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Stephen J. Monteith, Robert M. Starke, John A. Jane Jr. and Edward H. Oldfield

T ranssphenoidal adenomectomy is the mainstay of management of Cushing disease. The reported rates of remission after pituitary surgery for Cushing disease vary widely from center to center. Previous studies have evaluated the relationship between lowest postoperative serum cortisol levels 8 , 20 and the rapidity of immediate postoperative cortisol decline with surgical success. 18 , 19 We examine the impact of surgical technique on the rate of decline of postoperative cortisol and assess the basis of the unexplained delay in the hypocortisolism that

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Robert M. Starke, Brian J. Williams, John A. Jane Jr. and Jason P. Sheehan

N onfunctioning pituitary macroadenomas are tumors that do not cause endocrine alterations due to secretion of active hormones. These tumors most commonly come to the attention of medical staff secondary to mass effect on the optic apparatus or normal pituitary gland and stalk. Resection is the primary treatment modality for these tumors because it provides decompression as well as the possibility for a cure. Complete resection rates vary significantly in the literature; repeat surgery is often more complicated and associated with increased risk. In the

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Robert M. Starke, Brian J. Williams, Claire Hiles, James H. Nguyen, Mohamed Y. Elsharkawy and Jason P. Sheehan

volumetric calculations were performed using ImageJ (NIH) in all patient imaging studies. 60 Treatment was considered to have failed in any patient who had tumor progression of more than 15% even if the condition stabilized with further GKS or surgery. Statistical Analysis Data are presented as median or mean values and ranges for continuous variables and as frequency and percentage values for categorical variables. Statistical analyses of categorical variables were carried out using the chi-square test, the Fisher exact test, and the Mantel-Haenszel test for linear

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Chun-Po Yen, Dale Ding, Ching-Hsiao Cheng, Robert M. Starke, Mark Shaffrey and Jason Sheehan

treated remains controversial. Given its minimal invasiveness and generally favorable benefit-to-risk profile, Gamma Knife surgery (GKS) has emerged as a popular treatment tool for AVMs without immediate risk of hemorrhage. The aim of the current study is to evaluate the obliteration rate of incidental AVMs following GKS, the risk of hemorrhage after GKS, and the morbidity and mortality associated with this treatment modality. Methods Patient Population Between May 1989 and September 2009, a total of 1400 patients with AVMs were treated with GKS at the

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Lucia Schwyzer, Robert M. Starke, John A. Jane Jr. and Edward H. Oldfield

-secreting tumors produce levels of GH that can be easily measured in the peripheral blood, the correlation between tumor size and plasma GH levels varies widely from patient to patient. Furthermore, although there is a relationship between GH and IGF-1, it is nonlinear because of saturation of GH receptors when GH exceeds certain threshold levels, thresholds that also seem to vary widely from patient to patient. 3 To investigate this further, we examined various relationships between tumor size, plasma GH levels, and plasma IGF-1 before and after transsphenoidal surgery in

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Robert M. Starke, John A. Jane Jr., Ashok R. Asthagiri and John A. Jane Sr.

want residents involved in any aspect of their surgery, and the majority wanted them to partake in only minor procedures. 5 This, in spite of recent studies showing that resident participation was not associated with measured complications or worse outcomes. 3 , 4 , 11 , 12 , 20–22 , 24 , 26 , 27 But the greatest obstacle has been the initiation in 2003 of the common duty hour standards. 9 , 13 , 17 Program directors and chief residents feel strongly that these restrictions have compromised surgical training. 10 Moreover, the expected increase in educational

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Erin N. Kiehna, Robert M. Starke, Nader Pouratian and Aaron S. Dumont

A lthough RCTs are considered the gold standard of clinical research, improper design, execution, and reporting can seriously mitigate the impact of a potentially groundbreaking trial. To address these shortcomings and to standardize the reporting of Phase III clinical trials, the CONSORT criteria were published in 1996 10 and then revised in 2001. 33 Since their introduction, the quality of published RCTs has improved significantly in journals endorsing the CONSORT criteria. 22 , 32 For example, analyses of the cardiothoracic and general surgery

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Robert M. Starke, Ricardo J. Komotar and E. Sander Connolly

have addressed the benefit of surgical revascularization, the dismal prognosis of moyamoya disease 2–4 , 7 , 8 , 21 , 23 , 31 , 33 , 41–43 and a large number of case series demonstrating an improved outcome in surgically treated patients have provided evidence in support of revascularization procedures in a select group of patients. 4 , 7–11 , 16 , 17 , 25 , 29 , 30 , 32 , 34 , 40 , 43 Currently, the Ministry of Health and Welfare of Japan reports that bypass surgery is indicated when there are 1) repeated clinical symptoms due to apparent cerebral ischemia and (2

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Robert M. Starke, Chun-Po Yen, Dale Ding and Jason P. Sheehan

cerebral arteriovenous malformation . Stroke 29 : 931 – 934 , 1998 12 Hartmann A , Stapf C , Hofmeister C , Mohr JP , Sciacca RR , Stein BM , : Determinants of neurological outcome after surgery for brain arteriovenous malformation . Stroke 31 : 2361 – 2364 , 2000 13 Inoue HK , Ohye C : Hemorrhage risks and obliteration rates of arteriovenous malformations after gamma knife radiosurgery . J Neurosurg 97 : 5 Suppl 474 – 476 , 2002 14 Karlsson B , Lindquist C , Steiner L : Prediction of obliteration after gamma knife

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Robert M. Starke, Justin M. Cappuzzo, Nicholas J. Erickson and Jonathan H. Sherman

the literature . Neurochirurgie 61 : 201 – 207 , 2015 10.1016/j.neuchi.2013.08.010 6 Bodensteiner JB , Schaefer GB , Keller GM , McConnell JR : Incidental pineal cysts in a prospectively ascertained normal cohort . Clin Pediatr (Phila) 35 : 277 – 279 , 1996 10.1177/000992289603500510 7 Bruce JN , Pineal tumors . Winn HR : Youmans Neurological Surgery ed 6 Philadelphia , Saunders Elsevier , 2011 . 1359 – 1372 10.1016/B978-1-4160-5316-3.00128-3 8 Choy W , Kim W , Spasic M , Voth B , Yew A , Yang I : Pineal cyst: a