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At least 433 records · Page 24Linked to original sources
PubMed1991

Multimodal therapy for the management of localized Ewing's sarcoma of pelvic and sacral bones: a report from the second intergroup study.

A total of 59 eligible patients with localized Ewing's sarcoma of the pelvic and sacral bones were entered into a multimodal Intergroup Ewing's Sarcoma Study (IESS-II) (1978 to 1982) and compared with a historical control series of 68 patients entered into an earlier multimodal Intergroup Ewing's Sarcoma Study (IESS-I) (1973 to 1978). High-dose intermittent multiagent chemotherapy (vincristine, cyclophosphamide, Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH], and dactinomycin) was given to all patients for 6 weeks before and for 70 weeks following local therapy. All patients who had a tumor biopsy or incomplete resection performed received a dose of 55 Gy to the tumor bed. With a median follow-up time of 5.5 years, two of 59 patients (3%) had a local recurrence, five patients (8%) had a local recurrence and metastases, and 17 patients (29%) developed metastases only. There was significant statistical evidence of an advantage in relapse-free survival (RFS) and survival (S) for patients on IESS-II versus IESS-I, P = .006 and P = .002, respectively. At 5 years, the comparison between IESS-II versus IESS-I was 55% versus 23% for RFS and 63% versus 35% for S.

Adolescent↗
PubMed2002

Learning the thyroid examination--a multimodality intervention for internal medicine residents.

BACKGROUND: Many physicians have inadequate physical diagnosis skills and cannot detect thyroid abnormalities on physical examination. PURPOSE: To evaluate a multimodality intervention to improve thyroid examination skills using a prospective controlled trial in first-year residents enrolled in an academic internal medicine program. METHODS: The intervention group received a 60-minute educational session during which an endocrinologist described anatomical landmarks, thyroid abnormalities, and examination techniques using a slide show, computerized animation, videotape, and live demonstration on a volunteer with goiter. Residents examined a normal and a goitrous thyroid under the observation of a preceptor and received an evidence-based handout on the thyroid examination. The control group received no specific intervention. Examination technique and identification of thyroid abnormalities were blindly assessed in 2 stations of an objective structured clinical examination (OSCE). RESULTS: Of the 19 residents in the intervention group and the 20 in the control group, 6 (32%) and 3 (15%), respectively, observed the neck for thyroid abnormalities (P = 0.3), 17 (90%) and 16 (80%) used proper hand position (P = 0.7), and 13 (68%) and 15 (75%) had the patient swallow while the neck was palpated (P = 0.7). There was a significant difference in the mean scores based on thyroid physical findings during the OSCE between the intervention and control groups (100 vs. 52.5 [maximal possible score = 200], P = 0.047). CONCLUSION: A 1-hour multimodality learning session furthered the ability of first-year internal medicine residents to detect thyroid abnormalities.

Clinical Competence↗
PubMed1998

Multimodality visual evoked potentials in evaluating visual dysfunction in optic neuritis.

Visual information is processed via multiple, parallel channels. The present study examined the clinical feasibility of multimodality visual evoked potentials (VEPs) in optic neuritis. We recorded transient VEPs to 30' checkerboard patterns, chromatic and achromatic sinusoidal gratings and apparent motion, and steady-state VEPs to achromatic gratings in 15 normal controls and 14 patients. VEPs to 30' checks were abnormal in 10 eyes (7 patients); however, considering all five modalities, abnormal responses were seen in 20 eyes (12 patients). Abnormality rates were not equal among the visual stimuli, which thus suggested possible dysfunction of individual subdivisions in the visual pathways. We conclude that use of multimodality VEPs may increase both understanding of the pathophysiology of the visual pathways and diagnostic yield.

Adult↗
PubMed2005

Multimodal analgesia with gabapentin and local anesthetics prevents acute and chronic pain after breast surgery for cancer.

We evaluated the effect of multimodal analgesia on acute and chronic pain after breast surgery for cancer. Fifty patients scheduled for breast cancer surgery were blindly randomized to receive gabapentin, eutectic mixture of local anesthetics cream, and ropivacaine in the wound or three placebos. Pain (visual analog scale) and analgesics were recorded in the postanesthesia care unit (PACU) 3, 6, and 9 h and 8 days after surgery. Three and 6 mo later, patients were assessed for chronic pain. The treatment group consumed less paracetamol in the PACU (469 versus 991 mg; P < 0.002) and less Lonalgal (1.0 versus 4.4 tablets; P = 0.003) than the controls, exhibited lower visual analog scale scores at rest in the PACU (P = 0.001) and on postoperative Days 1, 3, and 5 (P = 0.040, P = 0.015, and P = 0.045, respectively), and after movement in the PACU (P = 0.001) and on postoperative Days 2, 4, and 8 (P = 0.028, P = 0.007, and P = 0.032, respectively). Three and 6 mo after surgery, 18 of 22 (82%) and 12 of 21 (57%) of the controls reported chronic pain versus 10 of 22 (45%) and 6 of 20 (30%) in the treatment group (P = 0.028 and P = 0.424, respectively); 5 of 22 and 4 of 21 of the controls required analgesics versus 0 of 22 and 0 of 20 of those treated (P = 0.048 and P = 0.107, respectively). Multimodal analgesia reduced acute and chronic pain after breast surgery for cancer.

Acute Disease↗
PubMed1995

Multimodality treatment of deep arteriovenous malformations: thalamus, basal ganglia, and brain stem.

THE THERAPEUTIC APPROACH toward arteriovenous malformations (AVMs) located in the basal ganglia, thalamus, and brain stem has evolved from microsurgical resection as the predominant therapy to a combination of microsurgery, embolization, and radiosurgery. This multimodality treatment was used in the management of 32 patients with deep AVMs of all sizes. Twenty-two patients with surgically accessible AVMs (i.e., typically located in the brain stem and thalamus) underwent microsurgical resection. The AVMs of half of these patients were devascularized preoperatively with transfemoral embolization. Five patients with residual AVMs were then treated with radiosurgery. Ten patients had AVMs, typically located in the basal ganglia, that were surgically inaccessible. These patients underwent embolization to reduce the AVM size, and the postembolization nidus was then treated with radiosurgery. For patients treated early in the series with a predominantly surgical approach, the complete resection rate was 43%. For patients treated later in the series after radiosurgery was incorporated into the management scheme, the complete elimination rate was 72%. Overall, there were no deaths in this series, and the permanent treatment-associated morbidity rate was 9%. These results indicate that an individualized, multimodality approach can be used to eliminate both large and small deep AVMs with an acceptably low morbidity and mortality rate.

Adolescent↗
PubMed1992

Comprehensive oral X-ray diagnosis: Scanora multimodal radiography. A preliminary description.

Scanora (Soredex, Orion Corporation, Helsinki, Finland) is a multimodal radiography system which utilizes the principles of narrow beam radiography and spiral tomography. The system includes an integrated multifunction X-ray unit, a coordinate system for object localization and a wide selection of dental and maxillofacial imaging problems. All imaging procedures are computer controlled and executed automatically. Clinical experience and preliminary results show that the multimodal imaging system has great potential in the detection of pathological conditions of the maxillofacial region.

Humans↗
PubMed2002

Effect of a random pattern through a multimode-fiber bundle on angular and spatial selectivity in volume holograms: experiments and theory.

We demonstrate a multimode-fiber bundle reference scheme in a photorefractive volume hologram and discuss its angular/spatial selectivity both experimentally and theoretically. We measure the angular/spatial selectivity, changing distances between the photorefractive crystal and the output facet of the multimode-fiber bundle. The distance variation leads to a beam-size change in the reference beam, however, the object-beam size was fixed in all cases. The dependence of the angular/spatial selectivity for random-pattern (RP) referencing on a hologram dimension was examined and the characteristics compared with those derived from Gaussian referencing. Experimental results show that the RP referencing makes little contribution to the enhancement in angular selectivity, even though it leads to a considerable enhancement in spatial selectivity. The angular selectivity is mainly dependent on the dimension of a volume hologram, even with RP referencing. It is also noteworthy that the use of an RP beam can cause some high-frequency noise in the angular-multiplexing regime, which should be avoided in a hologram memory system. Nonetheless, the spatial selectivity of the RP referencing shows nearly no dependence on hologram dimension, and is mainly dependent on the transversal speckle size of the random-pattern beam. These characteristics can also be verified by the numerical results presented here, which are in good agreement with the experimental results.

Journal Article↗
PubMed2004

Simulation of cross-talk reduction in multimode waveguide-based micro-optical switching systems by use of single-mode filters.

We propose a method to reduce cross talk by using single-mode filters, namely, extracting the fundamental mode from a multimode optical network (EFMON). The EFMON effect is evaluated for a three-step switching system consisting of cascade electro-optic (EO) waveguide prism deflector (WPD) micro-optical switches (MOSs) and a multimode waveguide network. The WPD MOS is optimized for single-mode operation in lead lanthanum zirconate titanate thin films as EO slab waveguides with a driving voltage of 12 V, a length of 310 microm, and a channel distance of 20 microm. Beam propagation method simulation reveals that mode disturbance, higher-order modes, and cross talk are accumulated by switching steps. A single-mode filter for EFMON in the output region of the switching system reduces cross talk to below -20 dB at a propagation length of 2000 microm in the single-mode filter and below -30 dB at 20000 microm.

Journal Article↗
PubMed2004

In-line optical fiber sensors based on cladded multimode tapered fibers.

The use of uniform-waist cladded multimode tapered optical fibers is demonstrated for evanescent wave spectroscopy and sensors. The tapering is a simple, low-loss process and consists of stretching the fiber while it is being heated with an oscillating flame torch. As examples, a refractive-index sensor and a hydrogen sensor are demonstrated by use of a conventional graded-index multimode optical fiber. Also, absorbance spectra are measured while the tapers are immersed in an absorbing liquid. It is found experimentally that the uniform waist is the part of the taper that contributes most to the sensor sensitivity. The taper waist diameter may also be used to adjust the sensor dynamic range.

Journal Article↗
PubMed2004

Slotted multimode-interference devices.

We describe a novel modification of multimode-interference devices that has broad applicability. The modification involves introducing a slot (or slots), of a specific width and effective refractive index and at a specific position, that runs the longitudinal length of the multimode-interference region. Introducing N slots reduces the self-image length by a factor of N + 1. Varying the effective refractive index or width of the slot(s) creates a switch. The slot modification can be accomplished in a variety of ways, actually increases bandwidth, and has good error tolerances.

Journal Article↗
PubMed2006

Electro-optic multimode interference device using organic materials.

We present experimental results verifying the optical robustness of a 1 x 1 multimode interference (MMI) device that is directly butt coupled with optical fibers at 70 degrees C for 1050 h and discuss the gradual increase of polarization dependent loss. Based on this structure, an electro-optic (EO) MMI waveguide device that can control the output optical power by using an electrode structure located directly on top of the multimode is presented. As a proof of principle, we demonstrate the switching operation of the EO-MMI device using commercially available chromophore as the active EO material.

Journal Article↗
PubMed2005

Intermode light diffusion in multimode optical waveguides with rough surfaces.

A theoretical analysis of incoherent intermode light power diffusion in multimode dielectric waveguides with rough (corrugated) surfaces is presented. The correlation length a of the surface-profile variations is assumed to be sufficiently large (a less less than lambda/2pi) to permit light scattering into the outer space only from the modes close to the critical angles of propagation and yet sufficiently small (a less less than d, where d is the average width of the waveguide) to permit direct interaction between a given mode and a large number of neighboring ones. The cases of a one-dimensional (1D) slab waveguide and a two-dimensional cylindrical waveguide (optical fiber) are analyzed, and we find that in both cases the partial differential equations that govern the evolution of the angular light power profile propagating along the waveguide are 1D and of the diffusion type. However, whereas in the former case the effective conductivity coefficient proves to be linearly dependent on the transverse-mode wave number, in the latter one the linear dependence is for the effective diffusion coefficient. The theoretical predictions are in reasonable agreement with experimental results for the intermode power diffusion in multimode (700 x 700) optical fibers with etched surfaces. The characteristic length of dispersion of a narrow angular power profile evaluated from the correlation length and standard deviation of heights of the surface profile proved to be in good agreement with the experimentally observed changes in the output angular power profiles.

Journal Article↗
PubMed2003

Optical limiting properties of nonlinear multimode waveguides.

An experimental investigation of the transmission of multimode capillary waveguides with a nonlinear absorber in the core shows an enhanced nonlinear absorption relative to the same length of bulk material. The results are consistent with partial mode filling within the cores of the waveguides. This study confirms the promising optical limiting capabilities of multimode nonlinear waveguides and implies that the mode structure should be considered in the design and evaluation of capillary array optical limiters.

Journal Article↗
PubMed2004

Subwavelength focusing and imaging by a multimode optical waveguide.

A simple subwavelength focusing system formed by a straight or bent multimode waveguide is investigated numerically. The simulation results indicate that an appropriately designed multimode waveguide can focus the outgoing waves of a point source and form an image with a full width at half-maximum of less than half a wavelength in the near-field area at the other side of the waveguide. The physical mechanism of the subwavelength focusing for this imaging system is explained.

Journal Article↗
PubMed2005

Principal modes in multimode waveguides.

We generalize the concept of principal states of polarization and prove the existence of principal modes in multimode waveguides. Principal modes do not suffer from modal dispersion to first order of frequency variation and form orthogonal bases at both the input and the output ends of the waveguide. We show that principal modes are generally different from eigenmodes, even in uniform waveguides, unlike the special case of a single-mode fiber with uniform birefringence. The difference is most pronounced when different eigenmodes possess similar group velocities and when their field patterns vary as a function of frequency. This work may provide a new basis for analysis and control of dispersion in multimode fiber systems.

Journal Article↗
PubMed2005

High-energy and high-peak-power nanosecond pulse generation with beam quality control in 200-microm core highly multimode Yb-doped fiber amplifiers.

We explored high-energy and high-peak-power pulse generation in large-core multimode fiber amplifiers, achieving what is to our knowledge the highest reported energies, up to 82 mJ for 500-ns pulses, 27 mJ for 50-ns pulses, and 2.4-MW peak power for 4-ns pulses at 1064 nm, using 200-microm-diameter and 0.062-N.A. core Yb-doped double-clad fiber amplifiers. The highly multimode nature of the fiber core was mitigated by use of a coiling-induced mode-filtering effect to yield a significant improvement in output-beam quality from M2 = 25 from an uncoiled fiber to M2 = 6.5 from a properly coiled fiber, with the corresponding reduction in number of propagating transverse modes from > or = 200 to < or = 20.

Journal Article↗
PubMed2005

Single polarization, single transverse mode, and widely tunable narrow-linewidth laser from a multimode vertical cavity surface-emitting laser by use of a coupled cavity.

A simple method for achieving a widely tunable narrow-linewidth, single polarization state and single transverse mode lasing oscillation from a commercially available multimode vertical cavity surface-emitting laser by use of a coupled cavity is reported. The laser has a wavelength tuning range of more than 5 nm along 850 nm, a side-mode suppression ratio of approximately 15 dB, and an output power of approximately 0.3 mW from a 50-microm multimode optical fiber at a bias current of 15 mA. The laser was operated in a single state of polarization lasing oscillation without any polarization switching.

Journal Article↗
PubMed2005

Cross-point analysis for a multimode fiber sensor based on surface plasmon resonance.

A novel analysis based on surface plasmon resonance (SPR) with a side-polished multimode fiber and a white-light (halogen light) source is presented. The sensing system is a multimode optical fiber in which half of the core has been polished away and a 40 nm gold layer is deposited on to the polished surface by dc sputter. The SPR dip in the optical spectrum is investigated with an optical spectrum analyzer (OSA). In our SPR fiber sensor, the use of liquids with different refractive indices leads to a shift in the spectral dip in the SPR curve. The cross point (CP) of the two SPR spectra obtained from the refractive-index liquid and the deionized water measurements was observed with the OSA. The CP is shifted sensitively in wavelength from 630 to 1300 nm relative to a change in the refractive index of the liquid from 1.34 to 1.46. High sensitivities of 1.9 x 10(-6) refractive-index units (RIUs) in the range of the refractive index of the liquid from 1.40 to 1.44 of 5.7 x 10(-7) RIUs above the value of 1.44 are proposed and demonstrated in our novel SPR analysis.

Journal Article↗