We employ a Genetic Algorithm for the dispersion optimization of a range of holey fibers (HF) with a small number of air holes but good confinement loss. We demonstrate that a dispersion of 0 +/- 0.1 ps/nm/km in the wavelength range between 1.5 and 1.6 microm is achievable for HFs with a range of different transversal structures, and discuss some of the trade-offs in terms of dispersion slope, nonlinearity and confinement loss. We then analyze the sensitivity of the total dispersion to small variations from the optimal value of specific structural parameters, and estimate the fabrication accuracy required for the reliable fabrication of such fibers.
Background: Radiotherapy is the primary treatment for nasopharyngeal carcinoma, and temporal lobe necrosis is observed in about 7% of patients after radiotherapy.Although some studies reported that these patients demonstrated cognitive impairment after radiotherapy, it is still unclear if the cognitive deficits are related to the radiation exposure or the radiation-induced necrosis.Objective: To compare the cognitive function of patients with and without temporal lobe necrosis after radiotherapy for nasopharyngeal carcinoma.Methods: A comprehensive neuropsychological battery was administered to 53 patients with nasopharyngeal carcinoma who had completed their radiotherapy at least 1 year previously.As evidenced by magnetic resonance imaging, 31 patients developed necrosis after treatment.Thirty-one age-and education-matched individuals were recruited as normal control subjects.Results: Whereas the performance of patients without temporal lobe necrosis was similar to that of normal (
We demonstrate mode division multiplexed WDM transmission using the LP01 and LP11 modes of a few mode fiber. The signal is recovered using a 6×6 MIMO equalizer at the receiver after amplification by a few mode EDFA.
Members Present Members Absent Don Brandt, Chair Saunders Smith Hugh McMillan, Planning Subcmte Chair Larry Stoff Darin Nutter, Operations Subcmte Chair Dick Hayter, Professional Practices Subcmte Chair Guests Present Jim Bochat Michael Collarin Cindy Cogil Dan Pettway Kelley Cramm Dusty Stoabs Eduardo Donoso Branko Todorovic Nathan Hart Vincent Tse Cameron Labunski Dennis Wessel Bill Simpson Eckhard Groll, ExO Staff Present Tim Wentz, CO Karen Murray, Staff Liaison to PDC Steve Comstock, Staff Liaison to PEC
This is a preliminary report of 102 patients with clinical diagnosis of late temporal lobe necrosis after radical radiation therapy for nasopharyngeal carcinoma during 1964 to 1983. Histologic verification was available in 12 cases. All but three patients had been treated in our institute using schedules with doses larger than the conventional 200 cGy per fraction. The incidence rate was 1.03%. In our 80 patients with only one course of external irradiation, the doses to the temporal lobes ranged from 1665 to 2127 ret, or 1286 to 1778 brain tolerance unit (btu). The latent interval ranged from 9 months to 16 years. The median observation period is 33 months. The symptomatology, working diagnosis, treatment, and outcome are described. Surgery was hazardous because of the bilaterality of the involvement and exploration for mere verification of diagnosis was unjustified in typical cases. Treatment with corticosteroid achieved durable objective response in 25 (35%) of 72 patients. The importance of early detection and corticosteroid treatment is discussed.
The aim of this study was to develop and evaluate an information system for monitoring impact of acute hospital care on health status of elderly patients, burden on carers, and consumer satisfaction with care. The study was undertaken on four acute care wards of an elderly care unit of a teaching hospital. We used a consensus-building process to achieve within-and-between-team convergence of policy and practice in the use of structured assessments on three wards, with parallel data collection by a research nurse on one ward. We describe the changes to our working practices, the costs of data collection, staff attitudes to the system and the assessment instruments, using 5-point Likert Scales, with additional in-depth interviews with senior staff for their attitudes to the system. We found that only nursing staff were able to change their practice. On admission, it was feasible to undertake functional assessment of activities of daily living (ADL), depression, perceived life quality and carer strain. Discharge assessment was only feasible for ADL. Other discharge assessments and follow-up assessments including consumer satisfaction interviews required audit assistant support. The total annual cost per ward was 6,225 pounds for the adopted system, or 6,455 pounds to incorporate follow-up assessments by audit assistant in a random sample of 50 patients. Staff attitudes to the system were positive, especially for use of the Relatives' Stress Scale, and for the value of follow-up interviews. We conclude that the participatory approach to the introduction of the information system produced a system which was perceived to be beneficial for patient care.(ABSTRACT TRUNCATED AT 250 WORDS)
The effects of cranial irradiation on hypothalamic-pituitary function were studied over a 5-year period in 31 adult patients with nasopharyngeal carcinoma. The estimated radiotherapy doses to the hypothalamus and pituitary were 3979±78 (± SD) and 6167±122 cGy, respectively. Within 2 years of radiotherapy, significant impairment in the secretion of growth hormone, gonadotrophins, corticotrophin and thyrotrophin were evident and 14 per cent of patients developed hyperprolactinaemia. Using life table analysis, the cumulative probability of endocrine dysfunction was estimated to be 62 per cent after 5 years with deficiencies in growth hormone, gonadotrophins, corticotrophin and thyrotrophin found in 63.5, 30.7, 26.7 and 14.9 per cent of patients, respectively. Growth hormone deficiency was the earliest endocrine dysfunction observed. Hyperprolactinaemia was uncommon in the male patients but occurred in five of eight women within 3 years of cranial irradiation. The alterations in gonadotrophin secretion suggest a defect in the pulsatile release of gonadotrophin releasing hormone. Twentyeight patients developed a hypothalamic pattern of delayed thyrotrophin response to thyrotrophin releasing hormone one year after radiotherapy—four subsequently became hypothyroid. Patients who received radiotherapy for cervical lymph nodes were at greater risk of developing hypothyroidism. Thus, in these patients with no pre-existing disease in the hypothalamic-pituitary region, progressive impairment in hypothalamic pituitary function leading to endocrine dysfunction requiring treatment occurs in 50 per cent of patients 5 years after cranial irradiation. Regular endocrine assessment should be performed in all patients following cranial irradiation.
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