The effects of motion on the dose distribution of proton radiotherapy for prostate cancer.

Proton radiotherapy of the prostate basal or whole seminal vesicles using scattering delivery systems is an effective treatment of prostate cancer that has been evaluated in prospective trials. Meanwhile, the use of pencil beam scanning (PBS) can further reduce the dose in the beam entrance channels and reduce the dose to the normal tissues. However, PBS dose distributions can be affected by intra- and interfractional motion.

Potentials of robust intensity modulated scanning proton plans for locally advanced lung cancer in comparison to intensity modulated photon plans.

Background And Purpose: The potentials of lung sparing, dose escalation, and the robustness of intensity modulated proton plans (IMPT(robust)), obtained by minimax optimization on multiple scenarios, were studied.

Materials And Methods: IMPT(robust) optimization as described by Fredriksson et al. [23] was evaluated by means of comparative treatment planning using breath hold CT data from 6 non-small cell lung cancer (NSCLC) patients.

Beam characteristics in two different proton uniform scanning systems: a side-by-side comparison.

Purpose: To compare clinically relevant dosimetric characteristics of proton therapy fields produced by two uniform scanning systems that have a number of similar hardware components but employ different techniques of beam spreading.

Methods: This work compares two technologically distinct systems implementing a method of uniform scanning and layer stacking that has been developed independently at Indiana University (IU) and by Ion Beam Applications, S. A.

Microdosimetric measurements for neutron-absorbed dose determination during proton therapy.

This work presents microdosimetric measurements performed at the Midwest Proton Radiotherapy Institute in Bloomington, Indiana, USA. The measurements were done simulating clinical setups with a water phantom and for a variety of stopping targets. The water phantom was irradiated by a proton spread out Bragg peak (SOBP) and by a proton pencil beam.

Lower physical activity is associated with skeletal muscle fat content in girls.

Unlabelled: Fat contained within skeletal muscle is strongly associated with obesity, type 2 diabetes mellitus, and metabolic syndrome. Physical inactivity may be a risk factor for greater fat infiltration within skeletal muscle during growth.

Purpose: We sought to examine the relationship between physical activity and skeletal muscle fat content of the calf and thigh in girls.

Chondral Defect Repair with Particulated Juvenile Cartilage Allograft.

Objective: This case study of 4 patients followed for at least 2 years was conducted to evaluate a cartilage repair procedure that involves transplanting particulated juvenile allograft cartilage.

Design: A multicenter, prospective, single-arm, 25-subject case study was designed to evaluate clinical outcomes such as IKDC and KOOS scores as well as the extent and quality of repair with MRI. In addition, there is an option for the transplants to be biopsied at various time points after implantation (up to 5 years).

Lateral dose profile characterization in scanning particle therapy.

Purpose: In light-ion beam dose delivery with the scanning technique the spacing between adjacent spots is an important parameter during treatment planning. In order to study the effect of spot spacing on dose conformity and robustness for single field uniform dose configurations, fundamental geometrical properties of placement of Gaussian beamlets are explored. In particular, the dependence of penumbra width and flatness on spot width and spot spacing is investigated.

Lighting up the nuclear pore complex.

It is generally accepted that transport through the nuclear pore complex (NPC) involves an abundance of phenylalanine-glycine rich protein domains (FG-domains) that serve as docking sites for soluble nuclear transport receptors (NTRs) and their cargo complexes. But the precise mechanism of translocation through the NPC allowing for high speed and selectivity is still vividly debated. To ultimately decipher the underlying gating mechanism it is indispensable to shed more light on the molecular arrangement of FG-domains and the distribution of NTR-binding sites within the central channel of the NPC.

Surgical management of articular cartilage defects of the knee.

Articular cartilage defects of the knee present diagnostic and treatment challenges for orthopaedic surgeons. As new data and technologies become available, treatment algorithms are continually being refined. It is important to examine treatment recommendations from the current literature and understand surgical techniques for articular cartilage repair.

Skeletal muscle fat content is inversely associated with bone strength in young girls.

Childhood obesity is an established risk factor for metabolic disease. The influence of obesity on bone development, however, remains controversial and may depend on the pattern of regional fat deposition. Therefore, we examined the associations of regional fat compartments of the calf and thigh with weight-bearing bone parameters in girls.

Outcomes after a single-stage procedure for cell-based cartilage repair: a prospective clinical safety trial with 2-year follow-up.

Background: There are currently several approaches being pursued to treat focal defects of articular cartilage, each having specific advantages or challenges. A single-stage procedure that uses autologous cartilage fragments, Cartilage Autograft Implantation System (CAIS), is being evaluated in patients and may offer a clinically effective option.

Purpose: To establish the safety of CAIS and to test whether CAIS improves quality of life by using standardized outcomes assessment tools.

Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair: International Cartilage Repair Society Recommendations Based on Current Scientific Evidence and Standards of Clinical Care.

Objective: To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products.

Design: A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field.

Clinical cartilage restoration: evolution and overview.

Background: Clinical cartilage restoration is evolving, with established and emerging technologies. Randomized, prospective studies with adequate power comparing the myriad of surgical techniques used to treat chondral injuries are still lacking and it remains a challenge for the surgeon treating patients to make evidence-based decisions.

Questions/purposes: We reviewed the history of the major cartilage repair/restorative procedures, indications for currently available repair/restorative procedures, and postoperative management.

Lower trabecular volumetric BMD at metaphyseal regions of weight-bearing bones is associated with prior fracture in young girls.

Understanding the etiology of skeletal fragility during growth is critical for the development of treatments and prevention strategies aimed at reducing the burden of childhood fractures. Thus we evaluated the relationship between prior fracture and bone parameters in young girls. Data from 465 girls aged 8 to 13 years from the Jump-In: Building Better Bones study were analyzed.

Associations of physical activity duration, frequency, and load with volumetric BMD, geometry, and bone strength in young girls.

Summary: More efficacious physical activity (PA) prescriptions for optimal bone development are needed. This study showed that PA duration, frequency, and load were all independently associated with bone parameters in young girls. Increased PA duration, frequency, and load are all important osteogenic stimuli that should be incorporated into future PA interventions.

Quantifying bone-relevant activity and its relation to bone strength in girls.

Unlabelled: Physical activity (PA) is critical for maximizing bone development during growth. However, there is no consensus on how well existing PA measurement tools predict bone strength.

Purpose: The purposes of this study were to compare four methods of quantifying PA (pedometer, 3-d PA recall (3DPAR), bone-specific PA questionnaire (BPAQ), and past year PA questionnaire (PYPAQ)), in young girls and to evaluate their ability to predict indices of bone strength.

A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee.

Objective: To assess the relative effectiveness of combining self-management and strength training for improving functional outcomes in patients with early knee osteoarthritis.

Methods: We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community-dwelling middle-aged adults (n = 273) ages 35-64 years with knee osteoarthritis, pain, and self-reported physical disability completed a strength training program, a self-management program, or a combined program.

Relationship of total body fat mass to weight-bearing bone volumetric density, geometry, and strength in young girls.

Understanding the influence of total body fat mass (TBFM) on bone during the peri-pubertal years is critical for the development of future interventions aimed at improving bone strength and reducing fracture risk. Thus, we evaluated the relationship of TBFM to volumetric bone mineral density (vBMD), geometry, and strength at metaphyseal and diaphyseal sites of the femur and tibia of young girls. Data from 396 girls aged 8-13 years from the "Jump-In: Building Better Bones" study were analyzed.

Progressive resistance training improves overall physical activity levels in patients with early osteoarthritis of the knee: a randomized controlled trial.

Background: Prescription of resistance training (RT) exercises is an essential aspect of management for knee osteoarthritis (OA). However, whether patients with knee OA who are randomly assigned to receive RT simply substitute RT for other modes of physical activity remains unclear.

Objective: The aim of this study was to determine the effect of a structured RT intervention on overall levels of moderate- and vigorous-intensity physical activity (MVPA) in patients with early-onset knee OA.

Sports after knee arthroplasty: partial versus total knee arthroplasty.

Osteoarthritis becomes more prevalent with increasing age, and currently is occurring more frequently in the "baby boomer" generation (ages 44-66 years). However, many individuals may be reluctant to undergo arthroplasty procedures because potential activity limitations. Thus, physicians must consider each patient's history and desired activity level after treatment.

Responsiveness of the International Knee Documentation Committee Subjective Knee Form in comparison to the Western Ontario and McMaster Universities Osteoarthritis Index, modified Cincinnati Knee Rating System, and Short Form 36 in patients with focal articular cartilage defects.

Background: The International Knee Documentation Committee Subjective Knee Form (IKDC SKF) is a patient-reported knee-specific outcome measure that has been shown to be a reliable, valid, and responsive measure for patients with a variety of knee conditions. Further testing is required to compare the reliability and responsiveness of the IKDC SKF to other commonly used patient-reported outcome measures for patients with articular cartilage lesions.

Hypothesis: The IKDC SKF has equal or better levels of reliability and responsiveness than the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Cincinnati Knee Rating System (CKRS), and the Short Form 36 in patients with articular cartilage lesions.

Use of a type I/III bilayer collagen membrane decreases reoperation rates for symptomatic hypertrophy after autologous chondrocyte implantation.

Background: Autologous chondrocyte implantation is associated with a high rate of reoperation, mostly due to hypertrophy of the periosteal patch. European studies investigating the use of collagen membranes as a periosteal substitute report significant decreases in reoperation rates to less than 5%. This multicenter study investigates the off-label use of 1 collagen membrane as a periosteal substitute for autologous chondrocyte implantation.