Radiosurgery from the brain to the spine: 20 years experience.

INTRODUCTION: Radiosurgery evolved from brain to spine. Mechanical and computer advances in linear accelerator (LINAC) radiosurgery apply precise single/fractional stereotactic radiation to multiple pathologies. METHODS: During a 10-year span the senior author used proton-beam radiosurgery in over 300 lesions, followed by gamma-knife, adapted and dedicated LINACS, including cyber-knife, in another 700 patients. The last 10 years, experience was accumulated with the Novalis in over 3,000 patients. Novalis uses a beam-shaper in a high-speed delivery LINAC. It operates using conventional circular arc, conformal static beam, dynamic conformal or intensity modulated modes. Patients treated with Novalis at the UCLA since 1997 were evaluated regarding effectiveness, complications and failure. These results were compared with previous 1997 data. RESULTS: Over 4,000 patients with trigeminal neuralgia/intractable pain, arteriovenous malformations/angiomas, metastases, ependymomas, gliomas, meningiomas hemangiopericytomas, schwannomas, adenomas, hemangioblastomas, and chordoma were treated. Spinal lesions were treated with frameless stereotaxis and on-line precision checks. Treatment was expeditious, comfortable and with reduced complications. Success is similar or superior to published data. Reduced treatment time of complex lesions and highly homogeneous dose compares favorably to other radiosurgery. CONCLUSIONS: The senior author's experience validates the novel shaped-beam approach. Long-term follow-up supports safety and effectiveness and capability to treat brain and spine.

The influence of food restriction during different periods of pregnancy.

Considering that the energy balance can be affected by factors such as pregnancy and food restriction and that the development of foetuses is different during different periods of pregnancy, the aim of this paper was to study the effects on the maternal and offspring energy balance of food restriction imposed at different periods of pregnancy. Pregnant and non-pregnant rats were subjected to four food intake treatments. Control groups received food ad libitum during the 20 days of the experiment. The other three groups were food restricted by receiving 50% of the control group food intake during the first half, the second half, or the whole experimental period. Food restriction imposed during the first half of the experimental period permitted a recuperation of energy intake, but compared to the control group, the rats gained less energy in the body. The offspring parameters studied were not affected by food restriction during the first half of the experimental period. Food restriction during the second half was more deleterious to the dams and to the offspring, which were born with less energy and weight. When food restriction was applied during the whole experimental period, the impairment in energy balance of offspring was similar to the one observed when food restriction occurred during the second half of pregnancy added to a decreased number of offspring. The dams, however, were more deeply affected than when food restriction was applied during the first half of the experimental period.