial pain may be divided into several distinct categories, each requiring a specific treatment approach. In some cases, however, such categorization is difficult and treatment is ineffective. We reviewed our extensive clinical experience and designed an algorithmic approach to the treatment of medically intractable facial pain that can be treated through surgical intervention.</p> <p>Methods</p> <p>Our treatment algorithm is based on taking into account underlying pathological processes, the anatomical distribution of pain, pain characteristics, the patient's age and medical condition, associated medical problems, the history of previous surgical interventions, and, in some cases, the results of psychological evaluation. The treatment modalities involved in this algorithm include diagnostic blocks, peripheral denervation procedures, craniotomy for microvascular decompression of cranial nerves, percutaneous rhizotomies using radiofrequency ablation, glycerol injection, balloon compression, peripheral nerve stimulation procedures, stereotactic radiosurgery, percutaneous trigeminal tractotomy, and motor cortex stimulation. We recommend that some patients not receive surgery at all, but rather be referred for other medical or psychological treatment.</p> <p>Results</p> <p>Our algorithmic approach was used in more than 100 consecutive patients with medically intractable facial pain. Clinical evaluations and diagnostic workups were followed in each case by the systematic choice of the appropriate intervention. The algorithm has proved easy to follow, and the recommendations include the identification of the optimal surgery for each patient with other options reserved for failures or recurrences. Our overall success rate in eliminating facial pain presently reaches 96%, which is higher than that observed in most clinical series reported to date</p> <p>Conclusion</p> <p>This treatment algorithm for the intractable facial pain appears to be effective for patients with a wide variety of painful conditions and may be recommended for use in other institutions.</p

Solar wind-magnetosphere coupling and the distant magnetotail: ISEE-3 observations

ISEE-3 Geotail observations are used to investigate the relationship between the interplanetary magnetic field, substorm activity, and the distant magnetotail. Magnetic field and plasma observations are used to present evidence for the existence of a quasi-permanent, curved reconnection neutral line in the distant tail. The distance to the neutral line varies from absolute value of X = 120 to 140 R/sub e near the center of the tail to beyond absolute value of X = 200 R/sub e at the flanks. Downstream of the neutral line the plasma sheet magnetic field is shown to be negative and directly proportional to negative B/sub z in the solar wind as observed by IMP-8. V/sub x in the distant plasma sheet is also found to be proportional to IMF B/sub z with southward IMF producing the highest anti-solar flow velocities. A global dayside reconnection efficiency of 20 +- 5% is derived from the ISEE-3/IMP-8 magnetic field comparisons. Substorm activity, as measured by the AL index, produces enhanced negative B/sub z and tailward V/sub x in the distant plasma sheet in agreement with the basic predictions of the reconnection-based models of substorms. The rate of magnetic flux transfer out of the tail as a function of AL is found to be consistent with previous near-Earth studies. Similarly, the mass and energy fluxes carried by plasma sheet flow down the tail are consistent with theoretical mass and energy budgets for an open magnetosphere. In summary, the ISEE-3 Geotail observations appear to provide good support for reconnection models of solar wind-magnetosphere coupling and substorm energy rates

Stochastic theory of spin-transfer oscillator linewidths

We present a stochastic theory of linewidths for magnetization oscillations in spin-valve structures driven by spin-polarized currents. Starting from a nonlinear oscillator model derived from spin-wave theory, we derive Langevin equations for amplitude and phase fluctuations due to the presence of thermal noise. We find that the spectral linewidths are inversely proportional to the spin-wave intensities with a lower bound that is determined purely by modulations in the oscillation frequencies. Reasonable quantitative agreement with recent experimental results from spin-valve nanopillars is demonstrated.Comment: Submitted to Physical Review

The Distance and Morphology of V723 Cassiopeiae (NOVA CASSIOPEIA 1995)

We present spatially resolved infrared spectra of V723 Cas (Nova Cassiopeia 1995) obtained over four years with the integral field spectrograph OSIRIS on Keck II. Also presented are one epoch of spatially unresolved spectra from the long slit spectrograph NIRSPEC on Keck II. The OSIRIS observations made use of the laser guide star adaptive optics facility that produced diffraction-limited spatial resolution of the strong coronal emission features in the nova ejecta. We remove the point-like continuum from V723 Cas data cubes to reveal details of the extended nebula and find that emission due to [Si VI] and [Ca VIII] has an equatorial ring structure with polar nodules-a strikingly different morphology than emission due to [Al IX], which appears as a prolate spheroid. The contrast in structure may indicate separate ejection events. Using the angular expansion and Doppler velocities observed over four epochs spaced at one year intervals, we determine the distance to V723 Cas to be 3.85+0.23-0.21 kpc. We present the OSIRIS three-dimensional data here in many ways: as narrowband images, one- and two-dimensional spectra, and a volume rendering that reveals the true shape of the ejecta.Comment: 37 pages, 8 figure

Venus-Solar Wind Interaction: Asymmetries and the Escape of O+ Ions

We study the interaction between Venus and the solar wind using a global three-dimensional self-consistent quasi-neutral hybrid (QNH) model. The model treats ions (H+, O+) as particles and electrons as a massless charge neutralising fluid. In the analysed Parker spiral interplanetary magnetic field (IMF) case (IMF = [8.09, 5.88, 0] nT) a notable north-south asymmetry of the magnetic field and plasma exists, especially in the properties of escaping planetary O+ ions. The asymmetry is associated with ion finite gyroradius effects. Furthermore, the IMF x-component results in a dawn-dusk asymmetry. Overall, the QNH model is found to reproduce the main observed plasma and magnetic field regions (the bow shock, the magnetosheath, the magnetic barrier and the magnetotail), implying the potential of the developed model to study the Venusian plasma environment and especially the non-thermal ion escape.Comment: 10 pages, 22 figures, accepted for Planetary and Space Scienc

RS Ophiuchi: Thermonuclear Explosion or Disc Instability?

Sokoloski et al (2008) have recently reported evidence that the recurrent nova RS Ophiuchi produced a pair of highly collimated radio jets within days of its 2006 outburst. This suggests that an accretion disc must be present during the outburst. However in the standard picture of recurrent novae as thermonuclear events, any such disc must be expelled from the white dwarf vicinity, as the nuclear energy yield greatly exceeds its binding energy. We suggest instead that the outbursts of RS Oph are thermal--viscous instabilities in a disc irradiated by the central accreting white dwarf. The distinctive feature of RS Oph is the very large size of its accretion disc. Given this, it fits naturally into a consistent picture of systems with unstable accretion discs. This picture explains the presence and speed of the jets, the brightness and duration of the outburst, and its rise time and linear decay, as well as the faintness of the quiescence. By contrast, the hitherto standard picture of recurrent thermonuclear explosions has a number of severe difficulties. These include the presence of jets, the faintness of quiescence, and the fact the the accretion disc must be unstable unless it is far smaller than any reasonable estimate.Comment: MNRAS, in pres

Two-component model of the interaction of an interstellar cloud with surrounding hot plasma

We present a two-component gasdynamic model of an interstellar cloud embedded in a hot plasma. It is assumed that the cloud consists of atomic hydrogen gas, interstellar plasma is quasineutral. Hydrogen atoms and plasma protons interact through a charge exchange process. Magnetic felds and radiative processes are ignored in the model. The influence of heat conduction within plasma on the interaction between a cloud and plasma is studied. We consider the extreme case and assume that hot plasma electrons instantly heat the plasma in the interaction region and that plasma flow can be described as isothermal. Using the two-component model of the interaction of cold neutral cloud and hot plasma, we estimate the lifetime of interstellar clouds. We focus on the clouds typical for the cluster of local interstellar clouds embedded in the hot Local Bubble and give an estimate of the lifetime of the Local interstellar cloud where the Sun currently travels. The charge transfer between highly charged plasma ions and neutral atoms generates X-ray emission. We assume typical abundance of heavy ions for the Local Bubble plasma and estimate the X-ray emissivity due to charge exchange from the interface between cold neutral cloud and hot plasma. Our results show that charge exchange X-ray emission from the neutral-plasma interfaces can be a non-negligible fraction of the observed X-ray emission.Comment: 9 pages, 7 figure

Success for All in England: Results From the Third Year of a National Evaluation

This article reports the third-year findings of a longitudinal evaluation in England of Success for All (SFA), a comprehensive literacy program. Eighteen SFA schools across England and 18 control schools, matched on prior achievement and demographics, were included in this quasi-experimental study. The results of hierarchical linear modeling analysis reveal a statistically significant positive school-level effect for SFA schools compared with control schools on standardized reading measures of word-level and decoding skills, and there were directionally positive but nonsignificant school-level effects on measures of comprehension and fluency. Practical and policy implications of these findings are discussed, particularly as they relate to recent English government policies encouraging schools to implement research-proven approaches

Learning and interaction in groups with computers: when do ability and gender matter?

In the research reported in this paper, we attempt to identify the background and process factors influencing the effectiveness of groupwork with computers in terms of mathematics learning. The research used a multi-site case study design in six schools and involved eight groups of six mixed-sex, mixed-ability pupils (aged 9-12) undertaking three research tasks – two using Logo and one a database. Our findings suggest that, contrary to other recent research, the pupil characteristics of gender and ability have no direct influence on progress in group tasks with computers. However, status effects – pupils' perceptions of gender and ability – do have an effect on the functioning of the group, which in turn can impede progress for all pupils concerned