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1

[The influence of posture on transmission and absorption of vibration energy in whole body vibration exercise].  

PubMed

Muscle exercise using whole body vibration platforms is well known as an alternative physical exercise in therapy as well as in high performance sports. Various studies could show an effectiveness in particular to improve maximal strength and springiness. Using these platforms there is no consideration to posture although the damage potential of vibration stress i. e. on intervertebral discs is well-known. Therefore the effect of posture on the transmission and absorption of vibration loads in bipedal standing was examined in a study with 20 sport students. They were exposed to a whole body vibration load in bipedal standing at a vibration frequency of 25 Hz. The transmission of energy was measured at the head in different postural positions. An average transmission of 9 % was measured in spontaneous bipedal standing. It significantly decreased with gradual changes of posture. After 6 weeks posture conditioning exercise this effect was significantly improved. In conclusion different posture in bipedal standing implies not only different energy absorption but also different effects on muscle performance which can explain the partly inconsistent results after vibration exercise. In addition whole body vibration exercise in a prone or sitting position may increase the risk of overload and should be avoided because of reduced energy absorption capacity. PMID:20229446

Berschin, G; Sommer, H-M

2010-03-01

2

Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS)  

PubMed Central

Both athletic and nonathletic population when subjected to any unaccustomed or unfamiliar exercise will experience pain 24-72 hours postexercise. This exercise especially eccentric in nature caused primarily by muscle damage is known as delayed-onset muscle soreness (DOMS). This damage is characterized by muscular pain, decreased muscle force production, reduce range of motion and discomfort experienced. DOMS is due to microscopic muscle fiber tears. The presence of DOMS increases risk of injury. A reduced range of motion may lead to the incapability to efficiently absorb the shock that affect physical activity. Alterations to mechanical motion may increase strain placed on soft tissue structures. Reduced force output may signal compensatory recruitment of muscles, thus leading to unaccustomed stress on musculature. Differences in strength ratios may also cause excessive strain on unaccustomed musculature. A range of interventions aimed at decreasing symptoms of DOMS have been proposed. Although voluminous research has been done in this regard, there is little consensus among the practitioners regarding the most effective way of treating DOMS. Mechanical oscillatory motion provided by vibration therapy. Vibration could represent an effective exercise intervention for enhancing neuromuscular performance in athletes. Vibration has shown effectiveness in flexibility and explosive power. Vibration can apply either local area or whole body vibration. Vibration therapy improves muscular strength, power development, kinesthetic awareness, decreased muscle sore, increased range of motion, and increased blood flow under the skin. VT was effective for reduction of DOMS and regaining full ROM. Application of whole body vibration therapy in postexercise demonstrates less pressure pain threshold, muscle soreness along with less reduction maximal isometric and isokinetic voluntary strength and lower creatine kinase levels in the blood. PMID:25121012

Imtiyaz, Shagufta

2014-01-01

3

MEASUREMENT OF WHOLE-BODY VIBRATION EXPOSURE FROM GARBAGE TRUCKS  

Microsoft Academic Search

Japanese garbage truck drivers are exposed to mechanical whole-body vibration during their work. Some drivers have suffered from low back pain from this vibration. However, there is no evidence of a relationship between the whole-body vibration from the garbage trucks and low back pain or occupational disease, due to the lack of investigations. A field study was conducted in order

S. Maeda; M. Morioka

1998-01-01

4

Effect of whole body vibrations on sound localization I. Frissena  

E-print Network

Effect of whole body vibrations on sound localization I. Frissena and C. Guastavinob a IRCCyN, 1 the efficacy of sound spatialization. While effects of whole-body vibrations have been found to impair simple front-back discrimination, their effect on sound localization per se has received scant attention. Here

Paris-Sud XI, Université de

5

Cognitive)ehavioral body image therapy for body dysmorphic disorder  

Microsoft Academic Search

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive pre- occupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior

James C. Rosen; Jeff Reiter; Pam Orosan

1995-01-01

6

Simulation of flow through vibrating screens with moving body method  

Microsoft Academic Search

A CFD study of the flow through vibrating screens has been conducted with moving body method of PHOENICS. The flow fields around the static and vibrating screens were calculated with laminar and turbulence models respectively, and the pressure-drop coefficients for both states were obtained. It was found that the flow field became very complex and vortex and backflow were produced

Wang Zong-ming; Zhao Yun-bo; Zhang Chun-xue; Deng Mao; Zhang Da-hai

2010-01-01

7

Case study: Use of vibration therapy in the treatment of diabetic peripheral small fiber neuropathy  

Microsoft Academic Search

The aim of the study was to describe a case of type II diabetic peripheral small fiber neuropathic pain treated with whole body vibration therapy after a failed trial of conventional drugs and interventional pain management. A 64-year-old male had chronic diabetic peripheral neuropathic pain in both his feet for about 2years. The patient tried multiple pain medications and various

Junggi Hong; Meredith J. Barnes; Nathan J. Kessler

8

Measurement of Whole-Body Vibration Exposure from Garbage Trucks  

NASA Astrophysics Data System (ADS)

Japanese garbage truck drivers are exposed to mechanical whole-body vibration during their work. Some drivers have suffered from low back pain from this vibration. However, there is no evidence of a relationship between the whole-body vibration from the garbage trucks and low back pain or occupational disease, due to the lack of investigations. A field study was conducted in order to characterize the health risks associated with garbage truck work. Three different types of truck were tested at different loadings and on different road surfaces, with the vibrations measured at the driver/seat interface (x,y, andz-axes). The vibrations were compared with the health risk guidance according to Annex B of ISO 2631-1 [1]. The findings of this study indicated that Japanese garbage truck drivers should not operate trucks for 2.5 h in a day, under current working conditions.

Maeda, S.; Morioka, M.

1998-08-01

9

Neural systemic impairment from whole-body vibration.  

PubMed

Insidious brain microinjury from motor vehicle-induced whole-body vibration (WBV) has not yet been investigated. For a long time we have believed that WBV would cause cumulative brain microinjury and impair cerebral function, which suggests an important risk factor for motor vehicle accidents and secondary cerebral vascular diseases. Fifty-six Sprague-Dawley rats were divided into seven groups (n?=?8): 1) 2-week normal control group, 2) 2-week sham control group (restrained in the tube without vibration), 3) 2-week vibration group (exposed to whole-body vibration at 30 Hz and 0.5g acceleration for 4 hr/day, 5 days/week, for 2 weeks), 4) 4-week sham control group, 5) 4-week vibration group, 6) 8-week sham control group, and 7) 8-week vibration group. At the end point, all rats were evaluated in behavior, physiological, and brain histopathological studies. The cerebral injury from WBV is a cumulative process starting with vasospasm squeezing of the endothelial cells, followed by constriction of the cerebral arteries. After the 4-week vibration, brain neuron apoptosis started. After the 8-week vibration, vacuoles increased further in the brain arteries. Brain capillary walls thickened, mean neuron size was obviously reduced, neuron necrosis became prominent, and wide-ranging chronic cerebral edema was seen. These pathological findings are strongly correlated with neural functional impairments. © 2014 Wiley Periodicals, Inc. PMID:25557339

Yan, Ji-Geng; Zhang, Lin-Ling; Agresti, Michael; LoGiudice, John; Sanger, James R; Matloub, Hani S; Havlik, Robert

2015-05-01

10

Effect of body shape on vibration of electric guitars  

NASA Astrophysics Data System (ADS)

The body vibrations of an electric guitar are typically ignored since the string vibrations are converted to sound through the use of a magnetic pickup. However, vibrations in the neck have been shown to cause dead spots at certain fret positions [H. Fleischer, J. Acoust. Soc. Am. 105, 1330 (1999)]. In this paper we compare the vibrational mode shapes and frequencies of three electric guitars with different body shapes. Two guitars are solid-body electrics: one with a body shape which is symmetric about the neck axis (Epiphone Coronet) and the other which is not (Gibson Explorer). Mode shapes and frequencies are considerably different for the body, though neck vibrations are more closely related. The third guitar is an arched top hollow-body electric (Gibson ES-335). For this guitar, the top and back plates and the air cavities may also contribute to the guitar sound quality. Mode shapes and frequencies are determined from experimental modal analysis using an impact hammer and accelerometer.

Russell, Daniel A.; Haveman, Wesley S.; Broden, Willis; Weibull, N. Pontus

2003-04-01

11

Whole-body vibration exposure in sport: four relevant cases.  

PubMed

This study investigates the whole-body vibration exposure in kite surfing, alpine skiing, snowboarding and cycling. The vibration exposure was experimentally evaluated following the ISO 2631 guidelines. Results evidenced that the most critical axis is the vertical one. The weighted vibration levels are always larger than 2.5 m/s(2) and the vibration dose values are larger than 25 m/s(1.75). The exposure limit values of the EU directive are reached after 8-37 min depending on the sport. The vibration magnitude is influenced by the athletes' speed, by their skill level and sometimes by the equipment. The large vibration values suggest that the practice of sport activities may be a confounding factor in the aetiology of vibration-related diseases. Practitioner Summary: The vibration exposure in some sports is expected to be large, but has never been quantified in the literature. Results of experiments performed in cycling, alpine and water sports outlined vibration levels exceeding the EU standard limit values. PMID:25267689

Tarabini, Marco; Saggin, Bortolino; Scaccabarozzi, Diego

2014-09-30

12

Mind-body therapies in integrative oncology.  

PubMed

There is growing interest in mind-body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled many such interventions to be evaluated for their efficacy, including studies of mind-body interventions to reduce pain, anxiety, insomnia, anticipatory, and treatment-related nauseas, hot flashes, and improved mood. Mind-body treatments evaluated for their utility in oncology include relaxation therapies, biofeedback, meditation and hypnosis, yoga, art and music therapy, tai chi, and qigong. Although studies are not always methodologically sound and results mixed, a growing number of well-designed studies provide convincing evidence that mind-body techniques are beneficial adjuncts to cancer treatment. The evidence is sufficient to recommend further investigation and adoption of these techniques in mainstream oncology care. PMID:21116746

Elkins, Gary; Fisher, William; Johnson, Aimee

2010-12-01

13

Use of mind-body medical therapies  

Microsoft Academic Search

OBJECT: Research demonstrating connections between the mind and body has increased interest in the potential of mind-body therapies.\\u000a Our aim was to examine the use of mind-body therapies, using data available from a national survey.\\u000a \\u000a \\u000a DESIGN: Analysis of a large nationally representative dataset that comprehensively evaluated the use of mind-body therapies in the\\u000a last year.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: United States households.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS\\/PARTICIPANTS:

Peter M. Wolsko; David M. Eisenberg; Roger B. Davis; Russell S. Phillips

2004-01-01

14

Small Vibrations Superimposed on a Prescribed Rigid Body Motion  

Microsoft Academic Search

A method for analysing flexible multibody systems in which the elastic deformations are small is presented. The motion is considered a gross non-linear rigid body motion with small linear vibrations superimposed on it. For periodic gross motion, this results in a system of rheo- linear differential equations for the deformations with periodic coefficients. The determination of the required equations with

A. L. SCHWAB; J. P. MEIJAARD

2002-01-01

15

Mind–Body Therapies in Integrative Oncology  

Microsoft Academic Search

Opinion statement  There is growing interest in mind–body therapies as adjuncts to mainstream cancer treatment, and an increasing number of patients\\u000a turn to these interventions for the control of emotional stress associated with cancer. Increased research funding has enabled\\u000a many such interventions to be evaluated for their efficacy, including studies of mind–body interventions to reduce pain, anxiety,\\u000a insomnia, anticipatory, and treatment-related

Gary Elkins; William Fisher; Aimee Johnson

2010-01-01

16

Whole body vibration alters proprioception in the trunk  

E-print Network

at different postures. J Sound Vib 2002;253(1):37-56. Bongers PM, Hulshof CT, Dijkstra L, Boshuizen HC, Groenhout HJ, Valken E. Back pain and exposure to whole body vibration in helicopter pilots. Ergonomics 1990;33(8):1007-26. Brumagne S, Cordo P, Lysens R..., 2003. Page 20 of 22 Granata KP, Sanford AS. Lumbar-pelvic coordination is influence by lifting task parameters. Spine 2000;25(11):1413-8. Granata, K. P., Slota, G. R., & Wilson, S. E. Influence of fatigue in neuromuscular control of spinal stability...

Li, Lu; Lamis, Farhana; Wilson, Sara E.

2008-01-01

17

Whole-body vibration slows the acquisition of fat in mature female rats  

Microsoft Academic Search

Objective:To evaluate the effects of whole-body vibration on fat, bone, leptin and muscle mass.Methods\\/Design:Thirty 7-month-old female 344 Fischer rats were randomized by weight into three groups (baseline, vibration or control; n=8–10 per group). Rats in the vibration group were placed inside individual compartments attached to a Pneu-Vibe vibration platform (Pneumex, Sandpoint, ID, USA) and vibrated at 30–50 Hz (6 mm

G F Maddalozzo; U T Iwaniec; R T Turner; C J Rosen; J J Widrick

2008-01-01

18

Guidelines for Whole-Body Vibration Health Surveillance  

NASA Astrophysics Data System (ADS)

There is strong epidemiological evidence that occupational exposure to WBV is associated with an increased risk of low back pain (LBP), sciatic pain, and degenerative changes in the spinal system, including lumbar intervertebral disc disorders. A prototype health surveillance scheme for WBV is presented in this paper. Surveillance is the collection, analysis, and dissemination of data for the purpose of prevention. The aims are to assess health status and diagnose vibration-induced disorders at an early stage, to inform the workers on the potential risk associated with vibration exposure, to give preventive advice to employers and employees and to control whether preventive measures which have been taken, were successful. It is suggested that a pre-placement health examination should be offered to each worker who will be exposed to WBV so as to make the worker aware of the hazards, to obtain baseline health data, and to identify medical conditions that may increase the risk due to WBV. The case history should focus on personal history, work history, and leisure activities involving driving of vehicles. The personal medical history should detail back pain complaints, disorders in the spine, any injuries or surgery to the musculoskeletal system. A physical examination on the lower back should be performed on workers who have experienced LBP symptoms over the past 12 months. The preplacement examination should be followed by periodic health reassessment with a regular interval according to the legislation of the country. It is suggested that periodic medical examination should be made available at least every 2 years to all workers who are exposed to WBV. Any change in vibration exposure at the workplace should be reported by the employer. If an increase in vibration exposure or a change in health status have occurred, the medical re-examination should be offered at shorter intervals at the discretion of the attending physician. There should be a periodic medical examination, which includes recording any change in exposure to WBV. The findings for the individual should be compared with previous examinations. Group data should also be compiled periodically. Medical removal may be considered along with re-placement in working practices without exposure to WBV. This paper presents opinions on health surveillance for whole-body vibration developed within a working group of partners funded on a European Community Network (BIOMED2 concerted action BMH4-CT98-3251: Research network on detection and prevention of injuries due to occupational vibration exposures). The health surveillance protocol and the draft questionnaire with explanation comments are presented for wider consideration by the science community and others before being considered appropriate for implementation.

POPE, M.; MAGNUSSON, M.; LUNDSTRÖM, R.; HULSHOF, C.; VERBEEK, J.; BOVENZI, M.

2002-05-01

19

Stochastic many-body perturbation theory for anharmonic molecular vibrations.  

PubMed

A new quantum Monte Carlo (QMC) method for anharmonic vibrational zero-point energies and transition frequencies is developed, which combines the diagrammatic vibrational many-body perturbation theory based on the Dyson equation with Monte Carlo integration. The infinite sums of the diagrammatic and thus size-consistent first- and second-order anharmonic corrections to the energy and self-energy are expressed as sums of a few m- or 2m-dimensional integrals of wave functions and a potential energy surface (PES) (m is the vibrational degrees of freedom). Each of these integrals is computed as the integrand (including the value of the PES) divided by the value of a judiciously chosen weight function evaluated on demand at geometries distributed randomly but according to the weight function via the Metropolis algorithm. In this way, the method completely avoids cumbersome evaluation and storage of high-order force constants necessary in the original formulation of the vibrational perturbation theory; it furthermore allows even higher-order force constants essentially up to an infinite order to be taken into account in a scalable, memory-efficient algorithm. The diagrammatic contributions to the frequency-dependent self-energies that are stochastically evaluated at discrete frequencies can be reliably interpolated, allowing the self-consistent solutions to the Dyson equation to be obtained. This method, therefore, can compute directly and stochastically the transition frequencies of fundamentals and overtones as well as their relative intensities as pole strengths, without fixed-node errors that plague some QMC. It is shown that, for an identical PES, the new method reproduces the correct deterministic values of the energies and frequencies within a few cm(-1) and pole strengths within a few thousandths. With the values of a PES evaluated on the fly at random geometries, the new method captures a noticeably greater proportion of anharmonic effects. PMID:25173003

Hermes, Matthew R; Hirata, So

2014-08-28

20

Stochastic many-body perturbation theory for anharmonic molecular vibrations  

NASA Astrophysics Data System (ADS)

A new quantum Monte Carlo (QMC) method for anharmonic vibrational zero-point energies and transition frequencies is developed, which combines the diagrammatic vibrational many-body perturbation theory based on the Dyson equation with Monte Carlo integration. The infinite sums of the diagrammatic and thus size-consistent first- and second-order anharmonic corrections to the energy and self-energy are expressed as sums of a few m- or 2m-dimensional integrals of wave functions and a potential energy surface (PES) (m is the vibrational degrees of freedom). Each of these integrals is computed as the integrand (including the value of the PES) divided by the value of a judiciously chosen weight function evaluated on demand at geometries distributed randomly but according to the weight function via the Metropolis algorithm. In this way, the method completely avoids cumbersome evaluation and storage of high-order force constants necessary in the original formulation of the vibrational perturbation theory; it furthermore allows even higher-order force constants essentially up to an infinite order to be taken into account in a scalable, memory-efficient algorithm. The diagrammatic contributions to the frequency-dependent self-energies that are stochastically evaluated at discrete frequencies can be reliably interpolated, allowing the self-consistent solutions to the Dyson equation to be obtained. This method, therefore, can compute directly and stochastically the transition frequencies of fundamentals and overtones as well as their relative intensities as pole strengths, without fixed-node errors that plague some QMC. It is shown that, for an identical PES, the new method reproduces the correct deterministic values of the energies and frequencies within a few cm-1 and pole strengths within a few thousandths. With the values of a PES evaluated on the fly at random geometries, the new method captures a noticeably greater proportion of anharmonic effects.

Hermes, Matthew R.; Hirata, So

2014-08-01

21

Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies  

Microsoft Academic Search

Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized\\u000a as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies\\/meditation,\\u000a Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better\\u000a understand the conceptualization of body awareness in

Wolf E Mehling; Judith Wrubel; Jennifer J Daubenmier; Cynthia J Price; Catherine E Kerr; Theresa Silow; Viranjini Gopisetty; Anita L Stewart

2011-01-01

22

Acute Effects of Loaded Whole Body Vibration Training on Performance  

PubMed Central

Background: The application of whole body vibration (WBV) as a warm-up scheme has been receiving an increasing interest among practitioners. Objectives: The aim of this study was to determine the effect of loaded and unloaded WBV on countermovement jump, speed and agility. Patients and Methods: Twenty-one healthy male college football players (age: 20.14 ± 1.65 years; body height: 179.9 ± 8.34 cm; body mass: 74.4 ± 13.0 kg; % body fat: 9.45 ± 4.8) underwent randomized controlled trials that involved standing in a half squat position (ST), ST with 30% of bodyweight (ST + 30%), whole body vibration at f = 50 Hz, A = 4 mm (WBV), and WBV with 30% bodyweight (WBV + 30% BW) after a standardized warm-up. Post measures of countermovement jump, 15-m sprint, and modified t-test were utilized for analyses. Results: One way repeated measures ANOVA revealed a significant difference in the countermovement jump performance, F (3, 60 = 9.06, ?2 = 2.21, P = 0.000. Post-hoc showed that WBV + 30% BW posted significant difference compared to (P = 0.008), ST + 30% BW (P = 0.000) and WBV (P = 0.000). There was also a significant difference in the sprint times among interventions, F (3, 60) = 23.0, ?2 = 0.865, P = 0.000. Post hoc showed that WBV + 30% BW displayed significantly lower time values than ST (P = 0.000), ST + 30% BW (P = 0.000) and WBV (P = 0.000). Lastly, there was a significant difference in the agility performance across experimental conditions at F(2.01, 40.1) = 21.0, ?2 = 0.954, P = 0.000. Post hoc demonstrated that WBV have lower times than ST (P = 0.013). Also, WBV + 30% BW posted lower times compared to ST (P = 0.000), ST + 30% (P = 0.000) and WBV (P = 0.003). Conclusions: Additional external load of 30% bodyweight under WBV posted superior gains in countermovement jump, speed and agility compared to unloaded WBV, loaded non-WBV and unloaded non-WBV interventions.

Pojskic, Haris; Pagaduan, Jeffrey; Uzicanin, Edin; Babajic, Fuad; Muratovic, Melika; Tomljanovic, Mario

2015-01-01

23

A multiple scales approach to sound generation by vibrating bodies  

NASA Technical Reports Server (NTRS)

The problem of determining the acoustic field in an inviscid, isentropic fluid generated by a solid body whose surface executes prescribed vibrations is formulated and solved as a multiple scales perturbation problem, using the Mach number M based on the maximum surface velocity as the perturbation parameter. Following the idea of multiple scales, new 'slow' spacial scales are introduced, which are defined as the usual physical spacial scale multiplied by powers of M. The governing nonlinear differential equations lead to a sequence of linear problems for the perturbation coefficient functions. However, it is shown that the higher order perturbation functions obtained in this manner will dominate the lower order solutions unless their dependence on the slow spacial scales is chosen in a certain manner. In particular, it is shown that the perturbation functions must satisfy an equation similar to Burgers' equation, with a slow spacial scale playing the role of the time-like variable. The method is illustrated by a simple one-dimenstional example, as well as by three different cases of a vibrating sphere. The results are compared with solutions obtained by purely numerical methods and some insights provided by the perturbation approach are discussed.

Geer, James F.; Pope, Dennis S.

1992-01-01

24

Signal Processing Methods for Removing the Effects of Whole Body Vibration upon Speech  

NASA Technical Reports Server (NTRS)

Humans may be exposed to whole-body vibration in environments where clear speech communications are crucial, particularly during the launch phases of space flight and in high-performance aircraft. Prior research has shown that high levels of vibration cause a decrease in speech intelligibility. However, the effects of whole-body vibration upon speech are not well understood, and no attempt has been made to restore speech distorted by whole-body vibration. In this paper, a model for speech under whole-body vibration is proposed and a method to remove its effect is described. The method described reduces the perceptual effects of vibration, yields higher ASR accuracy scores, and may significantly improve intelligibility. Possible applications include incorporation within communication systems to improve radio-communication systems in environments such a spaceflight, aviation, or off-road vehicle operations.

Bitner, Rachel M.; Begault, Durand R.

2014-01-01

25

Vibrational many-body methods for molecules and extended systems  

NASA Astrophysics Data System (ADS)

Vibrational many-body methods for molecules and extended systems have been developed that can account for the effects of anharmonicity in the potential energy surfaces (PESs) on energies and other observable properties. For molecules, we present a general scheme to calculate anharmonic vibrational frequencies and vibrationally-averaged structures along with applications to some key species in hydrocarbon combustion chemistry: HCO+, HCO, HNO, HOO, HOO--, CH3+, and CH3. We propose a hybrid, compact representation of PESs that combines the merits of two existing representations, which are a quartic force field (QFF) and numerical values on a rectilinear grid. We employed a combination of coupled-cluster singles and doubles (CCSD), CCSD with a second-order perturbation correction in the space of triples [CCSD(2)T] and in the space of triples and quadruples [CCSD(2)TQ], and a correlation-consistent basis set series to achieve the complete-correlation, complete-basis-set limits of the potential energy surfaces. The mean absolute deviation between the predicted and the observed frequencies is 11 cm --1. For extended systems, we generalized the formulations of the vibrational self-consistent field (VSCF), vibrational Moller--Plesset perturbation (VMP), and vibrational coupled-cluster (VCC) methods on the basis of a QFF in normal coordinates. We have identified algebraically and eliminated several terms in the formalisms of VSCF that have nonphysical size dependence, leading to compact and strictly size-extensive equations. This size-extensive VSCF method (XVSCF) thus defined has no contributions from cubic force constants and alters only the transition energies of the underlying harmonic-oscillator reference from a subset of quartic force constants. The mean-field potential of XVSCF felt by each mode is shown to be effectively harmonic, making the XVSCF equations subject to a self-consistent analytical solution without a basis-set expansion and matrix diagonalization, which are necessary in VSCF. We implemented the XVSCF method for finite systems, and applied it to polyacenes up to tetracene as well as to a model system of a linear chain of masses interacting through a quartic force field. We showed that the results of XVSCF and VSCF approach each other as the size of the system is increased, implicating the inclusion of unnecessary, nonphysical terms in VSCF. We have also shown that apart from reducing the scaling of the VSCF calculation from quartic to quadratic, XVSCF is nearly three orders of magnitude faster than VSCF implemented with a reduced set of force constants. The second-order VMP and VCC methods based on the XVSCF reference are shown to account for anharmonic effects due to all cubic and quartic force constants in a size-extensive fashion.

Keceli, Murat

26

Modeling the Human Body\\/Seat System in a Vibration Environment  

Microsoft Academic Search

The vibration environment is a common man-made artificial surrounding with which humans have a limited tolerance to cope due to their body dynamics. This research studied the dynamic characteristics of a seated human body\\/seat system in a vibration environment. The main result is a multi degrees of freedom lumped parameter model that synthesizes two basic dynamics: (i) global human dynamics,

Jacob Rosen; Mircea Arcan

2003-01-01

27

A CONTINUOUS MODEL FOR THE VERTICAL VIBRATION OF THE HUMAN BODY IN A STANDING POSITION  

Microsoft Academic Search

This paper is concerned with modelling the vertical vibration of the human body in a standing position. The human body is modelled as a column consisted of two uniform members with different properties. Solutions of the free vibration of the model are given and the effect of several distributions of the stiffnesses are considered. The modal mass, frequencies and axial

Tianjian Ji

28

Investigation of the transmission of fore and aft vibration through the human body  

Microsoft Academic Search

Understanding the behavior of human body under the influence of vibration is of great importance for the optimal motor vehicle system design. Therefore, great efforts are being done in order to discover as many information about the influence of vibration on human body as possible. So far the references show that the major scientific attention has been paid to vertical

Miroslav Demi?; Jovanka Luki?

2009-01-01

29

NEUROMOTOR RESPONSE TO WHOLE BODY VIBRATION TRANSMISSIBILITY IN THE HORIZONTAL DIRECTION AND ITS MATHEMATICAL MODEL  

E-print Network

................................................................................... 6 1.5 Overview of Whole Body Vibration Research in General: ...................................................... 7 1.5.1 Vibration-Induced Muscular Fatigue: ................................................................................ 8 1...-right) directions relative to the body. Typical 7 exposures include: driving automobiles and trucks, piloting helicopters and other aircraft and operating industrial vehicles such as off-road construction vehicles and forklifts. Transmission of WBV...

Hanumanthareddygari, Vinay

2010-09-02

30

[Stereotactic body radiation therapy: uncertainties and margins].  

PubMed

The principles governing stereotactic body radiation therapy are tight margins and large dose gradients around targets. Every step of treatment preparation and delivery must be evaluated before applying this technique in the clinic. Uncertainties remain in each of these steps: delineation, prescription with the biological equivalent dose, treatment planning, patient set-up taking into account movements, the machine accuracy. The calculation of margins to take into account uncertainties differs from conventional radiotherapy because of the delivery of few fractions and large dose gradients around the target. The quest of high accuracy is complicated by the difficulty to reach it and the lack of consensus regarding the prescription. Many schemes dose/number of fractions are described in clinical studies and there are differences in the way describing the delivered doses. While waiting for the ICRU report dedicated to this technique, it seems desirable to use the quantities proposed in ICRU Report 83 (IMRT) to report the dose distribution. PMID:25023588

Lacornerie, T; Marchesi, V; Reynaert, N

2014-01-01

31

[The effect of whole-body vibration: an unrecognized medical problem].  

PubMed

Exposure to whole-body vibration is a growing concern in industry, traffic and in other branches of the economy. This harmful physical factor endangers work efficiency and human health not only at work but also in everyday life, in public transportation and even at home. In spite of increasing exposure to vibrations, our medical practice does not pay adequate attention to the health effects of whole-body vibration. The paper deals with the basic characteristics of vibration (frequency, amplitude, velocity and acceleration), its adequate evaluation (effective or weighted average value, peak values, rating and weighting procedure of vibration measurement) and exposure (vibration direction, exposure time, transmission and dissipation). In industry and traffic, vibrations present complex oscillatory motions, characterized by a wide frequency spectrum, variable amplitude and acceleration, and different directions. To assess the harmful effects of vibration, the International Organization for Standardization (ISO) has proposed three standards for acceptable human exposure to whole-body vibration: fatigue-decreased proficiency boundary, exposure limit and reduced comfort boundary. Quantitative parameters of vibration for some vehicles, and for constructional, industrial and agricultural machinery are also given. The most pronounced long-term effect of whole-body vibration is damage to the spine. The spinal region most frequently affected is the lumbar part, where spinal deformation, lumbago and sciatica can develop. The possible cause of spinal damage could be mechanical overload and metabolic changes of the intervertebral disc. Other organ systems, such as peripheral and autonomic nervous, vestibular, vascular, digestive and female reproductive systems are also liable to become affected. Risk assessment of chronic health effects is based on the appropriate evaluation of whole-body vibration exposure and individual response. Health risk increases with the intensity and duration of vibration exposure. The concomitant factors are forced sitting posture and heavy physical work. Human response to whole-body vibration depends on factors promoting the development of degenerative changes such as constitution, previous spine disease and young age. The main problems in diagnosing whole-body vibration syndrome are differentiation of vibration induced disorders from age dependent changes of the spine and lack of a specific diagnostic method for assessing those changes. Therefore, only permanent medical surveillance can guarantee proper assessment of the damage induced by whole-body vibration. For vibration exposed workers preplacement and periodic examinations are recommended. Those should include a basic medical examination and an X-ray of the spine, or at least of its lumbar part. PMID:8311700

Bogadi-Sare, A

1993-09-01

32

Complementary therapies for reducing body weight: a systematic review  

Microsoft Academic Search

The prevalence of obesity is increasing at an alarming rate and a plethora of complementary therapies are on offer claiming effectiveness for reducing body weight. The aim of this systematic review is to critically assess the evidence from randomized controlled trials (RCTs) and systematic reviews of complementary therapies for reducing body weight. Literature searches were conducted on Medline, Embase, Amed,

M H Pittler; E Ernst

2005-01-01

33

Effects of whole body vibration training on postural control in older individuals: A 1 year randomized controlled trial  

Microsoft Academic Search

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n = 94), a fitness group (n = 60) or a control group (n = 66). Thewhole body vibration and fitness groups trained

An Bogaerts; Sabine Verschueren; Christophe Delecluse; Albrecht L. Claessens; Steven Boonen

2007-01-01

34

Body sway and vibration perception thresholds in normal aging and in patients with polyneuropathy.  

PubMed Central

Body sway and vibration perception in the lower limbs were measured in 32 normal subjects and 25 patients with peripheral neuropathies; nerve conduction studies were also performed in the patients with neuropathies. Body sway was measured by means of force-plate posturography, and three methods were used to assess vibration perception: a neurothesiometer, a semiquantitative tuning fork, and the bone vibrator of a conventional audiometer. Body sway and vibration perception were increased in the patients with peripheral neuropathies and there was significant correlation between these measures.d These findings, together with the lack of correlation between sway and muscle strength, indicate that the main source of unsteadiness in these patients is the loss of proprioceptive information. Vibration perception and body sway did not correlate with the electrophysiological variables, indicating that these measures assess different aspects of peripheral nerve function. In all subjects there was close correlation between vibration perception as assessed by the neurothesiometer and the audiometer could be used to screen proprioceptive function in patients with balance disorders. In normal subjects age correlated with vibration perception (measured with the neurothesiometer and audiometer) and also with body sway standing on foam. This suggests that the increased body sway in elderly people may partly be due to redue proprioception in the lower limbs. PMID:7897416

Bergin, P S; Bronstein, A M; Murray, N M; Sancovic, S; Zeppenfeld, D K

1995-01-01

35

Whole-body vibration and ergonomic study of US railroad locomotives  

Microsoft Academic Search

US locomotive operators have exposure to multi-axis whole-body vibration (WBV) and shocks while seated. This study assessed operator-related and ergonomic seating design factors that may have confounding or mitigating influence on WBV exposure and its effects. Vibration exposure was measured according to international guidelines (ISO 2631-1; 1997); ergonomic work place factors and vibration effects were studied with a cross-sectional survey

Eckardt Johanning; Paul Landsbergis; Siegfried Fischer; Eberhard Christ; Benno Göres; Raymond Luhrman

2006-01-01

36

Electromyography Activity of Vastus Lateralis Muscle During Whole-Body Vibrations of Different Frequencies  

Microsoft Academic Search

The aim of this study was to analyze electromyography (EMG) responses of vastus lateralis muscle to different whole-body vibration frequencies. For this purpose, 16 pro- fessional women volleyball players (age, 23.9 6 3.6 years; height, 182.5 6 11.1 cm; weight, 78.4 6 5.6 kg) voluntarily participated in the study. Vibration treatment was adminis- tered while standing on a vibrating platform

Marco Cardinale; Jon Lim

2003-01-01

37

Whole-body vibration slows the acquisition of fat in mature female rats  

PubMed Central

Objective To evaluate the effects of whole-body vibration on fat, bone, leptin and muscle mass. Methods/Design Thirty 7-month-old female 344 Fischer rats were randomized by weight into three groups (baseline, vibration or control; n=7–10 per group). Rats in the vibration group were placed inside individual compartments attached to a Pneu-Vibe vibration platform (Pneumex, Sandpoint, ID, USA) and vibrated at 30–50 Hz (6mm peak to peak) for 30 min per day, 5 days per week, for 12 weeks. The vibration intervention consisted of six 5-min cycles with a 1-min break between cycles. Results There were significant body composition differences between the whole-body vibration and the control groups. The whole-body vibration group weighed approximately 10% less (mean ± s.d.; 207 ± 10 vs 222 ± 15 g, P<0.03) and had less body fat (20.8 ± 3.8 vs 26.8 ± 5.9 g, P<0.05), a lower percentage of body fat (10.2 ± 1.7 vs 12 ± 2.0%, P<0.05), and lower serum leptin levels (1.06 ± 0.45 vs 2.27 ± 0.57 ng ml?1, P<0.01) than the age-matched controls. No differences were observed for total lean mass, bone mineral content (BMC), bone mineral density (BMD), insulin-like growth factor-I (IGF-I) or soleus (SOL) and extensor digitorum longus (EDL) mass or function. Regional high-resolution dual-energy X-ray absoptiometry scans of the lumbar spine (L1-4) revealed that the whole-body vibration group had significantly greater BMC (0.33 ± 0.05 vs 0.26 ± 0.03 g, P<0.01) and BMD (0.21 ± 0.01 vs 0.19 ± 0.01 gcm?2, P<0.01) than the control group. No differences between the groups were observed in the amount of food consumed. Conclusion These findings show that whole-body vibration reduced body fat accumulation and serum leptin without affecting whole body BMC, BMD or lean mass. However, the increase in vertebral BMC and BMD suggests that vibration may have resulted in local increases in bone mass and density. Also, whole-body vibration did not affect muscle function or food consumption. PMID:18663370

Maddalozzo, GF; Iwaniec, UT; Turner, RT; Rosen, CJ; Widrick, JJ

2008-01-01

38

Ernährungsmanagement versus Body-Image-Therapie bei Anorexia nervosa  

Microsoft Academic Search

Body image disturbances are highly predictive of the course of eating disorders, and addressing these problems effectively, has been an ongoing challenge to clinicians. This study examines whether a specific group therapy program geared to body image reduces different components of the body image disturbance more effectively than an unspecific nutritional management program. Patients and Methods: All 57 carefully diagnosed

Reimund Böse

2007-01-01

39

Whole Body Vibration Training - Improving Balance Control and Muscle Endurance  

PubMed Central

Exercise combined with whole body vibration (WBV) is becoming increasingly popular, although additional effects of WBV in comparison to conventional exercises are still discussed controversially in literature. Heterogeneous findings are attributed to large differences in the training designs between WBV and “control” groups in regard to training volume, load and type. In order to separate the additional effects of WBV from the overall adaptations due to the intervention, in this study, a four-week WBV training setup was compared to a matched intervention program with identical training parameters in both training settings except for the exposure to WBV. In a repeated-measures matched-subject design, 38 participants were assigned to either the WBV group (VIB) or the equivalent training group (CON). Training duration, number of sets, rest periods and task-specific instructions were matched between the groups. Balance, jump height and local static muscle endurance were assessed before and after the training period. The statistical analysis revealed significant interaction effects of group×time for balance and local static muscle endurance (p<0.05). Hence, WBV caused an additional effect on balance control (pre vs. post VIB +13%, p<0.05 and CON +6%, p?=?0.33) and local static muscle endurance (pre vs. post VIB +36%, p<0.05 and CON +11%, p?=?0.49). The effect on jump height remained insignificant (pre vs. post VIB +3%, p?=?0.25 and CON ±0%, p?=?0.82). This study provides evidence for the additional effects of WBV above conventional exercise alone. As far as balance and muscle endurance of the lower leg are concerned, a training program that includes WBV can provide supplementary benefits in young and well-trained adults compared to an equivalent program that does not include WBV. PMID:24587114

Ritzmann, Ramona; Kramer, Andreas; Bernhardt, Sascha; Gollhofer, Albert

2014-01-01

40

Therapeutic Effect of Whole Body Vibration on Chronic Knee Osteoarthritis  

PubMed Central

Objective To investigate the effect on pain reduction and strengthening of the whole body vibration (WBV) in chronic knee osteoarthritis (OA). Methods Patients were randomly divided into two groups: the study group (WBV with home based exercise) and control group (home based exercise only). They performed exercise and training for 8 weeks. Eleven patients in each group completed the study. Pain intensity was measured with the Numeric Rating Scale (NRS), functional scales were measured with Korean Western Ontario McMaster score (KWOMAC) and Lysholm Scoring Scale (LSS), quadriceps strength was measured with isokinetic torque and isometric torque and dynamic balance was measured with the Biodex Stability System. These measurements were performed before training, at 1 month after training and at 2 months after training. Results NRS was significantly decreased in each group, and change of pain intensity was significantly larger in the study group than in the control group after treatment. Functional improvements in KWOMAC and LSS were found in both groups, but no significant differences between the groups after treatment. Dynamic balance, isokinetic strength of right quadriceps and isometric strengths of both quadriceps muscles improved in both groups, but no significant differences between the groups after treatment. Isokinetic strength of left quadriceps did not improve in both groups after treatment. Conclusion In chronic knee OA patients, WBV reduced pain intensity and increased strength of the right quadriceps and dynamic balance performance. In comparison with the home based exercise program, WBV was superior only in pain reduction and similarly effective in strengthening of the quadriceps muscle and balance improvement. PMID:24020031

Park, Young Geun; Kwon, Bum Sun; Park, Jin-Woo; Cha, Dong Yeon; Nam, Ki Yeun; Sim, Kyoung Bo; Chang, Jihea

2013-01-01

41

Effects of Whole-Body Vibration Training on Bone-Free Lean Body Mass and Muscle Strength in Young Adults  

PubMed Central

Resistance training with whole-body vibration (WBV) is becoming increasingly popular as an alternative to conventional resistance training or as supplementary training. Despite its growing popularity, the specific effects of WBV training on muscle morphology, strength, and endurance are not well understood, particularly in young adults. The aim of this study was to determine the effects of WBV training on bone-free lean body mass (BFLBM), and maximal muscle strength and endurance in healthy, untrained, young individuals. Eighteen healthy men and women (21-39 years) were randomly assigned to either a body-weight exercise with WBV (VT) group or a control exercise group without WBV (CON). Participants performed eight exercises per 40- min session on a vibration platform (VT group, frequency = 30-40 Hz; amplitude = 2 mm) twice weekly for 12 weeks. Anthropometry, total and regional BFLBM (trunks, legs, and arms) measured by dual- energy X-ray absorptiometry, and muscle strength and endurance measured by maximal isometric lumbar extension strength, maximal isokinetic knee extension and flexion strength, and the number of sit- ups performed were recorded and compared. Two-way repeated-measures ANOVA revealed no significant changes between the groups in any of the measured variables. We conclude that 12 weeks of body weight vibration exercise compared to body weight exercise alone does not provide meaningful changes to BFLBM or muscle performance in healthy young adults. Key points A randomized controlled trial was conducted to investigate the effects of body-weight exercise combined with whole-body vibration on bone-free lean body mass and maximal muscle strength and endurance in healthy young individuals. Body-weight exercises for lower extremities and trunk muscles were performed twice weekly for 12 weeks. Participants in the exercise with whole-body vibration group increased the vibration frequency from 30, 35, to 40 Hz at a constant amplitude of 2 mm during the trial. A 12-week body-weight exercise program with whole-body vibration did not significantly increase bone-free lean body mass in healthy young individuals, and no additional increases in maximal muscle strength and endurance were observed. PMID:24149301

Osawa, Yusuke; Oguma, Yuko; Onishi, Shohei

2011-01-01

42

A MODAL ANALYSIS OF WHOLE-BODY VERTICAL VIBRATION, USING A FINITE ELEMENT MODEL OF THE HUMAN BODY  

Microsoft Academic Search

A two-dimensional model of human biomechanical responses to whole-body vibration has been developed, by using the finite element method. Beam, spring and mass elements were used to model the spine, viscera, head, pelvis and buttocks tissue in the mid-sagittal plane. The model was developed by comparison of the vibration mode shapes with those previously measured in the laboratory. At frequencies

S. Kitazaki; M. J. Griffin

1997-01-01

43

Treatment of posttraumatic arthrofibrosis of the radioulnar joint with vibration therapy (VMTX Vibromax Therapeutics™): A case report and narrative review of literature  

PubMed Central

Objective To present the clinical features of post traumatic arthrofibrosis and response to treatment with Vibromax Therapeutics™ (VMTX™) in 28 year old male soccer player. Rationale Many studies have reported an increase in muscle performance after whole-body vibration, but to date none have evaluated the possibility of vibration application as a therapy for functional restoration after injury. Conclusions Vibration training is being utilized in, strength training, performance enhancement and rehabilitation. Despite the lack of research in this area, the literature that is currently available and the results of this case study imply that vibration therapy has the potential to aid in the management of acute soft tissue injury and the sequela of disuse and immobilization. PMID:18327298

Macintyre, Ian; Kazemi, Mohsen

2008-01-01

44

Self-reported low back symptoms in urban bus drivers exposed to whole-body vibration.  

PubMed

The prevalence of self-reported low back symptoms was investigated by a postal questionnaire in a group of 234 urban bus drivers exposed to whole-body vibration and postural stress and in a control group of 125 maintenance workers employed at the same bus municipal company. The average vertical whole-body vibration magnitude measured on the seat pan of the buses was 0.4 m/s2. After controlling for potential confounders, the prevalence odds ratios for the bus drivers compared to the controls significantly exceeded 1 for several types of low back symptoms (leg pain, acute low back pain, low back pain). The occurrence of low back symptoms increased with increasing whole-body vibration exposure expressed in terms of total (lifetime) vibration dose (years m2/s4), equivalent vibration magnitude (m/s2), and duration of exposure (years of service). The highest prevalence of disc protrusion was found among the bus drivers with more severe whole-body vibration exposure. Frequent awkward postures at work were also related to some types of low back symptoms. It is concluded that bus driving is associated with an increased risk for low back troubles. This excess risk may be due to both whole-body vibration exposure and prolonged sitting in a constrained posture. The findings of this study also indicated that among the bus drivers low back symptoms occurred at whole-body vibration exposure levels that were lower than the health-based exposure limits proposed by the International Standard ISO 2631/1. PMID:1411756

Bovenzi, M; Zadini, A

1992-09-01

45

Torsional vibration analysis of a multi-body single cylinder internal combustion engine model  

Microsoft Academic Search

This paper presents a detailed multi-body numerical nonlinear dynamic model of a single cylinder internal combustion engine. The model comprises all rigid body inertial members, support bearings, joints, couplers, and connections between the various engine components, as well as means of vibration damping. The detailed model is parameterised, thus enabling virtual prototype testing of various engine designs, as well as

A. Boysal; H. Rahnejat

1997-01-01

46

Varying whole body vibration amplitude differentially affects tendon and ligament structural and material properties  

PubMed Central

Whole Body Vibration (WBV) is becoming increasingly popular for helping to maintain bone mass and strengthening muscle. Vibration regimens optimized for bone maintenance often operate at hypogravity levels (<1 G) and regimens for muscle strengthening often employ hypergravity (>1 G) vibrations. The effect of vibratory loads on tendon and ligament properties is unclear though excessive vibrations may be injurious. Our objective was to evaluate how tendon gene expression and the mechanical/histological properties of tendon and ligament were affected in response to WBV in the following groups: no vibration, low vibration (0.3 G peak-to-peak), and high vibration (2 G peak-to-peak). Rats were vibrated for 20 min a day, 5 days a week, for 5 weeks. Upon sacrifice, the medial collateral ligament (MCL), patellar tendon (PT), and the Achilles Tendon (AT) were isolated with insertion sites intact. All tissues were tensile tested to determine structural and material properties or used for histology. Patellar tendon was also subjected to quantitative RT-PCR to evaluate expression of anabolic and catabolic genes. No differences in biomechanical data between the control and the low vibration groups were found. There was evidence of significant weakness in the MCL with high vibration, but no significant effect on the PT or AT. Histology of the MCL and PT showed a hypercellular tissue response and some fiber disorganization with high vibration. High vibration caused an increase in collagen expression and a trend for an increase in IGF-1 expression suggesting a potential anabolic response to prevent tendon overuse injury. PMID:23623311

Keller, Benjamin V.; Davis, Matthew L.; Thompson, William R.; Dahners, Laurence E.; Weinhold, Paul S.

2014-01-01

47

Benefits of whole body vibration training in patients hospitalised for COPD exacerbations - a randomized clinical trial  

PubMed Central

Background Patients with stable COPD show improvements in exercise capacity and muscular function after the application of whole body vibration. We aimed to evaluate whether this modality added to conventional physiotherapy in exacerbated hospitalised COPD patients would be safe and would improve exercise capacity and quality of life. Methods 49 hospitalised exacerbated COPD patients were randomized (1:1) to undergo physiotherapy alone or physiotherapy with the addition of whole body vibration. The primary endpoint was the between-group difference of the 6-minute walking test (day of discharge – day of admission). Secondary assessments included chair rising test, quality of life, and serum marker analysis. Results Whole body vibration did not cause procedure-related adverse events. Compared to physiotherapy alone, it led to significantly stronger improvements in 6-minute walking test (95.55?±?76.29 m vs. 6.13?±?81.65 m; p?=?0.007) and St. Georges Respiratory Questionnaire (-6.43?±?14.25 vs. 5.59?±?19.15, p?=?0.049). Whole body vibration increased the expression of the transcription factor peroxisome proliferator receptor gamma coactivator-1-? and serum levels of irisin, while it decreased serum interleukin-8. Conclusion Whole body vibration during hospitalised exacerbations did not cause procedure-related adverse events and induced clinically significant benefits regarding exercise capacity and health-related quality of life that were associated with increased serum levels of irisin, a marker of muscle activity. Trial registration German Clinical Trials Register DRKS00005979. Registered 17 March 2014. PMID:24725369

2014-01-01

48

Fluid dynamic aspects of cardiovascular behavior during low-frequency whole-body vibration  

NASA Technical Reports Server (NTRS)

The behavior of the cardiovascular system during low frequency whole-body vibration, such as encountered by astronauts during launch and reentry, is examined from a fluid mechanical viewpoint. The vibration characteristics of typical manned spacecraft and other vibration environments are discussed, and existing results from in vivo studies of the hemodynamic aspects of this problem are reviewed. Recent theoretical solutions to related fluid mechanical problems are then used in the interpretation of these results and in discussing areas of future work. The results are included of studies of the effects of vibration on the work done by the heart and on pulsatile flow in blood vessels. It is shown that important changes in pulse velocity, the instantaneous velocity profile, mass flow rate, and wall shear stress may occur in a pulsatile flow due to the presence of vibration. The significance of this in terms of changes in peripheral vascular resistance and possible damage to the endothelium of blood vessels is discussed.

Nerem, R. M.

1973-01-01

49

Low back and neck pain in locomotive engineers exposed to whole-body vibration.  

PubMed

The objective of this study was to determine the prevalence and excess risk of low back pain and neck pain in locomotive engineers, and to investigate the relationship of both with whole-body vibration exposure. A cross-sectional survey comparing locomotive engineers with other rail worker referents was conducted. Current vibration levels were measured, cumulative exposures calculated for engineers and referents, and low back and neck pain assessed by a self-completed questionnaire. Median vibration exposure in the z- (vertical) axis was 0.62 m/s(2). Engineers experienced more frequent low back and neck pain, odds ratios (ORs) of 1.77 (95% confidence interval [CI]: 1.19-2.64) and 1.92 (95% CI: 1.22-3.02), respectively. The authors conclude that vibration close to the "action levels" of published standards contribute to low back and neck pain. Vibration levels need to be assessed conservatively and control measures introduced. PMID:24499248

McBride, David; Paulin, Sara; Herbison, G Peter; Waite, David; Bagheri, Nasser

2014-01-01

50

Synchronous whole-body vibration increases V O 2 during and following acute exercise  

Microsoft Academic Search

Single bout whole-body vibration (WBV) exercise has been shown to produce small but significant increases in oxygen consumption\\u000a (VO2). How much more a complete whole-body exercise session (multiple dynamic exercises targeting both upper and lower body muscles)\\u000a can increase VO2 is unknown. The purpose of this study was to quantify VO2 during and for an extended time period (24 h) following

Tom J. HazellPeter; Peter W. R. Lemon

51

The effects of whole body vibration on balance, joint position sense and cutaneous sensation  

Microsoft Academic Search

Whole body vibration (WBV) may enhance muscular strength and power but little is known about its influence on sensory-motor\\u000a function. Vibration of a single muscle or tendon affects the afferent system in a manner that depends on amplitude and frequency.\\u000a WBV stimulates many muscle groups simultaneously and the frequencies and amplitudes used are different from many of the studies\\u000a on

Ross D. PollockSally ProvanFinbarr; Sally Provan; Finbarr C. Martin; Di J. Newham

52

Mind-Body Therapies and Osteoarthritis of the Knee  

PubMed Central

Osteoarthritis of the knee is a major cause of disability among adults worldwide. Important treatment options include nonpharmacologic therapies, and especially symptom management strategies in which patients take an active role. Among these, mind-body therapies may have particular promise for alleviating the distressful symptoms associated with osteoarthritis of the knee. However, systematic reviews are lacking. The objective of this paper is to review English-language articles describing clinical studies evaluating the effects of patient-driven mind-body therapies on symptoms of knee osteoarthritis. Eight studies, representing a total of 267 participants, met the inclusion criteria. Interventions included tai chi, qigong, and yoga. Collectively, these studies suggest that specific mind-body practices may help alleviate pain and enhance physical function in adults suffering from osteoarthritis of the knee. However, sample sizes are small, rigorous investigations are few, and the potential benefits of several mind-body therapies have not yet been systematically tested. Additional high-quality studies are needed to clarify the effects of specific mind-body therapies on standardized measures of pain, physical function, and related indices in persons with osteoarthritis of the knee, and to investigate possible underlying mechanisms. PMID:21151770

Selfe, Terry Kit; Innes, Kim E.

2010-01-01

53

Effect of Whole-Body Vibration on Speech. Part 2; Effect on Intelligibility  

NASA Technical Reports Server (NTRS)

The effect on speech intelligibility was measured for speech where talkers reading Diagnostic Rhyme Test material were exposed to 0.7 g whole body vibration to simulate space vehicle launch. Across all talkers, the effect of vibration was to degrade the percentage of correctly transcribed words from 83% to 74%. The magnitude of the effect of vibration on speech communication varies between individuals, for both talkers and listeners. A worst case scenario for intelligibility would be the most sensitive listener hearing the most sensitive talker; one participant s intelligibility was reduced by 26% (97% to 71%) for one of the talkers.

Begault, Durand R.

2011-01-01

54

Biodynamic characteristics of upper limb reaching movements of the seated human under whole-body vibration.  

PubMed

Simulation of human movements is an essential component for proactive ergonomic analysis and biomechanical model development (Chaffin, 2001). Most studies on reach kinematics have described human movements in a static environment, however the models derived from these studies cannot be applied to the analysis of human reach movements in vibratory environments such as in-vehicle operations. This study analyzes three-dimensional joint kinematics of the upper extremity in reach movements performed in static and specific vibratory conditions and investigates vibration transmission to shoulder, elbow, and hand along the body path during pointing tasks. Thirteen seated subjects performed reach movements to five target directions distributed in their right hemisphere. The results show similarities in the characteristics of movement patterns and reach trajectories of upper body segments for static and dynamic environments. In addition, vibration transmission through upper body segments is affected by vibration frequency, direction, and location of the target to be reached. Similarities in the pattern of movement trajectories revealed by filtering vibration-induced oscillations indicate that coordination strategy may not be drastically different in static and vibratory environments. This finding may facilitate the development of active biodynamic models to predict human performance and behavior under whole body vibration exposure. PMID:22814094

Kim, Heon-Jeong; Martin, Bernard J

2013-02-01

55

Vibration control of a manipulator tip on a flexible body  

NASA Technical Reports Server (NTRS)

Vibration control of a rigid manipulator tip on a main flexible uniform beam is examined. It is proposed to add a compensator between the manipulator and the beam to rotate and extend/retrieve the manipulator during the control period. The 2D station-keeping maneuvers within the linear range without gravity and damping are considered. The compensatory open-loop control law, which depends on the amplitudes of the beam's flexible deformations at the connection joint, is synthesized using linear quadratic regulator techniques. After introducing the compensatory control into the system, system control is still stable, and the tip coordinates of the manipulator can be made to closely follow the rigid beam motion, which is assumed to be a desired motion.

Xu, J.; Bainum, P. M.; Li, F.

1992-01-01

56

Whole-Body Vibration Exposure Study in U.S. Railroad Locomotives—An Ergonomic Risk Assessment  

Microsoft Academic Search

Whole-body vibration exposure of locomotive engineers and the vibration attenuation of seats in 22 U.S. locomotives (built between 1959 and 2000) was studied during normal revenue service and following international measurement guidelines. Triaxial vibration measurements (duration mean 155 min, range 84–383 min) on the seat and on the floor were compared. In addition to the basic vibration evaluation (aw rms),

Eckardt Johanning; Siegfried Fischer; Eberhard Christ; Benno Göres; Paul Landsbergis

2002-01-01

57

Body temperature of the parasitic wasp Pimpla turionellae (Hymenoptera) during host location by vibrational sounding  

PubMed Central

The pupal parasitoid Pimpla turionellae (L.) uses self-produced vibrations transmitted on the plant substrate, so-called vibrational sounding, to locate immobile concealed pupal hosts. The wasps are able to use vibrational sounding reliably over a broad range of ambient temperatures and even show an increased signal frequency and intensity at low temperatures. The present study investigates how control of body temperature in the wasps by endothermic mechanisms may facilitate host location under changing thermal environments. Insect body temperature is measured with real-time IR thermography on plant-stem models at temperature treatments of 10, 18, 26 and 30 °C, whereas behaviour is recorded with respect to vibrational host location. The results reveal a low-level endothermy that likely interferes with vibrational sound production because it occurs only in nonsearching females. At the lowest temperature of 10 °C, the thoracic temperature is 1.15 °C warmer than the ambient surface temperature whereas, at the high temperatures of 26 and 30 ° C, the wasps cool down their thorax by 0.29 and 0.47 °C, respectively, and their head by 0.45 and 0.61 °C below ambient surface temperature. By contrast, regardless of ambient temperature, searching females always have a slightly elevated body temperature of at most 0.30 °C above the ambient surface temperature. Behavioural observations indicate that searching females interrupt host location more frequently at suboptimal temperatures, presumably due to the requirements of thermoregulation. It is assumed that both mechanisms, producing vibrations for host location and low-level endothermy, are located in the thorax. Endothermy by thoracic muscle work probably disturbs signal structure of vibrational sounding, so the processes cannot be used at the same time. PMID:22140295

KRODER, STEFAN; SAMIETZ, JÖRG; STABENTHEINER, ANTON; DORN, SILVIA

2011-01-01

58

Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder  

ERIC Educational Resources Information Center

This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…

Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

2011-01-01

59

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder  

ERIC Educational Resources Information Center

The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

2010-01-01

60

STUDYING THE STREAMLINING OF A BLUNTED BODY BY A VIBRATIONAL-NONEQUILIBRIUM DISSOCIATED GAS  

E-print Network

into consideration. Specific calculations have been carried out for oxygen and nitrogen. i. The Physical Flow Model calculated from the zero level; n and p are the concentration and density of the gas; m is the massSTUDYING THE STREAMLINING OF A BLUNTED BODY BY A VIBRATIONAL-NONEQUILIBRIUM DISSOCIATED GAS O. Yu

Riabov, Vladimir V.

61

Stabilization of the rotational motion of a rigid body on a vibrating base  

Microsoft Academic Search

The problem of the optimum (in a certain sense) stabilization of the permanent rotation of a heavy rigid body on a vibrating base is solved in the context of analytical control theory. Stabilization is achieved by means of a gimbal-suspended balanced gyroscope controlled by three moments. The control moments, obtained in explicit form, ensure the asymptotic stability of the rotational

V. V. Krementulo

1984-01-01

62

The effect of occupational whole-body vibration on standing balance: A systematic review  

Microsoft Academic Search

Adverse health effects from exposure to occupational whole-body vibration (WBV) are common among drivers. In particular some researchers consider that there is kinaesthetic and balance disturbance from WBV exposure in the workplace and this might be one of the aetiological factors responsible for occupational low back pain in drivers. The purpose of this study was to undertake a critical review

Ramakrishnan Mani; Stephan Milosavljevic; S. John Sullivan

2010-01-01

63

Stereotactic Body Radiation Therapy in Spinal Metastases  

SciTech Connect

Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

Ahmed, Kamran A. [Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN (United States); Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Rose, Peter S. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Olivier, Kenneth R. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Brinkmann, Debra H. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Laack, Nadia N., E-mail: laack.nadia@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

2012-04-01

64

DISSOCIATION REDUCTION IN BODY THERAPY DURING SEXUAL ABUSE RECOVERY  

PubMed Central

The study purpose was to examine dissociation in body therapy for women receiving psychotherapy for childhood sexual abuse. An initial intervention study provided an opportunity to examine dissociation; the sample of 24 women received eight, one-hour body therapy sessions. The Dissociative Experiences Scale served as the predictor variable, and the outcome measures reflected psychological and physical health, and body connection. Repeated measures analysis of variance was used to examine dissociation reduction across time. Pearson correlations were used to describe associations between the relative change in dissociation and outcomes. The results demonstrated that the greatest change was the reduction of dissociation; there was an incremental effect across time and a strong association between change in dissociation and health outcomes. High dissociation at baseline (moderate levels) predicted positive outcomes. The results demonstrated the importance of moderate dissociation as an indicator of distress, and the central role of dissociation reduction in health and healing. PMID:17400147

Price, Cynthia

2007-01-01

65

Measuring body layer vibration of vocal folds by high-frame-rate ultrasound synchronized with a modified electroglottograph.  

PubMed

The body-cover concept suggests that the vibration of body layer is an indispensable component of vocal fold vibration. To quantify this vibration, a synchronized system composed of a high-frame-rate ultrasound and a modified electroglottograph (EGG) was employed in this paper to simultaneously image the body layer vibration and record the vocal fold vibration phase information during natural phonations. After data acquisition, the displacements of in vivo body layer vibrations were measured from the ultrasonic radio frequency data, and the temporal reconstruction method was used to enhance the measurement accuracy. Results showed that the modified EGG, the waveform and characteristic points of which were identical to the conventional EGG, resolved the position conflict between the ultrasound transducer and EGG electrodes. The location and range of the vibrating body layer in the estimated displacement image were more clear and discernible than in the ultrasonic B-mode image. Quantitative analysis for vibration features of the body layer demonstrated that the body layer moved as a unit in the superior-inferior direction during the phonation of normal chest registers. PMID:23862828

Tang, Shanshan; Zhang, Yuanyuan; Qin, Xulei; Wang, Supin; Wan, Mingxi

2013-07-01

66

Whole body vibration and posture as risk factors for low back pain among forklift truck drivers  

NASA Astrophysics Data System (ADS)

A cross-sectional study was conducted to investigate the risks from whole-body vibration and posture demands for low back pain (LBP) among forklift truck (forklift) drivers. Using a validated questionnaire, information about health history was obtained over a period of two weeks in face-to-face interviews. The forklift drivers were observed in respect of their sitting posture, including frequency with which different positions were adopted (bending, leaning and twisting) and postural analyses were conducted using the OWAS and RULA techniques. Forklift vibrations at the seat (exposure) were measured in the three orthogonal axes ( x-fore and aft, y-lateral and z-vertical) under actual working conditions according to the recommendations of ISO 2631-1. The results showed that LBP was more prevalent amongst forklift drivers than among non-drivers and driving postures in which the trunk is considerably twisted or bent forward associated with greatest risk. Furthermore, forklift drivers showed to be exposed to acceptable levels of vibration in the x- and y-directions (i.e., below the EU Physical Agents Directive on Vibration Exposure recommended action level—0.5 m/s 2), but not in the z-direction. There were indications that whole-body vibration acts associatively with other factors (not independently) to precipitate LBP.

Hoy, J.; Mubarak, N.; Nelson, S.; Sweerts de Landas, M.; Magnusson, M.; Okunribido, O.; Pope, M.

2005-06-01

67

Whole body vibration exposures in metropolitan bus drivers: A comparison of three seats  

NASA Astrophysics Data System (ADS)

Using a repeated measures study design, three different seats were evaluated as 12 metropolitan bus drivers drove a standardized test route including city streets, old and new freeways, and a street segment containing 10 large speed humps. Three comparisons were made: (1) comparing seats made by different manufactures (Seats 1 and 2), (2) comparing seats with a standard foam (Seat 2) and silicone foam (Seat 3) seat pans, and (3) comparing WBV exposures based on individual factors such as seat pressure settings and body weight. Whole body vibration (WBV) exposures were measured using a tri-axial seat pan accelerometer and the attenuation capabilities of each seat were evaluated by comparing the vibrations measured at the floor and seat of the bus. There were significant WBV exposure differences between the various street types, which was shown across all seat types. The city street and older freeway segments had the highest WBV exposures with both segments producing WBV exposures slightly above the action limit for vibration dose value (VDV). Relative to Seat 2, Seat 1 performed better at attenuating impulsive and shock related WBV exposures; however, neither seat performed significantly better when average vibration ( A w) and VDV WBV exposures were compared. In addition, no performance differences were seen between the standard foam (Seat 2) and silicone foam (Seat 3) seat pans. Seat suspension stiffness (air pressure) was also examined, and the results indicated that the higher the seat air pressure the lower the A w, VDV, and static compressive dose ( S ed) vibration exposures. This study provided a unique opportunity to evaluate on-the-job whole body vibration exposures in a standardized, controlled setting.

Blood, R. P.; Ploger, J. D.; Yost, M. G.; Ching, R. P.; Johnson, P. W.

2010-01-01

68

Measurement of whole-body vibration exposure from speed control humps  

NASA Astrophysics Data System (ADS)

The main objective of speed control humps is to introduce shocks and high vibration levels when a car passes over them if its speed is higher than the allowable limit. Hump geometry is a major factor in altering the level of these shocks and specifying the speed limit. However, there is no study of the relationship between whole body vibration due to passing over a speed control hump and lower back pain or occupational diseases. In this study, an experimental investigation is conducted to evaluate health risks associated with different geometry speed control humps. Vibration levels and shocks are measured by a seat pad accelerometer placed under the driver's seat to evaluate hazard risks on the human body's lower back. The assessment is based on two standard methods of measuring whole body vibration: the British standard BS 6841 and the new ISO/DIS standard 2631-5. These methods are used to assess the effects of vehicle type, passenger location in the vehicle, vehicle speed, and speed control hump geometry. It was found that circular speed control humps currently installed on many public roads should be modified in order to eliminate hazards. Two newly designed speed humps were proved to be less hazardous than circular speed control humps.

Khorshid, E.; Alkalby, F.; Kamal, H.

2007-07-01

69

Spectral composition of a measuring signal during measurements of vibration rates of a moving body  

NASA Technical Reports Server (NTRS)

Cybernetics diagnostics of machines and mechanisms using the spectral approach is discussed. The problem of establishing the accuracy of determination of the spectral composition is investigated. In systems with rectilinear or rotary movement, the vibrations appear in the form of movement rate vibrations, which are equivalent to frequency modulation of the signal, in proportion to the mean movement rate of the body. The case of a harmonic signal which reproduces and analyzes the characteristics of the frequency modulated signal is discussed. Mathematical models are developed to show the relationships of the parameters.

Daynauskas, I. A. I.; Slepov, N. N.

1973-01-01

70

Mind-body Therapies for Menopausal Symptoms: A Systematic Review  

PubMed Central

Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

2010-01-01

71

Acute effects of whole body vibration during passive standing on soleus H-reflex in subjects with and without spinal cord injury  

E-print Network

1 Acute effects of whole body vibration during passive standing on soleus H-reflex in subjects cord injuries, whole body vibration, neuromuscular plasticity, motoneuronal excitability, soleus H-reflex Abstract Whole-body vibration (WBV) is being used to enhance neuromuscular performance including muscle

Popovic, Milos R.

72

Evaluation of lumbar vertebra injury risk to the seated human body when exposed to vertical vibration  

NASA Astrophysics Data System (ADS)

The objective of this research is to numerically determine the levels of vibration not to exceed accordingly to the corresponding dynamic stresses in the lumbar rachis when exposed to whole-body vibrations in order to identify the risk of adverse health effect to which professional heavy equipment drivers are particularly prone. A parametric finite element model of the lumbar rachis is generated in order to compute the modal parameters, the dynamic stresses and forces under harmonic excitations in a seated posture. The stress analysis reveals that the areas exposed to the highest fracture risk are the cancellous bone of the vertebral body as well as the vertebral endplate when vertical vibrations are transmitted from a seat to the lumbar spine of a driver. An injury risk factor has been developed in order to estimate the risk of adverse health effect arising from mechanical vibrations. It is shown that the injury risk factor increases with the age and consequently that the excitation amplitude must be limited to lower levels when age increases.

Ayari, H.; Thomas, M.; Doré, S.; Serrus, O.

2009-03-01

73

Analysis of damped vibrations of thin bodies embedded into a fractional derivative viscoelastic medium  

NASA Astrophysics Data System (ADS)

Damped vibrations of elastic thin bodies, such as plates and circular cylindrical shells, embedded into a viscoelastic medium, the rheological features of which are described by fractional derivatives, are considered in the present article. Besides the forces of viscous friction, a thin body is subjected to the action of external forces dependent on the coordinates of the middle surface and time. The boundary conditions are proposed in such a way that the governing equations allow the Navier-type solution. The Laplace integral transform method and the method of expansion of all functions entering into the set of governing equations in terms of the eigenfunctions of the given problem are used as the methods of solution. It is shown that as a result of such a procedure, the systems of equations in the generalized coordinates could be reduced to infinite sets of uncoupled equations, each of which describes damped vibrations of a mechanical oscillator based on the fractional derivative Kelvin-Voigt model.

Rossikhin, Yury A.; Shitikova, Marina V.

2013-04-01

74

Effect of four-month vertical whole body vibration on performance and balance  

Microsoft Academic Search

TORVINEN, S., P. KANNUS, H. SIEVANEN, T. A. JARVINEN, M. PASANEN, S. KONTULAINEN, T. L. JARVINEN, M. JARVINEN, P. OJA, and I. VUORI. Effect of four-month vertical whole body vibration on performance and balance. Med. Sci. Sports Exerc., Vol. 34, No. 9, pp. 1523-1528, 2002. Purpose: This randomized controlled study was designed to investigate the effects of a 4-month whole

SAILA TORVINEN; PEKKA KANNUS; MATTI PASANEN; SAIJA KONTULAINEN; PEKKA OJA; ILKKA VUORI

2002-01-01

75

Study on Development of the Seated Human Body System Exposed to Vehicular Ride Vibration Environment  

Microsoft Academic Search

\\u000a This paper tries to find an appropriate structure of human model, which can better represent the characteristics of the real\\u000a human body, using the apparent mass (APMS) and head transmissibility (STHT) in vertical vibrations. The model parameters were\\u000a identified through minimizing an error function comprising the measured and model response in terms of magnitude and phase\\u000a characteristics of APMS and

S. Rodean; M. Arghir

76

Effects of whole-body vibration and resistance training on knee extensors muscular performance  

Microsoft Academic Search

Whole-body vibration (WBV) is being promoted as an efficient complement to resistance training. The aim of this study was\\u000a to investigate the effects of an 8-week program of WBV in combination with resistance training on knee extensors muscular\\u000a performance. A group of 29 young adults (25 men, 4 women; age 21.8 ± 1.5) performed a WBV plus resistance training program\\u000a (WBV + RES) or

E. G. Artero; J. C. Espada-Fuentes; J. Argüelles-Cienfuegos; A. Román; P. J. Gómez-López; A. Gutiérrez

77

Whole body vibration and posture as risk factors for low back pain among forklift truck drivers  

Microsoft Academic Search

A cross-sectional study was conducted to investigate the risks from whole-body vibration and posture demands for low back pain (LBP) among forklift truck (forklift) drivers. Using a validated questionnaire, information about health history was obtained over a period of two weeks in face-to-face interviews. The forklift drivers were observed in respect of their sitting posture, including frequency with which different

J. Hoy; N. Mubarak; S. Nelson; M. Sweerts de Landas; M. Magnusson; O. Okunribido; M. Pope

2005-01-01

78

The influence of dynamic properties of ground soil on vibration characteristics of rigid body on sand ground  

Microsoft Academic Search

This study aims to investigate the influence of dynamic properties of the ground soil on vibration properties of a rigid body\\u000a placed on the sand ground surface to clarify the vibration behavior of a structure in terms of the interaction between the\\u000a structure and the ground. A series of cyclic triaxial tests and three types of model vibration tests were

Yoon-Sang Kim; Tae-Gyun Ha; Jae-Jin Choi; Choong-Ki Chung

2007-01-01

79

Influence of Combined Whole-Body Vibration Plus G-Loading on Visual Performance  

NASA Technical Reports Server (NTRS)

Recent engineering analyses of the integrated Ares-Orion stack show that vibration levels for Orion crews have the potential to be much higher than those experienced in Gemini, Apollo, and Shuttle vehicles. Of particular concern to the Constellation Program (CxP) is the 12 Hz thrust oscillation (TO) that the Ares-I rocket develops during the final 20 seconds preceding first-stage separation, at maximum G-loading. While the structural-dynamic mitigations being considered can assure that vibration due to TO is reduced to below the CxP crew health limit, it remains to be determined how far below this limit vibration must be reduced to enable effective crew performance during launch. Moreover, this "performance" vibration limit will inform the operations concepts (and crew-system interface designs) for this critical phase of flight. While Gemini and Apollo studies provide preliminary guidance, the data supporting the historical limits were obtained using less advanced interface technologies and very different operations concepts. In this study, supported by the Exploration Systems Mission Directorate (ESMD) Human Research Program, we investigated display readability-a fundamental prerequisite for any interaction with electronic crew-vehicle interfaces-while observers were subjected to 12 Hz vibration superimposed on the 3.8 G loading expected for the TO period of ascent. Two age-matched groups of participants (16 general population and 13 Crew Office) performed a numerical display reading task while undergoing sustained 3.8 G loading and whole-body vibration at 0, 0.15, 0.3, 0.5, and 0.7 g in the eyeballs in/out (x-axis) direction. The time-constrained reading task used an Orion-like display with 10- and 14-pt non-proportional sans-serif fonts, and was designed to emulate the visual acquisition and processing essential for crew system monitoring. Compared to the no-vibration baseline, we found no significant effect of vibration at 0.15 and 0.3 g on task error rates (ER) or response times (RT). Significant degradations in both ER and RT, however, were observed at 0.5 and 0.7 g for 10-pt, and at 0.7 g for 14-pt font displays. These objective performance measures were mirrored by participants' subjective ratings. Interestingly, we found that the impact of vibration on ER increased with distance from the center of the display, but only for vertical displacements. Furthermore, no significant ER or RT aftereffects were detected immediately following vibration, regardless of amplitude. Lastly, given that our reading task required no specialized spaceflight expertise, our finding that effects were not statistically distinct between our two groups is not surprising. The results from this empirical study provide initial guidance for evaluating the display readability trade-space between text-font size and vibration amplitude. However, the outcome of this work should be considered preliminary in nature for a number of reasons: 1. The single 12 Hz x-axis vibration employed was based on earlier load-cycle models of the induced TO environment at the end of Ares-I first stage flight. Recent analyses of TO mitigation designs suggest that significant concurrent off-axis vibration may also occur. 2. The shirtsleeve environment in which we tested fails to capture the full kinematic and dynamic complexity of the physical interface between crewmember and the still-to-bematured helmet-suit-seat designs, and the impact these will have for vibration transmission and consequent performance. 3. By examining performance in this reading and number processing task, we are only assessing readability, a first and necessary step that in itself does not directly address the performance of more sophisticated operational tasks such as vehicle-health monitoring or manual control of the vehicle.

Adelstein, Bernard D.; Beutter, Brent Robert; Kaiser, Mary K.; McCann, Robert S.; Stone, Leland S.; Anderson, Mark R.; Renema, Fritz; Paloski, William H.

2009-01-01

80

Transverse vibration and buckling of a cantilevered beam with tip body under constant axial base acceleration  

NASA Technical Reports Server (NTRS)

The planar transverse bending behavior of a uniform cantilevered beam with rigid tip body subject to constant axial base acceleration was analyzed. The beam is inextensible and capable of small elastic transverse bending deformations only. Two classes of tip bodies are recognized: (1) mass centers located along the beam tip tangent line; and (2) mass centers with arbitrary offset towards the beam attachment point. The steady state response is studied for the beam end condition cases: free, tip mass, tip body with restricted mass center offset, and tip body with arbitrary mass center offset. The first three cases constitute classical Euler buckling problems, and the characteristic equation for the critical loads/accelerations are determined. For the last case a unique steady state solution exists. The free vibration response is examined for the two classes of tip body. The characteristic equation, eigenfunctions and their orthogonality properties are obtained for the case of restricted mass center offset. The vibration problem is nonhomogeneous for the case of arbitrary mass center offset. The exact solution is obtained as a sum of the steady state solution and a superposition of simple harmonic motions.

Storch, J.; Gates, S.

1983-01-01

81

Perturbation moment in a floating gyroscope with an elastic float body in the case of an internal vibration source  

Microsoft Academic Search

A study is made of the effect of the elastic deformations of the float body in a hydrostatic-suspension gyroscope on the vibrational perturbation moment. The vibrations are generated by the gyromotor rotor, which shifts on the supports because of the imperfection of the latter. Consideration is given to the cases of very narrow and very wide end slots between the

K. P. Andreichenko; L. I. Mogilevich

1986-01-01

82

The Influence of Whole-Body Vibration on Creatine Kinase Activity and Jumping Performance in Young Basketball Players  

ERIC Educational Resources Information Center

Purpose: To quantify creatine kinase (CK) activity changes across time following an acute bout of whole-body vibration (WBV) and determine the association between changes in CK activity and jumping performance. Method: Twenty-six elite young basketball players were assigned to 3 groups: 36-Hz and 46-Hz vibration groups (G36 and G46, respectively)…

Fachina, Rafael; da Silva, Antônio; Falcão, William; Montagner, Paulo; Borin, João; Minozzo, Fábio; Falcão, Diego; Vancini, Rodrigo; Poston, Brach; de Lira, Claudio

2013-01-01

83

The Use of a Manual Vibrator in the Speech Therapy Program of Four School-Age Mentally Retarded Children.  

ERIC Educational Resources Information Center

The use of a manual vibrator to supplement the traditional speech therapy program for four moderately mentally retarded six- and seven-year-old children attending a special education class is discussed. (Author/SEW)

Grant, Lauren

1982-01-01

84

The effects of vibration therapy on muscle force loss following eccentrically induced muscle damage  

Microsoft Academic Search

The purpose of this study was to investigate the effects of acute vibration therapy (VT) on performance recovery after a bout\\u000a of strenuous eccentric exercise. Eight healthy males completed 300 maximal eccentric contractions of the quadriceps of one\\u000a leg on an isokinetic dynamometer. Immediately after exercise and 12 and 24 h post-exercise, the subjects underwent either\\u000a VT or a control treatment

Matthew J. BarnesBlake; Blake G. Perry; Toby Mündel; Darryl J. Cochrane

85

Inference-Based Therapy for Body Dysmorphic Disorder  

PubMed Central

Body dysmorphic disorder (BDD) is a debilitating disorder characterized by an excessive pre-occupation with an imagined or very slight defect in one’s physical appearance. Despite the overall success of cognitive behavioural therapy (CBT) in treating BDD, some people do not seem to benefit as much from this approach. Those with high overvalued ideation (OVI), for instance, have been shown to not respond well with CBT. The purpose of this study was to evaluate the efficacy of an inference-based therapy (IBT) in treating BDD. IBT is a cognitive intervention that was first developed for obsessive–compulsive disorder with high OVI, but whose focus on beliefs can also apply to a BDD population. IBT conceptualizes BDD obsessions (e.g., ‘I feel like my head is deformed’) as idiosyncratic inferences arrived at through inductive reasoning processes. Such primary inferences represent the starting point of obsessional doubt and the treatment focuses on addressing the faulty inferences that maintain the doubt. Thirteen BDD participants, of whom 10 completed, underwent a 20-week IBT for BDD. The participants improved significantly over the course of therapy, with large diminutions in BDD and depressive symptoms. OVI also decreased throughout therapy and was not found to be related to reduction in BDD symptoms. Although a controlled-trial comparing CBT with IBT is needed, it is proposed that IBT constitutes a promising treatment alternative for BDD especially in cases where OVI is high. PMID:21793103

Taillon, Annie; O’Connor, Kieron; Dupuis, Gilles; Lavoie, Marc

2013-01-01

86

Whole body vibration exposures in forklift operators: comparison of a mechanical and air suspension seat.  

PubMed

Using a repeated measures design, this study compared differences in whole body vibration (WBV) exposures when 12 forklift operators drove the same forklift with a mechanical suspension and an air suspension seat. A portable PDA-based WBV data acquisition system collected and analysed time-weighted and raw WBV data per ISO 2631-1 and 2631-5 WBV measurement standards. Tri-axial measurements of weighted vibration (A(w)), crest factor, vibration dose values, time-weighted average-peak, raw (+) peak, raw (-) peak and static compression dose (S(ed)) were compared between seats. There were significant differences in z-axis WBV exposures with the air suspension seat, yielding lower WBV exposures. In addition, there were differences between seats in how they attenuated WBV exposures based on the driver's weight. In the mechanical suspension seat, WBV exposures were weight-dependent, with lighter drivers having higher WBV exposures, whereas with the air suspension seat, the same trends were not as prevalent. STATEMENT OF RELEVANCE: This study contributes to the understanding of how different seat suspensions can influence WBV transmission and how some components of vibration transmission are dependent on the weight of the driver. Additional systematic studies are needed to quantify how various factors can influence WBV exposures. PMID:20967660

Blood, Ryan P; Ploger, James D; Johnson, Peter W

2010-11-01

87

Whole-body vibration transmissibility in supine humans: effects of board litter and neck collar.  

PubMed

Whole-body vibration has been identified as a stressor to supine patients during medical transportation. The transmissibility between the input platform acceleration and the output acceleration of the head, sternum, pelvis, head-sternum, and pelvis-sternum of eight supine subjects were investigated. Vibration files were utilized in the fore-aft, lateral, and vertical directions. The power spectral density across the bandwidth of 0.5-20 Hz was approximately flat for each file. A comparison between a baseline rigid-support and a support with a long spinal board strapped to a litter has shown that the latter has considerable effects on the transmitted motion in all directions with a double magnification in the vertical direction around 5 Hz. The results also showed that the neck-collar has increased the relative head-sternum flexion-extension because of the input fore-aft vibration, but reduced the head-sternum extension-compression due to the input vertical vibration. PMID:24075288

Meusch, John; Rahmatalla, Salam

2014-05-01

88

Modal analysis of human body vibration model for Indian subjects under sitting posture.  

PubMed

Need and importance of modelling in human body vibration research studies are well established. The study of biodynamic responses of human beings can be classified into experimental and analytical methods. In the past few decades, plenty of mathematical models have been developed based on the diverse field measurements to describe the biodynamic responses of human beings. In this paper, a complete study on lumped parameter model derived from 50th percentile anthropometric data for a seated 54- kg Indian male subject without backrest support under free un-damped conditions has been carried out considering human body segments to be of ellipsoidal shape. Conventional lumped parameter modelling considers the human body as several rigid masses interconnected by springs and dampers. In this study, concept of mass of interconnecting springs has been incorporated and eigenvalues thus obtained are found to be closer to the values reported in the literature. Results obtained clearly establish decoupling of vertical and fore-and-aft oscillations. PMID:25323415

Singh, Ishbir; Nigam, S P; Saran, V H

2014-10-17

89

Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia.  

PubMed

A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers. PMID:20527267

Rozali, A; Rampal, K G; Shamsul Bahri, M T; Sherina, M S; Shamsul Azhar, S; Khairuddin, H; Sulaiman, A

2009-09-01

90

Does Additional Body Therapy Improve the Treatment of Anorexia Nervosa? A Comparison of Two Approaches  

Microsoft Academic Search

The aim of this study was to determine the effectiveness of a multimodal cognitive-behavioral approach (CBT) with additional body therapy, when compared with a behavioral and family approach (BFT) without specific body therapy. A total of 38 matched inpatients with anorexia nervosa were compared with respect to depression, body dissatisfaction, weight, and eating attitudes, at

Fernando Fernández; José Turón; Jürg Siegfried; Rolf Meermann; Julio Vallejo

1995-01-01

91

Effect of whole-body vibration on BMD: a systematic review and meta-analysis  

Microsoft Academic Search

Summary  Our systematic review and meta-analysis of randomized controlled trials (RCTs) examining whole-body vibration (WBV) effect\\u000a on bone mineral density (BMD) found significant but small improvements in hip areal BMD (aBMD) in postmenopausal women and\\u000a in tibia and spine volumetric BMD in children\\/adolescents, but not in other BMD measurements in postmenopausal women and young\\u000a adults.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction  Animal experiments report anabolic bone changes

L. Slatkovska; S. M. H. Alibhai; J. Beyene; A. M. Cheung

2010-01-01

92

The Effects of Quadriceps Strength Following Static and Dynamic Whole Body Vibration Exercise.  

PubMed

Numerous studies have shown performance benefits from including whole-body vibration (WBV) whether as a training modality or an acute exercise protocol when utilized as a component of the resistance training program. Some studies have indicated that performing dynamic exercises as compared to static position exercises while exposed to WBV might be beneficial, however, evidence is lacking. Thus, the purpose of this study was to determine if an acute bout of dynamic vs. static squats performed during WBV results in increases in quadriceps force production via dynamic isokinetic knee extension and flexion exercise. PMID:25268289

Bush, Jill A; Blog, Gabriel L; Kang, Jie; Faigenbaum, Avery D; Ratamess, Nicholas A

2014-09-29

93

Effect of whole-body vibration on neuromuscular performance and body composition for females 65 years and older: a randomized-controlled trial.  

PubMed

We examined whether the effect of multipurpose exercise can be enhanced by whole-body vibration (WBV). One hundred and fifty-one post-menopausal women (68.5 ± 3.1 years) were randomly assigned to three groups: (1) a training group (TG); (2) training including vibration (VTG); and (3) a wellness control group (CG). TG and VTG performed the same training program twice weekly (60 min), consisting of aerobic and strength exercises, with the only difference that leg strength exercises (15 min) were performed with (VTG) or without (TG) vibration. CG performed a low-intensity "wellness" program. At baseline and after 18 months, body composition was determined using dual-X-ray-absorptiometry. Maximum isometric strength was determined for the legs and the trunk region. Leg power was measured by countermovement jumps using a force-measuring plate. In the TG lean body mass, total body fat, and abdominal fat were favorably affected, but no additive effects were generated by the vibration stimulus. However, concerning muscle strength and power, there was a tendency in favor of the VTG. Only vibration training resulted in a significant increase of leg and trunk flexion strength compared with CG. In summary, WBV embedded in a multipurpose exercise program showed minor additive effects on body composition and neuromuscular performance. PMID:20500555

von Stengel, S; Kemmler, W; Engelke, K; Kalender, W A

2012-02-01

94

Whole-Body Vibrations Do Not Elevate the Angiogenic Stimulus when Applied during Resistance Exercise  

PubMed Central

Knowledge about biological factors involved in exercise-induced angiogenesis is to date still scanty. The present study aimed to investigate the angiogenic stimulus of resistance exercise with and without superimposed whole-body vibrations. Responses to the exercise regimen before and after a 6-week training intervention were investigated in twenty-six healthy male subjects. Serum was collected at the initial and final exercise sessions and circulating levels of matrix metalloproteinases (MMP) -2 and -9, Vascular Endothelial Growth Factor (VEGF) and endostatin were determined via ELISA. Furthermore, we studied the proliferative effect of serum-treated human umbilical vein endothelial cells in vitro via BrdU-incorporation assay. It was found that circulating MMP-2, MMP-9, VEGF and endostatin levels were significantly elevated (P<0.001) from resting levels after both exercise interventions, with higher post-exercise VEGF concentrations in the resistance exercise (RE) group compared to the resistive vibration exercise (RVE) group. Moreover, RE provoked increased endothelial cell proliferation in vitro and higher post-exercise circulating endostatin concentrations after 6 weeks of training. These effects were elusive in the RVE group. The present findings suggest that resistance exercise leads to a transient rise in circulating angiogenic factors and superimposing vibrations to this exercise type might not further trigger a potential signaling of angiogenic stimulation in skeletal muscle. PMID:24260349

Beijer, Åsa; Rosenberger, André; Bölck, Birgit; Suhr, Frank; Rittweger, Jörn; Bloch, Wilhelm

2013-01-01

95

Contactless micromanipulation of small particles by an ultrasound field excited by a vibrating body  

NASA Astrophysics Data System (ADS)

A method is presented to position and displace micron-sized particles of a diameter between 10 and 100 ?m without contact to solid instruments. An ultrasound field is utilized for this purpose. It is excited in a fluid-filled gap between a harmonically vibrating body and a rigid plane surface of an arbitrary other body, e.g., an object slide or a wafer. In this ultrasound field a force field is established, which acts on the particles suspended in the fluid and moves them to certain positions. The advantage of the method is that it is possible to manipulate single particles or many particles in parallel on any surface, for example, on a structured wafer. Theoretical calculations of the force field and experimental results including three principles to displace particles with micrometer accuracy are shown. The method might be used for microassembly or cell manipulation and treatment. .

Haake, Albrecht; Dual, Jurg

2005-05-01

96

Characterization and calibration of piezoelectric polymers: In situ measurements of body vibrations  

NASA Astrophysics Data System (ADS)

Piezoelectric polymers are known for their flexibility in applications, mainly due to their bending ability, robustness, and variable sensor geometry. It is an optimal material for minimal-invasive investigations in vibrational systems, e.g., for wood, where acoustical impedance matches particularly well. Many applications may be imagined, e.g., monitoring of buildings, vehicles, machinery, alarm systems, such that our investigations may have a large impact on technology. Longitudinal piezoelectricity converts mechanical vibrations normal to the polymer-film plane into an electrical signal, and the respective piezoelectric coefficient needs to be carefully determined in dependence on the relevant material parameters. In order to evaluate efficiency and durability for piezopolymers, we use polyvinylidene fluoride and measure the piezoelectric coefficient with respect to static pressure, amplitude of the dynamically applied force, and long-term stability. A known problem is the slow relaxation of the material towards equilibrium, if the external pressure changes; here, we demonstrate how to counter this problem with careful calibration. Since our focus is on acoustical measurements, we determine accurately the frequency response curve - for acoustics probably the most important characteristic. Eventually, we show that our piezopolymer transducers can be used as a calibrated acoustical sensors for body vibration measurements on a wooden musical instrument, where it is important to perform minimal-invasive measurements. A comparison with the simultaneously recorded airborne sound yields important insight of the mechanism of sound radiation in comparison with the sound propagating in the material. This is especially important for transient signals, where not only the long-living eigenmodes contribute to the sound radiation. Our analyses support that piezopolymer sensors can be employed as a general tool for the determination of the internal dynamics of vibrating systems.

Kappel, Marcel; Abel, Markus; Gerhard, Reimund

2011-07-01

97

Effects of Whole-Body Vibration on Resistance Training for Untrained Adults  

PubMed Central

Although resistance training (RT) combined with whole-body vibration (WBV) is becoming increasingly popular among untrained adults, the additional effects of WBV on muscle fitness are still not well understood. The aim of the present study was to evaluate the effects of WBV on muscle strength, muscle power, muscle endurance, and neuromuscular activities compared with the identical RT without WBV. Thirty-three individuals (6 males and 27 females; 22-49 years old) were randomly assigned to a training program using slow-velocity RT coupled with WBV (RT- WBV group, n = 17) or an identical exercise program without WBV (RT group, n = 16). Participants performed eight exercises per 60 min session on a vibration platform (RT-WBV group, frequency, 35 Hz; amplitude, 2 mm) twice weekly for seven weeks. To evaluate the effects of WBV, the maximal isometric and isokinetic knee extension strength, maximal isometric lumbar extension strength, countermovement-jump, and the number of sit-ups were measured before and after the trial. Significantly higher increases were observed in the maximal isometric and concentric knee extension strength (p = 0.02, p = 0.04 , respectively), and maximal isometric lumbar extension strength at 60 degrees of trunk flexion (p = 0.02) in the RT-WBV group (+36.8%, +38.4%, +26.4%, respectively) in comparison to the RT group (+16.5%, +12.8%, +14.3%, respectively). A significant difference was also observed between the RT-WBV group (+8.4%) and the RT group (+4.7%) in the countermovement jump height (p = 0.02). In conclusion, the results suggest that significant additional increases in maximal isometric and concentric knee extension and lumbar extension strength, and countermovement jump height can be achieved by incorporating WBV into a slow-velocity RT program during the initial stage of regular RT in untrained healthy adults. Key points A randomized controlled trial was conducted to investigate the effects of slow velocity resistance training combined with whole-body vibration on maximal muscle strength, power, muscle endurance, and neuromuscular activities in healthy untrained individuals. Resistance training program for lower extremities and trunk muscles were performed twice weekly for 7 weeks. A 7 weeks slow velocity resistance training program with whole-body vibration significantly increased maximal isometric knee extension and lumbar extension strength and power in healthy untrained individuals. PMID:24149879

Osawa, Yusuke; Oguma, Yuko

2011-01-01

98

sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity  

PubMed Central

The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG) spectrum recorded during whole-body vibration (WBV) exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental) and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05), and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05). This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity. Key points The spikes observed in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity The motion artifacts are more pronounced in the first spike than the following spikes in the sEMG spectrum Reflex activity during WBV exercises is enhanced with an additional load of approximately 50% of the body mass PMID:25729290

Lienhard, Karin; Cabasson, Aline; Meste, Olivier; Colson, Serge S.

2015-01-01

99

Loads on a spinal implant measured in vivo during whole-body vibration.  

PubMed

After spinal surgery, patients often want to know whether driving a car or using public transportation can be dangerous for their spine. In order to answer this question, a clinically proven vertebral body replacement (VBR) has been modified. Six load sensors and a telemetry unit were integrated into the inductively powered implant. The modified implant allows the measurement of six load components. Telemeterized devices were implanted in five patients; four of them agreed to exposure themselves to whole-body vibration. During the measurements, the patients sat on a driver seat fixed to a hexapod. They were exposed to random single-axis vibrations in X, Y, and Z directions as well as in multi-axis XYZ directions with frequencies between 0.3 and 30 Hz. Three intensity levels (unweighted root mean square values of 0.25, 0.5 and 1.0 m/s(2)) were applied. Three postures were studied: sitting freely, using a vertical backrest, and a backrest declined by an angle of 25 degrees . The patients held their hands on their thighs. As expected, the maximum force on the VBR increased with increasing intensity and the number of axes. For the highest intensity level and multi-axis vibration, the maximum forces increased by 89% compared to sitting relaxed. Leaning at the backrest as well as lower intensity levels markedly decreased the implant loads. Driving a car or using public transportation systems-when the patient leans towards the backrest-leads to lower implant loads than walking, and can therefore be allowed already shortly after surgery. PMID:20186440

Rohlmann, Antonius; Hinz, Barbara; Blüthner, Ralph; Graichen, Friedmar; Bergmann, Georg

2010-07-01

100

Automated fiducial marker planning for thoracic stereotactic body radiation therapy  

NASA Astrophysics Data System (ADS)

Stereotactic body-radiation therapy (SBRT) has gained acceptance in treating lung cancer. Localization of a thoracic lesion is challenging as tumors can move significantly with breathing. Some SBRT systems compensate for tumor motion with the intrafraction tracking of targets by two stereo fluoroscopy cameras. However, many lung tumors lack a fluoroscopic signature and cannot be directly tracked. Small radiopaque fiducial markers, acting as fluoroscopically visible surrogates, are instead implanted nearby. The spacing and configuration of the fiducial markers is important to the success of the therapy as SBRT systems impose constraints on the geometry of a fiducial-marker constellation. It is difficult even for experienced physicians mentally assess the validity of a constellation a priori. To address this challenge, we present the first automated planning system for bronchoscopic fiducial-marker placement. Fiducial-marker planning is posed as a constrained combinatoric optimization problem. Constraints include requiring access from a navigable airway, having sufficient separation in the fluoroscopic imaging planes to resolve each individual marker, and avoidance of major blood vessels. Automated fiducial-marker planning takes approximately fifteen seconds, fitting within the clinical workflow. The resulting locations are integrated into a virtual bronchoscopic planning system, which provides guidance to each location during the implantation procedure. To date, we have retrospectively planned over 50 targets for treatment, and have implanted markers according to the automated plan in one patient who then underwent SBRT treatment. To our knowledge, this approach is the first to address automated bronchoscopic fiducialmarker planning for SBRT.

Gibbs, Jason D.; Rai, Lav; Wibowo, Henky; Tsalyuk, Serge; Anderson, Eric D.

2012-02-01

101

Regorafenib-induced transverse myelopathy after stereotactic body radiation therapy  

PubMed Central

Stereotactic body radiation therapy (SBRT) delivers large doses of radiation with great accuracy, but is known to have deleterious effects on the vascular compartment of irradiated tissues. Combining SBRT with targeted anti-angiogenesis agents, while able to increase therapeutic efficacy, may unexpectedly precipitate vascular-based toxicities. In this report, we describe a patient with colon cancer who developed transverse myelopathy from regorafenib 2 years after receiving SBRT for three metastatic liver lesions. Regorafenib (Stivarga), formerly BAY 73-4506, (Bayer HealthCare Pharmaceuticals, Montville, NJ) is a multiple receptor tyrosine kinase inhibitor with anti-angiogenic effects used in metastatic colon cancer. Its most common side effects are fatigue, diarrhea and hypertension. However, severe neurologic toxicity has not been previously recognized. Here, we illustrate a case in which the patient developed hyperalgesia and radicular pain 2 weeks after starting regorafenib. Several studies report an increased neurological toxicity when angiogenesis inhibitors are given after radiation therapy, and we postulate that the angioinhibitory effects of regorafenib accelerated subclinical microvascular injury from SBRT. This unexpected toxicity may be clinically relevant when giving targeted angiogenesis inhibitors after SBRT. PMID:25436137

Tian, Sibo; Nissenblatt, Michael

2014-01-01

102

Effect of whole body vibrations on performance indexes of aerobic power and flexibility in non-athlete men  

Microsoft Academic Search

The aim of the present study was to investigate the effect of one session whole body vibration (WBV) on anaerobic power and flexibility in non-athletic male students. The participants were 12 untrained healthy male students (age: 25.42 years; body mass: 72.99 kg; height: 175.92 cm and body fat percentage: 19.69%). On the day of assessment, the subjects carried out 10

Babak Davoodi; Sajad Arshadi; Shirin Zilaei Bouri

2010-01-01

103

The effects of whole-body vibration on the Wingate test for anaerobic power when applying individualized frequencies.  

PubMed

Recently, individualized frequency (I-Freq) has been introduced with the notion that athletes may elicit a greater reflex response at differing levels (Hz) of vibration. The aim of the study was to evaluate acute whole-body vibration as a feasible intervention to increase power in trained cyclists and evaluate the efficacy of using I-Freq as an alternative to 30Hz, a common frequency seen in the literature. Twelve highly trained, competitive male cyclists (age, 29.9 ± 10.0 years; body height, 175.4 ± 7.8 cm; body mass, 77.3 ± 13.9 kg) participated in the study. A Wingate test for anaerobic power was administered on 3 occasions: following a control of no vibration, 30 Hz, or I-freq. Measures of peak power, average power (AP), and the rate of fatigue were recorded and compared with the vibration conditions using separate repeated measures analysis of variance. Peak power, AP, and the rate of fatigue were not significantly impacted by either the 30 Hz or I-Freq vibration interventions (p > 0.05). Given the trained status of the individuals in this study, the ability to elicit an acute response may have been muted. Future studies should further refine the vibration parameters used and assess changes in untrained or recreationally trained populations. PMID:24378660

Surowiec, Rachel K; Wang, Henry; Nagelkirk, Paul R; Frame, Jeffrey W; Dickin, D Clark

2014-07-01

104

Lift force acting on a cylindrical body in a fluid near the boundary of a cavity performing translational vibrations  

NASA Astrophysics Data System (ADS)

The averaged lift force acting on a cylindrical body near the boundary of a cavity with a fluid performing translational vibrations was studied. Experiments were performed with variation the viscosity of the fluid, the size and relative density of the body, and vibration parameters were varied. The lift force was measured by the method of dynamic suspension of a body in a gravitational field in the case where the body performed inertial vibrations without touching the walls. It was found that the vibrations generated a repulsion force which held the heavy body over the bottom of the cavity, and the light body at a certain distance from the top wall. It was shown that the effect of the repulsion forces manifested itself at a distance comparable to the thickness of the Stokes layer and increased with approach to the wall. A description of the mechanism of generation of the lift force is given. It is shown that in the case of high dimensionless frequencies, the experimental and theoretical results are in agreement.

Ivanova, A. A.; Kozlov, V. G.; Shchipitsyn, V. D.

2014-09-01

105

Stereotactic body radiation therapy for centrally-located lung tumors  

PubMed Central

The application of high-dose irradiation to centrally-located lung tumors is generally considered to be of high risk in causing bronchial injury. The aim of the present retrospective study was to investigate the safety and efficacy of stereotactic body radiation therapy (SBRT) for patients with centrally-located lung tumors. In total, 28 patients who underwent SBRT for lung tumors within 2 cm of a major bronchus were retrospectively analyzed. The median total dose prescribed was 45 Gy (range, 36.3–52.5 Gy), the median fraction was 12 (range, 10–15) and the median dose per fraction was 3.6 Gy (range, 3–5 Gy). The median follow-up period for the surviving patients was 14 months (range, 10–41 months). The local control rate of SBRT was 100%, with a complete response (CR) rate of 32.1% (9/28); a partial response (PR) rate of 50% (14/28) and a stable disease (SD) rate of 17.9% (5/28). In total, 15 patients survived and 13 patients succumbed; 11 patients succumbed to tumor progression, one to congestive heart failure and one to a brain hemorrhage. The main side-effects included grade 2 esophagitis (17.9%; 5/28) atelectasis (10.7%; 3/28) and grade 2 late radiation pneumonitis (7.1%; 2/28). Severe late toxicity (? grade 3) was not observed in any patient. SBRT is an effective and safe therapy for centrally-located lung tumors. PMID:24944711

SHEN, GE; WANG, YING-JIE; SHEN, WEN-JIANG; ZHOU, ZHEN-SHAN; WANG, JUN-LIANG; SHENG, HONG-GUO; DONG, DA-PENG; ZHOU, MING; YANG, GANG; WANG, QIN-WEN; ZENG, YANJUN

2014-01-01

106

The effects of whole body vibration on mobility and balance in Parkinson disease: a systematic review.  

PubMed

Whole body vibration (WBV) is a contemporary treatment modality that holds promise as an exercise training method in health-compromised individuals. A growing number of studies on individuals with Parkinson Disease are examining whether WBV improves balance and functional mobility. However, interpreting WBV studies is challenging since there is variability in the manner in which WBV intervention is conducted. The primary goal of this systematic review was to investigate the effect of WBV on improving mobility and balance as measured by a battery of clinical tests, in patients with Parkinson disease. Studies based on WBV parameters were characterized and a systematic search of peer-reviewed literature in five major databases was conducted. Randomized-controlled trials investigating the effects of WBV in patients with a Parkinson diagnosis and no cognitive impairment were included. A total of six publications met the inclusion criteria. Overall, studies demonstrated mixed results in favor of WBV for improving balance or mobility. The majority of studies seem to suggest a favorable benefit following WBV for mobility and balance, but not when compared to other active intervention or placebo. There was variability in the manner in which WBV intervention was applied. Variations among the six studies included: duration of intervention and rest, follow-up period, type of control groups, frequency of vibration, number of treatment sessions and sex distribution of subjects. Future research is needed to investigate the effects of different types of equipment and treatment dosage in individuals with Parkinson disease. PMID:25031483

Sharififar, Sharareh; Coronado, Rogelio A; Romero, Sergio; Azari, Hassan; Thigpen, Mary

2014-07-01

107

The Effects of Whole Body Vibration on Mobility and Balance in Parkinson Disease: a Systematic Review  

PubMed Central

Whole body vibration (WBV) is a contemporary treatment modality that holds promise as an exercise training method in health–compromised individuals. A growing number of studies on individuals with Parkinson Disease are examining whether WBV improves balance and functional mobility. However, interpreting WBV studies is challenging since there is variability in the manner in which WBV intervention is conducted. The primary goal of this systematic review was to investigate the effect of WBV on improving mobility and balance as measured by a battery of clinical tests, in patients with Parkinson disease. Studies based on WBV parameters were characterized and a systematic search of peer-reviewed literature in five major databases was conducted. Randomized-controlled trials investigating the effects of WBV in patients with a Parkinson diagnosis and no cognitive impairment were included. A total of six publications met the inclusion criteria. Overall, studies demonstrated mixed results in favor of WBV for improving balance or mobility. The majority of studies seem to suggest a favorable benefit following WBV for mobility and balance, but not when compared to other active intervention or placebo. There was variability in the manner in which WBV intervention was applied. Variations among the six studies included: duration of intervention and rest, follow-up period, type of control groups, frequency of vibration, number of treatment sessions and sex distribution of subjects. Future research is needed to investigate the effects of different types of equipment and treatment dosage in individuals with Parkinson disease. PMID:25031483

Sharififar, Sharareh; Coronado, Rogelio A.; Romero, Sergio; Azari, Hassan; Thigpen, Mary

2014-01-01

108

Whole Body Vibration Exercises and the Improvement of the Flexibility in Patient with Metabolic Syndrome  

PubMed Central

Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword “flexibility” and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS. PMID:25276434

Sá-Caputo, Danúbia da Cunha; Ronikeili-Costa, Pedro; Carvalho-Lima, Rafaelle Pacheco; Bernardo, Luciana Camargo; Bravo-Monteiro, Milena Oliveira; Costa, Rebeca; de Moraes-Silva, Janaina; Paiva, Dulciane Nunes; Machado, Christiano Bittencourt; Mantilla-Giehl, Paula; Arnobio, Adriano; Marin, Pedro Jesus; Bernardo-Filho, Mario

2014-01-01

109

Effect of whole body vibration on the postural control of the spine in sitting.  

PubMed

Stability is defined by the ability to return to the initial (or unperturbed) state following a perturbation and hence can be assessed by quantifying the post-perturbation response. This response may be divided into two phases: an initial passive response phase, dependent upon both the steady state of the system and the system's intrinsic mechanical properties; and a recovery phase, dependent upon active control and reflexes. These two phases overlap and interact with each other. Whole body vibration (WBV) is assumed to influence neuro-sensory functions and perhaps both response stages. The current study observed the effect of WBV on several novel response factors that quantify the two phases in response to an external perturbation. The results indicate a significant effect of vibration exposure on: (1) the normalized maximum distance traveled by center of pressure (COP) from the neutral seated posture, and (2) the normalized time to maximum distance (?), such that B and ? increased after WBV exposure and decreased after sitting without WBV. These changes may be indicative of passive visco-elastic changes caused by WBV exposure on the spinal tissues which has been indicated as a creep deformation of tissues post-exposure. This change may make the spine vulnerable to injury. Similar trends were noticed in the variables calculated from center of mass data. PMID:25544340

Arora, Neha; Graham, Ryan B; Grenier, Sylvain G

2015-04-01

110

Whole Body Vibration at Different Exposure Frequencies: Infrared Thermography and Physiological Effects  

PubMed Central

The aim of this study was to investigate the effects of whole body vibration (WBV) on physiological parameters, cutaneous temperature, tactile sensitivity, and balance. Twenty-four healthy adults (25.3 ± 2.6 years) participated in four WBV sessions. They spent 15 minutes on a vibration platform in the vertical mode at four different frequencies (31, 35, 40, and 44?Hz) with 1?mm of amplitude. All variables were measured before and after WBV exposure. Pressure sensation in five anatomical regions and both feet was determined using Von Frey monofilaments. Postural sway was measured using a force plate. Cutaneous temperature was obtained with an infrared camera. WBV influences the discharge of the skin touch-pressure receptors, decreasing sensitivity at all measured frequencies and foot regions (P ? 0.05). Regarding balance, no differences were found after 20 minutes of WBV at frequencies of 31 and 35?Hz. At 40 and 44?Hz, participants showed higher anterior-posterior center of pressure (COP) velocity and length. The cutaneous temperature of the lower limbs decreased during and 10 minutes after WBV. WBV decreases touch-pressure sensitivity at all measured frequencies 10?min after exposure. This may be related to the impaired balance at higher frequencies since these variables have a role in maintaining postural stability. Vasoconstriction might explain the decreased lower limb temperature. PMID:25664338

Sonza, Anelise; Robinson, Caroline C.; Achaval, Matilde; Zaro, Milton A.

2015-01-01

111

Changes in postural sway frequency and complexity in altered sensory environments following whole body vibrations.  

PubMed

Studies assessing whole body vibration (WBV) have produced largely positive effects, with some neutral, on postural control with frequencies between 25 and 40 Hz. However no conclusive evidence indicates that 25-40 Hz elicits the optimal beneficial effects. To address this issue, a larger range of vibration intensity (10-50 Hz at peak-to-peak amplitudes of 2 and 5mm) was employed while increasing the postural complexity (altered somatosensory and/or visual information) to assess acute effects of 4-min of WBV on postural control. Twelve healthy young adults underwent postural assessment at four time intervals (prior to, immediately following and 10 and 20 min post WBV). Findings revealed both postural sway frequency and sway complexity/regularity were affected by WBV. Baseline posture demonstrated increased sway frequency (p=.04) following WBV with no changes in sway complexity. When the support surface was altered, changes in both the frequency and complexity of sway were elicited (p=.027, .002, respectively). When both somatosensory and visual information were altered delayed improvements in postural control were elicited (p=.05 and .01, for frequency and complexity, respectively). Given the differential acute effects as a function of postural task complexity, future longitudinal studies could determine the overall training effect on sway frequency and complexity. PMID:22516837

Dickin, D Clark; McClain, Matthew A; Hubble, Ryan P; Doan, Jon B; Sessford, David

2012-10-01

112

Hematuria in a runner after treatment with whole body vibration: a case report.  

PubMed

The use of whole body vibration (WBV) for therapeutic purposes is far from being standardized and the training protocols reported in the literature vary considerably. Currently, the optimal threshold for a beneficial effect is undetermined, and caution regarding potential health risks due to WBV is always necessary. In this case report, we present a 34-year-old otherwise healthy elite athlete (steeplechase runner) who suffered two episodes of hematuria (HT) after WBV training. Shortly after the third WBV, he had an episode of bright red urine. Seven days later, following the next WBV session (and again before his daily running session), a reddish-colored urine reappeared. Our patient was advised to stop WBV training and to take fluid before and during exertion. He did not experience any episode of HT during a 1-year follow-up with periodic check-ups, in spite of the continuation of his sporting career. The concomitance of the two types of trauma - daily running and WBV - could have been critical in this case for producing HT. In particular, we think that platforms providing side-alternating vibration (such as the Galileo platform) may pose some health risks if the feet are positioned too far from the axis of rotation. PMID:22590988

Franchignoni, F; Vercelli, S; Ozçakar, L

2013-06-01

113

Acute Bone Marker Responses to Whole-Body Vibration and Resistance Exercise in Young Women  

PubMed Central

Whole-body vibration (WBV) augments the musculoskeletal effects of resistance exercise (RE). However, its acute effects on bone turnover markers (BTM) have not been determined. This study examined BTM responses to acute high intensity RE and high intensity RE with WBV (WBV+RE) in young women (n=10) taking oral contraceptives in a randomized, cross-over repeated measures design. WBV+RE exposed subjects to 5 one-minute bouts of vibration (20 Hz, 3.38 peak–peak displacement, separated by 1 minute of rest) prior to RE. Fasting blood samples were obtained before (Pre), immediately post WBV (PostVib), immediately post RE (IP), and 30 minutes post RE (P30). Bone ALP did not change at any time point. TRAP5b significantly (p<0.05) increased from the Pre to PostVib, then decreased from IP to P30 for both conditions. CTX significantly decreased (p<0.05) from Pre to PostVib and from Pre to P30 only for WBV+RE. WBV+RE showed a greater decrease in CTX than RE (-12.6 ± 4.7% vs. -1.13 ± 3.5%). In conclusion, WBV was associated with acute decreases in CTX levels not elicited with resistance exercise alone in young women. PMID:22902255

Sherk, Vanessa D.; Chrisman, Carmen; Smith, Jessica; Young, Kaelin C.; Singh, Harshvardhan; Bemben, Michael G.; Bemben, Debra A.

2014-01-01

114

Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice  

PubMed Central

The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

Mayden,, Kelley D.

2012-01-01

115

Low back pain disorders and exposure to whole-body vibration in the workplace.  

PubMed

Occupational exposure to whole-body vibration (WBV) and postural stress in a driving environment may contribute to an increased risk for low back pain (LBP) disorders. In two epidemiological studies of bus drivers and tractor drivers, LBP disorders were found to be associated with age, back accidents, cumulative WBV dose, and postural overload. A review of the literature showed that the exposure-response relationship for WBV and injuries to the lower back is not fully clarified. There is a shortage of information on the health risk from WBV in female workers. Because it is estimated that several thousand women are exposed to intense WBV in the workplace, the health effects of WBV on female reproductive organs and vertebral column should be carefully investigated. PMID:8899913

Bovenzi, M

1996-02-01

116

Validity of self reported occupational exposures to hand transmitted and whole body vibration  

PubMed Central

OBJECTIVES—To assess the accuracy with which workers report their exposure to occupational sources of hand transmitted (HTV) and whole body vibration (WBV).?METHODS—179 Workers from various jobs involving exposure to HTV or WBV completed a self administered questionnaire about sources of occupational exposure to vibration in the past week. They were then observed at work over 1 hour, after which they completed a second questionnaire concerning their exposures during this observation period. The feasibility of reported sources of exposure during the past week was examined by questioning managers and by inspection of tools and machines in the workplace. The accuracy of reported sources and durations of exposure in the 1 hour period were assessed relative to what had been observed.?RESULTS—The feasibility of exposure in the previous week was confirmed for 97% of subjects who reported exposure to HTV, and for 93% of subjects who reported exposure to WBV. The individual sources of exposure reported were generally plausible, but occupational use of cars was substantially overreported, possibly because of confusion with their use in travel to and from work. The accuracy of exposures reported during the observation period was generally high, but some sources of HTV were confused—for example, nailing and stapling guns reported as riveting hammers, and hammer drills not distinguished from other sorts of drill. Workers overestimated their duration of exposure to HTV by a median factor of 2.5 (interquartile range (IQR) 1.6-5.9), but estimated durations of exposure were more accurate when the exposure was relatively continuous rather than for intermittent short periods. Reported durations of exposure to WBV were generally accurate (median ratio of reported to observed time 1.1, IQR 1.0-1.2).?CONCLUSIONS—Sources of recent occupational exposure to vibration seem to be reported with reasonable accuracy, but durations of exposure to HTV are systematically overestimated, particularly when the exposure is intermittent and for short periods. This raises the possibility that dose-response relations may have been biased in some of the studies on which exposure standards might be based, and that the levels in currently proposed standards may be too high. Future studies should pay attention to this source of error during data collection.???Keywords: vibration; exposure; assessment; validity PMID:10810109

Palmer, K.; Haward, B.; Griffin, M.; Bendall, H.; Coggon, D.

2000-01-01

117

Stereotactic Body Radiation Therapy Boost in Locally Advanced Pancreatic Cancer  

SciTech Connect

Purpose: To investigate the clinical application of a stereotactic body radiation therapy (SBRT) boost in locally advanced pancreatic cancer patients with a focus on local efficacy and toxicity. Methods and Materials: We retrospectively reviewed 30 patients with locally advanced and nonmetastatic pancreatic cancer who had been treated between 2004 and 2006. Follow-up duration ranged from 4 to 41 months (median, 14.5 months). A total dose of 40 Gy was delivered in 20 fractions using a conventional three-field technique, and then a single fraction of 14, 15, 16, or 17 Gy SBRT was administered as a boost without a break. Twenty-one patients received chemotherapy. Overall and local progression-free survival were calculated and prognostic factors were evaluated. Results: One-year overall survival and local progression-free survival rates were 60.0% and 70.2%, respectively. One patient (3%) developed Grade 4 toxicity. Carbohydrate antigen 19-9 response was found to be an independent prognostic factor for survival. Conclusions: Our findings indicate that a SBRT boost provides a safe means of increasing radiation dose. Based on the results of this study, we recommend that a well controlled Phase II study be conducted on locally advanced pancreatic cancer.

Seo, Young Seok [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Mi-Sook, E-mail: mskim@kcch.re.k [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Yoo, Sung Yul; Cho, Chul Koo; Yang, Kwang Mo; Yoo, Hyung Jun; Choi, Chul Won [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Lee, Dong Han [CyberKnife Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Jin [Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Min Suk [Department of Pathology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kang, Hye Jin [Department of Hemato-Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, YoungHan [Department of Radiology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2009-12-01

118

Functional Genomics in the Study of Mind-Body Therapies  

PubMed Central

Background Mind-body therapies (MBTs) are used throughout the world in treatment, disease prevention, and health promotion. However, the mechanisms by which MBTs exert their positive effects are not well understood. Investigations into MBTs using functional genomics have revolutionized the understanding of MBT mechanisms and their effects on human physiology. Methods We searched the literature for the effects of MBTs on functional genomics determinants using MEDLINE, supplemented by a manual search of additional journals and a reference list review. Results We reviewed 15 trials that measured global or targeted transcriptomic, epigenomic, or proteomic changes in peripheral blood. Sample sizes ranged from small pilot studies (n=2) to large trials (n=500). While the reliability of individual genes from trial to trial was often inconsistent, genes related to inflammatory response, particularly those involved in the nuclear factor-kappa B (NF-?B) pathway, were consistently downregulated across most studies. Conclusion In general, existing trials focusing on gene expression changes brought about by MBTs have revealed intriguing connections to the immune system through the NF-?B cascade, to telomere maintenance, and to apoptotic regulation. However, these findings are limited to a small number of trials and relatively small sample sizes. More rigorous randomized controlled trials of healthy subjects and specific disease states are warranted. Future research should investigate functional genomics areas both upstream and downstream of MBT-related gene expression changes—from epigenomics to proteomics and metabolomics. PMID:25598735

Niles, Halsey; Mehta, Darshan H.; Corrigan, Alexandra A.; Bhasin, Manoj K.; Denninger, John W.

2014-01-01

119

Evaluation of an occupational health intervention programme on whole-body vibration in forklift truck drivers: a controlled trial  

Microsoft Academic Search

Objectives: To evaluate process and outcome of a multifaceted occupational health intervention programme on whole-body vibration (WBV) in forklift truck drivers. Methods: An experimental pretest\\/post-test control group study design. The authors trained occupational health services ( OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In

C. T. J. Hulshof; J. H. A. M. Verbeek; I. T. J. Braam; M. Bovenzi; F. J. H. van Dijk

2006-01-01

120

The effects of vibration therapy on muscle force loss following eccentrically induced muscle damage.  

PubMed

The purpose of this study was to investigate the effects of acute vibration therapy (VT) on performance recovery after a bout of strenuous eccentric exercise. Eight healthy males completed 300 maximal eccentric contractions of the quadriceps of one leg on an isokinetic dynamometer. Immediately after exercise and 12 and 24 h post-exercise, the subjects underwent either VT or a control treatment of no VT. Five sets of 1 min VT was performed at 26 Hz, with 6 mm peak-to-peak displacement, on a commercially available vibration machine. At least 2 weeks after the initial trial, the subjects completed the second trial using the contralateral leg and other treatment. Peak and average peak isometric tension and isokinetic concentric and eccentric torque were measured prior to exercise and 24 and 48 h post-exercise. Treatment with VT resulted in significantly (all P < 0.05) greater decrements in peak (-38%) and average peak eccentric (-39%) torque 24 h after eccentric exercise as compared to a control treatment (-24 and -29%, respectively). These results suggest that the use of 26 Hz VT in the first 24 h after damaging exercise may be detrimental to the magnitude of force loss and/or recovery over this period. PMID:21750975

Barnes, Matthew J; Perry, Blake G; Mündel, Toby; Cochrane, Darryl J

2012-03-01

121

[How relevant are diagnostics and therapy in body image disorder?].  

PubMed

Body image-related interventions become increasingly important in the treatment of anorexia and bulimia nervosa. Previous studies concerning body image disturbance conducted by means of diverse research methods focused on different components of body image - the perceptive, cognitive-emotional and the behavioral component. However, regarding the etiology, maintenance and treatment of body image disturbance in eating disorders, many questions remain unanswered. An integrative perspective on the different body image components within a theoretical framework as well as the development of specific body image-related interventions according to individual indications would be desirable. PMID:25594272

Vocks, Silja; Bauer, Anika

2015-01-01

122

Movement of the Upper-Body of Seated Subjects Exposed to Vertical Whole-Body Vibration at the Principal Resonance Frequency  

NASA Astrophysics Data System (ADS)

The dynamic responses of eight male subjects exposed to vertical whole-body vibration have been measured at eight locations of the body in three directions within the sagittal plane: in the vertical, fore-and-aft and pitch axes. The motions were measured on the body surface at the first, fifth and tenth thoracic vertebra (T1, T5, T10), at the first, third and fifth lumbar vertebra (L1, L3, L5) and at the pelvis (the posterior-superior iliac spine), and were corrected so as to estimate the motions of the skeleton. The head motion was measured with a bite bar. The force at the seat surface was also measured. The subjects were exposed to vertical random vibration in the frequency range from 0·5-20 Hz at a magnitude of 1·0 ms-2r.m.s. The movement of the upper-body at the principal resonance frequency of the driving-point apparent mass is illustrated by using the transmissibilities from seat vertical vibration to vertical and fore-and-aft vibration at the eight locations on the body. A bending of the lumbar spine, and probably the lowest thoracic spine, possibly coupled with a rocking motion of the upper thoracic spine about the lower thoracic spine, appeared to be dominant. A small bending along the full length of thoracic spine was also found. Pitch motion of the pelvis, possibly accompanied by longitudinal and shear deformations of the tissue underneath the pelvis, was found to occur near the resonance frequency range, but did not appear to make a principal contribution to the resonance observed in the apparent mass. Any significant axial motions along the spine occurred at higher frequencies.

Matsumoto, Y.; Griffin, M. J.

1998-08-01

123

[The effect of betahistine on histological changes in rabbit brain in model of whole body wide-frequency vibration].  

PubMed

In acute experiments in conscious rabbits was studied protective action of selective blocker of histamine H3-receptor betahistine (2mg/kg i/v) against histological changes in precentral and postcentral gyrus, as well as in temporal lobe of cerebral cortex, thalamus, hypothalamus, and cerebellum, arising in case of modeling of whole body wide-frequency vibration. Betahistine attenuates edematous and degenerative changes in neurons and reciprocal glial reaction, caused by vibration, but does not eliminate edema in perivascular spaces. This effect may be related to the improvement of blood supply as a result of of vasodilatory action and decrease of oxygen consumption via vestibuloprotective effect. PMID:24003483

Shimkus, Iu Iu; Sapegin, I D

2013-01-01

124

Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer  

SciTech Connect

Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P{sub NON}) and adaptive plan (P{sub ADP}), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P{sub NON} and P{sub ADP} for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d{sub T-OAR}), initial internal target volume (ITV{sub 1}), ITV change (?ITV), and effective ITV diameter change (?d{sub ITV}). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from ?59.6% to 13.0%, with a mean (±SD) of ?21.0% (±21.4%). On average of all patients, P{sub ADP} resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. ?d{sub ITV}/d{sub T-OAR} was found to correlate with changes in dose to 5 cc (?D5cc) of esophagus (r=0.61) and dose to 30 cc (?D30cc) of chest wall (r=0.81). Stronger correlations between ?d{sub ITV}/d{sub T-OAR} and ?D30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment.

Qin, Yujiao [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Zhang, Fan [Occupational and Environmental Safety Office, Duke University Medical Center, Durham, North Carolina (United States); Yoo, David S.; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing, E-mail: jing.cai@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

2013-09-01

125

The impact of self-reported exposure to whole-body-vibrations on the risk of disability pension among men: a 15 year prospective study  

PubMed Central

Background Whole-body-vibrations are often associated with adverse health effect but the long term effects are less known. This study investigates the association between occupational exposures to whole-body vibrations, and subsequent transition to disability pension. Methods A total of 4215 male employees were followed up for subsequent disability pension retirement. Exposure to whole-body-vibration was self-reported while new cases of disability pension were retrieved from a national register. Results The hazard ratio (HR) for disability pension retirement among men exposed to whole-body-vibrations was 1.61 (95% confidence interval (CI) 1.07-2.40) after adjustment for age, smoking habits, BMI, physical job demands and awkward work postures. In our model, with the available explanatory variables, 5.6% of the male disability pension cases were attributable to whole-body-vibrations. Conclusions Exposure to whole-body-vibrations predicts subsequent disability pension retirement. Continued reduction of whole-body-vibrations may reduce the number of new cases of disability pension. PMID:20525268

2010-01-01

126

Effect of Training with Whole Body Vibration on the Sitting Balance of Stroke Patients  

PubMed Central

[Purpose] The purpose of this study was to determine the effects of task-oriented training with whole body vibration (WBV) on the sitting balance of stroke patients. [Subjects] The subjects were 30 stroke patients who were randomly divided into experimental (n1=15) and control (n2=15) groups. [Methods] Subjects in both groups received general training five times per week. Subjects in the experimental group practiced an additional task-oriented training program with WBV, which was performed for 15 minutes, five times per week, for four weeks. The center of pressure (COP) path length and average velocity were used to assess subjects static sitting balance, and the Modified Functional Reach Test (MFRT) was used to assess their dynamic sitting balance. The paired t-test was performed to test the significance of differences between before and after the intervention. The independent t-test was conducted to test the significance of differences between the groups. [Results] Following the intervention, the experimental group showed a significant change in MFRT. [Conclusion] The results of this study suggest that task-oriented training with WBV is feasible and efficacious for stroke patients. PMID:25276025

Choi, Sung-Jin; Shin, Won-Seob; Oh, Bok-Kyun; Shim, Jae-Kwang; Bang, Dae-Hyouk

2014-01-01

127

The Effect of a Single Session of Whole-Body Vibration Training in Recreationally Active Men on the Excitability of the Central and Peripheral Nervous System  

PubMed Central

Vibration training has become a popular method used in professional sports and recreation. In this study, we examined the effect of whole-body vibration training on the central nervous system and muscle excitability in a group of 28 active men. Subjects were assigned randomly to one of two experimental groups with different variables of vibrations. The chronaximetry method was used to evaluate the effect of a single session of whole-body vibration training on the excitability of the rectus femoris and brachioradialis muscles. The examination of the fusing and flickering frequencies of the light stimulus was performed. An increase in the excitability of the quadriceps femoris muscle due to low intensity vibrations (20 Hz frequency, 2 mm amplitude) was noted, and a return to the initial values was observed 30 min after the application of vibration. High intensity vibrations (60 Hz frequency, 4 mm amplitude) caused elongations of the chronaxy time; however, these differences were not statistically significant. Neither a low intensity vibration amplitude of 2 mm (frequency of 20 Hz) nor a high intensity vibration amplitude of 4 mm (frequency of 60 Hz) caused a change in the excitability of the central nervous system, as revealed by the average frequency of the fusing and flickering of the light stimulus. A single session of high intensity whole-body vibration did not significantly decrease the excitability of the peripheral nervous system while the central nervous system did not seem to be affected. PMID:25114735

Chmielewska, Daria; Piecha, Magdalena; B?aszczak, Edward; Król, Piotr; Smykla, Agnieszka; Juras, Grzegorz

2014-01-01

128

Stereotactic Body radiation therapy for liver tumors with or without rotational intensity modulated radiation therapy  

PubMed Central

Background To evaluate the feasibility and efficacy of Stereotactic body radiation therapy (SBRT) for primary liver lesions and liver metastases treated with linear accelerators with or without rotational Intensity Modulated RadioTherapy (IMRT). Methods Patients with either hepatocellular carcinoma, cholangiocarcinoma or metastatic liver lesions who had one to three lesions treated with SBRT in a single institution were retrospectively reviewed. Tumor response was evaluated according to EASL criteria 3 months after SBRT completion using MRI and/or abdominal CT scan. Responses were categorised as: Stable Disease (SD), Partial Response (PR), Complete Response (CR), Local Progression or Distant Progression in cases of new intra-hepatic lesions out-of-field or extra-hepatic metastases. Local Control (LC), Progression Free Survival (PFS), Overall Survival (OS) and treatment-related toxicities are reported. Results Between 2007 and 2012, 20 patients with a total of 24 lesions were treated with SBRT. Fourteen patients presented hepatocellular carcinoma (HCC), the others had either metastatic lesions from colorectal cancer (CRC) or cholangiocarcinoma. The median diameter of the lesions was 23 mm (5–98). The dose per fraction ranged from 6 to 20 Gy with a median total dose of 60 Gy (range: 36–60 Gy). The dose was prescribed to the 80% isodose line covering the PTV. The median follow-up was 24 months (15.7-29.7). The actuarial LC rate was 78% for patients with HCC and 83% for those with adenocarcinoma and cholangiocarcinoma. Median OS was 37 months and OS rates were 83% at 12 and 24 months for HCC and 100% for adenocarcinoma. PFS was 54% for HCC and 50% for other types of tumors at 24 months. Acute grade 3–4 toxicities occurred in 2 patients; a small proportion of the other patients experienced grade 1 or 2 toxicities. Conclusions SBRT provides excellent local control with minimal side effects in selected patients. PMID:24279802

2013-01-01

129

Effects of experimental exposure to high-frequency whole-body vertical vibration on the nervous system of animals  

Microsoft Academic Search

changes in the nervous system of dogs, rabbits, and cats exposed to the acute and chronic action of whole-body vertical vibration (50 Hz, 0.8 ram, 105 dB, 4 h) were studied. In the acute experiments extensive and universal circulatory disorders developed: regional angiospasms, cerebral edema, acute swelling of ganglionic cells, vasopareses, confluent diapedetic hemorrhages into the brain and viscera. These

A. S. Mel'kumova; V. V. Russkikh

1973-01-01

130

Cognitive Behavior Therapy with Body Image Exposure for Bulimia Nervosa: A Case Example  

ERIC Educational Resources Information Center

Cognitive behavior therapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more…

Delinsky, Sherrie S.; Wilson, G. Terence

2010-01-01

131

EFFECTS OF WHOLE BODY VIBRATION ON STRENGTH AND JUMPING PERFORMANCE IN VOLLEYBALL AND BEACH VOLLEYBALL PLAYERS  

PubMed Central

The primary aim of this study was to examine the effects of 6-week strength training with whole body vibration (WBV) on leg strength and jumping performance in volleyball and beach volleyball players. Twenty-three sub-elite male volleyball (VB; n=12) and beach volleyball players (BVB; n=11) aged 21.2±3.0 years were divided into two groups and subjected to 6 weeks of strength training (three one-hour sessions per week): (I) 12 players (6 VB and 6 BVB players) underwent training with WBV (30-40 Hz, 1.7-2.5 mm, 3.0-5.7 g), and (II) 11 players (6 VB and 5 BVB players) underwent traditional strength training. Squat jump (SJ) and countermovement squat jump (CMJ) measurements by the Ergo Tester contact platform and maximum leg press test (1RM) were conducted. Three-factor (2 time x 2 WBV use x 2 discipline) analysis of variance for SJ, CMJ and 1RM revealed a significant time main effect (p<0.001), a WBV use effect (p<0.001) and a discipline effect (p<0.001). Significantly greater improvements in the SJ (p<0.001) and CMJ (p<0.001) and in 1RM (p<0.001) were found in the WBV training groups than in traditional training groups. Significant 3-way interaction effects (training, WBV use, discipline kind) were also found for SJ, CMJ and 1RM (p=0.001, p<0.001, p=0.001, respectively). It can be concluded that implementation of 6-week WBV training in routine practice in volleyball and beach volleyball players increases leg strength more and leads to greater improvement in jump performance than traditional strength training, but greater improvements can be expected in beach volleyball players than in volleyball players. PMID:25187676

Zmijewski, P.; Jimenez-Olmedo, J.M.; Jové-Tossi, M.A.; Martínez-Carbonell, A.; Suárez-Llorca, C.; Andreu-Cabrera, E.

2014-01-01

132

Whole-body vibration in underground load-haul-dump vehicles.  

PubMed

Whole-body vibrations (WBV) were measured at the seatpan of load-haul-dump (LHD) vehicles of 3.5-, 5-, 6- and 8-yard capacity at two underground mines. Twenty-two sets of measurements were made involving 11 vehicles, 8 operators and 4 work locations. In each set frequency-weighted rms and peak accelerations were measured in the x, y and z directions, as defined by the ISO (1982), during mucking, driving full, dumping and driving empty. Significant differences in rms accelerations were found between vehicle sizes and between operational tasks (less than or equal to 0.05). The smallest (3.5 yd) vehicle produced the greatest accelerations in the x and z directions. Accelerations in the x and z directions were also greater when driving full and empty than when mucking and dumping. The highest frequency-weighted rms accelerations of 2.0 to 2.8 m/s-2 were recorded in the z (longitudinal) direction. Peak accelerations ranged from 1.2 to greater than or equal to 20 m/s2, resulting in crest-factor ratios in excess of six. The exposure periods for each task were used to calculate mean daily acceleration exposures (m/s2). Of the 22 sets of measurements, 20 exceeded the International Standards Organization (ISO) six-hour daily exposure limit in the z direction of acceleration, and 9 exceeded the six-hour daily exposure limits in all three directions. Acceleration exposure ratios calculated using resultant acceleration vectors as described in ISO (1982), were found to exceed the ISO exposure limit for health or safety in all 22 cases. One-third octave band frequency analysis of the weighted signals indicated that the dominant frequencies were usually 1.6 to 3.15 Hz, except when the vehicles were idling and higher frequencies predominated. PMID:2598904

Village, J; Morrison, J B; Leong, D K

1989-10-01

133

Effects of whole body vibration on strength and jumping performance in volleyball and beach volleyball players.  

PubMed

The primary aim of this study was to examine the effects of 6-week strength training with whole body vibration (WBV) on leg strength and jumping performance in volleyball and beach volleyball players. Twenty-three sub-elite male volleyball (VB; n=12) and beach volleyball players (BVB; n=11) aged 21.2±3.0 years were divided into two groups and subjected to 6 weeks of strength training (three one-hour sessions per week): (I) 12 players (6 VB and 6 BVB players) underwent training with WBV (30-40 Hz, 1.7-2.5 mm, 3.0-5.7 g), and (II) 11 players (6 VB and 5 BVB players) underwent traditional strength training. Squat jump (SJ) and countermovement squat jump (CMJ) measurements by the Ergo Tester contact platform and maximum leg press test (1RM) were conducted. Three-factor (2 time x 2 WBV use x 2 discipline) analysis of variance for SJ, CMJ and 1RM revealed a significant time main effect (p<0.001), a WBV use effect (p<0.001) and a discipline effect (p<0.001). Significantly greater improvements in the SJ (p<0.001) and CMJ (p<0.001) and in 1RM (p<0.001) were found in the WBV training groups than in traditional training groups. Significant 3-way interaction effects (training, WBV use, discipline kind) were also found for SJ, CMJ and 1RM (p=0.001, p<0.001, p=0.001, respectively). It can be concluded that implementation of 6-week WBV training in routine practice in volleyball and beach volleyball players increases leg strength more and leads to greater improvement in jump performance than traditional strength training, but greater improvements can be expected in beach volleyball players than in volleyball players. PMID:25187676

Pérez-Turpin, J A; Zmijewski, P; Jimenez-Olmedo, J M; Jové-Tossi, M A; Martínez-Carbonell, A; Suárez-Llorca, C; Andreu-Cabrera, E

2014-08-01

134

Immediate changes in temporomandibular joint opening and pain following vibration therapy: a feasibility pilot study  

PubMed Central

Objective The purpose of this pilot study was to determine the scientific and process feasibility in an effort to direct future larger trials. Methods: Scientific Feasibility: Twelve subjects were randomly allocated to an intervention and a control group. The intervention protocol consisted of intraoral vibration therapy on the muscles of mastication bilaterally for a period of 1 minute per muscle. Process Feasibility: Several feasibility outcomes were examined including recruitment and retention rates and consent. Results: Scientific Feasibility: Large effect sizes were generated for both mouth opening and VAS in favour of the intervention group. Process Feasibility: a recruitment ratio of 2.3 respondents to 1 participant was determined, along with a retention to loss ratio of 13:1 and a consent to loss ratio of 12:0. Conclusion: Scientific Feasibility: The scientific results should be interpreted with caution due to the small sample sizes employed. The study seems to support the scientific feasibility of a future larger single treatment trial. Process Feasibility: Recruitment and retention rates and ratios seem to support future studies. Utilizing the feasibility results of the current study to direct a future larger multiple treatment trial consistent with other comparable TMD studies however is limited. PMID:25550672

Muir, Brad; Brown, Courtney; Brown, Tara; Tatlow, Dionne; Buhay, Jeremy

2014-01-01

135

The ISO standard: Guide for the evaluation of human exposure to whole-body vibration  

NASA Technical Reports Server (NTRS)

The international guideline is discussed in terms of safety and human tolerance. Charts for equal subjective vibration intensity, subjective judgement of equal fatigue, and severe discomfort boundaries are included.

Vongierke, H. E.

1975-01-01

136

[Intensity-modulated radiation therapy and stereotactic body radiation therapy for head and neck tumors: evidence-based medicine].  

PubMed

Over the last decade, there have been many technical advances in radiation therapy, such as the spread of intensity-modulated conformal radiotherapy, and the rise of stereotactic body radiation therapy. By allowing better dose-to-target conformation and thus better organs at risk-sparing, these techniques seem very promising, particularly in the field of head and neck tumors. The present work aims at analyzing the level of evidence and recommendation supporting the use of high-technology radiotherapy in head and neck neoplasms, by reviewing the available literature. PMID:25155467

Lapierre, A; Martin, F; Lapeyre, M

2014-10-01

137

Low-magnitude high-frequency loading, by whole-body vibration, accelerates early implant osseointegration in ovariectomized rats  

PubMed Central

Osteoporosis deteriorates jaw bone quality and may compromise early implant osseointegration and early implant loading. The influence of low-magnitude, high-frequency (LMHF) vibration on peri-implant bone healing and implant integration in osteoporotic bones remains poorly understood. LMHF loading via whole-body vibration (WBV) for 8 weeks has previously been demonstrated to significantly enhance bone-to-implant contact, peri-implant bone fraction and implant mechanical properties in osteoporotic rats. In the present study, LMHF loading by WBV was performed in osteoporotic rats, with a loading duration of 4 weeks during the early stages of bone healing. The results indicated that 4-week LMHF loading by WBV partly reversed the negative effects of osteoporosis and accelerated early peri-implant osseointegration in ovariectomized rats. PMID:25270245

LIANG, YONG-QIANG; QI, MENG-CHUN; XU, JIANG; XU, JUAN; LIU, HUA-WEI; DONG, WEI; LI, JIN-YUAN; HU, MIN

2014-01-01

138

Low-magnitude high-frequency loading, by whole-body vibration, accelerates early implant osseointegration in ovariectomized rats.  

PubMed

Osteoporosis deteriorates jaw bone quality and may compromise early implant osseointegration and early implant loading. The influence of low?magnitude, high?frequency (LMHF) vibration on peri?implant bone healing and implant integration in osteoporotic bones remains poorly understood. LMHF loading via whole?body vibration (WBV) for 8 weeks has previously been demonstrated to significantly enhance bone?to?implant contact, peri?implant bone fraction and implant mechanical properties in osteoporotic rats. In the present study, LMHF loading by WBV was performed in osteoporotic rats, with a loading duration of 4 weeks during the early stages of bone healing. The results indicated that 4?week LMHF loading by WBV partly reversed the negative effects of osteoporosis and accelerated early peri?implant osseointegration in ovariectomized rats. PMID:25270245

Liang, Yong-Qiang; Qi, Meng-Chun; Xu, Jiang; Xu, Juan; Liu, Hua-Wei; Dong, Wei; Li, Jin-Yuan; Hu, Min

2014-12-01

139

Advanced lung cancer: aggressive surgical therapy vertebral body involvement.  

PubMed

The NOMS considerations provide a dynamic decision framework to determine the optimal combination of systemic and radiation therapies and surgery. Generally, NSCLC metastases to the spine require SRS because cEBRT usually fails to provide consistent long-term local control. Patients with spinal cord compression secondary to NSCLC require surgical decompression to safely undergo SRS and to reduce the risk of radiation-induced spinal cord injury. Separation surgery allows spinal cord decompression and spinal stabilization using the posterior approach and, in combination with SRS, has been shown to provide reliable local control with low risk of wound complication or spinal hardware fracture. PMID:25441135

Bilsky, Mark H; Laufer, Ilya; Matros, Evan; Yamada, Joshua; Rusch, Valerie W

2014-11-01

140

Menopause, the metabolic syndrome, and mind-body therapies.  

PubMed

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

Innes, Kim E; Selfe, Terry Kit; Taylor, Ann Gill

2008-01-01

141

Menopause, the metabolic syndrome, and mind-body therapies  

PubMed Central

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

Innes, Kim E.; Selfe, Terry Kit; Taylor, Ann Gill

2009-01-01

142

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy  

PubMed Central

The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder. PMID:23467711

Prazeres, Angélica M; Nascimento, Antônio L; Fontenelle, Leonardo F

2013-01-01

143

EMG and Heart Rate Responses Decline within 5 Days of Daily Whole-Body Vibration Training with Squatting  

PubMed Central

In this study, we examined the acute effects of a 5-day daily whole-body vibration (WBV) training on electromyography (EMG) responses of the m. rectus femoris and m. gastrocnemius lateralis, heart rate (HR, continuously recorded), and blood lactate levels. The purpose of the study was to investigate the adaptation of muscle activity, heart rate and blood lactate levels during 5 days of daily training. Two groups of healthy male subjects performed either squat exercises with vibration at 20 Hz on a side alternating platform (SE+V, n?=?20, age ?=?31.9±7.5 yrs., height ?=?178.8±6.2 cm, body mass ?=?79.2±11.4 kg) or squat exercises alone (SE, n?=?21, age ?=?28.4±7.3 years, height ?=?178.9±7.4 cm, body mass ?=?77.2±9.7 kg). On training day 1, EMG amplitudes of the m. rectus femoris were significantly higher (P<0.05) during SE+V than during SE. However, this difference was no longer statistically significant on training days 3 and 5. The heart rate (HR) response was significantly higher (P<0.05) during SE+V than during SE on all training days, but showed a constant decline throughout the training days. On training day 1, blood lactate increased significantly more after SE+V than after SE (P<0.05). On the following training days, this difference became much smaller but remained significantly different. The specific physiological responses to WBV were largest on the initial training day and most of them declined during subsequent training days, showing a rapid neuromuscular and cardiovascular adaptation to the vibration stimulus. PMID:24905721

Rosenberger, André; Liphardt, Anna-Maria; Bargmann, Arne; Müller, Klaus; Beck, Luis; Mester, Joachim; Zange, Jochen

2014-01-01

144

Comparison of whole-body vibration exposures in buses: effects and interactions of bus and seat design.  

PubMed

Bus and seat design may be important for the drivers' whole-body vibration (WBV). WBV exposures in buses during actual operation were assessed. WBV attenuation performance between an air-suspension seat and a static pedestal seat in low-floor buses was compared; there were no differences in WBV attenuation between the seats. Air-suspension seat performance in a high-floor and low-floor bus was compared. Relative to the pedestal seat with its relatively static, limited travel seat suspension, the air-suspension seat with its dynamic, longer travel suspension provided little additional benefit. Relative to the measurement collected at the bus floor, the air-suspension seat amplified the WBV exposures in the high-floor bus. All WBV exposures were below European Union (EU) daily exposure action values. The EU Vibration Directive only allows the predominant axis of vibration exposure to be evaluated but a tri-axial vector sum exposure may be more representative of the actual health risks. PMID:25290555

Jonsson, Per M G; Rynell, Patrik W; Hagberg, Mats; Johnson, Peter W

2014-10-01

145

Insulin Therapy and Body Weight, Body Composition and Muscular Strength in Patients with Type 2 Diabetes Mellitus  

PubMed Central

Aims. To determine the progression of body weight (BW) and body composition (BC) in patients with type 2 diabetes mellitus (T2D) on insulin therapy and the consequences on muscle strength (MS) as a reflect of free fat mass increases. Research design and methods. We analysed BC using air displacement plethysmography and MS by hand grip dynamometry in 40 T2D before and after three (M3) and six months (M6) of insulin therapy. Results. at baseline HbA1c was 9.76 ±1.6% and BW was stable with fat mass (FM) 28 ± 10.7?kg; and fat free mass (FFM) 52.4 ± 11?kg; at M6, HbA1c improved to 7.56 ± 0.8%; insulin doses tended to increase. BW gain at M6 was + 3.2 ± 4.2?kg and with an increase of only 25% by M3; it was composed of FM, whereas FFM was unchanged. MS did not increase on insulin therapy. Conclusions. In T2D, BW gain was composed exclusively of FM with no improvement in MS. PMID:20721344

Gin, H.; Rigalleau, V.; Perlemoine, C.

2010-01-01

146

Effect of a combination of whole body vibration exercise and squat training on body balance, muscle power, and walking ability in the elderly  

PubMed Central

A randomized controlled trial was conducted to clarify the beneficial effect of whole body vibration (WBV) exercise plus squat training on body balance, muscle power, and walking ability in the elderly with knee osteoarthritis and/or spondylosis. Of 35 ambulatory patients (14 men and 21 women) who were recruited at our outpatient clinic, 28 (80.0%, 12 men and 16 women) participated in the trial. The subjects (mean age 72.4 years) were randomly divided into two groups (n=14 in each group), ie, a WBV exercise alone group and a WBV exercise plus squat training group. A 4-minute WBV exercise (frequency 20 Hz) was performed 2 days per week in both groups; squat training (20 times per minute) was added during the 4-minute WBV training session in the WBV exercise plus squat training group. The duration of the trial was 6 months. The exercise and training program was safe and well tolerated. WBV exercise alone improved indices of body balance and walking velocity from baseline values. However, WBV exercise plus squat training was more effective for improving tandem gait step number and chair-rising time compared with WBV exercise alone. These results suggest the benefit and safety of WBV exercise plus squat training for improving physical function in terms of body balance and muscle power in the elderly. PMID:24591837

Osugi, Tomohiro; Iwamoto, Jun; Yamazaki, Michio; Takakuwa, Masayuki

2014-01-01

147

Mind-body therapy in the management and prevention of coronary disease  

Microsoft Academic Search

Conventional mind-body therapy has been proven a valuable noninvasive way to manage coronary disease. Yoga practice, especially,\\u000a has been found to be valuable in preventing adverse outcomes of coronary disease by improving resistance to stress.

Dipak P. Pandya; Vaidehi H. Vyas; Shrirupa H. Vyas

1999-01-01

148

Deconstructing the Mirror's Reflection: Narrative Therapy Groups for Women Dissatisfied with Their Body  

ERIC Educational Resources Information Center

Women facing middle age and beyond are pressured by a cultural ideal of slimness. The authors review literature pertaining to the factors affecting the societal perceptions of body image and address relevant counseling interventions, specifically, group therapy based on narrative theory, that are aimed at this population.

Duba, Jill D.; Kindsvatter, Aaron; Priddy, Constance J.

2010-01-01

149

Antipyretic Therapy in Critically Ill Patients with Sepsis: An Interaction with Body Temperature  

PubMed Central

Background and Objective The effect of antipyretic therapy on mortality in patients with sepsis remains undetermined. The present study aimed to investigate the role of antipyretic therapy in ICU patients with sepsis by using a large clinical database. Methods The multiparameter intelligent monitoring in intensive care II (MIMIC- II) database was employed for the study. Adult patients with sepsis were included for analysis. Antipyretic therapy included antipyretic medication and external cooling. Multivariable model with interaction terms were employed to explore the association of antipyretic therapy and mortality risk. Main Results A total of 15,268 patients fulfilled inclusion criteria and were included in the study. In multivariable model by treating temperature as a continuous variable, there was significant interaction between antipyretic therapy and the maximum temperature (Tmax). While antipyretic therapy had no significant effect on mortality in low temperature quintiles, antipyretic therapy was associated with increased risk of death in the quintile with body temperature >39°C (OR: 1.29, 95% CI: 1.04–1.61). Conclusion Our study shows that there is no beneficial effect on reducing mortality risk with the use of antipyretic therapy in ICU patients with sepsis. External cooling may even be harmful in patients with sepsis. PMID:25822614

Zhang, Zhongheng; Chen, Lin; Ni, Hongying

2015-01-01

150

Prevalence and pattern of occupational exposure to whole body vibration in Great Britain: findings from a national survey  

PubMed Central

OBJECTIVES—To estimate the number of workers in Great Britain with significant occupational exposure to whole body vibration (WBV) and to identify the common sources of exposure and the occupations and industries where such exposures arise.?METHODS—A postal questionnaire was posted to a random community sample of 22 194 men and women of working age. Among other things, the questionnaire asked about exposure to WBV in the past week, including occupational and common non-occupational sources. Responses were assessed by occupation and industry, and national prevalence estimates were derived from census information. Estimates were also made of the average estimated daily personal dose of vibration (eVDV).?RESULTS—From the 12 907 responses it was estimated that 7.2 million men and 1.8 million women in Great Britain are exposed to WBV at work in a 1 week period if the occupational use of cars, vans, buses, trains, and motor cycles is included within the definition of exposure. The eVDV of >374 000 men and 9000 women was estimated to exceed a proposed British Standard action level of 15 ms-1.75. Occupations in which the estimated exposures most often exceeded 15 ms-1.75 included forklift truck and mechanical truck drivers, farm owners and managers, farm workers, and drivers of road goods vehicles. These occupations also contributed the largest estimated numbers of workers in Great Britain with such levels of exposure. The highest estimated median occupational eVDVs were found in forklift truck drivers, drivers of road goods vehicles, bus and coach drivers, and technical and wholesale sales representatives, among whom a greater contribution to total dose was received from occupational exposures than from non-occupational ones; but in many other occupations the reverse applied. The most common sources of occupational exposure to WBV are cars, vans, forklift trucks, lorries, tractors, buses, and loaders.?CONCLUSIONS—Exposure to whole body vibration is common, but only a small proportion of exposures exceed the action level proposed in British standards, and in many occupations, non-occupational sources are more important than those at work. The commonest occupational sources of WBV and occupations with particularly high exposures have been identified, providing a basis for targeting future control activities.???Keywords: whole body vibration; population; prevalence; exposure PMID:10810108

Palmer, K.; Griffin, M.; Bendall, H.; Pannett, B.; Coggon, D.

2000-01-01

151

Combined whole-body vibration, resistance exercise, and sustained vascular occlusion increases PGC-1? and VEGF mRNA abundances.  

PubMed

We previously reported that high load resistance exercise with superimposed whole-body vibration and sustained vascular occlusion (vibroX) markedly improves cycling endurance capacity, increases capillary-to-fibre ratio and skeletal muscle oxidative enzyme activity in untrained young women. These findings are intriguing, since increases in oxidative muscle phenotype and endurance capacity are typically induced by endurance but not heavy resistance exercise. Here, we tested the hypothesis that vibroX activates genes associated with mitochondrial biogenesis and angiogenesis. Eight healthy, recreationally resistance-trained young men performed either vibroX or resistance exercise (RES) in a randomised, cross-over design. Needle biopsies (M. vastus lateralis) were obtained at rest and 3 h post-exercise. Changes in relative gene expression levels were assessed by real-time quantitative PCR. After vibroX, vascular endothelial growth factor and peroxisome proliferator-activated receptor-? coactivator 1? mRNA abundances increased to 2- and 4.4-fold, respectively, but did not significantly change above resting values after RES. Other genes involved in mitochondrial biogenesis were not affected by either exercise modality. While vibroX increased the expression of hexokinase II, xanthine dehydrogenase, and manganese superoxide dismutase mRNA, there were no changes in these transcripts after RES. This study demonstrates that high load resistance exercise with superimposed whole-body vibration and sustained vascular occlusion activates metabolic and angiogenic gene programs, which are usually activated after endurance but not resistance exercise. Thus, targeted modification of high load resistance exercise by vibration and vascular occlusion might represent a novel strategy to induce endurance-type muscle adaptations. PMID:23086295

Item, Flurin; Nocito, Antonio; Thöny, Sandra; Bächler, Thomas; Boutellier, Urs; Wenger, Roland H; Toigo, Marco

2013-04-01

152

Effect of Whole Body Vibration Exercise in the Horizontal Direction on Balance and Fear of Falling in Elderly People: A Pilot Study  

PubMed Central

[Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies. PMID:25140102

Shim, ChungSin; Lee, YunBok; Lee, DongGeon; Jeong, BeomHo; Kim, JinBeom; Choi, YoungWoo; Lee, GyuChang; Park, Dong-sik

2014-01-01

153

[Clinical care of lung cancer patients with body image changes after targeted therapy].  

PubMed

Lung cancer has a relatively short survival prognosis and advanced disease progression. Therefore, targeted therapy has become one of the most frequent treatments of this disease. Targeted therapy has several features that effectively extend the survival period; is easy to apply and use; and has fewer side effects than chemotherapy. Therefore, this therapy approach has become the preferred choice of patients with advanced lung cancer. However, current targeted therapies like Iressa and Tarceva produce side effects such as skin dryness and acneiform eruption that may bother patients. These side effects may further cause patient concern over negative changes in their body image, and these concerns may influence their work and social lives. Additionally, some patients treated with targeted therapy worry about their chances of survival if they reduce or stop the medication to avoid the side effects. Consequently, patients may struggle with both physical and psychological impacts, and may have problems sustaining a good quality of life. This article focuses on delivering relevant information to patients receiving targeted therapy who suffer from dermatological toxicity and damage to their body image. We demonstrate an assessment tool and information to help patients cope with physical and psychosocial issues through daily skin care routines, mental / psychological supports, and cognitive behavior therapy. These measures may help patients rebuild a positive self-concept. We plan to develop further associated training to provide professionals / care providers with the appropriate knowledge and skills to care for cancer patients in a resource-limited environment so that they may improve the quality of nursing care for patients with body image changes. PMID:25116319

Chan, Jui-Chun; Liao, Yu-Chien; Lee, Yun-Hsiang; Lai, Yeur-Hur

2014-08-01

154

Effect of 6Month Whole Body Vibration Training on Hip Density, Muscle Strength, and Postural Control in Postmenopausal Women: A Randomized Controlled Pilot Study  

Microsoft Academic Search

High-frequency mechanical strain seems to stimulate bone strength in animals. In this random- ized controlled trial, hip BMD was measured in postmenopausal women after a 24-week whole body vibration (WBV) training program. Vibration training significantly increased BMD of the hip. These findings suggest that WBV training might be useful in the prevention of osteoporosis. Introduction: High-frequency mechanical strain has been

Sabine MP Verschueren; Machteld Roelants; Christophe Delecluse; Stephan Swinnen; Dirk Vanderschueren; Steven Boonen

2004-01-01

155

The Effect of Whole Body Horizontal Vibration in Position Sense and Dynamic Stability of the Spine  

E-print Network

Bbody Vibration...................... 5 1.2.2 Whole Bbody Vvibration and Mmuscle Ffatigue............................... 7 1.3 Low Bback Ppain and SsStability of Llumbar Sspine................................ 9 1.4 Proprioception- Aa Ccomponent... are disabled from working as a result of musculoskeletal disorders (MSDs), especially back pain, than from any other group of diseases [7]. Although complex social and economic forces may account for part of this increase, there is suggestive evidence...

Lamis, Farhana

2008-06-09

156

Psychophysical relationships characterizing human response to whole-body sinusoidal vertical vibration  

NASA Technical Reports Server (NTRS)

An experimental investigation determined that the psychophysical relationships between subjective discomfort evaluations to vibratory stimuli and subjective evaluations of the intensity of vibratory stimuli can be expressed in a linear fashion. Furthermore, significant differences were found to exist between discomfort and intensity subjective response for several but not all discrete frequencies investigated. The implication of these results is that ride quality criteria based upon subjective evaluation of vibration intensity should be applied cautiously in the development of criteria for human comfort.

Leatherwood, J. D.; Dempsey, T. K.

1976-01-01

157

A summary of current Bureau research into the effects of whole-body vibration and shock on operators of underground mobile equipment  

SciTech Connect

This report discusses current research by the U.S. Bureau of Mines on the effects of whole-body vibration (WBV) and shock on underground mobile equipment operators. The highlights of a comprehensive literature review of WBV, shock, and seating are presented. Factors discussed include health and physiological effects, comfort, performance, and fatigue. Vibration data were collected from shuttle cars and ramcars at several underground coal mines in Pennsylvania, Ohio, and Illinois. The data were formatted so that they could be used to drive the Bureau's motion platform, and to compare them with ANSI S3-1979, Guide for the Evaluation of Human Exposure to Whole-Body Vibration. Human subject testing in the Bureau's vibration research laboratory evaluated the effects of two different seat angles and of the presence or absence of vibration and of foam padding on heart rate, blood pressure, and subjective discomfort. Only vibration significantly increased heart rate and systolic and mean blood pressures. Vibration and a steel seat had a significant effect on subjective discomfort. The apparatus used for these tests and the experimental procedures are described in detail. Recommendations are made for additional research on the exposure of underground mining machine operators to WBV and shock.

Love, A.C.; Unger, R.L.; Bobick, T.G.; Fowkes, R.S.

1992-01-01

158

Microcirculation of skeletal muscle adapts differently to a resistive exercise intervention with and without superimposed whole-body vibrations.  

PubMed

Whole-body vibration (WBV) training is commonly practiced and may enhance peripheral blood flow. Here, we investigated muscle morphology and acute microcirculatory responses before and after a 6-week resistive exercise training intervention without (RE) or with (RVE) simultaneous whole-body vibrations (20 Hz, 6 mm peak-to-peak amplitude) in 26 healthy men in a randomized, controlled parallel-design study. Total haemoglobin (tHb) and tissue oxygenation index (TOI) were measured in gastrocnemius muscle (GM) with near-infrared spectroscopy (NIRS). Whole-body oxygen consumption (VO2 ) was measured via spirometry, and skeletal muscle morphology was determined in soleus (SOL) muscle biopsies. Our data reveal that exercise-induced muscle deoxygenation both before and after 6 weeks training was similar in RE and RVE (P = 0·76), although VO2 was 20% higher in the RVE group (P<0·001). The RVE group showed a 14%-point increase in reactive hyperaemia (P = 0·007) and a 27% increase in blood volume (P<0·01) in GM after 6 weeks of training. The number of capillaries around fibres was increased by 15% after 6 weeks training in both groups (P<0·001) with no specific effect of superimposed WBV (P = 0·61). Neither of the training regimens induced fibre hypertrophy in SOL. The present findings suggest an increased blood volume and vasodilator response in GM as an adaptation to long-term RVE, which was not observed after RE alone. We conclude that RVE training enhances vasodilation of small arterioles and possibly capillaries. This effect might be advantageous for muscle thermoregulation and the delivery of oxygen and nutrients to exercising muscle and removal of carbon dioxide and metabolites. PMID:25041226

Beijer, Asa; Degens, Hans; Weber, Tobias; Rosenberger, André; Gehlert, Sebastian; Herrera, Frankyn; Kohl-Bareis, Matthias; Zange, Jochen; Bloch, Wilhelm; Rittweger, Jörn

2014-07-21

159

The metabolic syndrome and mind-body therapies: a systematic review.  

PubMed

The metabolic syndrome, affecting a substantial and increasing percentage of the worldwide population, is comprised of a cluster of symptoms associated with increased risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation, have become increasingly popular worldwide. These complementary therapies have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome. However, clinical trial data concerning the effectiveness of these practices on the syndrome as a whole have not been evaluated using a systematic and synthesizing approach. A systematic review was conducted to critically evaluate the data from clinical trials examining the efficacy of mind-body therapies as supportive care modalities for management of the metabolic syndrome. Three clinical trials addressing the use of mind-body therapies for management of the metabolic syndrome were identified. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome. PMID:21773016

Anderson, Joel G; Taylor, Ann Gill

2011-01-01

160

Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression  

PubMed Central

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research. PMID:23662111

Kinser, Patricia Anne; Robins, Jo Lynne

2013-01-01

161

Evidence for an additional effect of whole-body vibration above resistive exercise alone in preventing bone loss during prolonged bed rest  

Microsoft Academic Search

Summary  The addition of whole-body vibration to high-load resistive exercise may provide a better stimulus for the reduction of bone\\u000a loss during prolonged bed rest (spaceflight simulation) than high-load resistive exercise alone.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction  Prior work suggests that the addition of whole-body vibration to high-load resistive exercise (RVE) may be more effective\\u000a in preventing bone loss in spaceflight and its simulation (bed rest)

D. L. Belavý; G. Beller; G. Armbrecht; F. H. Perschel; R. Fitzner; O. Bock; H. Börst; C. Degner; U. Gast; D. Felsenberg

2011-01-01

162

Outcomes of Manualized Cognitive-Behavioral Body Image Therapy with Eating Disordered Women Treated in a Private Clinical Practice  

Microsoft Academic Search

Body image change is an important component of the treatment of eating disorders, and cognitive behavioral body image therapy has substantial empirical support as efficacious in the improvement of body image difficulties and disorders. Most evidence comes from randomized, controlled, outcome studies and does not examine effectiveness for persons with clinical eating disorders in the context of “usual care” settings.

Stacey Nye; Thomas F. Cash

2006-01-01

163

Tumor cells, but not endothelial cells, mediate eradication of primary sarcomas by stereotactic body radiation therapy.  

PubMed

Cancer clinics currently use high-dose stereotactic body radiation therapy as a curative treatment for several kinds of cancers. However, the contribution of vascular endothelial cells to tumor response to radiation remains controversial. Using dual recombinase technology, we generated primary sarcomas in mice with targeted genetic mutations specifically in tumor cells or endothelial cells. We selectively mutated the proapoptotic gene Bax or the DNA damage response gene Atm to genetically manipulate the radiosensitivity of endothelial cells in primary soft tissue sarcomas. Bax deletion from endothelial cells did not affect radiation-induced cell death in tumor endothelial cells or sarcoma response to radiation therapy. Although Atm deletion increased endothelial cell death after radiation therapy, deletion of Atm from endothelial cells failed to enhance sarcoma eradication. In contrast, deletion of Atm from tumor cells increased sarcoma eradication by radiation therapy. These results demonstrate that tumor cells, rather than endothelial cells, are critical targets that regulate sarcoma eradication by radiation therapy. Treatment with BEZ235, a small-molecule protein kinase inhibitor, radiosensitized primary sarcomas more than the heart. These results suggest that inhibiting ATM kinase during radiation therapy is a viable strategy for radiosensitization of some tumors. PMID:25761890

Moding, Everett J; Castle, Katherine D; Perez, Bradford A; Oh, Patrick; Min, Hooney D; Norris, Hannah; Ma, Yan; Cardona, Diana M; Lee, Chang-Lung; Kirsch, David G

2015-03-11

164

Vehicle design influences whole body vibration exposures: effect of the location of the front axle relative to the cab.  

PubMed

Using a repeated measure design, this study compared differences in whole body vibration (WBV) exposures among 13 drivers who drove a truck with the cab over the front axle (cab-over design) and a truck with the cab situated behind the front axle (non-cab-over design). The drivers drove both trucks over a standardized route that comprised three distinct segments: a freeway segment, a city street segment with stop-and-go driving (traffic lights), and a city street segment without traffic lights. A portable WBV data acquisition system collected tri-axial time-weighted and raw WBV data per ISO 2631-1 and 2631-5 standards. Simultaneous global positioning system (GPS) data were also collected to compare vehicle speeds. The GPS data indicated that there were no speed differences between the two vehicles. However, average and impulsive z-axis vibration levels were significantly higher for the cab-over design than for the non-cab-over design. In addition, significant WBV exposure differences between road types were found, with the freeway segments having the lowest exposures and the city street segments without traffic lights having the highest exposures. Vehicle type and the associated WBV exposures should be considered when purchasing vehicles to be used by full-time professional vehicle operators. PMID:21623531

Blood, Ryan P; Rynell, Patrik W; Johnson, Peter W

2011-06-01

165

EFFECTS OF 6?WEEK WHOLE BODY VIBRATION TRAINING ON THE REFLEX RESPONSE OF THE ANKLE MUSCLES: A RANDOMIZED CONTROLLED TRIAL  

PubMed Central

Background: The ligament sprain of the lateral ankle is the most frequent injury that occurs when participating in sports. Whole body vibration (WBV) is a training method that has been recently introduced as a rehabilitative tool for treatment of athletes. It has been hypothesized that the transmission of mechanical oscillations from the vibrating platform may lead to physiological changes in muscle spindles, joint mechanoreceptors, as well as improve balance. Propose: The aim of this study was to assess the effects of a 6?week WBV training program on the reflex response mechanism of the peroneus longus (PL), peroneus brevis (PB) and anterior tibialis (AT) muscles in ankle inversion at 30º from horizontal, in a static position. Methods: This study was a single?blinded and randomized controlled trial. Forty?four healthy, physically active participants were randomly split into two groups: the experimental group (n = 26) (the WBV training) and control group (n = 18). Reaction time (RT), maximum electromyographic (EMG) peak (peak EMG), time to the maximum peak EMG (peak EMG time) and reflex electrical activity of all the muscles were assessed before and after the WBV training through surface EMG. Results: After 6?weeks WBV training, there were no significant changes in the variables analysed for all the muscles involved. Conclusion: A 6?week WBV training does not improve the reflex response mechanism of the lateral stabilizing muscles of the ankle. Level of evidence: 1b PMID:23439725

Rubio, Jacobo A.; Ramos, Domingo J.; Esteban, Paula; Mendizábal, Susana; Jiménez, Fernando

2013-01-01

166

Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players  

PubMed Central

Objective: To quantify the acute effect of whole body vibration (WBV) training on arm countermovement vertical jump (ACMVJ), grip strength, and flexibility performance. Methods: Eighteen female elite field hockey players each completed three interventions of WBV, control, and cycling in a balanced random manner. WBV was performed on a Galileo machine (26 Hz) with six different exercises being performed. For the control, the same six exercises were performed at 0 Hz, whilst cycling was performed at 50 W. Each intervention was 5 min in duration with ACMVJ, grip strength, and flexibility measurements being conducted pre and post intervention. Results: There was a positive interaction effect (interventionxpre-post) of enhanced ACMVJ (p<0.001) and flexibility (p<0.05) parameters following WBV; however no changes were observed after the control and cycling interventions. There was no interaction effect for grip strength following the three interventions. Conclusions: Acute WBV causes neural potentiation of the stretch reflex loop as shown by the improved ACMVJ and flexibility performance. Additionally, muscle groups less proportionally exposed to vibration do not exhibit physiological changes that potentiate muscular performance. PMID:16244199

Cochrane, D; Stannard, S

2005-01-01

167

Acute effects of whole-body vibration on jump force and jump rate of force development: a comparative study of different devices.  

PubMed

The goal of this study was to compare the acute effects of whole-body vibration (WBV) delivered by 3 devices with different mechanical behavior on jump force (JF) and jump rate of force development (JRFD). Twelve healthy persons (4 women and 8 men; age 30.5 ± 8.8 years; height 178.6 ± 7.3 cm; body mass 74.8 ± 9.7 kg) were exposed to WBV for 15 and 40 seconds using 2 professional devices (power plate [PP; vertical vibration] and Galileo 2000 [GA; oscillatory motion around the horizontal axis in addition to vertical vibration]) and a home-use device [Power Maxx, PM; horizontal vibration]). The JF and JRFD were evaluated before, immediately after, and 5 minutes after WBV. The JF measured immediately after 40 seconds of vibration by the GA device was reduced (3%, p = 0.05), and JRFD measured after 5 minutes of rest after 40 seconds of vibration by the PM device was reduced (12%, p < 0.05) compared with the baseline value. The acute effects of WBV (15 or 40 seconds) on JF and JRFD were not significantly different among the 3 devices. In conclusion, our hypothesis that WBV devices with different mechanical behaviors would result in different acute effects on muscle performance was not confirmed. PMID:22126972

Bagheri, Javad; van den Berg-Emons, Rita J; Pel, Johan J; Horemans, Herwin L; Stam, Henk J

2012-03-01

168

A numerical scheme for the identification of hybrid systems describing the vibration of flexible beams with tip bodies  

NASA Technical Reports Server (NTRS)

A cubic spline based Galerkin-like method is developed for the identification of a class of hybrid systems which describe the transverse vibration to flexible beams with attached tip bodies. The identification problem is formulated as a least squares fit to data subject to the system dynamics given by a coupled system of ordnary and partial differential equations recast as an abstract evolution equation (AEE) in an appropriate infinite dimensional Hilbert space. Projecting the AEE into spline-based subspaces leads naturally to a sequence of approximating finite dimensional identification problems. The solutions to these problems are shown to exist, are relatively easily computed, and are shown to, in some sense, converge to solutions to the original identification problem. Numerical results for a variety of examples are discussed.

Rosen, I. G.

1984-01-01

169

Developing, Maintaining, and Using a Body of Knowledge for the Massage Therapy Profession  

PubMed Central

Background: The diverse field of massage therapy has lacked a formal body of knowledge to serve as a practice and educational foundation and to guide future development. This deficit has hampered the growth of the profession and its acceptance and recognition by the medical and allied health care community. Purpose: To provide massage therapists, bodyworkers, physicians, educators, and associated allied health care professionals in the United States with a description of the purpose and development of the massage therapy body of knowledge (MTBOK) and recommendations for its future development and utilization. Methods: Professional groups in the massage therapy community came together and established a task force to develop a body of knowledge for the profession. Five groups became the stewards for this effort. A nationwide search produced a task force of eight volunteers from diverse areas of the profession charged with the responsibility of researching and developing the MTBOK document. Review of documents, curricula, state laws and regulations, certification exam content, interviews, and public comment resulted in the development of the MTBOK. During development multiple opportunities for comment and discussion by stakeholders (public) were provided in an effort to create a professional consensus. Results: The resulting MTBOK document establishes professional descriptions of the field; scope of practice; knowledge, skills, and abilities for entry-level massage therapists; and definitions for terminology to insure standardization, in order to provide a foundation for future discussion and growth. Conclusions: The MTBOK fulfills the goal for which it was developed, to serve as a foundation for the growth and development of the massage therapy profession as a whole. A living document, it should continue to evolve and grow with the profession. Maintenance and continued stewardship of this document by the massage therapy community is vital for continued professional progress. PMID:22016755

Sefton, JoEllen M.; Shea, Michael; Hines, Chip

2011-01-01

170

Thinking Through the Body: The Conceptualization of Yoga as Therapy for Individuals With Eating Disorders  

Microsoft Academic Search

Yoga has historically been viewed as a discipline that increases self-awareness through body based practices, meditation, self-study, and the reading of philosophical texts. In the 21st century the mindfulness techniques of yoga have been adapted as an adjunct to the treatment of individuals with eating disorders. In an effort to understand the conceptualization of yoga as therapy for individuals with

Laura Douglass

2010-01-01

171

Myoelectric Response of Back Muscles to Vertical Random Whole-Body Vibration with Different Magnitudes at Different Postures  

NASA Astrophysics Data System (ADS)

Back muscle forces contribute essentially to the whole-body vibration-induced spinal load. The electromyogram (EMG) can help to estimate these forces during whole-body vibration (WBV). Thirty-eight subjects were exposed to identical random low-frequency WBV (0·7, 1·0 and 1·4 m/s-2 r.m.s. weighted acceleration) at a relaxed, erect and bent forward postures. The acceleration of the seat and the force between the seat and the buttocks were measured. Six EMGs were derived from the right side of the m. trapezius pars descendens, m. ileocostalis lumborum pars thoracis, m. ileocostalis lumborum pars lumborum; m. longissimus thoracis pars thoracis, m. longissimus thoracis pars lumborum, and lumbar multifidus muscle. All data were filtered for anti-aliasing and sampled with 1000 Hz. Artefacts caused by the ECG in the EMG were identified and eliminated in the time domain using wavelets. The individually rectified and normalized EMGs were averaged across subjects. The EMGs without WBV exhibited characteristic patterns for the three postures examined. The coherence and transfer functions indicated characteristic myoelectric responses to random WBV with several effects of posture and WBV magnitude. A comprehensive set of transfer functions from the seat acceleration or the mean normalized input force to the mean processed EMG was presented.The results can be used for the development of more sophisticated models with a separate control of various back muscle groups. However, the EMG-force relationship under dynamic conditions needs to be examined in more detail before the results can be implemented. Since different reflex mechanisms depending on the frequency of WBV are linked with different types of active muscle fibres, various time delays between the EMG and muscle force may be necessary.

BLÜTHNER, R.; SEIDEL, H.; HINZ, B.

2002-05-01

172

A Comparative Evaluation of Cognitive-Behavioral Therapy (CBT) Versus Exercise Therapy (ET) for the Treatment of Body Image DisturbancePreliminary Findings  

Microsoft Academic Search

Cognitive-behavioral therapy (CBT) was compared to a combination of aerobic\\/anaerobic exercise therapy (ET) for the treatment of elevated levels of body image disturbance in college females. CBT consisted of a modification of the 1987 Butters and Cash procedure that was tailored for group intervention; ET consisted of weightlifting and aerobic dancing. Using a counterbalancing procedure, the same therapists conducted both

Erik Fisher; J. Kevin Thompson

1994-01-01

173

Whole body vibration exercise improves body balance and walking velocity in postmenopausal osteoporotic women treated with alendronate: Galileo and Alendronate Intervention Trail (GAIT).  

PubMed

A randomized controlled trial was conducted to determine the effect of 6 months of whole body vibration (WBV) exercise on physical function in postmenopausal osteoporotic women treated with alendronate. Fifty-two ambulatory postmenopausal women with osteoporosis (mean age: 74.2 years, range: 51-91 years) were randomly divided into two groups: an exercise group and a control group. A four-minute WBV exercise was performed two days per week only in the exercise group. No exercise was performed in the control group. All the women were treated with alendronate. After 6 months of the WBV exercise, the indices for flexibility, body balance, and walking velocity were significantly improved in the exercise group compared with the control group. The exercise was safe and well tolerated. The reductions in serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen during the 6-month period were comparable between the two groups. The present study showed the benefit and safety of WBV exercise for improving physical function in postmenopausal osteoporotic women treated with alendronate. PMID:22947545

Iwamoto, J; Sato, Y; Takeda, T; Matsumoto, H

2012-09-01

174

Wearable ballistocardiography: Preliminary methods for mapping surface vibration measurements to whole body forces.  

PubMed

The recent resurgence of ballistocardiogram (BCG) measurement and interpretation technologies has led to a wide range of powerful tools available for unobtrusively assessing mechanical aspects of cardiovascular health at home. Researchers have demonstrated a multitude of modern BCG measurement modalities, including beds, chairs, weighing scales, and wearable approaches. However, many modalities produce significant variations in the morphology of the measured BCG, creating confusion in the analysis and interpretation of the signals. This paper creates a framework for comparing wearable BCG measurements to whole body measurements - such as taken with a weighing scale system - to eventually allow the same analysis and interpretation tools that have been developed for whole body systems to be applied in the future to wearable systems. To the best of our knowledge, it represents the first attempt to morphologically compare vertical acceleration recordings measured on different locations on the torso to whole body displacements measured by BCG instrumentation. PMID:25571158

Wiens, Andrew; Etemadi, Mozziyar; Klein, Liviu; Roy, Shuvo; Inan, Omer T

2014-08-01

175

Vibroacoustic sound therapy improves pain management and more.  

PubMed

Vibroacoustic therapy is a new sound technology that uses audible sound vibrations to reduce symptoms, invoke relaxation, and alleviate stress. This technology is developed based on the recognition that external vibration can influence body function. Research demonstrates the effectiveness of vibroacoustic therapy. Implications for nurses include investigating the possibilities of vibroacoustic therapy in various nursing settings to promote patient well-being and improve the therapeutic environment. PMID:15222599

Boyd-Brewer, Chris; McCaffrey, Ruth

2004-01-01

176

Chemotherapy followed by half-body radiation therapy for canine lymphoma.  

PubMed

A protocol of induction chemotherapy followed by half-body radiation therapy for treatment of lymphoma was used in 94 dogs. Seventy-three (78%) dogs achieved complete remission. Substage (P = .011) and phenotype (P = .015) were identified as predictors of complete remission rate. Of these, 52 dogs received half-body irradiation. Cranial and caudal halves received a total dose of 8.0 Gy, given in 2 fractions of 4.0 Gy on consecutive days with cobalt-60 photons and a 3-week interval between halves. Median 1st remission for these dogs was 311 days. Anemia was identified as the only predictor for length of 1st remission (P = .024). Toxicoses after half-body irradiation generally were mild and infrequent and included myelosuppression and gastrointestinal signs. Thirty-one dogs relapsed and 20 resumed treatment with induction followed by maintenance chemotherapy. Seventeen (85%) dogs achieved a 2nd complete remission. Median overall remission for all 52 dogs was 486 days. Results of this study suggest that half-body radiation therapy after induction chemotherapy is well tolerated and might increase remission duration compared with conventional protocols that use chemotherapy alone, but this increase might not be long enough to be clinically relevant or to justify application of the method described herein. PMID:15515588

Williams, Laurel E; Johnson, Jeffrey L; Hauck, Marlene L; Ruslander, David M; Price, G Sylvester; Thrall, Donald E

2004-01-01

177

Effects of whole body vibration on the skeleton and other organ systems in man and animal models: What we know and what we need to know  

Microsoft Academic Search

Previous investigations reported enhanced osseous parameters subsequent to administration of whole body vibration (WBV). While the efficacy of WBV continues to be explored, scientific inquiries should consider several key factors. Bone remodeling patterns differ according to age and hormonal status. Therefore, WBV protocols should be designed specifically for the subject population investigated. Further, administration of WBV to individuals at greatest

Rhonda D. Prisby; Marie-Hélène Lafage-Proust; Luc Malaval; Alain Belli; Laurence Vico

2008-01-01

178

Vibrational investigation of calcium-silicate cements for endodontics in simulated body fluids  

NASA Astrophysics Data System (ADS)

Calcium-silicate MTA (Mineral Trioxide Aggregate) cements have been recently developed for oral and endodontic surgery. This study was aimed at investigating commercial (White ProRoot MTA, White and Grey MTA-Angelus) and experimental (wTC-Bi) accelerated calcium-silicate cements with regards to composition, hydration products and bioactivity upon incubation for 1-28 days at 37 °C, in Dulbecco's Phosphate Buffered Saline (DPBS). Deposits on the surface of the cements and the composition changes during incubation were investigated by micro-Raman and ATR/FT-IR spectroscopy, and pH measurements. Vibrational techniques disclosed significant differences in composition among the unhydrated cements, which significantly affected the bioactivity as well as pH, and hydration products of the cements. After one day in DPBS, all the cements were covered by a more or less homogeneous layer of B-type carbonated apatite. The experimental cement maintained a high bioactivity, only slightly lower than the other cements and appears a valid alternative to commercial cements, in view of its adequate setting time properties. The bioactivity represents an essential property to favour bone healing and makes the calcium-silicate cements the gold standard materials for root-apical endodontic surgery.

Taddei, Paola; Modena, Enrico; Tinti, Anna; Siboni, Francesco; Prati, Carlo; Gandolfi, Maria Giovanna

2011-05-01

179

Holistic Therapy Holistic Massage: This hour long session involves a complete relaxation of the body while easing  

E-print Network

. Shamanic Energy Therapy: This session harness energetic healing which allows us to step forward into our: This deep foot massage works on energy lines mirroring the whole body system. Applying gentle pressure

O'Mahony, Donal E.

180

Evaluation of a six-week whole-body vibration intervention on neuromuscular performance in older adults.  

PubMed

Research in the field of whole-body vibration (WBV) for the enhancement of neuromuscular performance is becoming increasingly popular. However, additional understanding of optimal WBV training protocols is still necessary to develop optimal and effective training and prevention concepts, especially for elderly people. The intention of this study was to evaluate a 6-week WBV intervention program based on optimal vibration loads adapted from the literature on lower-limb strength parameters and performance, as well as on perceived exertion according to a subjective rating. A total of 21 older adults were allocated randomly into either a WBV training or control group (CO). Before and after the intervention period, jump height was measured during a countermovement jump. In addition, isolated isokinetic maximal knee extension and flexion strength, mean power, and work were recorded using a motor-driven dynamometer. Borg's scale for rating of perceived exertion was used to evaluate the intensity of WBV exercises within each training session. After the intervention period, jump height increased by 18.55% (p < 0.001) in the WBV group, whereas values of the CO remained unchanged. There were no statistically significant differences in isokinetic maximal strength, mean power, or work values in knee extension or flexion (all p > 0.05). Finally, the subjective perceived exertion of the WBV exercises and respective training parameters ranged between moderate rating levels of 7 and 13 of Borg's scale. Our data show that WBV is a feasible and safe training program for elderly people to increase multijoint strength performance of the lower limbs during a countermovement jump. This could help to determine the potential of WBV programs in training of the elderly to prevent age-related reduction of neuromuscular performance. PMID:25028997

Perchthaler, Dennis; Grau, Stefan; Hein, Tobias

2015-01-01

181

An Updated Review of Epidemiologic Studies on the Relationship Between Exposure to Whole-Body Vibration and Low Back Pain  

NASA Astrophysics Data System (ADS)

The aim of this paper is to update the information on the epidemiologic evidence of the adverse health effects of whole-body vibration (WBV) on the spinal system by means of a review of the epidemiologic studies published between 1986 and 1996. In a systematic search of epidemiologic studies of low back pain (LBP) disorders and occupations with exposure to WBV, 37 articles were retrieved. The quality of each study was evaluated according to criteria concerning the assessment of vibration exposure, assessment of health effects, and methodology. The epidemiologic studies reaching an adequate score on each of the above mentioned criteria, were included in the final review. A meta-analysis was also conducted in order to combine the results of independent epidemiologic studies. After applying the selection criteria, 16 articles reporting the occurrence of LBP disorders in 19 WBV-exposed occupational groups, reached a sufficient score. The study design was cross-sectional for 13 occupational groups, longitudinal for 5 groups and of case-control type for one group. The main reasons for the exclusion of studies were insufficient quantitative information on WBV exposure and the lack of control groups. The findings of the selected studies and the results of the meta-analysis of both cross-sectional and cohort studies showed that occupational exposure to WBV is associated with an increased risk of LBP, sciatic pain, and degenerative changes in the spinal system, including lumbar intervertebral disc disorders. Owing to the cross-sectional design of the majority of the reviewed studies, this epidemiologic evidence is not sufficient to outline a clear exposure-response relationship between WBV exposure and LBP disorders. Upon comparing the epidemiological studies included in this review with those conducted before 1986, it is concluded that research design and the quality of exposure and health effect data in the field of WBV have improved in the last decade.

Bovenzi, M.; Hulshof, C. T. J.

1998-08-01

182

The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis  

PubMed Central

Importance Psychological and health-restorative benefits of mind-body therapies have been investigated, but their impact on the immune system remain less defined. Objective To conduct the first comprehensive review of available controlled trial evidence to evaluate the effects of mind-body therapies on the immune system, focusing on markers of inflammation and anti-viral related immune responses. Methods Data sources included MEDLINE, CINAHL, SPORTDiscus, and PsycINFO through September 1, 2013. Randomized controlled trials published in English evaluating at least four weeks of Tai Chi, Qi Gong, meditation, or Yoga that reported immune outcome measures were selected. Studies were synthesized separately by inflammatory (n?=?18), anti-viral related immunity (n?=?7), and enumerative (n?=?14) outcomes measures. We performed random-effects meta-analyses using standardized mean difference when appropriate. Results Thirty-four studies published in 39 articles (total 2, 219 participants) met inclusion criteria. For inflammatory measures, after 7 to 16 weeks of mind-body intervention, there was a moderate effect on reduction of C-reactive protein (effect size [ES], 0.58; 95% confidence interval [CI], 0.04 to 1.12), a small but not statistically significant reduction of interleukin-6 (ES, 0.35; 95% CI, ?0.04 to 0.75), and negligible effect on tumor necrosis factor-? (ES, 0.21; 95% CI, ?0.15 to 0.58). For anti-viral related immune and enumerative measures, there were negligible effects on CD4 counts (ES, 0.15; 95% CI, ?0.04 to 0.34) and natural killer cell counts (ES, 0.12, 95% CI ?0.21 to 0.45). Some evidence indicated mind-body therapies increase immune responses to vaccination. Conclusions Mind-body therapies reduce markers of inflammation and influence virus-specific immune responses to vaccination despite minimal evidence suggesting effects on resting anti-viral or enumerative measures. These immunomodulatory effects, albeit incomplete, warrant further methodologically rigorous studies to determine the clinical implications of these findings for inflammatory and infectious disease outcomes. PMID:24988414

Morgan, Nani; Irwin, Michael R.; Chung, Mei; Wang, Chenchen

2014-01-01

183

Stereotactic Ablative Body Radiation Therapy for Octogenarians With Non-Small Cell Lung Cancer  

SciTech Connect

Purpose: To retrospectively investigate treatment outcomes of stereotactic ablative body radiation therapy (SABR) for octogenarians with non-small cell lung cancer (NSCLC). Methods and Materials: Between 2005 and 2012, 109 patients aged ?80 years with T1-2N0M0 NSCLC were treated with SABR: 47 patients had histology-unproven lung cancer; 62 patients had pathologically proven NSCLC. The prescribed doses were either 50 Gy/5 fractions for peripheral tumors or 40 Gy/5 fractions for centrally located tumors. The treatment outcomes, toxicities, and the correlating factors for overall survival (OS) were evaluated. Results: The median follow-up duration after SABR was 24.2 (range, 3.0-64.6) months. Only limited toxicities were observed, except for 1 grade 5 radiation pneumonitis. The 3-year local, regional, and distant metastasis-free survival rates were 82.3%, 90.1%, and 76.8%, respectively. The OS and lung cancer-specific survival rates were 53.7% and 70.8%, respectively. Multivariate analysis revealed that medically inoperable, low body mass index, high T stage, and high C-reactive protein were the predictors for short OS. The OS for the operable octogenarians was significantly better than that for inoperable (P<.01). Conclusions: Stereotactic ablative body radiation therapy for octogenarians was feasible, with excellent OS. Multivariate analysis revealed that operability was one of the predictors for OS. For medically operable octogenarians with early-stage NSCLC, SABR should be prospectively compared with resection.

Takeda, Atsuya; Sanuki, Naoko; Eriguchi, Takahisa [Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa (Japan)] [Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa (Japan); Kaneko, Takeshi [Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa (Japan) [Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa (Japan); Department of Respirology, Ofuna Chuo Hospital, Kanagawa (Japan); Morita, Satoshi [Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Kanagawa (Japan)] [Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Kanagawa (Japan); Handa, Hiroshi [Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa (Japan) [Respiratory Disease Center, Yokohama City University Medical Center, Kanagawa (Japan); Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa (Japan); Aoki, Yousuke; Oku, Yohei [Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa (Japan)] [Radiation Oncology Center, Ofuna Chuo Hospital, Kanagawa (Japan); Kunieda, Etsuo, E-mail: kunieda-mi@umin.ac.jp [Department of Radiation Oncology, Tokai University, Kanagawa (Japan)] [Department of Radiation Oncology, Tokai University, Kanagawa (Japan)

2013-06-01

184

Dose estimation for internal organs during boron neutron capture therapy for body-trunk tumors.  

PubMed

Radiation doses during boron neutron capture therapy for body-trunk tumors were estimated for various internal organs, using data from patients treated at Kyoto University Research Reactor Institute. Dose-volume histograms were constructed for tissues of the lung, liver, kidney, pancreas, and bowel. For pleural mesothelioma, the target total dose to the normal lung tissues on the diseased side is 5Gy-Eq in average for the whole lung. It was confirmed that the dose to the liver should be carefully considered in cases of right lung disease. PMID:24679832

Sakurai, Y; Tanaka, H; Suzuki, M; Masunaga, S; Kinashi, Y; Kondo, N; Ono, K; Maruhashi, A

2014-06-01

185

Habit Reversal Therapy for Body-Focused Repetitive Behaviors in Williams Syndrome: A Case Study  

PubMed Central

Williams syndrome (WS) is genetic neurodevelopmental disorder with a well-characterized cognitive and behavioral phenotype. Research has consistently demonstrated high rates of psychopathology in this population; however, little research has examined the use of empirically-supported psychosocial interventions in those with WS. The current case study reports on the use of Habit Reversal Therapy (HRT) to treat multiple body-focused repetitive behaviors in a child with WS. Although HRT is a well-established cognitive-behavioral intervention for body-focused repetitive behaviors, it has been infrequently used in populations with developmental disabilities. An etiologically-informed approach was used to adapt HRT to fit the known behavioral and cognitive phenotype of WS. Results suggest that HRT may be beneficial for this population. Modified treatment elements are described and future research areas highlighted. PMID:24357918

Klein-Tasman, Bonita P.

2013-01-01

186

4? Noncoplanar Stereotactic Body Radiation Therapy for Centrally Located or Larger Lung Tumors  

SciTech Connect

Purpose: To investigate the dosimetric improvements in stereotactic body radiation therapy for patients with larger or central lung tumors using a highly noncoplanar 4? planning system. Methods and Materials: This study involved 12 patients with centrally located or larger lung tumors previously treated with 7- to 9-field static beam intensity modulated radiation therapy to 50 Gy. They were replanned using volumetric modulated arc therapy and 4? plans, in which a column generation method was used to optimize the beam orientation and the fluence map. Maximum doses to the heart, esophagus, trachea/bronchus, and spinal cord, as well as the 50% isodose volume, the lung volumes receiving 20, 10, and 5 Gy were minimized and compared against the clinical plans. A dose escalation study was performed to determine whether a higher prescription dose to the tumor would be achievable using 4? without violating dose limits set by the clinical plans. The deliverability of 4? plans was preliminarily tested. Results: Using 4? plans, the maximum heart, esophagus, trachea, bronchus and spinal cord doses were reduced by 32%, 72%, 37%, 44%, and 53% (P?.001), respectively, and R{sub 50} was reduced by more than 50%. Lung V{sub 20}, V{sub 10}, and V{sub 5} were reduced by 64%, 53%, and 32% (P?.001), respectively. The improved sparing of organs at risk was achieved while also improving planning target volume (PTV) coverage. The minimal PTV doses were increased by the 4? plans by 12% (P=.002). Consequently, escalated PTV doses of 68 to 70 Gy were achieved in all patients. Conclusions: We have shown that there is a large potential for plan quality improvement and dose escalation for patients with larger or centrally located lung tumors using noncoplanar beams with sufficient quality and quantity. Compared against the clinical volumetric modulated arc therapy and static intensity modulated radiation therapy plans, the 4? plans yielded significantly and consistently improved tumor coverage and critical organ sparing. Given the known challenges in central structure dose constraints in stereotactic body radiation therapy to the lung, 4? planning may increase efficacy and reduce toxicity.

Dong, Peng; Lee, Percy; Ruan, Dan [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States)] [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Long, Troy; Romeijn, Edwin [Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan (United States)] [Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan (United States); Low, Daniel A.; Kupelian, Patrick; Abraham, John; Yang, Yingli [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States)] [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States); Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States)] [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California (United States)

2013-07-01

187

Optimization of Car Body under Constraints of Noise, Vibration, and Harshness (NVH), and Crash  

NASA Technical Reports Server (NTRS)

To be competitive on the today's market, cars have to be as light as possible while meeting the Noise, Vibration, and Harshness (NVH) requirements and conforming to Government-man dated crash survival regulations. The latter are difficult to meet because they involve very compute-intensive, nonlinear analysis, e.g., the code RADIOSS capable of simulation of the dynamics, and the geometrical and material nonlinearities of a thin-walled car structure in crash, would require over 12 days of elapsed time for a single design of a 390K elastic degrees of freedom model, if executed on a single processor of the state-of-the-art SGI Origin2000 computer. Of course, in optimization that crash analysis would have to be invoked many times. Needless to say, that has rendered such optimization intractable until now. The car finite element model is shown. The advent of computers that comprise large numbers of concurrently operating processors has created a new environment wherein the above optimization, and other engineering problems heretofore regarded as intractable may be solved. The procedure, shown, is a piecewise approximation based method and involves using a sensitivity based Taylor series approximation model for NVH and a polynomial response surface model for Crash. In that method the NVH constraints are evaluated using a finite element code (MSC/NASTRAN) that yields the constraint values and their derivatives with respect to design variables. The crash constraints are evaluated using the explicit code RADIOSS on the Origin 2000 operating on 256 processors simultaneously to generate data for a polynomial response surface in the design variable domain. The NVH constraints and their derivatives combined with the response surface for the crash constraints form an approximation to the system analysis (surrogate analysis) that enables a cycle of multidisciplinary optimization within move limits. In the inner loop, the NVH sensitivities are recomputed to update the NVH approximation model while keeping the Crash response surface constant. In every outer loop, the Crash response surface approximation is updated, including a gradual increase in the order of the response surface and the response surface extension in the direction of the search. In this optimization task, the NVH discipline has 30 design variables while the crash discipline has 20 design variables. A subset of these design variables (10) are common to both the NVH and crash disciplines. In order to construct a linear response surface for the Crash discipline constraints, a minimum of 21 design points would have to be analyzed using the RADIOSS code. On a single processor in Origin 2000 that amount of computing would require over 9 months! In this work, these runs were carried out concurrently on the Origin 2000 using multiple processors, ranging from 8 to 16, for each crash (RADIOSS) analysis. Another figure shows the wall time required for a single RADIOSS analysis using varying number of processors, as well as provides a comparison of 2 different common data placement procedures within the allotted memories for each analysis. The initial design is an infeasible design with NVH discipline Static Torsion constraint violations of over 10%. The final optimized design is a feasible design with a weight reduction of 15 kg compared to the initial design. This work demonstrates how advanced methodology for optimization combined with the technology of concurrent processing enables applications that until now were out of reach because of very long time-to-solution.

Kodiyalam, Srinivas; Yang, Ren-Jye; Sobieszczanski-Sobieski, Jaroslaw (Editor)

2000-01-01

188

Effect of Fractionation in Stereotactic Body Radiation Therapy Using the Linear Quadratic Model  

SciTech Connect

Purpose: To examine the fractionation effect of stereotactic body radiation therapy with a heterogeneous dose distribution. Methods: Derived from the linear quadratic formula with measurements from a hypothetical 2-cm radiosurgical tumor, the threshold percentage was defined as (?/?{sub tissue}/?/?{sub tumor}), the balance ?/? ratio was defined as (prescription dose/tissue tolerance*?/?{sub tumor}), and the balance dose was defined as (tissue tolerance/threshold percentage). Results: With increasing fractions and equivalent peripheral dose to the target, the biological equivalent dose of “hot spots” in a target decreases. The relative biological equivalent doses of serial organs decrease only when the relative percentage of its dose to the prescription dose is above the threshold percentage. The volume of parallel organs at risk decreases only when the tumor's ?/? ratio is above the balance ?/? ratio and the prescription dose is lower than balance dose. Conclusions: The potential benefits of fractionation in stereotactic body radiation therapy depend on the complex interplay between the total dose, ?/? ratios, and dose differences between the target and the surrounding normal tissues.

Yang, Jun, E-mail: JunBME@yahoo.com [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States) [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States); Philadelphia Cyberknife, Havertown, Pennsylvania (United States); Lamond, John [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States) [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States); Philadelphia Cyberknife, Havertown, Pennsylvania (United States); Fowler, Jack [Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin (United States)] [Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin (United States); Lanciano, Rachelle [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States) [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States); Philadelphia Cyberknife, Havertown, Pennsylvania (United States); Feng, Jing [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States)] [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States); Brady, Luther [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States) [Department of Radiation Oncology, Drexel University, Philadelphia, Pennsylvania (United States); Philadelphia Cyberknife, Havertown, Pennsylvania (United States)

2013-05-01

189

Body Mass Index as a Predictive Factor of Periodontal Therapy Outcomes  

PubMed Central

Body mass index (BMI) and obesity are associated with the prevalence, extent, and severity of periodontitis. This study investigated the predictive role of overweight/obesity on clinical response following non-surgical periodontal therapy in patients with severe periodontitis. Two hundred sixty adults received an intensive course of non-surgical periodontal therapy. Periodontal status at baseline and 2 months was based upon probing pocket depths (PPD), clinical attachment levels (CAL), and whole-mouth gingival bleeding (FMBS) as assessed by two calibrated examiners. Generalized estimating equations (GEE) were used to estimate the impact of BMI and overweight/obesity on periodontal treatment response while controlling for baseline status, age, smoking status (smoker or non-smoker), and full-mouth dental plaque score. BMI (continuous variable) and obesity (vs. normal weight) were associated with worse mean PPD (p < .005), percentage of PPD > 4 mm (p = .01), but not with FMBS (p > .05) or CAL (p > .05) at 2 months, independent of age, smoking status, or dental plaque levels. The magnitude of this association was similar to that of smoking, which was also linked to a worse clinical periodontal outcome (p < .01). BMI and obesity appear to be independent predictors of poor response following non-surgical periodontal therapy. PMID:24165943

Suvan, J.; Petrie, A.; Moles, D.R.; Nibali, L.; Patel, K.; Darbar, U.; Donos, N.; Tonetti, M.; D’Aiuto, F.

2014-01-01

190

Vertical and dual-axis vibration of the seated human body: Nonlinearity, cross-axis coupling, and associations between resonances in transmissibility and apparent mass  

NASA Astrophysics Data System (ADS)

The vertical apparent mass of the human body exhibits nonlinearity, with the principal resonance frequency reducing as the vibration magnitude increases. Measures of the transmission of vibration to the spine and the pelvis have suggested complex modes are responsible for the dominant resonance during vertical excitation, but the modes present with dual-axis excitation have not been investigated. This study was designed to examine how the apparent mass and transmissibility of the human body depend on the magnitude of vertical excitation and the addition of fore-and-aft excitation, and the relation between the apparent mass and the transmissibility of the body. The movement of the body (over the first, fifth and twelfth thoracic vertebrae, the third lumbar vertebra, and the pelvis) in the fore-and-aft and vertical directions (and in pitch at the pelvis) was measured in 12 male subjects sitting with their hands on their laps during random vertical vibration excitation (over the range 0.25-20 Hz) at three vibration magnitudes (0.25, 0.5 and 1.0 m s-2 rms). At the highest magnitude of vertical excitation (1.0 m s-2 rms) the effect of adding fore-aft vibration (at 0.25, 0.5, and 1.0 m s-2 rms) was investigated. The forces in the vertical and fore-and-aft directions on the seat surface were also measured so as to calculate apparent masses. Resonances in the apparent mass and transmissibility to the spine and pelvis in the fore-and-aft and vertical directions, and pitch transmissibility to the pelvis, shifted to lower frequencies as the magnitude of vertical excitation increased and as the magnitude of the additional fore-and-aft excitation increased. The nonlinear resonant behaviour of the apparent mass and transmissibility during dual-axis vibration excitation suggests coupling between the principal mode associated with vertical excitation and the cross-axis influence of fore-and-aft excitation. The transmissibility measures are consistent with complex modes contributing to motion of the body at the principal resonance: pitch motions of the upper thoracic and lumbar spine, and vertical and fore-aft motion of the pelvis and spine. The mode varies with the magnitude of vertical and fore-and-aft excitation.

Zheng, Guangtai; Qiu, Yi; Griffin, Michael J.

2012-12-01

191

Whole-body vibration decreases the proliferative response of TCD4+ cells in elderly individuals with knee osteoarthritis  

PubMed Central

The aim of this study was to investigate the effect of adding whole-body vibration (WBV; frequency = 35 to 40?Hz; amplitude = 4?mm) to squat training on the T-cell proliferative response of elderly patients with osteoarthritis (OA) of the knee. This study was a randomized controlled trial in which the selected variables were assessed before and after 12 weeks of training. Twenty-six subjects (72 ± 5 years of age) were divided into three groups: 1) squat training with WBV (WBV, N = 8); 2) squat training without WBV (N = 10), and 3) a control group (N = 8). Women who were ?60 years of age and had been diagnosed with OA in at least one knee were eligible. The intervention consisted of 12 uninterrupted weeks of squatting exercise training performed 3 times/week. Peripheral blood mononuclear cells were obtained from peripheral blood collected before and after training. The proliferation of TCD4+ and TCD8+ cells was evaluated by flow cytometry measuring the carboxyfluorescein succinimidyl ester fluorescence decay before and after the intervention (?). The proliferative response of TCD4+ cells (P = 0.02, effect size = 1.0) showed a significant decrease (23%) in the WBV group compared to the control group, while there was no difference between groups regarding the proliferative response of TCD8+ cells (P = 0.12, effect size = 2.23). The data suggest that the addition of WBV to squat exercise training might modulate T-cell-mediated immunity, minimizing or slowing disease progression in elderly patients with OA of the knee. PMID:22948377

Tossige-Gomes, R.; Avelar, N.C.P.; Simão, A.P.; Neves, C.D.C.; Brito-Melo, G.E.A.; Coimbra, C.C.; Rocha-Vieira, E.; Lacerda, A.C.R.

2012-01-01

192

Predicting the health risks related to whole-body vibration and shock: a comparison of alternative assessment methods for high-acceleration events in vehicles.  

PubMed

In this paper, alternative assessment methods for whole-body vibration and shocks are compared by means of 70 vibration samples measured from 13 work vehicles, deliberately selected to represent periods containing shocks. Five methodologies (ISO 2631-1:1997, BS 6841:1987, ISO 2631-5:2004, DIN SPEC 45697:2012 and one specified by Gunston [2011], 'G-method') were applied to the vibration samples. In order to compare different evaluation metrics, limiting exposures were determined by calculating times to reach the upper limit thresholds given in the methods. Over 10-fold shorter times to exposure thresholds were obtained for the tri-axial VDV (BS 6841) than for the dominant r.m.s. (ISO 2631-1) when exposures were of high magnitude or contained substantial shocks. Under these exposure conditions, the sixth power approaches (ISO 2631-5, DIN SPEC, G-method) are more stringent than a fourth power VDV method. The r.m.s. method may lead to misleading outcomes especially if a lengthy measurement includes a small number of severe impacts. In conclusion, methodologies produce different evaluations of the vibration severity depending on the exposure characteristics, and the correct method must be selected. Practitioner Summary: Health risks related to whole-body vibration and high acceleration events may be predicted by means of several different methods. This study compares five such methods giving emphasis on their applicability in the presence of shocks. The results showed significant discrepancies between the risk assessments, especially for the most extreme exposures. PMID:25312024

Rantaharju, Taneli; Mansfield, Neil J; Ala-Hiiro, Jussi M; Gunston, Thomas P

2014-10-14

193

AUTHOR:SAILA TORVINEN, PEKKA KANNUS, HARRI SIEV NEN, TERO A. H. J RVINEN, MATTI PASANEN, SAIJA KONTULAINEN, TEPPO L. N. J RVINEN, MARKKU J RVINEN, PEKKA OJA, and ILKKA VUORI TITLE:Effect of four-month vertical whole body vibration on performance and balance  

Microsoft Academic Search

Purpose: This randomized controlled study was designed to investigate the effects of a 4-month whole body vibration-intervention on muscle performance and body balance in young, healthy, nonathletic adults. Methods: Fifty-six volunteers (21 men and 35 women, aged 19-38 yr) were randomized to either the vibration group or control group. The vibration-intervention consisted of a 4-month whole body vibration training (4

VIBRATION LOADING

194

[A case of liver metastasis from esophageal cancer treated with stereotactic body radiation therapy].  

PubMed

A 70-year-old woman was diagnosed as having advanced lower thoracic esophageal cancer with abdominal lymph node metastases(T3N1M0, Stage III). After administering 2 courses of neoadjuvant chemotherapy with 5-fluorouracil(5- FU)( 800 mg/m2)and cisplatin(80 mg/m2), we performed curative surgery with D2 lymph node dissection. The patient could not receive adjuvant chemotherapy because of her poor performance status. After curative surgery, liver metastasis appeared in segment 8. The liver metastasis(S8)was treated with stereotactic body radiation therapy(SBRT)( 60 Gy/3 Fr). After SBRT, we administered systemic chemotherapy with docetaxel and nedaplatin as second-line chemotherapy. The patient had no recurrence for 12 months after SBRT. SBRT exhibited an excellent local therapeutic effect without any serious complications, suggesting that it is an effective treatment for liver metastasis from esophageal cancer. PMID:24393943

Egawa, Tomohisa; Okubo, Yusuke; Kemmochi, Takeshi; Mori, Takayuki; Sato, Shinji; Nishiya, Shin; Mihara, Koki; Ito, Yasuhiro; Makino, Hiroyuki; Nagashima, Atsushi

2013-11-01

195

[Comments on influence of different functional status of the body on clinical effects of acupuncture therapy].  

PubMed

Functional status is an important factor affecting clinical therapeutic effect of acupuncture therapy. Authors of the present article make an analysis on the related descriptions of ancient classical books about the patient's body constitution, age, duration of disease, type of disease or clinical conditions, psychological state, etc. which determine the functional state of patients. Moreover, the authors also make some comments on the results of modern clinical trials and experimental studies. However, till now, the results of many related modern studies were lower in reliability due to unreliable methodology. Fewer clinical trials involve the patient's psychological state, and constitution from the viewpoint of Chinese medicine. Correspondingly, the related experimental studies are fewer. The authors suggest that in the coming days clinical trials should be greatly improved in quality and the mutual interference among the influential factors should be excluded. At the same time, experimental studies on the related biochemical mechanisms should be strengthened. PMID:24308194

Li, Zheng-Jie; Zeng, Fang; Yang, Jie; Ren, Yu-Lan; Liang, Fan-Rang

2013-10-01

196

General strategy for the protection of organs at risk in IMRT therapy of a moving body  

SciTech Connect

We investigated protection strategies of organs at risk (OARs) in intensity modulated radiation therapy (IMRT). These strategies apply to delivery of IMRT to moving body anatomies that show relative displacement of OAR in close proximity to a tumor target. We formulated an efficient genetic algorithm which makes it possible to search for global minima in a complex landscape of multiple irradiation strategies delivering a given, predetermined intensity map to a target. The optimal strategy was investigated with respect to minimizing the dose delivered to the OAR. The optimization procedure developed relies on variability of all parameters available for control of radiation delivery in modern linear accelerators, including adaptation of leaf trajectories and simultaneous modification of beam dose rate during irradiation. We showed that the optimization algorithms lead to a significant reduction in the dose delivered to OAR in cases where organs at risk move relative to a treatment target.

Abolfath, Ramin M.; Papiez, Lech [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas 75390 (United States)

2009-07-15

197

Best of International Stereotactic Radiosurgery Society Congress 2013: stereotactic body radiation therapy. Part II: nonspinal tumors.  

PubMed

The 11th biennial International Stereotactic Radiosurgery Society Congress represented another historical gathering of professionals in the field of stereotactic radiosurgery. This congress was held on 16-20 June 2013 in Toronto (ON, Canada), and the chairman was Arjun Sahgal, co-chair was Michael Schwartz and president of the society was Jean Regis. The congress attracted 550 attendants from all over the world and over 300 abstracts were presented. Among the abstracts presented, 62 (36 oral) were pertaining to stereotactic body radiation therapy (SBRT). Exciting new findings were presented by colleagues from North America, Europe and Asia. This short conference scene (part II) provides a summary of the best abstracts on SBRT for nonspinal tumors presented in the congress. A separate conference scene on SBRT for spinal tumors (part I) also appears in this issue of Future Oncology. PMID:23980677

Lo, Simon S; Chang, Eric L; Ryu, Samuel; Chung, Hans; Slotman, Ben J; Teh, Bin S; Sahgal, Arjun

2013-09-01

198

Best of International Stereotactic Radiosurgery Society Congress 2013: stereotactic body radiation therapy. Part I: spinal tumors.  

PubMed

The 11th biennial International Stereotactic Radiosurgery Society Congress represented another historical gathering of professionals in the field of stereotactic radiosurgery. This congress was held on 16-20 June 2013 in Toronto (ON, Canada), and the chairman was Arjun Sahgal, the co-chair was Michael Schwartz and president of the society was Jean Regis. The congress attracted 550 attendants from all over the world and over 300 abstracts were presented. Among the abstracts presented, 62 (36 oral) were pertaining to stereotactic body radiation therapy (SBRT). Exciting new findings were presented by colleagues from North America, Europe and Asia. This short conference scene (part I) provides a summary of the best abstracts on SBRT for spinal tumors presented in the congress. A separate conference scene on SBRT for nonspinal tumors (part II) also appears in this issue of Future Oncology. PMID:23980676

Lo, Simon S; Chang, Eric L; Ryu, Samuel; Chung, Hans; Slotman, Ben J; Teh, Bin S; Sahgal, Arjun

2013-09-01

199

Quality of Life After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) provides a high local control rate for primary and metastatic liver tumors. The aim of this study is to assess the impact of this treatment on the patient's quality of life. This is the first report of quality of life associated with liver SBRT. Methods and Materials: From October 2002 to March 2007, a total of 28 patients not suitable for other local treatments and with Karnofsky performance status of at least 80% were entered in a Phase I-II study of SBRT for liver tumors. Quality of life was a secondary end point. Two generic quality of life instruments were investigated, EuroQol-5D (EQ-5D) and EuroQoL-Visual Analogue Scale (EQ-5D VAS), in addition to a disease-specific questionnaire, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30). Points of measurement were directly before and 1, 3, and 6 months after treatment. Mean scores and SDs were calculated. Statistical analysis was performed using paired-samples t-test and Student t-test. Results: The calculated EQ-5D index, EQ-5D VAS and QLQ C-30 global health status showed that mean quality of life of the patient group was not significantly influenced by treatment with SBRT; if anything, a tendency toward improvement was found. Conclusions: Stereotactic body radiation therapy combines a high local control rate, by delivering a high dose per fraction, with no significant change in quality of life. Multicenter studies including larger numbers of patients are recommended and under development.

Mendez Romero, Alejandra [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)], E-mail: a.mendezromero@erasmusmc.nl; Wunderink, Wouter [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Os, Rob M. van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Nowak, Peter J.C.M.; Heijmen, Ben J.M.; Nuyttens, Joost J.; Brandwijk, Rene P. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Verhoef, Cornelis; IJzermans, Jan N.M. [Department of Surgery, Erasmus MC, Rotterdam (Netherlands); Levendag, Peter C. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

2008-04-01

200

Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases  

PubMed Central

Purpose Stereotactic body radiation therapy (SBRT) is being applied more widely for oligometastatic disease. This technique is now being used for non-spine bony metastases in addition to liver, spine, and lung. However, there are few studies examining the toxicity and outcomes of SBRT for non-spine bone metastases. Methods and Materials Between 2008 and 2012, 74 subjects with oligometastatic non-spine bony metastases of varying histologies were treated at the Mayo Clinic with SBRT. A total of 85 non-spine bony sites were treated. Median local control, overall survival, and progression-free survival were described. Acute toxicity (defined as toxicity <90 days) and late toxicity (defined as toxicity ?90 days) were reported and graded as per standardized Common Toxicity Criteria for Adverse Events 4.0 criteria. Results The median age of patients treated was 60 years. The most common histology was prostate cancer (31%) and most patients had fewer than 3 sites of disease at the time of simulation (64%). Most of the non-spine bony sites lay within the pelvis (65%). Dose and fractionation varied but the most common prescription was 24 Gy/1 fraction. Local recurrence occurred in 7 patients with a median time to failure of 2.8 months. Local control was 91.8% at 1 year. With a median follow-up of 7.6 months, median SBRT specific overall survival and progression-free survival were 9.3 months and 9.7 months, respectively. Eighteen patients developed acute toxicity (mostly grade 1 and 2 fatigue and acute pain flare); 9 patients developed grade 1–2 late toxicities. Two patients developed pathologic fractures but both were asymptomatic. There were no late grade 3 or 4 toxicities. Conclusions Stereotactic body radiation therapy is a feasible and tolerable treatment for non-spine bony metastases. Longer follow-up will be needed to accurately determine late effects. PMID:24890360

Owen, Dawn; Laack, Nadia N.; Mayo, Charles S.; Garces, Yolanda I.; Park, Sean S.; Bauer, Heather J.; Nelson, Kathryn; Miller, Robert W.; Brown, Paul D.; Olivier, Kenneth R.

2015-01-01

201

Changes in circulating angiogenic factors after an acute training bout before and after resistance training with or without whole-body-vibration training  

NASA Astrophysics Data System (ADS)

Both Resistance Exercise and Whole-Body-Vibration training are currently considered as countermeasures against microgravity-induced physiological deconditioning. Here we investigated the effects of whole-body vibration superimposed upon resistance exercise. Within this context, the present study focuses on changes in circulating angiogenic factors as indicators of skeletal muscle adaption. Methods: Twenty-six healthy male subjects (25.2 ± 4.2 yr) were included in this two-group parallel-designed study and randomly assigned to one of the training interventions: either resistance exercise (RE) or resistance vibration exercise (RVE). Participants trained 2-3 times per week for 6 weeks (completing 16 training sessions), where one session took 9 ± 1 min. Participants trained with weights on a guided barbell. The individual training load was set at 80% of their 1-Repetition-Maximum. Each training session consisted of three sets with 8 squats and 12 heel raises, following an incremental training design with regards to weight (RE and RVE) and vibration frequency (RVE only). The vibration frequency was increased from 20 Hz in the first week till 40 Hz during the last two weeks with 5-Hz weekly increments. At the first and 16 ^{th} training session, six blood samples (pre training and 2 min, 5 min, 15 min, 35 min and 75 min post training) were taken. Circulating levels of vascular endothelial growth factor (VEGF), Endostatin and Matrix Metalloproteinases -2 and -9 (MMPs) were determined in serum using Enzyme-linked Immunosorbent Assays. Results: MMP-2 levels increased by 7.0% (SE = 2.7%, P < 0.001) within two minutes after the exercise bout and then decreased to 5.7% below baseline (SE = 2.4%, P < 0.001) between 15 and 75 minutes post exercise. This response was comparable before and after the training programs (P = 0.70) and also between the two intervention groups (P = 0.42). Preliminary analyses indicate that a similar pattern applies to circulating MMP-9, VEGF and Endostatin levels. Conclusion: The present findings suggest 1) that resistance exercise, both with and without superimposed vibration, leads to a transient rise in circulating angiogenic factors, 2) which is not altered after a period of resistance exercise with or without vibration.

Beijer, Åsa; Degens, Hans; May, Francisca; Bloch, Wilhelm; Rittweger, Joern; Rosenberger, Andre

2012-07-01

202

4D VMAT, gated VMAT, and 3D VMAT for stereotactic body radiation therapy in lung  

NASA Astrophysics Data System (ADS)

Four-dimensional volumetric modulated arc therapy (4D VMAT) is a treatment strategy for lung cancers that aims to exploit relative target and tissue motion to improve organ at risk (OAR) sparing. The algorithm incorporates the entire patient respiratory cycle using 4D CT data into the optimization process. Resulting treatment plans synchronize the delivery of each beam aperture to a specific phase of target motion. Stereotactic body radiation therapy treatment plans for 4D VMAT, gated VMAT, and 3D VMAT were generated on three patients with non-small cell lung cancer. Tumour motion ranged from 1.4-3.4 cm. The dose and fractionation scheme was 48 Gy in four fractions. A B-spline transformation model registered the 4D CT images. 4D dose volume histograms (4D DVH) were calculated from total dose accumulated at the maximum exhalation. For the majority of OARs, gated VMAT achieved the most radiation sparing but treatment times were 77-148% longer than 3D VMAT. 4D VMAT plan qualities were comparable to gated VMAT, but treatment times were only 11-25% longer than 3D VMAT. 4D VMAT's improvement of healthy tissue sparing can allow for further dose escalation. Future study could potentially adapt 4D VMAT to irregular patient breathing patterns.

Chin, E.; Loewen, S. K.; Nichol, A.; Otto, K.

2013-02-01

203

Toxicity and outcomes of thoracic re-irradiation using stereotactic body radiation therapy (SBRT)  

PubMed Central

Background Patients treated for a thoracic malignancy carry a significant risk of developing other lung lesions. Locoregional control of intrathoracic recurrences is challenging due to the impact of prior therapies on normal tissues. We examined the safety and efficacy of thoracic re-irradiation using high-precision image-guided stereotactic body radiation therapy (SBRT). Methods Records of 39 patients with prior intra-thoracic conventionally fractionated radiation therapy (RT) who underwent SBRT for a subsequent primary, recurrent or metastatic lung tumor from 11/2004 to 7/2011 were retrospectively reviewed. Results Median dose of prior RT was 61 Gy (range 30–80 Gy). Median biologically effective prescription dose (?/??=?10) (BED10) of SBRT was 70.4 Gy (range 42.6-180 Gy). With a median followup of 12.6 months among survivors, 1- and 2-year actuarial local progression-free survival (LPFS) were 77% and 64%, respectively. Median recurrence-free (RFS) and overall survival (OS) were 13.8 and 22.0 months, respectively. Patients without overlap of high-dose regions of the primary and re-irradiation plans were more likely to receive a BED10 ?100 Gy, which was associated with higher LPFS (hazard ratio, [HR]?=?0.18, p?=?0.04), RFS ([HR]?=?0.31, p?=?0.038) and OS ([HR]?=?0.25, p?=?0.014). Grade 2 and 3 pulmonary toxicity was observed in 18% and 5% of patients, respectively. Other grade 2–4 toxicities included chest wall pain in 18%, fatigue in 15% and skin toxicity in 5%. No grade 5 events occurred. Conclusions SBRT can be safely and successfully administered to patients with prior thoracic RT. Dose reduction for cases with direct overlap of successive radiation fields results in acceptable re-treatment toxicity profile. PMID:23617949

2013-01-01

204

Differential Effects of Oral Estrogen versus Oral Estrogen-Androgen Replacement Therapy on Body Composition in Postmenopausal Women  

Microsoft Academic Search

Menopause is associated with decreased lean body mass and increased fat due to aging and declining hormone secretion. Estrogens or estrogen-progestins have been used to alleviate vasomotor symptoms. However, estrogen-androgen (E\\/A) therapy is also used for vasomotor symptom relief and has been shown to increase lean body mass while decreasing fat mass. The objective of this 16-wk, double-blind, randomized, par-

ADRIAN S. DOBS; TAM NGUYEN; CINDY PACE; CARLA P. ROBERTS

205

Massage therapy for cancer patients: a reciprocal relationship between body and mind  

PubMed Central

Some cancer patients use therapeutic massage to reduce symptoms, improve coping, and enhance quality of life. Although a meta-analysis concludes that massage can confer short-term benefits in terms of psychological wellbeing and reduction of some symptoms, additional validated randomized controlled studies are necessary to determine specific indications for various types of therapeutic massage. In addition, mechanistic studies need to be conducted to discriminate the relative contributions of the therapist and of the reciprocal relationship between body and mind in the subject. Nuclear magnetic resonance techniques can be used to capture dynamic in vivo responses to biomechanical signals induced by massage of myofascial tissue. The relationship of myofascial communication systems (called “meridians”) to activity in the subcortical central nervous system can be evaluated. Understanding this relationship has important implications for symptom control in cancer patients, because it opens up new research avenues that link self-reported pain with the subjective quality of suffering. The reciprocal body–mind relationship is an important target for manipulation therapies that can reduce suffering. PMID:17576465

Sagar, S.M.; Dryden, T.; Wong, R.K.

2007-01-01

206

Stereotactic body radiation therapy planning with duodenal sparing using volumetric-modulated arc therapy vs intensity-modulated radiation therapy in locally advanced pancreatic cancer: A dosimetric analysis  

SciTech Connect

Stereotactic body radiation therapy (SBRT) achieves excellent local control for locally advanced pancreatic cancer (LAPC), but may increase late duodenal toxicity. Volumetric-modulated arc therapy (VMAT) delivers intensity-modulated radiation therapy (IMRT) with a rotating gantry rather than multiple fixed beams. This study dosimetrically evaluates the feasibility of implementing duodenal constraints for SBRT using VMAT vs IMRT. Non–duodenal sparing (NS) and duodenal-sparing (DS) VMAT and IMRT plans delivering 25 Gy in 1 fraction were generated for 15 patients with LAPC. DS plans were constrained to duodenal D{sub max} of<30 Gy at any point. VMAT used 1 360° coplanar arc with 4° spacing between control points, whereas IMRT used 9 coplanar beams with fixed gantry positions at 40° angles. Dosimetric parameters for target volumes and organs at risk were compared for DS planning vs NS planning and VMAT vs IMRT using paired-sample Wilcoxon signed rank tests. Both DS VMAT and DS IMRT achieved significantly reduced duodenal D{sub mean}, D{sub max}, D{sub 1cc}, D{sub 4%}, and V{sub 20} {sub Gy} compared with NS plans (all p?0.002). DS constraints compromised target coverage for IMRT as demonstrated by reduced V{sub 95%} (p = 0.01) and D{sub mean} (p = 0.02), but not for VMAT. DS constraints resulted in increased dose to right kidney, spinal cord, stomach, and liver for VMAT. Direct comparison of DS VMAT and DS IMRT revealed that VMAT was superior in sparing the left kidney (p<0.001) and the spinal cord (p<0.001), whereas IMRT was superior in sparing the stomach (p = 0.05) and the liver (p = 0.003). DS VMAT required 21% fewer monitor units (p<0.001) and delivered treatment 2.4 minutes faster (p<0.001) than DS IMRT. Implementing DS constraints during SBRT planning for LAPC can significantly reduce duodenal point or volumetric dose parameters for both VMAT and IMRT. The primary consequence of implementing DS constraints for VMAT is increased dose to other organs at risk, whereas for IMRT it is compromised target coverage. These findings suggest clinical situations where each technique may be most useful if DS constraints are to be employed.

Kumar, Rachit; Wild, Aaron T.; Ziegler, Mark A.; Hooker, Ted K.; Dah, Samson D.; Tran, Phuoc T.; Kang, Jun; Smith, Koren; Zeng, Jing [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, 401N. Broadway, Weinberg Suite 1440, Baltimore, MD 21231 (United States); Pawlik, Timothy M. [Department of Surgery, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Tryggestad, Erik [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, 401N. Broadway, Weinberg Suite 1440, Baltimore, MD 21231 (United States); Ford, Eric [Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA (United States); Herman, Joseph M., E-mail: jherma15@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, 401N. Broadway, Weinberg Suite 1440, Baltimore, MD 21231 (United States)

2013-10-01

207

Critical Appraisal of Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Metastases to Abdominal Lymph Nodes  

SciTech Connect

Purpose: A planning study was performed comparing volumetric modulated arcs, RapidArc (RA), fixed beam IMRT (IM), and conformal radiotherapy (CRT) with multiple static fields or short conformal arcs in a series of patients treated with hypofractionated stereotactic body radiation therapy (SBRT) for solitary or oligo-metastases from different tumors to abdominal lymph nodes. Methods and Materials: Fourteen patients were included in the study. Dose prescription was set to 45 Gy (mean dose to clinical target volume [CTV]) in six fractions of 7.5 Gy. Objectives for CTV and planning target volume (PTV) were as follows: Dose{sub min} >95%, Dose{sub max} <107%. For organs at risk the following objectives were used: Maximum dose to spine <18 Gy; V{sub 15Gy} <35% for both kidneys, V{sub 36Gy} <1% for duodenum, V{sub 36Gy} <3% for stomach and small bowel, V{sub 15Gy} <(total liver volume - 700 cm{sup 3}) for liver. Dose-volume histograms were evaluated to assess plan quality. Results: Planning objectives on CTV and PTV were achieved by all techniques. Use of RA improved PTV coverage (V{sub 95%} = 90.2% +- 5.2% for RA compared with 82.5% +- 9.6% and 84.5% +- 8.2% for CRT and IM, respectively). Most planning objectives for organs at risk were met by all techniques except for the duodenum, small bowel, and stomach, in which the CRT plans exceeded the dose/volume constraints in some patients. The MU/fraction values were as follows: 2186 +- 211 for RA, 2583 +- 699 for IM, and 1554 +- 153 for CRT. Effective treatment time resulted as follows: 3.7 +- 0.4 min for RA, 10.6 +- 1.2 min for IM, and 6.3 +- 0.5 min for CRT. Conclusions: Delivery of SBRT by RA showed improvements in conformal avoidance with respect to standard conformal irradiation. Delivery parameters confirmed logistical advantages of RA, particularly compared with IM.

Bignardi, Mario [Istituto Clinico Humanitas, Radiation Oncology, Rozzano (Italy); Cozzi, Luca, E-mail: lucozzi@iosi.c [Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona (Switzerland); Fogliata, Antonella [Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona (Switzerland); Lattuada, Paola; Mancosu, Pietro; Navarria, Piera; Urso, Gaetano; Vigorito, Sabrina; Scorsetti, Marta [Istituto Clinico Humanitas, Radiation Oncology, Rozzano (Italy)

2009-12-01

208

A whole-body pharmacokinetic model for the early assessment of targeted radionuclide therapy agents  

NASA Astrophysics Data System (ADS)

Early assessment of targeted radionuclide therapy (TRT) agent effectiveness based on its pharmacokinetic (PK) properties could provide a means to expedite agent development or rejection. A whole-body PK model was developed that not only simplifies the complex radiation dosimetry and physiology of TRT but also provides criteria for normal tissue and tumor PK parameters that achieve effective TRT while limiting toxicity. Because biologically effective dose (BED) may be more of a relevant quantity than absorbed dose for establishing tumor response relationships, the model was expanded to include BED. The model consisted of two coupled normal body compartments and one decoupled tumor compartment. Differential equations were used to develop an equation that predicted TRT efficacy. PK scenarios were created by pairing normal body influx and efflux parameters with a range of tumor influx and efflux parameters. Each PK scenario yielded a maximum delivered tumor absorbed dose that limited the whole body dose to 2 Gy. The dose rate and repair rate were used for BED. The relationships between the tumor influx-to-efflux ratio (k34:k 43), central compartment efflux-to-influx ratio (k12:k 21), central elimination (ke1), and tumor repair rate (mu), and tumor BED were investigated. The model was used to find the PK parameters for NM404 and FLT within a xenograft model. The TCC of both Compartment 1 and tumor were fit to the equations of the model using Levenberg-Marquardt. The parameter errors were propagated into dosimetry uncertainties. Sensitivity functions were derived for each PK parameter that described the change in TCC as a result of a change in the PK parameter value at each time. Cramer-Rao Lower Bounds (CRLB) theory was used to derive optimal sampling schedules based on the sensitivity of the derived PK parameters. The experimental and optimal sampling schedules were compared by running simulations that measured the precision and accuracy of the measured PK parameters. The TRT PK model that was developed has the capability of predicting effectiveness when PK parameters are known. This work also represents a step in the direction of establishing relative PK criteria of when the BED formalism is more applicable than absorbed dose for TRT.

Grudzinski, Joseph J.

209

Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors1  

PubMed Central

OBJECTIVES: The full potential of stereotactic body radiation therapy (SBRT), in the treatment of unresectable intrahepatic malignancies, has yet to be realized as our experience is still limited. Thus, we evaluated SBRT outcomes for primary and metastatic liver tumors, with the goal of identifying factors that may aid in optimization of therapy. METHODS: From 2005 to 2010, 62 patients with 106 primary and metastatic liver tumors were treated with SBRT to a median biologic effective dose (BED) of 100 Gy (42.6–180). The majority of patients received either three (47%) or five fractions (48%). Median gross tumor volume (GTV) was 8.8 cm3 (0.2–222.4). RESULTS: With a median follow-up of 18 months (0.46–46.8), freedom from local progression (FFLP) was observed in 97 of 106 treated tumors, with 1- and 2-year FFLP rates of 93% and 82%. Median overall survival (OS) for all patients was 25.2 months, with 1- and 2-year OS of 81% and 52%. Neither BED nor GTV significantly predicted for FFLP. Local failure was associated with a higher risk of death [hazard ratio (HR) = 5.1, P = .0007]. One Child-Pugh Class B patient developed radiation-induced liver disease. There were no other significant toxicities. CONCLUSIONS: SBRT provides excellent local control for both primary and metastatic liver lesions with minimal toxicity. Future studies should focus on appropriate selection of patients and on careful assessment of liver function to maximize both the safety and efficacy of treatment. PMID:23908687

Liu, Erqi; Stenmark, Matthew H; Schipper, Matthew J; Balter, James M; Kessler, Marc L; Caoili, Elaine M; Lee, Oliver E; Ben-Josef, Edgar; Lawrence, Theodore S; Feng, Mary

2013-01-01

210

Stereotactic body radiation therapy in the treatment of oligometastatic prostate cancer  

PubMed Central

Purpose/objective(s): To report outcomes and toxicity for patients with oligometastatic (?5 lesions) prostate cancer (PCa) treated with stereotactic body radiation therapy (SBRT). Materials/methods: Seventeen men with 21 PCa lesions were treated with SBRT between February 2009 and November 2011. All patients had a detectable prostate-specific antigen (PSA) at the time of SBRT, and 11 patients (65%) had hormone-refractory (HR) disease. Treatment sites included bone (n = 19), lymph nodes (n = 1), and liver (n = 1). For patients with bone lesions, the median dose was 20 Gy (range, 8–24 Gy) in a single fraction (range, 1–3). All but two patients received some form of anti-androgen therapy after completing SBRT. Results: Local control (LC) was 100%, and the PSA nadir was undetectable in nine patients (53%). The first post-SBRT PSA was lower than pre-treatment levels in 15 patients (88%), and continued to decline or remain undetectable in 12 patients (71%) at a median follow-up of 6 months (range, 2–24 months). Median PSA measurements before SBRT and at last follow-up were 2.1 ng/dl (range, 0.13–36.4) and 0.17 ng/dl (range, <0.1–140), respectively. Six (55%) of the 11 patients with HR PCa achieved either undetectable or declining PSA at a median follow-up of 4.8 months (range, 2.2–6.0 months). Reported toxicities included one case each of grade 2 dyspnea and back pain, there were no cases of grade ?3 toxicity following treatment. Conclusion: We report excellent LC with SBRT in oligometastatic PCa. More importantly, over half the patients achieved an undetectable PSA after SBRT. Further follow-up is necessary to assess the long-term impact of SBRT on LC, toxicity, PSA response, and clinical outcomes. PMID:23346551

Ahmed, Kamran A.; Barney, Brandon M.; Davis, Brian J.; Park, Sean S.; Kwon, Eugene D.; Olivier, Kenneth R.

2013-01-01

211

Stereotactic body radiation therapy for non-resectable tumors of the pancreas  

PubMed Central

Purpose Stereotactic body radiation therapy (SBRT) has emerged as a potential treatment option for local tumor control of primary malignancies of the pancreas. We report on our experience with SBRT in patients with pancreatic adenocarcinoma whom were found not to be candidates for surgical resection. Methods The prospective database of the first 20 consecutive patients receiving SBRT for unresectable pancreatic adenocarcinomas and a neuroendocrine tumor under an IRB approved protocol was reviewed. Prior to SBRT, cylindrical solid gold fiducial markers were placed within or around the tumor endoscopically (n=13), surgically (n=4), or percutaneously under CT-guidance (n=3) to allow for tracking of tumor during therapy. Mean radiation dose was 25 Gray (range 22–30Gy) delivered over 1–3 fractions. Chemotherapy was given to 68% of patients in various schedules/timing. Results Patients had a mean gross tumor volume of 57.2 cm3 (range 10.1–118 cm3) before SBRT. The mean total gross tumor volume reduction at 3 and 6 months after SBRT were 21 and 38%, respectively (P<0.05). Median follow-up was 14.57 months (range 5–23 months). The overall rate of freedom from local progression at 6 and 12 months were 88 and 65%. The probability of overall survival at 6 and 12 months were 89 and 56%. No patient had a complication related to fiducial markers placement regardless of modality. The rate of radiation induced adverse events was: grade 1–2 (11%) and grade 3 (16%). There were no grade 4/5 adverse events seen. Conclusion Our preliminary results showed SBRT as a safe and likely effective local treatment modality for pancreatic primary malignancy with acceptable rate of adverse events. PMID:21937061

Goyal, K; Einstein, D; Ibarra, RA; Yao, M; Kunos, C; Ellis, R; Brindle, J; Singh, D; Hardacre, J; Zhang, Y; Fabien, J; Brindle, J; Funkhouser, G; Machtay, M; Sanabria, JR

2014-01-01

212

Voxel-Based Dose Reconstruction for Total Body Irradiation With Helical TomoTherapy  

SciTech Connect

Purpose: We have developed a megavoltage CT (MVCT)-based dose reconstruction strategy for total body irradiation (TBI) with helical TomoTherapy (HT) using a deformable registration model to account for the patient's interfraction changes. The proposed technique serves as an efficient tool for delivered dose verification and, potentially, plan adaptation. Methods and Materials: Four patients with acute myelogenous leukemia treated with TBI using HT were selected for this study. The prescription was 12 Gy, 2 Gy/fraction, twice per day, given at least 6 h apart. The original plan achieved coverage of 80% of the clinical target volume (CTV) by the 12 Gy isodose surface. MVCTs were acquired prior to each treatment. Regions of interest were contoured on each MVCT. The dose for each fraction was calculated based on the MVCT using the HT planned adaptive station. B-spline deformable registration was conducted to establish voxel-to-voxel correspondence between the MVCT and the planning CT. The resultant deformation vector was employed to map the reconstructed dose from each fraction to the same point as the plan dose, and a voxel-to-voxel summed dose from all six fractions was obtained. The reconstructed dose distribution and its dosimetric parameters were compared with those of the original treatment plan. Results: While changes in CTV contours occurred in all patients, the reconstructed dose distribution showed that the dose-volume histogram for CTV coverage was close (<1.5%) to that of the original plan. For sensitive structures, the differences between the reconstructed and the planned doses were less than 3.0%. Conclusion: Voxel-based dose reconstruction strategy that takes into account interfraction anatomical changes using MVCTs is a powerful tool for treatment verification of the delivered doses. This proposed technique can also be applied to adaptive TBI therapy using HT.

Chao Ming, E-mail: mchao@uams.edu [Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205-7199 (United States); Penagaricano, Jose; Yan Yulong; Moros, Eduardo G.; Corry, Peter; Ratanatharathorn, Vaneerat [Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205-7199 (United States)

2012-04-01

213

Seven Day Insertion Rest in Whole Body Vibration Improves Multi-Level Bone Quality in Tail Suspension Rats  

PubMed Central

Objective This study aimed to investigate the effects of low-magnitude, high-frequency vibration with rest days on bone quality at multiple levels. Methods Forty-nine three-month-old male Wistar rats were randomly divided into seven groups, namely, vibrational loading for X day followed by X day rest (VLXR, X?=?1, 3, 5, 7), vibrational loading every day (VLNR), tail suspension (SPD), and baseline control (BCL). One week after tail suspension, rats were loaded by vibrational loading (35 Hz, 0.25 g, 15 min/day) except SPD and BCL. Fluorescence markers were used in all rats. Eight weeks later, femora were harvested to investigate macromechanical properties, and micro-computed tomography scanning and fluorescence test were used to evaluate microarchitecture and bone growth rate. Atomic force microscopy analyses and nanoindentation test were used to analyze the nanostructure and mechanical properties of bone material, respectively. Inductively coupled plasma optical emission spectroscopy was used for quantitative chemical analyses. Results Microarchitecture, mineral apposition rate and bone formation rate and macromechanical properties were improved in VL7R. Grain size and roughness were significantly different among all groups. No statistical difference was found for the mechanical properties of the bone material, and the chemical composition of all groups was almost similar. Conclusions Low-magnitude, high-frequency vibration with rest days altered bone microarchitecture and macro-biomechanical properties, and VL7R was more efficacious in improving bone loss caused by mechanical disuse, which provided theoretical basis and explored the mechanisms of vibration for improving bone quality in clinics. PMID:24637608

Zhang, Rui; Gong, He; Zhu, Dong; Gao, Jiazi; Fang, Juan; Fan, Yubo

2014-01-01

214

Effects of whole body vibration on bone mineral density and falls: results of the randomized controlled ELVIS study with postmenopausal women  

Microsoft Academic Search

Summary  We determined whether the effect of exercise on bone mineral density (BMD) and falls can be enhanced by whole body vibration\\u000a (WBV). In summary, the multi-purpose exercise training was effective to increase lumbar BMD but added WBV did not enhance\\u000a this effect. However, falls were lowest in the exercise program combined with WBV.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction  WBV is a new approach to reduce

S. von Stengel; W. Kemmler; K. Engelke; W. A. Kalender

2011-01-01

215

Spline-based Rayleigh-Ritz methods for the approximation of the natural modes of vibration for flexible beams with tip bodies  

NASA Technical Reports Server (NTRS)

Rayleigh-Ritz methods for the approximation of the natural modes for a class of vibration problems involving flexible beams with tip bodies using subspaces of piecewise polynomial spline functions are developed. An abstract operator-theoretic formulation of the eigenvalue problem is derived and spectral properties investigated. The existing theory for spline-based Rayleigh-Ritz methods applied to elliptic differential operators and the approximation properties of interpolatory splines are used to argue convergence and establish rates of convergence. An example and numerical results are discussed.

Rosen, I. G.

1986-01-01

216

Spline-based Rayleigh-Ritz methods for the approximation of the natural modes of vibration for flexible beams with tip bodies  

NASA Technical Reports Server (NTRS)

Rayleigh-Ritz methods for the approximation of the natural modes for a class of vibration problems involving flexible beams with tip bodies using subspaces of piecewise polynomial spline functions are developed. An abstract operator theoretic formulation of the eigenvalue problem is derived and spectral properties investigated. The existing theory for spline-based Rayleigh-Ritz methods applied to elliptic differential operators and the approximation properties of interpolatory splines are useed to argue convergence and establish rates of convergence. An example and numerical results are discussed.

Rosen, I. G.

1985-01-01

217

Obesity Increases the Risk of Chest Wall Pain From Thoracic Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumors within <2.5 cm of the chest wall; 104 (39%) developed skin toxicity (any grade); 14 (5%) developed acute pain (any grade), and 45 (17%) developed chronic pain (Grade 1 in 22 cases [49%] and Grade 2 or 3 in 23 cases [51%]). Both skin toxicity and chest wall pain were associated with the V{sub 30}, or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI {>=}29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.

Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Thomas, Jimmy; Shah, Deep; Allen, Pamela K.; Wei, Xiong; Mitchell, Kevin [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gao, Song; Balter, Peter [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko; Chang, Joe Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2011-09-01

218

Whole-body vibration experienced by haulage truck operators in surface mining operations: a comparison of various analysis methods utilized in the prediction of health risks.  

PubMed

Whole body vibration (WBV) was measured on eight surface haulage trucks in three size classes (35, 100, 150ton haul capacities). Vibration was measured at the seat/operator interface in accordance with the ISO 2631-1 standard during 1h of normal operation. Highest acceleration readings were observed in the z-axis (vertical). Estimated equivalent daily exposure values in the range of 0.44-0.82 ms(-2) were observed using the frequency-weighted r.m.s method and 8.7-16.4ms(-1.75) using the vibration dose value method. Assessment was carried out using ISO 2631-1 and 2631-5. Operators of surface haulage trucks are regularly exposed to WBV levels that exceed safety limits as dictated by the ISO 2631-1 standard. However, according to ISO 2631-5 the probability of an adverse health effect remains low. These findings confirm an apparent disagreement between the two analysis methods. PMID:20185120

Smets, Martin P H; Eger, Tammy R; Grenier, Sylvain G

2010-10-01

219

City bus driving and low back pain: a study of the exposures to posture demands, manual materials handling and whole-body vibration.  

PubMed

A cross-sectional study was conducted to investigate worker exposure to posture demands, manual materials handling (MMH) and whole body vibration as risks for low back pain (LBP). Using validated questionnaire, information about driving experience, driving (sitting) posture MMH, and health history was obtained from 80 city bus drivers. Twelve drivers were observed during their service route driving (at least one complete round trip) and vibration measurements were obtained at the seat and according to the recommendations of ISO 2631 (1997), for three models of bus (a mini-bus, a single-decker bus, a double-decker bus). The results showed that city bus drivers spend about 60% of the daily work time actually driving, often with the torso straight or unsupported, perform occasional and light MMH, and experience discomforting shock/jerking vibration events. Transient and mild LBP (not likely to interfere with work or customary levels of activity) was found to be prevalent among the drivers and a need for ergonomic evaluation of the drivers' seat was suggested. PMID:17225292

Okunribido, Olanrewaju O; Shimbles, Steven J; Magnusson, Marianne; Pope, Malcolm

2007-01-01

220

Interactions of hormone replacement therapy, body weight and bilateral oophorectomy in breast cancer risk  

PubMed Central

Purpose To examine potential modifying effects of body weight and bilateral oophorectomy on the association of hormone replacement therapy (HRT) with risk of breast cancer, overall and by subtypes according to status of estrogen receptor (ER), progesterone receptor (PR), and human-epidermal-growth-factor receptor 2 (Her2) among postmenopausal women. Experimental Design This analysis included 2,510 postmenopausal white women recruited in the Nashville Breast Health Study, a population-based case-control study of breast cancer. Multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between HRT use and risk of breast cancer overall and by subtypes, adjusted for age and education. Results Among women with natural menopause and body-mass-index (BMI) <25 kg/m2, ever-use of HRT was associated with increased breast-cancer risk (OR=1.95, 95% CI=1.32-2.88). Risk was elevated with duration of HRT use (p-for-trend=0.002). Similar association patterns were found for ER+, ER+PR+, and luminal-A cancer subtypes but not ER-, ER-PR-, and triple-negative cancer. In contrast, ever-HRT-use in overweight women (BMI?25 kg/m2) showed no association with risk of breast cancer overall or by subtypes; interaction tests for modifying effect of BMI were statistically significant. Ever-HRT-use was associated with decreased breast-cancer risk (OR=0.70, 95% CI=0.38-1.31) among women with prior bilateral oophorectomy but elevated risk (OR=1.45, 95% CI=0.92-2.29) among those with hysterectomy without bilateral oophorectomy (p-for-interaction=0.057). Similar associations were seen for virtually all breast-cancer subtypes, although interaction tests were statistically significant for ER+ and luminal A only. Conclusion Body weight and bilateral oophorectomy modify associations between HRT use and breast-cancer risk, especially the risk of hormone-receptor-positive tumors. PMID:24423614

Cui, Yong; Deming-Halverson, Sandra L.; Beeghly-Fadiel, Alicia; Lipworth, Loren; Shrubsole, Martha J.; Fair, Alecia M.; Shu, Xiao-Ou; Zheng, Wei

2014-01-01

221

Failure Mode and Effect Analysis for Delivery of Lung Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: To improve the quality and safety of our practice of stereotactic body radiation therapy (SBRT), we analyzed the process following the failure mode and effects analysis (FMEA) method. Methods: The FMEA was performed by a multidisciplinary team. For each step in the SBRT delivery process, a potential failure occurrence was derived and three factors were assessed: the probability of each occurrence, the severity if the event occurs, and the probability of detection by the treatment team. A rank of 1 to 10 was assigned to each factor, and then the multiplied ranks yielded the relative risks (risk priority numbers). The failure modes with the highest risk priority numbers were then considered to implement process improvement measures. Results: A total of 28 occurrences were derived, of which nine events scored with significantly high risk priority numbers. The risk priority numbers of the highest ranked events ranged from 20 to 80. These included transcription errors of the stereotactic coordinates and machine failures. Conclusion: Several areas of our SBRT delivery were reconsidered in terms of process improvement, and safety measures, including treatment checklists and a surgical time-out, were added for our practice of gantry-based image-guided SBRT. This study serves as a guide for other users of SBRT to perform FMEA of their own practice.

Perks, Julian R., E-mail: julian.perks@ucdmc.ucdavis.edu [University of California Davis Medical Center, Sacramento, CA (United States); Stanic, Sinisa; Stern, Robin L.; Henk, Barbara; Nelson, Marsha S.; Harse, Rick D.; Mathai, Mathew; Purdy, James A.; Valicenti, Richard K.; Siefkin, Allan D.; Chen, Allen M. [University of California Davis Medical Center, Sacramento, CA (United States)

2012-07-15

222

Cyberknife Stereotactic Body Radiation Therapy for Nonresectable Tumors of the Liver: Preliminary Results  

PubMed Central

Purpose. Stereotactic body radiation therapy (SBRT) has emerged as a treatment option for local tumor control of primary and secondary malignancies of the liver. We report on our updated experience with SBRT in patients with non-resectable tumors of the liver. Methods. Our first 17 consecutive patients (mean age 58.1 years) receiving SBRT for HCC (n = 6), IHC (n = 3), and LM (n = 8) are presented. Mean radiation dose was 34Gy delivered over 1–3 fractions. Results. Treated patients had a mean decrease in maximum pretreatment tumor diameter from 6.9 ± 4.6?cm to 5.0 ± 2.1?cm at three months after treatment (P < .05). The mean total tumor volume reduction was 44% at six months (P < .05). 82% of all patients (14/17) achieved local control with a median follow-up of 8 months. 100% of patients with HCC (n = 6) achieved local control. Patients with surgically placed fiducial markers had no complications related to marker placement. Conclusion. Our preliminary results showed that SBRT is a safe and effective local treatment modality in selected patients with liver malignancies with minimal adverse events. Further studies are needed to define its role in the management of these malignancies. PMID:20689733

Goyal, K.; Einstein, D.; Yao, M.; Kunos, C.; Barton, F.; Singh, D.; Siegel, C.; Stulberg, J.; Sanabria, J.

2010-01-01

223

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions  

PubMed Central

SYNOPSIS Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with nonexistent or slight defect(s) in appearance, usually begins during early adolescence and appears to be common in youth. BDD is characterized by substantial impairment in psychosocial functioning and markedly high rates of suicidality. Cognitive-behavioral therapy (CBT) tailored to BDD’s unique features is the best tested and most promising psychosocial treatment for adults with BDD. CBT has been used for youth with BDD, but it has not been systematically developed for or tested in this age group, and there is a pressing need for this work to be done. This article focuses on CBT for BDD in adults and youth, possible adaptations for youth, and the need for treatment research in youth. We also discuss BDD’s prevalence, clinical features, how to diagnose BDD in youth, recommended pharmacotherapy for BDD (serotonin-reuptake inhibitors), and treatments that are not recommended (surgery and other cosmetic treatments). PMID:21440856

Phillips, Katharine A.; Rogers, Jamison

2011-01-01

224

Interinstitutional Variations in Planning for Stereotactic Body Radiation Therapy for Lung Cancer  

SciTech Connect

Purpose: The aim of this study was to assess interinstitutional variations in planning for stereotactic body radiation therapy (SBRT) for lung cancer before the start of the Japan Clinical Oncology Group (JCOG) 0403 trial. Methods and Materials: Eleven institutions created virtual plans for four cases of solitary lung cancer. The created plans should satisfy the target definitions and the dose constraints for the JCOG 0403 protocol. Results: FOCUS/XiO (CMS) was used in six institutions, Eclipse (Varian) in 3, Cadplan (Varian) in one, and Pinnacle3 (Philips/ADAC) in one. Dose calculation algorithms of Clarkson with effective path length correction and superposition were used in FOCUS/XiO; pencil beam convolution with Batho power law correction was used in Eclipse and Cadplan; and collapsed cone convolution superposition was used in Pinnacle3. For the target volumes, the overall coefficient of variation was 16.6%, and the interinstitutional variations were not significant. For maximal dose, minimal dose, D95, and the homogeneity index of the planning target volume, the interinstitutional variations were significant. The dose calculation algorithm was a significant factor in these variations. No violation of the dose constraints for the protocol was observed. Conclusion: There can be notable interinstitutional variations in planning for SBRT, including both interobserver variations in the estimate of target volumes as well as dose calculation effects related to the use of different dose calculation algorithms.

Matsuo, Yukinori [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Takayama, Kenji [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Nagata, Yasushi [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan)]. E-mail: nag@kuhp.kyoto-u.ac.jp; Kunieda, Etsuo [Department of Radiology, Keio University, Tokyo (Japan); Tateoka, Kunihiko [Radiation Oncology, Imaging and Diagnosis, Molecular and Organ Regulation, Sapporo Medical University, Graduate School of Medicine, Sapporo (Japan); Ishizuka, Naoki [Division of Preventive Medicine, Department of Community Health and Medicine, Research Institute, International Medical Center of Japan, Tokyo (Japan); Mizowaki, Takashi [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Norihisa, Yoshiki [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Sakamoto, Masato [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Narita, Yuichiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Ishikura, Satoshi [Radiation Oncology Division, National Cancer Center Hospital East, Kashiwa (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan)

2007-06-01

225

Whole body correction of mucopolysaccharidosis IIIA by intracerebrospinal fluid gene therapy  

PubMed Central

For most lysosomal storage diseases (LSDs) affecting the CNS, there is currently no cure. The BBB, which limits the bioavailability of drugs administered systemically, and the short half-life of lysosomal enzymes, hamper the development of effective therapies. Mucopolysaccharidosis type IIIA (MPS IIIA) is an autosomic recessive LSD caused by a deficiency in sulfamidase, a sulfatase involved in the stepwise degradation of glycosaminoglycan (GAG) heparan sulfate. Here, we demonstrate that intracerebrospinal fluid (intra-CSF) administration of serotype 9 adenoassociated viral vectors (AAV9s) encoding sulfamidase corrects both CNS and somatic pathology in MPS IIIA mice. Following vector administration, enzymatic activity increased throughout the brain and in serum, leading to whole body correction of GAG accumulation and lysosomal pathology, normalization of behavioral deficits, and prolonged survival. To test this strategy in a larger animal, we treated beagle dogs using intracisternal or intracerebroventricular delivery. Administration of sulfamidase-encoding AAV9 resulted in transgenic expression throughout the CNS and liver and increased sulfamidase activity in CSF. High-titer serum antibodies against AAV9 only partially blocked CSF-mediated gene transfer to the brains of dogs. Consistently, anti-AAV antibody titers were lower in CSF than in serum collected from healthy and MPS IIIA–affected children. These results support the clinical translation of this approach for the treatment of MPS IIIA and other LSDs with CNS involvement. PMID:23863627

Haurigot, Virginia; Marcó, Sara; Ribera, Albert; Garcia, Miguel; Ruzo, Albert; Villacampa, Pilar; Ayuso, Eduard; Añor, Sònia; Andaluz, Anna; Pineda, Mercedes; García-Fructuoso, Gemma; Molas, Maria; Maggioni, Luca; Muñoz, Sergio; Motas, Sandra; Ruberte, Jesús; Mingozzi, Federico; Pumarola, Martí; Bosch, Fatima

2013-01-01

226

Whole-body vibration can reduce calciuria induced by high protein intakes and may counteract bone resorption: A preliminary study  

Microsoft Academic Search

Excess protein intake can adversely affect the bone via an increase in calcium excretion, while suitable mechanical loading promotes osteogenesis. We therefore investigated whether vibration exposure could alleviate the bone mineral losses associated with a metabolic acidosis. Ten healthy individuals aged 22 – 29 years (median = 25) underwent three 5-day study periods while monitoring their dietary intake. The study consisted of recording the

M. Cardinale; J. Leiper; P. Farajian; M. Heer

2007-01-01

227

Stereotactic Body Radiation Therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience  

PubMed Central

Background Stereotactic body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation which may be radiobiologically favorable to conventional low-dose fractions commonly used for prostate cancer radiotherapy. We report our early experience using SBRT for localized prostate cancer. Methods Patients treated with SBRT from June 2008 to May 2010 at Georgetown University Hospital for localized prostate carcinoma, with or without the use of androgen deprivation therapy (ADT), were included in this retrospective review of data that was prospectively collected in an institutional database. Treatment was delivered using the CyberKnife® with doses of 35 Gy or 36.25 Gy in 5 fractions. Biochemical control was assessed using the Phoenix definition. Toxicities were recorded and scored using the CTCAE v.3. Quality of life was assessed before and after treatment using the Short Form-12 Health Survey (SF-12), the American Urological Association Symptom Score (AUA) and Sexual Health Inventory for Men (SHIM) questionnaires. Late urinary symptom flare was defined as an AUA score???15 with an increase of???5 points above baseline six months after the completion of SBRT. Results One hundred patients (37 low-, 55 intermediate- and 8 high-risk according to the D’Amico classification) at a median age of 69 years (range, 48–90 years) received SBRT, with 11 patients receiving ADT. The median pre-treatment prostate-specific antigen (PSA) was 6.2 ng/ml (range, 1.9-31.6 ng/ml) and the median follow-up was 2.3 years (range, 1.4-3.5 years). At 2 years, median PSA decreased to 0.49 ng/ml (range, 0.1-1.9 ng/ml). Benign PSA bounce occurred in 31% of patients. There was one biochemical failure in a high-risk patient, yielding a two-year actuarial biochemical relapse free survival of 99%. The 2-year actuarial incidence rates of GI and GU toxicity???grade 2 were 1% and 31%, respectively. A median baseline AUA symptom score of 8 significantly increased to 11 at 1 month (p?=?0.001), however returned to baseline at 3 months (p?=?0.60). Twenty one percent of patients experienced a late transient urinary symptom flare in the first two years following treatment. Of patients who were sexually potent prior to treatment, 79% maintained potency at 2 years post-treatment. Conclusions SBRT for clinically localized prostate cancer was well tolerated, with an early biochemical response similar to other radiation therapy treatments. Benign PSA bounces were common. Late GI and GU toxicity rates were comparable to conventionally fractionated radiation therapy and brachytherapy. Late urinary symptom flares were observed but the majority resolved with conservative management. A high percentage of men who were potent prior to treatment remained potent two years following treatment. PMID:23497695

2013-01-01

228

An analytic model of the in-line and cross-axis apparent mass of the seated human body exposed to vertical vibration with and without a backrest  

NASA Astrophysics Data System (ADS)

During vertical excitation of the seated human body there are vertical and fore-and-aft forces at the seat that are influenced by contact with a backrest, so it is desirable to take into account the effect of a backrest when developing models of the seated human body. Initially, a seven degree-of-freedom multi-body dynamic model was developed for the human body sitting with an upright posture unsupported by a backrest and exposed to vertical vibration. The model was optimized to fit the vertical apparent mass and the fore-and-aft cross-axis apparent mass measured on a seat. The model was then extended by the addition of vertical and fore-and-aft reaction forces to the upper lumbar spine to model the interaction between the human body and a backrest. By minimizing the least square error between experimental data and the analytical solution of the apparent masses on the seat and at the back, the human body model was able to represent both the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat and at the back. Parameter sensitivity studies showed that the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat and the backrest were all highly sensitive to the axial stiffness of the tissue beneath the pelvis. Pitch motion of the upper-body contributed to the vertical apparent mass and the fore-and-aft cross-axis apparent mass on the seat. The apparent mass at the back was more sensitive to the stiffness and damping of the lower back than the properties of the upper back.

Zheng, Guangtai; Qiu, Yi; Griffin, Michael J.

2011-12-01

229

The Study of External Dose Rate and Retained Body Activity of Patients Receiving 131I Therapy for Differentiated Thyroid Carcinoma  

PubMed Central

Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 ?Sv·h?1 at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. PMID:25337944

Zhang, Haiying; Jiao, Ling; Cui, Songye; Wang, Liang; Tan, Jian; Zhang, Guizhi; He, Yajing; Ruan, Shuzhou; Fan, Saijun; Zhang, Wenyi

2014-01-01

230

The biological effectiveness of targeted radionuclide therapy based on a whole-body pharmacokinetic model  

NASA Astrophysics Data System (ADS)

Biologically effective dose (BED) may be more of a relevant quantity than absorbed dose for establishing tumour response relationships. By taking into account the dose rate and tissue-specific parameters such as repair and radiosensitivity, it is possible to compare the relative biological effects of different targeted radionuclide therapy (TRT) agents. The aim of this work was to develop an analytical tumour BED calculation for TRT that could predict a relative biological effect based on normal body and tumour pharmacokinetics. This work represents a step in the direction of establishing relative pharmacokinetic criteria of when the BED formalism is more applicable than absorbed dose for TRT. A previously established pharmacokinetic (PK) model for TRT was used and adapted into the BED formalism. An analytical equation for the protraction factor, which incorporates dose rate and repair rate, was derived. Dose rates within the normal body and tumour were related to the slopes of their time-activity curves which were determined by the ratios of their respective PK parameters. The relationships between the tumour influx-to-efflux ratio (k34:k43), central compartment efflux-to-influx ratio (k12:k21), central elimination (kel), and tumour repair rate (?), and tumour BED were investigated. As the k34:k43 ratio increases and the k12:k21 ratio decreases, the difference between tumour BED and D increases. In contrast, as the k34:k43 ratios decrease and the k12:k21 ratios increase, the tumour BED approaches D. At large k34:k43 ratios, the difference between tumour BED and D increases to a maximum as kel increases. At small k34:k43 ratios, the tumour BED approaches D at very small kel. At small ? and small k34:k43 ratios, the tumour BED approaches D. For large k34:k43 ratios, large ? values cause tumour BED to approach D. This work represents a step in the direction of establishing relative PK criteria of when the BED formalism is more applicable than absorbed dose for TRT. It also provides a framework by which the biological effects of different TRT agents can be compared in order to predict efficacy.

Grudzinski, Joseph J.; Tomé, Wolfgang; Weichert, Jamey P.; Jeraj, Robert

2010-10-01

231

A new framework for evaluating potential risk of back disorders due to whole body vibration and repeated mechanical shock.  

PubMed

A number of studies have examined the potential relationship between exposure to occupational vibration and low back pain associated with operation of vehicles. Only a handful of studies, however, have attempted to differentiate between the relative contributions of the steady state and transient mechanical shock components (the latter also being known as 'jarring and jolting', 'high acceleration event', 'multiple shocks' and 'impact') of the vibration exposure. The primary objective of this paper is to present a review of current studies that examine mechanical shock, present a case for the importance of evaluating both steady state and mechanical shock components and propose a new framework for evaluating the health effects due to occupational vibration exposure. A computerized bibliographical search of several databases was performed with special reference to the health effects of mechanical shock in relation to lower back disorders. Based on the analysis, eight experimental studies and nine epidemiological studies with relevance to exposure to 'mechanical shock' were identified. These studies suggested that rough vehicle rides are prevalent and that repeated exposure to mechanical shock may increase the risk of lower back pain. There is an urgent need for assessing the health effects of mechanical shocks in epidemiological studies. In particular, the new ISO 2631-5: International Organization for Standardization 2004 standard for shock exposure assessment should be evaluated with regard to musculoskeletal health effects. PMID:17536775

Waters, Thomas; Rauche, Christin; Genaidy, Ash; Rashed, Tarek

2007-03-01

232

Phase 1 Clinical Trial of Stereotactic Body Radiation Therapy Concomitant With Neoadjuvant Chemotherapy for Breast Cancer  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) allows stereotactic irradiation of thoracic tumors. It may have a real impact on patients who may not otherwise qualify for breast-conserving surgery. We conducted a phase 1 trial that tested 5 dose levels of SBRT concomitant with neoadjuvant chemotherapy (NACT) before to surgery. The purpose of the current dose escalation study was to determine the maximum tolerable dose of SBRT in the treatment of breast cancer. Methods and Materials: To define toxicity, we performed dermatologic examinations that included clinical examinations by 2 separate physicians and technical evaluations using colorimetry, dermoscopy, and skin ultrasonography. Dermatologic examinations were performed before NACT, 36 and 56 days after the beginning of NACT, and before surgery. Surgery was performed 4 to 8 weeks after the last chemotherapy session. Efficacy, the primary endpoint, was determined by the pathologic complete response (pCR) rate. Results: Maximum tolerable dose was not reached. Only 1 case of dose-limiting toxicity was reported (grade 3 dermatologic toxicity), and SBRT was overall well tolerated. The pCR rate was 36%, with none being observed at the first 2 dose levels, and the highest rate being obtained at dose level 3 (25.5 Gy delivered in 3 fractions). Furthermore, the breast-conserving surgery rate was up to 92% compared with an 8% total mastectomy rate. No surgical complications were reported. Conclusions: This study demonstrates that SBRT can be safely combined with NACT. Regarding the efficacy endpoints, this trial showed promising results in terms of pCR rate (36%) and breast-conserving rate (92%). The findings provide a strong rationale for extending the study into a phase 2 trial. In view of the absence of correlation between dose and pCR, and given that the data from dose level 3 met the statistical requirements, a dose of 25.5 Gy in 3 fractions should be used for the phase 2 trial.

Bondiau, Pierre-Yves, E-mail: pierre-yves.bondiau@nice.unicancer.fr [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France)] [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France); Courdi, Adel [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France)] [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France); Bahadoran, Phillipe [Department of Dermatology, University Hospital of Nice, Nice (France)] [Department of Dermatology, University Hospital of Nice, Nice (France); Chamorey, Emmanuel [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France)] [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France); Queille-Roussel, Catherine [Centre de Pharmacologie Clinique Appliquée à la Dermatologie, Nice (France)] [Centre de Pharmacologie Clinique Appliquée à la Dermatologie, Nice (France); Lallement, Michel; Birtwisle-Peyrottes, Isabelle; Chapellier, Claire; Pacquelet-Cheli, Sandrine; Ferrero, Jean-Marc [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France)] [Department of Radiotherapy, Centre Antoine Lacassagne, Nice (France)

2013-04-01

233

Dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer.  

PubMed

To quantitatively evaluate dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer. Overall, 11 lung SBRT patients (8 female and 3 male; mean age: 75.0 years) with medially located tumors were included. Treatment plans with simulated rotational offsets of 1°, 3°, and 5° in roll, yaw, and pitch were generated and compared with the original plans. Both clockwise and counterclockwise rotations were investigated. The following dosimetric metrics were quantitatively evaluated: planning target volume coverage (PTV V100%), max PTV dose (PTV Dmax), percentage prescription dose to 0.35cc of cord (cord D0.35cc), percentage prescription dose to 0.35cc and 5cc of esophagus (esophagus D0.35cc and D5cc), and volume of the lungs receiving at least 20Gy (lung V20). Statistical significance was tested using Wilcoxon signed rank test at the significance level of 0.05. Overall, small differences were found in all dosimetric matrices at all rotational offsets: 95.6% of differences were < 1% or < 1Gy. Of all rotational offsets, largest change in PTV V100%, PTV Dmax, cord D0.35cc, esophagus D0.35cc, esophagus D5cc, and lung V20 was - 8.36%, - 6.06%, 11.96%, 8.66%, 6.02%, and - 0.69%, respectively. No significant correlation was found between any dosimetric change and tumor-to-cord/esophagus distances (R(2) range: 0 to 0.44). Larger dosimetric changes and intersubject variations were observed at larger rotational offsets. Small dosimetric differences were found owing to rotational offsets up to 5° in lung SBRT for medially located tumors. Larger intersubject variations were observed at larger rotational offsets. PMID:24485056

Yang, Yun; Catalano, Suzanne; Kelsey, Chris R; Yoo, David S; Yin, Fang-Fang; Cai, Jing

2014-01-01

234

Generalizable Class Solutions for Treatment Planning of Spinal Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: Spinal stereotactic body radiation therapy (SBRT) continues to emerge as an effective therapeutic approach to spinal metastases; however, treatment planning and delivery remain resource intensive at many centers, which may hamper efficient implementation in clinical practice. We sought to develop a generalizable class solution approach for spinal SBRT treatment planning that would allow confidence that a given plan provides optimal target coverage, reduce integral dose, and maximize planning efficiency. Methods and Materials: We examined 91 patients treated with spinal SBRT at our institution. Treatment plans were categorized by lesion location, clinical target volume (CTV) configuration, and dose fractionation scheme, and then analyzed to determine the technically achievable dose gradient. A radial cord expansion was subtracted from the CTV to yield a planning CTV (pCTV) construct for plan evaluation. We reviewed the treatment plans with respect to target coverage, dose gradient, integral dose, conformality, and maximum cord dose to select the best plans and develop a set of class solutions. Results: The class solution technique generated plans that maintained target coverage and improved conformality (1.2-fold increase in the 95% van't Riet Conformation Number describing the conformality of a reference dose to the target) while reducing normal tissue integral dose (1.3-fold decrease in the volume receiving 4 Gy (V{sub 4Gy}) and machine output (19% monitor unit (MU) reduction). In trials of planning efficiency, the class solution technique reduced treatment planning time by 30% to 60% and MUs required by {approx}20%: an effect independent of prior planning experience. Conclusions: We have developed a set of class solutions for spinal SBRT that incorporate a pCTV metric for plan evaluation while yielding dosimetrically superior treatment plans with increased planning efficiency. Our technique thus allows for efficient, reproducible, and high-quality spinal SBRT treatment planning.

Weksberg, David C.; Palmer, Matthew B.; Vu, Khoi N.; Rebueno, Neal C.; Sharp, Hadley J. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Luo, Dershan; Yang, James N.; Shiu, Almon S. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rhines, Laurence D. [Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); McAleer, Mary Frances; Brown, Paul D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Eric L., E-mail: eric.L.chang@usc.edu [Department of Radiation Oncology, University of Southern California Keck School of Medicine, Norris Cancer Hospital, Los Angeles, California (United States)

2012-11-01

235

Dosimetric evaluation of simultaneous integrated boost during stereotactic body radiation therapy for pancreatic cancer.  

PubMed

Stereotactic body radiation therapy (SBRT) provides a promising way to treat locally advanced pancreatic cancer and borderline resectable pancreatic cancer. A simultaneous integrated boost (SIB) to the region of vessel abutment or encasement during SBRT has the potential to downstage otherwise likely positive surgical margins. Despite the potential benefit of using SIB-SBRT, the ability to boost is limited by the local geometry of the organs at risk (OARs), such as stomach, duodenum, and bowel (SDB), relative to tumor. In this study, we have retrospectively replanned 20 patients with 25Gy prescribed to the planning target volume (PTV) and 33~80Gy to the boost target volume (BTV) using an SIB technique for all patients. The number of plans and patients able to satisfy a set of clinically established constraints is analyzed. The ability to boost vessels (within the gross target volume [GTV]) is shown to correlate with the overlap volume (OLV), defined to be the overlap between the GTV + a 1(OLV1)- or 2(OLV2)-cm margin with the union of SDB. Integral dose, boost dose contrast (BDC), biologically effective BDC, tumor control probability for BTV, and normal tissue complication probabilities are used to analyze the dosimetric results. More than 65% of the cases can deliver a boost to 40Gy while satisfying all OAR constraints. An OLV2 of 100cm(3) is identified as the cutoff volume: for cases with OLV2 larger than 100cm(3), it is very unlikely the case could achieve 25Gy to the PTV while successfully meeting all the OAR constraints. PMID:25445989

Yang, Wensha; Reznik, Robert; Fraass, Benedick A; Nissen, Nicholas; Hendifar, Andrew; Wachsman, Ashley; Sandler, Howard; Tuli, Richard

2015-01-01

236

Probabilities of Radiation Myelopathy Specific to Stereotactic Body Radiation Therapy to Guide Safe Practice  

SciTech Connect

Purpose: Dose-volume histogram (DVH) results for 9 cases of post spine stereotactic body radiation therapy (SBRT) radiation myelopathy (RM) are reported and compared with a cohort of 66 spine SBRT patients without RM. Methods and Materials: DVH data were centrally analyzed according to the thecal sac point maximum (Pmax) volume, 0.1- to 1-cc volumes in increments of 0.1 cc, and to the 2 cc volume. 2-Gy biologically equivalent doses (nBED) were calculated using an {alpha}/{beta} = 2 Gy (units = Gy{sub 2/2}). For the 2 cohorts, the nBED means and distributions were compared using the t test and Mann-Whitney test, respectively. Significance (P<.05) was defined as concordance of both tests at each specified volume. A logistic regression model was developed to estimate the probability of RM using the dose distribution for a given volume. Results: Significant differences in both the means and distributions at the Pmax and up to the 0.8-cc volume were observed. Concordant significance was greatest for the Pmax volume. At the Pmax volume the fit of the logistic regression model, summarized by the area under the curve, was 0.87. A risk of RM of 5% or less was observed when limiting the thecal sac Pmax volume doses to 12.4 Gy in a single fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. Conclusion: We report the first logistic regression model yielding estimates for the probability of human RM specific to SBRT.

Sahgal, Arjun, E-mail: arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada) [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States)] [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States); Ma, Lijun [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States); Chang, Eric [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States)] [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States); Chao, Sam [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Muacevic, Alexander [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany)] [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany); Gorgulho, Alessandra [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States)] [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States); Soltys, Scott [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)] [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)] [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Angelov, Lilyana [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Gibbs, Iris [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada)] [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Larson, David A. [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)

2013-02-01

237

Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer  

PubMed Central

Background Hypofractionated stereotactic body radiation therapy (SBRT) has been advanced as monotherapy for low-risk prostate cancer. We examined the dose distributions and early clinical outcomes using this modality for the treatment of intermediate-risk prostate cancer. Methods Forty-one sequential hormone-naïve intermediate-risk prostate cancer patients received 35–36.25 Gy of CyberKnife-delivered SBRT in 5 fractions. Radiation dose distributions were analyzed for coverage of potential microscopic ECE by measuring the distance from the prostatic capsule to the 33 Gy isodose line. PSA levels, toxicities, and quality of life (QOL) measures were assessed at baseline and follow-up. Results All patients completed treatment with a mean coverage by the 33 Gy isodose line extending >5 mm beyond the prostatic capsule in all directions except posteriorly. Clinical responses were documented by a mean PSA decrease from 7.67 ng/mL pretreatment to 0.64 ng/mL at the median follow-up of 21 months. Forty patients remain free from biochemical progression. No Grade 3 or 4 toxicities were observed. Mean EPIC urinary irritation/obstruction and bowel QOL scores exhibited a transient decline post-treatment with a subsequent return to baseline. No significant change in sexual QOL was observed. Conclusions In this intermediate-risk patient population, an adequate radiation dose was delivered to areas of expected microscopic ECE in the majority of patients. Although prospective studies are needed to confirm long-term tumor control and toxicity, the short-term PSA response, biochemical relapse-free survival rate, and QOL in this interim analysis are comparable to results reported for prostate brachytherapy or external beam radiotherapy. Trial registration The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510). PMID:23369294

2013-01-01

238

Dosimetric comparison of patient setup strategies in stereotactic body radiation therapy for lung cancer  

SciTech Connect

Purpose: In this work, the authors retrospectively compared the accumulated dose over the treatment course for stereotactic body radiation therapy (SBRT) of lung cancer for three patient setup strategies. Methods: Ten patients who underwent lung SBRT were selected for this study. At each fraction, patients were immobilized using a vacuum cushion and were CT scanned. Treatment plans were performed on the simulation CT. The planning target volume (PTV) was created by adding a 5-mm uniform margin to the internal target volume derived from the 4DCT. All plans were normalized such that 99% of the PTV received 60 Gy. The plan parameters were copied onto the daily CT images for dose recalculation under three setup scenarios: skin marker, bony structure, and soft tissue based alignments. The accumulated dose was calculated by summing the dose at each fraction along the trajectory of a voxel over the treatment course through deformable image registration of each CT with the planning CT. The accumulated doses were analyzed for the comparison of setup accuracy. Results: The tumor volume receiving 60 Gy was 91.7 {+-} 17.9%, 74.1 {+-} 39.1%, and 99.6 {+-} 1.3% for setup using skin marks, bony structures, and soft tissue, respectively. The isodose line covering 100% of the GTV was 55.5 {+-} 7.1, 42.1 {+-} 16.0, and 64.3 {+-} 7.1 Gy, respectively. The corresponding average biologically effective dose of the tumor was 237.3 {+-} 29.4, 207.4 {+-} 61.2, and 258.3 {+-} 17.7 Gy, respectively. The differences in lung biologically effective dose, mean dose, and V20 between the setup scenarios were insignificant. Conclusions: The authors' results suggest that skin marks and bony structure are insufficient for aligning patients in lung SBRT. Soft tissue based alignment is needed to match the prescribed dose delivered to the tumors.

Wu Jianzhou; He, Tongming T. [Radiation Oncology, Swedish Cancer Institute, Seattle, Washington 98104 (United States); Betzing, Christopher; Fuss, Martin [Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon 97239 (United States); D'Souza, Warren D. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21044 (United States)

2013-05-15

239

Dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer  

SciTech Connect

To quantitatively evaluate dosimetric effects of rotational offsets in stereotactic body radiation therapy (SBRT) for lung cancer. Overall, 11 lung SBRT patients (8 female and 3 male; mean age: 75.0 years) with medially located tumors were included. Treatment plans with simulated rotational offsets of 1°, 3°, and 5° in roll, yaw, and pitch were generated and compared with the original plans. Both clockwise and counterclockwise rotations were investigated. The following dosimetric metrics were quantitatively evaluated: planning target volume coverage (PTV V{sub 100%}), max PTV dose (PTV D{sub max}), percentage prescription dose to 0.35 cc of cord (cord D{sub 0.35} {sub cc}), percentage prescription dose to 0.35 cc and 5 cc of esophagus (esophagus D{sub 0.35} {sub cc} and D{sub 5} {sub cc}), and volume of the lungs receiving at least 20 Gy (lung V{sub 20}). Statistical significance was tested using Wilcoxon signed rank test at the significance level of 0.05. Overall, small differences were found in all dosimetric matrices at all rotational offsets: 95.6% of differences were < 1% or < 1 Gy. Of all rotational offsets, largest change in PTV V{sub 100%}, PTV D{sub max}, cord D{sub 0.35} {sub cc}, esophagus D{sub 0.35} {sub cc}, esophagus D{sub 5} {sub cc}, and lung V{sub 20} was ? 8.36%, ? 6.06%, 11.96%, 8.66%, 6.02%, and ? 0.69%, respectively. No significant correlation was found between any dosimetric change and tumor-to-cord/esophagus distances (R{sup 2} range: 0 to 0.44). Larger dosimetric changes and intersubject variations were observed at larger rotational offsets. Small dosimetric differences were found owing to rotational offsets up to 5° in lung SBRT for medially located tumors. Larger intersubject variations were observed at larger rotational offsets.

Yang, Yun; Catalano, Suzanne; Kelsey, Chris R.; Yoo, David S.; Yin, Fang-Fang; Cai, Jing, E-mail: jing.cai@duke.edu

2014-04-01

240

The efficacy of stereotactic body radiation therapy on huge hepatocellular carcinoma unsuitable for other local modalities  

PubMed Central

Background and aim To evaluate the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients with unresectable huge hepatocellular carcinoma (HCC) unsuitable of other standard treatment option. Methods Between 2009 and 2011, 22 patients with unresectable huge HCC (?10 cm) were treated with SBRT. dose ranged from 26 Gy to 40 Gy in five fractions. Overall survival (OS) and disease-progression free survival (DPFS) were determined by Kaplan-Meier analysis. Tumor response and toxicities were also assessed. Results After a median follow-up of 11.5 month (range 2–46 months). The objective response rate was achieved in 86.3% (complete response (CR): 22.7% and partial response (PR): 63.6%). The 1-yr. local control rate was 55.56%. The 1-year OS was 50% and median survival was 11 months (range 2–46 months). In univariate analysis, Child-Pugh stage (p?=?0.0056) and SBRT dose (p?=?0.0017) were significant factors for survival. However, in multivariate analysis, SBRT dose (p?=?0.0072) was the most significant factor, while Child-Pugh stage of borderline significance. (p?=?0.0514). Acute toxicities were mild and well tolerated. Conclusion This study showed that SBRT can be delivered safely to huge HCC and achieved a substantial tumor regression and survival. The results suggest this technique should be considered a salvage treatment. However, local and regional recurrence remain the major cause of failure. Further studies of combination of SBRT and other treatment modalities may be reasonable. PMID:24885086

2014-01-01

241

Patient-reported urinary incontinence following stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer  

PubMed Central

Purpose Urinary incontinence (UI) following prostate radiotherapy is a rare toxicity that adversely affects a patient’s quality of life. This study sought to evaluate the incidence of UI following stereotactic body radiation therapy (SBRT) for prostate cancer. Methods Between February, 2008 and October, 2010, 204 men with clinically localized prostate cancer were treated definitively with SBRT at Georgetown University Hospital. Patients were treated to 35–36.25 Gray (Gy) in 5 fractions delivered with the CyberKnife (Accuray). UI was assessed via the Expanded Prostate Index Composite (EPIC)-26. Results Baseline UI was common with 4.4%, 1.0% and 3.4% of patients reporting leaking?>?1 time per day, frequent dribbling and pad usage, respectively. Three year post treatment, 5.7%, 6.4% and 10.8% of patients reported UI based on leaking?>?1 time per day, frequent dribbling and pad usage, respectively. Average EPIC UI summary scores showed an acute transient decline at one month post-SBRT then a second a gradual decline over the next three years. The proportion of men feeling that their UI was a moderate to big problem increased from 1% at baseline to 6.4% at three years post-SBRT. Conclusions Prostate SBRT was well tolerated with UI rates comparable to conventionally fractionated radiotherapy and brachytherapy. More than 90% of men who were pad-free prior to treatment remained pad-free three years following treatment. Less than 10% of men felt post-treatment UI was a moderate to big problem at any time point following treatment. Longer term follow-up is needed to confirm late effects. PMID:24966110

2014-01-01

242

Vertebral Compression Fracture (VCF) After Spine Stereotactic Body Radiation Therapy (SBRT): Analysis of Predictive Factors  

SciTech Connect

Purpose: Vertebral compression fractures (VCFs) are increasingly observed after spine stereotactic body radiation therapy (SBRT). The aim of this study was to determine the risk of VCF after spine SBRT and identify clinical and dosimetric factors predictive for VCF. The analysis incorporated the recently described Spinal Instability Neoplastic Score (SINS) criteria. Methods and Materials: The primary endpoint of this study was the development of a de novo VCF (ie, new endplate fracture or collapse deformity) or fracture progression based on an existing fracture at the site of treatment after SBRT. We retrospectively scored 167 spinal segments in 90 patients treated with spine SBRT according to each of the 6 SINS criteria. We also evaluated the presence of paraspinal extension, prior radiation, various dosimetric parameters including dose per fraction ({>=}20 Gy vs <20 Gy), age, and histology. Results: The median follow-up was 7.4 months. We identified 19 fractures (11%): 12 de novo fractures (63%) and 7 cases of fracture progression (37%). The mean time to fracture after SBRT was 3.3 months (range, 0.5-21.6 months). The 1-year fracture-free probability was 87.3%. Multivariate analysis confirmed that alignment (P=.0003), lytic lesions (P=.007), lung (P=.03) and hepatocellular (P<.0001) primary histologies, and dose per fraction of 20 Gy or greater (P=.004) were significant predictors of VCF. Conclusions: The presence of kyphotic/scoliotic deformity and the presence of lytic tumor were the only predictive factors of VCF based on the original 6 SINS criteria. We also report that patients with lung and hepatocellular tumors and treatment with SBRT of 20 Gy or greater in a single fraction are at a higher risk of VCF.

Cunha, Marcelo V.R. [Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Al-Omair, Ameen [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Atenafu, Eshetu G. [Department of Biostatistics, University Health Network, University of Toronto, Toronto, Ontario (Canada)] [Department of Biostatistics, University Health Network, University of Toronto, Toronto, Ontario (Canada); Masucci, Giuseppina Laura; Letourneau, Daniel [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Korol, Renee [Department of Medical Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Department of Medical Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Yu, Eugene [Department of Radiology and Otolaryngology-Head and Neck Surgery, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiology and Otolaryngology-Head and Neck Surgery, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario (Canada); Howard, Peter [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lochray, Fiona [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Costa, Leodante B. da [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Fehlings, Michael G. [Division of Neurosurgery and Spinal Program, Toronto Western Hospital, University of Toronto, Toronto, Ontario (Canada)] [Division of Neurosurgery and Spinal Program, Toronto Western Hospital, University of Toronto, Toronto, Ontario (Canada); Sahgal, Arjun, E-mail: arjun.sahgal@sunnybrook.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada) [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

2012-11-01

243

Cryobanking of embryoid bodies to facilitate basic research and cell-based therapies.  

PubMed

Pluripotent stem cells offer unique opportunities for curing debilitating diseases. However, further comprehensive research is needed to better understand cell signaling during the differentiation of pluripotent cells into different cell lineages and accordingly to develop clinically applicable protocols. One of the limiting steps for differentiation studies is proper culture and expansion of pluripotent stem cells, which is labor intensive, expensive, and requires a great deal of expertise. This limiting step can be overcome by successful banking and distribution of embryoid bodies (EBs), which are aggregates of pluripotent stem cells and typically the starting point of differentiation protocols. The objective of this study was to investigate the feasibility of EB banking by studying survival and functionality of cryopreserved EBs. To this end, EBs were formed by culturing mouse 129 embryonic stem (ES) cells in the absence of leukemia inhibitory factor (LIF) in hanging drops and then subjected to different cryopreservation protocols. In a series of experiments, we first tested the postthaw survival of EBs as a function of dimethylsulfoxide (DMSO) and extracellular trehalose concentrations and cooling rates. Next, we studied the functionality of cryopreserved EBs by assessing their postthaw attachment, growth, and differentiation into various cell types. Higher (?5%) DMSO concentrations alone or in combination with trehalose (0.1?M and 0.2?M) yielded good postthaw survival rates of >80%, whereas cooling of EBs at 1°C/min in the presence of 5% DMSO +0.1?M trehalose gave the best attachment and growth rates, with differentiation into cell lineages of three germ layers. Taken together, our results suggest that EBs are tolerant to cryopreservation-associated stresses and retain their differentiation potential after freezing and thawing. Furthermore, our experiments with dissociated EB cells and nondissociated EBs suggest that the extracellular matrix may play a beneficial role in the cryotolerance of EBs. Overall, our data support the feasibility of EB banking, which would facilitate advancement of cell-based therapies. PMID:21978080

Sharma, Shruti; Szurek, Edyta A; Rzucidlo, Jacek S; Liour, Sean S; Eroglu, Ali

2011-12-01

244

The Use of Gated and 4D CT Imaging in Planning for Stereotactic Body Radiation Therapy  

SciTech Connect

The localization of treatment targets is of utmost importance for patients receiving stereotactic body radiation therapy (SBRT), where the dose per fraction is large. While both setup or respiration-induced motion components affect the localization of the treatment volume, the purpose of this work is to describe our management of the intrafraction localization uncertainty induced by normal respiration. At our institution, we have implemented gated computed tomography (CT) acquisition with an active breathing control system (ABC), and 4-dimensional (4D) CT using a skin-based marker and retrospective respiration phase-based image sorting. During gated simulation, 3D CT images were acquired corresponding to end-inhalation and end-exhalation. For 4D CT imaging, 3D CT images were acquired corresponding to 8 phases of the respiratory cycle. In addition to gated or 4D CT images, we acquired a conventional free-breathing CT (FB). For both gated and 4D CT images, the target contours were registered to the FB scan in the planning system. These contours were then combined in the FB image set to form the internal target volume (ITV). Dynamic conformal arc treatment plans were generated for the ITV using the FB scan and the gated or 4D scans with an additional 7-mm margin for patient setup uncertainty. We have described our results for a pancreas and a lung tumor case. Plans were normalized so that the PTV received 95% of the prescription dose. The dose distribution for all the critical structures in the pancreas and lung tumor cases resulted in increased sparing when the ITV was defined using gated or 4D CT images than when the FB scan was used. Our results show that patient-specific target definition using gated or 4D CT scans lead to improved normal tissue sparing.

D'Souza, Warren D. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)]. E-mail: wdsou001@umaryland.edu; Nazareth, Daryl P. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Zhang Bin [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Deyoung, Chad [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Suntharalingam, Mohan [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Kwok, Young [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Yu, Cedric X. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)

2007-07-01

245

Ride quality and international standard ISO 2631 (Guide for the evaluation of human exposure to whole-body vibration)  

NASA Technical Reports Server (NTRS)

The evolution of the standard, which is aimed at promoting research and production of more data, and providing some design guidance, is outlined and its contents summarized. Some of the assumptions and information on which it is based are analyzed. Its application to vehicle ride quality is considered in the context of the safety, efficiency and comfort of crew and passengers. The importance of establishing the precise criteria against which vibration limits are required is underlined, particularly the difficulties of first defining comfort and then postulating appropriate levels. Some current and future work related to improving the standard is outlined and additional suggestions offered.

Allen, G. R.

1975-01-01

246

Resistive exercises, with or without whole body vibration, prevent vertebral marrow fat accumulation during 60 days of head-down tilt bed rest in men.  

PubMed

Fat accumulates in the bone marrow of lumbar vertebrae with bed rest. Exercise with or without whole body vibration may counter this effect. Our objectives were to measure 1) the vertebral fat fraction (VFF) of men subjected to bed rest who performed resistive exercises with (RVE, n = 7) or without whole body vibration(RE, n = 8) or no exercise (CTR, n = 9) using three MRI techniques; and 2) changes in peripheral blood counts. Twenty-four healthy men (age: 20-45 yr) underwent -6° head-down tilt (HDT) bed rest for 60 days. MRI was performed using three techniques (fat saturation, proton spectroscopy, and in and out of phase) to measure the fat fraction of L(3), L(4), and/or L(5) at baseline, mid-HDT, and end-HDT. Erythrocytes and leukocytes were counted at HDT days 19, 33, 47, 54, and 60. The mean absolute VFF was increased in the CTR group at mid-HDT and end-HDT (+3.9 ± 1.3 and +3.6 ± 1.2%, respectively, both P < 0.05). The RE group had a smaller VFF change than the CTR group at mid-HDT (-0.9 ± 1.2 vs. +3.9 ± 1.3%, P < 0.05). The RVE group had a smaller VFF change than the CTR group at end-HDT (-2.6 ± 1.9 vs. +3.5 ± 1.2%, P < 0.05). Erythrocyte counts were increased in all groups at HDT day 19 and HDT day 33 and in the RE group at HDT day 54 (all P < 0.05). Bed rest for 60 days at -6° HDT increased lumbar VFF in men beyond natural involution. RVE and RE regimens effectively prevented VFF accumulation. Higher erythrocyte counts were not altered by RVE or RE. Whole body vibration, along with RE administered to people with prolonged immobility, may prevent fat accumulation in their bone marrow. PMID:22442031

Trudel, Guy; Coletta, Elizabeth; Cameron, Ian; Belavy, Daniel L; Lecompte, Martin; Armbrecht, Gabriele; Felsenberg, Dieter; Uhthoff, Hans K

2012-06-01

247

Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up  

PubMed Central

The suitability and effectiveness of whole body vibration (WBV) exercise in rehabilitation after injury of the anterior cruciate ligament (ACL) was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20) or standard rehabilitation exercise protocol (n=20). Both protocols started in the 2nd week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol. Key points In this prospective randomized controlled clinical trial, we tested the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination) and would be less time consuming than a current standard muscle strengthening protocol in forty patients who underwent ACL reconstruction. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group as compared to the standard exercise group. Both protocols showed no differences regarding clinical assessment, Lysholm score, isokinetic and isometric strength. Despite a more than 50% reduction in time spent for exercise sessions, the WBV group achieved significant better results in the stability test. In conclusion, the presented WBV program can be considered as a practical alternative to a standard exercise program during ACL-rehabilitation. PMID:25177185

Berschin, Gereon; Sommer, Björn; Behrens, Antje; Sommer, Hans-Martin

2014-01-01

248

Mathematical equations and system identification models for a portable pneumatic bladder system designed to reduce human exposure to whole body shock and vibration  

NASA Astrophysics Data System (ADS)

A mathematical representation is sought to model the behavior of a portable pneumatic foam bladder designed to mitigate the effects of human exposure to shock and whole body random vibration. Fluid Dynamics principles are used to derive the analytic differential equations used for the physical equations Model. Additionally, combination of Wiener and Hammerstein block oriented representation techniques have been selected to create system identification (SID) block oriented models. A number of algorithms have been iterated to obtain numerical solutions for the system of equations which was found to be coupled and non-linear, with no analytic closed form solution. The purpose is to be able to predict the response of such system due to random vibrations and shock within reasonable margin of error. The constructed models were found to be accurate within accepted confidence level. Beside the analytic set of physical equations model representation, a linear SID model was selected to take advantage of the available vast amount of mathematical tools available to further analyze and redesign the bladder as a dynamic system. Measured field-test and lab test data have been collected from several helicopter and land terrain vehicle experiments. Numerous excitation and response acceleration measurement records were collected and used to prove the agreement with predictions. The estimation of two selected models were later applied to standard metrics in the frequency domain realization and compared with measurement responses. The collected test records are obtained from measured data at the US Army fields and facilities and at UNLV-CMEST environmental lab. The emerged models have been validated for conformity with actual accelerometer measurement responses and found within accepted error tolerance that is in both time and frequency domains. Further, standard metrics have been used to further confirm the confidence in the validation results. When comparing model prediction with the already proven pneumatic bladder system effectiveness both equally proves that bladder performance exceeds metrics standard to reduce human exposure to shock and random vibrations.

Aziz Ayyad, Ezzat

249

Effect of Postmenopausal Hormone Therapy on Body Weight and Waist and Hip Girths  

Microsoft Academic Search

Reports from cross-sectional comparisons, nonrandomized pro- spective studies, and relatively small clinical trials indicate that post- menopausal hormone therapy may slightly decrease the amount of weight typically gained by women during the decade following meno- pause. Despite this, widespread belief remains that hormone therapy may cause weight gain. We use data from the Postmenopausal Es- trogen\\/Progestin Interventions trial to characterize

MARK A. ESPELAND; MARCIA L. STEFANICK; DONNA KRITZ-SILVERSTEIN; S. EDWIN FINEBERG; MYRON A. WACLAWIW; MARGARET K. JAMES; GAIL A. GREENDALE

2009-01-01

250

Spatial and dose–response analysis of fibrotic lung changes after stereotactic body radiation therapy  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) is becoming the standard of care for early stage nonoperable lung cancers. Accurate dose–response modeling is challenging for SBRT because of the decreased number of clinical toxicity events. As a surrogate for a clinical toxicity endpoint, studies have proposed to use radiographic changes in follow up computed tomography (CT) scans to evaluate lung SBRT normal tissue effects. The purpose of the current study was to use local fibrotic lung regions to spatially and dosimetrically evaluate lung changes in patients that underwent SBRT.Methods: Forty seven SBRT patients treated at our institution from 2003 to 2009 were used for the current study. Our patient cohort had a total of 148 follow up CT scans ranging from 3 to 48 months post-therapy. Post-treatment scans were binned into intervals of 3, 6, 12, 18, 24, 30, and 36 months after the completion of treatment. Deformable image registration was used to align the follow up CT scans with the pretreatment CT and dose distribution. Areas of visible fibrotic changes were contoured. The centroid of each gross tumor volume (GTV) and contoured fibrosis volume was calculated and the fibrosis volume location and movement (magnitude and direction) relative to the GTV and 30 Gy isodose centroid were analyzed. To perform a dose–response analysis, each voxel in the fibrosis volume was sorted into 10 Gy dose bins and the average CT number value for each dose bin was calculated. Dose–response curves were generated by plotting the CT number as a function of dose bin and time posttherapy.Results: Both fibrosis and GTV centroids were concentrated in the upper third of the lung. The average radial movement of fibrosis centroids relative to the GTV centroids was 2.6 cm with movement greater than 5 cm occurring in 11% of patients. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. The authors observed a CT number plateau at doses ranging from 30 to 50 Gy for the 3, 6, and 12 months posttherapy time points. There was no evident plateau for the dose–response curves generated using data from the 18, 24, 30, and 36 months posttherapy time points.Conclusions: Regions of local fibrotic lung changes in patients that underwent SBRT were evaluated spatially and dosimetrically. The authors found that the average fibrosis movement was 2.6 cm with movement greater than 5 cm possible. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. Furthermore, our dose–response data also suggest that one of the possible explanations of the CT number plateau effect may be the time posttherapy of the acquired data. Understanding normal tissue dose–response is important for reducing toxicity after SBRT, especially in cases where larger tumors are treated. The methods presented in the current work build on prior quantitative studies and further enhance the understanding of normal lung dose–response after SBRT.

Vinogradskiy, Yevegeniy; Diot, Quentin; Kavanagh, Brian; Schefter, Tracey; Gaspar, Laurie; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States)

2013-08-15

251

Statistical analysis of target motion in gated lung stereotactic body radiation therapy  

NASA Astrophysics Data System (ADS)

An external surrogate-based respiratory gating technique is a useful method to reduce target margins for the treatment of a moving lung tumor. The success of this technique relies on a good correlation between the motion of the external markers and the internal tumor as well as the repeatability of the respiratory motion. In gated lung stereotactic body radiation therapy (SBRT), the treatment time for each fraction could exceed 30 min due to large fractional dose. Tumor motion may experience pattern changes such as baseline shift during such extended treatment time. The purpose of this study is to analyze tumor motion traces in actual treatment situations and to evaluate the effect of the target baseline shift in gated lung SBRT treatment. Real-time motion data for both the external markers and tumors from 51 lung SBRT treatments with Cyberknife Synchrony technology were analyzed in this study. The treatment time is typically greater than 30 min. The baseline shift was calculated with a rolling average window equivalent to ~20 s and subtracted from that at the beginning. The magnitude of the baseline shift and its relationship with treatment time were investigated. Phase gating simulation was retrospectively performed on 12 carefully selected treatments with respiratory amplitude larger than 5 mm and regular phases. A customized gating window was defined for each individual treatment. It was found that the baseline shifts are specific to each patient and each fraction. Statistical analysis revealed that more than 69% treatments exhibited increased baseline shifts with the lapse of treatment time. The magnitude of the baseline shift could reach 5.3 mm during a 30 min treatment. Gating simulation showed that tumor excursion was caused mainly by the uncertainties in phase gating simulation and baseline shift, the latter being the primary factor. With a 5 mm gating window, 2 out of 12 treatments in the study group showed significant tumor excursion. Baseline shifts alone could cause up to 20% of tumor excursion outside the gating window. It is concluded that baseline shifts may increase with the treatment time and are more likely to act as a time-dependent systematic error. For phase-based gated lung SBRT, a baseline shift may be one of the major sources of targeting error during treatment.

Zhao, Bo; Yang, Yong; Li, Tianfang; Li, Xiang; Heron, Dwight E.; Saiful Huq, M.

2011-03-01

252

High-dose MVCT image guidance for stereotactic body radiation therapy  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) is a potent treatment for early stage primary and limited metastatic disease. Accurate tumor localization is essential to administer SBRT safely and effectively. Tomotherapy combines helical IMRT with onboard megavoltage CT (MVCT) imaging and is well suited for SBRT; however, MVCT results in reduced soft tissue contrast and increased image noise compared with kilovoltage CT. The goal of this work was to investigate the use of increased imaging doses on a clinical tomotherapy machine to improve image quality for SBRT image guidance. Methods: Two nonstandard, high-dose imaging modes were created on a tomotherapy machine by increasing the linear accelerator (LINAC) pulse rate from the nominal setting of 80 Hz, to 160 Hz and 300 Hz, respectively. Weighted CT dose indexes (wCTDIs) were measured for the standard, medium, and high-dose modes in a 30 cm solid water phantom using a calibrated A1SL ion chamber. Image quality was assessed from scans of a customized image quality phantom. Metrics evaluated include: contrast-to-noise ratios (CNRs), high-contrast spatial resolution, image uniformity, and percent image noise. In addition, two patients receiving SBRT were localized using high-dose MVCT scans. Raw detector data collected after each scan were used to reconstruct standard-dose images for comparison. Results: MVCT scans acquired using a pitch of 1.0 resulted in wCTDI values of 2.2, 4.7, and 8.5 cGy for the standard, medium, and high-dose modes respectively. CNR values for both low and high-contrast materials were found to increase with the square root of dose. Axial high-contrast spatial resolution was comparable for all imaging modes at 0.5 lp/mm. Image uniformity was improved and percent noise decreased as the imaging dose increased. Similar improvements in image quality were observed in patient images, with decreases in image noise being the most notable. Conclusions: High-dose imaging modes are made possible on a clinical tomotherapy machine by increasing the LINAC pulse rate. Increasing the imaging dose results in increased CNRs; making it easier to distinguish the boundaries of low contrast objects. The imaging dose levels observed in this work are considered acceptable at our institution for SBRT treatments delivered in 3-5 fractions.

Westerly, David C.; Schefter, Tracey E.; Kavanagh, Brian D.; Chao, Edward; Lucas, Dan; Flynn, Ryan T.; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States); Accuray Inc., Madison, Wisconsin 53717 (United States); Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242 (United States); Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States)

2012-08-15

253

Improved Irritative Voiding Symptoms 3 Years after Stereotactic Body Radiation Therapy for Prostate Cancer  

PubMed Central

Background: Irritative voiding symptoms are common in elderly men and following prostate radiotherapy. There is limited clinical data on the impact of hypofractionated treatment on irritative voiding symptoms. This study sought to evaluate urgency, frequency, and nocturia following stereotactic body radiation therapy (SBRT) for prostate cancer. Methods: Patients treated with SBRT monotherapy for localized prostate cancer from August 2007 to July 2011 at Georgetown University Hospital were included in this study. Treatment was delivered using the CyberKnife® with doses of 35–36.25?Gy in five fractions. Patient-reported urinary symptoms were assessed using the International Prostate Symptom Score (IPSS) before treatment and at 1, 3, 6, 9, and 12?months post-treatment and every 6?months thereafter. Results: Two hundred four patients at a median age of 69?years received SBRT with a median follow-up of 4.8?years. Prior to treatment, 50.0% of patients reported moderate to severe lower urinary tract symptoms (LUTS) and 17.7% felt that urinary frequency was a moderate to big problem. The mean prostate volume was 39?cc and 8% had prior procedures for benign prostatic hyperplasia. A mean baseline IPSS-irritative (IPSS-I) score of 4.8 significantly increased to 6.5 at 1?month (p?

Rana, Zaker; Cyr, Robyn A.; Chen, Leonard N.; Kim, Brian S.; Moures, Rudy A.; Yung, Thomas M.; Lei, Siyuan; Collins, Brian T.; Suy, Simeng; Dritschilo, Anatoly; Lynch, John H.; Collins, Sean P.

2014-01-01

254

Reproducibility of Tumor Motion Probability Distribution Function in Stereotactic Body Radiation Therapy of Lung Cancer  

SciTech Connect

Purpose: To evaluate the reproducibility of tumor motion probability distribution function (PDF) in stereotactic body radiation therapy (SBRT) of lung cancer using cine megavoltage (MV) images. Methods and Materials: Cine MV images of 20 patients acquired during three-dimensional conformal (6-11 beams) SBRT treatments were retrospectively analyzed to extract tumor motion trajectories. For each patient, tumor motion PDFs were generated per fraction (PDF{sub n}) using three selected 'usable' beams. Patients without at least three usable beams were excluded from the study. Fractional PDF reproducibility (R{sub n}) was calculated as the Dice similarity coefficient between PDF{sub n} to a 'ground-truth' PDF (PDF{sub g}), which was generated using the selected beams of all fractions. The mean of R{sub n}, labeled as R{sub m}, was calculated for each patient and correlated to the patient's mean tumor motion rang (A{sub m}). Change of R{sub m} during the course of SBRT treatments was also evaluated. Intra- and intersubject coefficient of variation (CV) of R{sub m} and A{sub m} were determined. Results: Thirteen patients had at least three usable beams and were analyzed. The mean of R{sub m} was 0.87 (range, 0.84-0.95). The mean of A{sub m} was 3.18 mm (range, 0.46-7.80 mm). R{sub m} was found to decrease as A{sub m} increases following an equation of R{sub m} = 0.17e{sup -0.9Am} + 0.84. R{sub m} also decreased slightly throughout the course of treatments. Intersubject CV of R{sub m} (0.05) was comparable to intrasubject CV of R{sub m} (range, 0.02-0.09); intersubject CV of A{sub m} (0.73) was significantly greater than intrasubject CV of A{sub m} (range, 0.09-0.24). Conclusions: Tumor motion PDF can be determined using cine MV images acquired during the treatments. The reproducibility of lung tumor motion PDF decreased exponentially as the tumor motion range increased and decreased slightly throughout the course of the treatments.

Zhang Fan [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States) [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Hu Jing [Department of Radiation Oncology, National Cancer Centre (Singapore)] [Department of Radiation Oncology, National Cancer Centre (Singapore); Kelsey, Chris R.; Yoo, David [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)] [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin Fangfang [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States) [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Cai Jing, E-mail: jing.cai@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States)

2012-11-01

255

Dosimetric effects on small-field beam-modeling for stereotactic body radiation therapy  

NASA Astrophysics Data System (ADS)

The treatment planning of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) requires high accuracy of dosimetric data for small radiation fields. The dosimetric effects on the beam-modeling process of a treatment planning system (TPS) were investigated using different measured small-field data sets. We performed small-field dosimetry with three detectors: a CC13 ion chamber, a CC01 ion chamber, and an edge detector. Percentage depth doses (PDDs) and dose profiles for field sizes given by 3 × 3 cm2, 2 × 2 cm2, and 1 × 1 cm2 were obtained for 6 MV and 15 MV photon beams. Each measured data set was used as data input for a TPS, in which a beam-modeling process was implemented using the collapsed cone convolution (CCC) algorithm for dose calculation. The measured data were used to generate six beam-models based on each combination of detector type and photon energy, which were then used to calculate the corresponding PDDs and dose profiles for various depths and field sizes. Root mean square differences (RMSDs) between the calculated and the measured doses were evaluated for the PDDs and the dose profiles. The RMSDs of PDDs beyond the maximum dose depth were within an accuracy of 0.2-0.6%, being clinically acceptable. The RMSDs of the dose profiles corresponding to the CC13, the CC01, and the edge detector were 2.80%, 1.49%, and 1.46% for a beam energy of 6 MV and 2.34%, 1.15%, and 1.44% for a beam energy of 15 MV, respectively. The calculated results for the CC13 ion chamber showed the most discrepancy compared to the measured data, due to the relatively large sensitive volume of this detector. However, the calculated dose profiles for the detectors were not significantly different from another. The physical algorithm used in the beam-modeling process did not seem to be sensitive to blurred data measured with detectors with large sensitive volumes. Each beam-model was used to clinically evaluate lung and lymphatic node SBRT plans, yielding almost equal dose distributions for the treatment targets, while the mean doses related to the organs at risk (OARs) deviated by approximately 0.7-1.2%. The use of the measured data sets from different detectors for the beam-modeling process still provided acceptable dose distributions with accuracies within 2%.

Cho, Woong; Kim, Suzy; Kim, Jung-In; Wu, Hong-Gyun; Jung, Joo-Young; Kim, Min-Joo; Suh, Tae-Suk; Kim, Jin-Young; Kim, Jong Won

2015-02-01

256

Dose-Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer  

SciTech Connect

Purpose: To identify dose-volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials: This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose-volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results: With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose-volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder (p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV {>=}37.7 ml and V25 <4.2%; and patients with PTV {>=}37.7 ml and V25 {>=}4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively (p = 0.013). Conclusions: Lung V25 and PTV volume were significant factors associated with RP after SBRT.

Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Shibuya, Keiko; Nakamura, Mitsuhiro; Narabayashi, Masaru; Sakanaka, Katsuyuki; Ueki, Nami; Miyagi, Ken; Norihisa, Yoshiki; Mizowaki, Takashi [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Nagata, Yasushi [Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan)

2012-07-15

257

Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer  

Microsoft Academic Search

Background  The CyberKnife is an appealing delivery system for hypofractionated stereotactic body radiation therapy (SBRT) because of\\u000a its ability to deliver highly conformal radiation therapy to moving targets. This conformity is achieved via 100s of non-coplanar\\u000a radiation beams, which could potentially increase transitory testicular irradiation and result in post-therapy hypogonadism.\\u000a We report on our early experience with CyberKnife SBRT for low-

Eric K Oermann; Simeng Suy; Heather N Hanscom; Joy S Kim; Sue Lei; Xia Yu; Guowei Zhang; Brook Ennis; JoyAnn P Rohan; Nathaniel Piel; Benjamin A Sherer; Devin Borum; Viola J Chen; Gerald P Batipps; Nicholas L Constantinople; Stephen W Dejter; Gaurav Bandi; John Pahira; Kevin G McGeagh; Lucile Adams-Campbell; Reena Jha; Nancy A Dawson; Brian T Collins; Anatoly Dritschilo; John H Lynch; Sean P Collins

2011-01-01

258

Effect of anti-tumor necrosis factor-? therapies on body mass index in patients with psoriasis  

Microsoft Academic Search

Psoriasis is a lifelong, chronic and immune-mediated skin disease affecting ?1–3% of the Caucasian population. Pathogenesis of psoriasis is associated with an increased expression of tumor necrosis factor-alpha (TNF-?). TNF-? is a pro-inflammatory cytokine and important mediator of cachexia. Anti-TNF-? therapies are effective in the treatment of psoriasis. The primary end-point was to investigate retrospectively the effect of anti-TNF-therapies on

Rosita Saraceno; Caterina Schipani; Annamaria Mazzotta; Maria Esposito; Laura Di Renzo; Antonino De Lorenzo; Sergio Chimenti

2008-01-01

259

Six-Dimensional Correction of Intra-Fractional Prostate Motion with CyberKnife Stereotactic Body Radiation Therapy.  

PubMed

Large fraction radiation therapy offers a shorter course of treatment and radiobiological advantages for prostate cancer treatment. The CyberKnife is an attractive technology for delivering large fraction doses based on the ability to deliver highly conformal radiation therapy to moving targets. In addition to intra-fractional translational motion (left-right, superior-inferior, and anterior-posterior), prostate rotation (pitch, roll, and yaw) can increase geographical miss risk. We describe our experience with six-dimensional (6D) intra-fraction prostate motion correction using CyberKnife stereotactic body radiation therapy (SBRT). Eighty-eight patients were treated by SBRT alone or with supplemental external radiation therapy. Trans-perineal placement of four gold fiducials within the prostate accommodated X-ray guided prostate localization and beam adjustment. Fiducial separation and non-overlapping positioning permitted the orthogonal imaging required for 6D tracking. Fiducial placement accuracy was assessed using the CyberKnife fiducial extraction algorithm. Acute toxicities were assessed using Common Toxicity Criteria v3. There were no Grade 3, or higher, complications and acute morbidity was minimal. Ninety-eight percent of patients completed treatment employing 6D prostate motion tracking with intra-fractional beam correction. Suboptimal fiducial placement limited treatment to 3D tracking in two patients. Our experience may guide others in performing 6D correction of prostate motion with CyberKnife SBRT. PMID:22655248

Lei, Siyuan; Piel, Nathaniel; Oermann, Eric K; Chen, Viola; Ju, Andrew W; Dahal, Kedar N; Hanscom, Heather N; Kim, Joy S; Yu, Xia; Zhang, Guowei; Collins, Brian T; Jha, Reena; Dritschilo, Anatoly; Suy, Simeng; Collins, Sean P

2011-01-01

260

Six-Dimensional Correction of Intra-Fractional Prostate Motion with CyberKnife Stereotactic Body Radiation Therapy  

PubMed Central

Large fraction radiation therapy offers a shorter course of treatment and radiobiological advantages for prostate cancer treatment. The CyberKnife is an attractive technology for delivering large fraction doses based on the ability to deliver highly conformal radiation therapy to moving targets. In addition to intra-fractional translational motion (left–right, superior–inferior, and anterior–posterior), prostate rotation (pitch, roll, and yaw) can increase geographical miss risk. We describe our experience with six-dimensional (6D) intra-fraction prostate motion correction using CyberKnife stereotactic body radiation therapy (SBRT). Eighty-eight patients were treated by SBRT alone or with supplemental external radiation therapy. Trans-perineal placement of four gold fiducials within the prostate accommodated X-ray guided prostate localization and beam adjustment. Fiducial separation and non-overlapping positioning permitted the orthogonal imaging required for 6D tracking. Fiducial placement accuracy was assessed using the CyberKnife fiducial extraction algorithm. Acute toxicities were assessed using Common Toxicity Criteria v3. There were no Grade 3, or higher, complications and acute morbidity was minimal. Ninety-eight percent of patients completed treatment employing 6D prostate motion tracking with intra-fractional beam correction. Suboptimal fiducial placement limited treatment to 3D tracking in two patients. Our experience may guide others in performing 6D correction of prostate motion with CyberKnife SBRT. PMID:22655248

Lei, Siyuan; Piel, Nathaniel; Oermann, Eric K.; Chen, Viola; Ju, Andrew W.; Dahal, Kedar N.; Hanscom, Heather N.; Kim, Joy S.; Yu, Xia; Zhang, Guowei; Collins, Brian T.; Jha, Reena; Dritschilo, Anatoly; Suy, Simeng; Collins, Sean P.

2011-01-01

261

Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy.  

PubMed

Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12 weeks of endurance training. Primary endpoints were insulin sensitivity (euglycemic-hyperinsulinemic clamps with concomitant glucose-tracer infusion) and body composition (dual-energy X-ray absorptiometry and magnetic resonance imaging). The secondary endpoint was systemic inflammation. Statistical analysis was carried out using two-way ANOVA. Endurance training increased VO2max (ml(O2)/min per kg) by 11 and 13% in the patients and controls respectively (P<0.0001). The patients and controls demonstrated an increase in peripheral tissue insulin sensitivity of 14 and 11% respectively (P<0.05), with no effect on hepatic insulin sensitivity (P=0.32). Muscle protein content of GLUT4 (SLC2A4) and total AKT (AKT1) was also increased in response to the training (P<0.05 and P<0.01 respectively). Body weight (P<0.0001) and whole-body fat mass (FM) (P<0.01) were reduced, while lean body mass (P=0.99) was unchanged. Additionally, reductions were observed in abdominal (P<0.01), subcutaneous (P<0.05), and visceral (P<0.01) FM amounts. The concentrations of plasma markers of systemic inflammation were unchanged in response to the training. No group × time interactions were observed, except for thigh intermuscular adipose tissue (IMAT) (P=0.01), reflecting a significant reduction in the amount of IMAT in the controls (P<0.05) not observed in the patients (P=0.64). In response to endurance training, ADT-treated prostate cancer patients exhibited improved insulin sensitivity and body composition to a similar degree as eugonadal men. PMID:23744766

Hvid, Thine; Winding, Kamilla; Rinnov, Anders; Dejgaard, Thomas; Thomsen, Carsten; Iversen, Peter; Brasso, Klaus; Mikines, Kari J; van Hall, Gerrit; Lindegaard, Birgitte; Solomon, Thomas P J; Pedersen, Bente K

2013-10-01

262

A pilot study of intensity modulated radiation therapy with hypofractionated stereotactic body radiation therapy (SBRT) boost in the treatment of intermediate- to high-risk prostate cancer.  

PubMed

Clinical data suggest that large radiation fractions are biologically superior to smaller fraction sizes in prostate cancer radiotherapy. The CyberKnife is an appealing delivery system for hypofractionated radiosurgery due to its ability to deliver highly conformal radiation and to track and adjust for prostate motion in real-time. We report our early experience using the CyberKnife to deliver a hypofractionated stereotactic body radiation therapy (SBRT) boost to patients with intermediate- to high-risk prostate cancer. Twenty-four patients were treated with hypofractionated SBRT and supplemental external radiation therapy plus or minus androgen deprivation therapy (ADT). Patients were treated with SBRT to a dose of 19.5 Gy in 3 fractions followed by intensity modulated radiation therapy (IMRT) to a dose of 50.4 Gy in 28 fractions. Quality of life data were collected with American Urological Association (AUA) symptom score and Expanded Prostate Cancer Index Composite (EPIC) questionnaires before and after treatment. PSA responses were monitored; acute urinary and rectal toxicities were assessed using Common Toxicity Criteria (CTC) v3. All 24 patients completed the planned treatment with an average follow-up of 9.3 months. For patients who did not receive ADT, the median pre-treatment PSA was 10.6 ng/ml and decreased in all patients to a median of 1.5 ng/ml by 6 months post-treatment. Acute effects associated with treatment included Grade 2 urinary and gastrointestinal toxicity but no patient experienced acute Grade 3 or greater toxicity. AUA and EPIC scores returned to baseline by six months post-treatment. Hypofractionated SBRT combined with IMRT offers radiobiological benefits of a large fraction boost for dose escalation and is a well tolerated treatment option for men with intermediate- to high-risk prostate cancer. Early results are encouraging with biochemical response and acceptable toxicity. These data provide a basis for the design of a phase II clinical trial. PMID:20815416

Oermann, Eric K; Slack, Rebecca S; Hanscom, Heather N; Lei, Sue; Suy, Simeng; Park, Hyeon U; Kim, Joy S; Sherer, Benjamin A; Collins, Brian T; Satinsky, Andrew N; Harter, K William; Batipps, Gerald P; Constantinople, Nicholas L; Dejter, Stephen W; Maxted, William C; Regan, James B; Pahira, John J; McGeagh, Kevin G; Jha, Reena C; Dawson, Nancy A; Dritschilo, Anatoly; Lynch, John H; Collins, Sean P

2010-10-01

263

Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control  

Microsoft Academic Search

Background  Melanoma and renal cell carcinoma (RCC) are traditionally considered less radioresponsive than other histologies. Whereas\\u000a stereotactic body radiation therapy (SBRT) involves radiation dose intensification via escalation, we hypothesize SBRT might\\u000a result in similar high local control rates as previously published on metastases of varying histologies.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The records of patients with metastatic melanoma (n = 17 patients, 28 lesions) or RCC

Michelle A Stinauer; Brian D Kavanagh; Tracey E Schefter; Rene Gonzalez; Thomas Flaig; Karl Lewis; William Robinson; Mark Chidel; Michael Glode; David Raben

2011-01-01

264

Mixed quantum/classical theory of rotationally and vibrationally inelastic scattering in space-fixed and body-fixed reference frames  

SciTech Connect

We formulated the mixed quantum/classical theory for rotationally and vibrationally inelastic scattering process in the diatomic molecule + atom system. Two versions of theory are presented, first in the space-fixed and second in the body-fixed reference frame. First version is easy to derive and the resultant equations of motion are transparent, but the state-to-state transition matrix is complex-valued and dense. Such calculations may be computationally demanding for heavier molecules and/or higher temperatures, when the number of accessible channels becomes large. In contrast, the second version of theory requires some tedious derivations and the final equations of motion are rather complicated (not particularly intuitive). However, the state-to-state transitions are driven by real-valued sparse matrixes of much smaller size. Thus, this formulation is the method of choice from the computational point of view, while the space-fixed formulation can serve as a test of the body-fixed equations of motion, and the code. Rigorous numerical tests were carried out for a model system to ensure that all equations, matrixes, and computer codes in both formulations are correct.

Semenov, Alexander; Babikov, Dmitri, E-mail: dmitri.babikov@mu.edu [Chemistry Department, Wehr Chemistry Building, Marquette University, Milwaukee, Wisconsin 53201-1881 (United States)] [Chemistry Department, Wehr Chemistry Building, Marquette University, Milwaukee, Wisconsin 53201-1881 (United States)

2013-11-07

265

Proton Arc Reduces Range Uncertainty Effects and Improves Conformality Compared With Photon Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer  

SciTech Connect

Purpose: To describe, in a setting of non-small cell lung cancer (NSCLC), the theoretical dosimetric advantages of proton arc stereotactic body radiation therapy (SBRT) in which the beam penumbra of a rotating beam is used to reduce the impact of range uncertainties. Methods and Materials: Thirteen patients with early-stage NSCLC treated with proton SBRT underwent repeat planning with photon volumetric modulated arc therapy (Photon-VMAT) and an in-house-developed arc planning approach for both proton passive scattering (Passive-Arc) and intensity modulated proton therapy (IMPT-Arc). An arc was mimicked with a series of beams placed at 10° increments. Tumor and organ at risk doses were compared in the context of high- and low-dose regions, represented by volumes receiving >50% and <50% of the prescription dose, respectively. Results: In the high-dose region, conformality index values are 2.56, 1.91, 1.31, and 1.74, and homogeneity index values are 1.29, 1.22, 1.52, and 1.18, respectively, for 3 proton passive scattered beams, Passive-Arc, IMPT-Arc, and Photon-VMAT. Therefore, proton arc leads to a 30% reduction in the 95% isodose line volume to 3-beam proton plan, sparing surrounding organs, such as lung and chest wall. For chest wall, V30 is reduced from 21 cm{sup 3} (3 proton beams) to 11.5 cm{sup 3}, 12.9 cm{sup 3}, and 8.63 cm{sup 3} (P=.005) for Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. In the low-dose region, the mean lung dose and V20 of the ipsilateral lung are 5.01 Gy(relative biological effectiveness [RBE]), 4.38 Gy(RBE), 4.91 Gy(RBE), and 5.99 Gy(RBE) and 9.5%, 7.5%, 9.0%, and 10.0%, respectively, for 3-beam, Passive-Arc, IMPT-Arc, and Photon-VMAT, respectively. Conclusions: Stereotactic body radiation therapy with proton arc and Photon-VMAT generate significantly more conformal high-dose volumes than standard proton SBRT, without loss of coverage of the tumor and with significant sparing of nearby organs, such as chest wall. In addition, both proton arc approaches spare the healthy lung from low-dose radiation relative to photon VMAT. Our data suggest that IMPT-Arc should be developed for clinical use.

Seco, Joao, E-mail: jseco@partners.org [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Gu, Guan; Marcelos, Tiago; Kooy, Hanne; Willers, Henning [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2013-09-01

266

Impact of l-citrulline supplementation and whole-body vibration training on arterial stiffness and leg muscle function in obese postmenopausal women with high blood pressure.  

PubMed

Aging is associated with increased arterial stiffness (pulse wave velocity, PWV) and muscle strength/mass loss. Exercise training alone is not always effective to improve PWV and lean mass (LM) in older women. To investigate the independent and combined effects of whole-body vibration training (WBVT) and l-citrulline supplementation on PWV and muscle function in women, forty-one postmenopausal women aged 58±3years and body mass index (34±2kg/m(2)) were randomly assigned to the following groups: WBVT, l-citrulline, and WBVT+l-citrulline for 8weeks. WBVT consisted of four leg exercises three times weekly. Aortic (cfPWV) and leg (faPWV) PWV, leg LM index, leg strength, and body fat percentage (BF%) were measured before and after the interventions. WBVT+l-citrulline decreased cfPWV (-0.91±0.21m/s, P<0.01) compared to both groups. All interventions decreased faPWV (P<0.05) similarly. Leg LM index increased (2.7±0.5%, P<0.001) after WBVT+l-citrulline compared with l-citrulline. Both WBVT interventions increased leg strength (~37%, P<0.001) compared to l-citrulline while decreased BF% (~2.0%, P<0.01). Reductions in cfPWV were correlated with increases in leg LM index (r=-0.63, P<0.05). Our findings suggest that leg muscle strength and arterial stiffness can be improved after WBVT, but its combination with l-citrulline supplementation enhanced benefits on aortic stiffness and leg LM. Therefore, WBVT+l-citrulline could be an intervention for improving arterial stiffness and leg muscle function in obese postmenopausal women with prehypertension or hypertension, thereby reducing their cardiovascular and disability risk. PMID:25636814

Figueroa, Arturo; Alvarez-Alvarado, Stacey; Ormsbee, Michael J; Madzima, Takudzwa A; Campbell, Jeremiah C; Wong, Alexei

2015-03-01

267

Mild Increases in Body Temperature Could Improve Anticancer Therapy | Physical Sciences in Oncology  

Cancer.gov

One of the consistent characteristics of human solid tumors is that they exert a significant outward pressure that inhibits the ability of drugs to reach the inner recesses of the tumor. Most solid tumors are also hypoxic, that is, the oxygen concentration deep inside tumors is much lower than is normal in human tissues, and this hypoxia also works against many anticancer therapies.

268

Dose Escalation, Not "New Biology," Can Account for the Efficacy of Stereotactic Body Radiation Therapy With  

E-print Network

of certain tumors (1), including some lung cancers, liver metastases, brain metastases, recurrent brain Radiation Therapy With Non-Small Cell Lung Cancer J. Martin Brown, PhD,* David J. Brenner, PhD,y and David J tumors, spinal metastases, and kidney and pancreatic tumors. Typically SBRT involves the delivery of 1

Brenner, David Jonathan

269

Systematic measurements of whole-body imaging dose distributions in image-guided radiation therapy  

SciTech Connect

Purpose: The full benefit of the increased precision of contemporary treatment techniques can only be exploited if the accuracy of the patient positioning is guaranteed. Therefore, more and more imaging modalities are used in the process of the patient setup in clinical routine of radiation therapy. The improved accuracy in patient positioning, however, results in additional dose contributions to the integral patient dose. To quantify this, absorbed dose measurements from typical imaging procedures involved in an image-guided radiation therapy treatment were measured in an anthropomorphic phantom for a complete course of treatment. The experimental setup, including the measurement positions in the phantom, was exactly the same as in a preceding study of radiotherapy stray dose measurements. This allows a direct combination of imaging dose distributions with the therapy dose distribution. Methods: Individually calibrated thermoluminescent dosimeters were used to measure absorbed dose in an anthropomorphic phantom at 184 locations. The dose distributions from imaging devices used with treatment machines from the manufacturers Accuray, Elekta, Siemens, and Varian and from computed tomography scanners from GE Healthcare were determined and the resulting effective dose was calculated. The list of investigated imaging techniques consisted of cone beam computed tomography (kilo- and megavoltage), megavoltage fan beam computed tomography, kilo- and megavoltage planar imaging, planning computed tomography with and without gating methods and planar scout views. Results: A conventional 3D planning CT resulted in an effective dose additional to the treatment stray dose of less than 1 mSv outside of the treated volume, whereas a 4D planning CT resulted in a 10 times larger dose. For a daily setup of the patient with two planar kilovoltage images or with a fan beam CT at the TomoTherapy unit, an additional effective dose outside of the treated volume of less than 0.4 mSv and 1.4 mSv was measured, respectively. Using kilovoltage or megavoltage radiation to obtain cone beam computed tomography scans led to an additional dose of 8-46 mSv. For treatment verification images performed once per week using double exposure technique, an additional effective dose of up to 18 mSv was measured. Conclusions: Daily setup imaging using kilovoltage planar images or TomoTherapy megavoltage fan beam CT imaging can be used as a standard procedure in clinical routine. Daily kilovoltage and megavoltage cone beam computed tomography setup imaging should be applied on an individual or indication based protocol. Depending on the imaging scheme applied, image-guided radiation therapy can be administered without increasing the dose outside of the treated volume compared to therapies without image guidance.

Haelg, Roger A.; Besserer, Juergen; Schneider, Uwe [Radiotherapie Hirslanden AG, Institute for Radiotherapy, Aarau 5000 (Switzerland); Vetsuisse Faculty, University of Zurich, Zurich 8057 (Switzerland) and Radiotherapie Hirslanden AG, Institute for Radiotherapy, Aarau 5000 (Switzerland)

2012-12-15

270

MINDFUL AWARENESS IN BODY-ORIENTED THERAPY FOR FEMALE VETERANS WITH POST-TRAUMATIC STRESS DISORDER TAKING PRESCRIPTION ANALGESICS FOR CHRONIC PAIN: A FEASIBILITY STUDY  

PubMed Central

Context Preliminary studies of body therapy for women in trauma recovery suggest positive results but are not specific to women with post-traumatic stress disorder (PTSD) and chronic pain. Objective and Participants To examine the feasibility and acceptability of body-oriented therapy for female veterans with PTSD and chronic pain taking prescription analgesics. Design and Setting A 2-group, randomized, repeated-measures design was employed. Female veterans (N=14) were recruited from a Veterans Affairs (VA) healthcare system in the Northwest United States (VA Puget Sound Health Care System, Seattle, Washington). Participants were assigned to either treatment as usual (TAU) or treatment as usual and 8 weekly individual body-oriented therapy sessions (mindful awareness in body-oriented therapy group). Measures Written questionnaires and interviews were used assess intervention acceptability; reliable and valid measures were administered at 3 time points to evaluate measurement acceptability and performance; and within-treatment process measures and a participant post-intervention questionnaire assessed treatment fidelity. Intervention A body-oriented therapy protocol, “Mindful Awareness in Body-oriented Therapy” (MABT) was used. This is a mind-body approach that incorporates massage, mindfulness, and the emotional processing of psychotherapy. Results Over 10 weeks of recruitment, 31 women expressed interest in study participation. The primary reason for exclusion was the lack of prescription analgesic use for chronic pain. Study participants adhered to study procedures, and 100% attended at least 7 of 8 sessions; all completed in-person post-treatment assessment. Written questionnaires about intervention experience suggest increased tools for pain relief/relaxation, increased body/mind connection, and increased trust/safety. Ten of 14 responded to mailed 3-month follow-up. The response-to-process measures indicated the feasibility of implementing the manualized protocol and point to the need for longer sessions and a longer intervention period with this population. PMID:17985809

Price, Cynthia J.; McBride, Brittney; Hyerle, Lynne; Kivlahan, Daniel R.

2011-01-01

271

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy  

PubMed Central

Prostate cancer (PCa) is the most common visceral malignancy in men with androgen deprivation therapy (ADT) the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data (up to 2 years) for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality. PMID:22367184

Storer, Thomas W; Miciek, Renee; Travison, Thomas G

2012-01-01

272

Perceived outcomes of music therapy with Body Tambura in end of life care – a qualitative pilot study  

PubMed Central

Background In recent years, music therapy is increasingly used in palliative care. The aim of this pilot study was to record and describe the subjective experiences of patients and their relatives undergoing music therapy with a Body Tambura in a German hospice and to develop hypotheses for future studies. Methods In a qualitative interview pilot study, data collection and analyses were performed according to the methodological framework of grounded theory. We included German-speaking patients, or relatives of patients, receiving end of life care in an inpatient hospice setting. Results 11 persons consisting of 8 patients (age range 51–82 years, 4 male and 4 female) and 3 relatives were treated and interviewed. All patients suffered from cancer in an advanced stage. The most often described subjective experiences were a relaxing and calming effect, sensations that the body feels lighter, and the generation of relaxing images and visualizations. Family members enjoyed listening to the music and felt more connected with the sick family member. Conclusion Patient reported beneficial aspects. The small sample size could be seen as a limitation. Assessment instruments measuring relaxation, stress, quality of life and should be included in future quantitative studies. PMID:24708801

2014-01-01

273

Mindful awareness in body-oriented therapy as an adjunct to women's substance use disorder treatment: a pilot feasibility study.  

PubMed

This study examined mindful awareness in body-oriented therapy (MABT) feasibility as a novel adjunct to women's substance use disorder (SUD) treatment. As an individual therapy, MABT combines manual and mind-body approaches to develop interoception and self-care tools for emotion regulation. A 2-group randomized controlled trial repeated-measures design was used, comparing MABT to treatment as usual (TAU) on relapse to substance use and related health outcomes. Sixty-one women were screened for eligibility, and 46 enrolled. Participants randomized to MABT received 8 weekly MABT sessions. Results showed moderate to large effects, including significantly fewer days on substance use, the primary outcome, for MABT compared with TAU at posttest. Secondary outcomes showed improved eating disorder symptoms, depression, anxiety, dissociation, perceived stress, physical symptom frequency, and bodily dissociation for MABT compared with TAU at the 9-month follow-up. In conclusion, it is feasible to implement MABT in women's SUD treatment, and results suggest that MABT is worthy of further efficacy testing. PMID:22119181

Price, Cynthia J; Wells, Elizabeth A; Donovan, Dennis M; Rue, Tessa

2012-07-01

274

Adaptive Liver Stereotactic Body Radiation Therapy: Automated Daily Plan Reoptimization Prevents Dose Delivery Degradation Caused by Anatomy Deformations  

SciTech Connect

Purpose: To investigate how dose distributions for liver stereotactic body radiation therapy (SBRT) can be improved by using automated, daily plan reoptimization to account for anatomy deformations, compared with setup corrections only. Methods and Materials: For 12 tumors, 3 strategies for dose delivery were simulated. In the first strategy, computed tomography scans made before each treatment fraction were used only for patient repositioning before dose delivery for correction of detected tumor setup errors. In adaptive second and third strategies, in addition to the isocenter shift, intensity modulated radiation therapy beam profiles were reoptimized or both intensity profiles and beam orientations were reoptimized, respectively. All optimizations were performed with a recently published algorithm for automated, multicriteria optimization of both beam profiles and beam angles. Results: In 6 of 12 cases, violations of organs at risk (ie, heart, stomach, kidney) constraints of 1 to 6 Gy in single fractions occurred in cases of tumor repositioning only. By using the adaptive strategies, these could be avoided (<1 Gy). For 1 case, this needed adaptation by slightly underdosing the planning target volume. For 2 cases with restricted tumor dose in the planning phase to avoid organ-at-risk constraint violations, fraction doses could be increased by 1 and 2 Gy because of more favorable anatomy. Daily reoptimization of both beam profiles and beam angles (third strategy) performed slightly better than reoptimization of profiles only, but the latter required only a few minutes of computation time, whereas full reoptimization took several hours. Conclusions: This simulation study demonstrated that replanning based on daily acquired computed tomography scans can improve liver stereotactic body radiation therapy dose delivery.

Leinders, Suzanne M. [Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Delft University of Technology, Delft (Netherlands); Breedveld, Sebastiaan; Méndez Romero, Alejandra [Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Schaart, Dennis [Delft University of Technology, Delft (Netherlands); Seppenwoolde, Yvette, E-mail: y.seppenwoolde@erasmusmc.nl [Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Heijmen, Ben J.M. [Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

2013-12-01

275

NOTE: Individual radiation therapy patient whole-body phantoms for peripheral dose evaluations: method and specific software  

NASA Astrophysics Data System (ADS)

This study presents a method aimed at creating radiotherapy (RT) patient-adjustable whole-body phantoms to permit retrospective and prospective peripheral dose evaluations for enhanced patient radioprotection. Our strategy involves virtual whole-body patient models (WBPM) in different RT treatment positions for both genders and for different age groups. It includes a software tool designed to match the anatomy of the phantoms with the anatomy of the actual patients, based on the quality of patient data available. The procedure for adjusting a WBPM to patient morphology includes typical dimensions available in basic auxological tables for the French population. Adjustment is semi-automatic. Because of the complexity of the human anatomy, skilled personnel are required to validate changes made in the phantom anatomy. This research is part of a global project aimed at proposing appropriate methods and software tools capable of reconstituting the anatomy and dose evaluations in the entire body of RT patients in an adapted treatment planning system (TPS). The graphic user interface is that of a TPS adapted to obtain a comfortable working process. Such WBPM have been used to supplement patient therapy planning images, usually restricted to regions involved in treatment. Here we report, as an example, the case of a patient treated for prostate cancer whose therapy planning images were complemented by an anatomy model. Although present results are preliminary and our research is ongoing, they appear encouraging, since such patient-adjusted phantoms are crucial in the optimization of radiation protection of patients and for follow-up studies.

Alziar, I.; Bonniaud, G.; Couanet, D.; Ruaud, J. B.; Vicente, C.; Giordana, G.; Ben-Harrath, O.; Diaz, J. C.; Grandjean, P.; Kafrouni, H.; Chavaudra, J.; Lefkopoulos, D.; de Vathaire, F.; Diallo, I.

2009-09-01

276

Sibutramine Plus Meal Replacement Therapy for Body Weight Loss and Maintenance in Obese Patients  

Microsoft Academic Search

Objective: Our objective was to assess the efficacy and safety of sibutramine with a low-calorie diet (LCD) and commercial meal-replacement product in achieving weight loss and weight-loss maintenance in obese patients.Research Methods and Procedures: Eight U.S. centers recruited 148 obese patients for a 3-month comprehensive weight-loss therapy (Phase I) comprising daily sibutramine 10 mg + LCD (two Slim-Fast meal-replacement shakes,

James L. Early; Caroline M. Apovian; Louis J. Aronne; Madelyn H. Fernstrom; Arthur Frank; Frank L. Greenway; David Heber; Robert F. Kushner; Kristine M. Cwik; Julia K. Walch; Ann C. Hewkin; Vicky Blakesley

2007-01-01

277

Accurate tumor localization and tracking in radiation therapy using wireless body sensor networks.  

PubMed

Radiation therapy is an effective method to combat cancerous tumors by killing the malignant cells or controlling their growth. Knowing the exact position of the tumor is a very critical prerequisite in radiation therapy. Since the position of the tumor changes during the process of radiation therapy due to the patient?s movements and respiration, a real-time tumor tracking method is highly desirable in order to deliver a sufficient dose of radiation to the tumor region without damaging the surrounding healthy tissues. In this paper, we develop a novel tumor positioning method based on spatial sparsity. We estimate the position by processing the received signals from only one implantable RF transmitter. The proposed method uses less number of sensors compared to common magnetic transponder based approaches. The performance of the proposed method is evaluated in two different cases: (1) when the tissue configuration is perfectly determined (acquired beforehand by MRI or CT) and (2) when there are some uncertainties about the tissue boundaries. The results demonstrate the high accuracy and performance of the proposed method, even when the tissue boundaries are imperfectly known. PMID:24832352

Pourhomayoun, Mohammad; Jin, Zhanpeng; Fowler, Mark

2014-07-01

278

Increased Bowel Toxicity in Patients Treated With a Vascular Endothelial Growth Factor Inhibitor (VEGFI) After Stereotactic Body Radiation Therapy (SBRT)  

SciTech Connect

Purpose: Gastrointestinal injury occurs rarely with agents that affect the vascular endothelial growth factor receptor and with abdominal stereotactic body radiation therapy (SBRT). We explored the incidence of serious bowel injury (SBI) in patients treated with SBRT with or without vascular endothelial growth factor inhibitor (VEGFI) therapy. Methods and Materials: Seventy-six patients with 84 primary or metastatic intra-abdominal lesions underwent SBRT (median dose, 50 Gy in 5 fractions). Of the patients, 20 (26%) received VEGFI within 2 years after SBRT (bevacizumab, n=14; sorafenib, n=4; pazopanib, n=1; sunitinib, n=1). The incidence of SBI (Common Terminology Criteria for Adverse Events, version 4.0, grade 3-5 ulceration or perforation) after SBRT was obtained, and the relationship between SBI and VEGFI was examined. Results: In the combined population, 7 patients (9%) had SBI at a median of 4.6 months (range, 3-17 months) from SBRT. All 7 had received VEGFI before SBI and within 13 months of completing SBRT, and 5 received VEGFI within 3 months of SBRT. The 6-month estimate of SBI in the 26 patients receiving VEGFI within 3 months of SBRT was 38%. No SBIs were noted in the 63 patients not receiving VEGFI. The log–rank test showed a significant correlation between SBI and VEGFI within 3 months of SBRT (P=.0006) but not between SBI and radiation therapy bowel dose (P=.20). Conclusions: The combination of SBRT and VEGFI results in a higher risk of SBI than would be expected with either treatment independently. Local therapies other than SBRT may be considered if a patient is likely to receive a VEGFI in the near future.

Barney, Brandon M., E-mail: barney.brandon@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Markovic, Svetomir N. [Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota (United States); Laack, Nadia N.; Miller, Robert C.; Sarkaria, Jann N. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Macdonald, O. Kenneth [Therapeutic Radiologists Incorporated, Kansas City, Kansas (United States); Bauer, Heather J.; Olivier, Kenneth R. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

2013-09-01

279

Vibration manual  

NASA Technical Reports Server (NTRS)

Guidelines of the methods and applications used in vibration technology at the MSFC are presented. The purpose of the guidelines is to provide a practical tool for coordination and understanding between industry and government groups concerned with vibration of systems and equipments. Topics covered include measuring, reducing, analyzing, and methods for obtaining simulated environments and formulating vibration specifications. Methods for vibration and shock testing, theoretical aspects of data processing, vibration response analysis, and techniques of designing for vibration are also presented.

Green, C.

1971-01-01

280

Effects of an eight-week whole body vibration on lower extremity muscle tone and function in children with cerebral palsy.  

PubMed

The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy with a complete crossover design. Sixteen participants aged 9.2 (2.1) years participated in this study. Half of the participants received a 10-min WBV, 3 times a week for 8 weeks. Then a 4-week washout period followed, after which they received a sham WBV 3 times a week for 8 weeks. The other half received the intervention in a reversed order. The participants were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, 1 day after, and 3 days after each intervention. Repeated-measures analyses revealed significant beneficial effects on most variables expect the passive range-of-motion measurement. Significant correlations were found between timed up-and-go and relaxation index, and between timed up-and-go and six-minute walk test. The results suggested that an 8-week WBV intervention normalized muscle tone, improved active joint range and enhanced ambulatory performance in children with cerebral palsy for at least 3 days. These indicated that regular WBV can serve as an alternative, safe, and efficient treatment for these children in both clinical and home settings. PMID:25575288

Cheng, Hsin-Yi Kathy; Yu, Yu-Chun; Wong, Alice May-Kuen; Tsai, Yung-Shen; Ju, Yan-Ying

2015-03-01

281

Neuromotor Transmissibility of Horizontal Seatpan Vibration  

E-print Network

Exposure to occupational whole body vibration (WBV) is associated with low back pain disorders, musculoskeletal disorders, and degeneration of spine. Transmission of vibration to the neuromotor system may play a role in the etiology...

Channamallu, Raghu Ram

2007-12-16

282

Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil.  

PubMed

This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:25175295

Edmonds, Alexander; Sanabria, Emilia

2014-01-01

283

Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil  

PubMed Central

This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:25175295

Edmonds, Alexander; Sanabria, Emilia

2014-01-01

284

Assessment of organ specific neutron equivalent doses in proton therapy using computational whole-body age-dependent voxel phantoms  

PubMed Central

Proton beams used for radiotherapy will produce neutrons when interacting with matter. The purpose of this study was to quantify the equivalent dose to tissue due to secondary neutrons in pediatric and adult patients treated by proton therapy for brain lesions. Assessment of the equivalent dose to organs away from the target requires whole-body geometrical information. Furthermore, because patient geometry depends on age at exposure, age-dependent representations are also needed. We implemented age-dependent phantoms into our proton Monte Carlo dose calculation environment. We considered 8 typical radiation fields, 2 of which had been previously used to treat pediatric patients. The other 6 fields were additionally considered to allow a systematic study of equivalent doses as a function of field parameters. For all phantoms and all fields, we simulated organ specific equivalent neutron doses and analyzed for each organ (1) the equivalent dose due to neutrons as a function of distance to the target; (2) the equivalent dose due to neutrons as a function of patient age; (3) the equivalent dose due to neutrons as a function of field parameters; and (4) the ratio of contributions to secondary dose from the treatment head versus the contribution from the patient’s body tissues. This work reports organ specific equivalent neutron doses for up to 48 organs in a patient. We demonstrate quantitatively how organ equivalent doses for adult and pediatric patients vary as a function of patient’s age, organ, and field parameters. Neutron doses increase with increasing range and modulation width but decrease with field size (as defined by the aperture). We analyzed the ratio of neutron dose contributions from the patient and from the treatment head, and found that neutron equivalent doses fall off rapidly as a function of distance from the target, in agreement with experimental data. It appears that for the fields used in this study, the neutron dose lateral to the field is smaller than the reported scattered photon doses in a typical intensity modulated photon treatment. Most importantly, our study shows that neutron doses to specific organs depend considerably on the patient’s age and body stature. The younger the patient, the higher the dose deposited due to neutrons. Given the fact that the risk also increases with decreasing patient age, this factor needs to be taken into account when treating pediatric patients of very young ages and/or of small body size. The neutron dose from a course of proton therapy treatment (assuming 70 Gy in 30 fractions) could potentially (depending on patient’s age, organ, treatment site and area of CT scan) be equivalent to up to ?30 CT scans. PMID:18199910

Jarlskog, Christina Zacharatou; Lee, Choonik; Bolch, Wesley E.; Xu, X. George

2009-01-01

285

Accelerometer-based wireless body area network to estimate intensity of therapy in post-acute rehabilitation  

PubMed Central

Background It has been suggested that there is a dose-response relationship between the amount of therapy and functional recovery in post-acute rehabilitation care. To this day, only the total time of therapy has been investigated as a potential determinant of this dose-response relationship because of methodological and measurement challenges. The primary objective of this study was to compare time and motion measures during real life physical therapy with estimates of active time (i.e. the time during which a patient is active physically) obtained with a wireless body area network (WBAN) of 3D accelerometer modules positioned at the hip, wrist and ankle. The secondary objective was to assess the differences in estimates of active time when using a single accelerometer module positioned at the hip. Methods Five patients (77.4 ± 5.2 y) with 4 different admission diagnoses (stroke, lower limb fracture, amputation and immobilization syndrome) were recruited in a post-acute rehabilitation center and observed during their physical therapy sessions throughout their stay. Active time was recorded by a trained observer using a continuous time and motion analysis program running on a Tablet-PC. Two WBAN configurations were used: 1) three accelerometer modules located at the hip, wrist and ankle (M3) and 2) one accelerometer located at the hip (M1). Acceleration signals from the WBANs were synchronized with the observations. Estimates of active time were computed based on the temporal density of the acceleration signals. Results A total of 62 physical therapy sessions were observed. Strong associations were found between WBANs estimates of active time and time and motion measures of active time. For the combined sessions, the intraclass correlation coefficient (ICC) was 0.93 (P ? 0.001) for M3 and 0.79 (P ? 0.001) for M1. The mean percentage of differences between observation measures and estimates from the WBAN of active time was -8.7% ± 2.0% using data from M3 and -16.4% ± 10.4% using data from M1. Conclusion WBANs estimates of active time compare favorably with results from observation-based time and motion measures. While the investigation on the association between active time and outcomes of rehabilitation needs to be studied in a larger scale study, the use of an accelerometer-based WBAN to measure active time is a promising approach that offers a better overall precision than methods relying on work sampling. Depending on the accuracy needed, the use of a single accelerometer module positioned on the hip may still be an interesting alternative to using multiple modules. PMID:18764954

Choquette, Stéphane; Hamel, Mathieu; Boissy, Patrick

2008-01-01

286

Measures of internal lumbar load in professional drivers - the use of a whole-body finite-element model for the evaluation of adverse health effects of multi-axis vibration.  

PubMed

The present study aimed to (1) employ the method for evaluation of vibration containing multiple shocks according to ISO/CD 2631-5:2014 (Model 1) and DIN SPEC 45697:2012 in a cohort of 537 professional drivers, (2) deliver the results for a re-analysis of epidemiological data obtained in the VIBRISKS study, (3) clarify the extent to which vibration acceleration and individual variables influence risk values, such as the daily compressive dose Sed and the risk factor R, and (4) compare the results with in vivo measurements and those obtained in previous studies with similar models. The risk factor R was influenced by the acceleration, lifetime exposure duration, sitting posture, age at the start of exposure and body mass/body mass index in order of decreasing effect. Age and annual and daily exposure duration had only a marginal effect. The daily compressive dose Sed and the risk factor R showed weak linear association with the daily vibration exposure A(8) and the vibration dose value VDV. The study revealed high shear forces in the lumbar spine. PMID:25290764

Schust, Marianne; Menzel, Gerhard; Hofmann, Jörg; Forta, Nazim Gizem; Pinto, Iole; Hinz, Barbara; Bovenzi, Massimo

2014-10-01

287

Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography  

SciTech Connect

Purpose: To evaluate setup error and tumor motion during beam delivery by using 4-dimensional cone beam computed tomography (4D CBCT) and to assess the adequacy of the planning target volume (PTV) margin for lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). Methods and Materials: Fifteen lung cancer patients treated by single-arc VMAT-SBRT were selected in this analysis. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on maximum inspiration and maximum expiration CT datasets from 4D CT respiratory sorting and merged into internal target volumes (ITVs). The PTV margin was isotropically taken as 5 mm. Registration was automatically performed using “pre-3D” CBCT. Treatment was performed with a D95 prescription of 50 Gy delivered in 4 fractions. The 4D tumor locations during beam delivery were determined using in-treatment 4D CBCT images acquired in each fraction. Then, the discrepancy between the actual tumor location and the ITV was evaluated in the lateral, vertical, and longitudinal directions. Results: Overall, 55 4D CBCT sets during VMAT-SBRT were successfully obtained. The amplitude of tumor motion was less than 10 mm in all directions. The average displacements between ITV and actual tumor location during treatment were 0.41 ± 0.93 mm, 0.15 ± 0.58 mm, and 0.60 ± 0.99 mm for the craniocaudal, left-right, and anteroposterior directions, respectively. The discrepancy in each phase did not exceed 5 mm in any direction. Conclusions: With in-treatment 4D CBCT, we confirmed the required PTV margins when the registration for moving target was performed using pre-3D CBCT. In-treatment 4D CBCT is a direct method for quantitatively assessing the intrafractional location of a moving target.

Takahashi, Wataru; Yamashita, Hideomi; Kida, Satoshi; Masutani, Yoshitaka; Sakumi, Akira; Ohtomo, Kuni; Nakagawa, Keiichi [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan)] [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Haga, Akihiro, E-mail: haga-haga@umin.ac.jp [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan)] [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan)

2013-07-01

288

Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy.  

PubMed

We aim for this contribution to operate bi-directionally, both as a "bedside to bench" reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial conditions. PMID:24312056

Ross, Sara N; Ware, Ken

2013-01-01

289

Dosimetric Implications of an Injection of Hyaluronic Acid for Preserving the Rectal Wall in Prostate Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: This study assessed the contribution of ahyaluronic acid (HA) injection between the rectum and the prostate to reducing the dose to the rectal wall in stereotactic body radiation therapy (SBRT). Methods and Materials: As part of a phase 2 study of hypofractionated radiation therapy (62 Gy in 20 fractions), the patients received a transperineal injection of 10 cc HA between the rectum and the prostate. A dosimetric computed tomographic (CT) scan was systematically performed before (CT1) and after (CT2) the injection. Two 9-beam intensity modulated radiation therapy-SBRT plans were optimized for the first 10 patients on both CTs according to 2 dosage levels: 5 × 6.5 Gy (PlanA) and 5 × 8.5 Gy (PlanB). Rectal wall parameters were compared with a dose–volume histogram, and the prostate–rectum separation was measured at 7 levels of the prostate on the center line of the organ. Results: For both plans, the average volume of the rectal wall receiving the 90% isodose line (V90%) was reduced up to 90% after injection. There was no significant difference (P=.32) between doses received by the rectal wall on CT1 and CT2 at the base of the prostate. This variation became significant from the median plane to the apex of the prostate (P=.002). No significant differences were found between PlanA without HA and PlanB with HA for each level of the prostate (P=.77, at the isocenter of the prostate). Conclusions: HA injection significantly reduced the dose to the rectal wall and allowed a dose escalation from 6.5 Gy to 8.5 Gy without increasing the dose to the rectum. A phase 2 study is under way in our department to assess the rate of acute and late rectal toxicities when SBRT (5 × 8.5 Gy) is combined with an injection of HA.

Chapet, Olivier, E-mail: olivier.chapet@chu-lyon.fr [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Udrescu, Corina [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Department of Medical Physics, Centre Hospitalier Lyon Sud, Pierre Benite (France); Tanguy, Ronan [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Ruffion, Alain [Department of Urology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Fenoglietto, Pascal [Department of Radiation Oncology, Centre Val d'Aurelle, Montpellier (France); Sotton, Marie-Pierre [Department of Medical Physics, Centre Hospitalier Lyon Sud, Pierre Benite (France); Devonec, Marian [Department of Urology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Colombel, Marc [Department of Urology, Hopital Edouard Herriot, Lyon (France); Jalade, Patrice [Department of Medical Physics, Centre Hospitalier Lyon Sud, Pierre Benite (France); Azria, David [Department of Radiation Oncology, Centre Val d'Aurelle, Montpellier (France)

2014-02-01

290

Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy  

PubMed Central

We aim for this contribution to operate bi-directionally, both as a “bedside to bench” reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial conditions. PMID:24312056

Ross, Sara N.; Ware, Ken

2013-01-01

291

Development of Adaptive Helicopter Seat for Aircrew Vibration Reduction  

Microsoft Academic Search

The high level vibration of helicopter flight can cause physiological harm to the aircrew and may lead to occupational health issues. This article presents the development of an adaptive helicopter seat mount to reduce the vibration levels transmitted to the aircrew body. Flight test on a Bell-412 helicopter was conducted to measure the aircrew body vibration levels and vibration transmission

Yong Chen; Viresh Wickramasinghe; David G. Zimcik

2011-01-01

292

Image-Guided Robotic Stereotactic Body Radiation Therapy for Liver Metastases: Is There a Dose Response Relationship?  

SciTech Connect

Purpose: To evaluate the outcome, tolerance, and toxicity of stereotactic body radiotherapy, using image-guided robotic radiation delivery, for the treatment of patients with unresectable liver metastases. Methods and Material: Patients were treated with real-time respiratory tracking between July 2007 and April 2009. Their records were retrospectively reviewed. Metastases from colorectal carcinoma and other primaries were not necessarily confined to liver. Toxicity was evaluated using National Cancer Institute Common Criteria for Adverse Events version 3.0. Results: Forty-two patients with 62 metastases were treated with two dose levels of 40 Gy in four Dose per Fraction (23) and 45 Gy in three Dose per Fraction (13). Median follow-up was 14.3 months (range, 3-23 months). Actuarial local control for 1 and 2 years was 90% and 86%, respectively. At last follow-up, 41 (66%) complete responses and eight (13%) partial responses were observed. Five lesions were stable. Nine lesions (13%) were locally progressed. Overall survival was 94% at 1 year and 48% at 2 years. The most common toxicity was Grade 1 or 2 nausea. One patient experienced Grade 3 epidermitis. The dose level did not significantly contribute to the outcome, toxicity, or survival. Conclusion: Image-guided robotic stereotactic body radiation therapy is feasible, safe, and effective, with encouraging local control. It provides a strong alternative for patients who cannot undergo surgery.

Vautravers-Dewas, Claire [Departement universitaire de Radiotherapie, Centre Oscar Lambret, Lille (France); Departement universitaire de Radiotherapie, Centre Georges-Francois Leclerc, Dijon (France); Dewas, Sylvain [Departement universitaire de Radiotherapie, Centre Oscar Lambret, Lille (France); Bonodeau, Francois [Service d'imagerie medicale, Centre Oscar Lambret, Lille (France); Adenis, Antoine [Departement d'Oncologie medicale, Centre Oscar Lambret, Lille (France); Lacornerie, Thomas [Departement universitaire de Radiotherapie, Centre Oscar Lambret, Lille (France); Penel, Nicolas [Departement d'Oncologie medicale, Centre Oscar Lambret, Lille (France); Lartigau, Eric [Departement universitaire de Radiotherapie, Centre Oscar Lambret, Lille (France); Mirabel, Xavier, E-mail: x-mirabel@o-lambret.fr [Departement universitaire de Radiotherapie, Centre Oscar Lambret, Lille (France)

2011-11-01

293

Effects of short-period exercise training and orlistat therapy on body composition and maximal power production capacity in obese patients.  

PubMed

We examined the effects of weight loss induced by diet-orlistat (DO) and diet-orlistat combined with exercise (DOE) on maximal work rate production (Wmax) capacity in obese patients. Total of 24 obese patients were involved in this study. Twelve of them were subjected to DO therapy only and the remaining 12 patients participated in a regular aerobic exercise-training program in addition to DO therapy (DOE). Each patient performed two incremental ramp exercise tests up to exhaustion using an electromagnetically-braked cycle ergometer: one at the onset and one at the end of the 4th week. DOE therapy caused a significant decrease in total body weight: 101.5+/-17.4 kg (basal) vs 96.3+/-17.3 kg (4 wk) associated with a significant decrease in body fat mass: 45.0+/-10.5 kg (basal) vs 40.9+/-9.8 kg (4 wk). DO therapy also resulted in a significant decrease of total body weight 94.9+/-14.9 kg (basal) vs 91.6+/-13.5 kg (4 wk) associated with small but significant decreases in body fat mass: 37.7+/-5.6 kg (basal) to 36.0+/-6.2 kg (4 wk). Weight reduction achieved during DO therapy was not associated with increased Wmax capacity: 106+/-32 W (basal) vs 106+/-33 W (4 wk), while DOE therapy resulted in a markedly increased Wmax capacity: 109+/-39 W (basal) vs 138+/-30 W (4 wk). DO therapy combined with aerobic exercise training resulted in a significant reduction of fat mass tissue and markedly improved the aerobic fitness and Wmax capacities of obese patients. Considering this improvement within such a short period, physicians should consider applying an aerobic exercise-training program to sedentary obese patients for improving their physical fitness and thereby reduce the negative outcomes of obesity. PMID:14984314

Colak, R; Ozcelik, O

2004-01-01

294

Body-wide gene therapy of Duchenne muscular dystrophy in the mdx mouse model  

PubMed Central

Duchenne muscular dystrophy is an X-linked muscle disease characterized by mutations in the dystrophin gene. Many of these can be corrected at the posttranscriptional level by skipping the mutated exon. We have obtained persistent exon skipping in mdx mice by tail vein injection with an adeno-associated viral (AAV) vector expressing antisense sequences as part of the stable cellular U1 small nuclear RNA. Systemic delivery of the AAV construct resulted in effective body-wide colonization, significant recovery of the functional properties in vivo, and lower creatine kinase serum levels, suggesting an overall decrease in muscle wasting. The transduced muscles rescued dystrophin expression and displayed a significant recovery of function toward the normal values at single muscle fiber level. This approach provides solid bases for a systemic use of AAV-mediated antisense-U1 small nuclear RNA expression for the therapeutic treatment of Duchenne muscular dystrophy. PMID:16501048

Denti, Michela Alessandra; Rosa, Alessandro; D’Antona, Giuseppe; Sthandier, Olga; De Angelis, Fernanda Gabriella; Nicoletti, Carmine; Allocca, Mariacarmela; Pansarasa, Orietta; Parente, Valeria; Musarò, Antonio; Auricchio, Alberto; Bottinelli, Roberto; Bozzoni, Irene

2006-01-01

295

Body-wide gene therapy of Duchenne muscular dystrophy in the mdx mouse model.  

PubMed

Duchenne muscular dystrophy is an X-linked muscle disease characterized by mutations in the dystrophin gene. Many of these can be corrected at the posttranscriptional level by skipping the mutated exon. We have obtained persistent exon skipping in mdx mice by tail vein injection with an adeno-associated viral (AAV) vector expressing antisense sequences as part of the stable cellular U1 small nuclear RNA. Systemic delivery of the AAV construct resulted in effective body-wide colonization, significant recovery of the functional properties in vivo, and lower creatine kinase serum levels, suggesting an overall decrease in muscle wasting. The transduced muscles rescued dystrophin expression and displayed a significant recovery of function toward the normal values at single muscle fiber level. This approach provides solid bases for a systemic use of AAV-mediated antisense-U1 small nuclear RNA expression for the therapeutic treatment of Duchenne muscular dystrophy. PMID:16501048

Denti, Michela Alessandra; Rosa, Alessandro; D'Antona, Giuseppe; Sthandier, Olga; De Angelis, Fernanda Gabriella; Nicoletti, Carmine; Allocca, Mariacarmela; Pansarasa, Orietta; Parente, Valeria; Musarò, Antonio; Auricchio, Alberto; Bottinelli, Roberto; Bozzoni, Irene

2006-03-01

296

Fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body metastases: acceptable local control and normal tissue tolerance with 5 fraction approach  

PubMed Central

This retrospective analysis examines the local control and toxicity of five-fraction fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body (VB) metastases. All patients had favorable performance status (ECOG 0–1), oligometastatic disease, and no prior spine irradiation. A prescribed dose of 30–35 Gy was delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight spine tracking. Suggested maximum spinal cord and esophagus point doses were 30 and 40 Gy, respectively. A median 30 Gy (IQR, 30–35 Gy) dose was delivered to a median prescription isodose line of 70% (IQR, 65–77%) to 20 patients. At 34 months median follow-up (IQR, 25–40 months) for surviving patients, the 1- and 2-year Kaplan–Meier local control estimates were 80 and 73%, respectively. Two of the five local failures were infield in patients who had received irradiation to the gross tumor volume and three were paravertebral failures just outside the PTV in patients with prior corpectomy. No local failures occurred in patients who completed VB radiation alone. The 1- and 2-year Kaplan–Meier overall survival estimates were 80 and 57%, respectively. Most deaths were attributed to metastatic disease; one death was attributed to local recurrence. The mean maximum point doses were 26.4 Gy (SD, 5.1 Gy) to the spinal cord and 29.1 Gy (SD, 8.9 Gy) to the esophagus. Patients receiving maximum esophagus point doses greater than 35 Gy experienced acute dysphagia (Grade I/II). No spinal cord toxicity was documented. Five-fraction fiducial-free CyberKnife SBRT is an acceptable treatment option for newly diagnosed VB metastases with promising local control rates and minimal toxicity despite the close proximity of such tumors to the spinal cord and esophagus. A prospective study aimed at further enhancing local control by targeting the intact VB and escalating the total dose is planned. PMID:22645718

Gill, Beant; Oermann, Eric; Ju, Andrew; Suy, Simeng; Yu, Xia; Rabin, Jennifer; Kalhorn, Christopher; Nair, Mani N.; Voyadzis, Jean-Marc; Unger, Keith; Collins, Sean P.; Harter, K. W.; Collins, Brian T.

2012-01-01

297

Fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body metastases: acceptable local control and normal tissue tolerance with 5 fraction approach.  

PubMed

This retrospective analysis examines the local control and toxicity of five-fraction fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body (VB) metastases. All patients had favorable performance status (ECOG 0-1), oligometastatic disease, and no prior spine irradiation. A prescribed dose of 30-35 Gy was delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight spine tracking. Suggested maximum spinal cord and esophagus point doses were 30 and 40 Gy, respectively. A median 30 Gy (IQR, 30-35 Gy) dose was delivered to a median prescription isodose line of 70% (IQR, 65-77%) to 20 patients. At 34 months median follow-up (IQR, 25-40 months) for surviving patients, the 1- and 2-year Kaplan-Meier local control estimates were 80 and 73%, respectively. Two of the five local failures were infield in patients who had received irradiation to the gross tumor volume and three were paravertebral failures just outside the PTV in patients with prior corpectomy. No local failures occurred in patients who completed VB radiation alone. The 1- and 2-year Kaplan-Meier overall survival estimates were 80 and 57%, respectively. Most deaths were attributed to metastatic disease; one death was attributed to local recurrence. The mean maximum point doses were 26.4 Gy (SD, 5.1 Gy) to the spinal cord and 29.1 Gy (SD, 8.9 Gy) to the esophagus. Patients receiving maximum esophagus point doses greater than 35 Gy experienced acute dysphagia (Grade I/II). No spinal cord toxicity was documented. Five-fraction fiducial-free CyberKnife SBRT is an acceptable treatment option for newly diagnosed VB metastases with promising local control rates and minimal toxicity despite the close proximity of such tumors to the spinal cord and esophagus. A prospective study aimed at further enhancing local control by targeting the intact VB and escalating the total dose is planned. PMID:22645718

Gill, Beant; Oermann, Eric; Ju, Andrew; Suy, Simeng; Yu, Xia; Rabin, Jennifer; Kalhorn, Christopher; Nair, Mani N; Voyadzis, Jean-Marc; Unger, Keith; Collins, Sean P; Harter, K W; Collins, Brian T

2012-01-01

298

Effect of whole-body vibration and insulin-like growth factor-I on muscle paralysis-induced bone degeneration after botulinum toxin injection in mice.  

PubMed

Botulinum toxin A (BTX)-induced muscle paralysis results in pronounced bone degradation with substantial bone loss. We hypothesized that whole-body vibration (WBV) and insulin-like growth factor-I (IGF-I) treatment can counteract paralysis-induced bone degradation following BTX injections by activation of the protein kinase B (Akt) signaling pathway. Female C57BL/6 mice (n = 60, 16 weeks) were assigned into six groups (n = 10 each): SHAM, BTX, BTX+WBV, BTX+IGF-I, BTX+WBV+IGF-I, and a baseline group, which was killed at the beginning of the study. Mice received a BTX (1.0 U/0.1 mL) or saline (SHAM) injection in the right hind limb. The BTX+IGF-I and BTX+WBV+IGF-I groups obtained daily subcutaneous injections of human IGF-I (1 ?g/day). The BTX+WBV and BTX+WBV+IGF-I groups underwent WBV (25 Hz, 2.1 g, 0.83 mm) for 30 min/day, 5 days/week for 4 weeks. Femora were scanned by pQCT, and mechanical properties were determined. On tibial sections TRAP staining, static histomorphometry, and immunohistochemical staining against Akt, phospho-Akt, IGF-IR (IGF-I receptor), and phospho-IGF-IR were conducted. BTX injection decreased trabecular and cortical bone mineral density. The WBV and WBV+IGF-I groups showed no difference in trabecular bone mineral density compared to the SHAM group. The phospho-IGF-IR and phospho-Akt stainings were not differentially altered in the injected hind limbs between groups. We found that high-frequency, low-magnitude WBV can counteract paralysis-induced bone loss following BTX injections, while we could not detect any effect of treatment with IGF-I. PMID:24292598

Niehoff, Anja; Lechner, Philipp; Ratiu, Oana; Reuter, Sven; Hamann, Nina; Brüggemann, Gert-Peter; Schönau, Eckhard; Bloch, Wilhelm; Beccard, Ralf

2014-04-01

299

The effects of passive warm-up vs. whole-body vibration on high-intensity performance during sprint cycle exercise.  

PubMed

The purpose of this study was to compare the effects of passive warm-up (PW), whole-body vibration (WBV), and control (C) on high-intensity performance during sprint cycle exercise. Six recreationally trained men performed a 30-second sprint cycle test after the 3 aforementioned conditions; each test was carried out on a different day after balanced-order experimental tests. The WBV consisted of 5 minutes of squats associated with WBV (45 Hz, 2 mm). The PW consisted of 30 minutes of PW using a thermal blanket on the thighs and legs (35 W). The C consisted of 30 minutes of no warm-up with the subject lying down. Motor neuron excitability from the vastus lateralis muscle, evaluated by electromyography (EMG), was determined before exercise at rest and during sprint cycle exercise. Blood lactate levels (BLs), evaluated by spectroscopy, and muscle temperature (MT) of the thigh, estimated indirectly by measuring skin temperature, were determined at following time points: before exercise at rest (before and after experimental conditions), immediately, and 3 minutes after the 30-second sprint cycle test. Peak power, relative power, relative work, time of peak power, and pedaling cadence were significantly higher in the WBV compared with that for C (p < 0.05). Although MT was significantly greater in PW compared with that in WBV and C before exercise (p < 0.01), no significant differences were observed between the experimental conditions for BL immediately after sprint cycle exercise (p = 0.35) and in EMG during sprint cycle exercise (p = 0.16). Thus, it is plausible to suggest WBV as a method for an acute increase in high-intensity performance during sprint cycle exercise for athletes immediately before competition or training. PMID:22293678

Avelar, Núbia C P; Costa, Sidney J; da Fonseca, Sueli F; Tossige-Gomes, Rosalina; Gripp, Fernando J; Coimbra, Cândido C; Lacerda, Ana C R

2012-11-01

300

Effect of body mass index on shifts in ultrasound-based image-guided intensity-modulated radiation therapy for abdominal malignancies  

Microsoft Academic Search

Background and purposeWe investigated whether corrective shifts determined by daily ultrasound-based image-guidance correlate with body mass index (BMI) of patients treated with image-guided intensity-modulated radiation therapy (IG-IMRT) for abdominal malignancies. The utility of daily image-guidance, particularly for patients with BMI>25.0, is examined.

Mehee Choi; Clifton D. Fuller; Samuel J. Wang; Ather Siddiqi; Adrian Wonge; Charles R. Thomas Jr.; Martin Fuss

2009-01-01

301

Ketone body therapy: from the ketogenic diet to the oral administration of ketone ester.  

PubMed

Ketone bodies (KBs), acetoacetate and ?-hydroxybutyrate (?HB), were considered harmful metabolic by-products when discovered in the mid-19th century in the urine of patients with diabetic ketoacidosis. It took physicians many years to realize that KBs are normal metabolites synthesized by the liver and exported into the systemic circulation to serve as an energy source for most extrahepatic tissues. Studies have shown that the brain (which normally uses glucose for energy) can readily utilize KBs as an alternative fuel. Even when there is diminished glucose utilization in cognition-critical brain areas, as may occur early in Alzheimer's disease (AD), there is preliminary evidence that these same areas remain capable of metabolizing KBs. Because the ketogenic diet (KD) is difficult to prepare and follow, and effectiveness of KB treatment in certain patients may be enhanced by raising plasma KB levels to ?2 mM, KB esters, such as 1,3-butanediol monoester of ?HB and glyceryl-tris-3-hydroxybutyrate, have been devised. When administered orally in controlled dosages, these esters can produce plasma KB levels comparable to those achieved by the most rigorous KD, thus providing a safe, convenient, and versatile new approach to the study and potential treatment of a variety of diseases, including epilepsy, AD, and Parkinson's disease. PMID:24598140

Hashim, Sami A; VanItallie, Theodore B

2014-09-01

302

Obstructive voiding symptoms following stereotactic body radiation therapy for prostate cancer  

PubMed Central

Background Obstructive voiding symptoms (OVS) are common following prostate cancer treatment with radiation therapy. The risk of urinary retention (UR) following hypofractionated radiotherapy has yet to be fully elucidated. This study sought to evaluate OVS and UR requiring catheterization following SBRT for prostate cancer. Methods Patients treated with SBRT for localized prostate cancer from February 2008 to July 2011 at Georgetown University were included in this study. Treatment was delivered using the CyberKnife® with doses of 35 Gy-36.25 Gy in 5 fractions. UR was prospectively scored using the CTCAE v.3. Patient-reported OVS were assessed using the IPSS-obstructive subdomain at baseline and at 1, 3, 6, 9, 12, 18 and 24 months. Associated bother was evaluated via the EPIC-26. Results 269 patients at a median age of 69 years received SBRT with a median follow-up of 3 years. The mean prostate volume was 39 cc. Prior to treatment, 50.6% of patients reported moderate to severe lower urinary track symptoms per the IPSS and 6.7% felt that weak urine stream and/or incomplete emptying were a moderate to big problem. The 2-year actuarial incidence rates of acute and late UR ? grade 2 were 39.5% and 41.4%. Alpha-antagonist utilization rose at one month (58%) and 18 months (48%) post-treatment. However, Grade 3 UR was low with only 4 men (1.5%) requiring catheterization and/or TURP. A mean baseline IPSS-obstructive score of 3.6 significantly increased to 5.0 at 1 month (p < 0.0001); however, it returned to baseline in 92.6% within a median time of 3 months. Late increases in OVS were common, but transient. Only 7.1% of patients felt that weak urine stream and/or incomplete emptying was a moderate to big problem at two years post-SBRT (p = 0.6854). Conclusions SBRT treatment caused an acute increase in OVS which peaked within the first month post-treatment, though acute UR requiring catheterization was rare. OVS returned to baseline in > 90% of patients within a median time of three months. Transient Late increases in OVS were common. However, less than 10% of patients felt that OVS were a moderate to big problem at two years post-SBRT. PMID:25056726

2014-01-01

303

Whole Body Periodic Acceleration Is an Effective Therapy to Ameliorate Muscular Dystrophy in mdx Mice  

PubMed Central

Duchenne muscular dystrophy (DMD) is a genetic disorder caused by the absence of dystrophin in both skeletal and cardiac muscles. This leads to severe muscle degeneration, and dilated cardiomyopathy that produces patient death, which in most cases occurs before the end of the second decade. Several lines of evidence have shown that modulators of nitric oxide (NO) pathway can improve skeletal muscle and cardiac function in the mdx mouse, a mouse model for DMD. Whole body periodic acceleration (pGz) is produced by applying sinusoidal motion to supine humans and in standing conscious rodents in a headward-footward direction using a motion platform. It adds small pulses as a function of movement frequency to the circulation thereby increasing pulsatile shear stress to the vascular endothelium, which in turn increases production of NO. In this study, we examined the potential therapeutic properties of pGz for the treatment of skeletal muscle pathology observed in the mdx mouse. We found that pGz (480 cpm, 8 days, 1 hr per day) decreased intracellular Ca2+ and Na+ overload, diminished serum levels of creatine kinase (CK) and reduced intracellular accumulation of Evans Blue. Furthermore, pGz increased muscle force generation and expression of both utrophin and the carboxy-terminal PDZ ligand of nNOS (CAPON). Likewise, pGz (120 cpm, 12 h) applied in vitro to skeletal muscle myotubes reduced Ca2+ and Na+ overload, diminished abnormal sarcolemmal Ca2+ entry and increased phosphorylation of endothelial NOS. Overall, this study provides new insights into the potential therapeutic efficacy of pGz as a non-invasive and non-pharmacological approach for the treatment of DMD patients through activation of the NO pathway. PMID:25181488

Altamirano, Francisco; Perez, Claudio F.; Liu, Min; Widrick, Jeffrey; Barton, Elisabeth R.; Allen, Paul D.; Adams, Jose A.; Lopez, Jose R.

2014-01-01

304

SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

Wang, T; Zhu, L [Georgia Institute of Technology, Atlanta, GA (Georgia); Khan, M; Landry, J; Rajpara, R; Hawk, N [Emory University, Atlanta, GA (United States)

2014-06-01

305

Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety  

PubMed Central

Background Concurrent chemoradiation is a standard option for locally advanced pancreatic cancer (LAPC). Concurrent conventional radiation with full-dose gemcitabine has significant toxicity. Stereotactic body radiation therapy (SBRT) may provide the opportunity to administer radiation in a shorter time frame with similar efficacy and reduced toxicity. This Pilot study assessed the safety of concurrent full-dose gemcitabine with SBRT for LAPC. Methods Patients received gemcitabine, 1000 mg/m2 for 6 cycles. During week 4 of cycle 1, patients received SBRT (25 Gy delivered in five consecutive daily fractions of 5 Gy prescribed to the 75-83% isodose line). Acute and late toxicities were assessed using NIH CTCAE v3. Tumor response was assessed by RECIST. Patients underwent an esophagogastroduodenoscopy at baseline, 2, and 6 months to assess the duodenal mucosa. Quality of life (QoL) data was collected before and after treatment using the QLQ-C30 and QLQ-PAN26 questionnaires. Results Between September 2009 and February 2011, 11 patients enrolled with one withdrawal during radiation therapy. Patients had grade 1 to 2 gastrointestinal toxicity from the start of SBRT to 2 weeks after treatment. There were no grade 3 or greater radiation-related toxicities or delays for cycle 2 of gemcitabine. On endoscopy, there were no grade 2 or higher mucosal toxicities. Two patients had a partial response. The median progression free and overall survival were 6.8 and 12.2 months, respectively. Global QoL did not change between baseline and immediately after radiation treatment. Conclusions SBRT with concurrent full dose gemcitabine is safe when administered to patients with LAPC. There is no delay in administration of radiation or chemotherapy, and radiation is completed with minimal toxicity. PMID:23452509

2013-01-01

306

Is Stereotactic Body Radiation Therapy an Attractive Option for Unresectable Liver Metastases? A Preliminary Report From a Phase 2 Trial  

SciTech Connect

Purpose: To evaluate the feasibility of high-dose stereotactic body radiation therapy (SBRT) in the treatment of unresectable liver metastases. Methods and Materials: Patients with 1 to 3 liver metastases, with maximum individual tumor diameters less than 6 cm and a Karnofsky Performance Status of at least 70, were enrolled and treated by SBRT on a phase 2 clinical trial. Dose prescription was 75 Gy on 3 consecutive days. SBRT was delivered using the volumetric modulated arc therapy by RapidArc (Varian, Palo Alto, CA) technique. The primary end-point was in-field local control. Secondary end-points were toxicity and survival. Results: Between February 2010 and September 2011, a total of 61 patients with 76 lesions were treated. Among the patients, 21 (34.3%) had stable extrahepatic disease at study entry. The most frequent primary sites were colorectal (45.9%) and breast (18%). Of the patients, 78.7% had 1 lesion, 18.0% had 2 lesions, and 3.3% had 3 lesions. After a median of 12 months (range, 2-26 months), the in-field local response rate was 94%. The median overall survival rate was 19 months, and actuarial survival at 12 months was 83.5%. None of the patients experienced grade 3 or higher acute toxicity. No radiation-induced liver disease was detected. One patient experienced G3 late toxicity at 6 months, resulting from chest wall pain. Conclusions: SBRT for unresectable liver metastases can be considered an effective, safe, and noninvasive therapeutic option, with excellent rates of local control and a low treatment-related toxicity.

Scorsetti, Marta; Arcangeli, Stefano; Tozzi, Angelo; Comito, Tiziana [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy)] [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy); Alongi, Filippo, E-mail: filippo.alongi@humanitas.it [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy)] [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy); Navarria, Pierina; Mancosu, Pietro; Reggiori, Giacomo [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy)] [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy); Fogliata, Antonella [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)] [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Torzilli, Guido [Surgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy)] [Surgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy); Tomatis, Stefano [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy)] [Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Milano (Italy); Cozzi, Luca [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)] [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

2013-06-01

307

Stereotactic Body Radiation Therapy for Primary, Recurrent, and Metastatic Tumors in the Head-and-Neck Region  

SciTech Connect

Purpose: To determine the feasibility, safety, and efficacy of stereotactic body radiation therapy (SBRT), also known as radiosurgery, in patients with head-and-neck cancers. Methods and Materials: Patients with pathologically proven malignant lesions in the head-and-neck region were treated using single-dose SBRT (S-SBRT) or fractionated SBRT (F-SBRT). Radiation doses were either single-fraction 13-18 Gy for S-SBRT or 36-48 Gy in five to eight fractions for F-SBRT. Response evaluation was based on clinical examinations and computed tomography/magnetic resonance imaging scans. Pre- and post-SBRT tumor dimensions were measured in three axes, and tumor volumes were calculated. Response evaluation also was performed using World Health Organization criteria. Results: Fifty-five lesions were treated in 44 patients (25 men, 19 women). There were three groups of patients: those with primary (n = 10), recurrent (n = 21), and metastatic tumors (n = 13). The predominant histologic type was squamous cell carcinoma (n = 33). The majority of lesions were treated using F-SBRT (n = 37). Based on radiographic and clinical assessment, a 77% (complete + partial response) response rate was noted. Percentage of reduction in tumor volume was 52% {+-} 38% based on follow-up scans in 24 patients. Tumor control rates at 1 year were 83.3% and 60.6% in the primary and recurrent groups, respectively. Median overall survival was 28.7, 6.7, and 5.6 months for the primary, recurrent, and metastatic groups, respectively. Radiation Therapy Oncology Group Grade 1-2 mucositis was noted in all patients treated for oropharyngeal or laryngeal lesions. Conclusions: The SBRT in single or fractionated doses offers a viable treatment option for selected patients with primary, recurrent, and metastatic head-and-neck cancers with functional preservation.

Siddiqui, Farzan; Patel, Mehul [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Khan, Mumtaz; McLean, Scott [Department of Otolaryngology, Head and Neck Surgery, Henry Ford Health System, Detroit, MI (United States); Dragovic, Jadranka; Jin, J.-Y.; Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Ryu, Samuel [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States)], E-mail: sryu1@hfhs.org

2009-07-15

308

Phase I Dose-Escalation Study of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer  

PubMed Central

Purpose To evaluate the tolerability of escalating doses of stereotactic body radiation therapy in the treatment of localized prostate cancer. Patients and Methods Eligible patients included those with Gleason score 2 to 6 with prostate-specific antigen (PSA) ? 20, Gleason score 7 with PSA ? 15, ? T2b, prostate size ? 60 cm3, and American Urological Association (AUA) score ? 15. Pretreatment preparation required an enema and placement of a rectal balloon. Dose-limiting toxicity (DLT) was defined as grade 3 or worse GI/genitourinary (GU) toxicity by Common Terminology Criteria of Adverse Events (version 3). Patients completed quality-of-life questionnaires at defined intervals. Results Groups of 15 patients received 45 Gy, 47.5 Gy, and 50 Gy in five fractions (45 total patients). The median follow-up is 30 months (range, 3 to 36 months), 18 months (range, 0 to 30 months), and 12 months (range, 3 to 18 months) for the 45 Gy, 47.5 Gy, and 50 Gy groups, respectively. For all patients, GI grade ? 2 and grade ? 3 toxicity occurred in 18% and 2%, respectively, and GU grade ? 2 and grade ? 3 toxicity occurred in 31% and 4%, respectively. Mean AUA scores increased significantly from baseline in the 47.5-Gy dose level (P = .002) as compared with the other dose levels, where mean values returned to baseline. Rectal quality-of-life scores (Expanded Prostate Cancer Index Composite) fell from baseline up to 12 months but trended back at 18 months. In all patients, PSA control is 100% by the nadir + 2 ng/mL failure definition. Conclusion Dose escalation to 50 Gy has been completed without DLT. A multicenter phase II trial is underway treating patients to 50 Gy in five fractions to further evaluate this experimental therapy. PMID:21464418

Boike, Thomas P.; Lotan, Yair; Cho, L. Chinsoo; Brindle, Jeffrey; DeRose, Paul; Xie, Xian-Jin; Yan, Jingsheng; Foster, Ryan; Pistenmaa, David; Perkins, Alida; Cooley, Susan; Timmerman, Robert

2011-01-01

309

Evaluation of Rotational Errors in Treatment Setup of Stereotactic Body Radiation Therapy of Liver Cancer  

SciTech Connect

Purpose: To evaluate the dosimetric impact of rotational setup errors in stereotactic body radiotherapy (SBRT) treatment of liver tumors and to investigate whether translational shifts can compensate for rotation. Methods and Materials: The positioning accuracy in 20 patients with liver malignancies treated with SBRT was reevaluated offline by matching the patients' cone-beam computed tomography (CT) scans (n=75) to the planning CT scans and adjusting the 3 rotational angles (pitch, roll, and yaw). Systematic and random setup errors were calculated. The dosimetric changes caused by rotational setup errors were quantified for both simulated and observed patient rotations. Dose distributions recalculated on the rotated CT scans were compared with the original planned doses. Translational corrections were simulated based on manual translational registration of the rotated images to the original CT scans. The correction efficacy was evaluated by comparing the recalculated plans with the original plans. Results: The systematic rotational setup errors were -0.06 Degree-Sign {+-} 0.68 Degree-Sign , -0.29 Degree-Sign {+-} 0.62 Degree-Sign , and -0.24 Degree-Sign {+-} 0.61 Degree-Sign ; the random setup errors were 0.80 Degree-Sign , 1.05 Degree-Sign , and 0.61 Degree-Sign for pitch, roll, and yaw, respectively. Analysis of CBCT images showed that 56.0%, 14.7%, and 1.3% of treated fractions had rotational errors of >1 Degree-Sign , >2 Degree-Sign , and >3 Degree-Sign , respectively, in any one of the rotational axes. Rotational simulations demonstrated that the reduction of gross tumor volume (GTV) coverage was <2% when rotation was <3 Degree-Sign . Recalculated plans using actual patient roll motions showed similar reduction (<2%) in GTV coverage. Translational corrections improved the GTV coverage to within 3% of the original values. For organs at risk (OAR), the dosimetric impact varied case by case. Conclusion: Actual rotational setup errors in SBRT for liver tumors are relatively small in magnitude and are unlikely to affect GTV coverage significantly. Translational corrections can be optimized to compensate for rotational setup errors. However, caution regarding possible dose increases to OAR needs to be exercised.

Cao Minsong; Lasley, Foster D.; Das, Indra J.; DesRosiers, Colleen M.; Slessinger, Eric D. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States)] [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Cardenes, Higinia R., E-mail: hcardene@iupui.edu [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States)

2012-11-01

310

Stereotactic Body Radiation Therapy in Centrally and Superiorly Located Stage I or Isolated Recurrent Non-Small-Cell Lung Cancer  

SciTech Connect

Purpose: To evaluate the efficacy and adverse effects of image-guided stereotactic body radiation therapy (SBRT) in centrally/superiorly located non-small-cell lung cancer (NSCLC). Materials and Methods: We delivered SBRT to 27 patients, 13 with Stage I and 14 with isolated recurrent NSCLC. A central/superior location was defined as being within 2 cm of the bronchial tree, major vessels, esophagus, heart, trachea, pericardium, brachial plexus, or vertebral body, but 1 cm away from the spinal canal. All patients underwent four-dimensional computed tomography-based planning, and daily computed tomography-on-rail guided SBRT. The prescribed dose of 40 Gy (n = 7) to the planning target volume was escalated to 50 Gy (n = 20) in 4 consecutive days. Results: With a median follow-up of 17 months (range, 6-40 months), the crude local control at the treated site was 100% using 50 Gy. However, 3 of 7 patients had local recurrences when treated using 40 Gy. Of the patients with Stage I disease, 1 (7.7%) and 2 (15.4%) developed mediastinal lymph node metastasis and distant metastases, respectively. Of the patients with recurrent disease, 3 (21.4%) and 5 (35.7%) developed mediastinal lymph node metastasis and distant metastasis, respectively. Four patients (28.6%) with recurrent disease but none with Stage I disease developed Grade 2 pneumonitis. Three patients (11.1%) developed Grade 2-3 dermatitis and chest wall pain. One patient developed brachial plexus neuropathy. No esophagitis was noted in any patient. Conclusions: Image-guided SBRT using 50 Gy delivered in four fractions is feasible and resulted in excellent local control.

Chang, Joe Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: jychang@mdanderson.org; Balter, Peter A.; Dong Lei [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Yang Qiuan; Liao Zhongxing; Jeter, Melenda; Bucci, M. Kara; McAleer, Mary F. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Mehran, Reza J.; Roth, Jack A. [Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2008-11-15

311

Daily Alignment Results of In-Room Computed Tomography-Guided Stereotactic Body Radiation Therapy for Lung Cancer  

SciTech Connect

Purpose: To determine the extent of interfractional setup errors and day-to-day organ motion errors by assessing daily bone alignment results and changes in soft tissue tumor position during hypofractionated, in-room computed tomography (CT)-guided stereotactic body radiation therapy (SBRT) of lung cancer. Methods and Materials: Daily alignment results during SBRT were analyzed for 117 tumors in 112 patients. Patients received 40-50 Gy of SBRT in four to five fractions using an integrated CT-LINAC system. The free-breathing CT scans acquired during treatment setup were retrospectively realigned to match with each of the bony references and the gross tumor volume (GTV) defined on the reference CT by rigid-body registration, and the daily deviations were calculated. Results: The mean magnitude ({+-} SD) three-dimensional shift from the initial skin marks to the final bone-aligned positions was 9.4 {+-} 5.7 mm. The mean daily GTV deviation from the bone position was 0.1 {+-} 3.8 mm in the anterior-posterior direction, -0.01 {+-} 4.2 mm in the superior-inferior direction, and 0.2 {+-} 2.5 mm in the lateral direction. A clinically noteworthy trend (net change >5 mm in any direction) in GTV position relative to the bone was observed in 23 cases (20%). Conclusions: Soft tissue target position can change significantly beyond the motion envelope defined in the original internal target volume in four-dimensional CT-based treatment planning for SBRT of lung cancer. Additional margin should be considered for adequate coverage of interfractional changes.

Ikushima, Hitoshi; Balter, Peter [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hunjun, Sandeep [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Bucci, M. Kara; Liao Zhongxing; McAleer, Mary F. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Yu, Zhiqian H.; Zhang, Yongbin [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Dong, Lei, E-mail: ldong@mdanderson.or [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2011-02-01

312

Direct Plan Comparison of RapidArc and CyberKnife for Spine Stereotactic Body Radiation Therapy  

E-print Network

We compared the treatment planning performance of RapidArc (RA) vs. CyberKnife (CK) for spinal stereotactic body radiation therapy (SBRT). Ten patients with spinal lesions who had been treated with CK were re-planned with RA, which consisted of two complete arcs. Computed tomography (CT) and volumetric dose data of CK, generated using the Multiplan (Accuray) treatment planning system (TPS) and the Ray-Trace algorithm, were imported to Varian Eclipse TPS in Dicom format, and the data were compared with the RA plan using analytical anisotropic algorithm (AAA) dose calculation. The optimized dose priorities for both CK and RA plans were similar for all patients. The highest priority was to provide enough dose coverage to the planned target volume (PTV) while limiting the maximum dose to the spinal cord. Plan quality was evaluated with respect to PTV coverage, conformity index (CI), high-dose spillage, intermediate-dose spillage (R50% and D2cm), and maximum dose to the spinal cord, which are criteria recommended ...

Choi, Young Eun; Song, Si Yeol; Choi, Eun Kyung; Ahn, Seung Do; Cho, Byungchul

2015-01-01

313

Normal Liver Tissue Density Dose Response in Patients Treated With Stereotactic Body Radiation Therapy for Liver Metastases  

SciTech Connect

Purpose: To evaluate the temporal dose response of normal liver tissue for patients with liver metastases treated with stereotactic body radiation therapy (SBRT). Methods and Materials: Ninety-nine noncontrast follow-up computed tomography (CT) scans of 34 patients who received SBRT between 2004 and 2011 were retrospectively analyzed at a median of 8 months post-SBRT (range, 0.7-36 months). SBRT-induced normal liver tissue density changes in follow-up CT scans were evaluated at 2, 6, 10, 15, and 27 months. The dose distributions from planning CTs were mapped to follow-up CTs to relate the mean Hounsfield unit change ({Delta}HU) to dose received over the range 0-55 Gy in 3-5 fractions. An absolute density change of 7 HU was considered a significant radiographic change in normal liver tissue. Results: Increasing radiation dose was linearly correlated with lower post-SBRT liver tissue density (slope, -0.65 {Delta}HU/5 Gy). The threshold for significant change (-7 {Delta}HU) was observed in the range of 30-35 Gy. This effect did not vary significantly over the time intervals evaluated. Conclusions: SBRT induces a dose-dependent and relatively time-independent hypodense radiation reaction within normal liver tissue that is characterized by a decrease of >7 HU in liver density for doses >30-35 Gy.

Howells, Christopher C.; Stinauer, Michelle A.; Diot, Quentin; Westerly, David C.; Schefter, Tracey E.; Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Miften, Moyed, E-mail: Moyed.Miften@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

2012-11-01

314

Application of modified dynamic conformal arc (MDCA) technique on liver stereotactic body radiation therapy (SBRT) planning following RTOG 0438 guideline.  

PubMed

Liver stereotactic body radiation therapy (SBRT) is a feasible treatment method for the nonoperable, patient with early-stage liver cancer. Treatment planning for the SBRT is very important and has to consider the simulation accuracy, planning time, treatment efficiency effects etc. The modified dynamic conformal arc (MDCA) technique is a 3-dimensional conformal arc planning method, which has been proposed for liver SBRT planning at our center. In this study, we compared the MDCA technique with the RapidArc technique in terms of planning target volume (PTV) coverage and sparing of organs at risk (OARs). The results show that the MDCA technique has comparable plan quality to RapidArc considering PTV coverage, hot spots, heterogeneity index, and effective liver volume. For the 5 PTVs studied among 4 patients, the MDCA plan, when compared with the RapidArc plan, showed 9% more hot spots, more heterogeneity effect, more sparing of OARs, and lower liver effective volume. The monitor unit (MU) number for the MDCA plan is much lower than for the RapidArc plans. The MDCA plan has the advantages of less planning time, no-collision treatment, and a lower MU number. PMID:25172164

Shi, Chengyu; Chen, Yong; Fang, Deborah Xiangdong; Iannuzzi, Christopher

2015-01-01

315

Modulation of Total Body Irradiation Induced Life Shortening by Systemic Intravenous MnSOD-Plasmid Liposome Gene Therapy  

PubMed Central

To determine whether systemic administration of MnSOD-PL protected mice from the acute hematopoietic syndrome as well as delayed death following total body irradiation (TBI), C57BL/6J mice received intravenously 100?l liposomes containing 100?g of human MnSOD-transgene plasmid 24 hours prior to 9.5 Gy or 1.0 Gy. The dose of 9.5 Gy was lethal to 42% of irradiated control female and 74% of irradiated control male mice respectively at 30 days with bone marrow hypocellularity consistent with the hematopoietic syndrome. A statistically significant increase in survival was detected in MnSOD-PL treated compared to 9.5 Gy irradiated control female mice out to 400 days, and in male mice out to 340 days. The incidence of tumors was similar between surviving groups. Between 350 to 600 days, outcome was similar for both MnSOD-PL treated and control irradiated groups consistent with aging with no difference in gross or microscopic pathologic evidence of tumors. Male and female mice receiving 1.0 Gy TBI showed irradiation induced life shortening after 120 days that was decreased by MnSOD-PL administration, and was associated with no increase in rate of tumor associated death. Therefore, systemic MnSOD-PL radioprotective gene therapy is not associated with a detectably higher incidence of late carcinogenesis. PMID:19024650

Epperly, Michael W.; Smith, Tracy; Wang, Hong; Schlesselman, James; Franicola, Darcy; Greenberger, Joel S.

2008-01-01

316

Red Shell: Defining a High-Risk Zone of Normal Tissue Damage in Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: To define a volume of tissue just outside of the clinical target volume (CTV) or planning target volume (PTV) in stereotactic body radiation therapy (SBRT) that receives doses appreciably above the tolerance level and in which other critical tissue structures must be avoided. Methods and Materials: We define the tissue between the borders of the CTV and PTV as the Inner Red Shell. The tissue surrounding the PTV that receives higher than the local tissue tolerance is defined as the Outer Red Shell. Contributing factors to the volume of the Red Shell include the prescription dose, dose gradient and PTV size, together with the type of tissue and its tolerance are discussed. An illustrative example and two clinical cases are reported. Results: The volume of Red Shell increases with higher prescription dose, slower dose fall-off, larger PTV volume, and higher tissue radiosensitivity. Avoidance of proximal critical serial organs may alter the volume and shape of the Red Shell after repeated, detailed treatment planning. Conclusion: Rather than defining tolerance and toxicity as simply a dose level received by the tissues, the volume of tissue receiving risk levels above tolerance can be quantified as the 'cost' of SBRT. This concept may be adopted in other techniques offering ablative and high-dose gradients. Further consideration should be given to collecting clinical data for refining the choice of constraint doses, especially in parts of the brain, lung, liver, and kidney.

Yang, Jun, E-mail: JunBME@yahoo.co [Philadelphia CyberKnife, Havertown, PA (United States); Fowler, Jack F. [Departments of Human Oncology and Medical Physics, University of Wisconsin, Madison, WI (United States); Lamond, John P.; Lanciano, Rachelle; Feng Jing; Brady, Luther W. [Philadelphia CyberKnife, Havertown, PA (United States)

2010-07-01

317

String Vibrations  

NSDL National Science Digital Library

This site, by Andrew Davidhazy at the Rochester Institute of Technology, describes how to make interesting and artistic photographs of a vibrating string. Davidhazy explains how the string is vibrated, how the string is lit, and even the exposure time and the effect it has on the resulting image. Four images of the vibrating string are included.

Davidhazy, Andrew

318

Modelling the effects of exposure to whole-body vibration on low-back pain and its long-term consequences for sickness absence and associated work disability  

NASA Astrophysics Data System (ADS)

BackgroundExposure to whole-body vibration (WBV) is a well-known risk factor for the occurrence of low-back pain (LBP). Little is known about the long-term course of back pain in workers exposed to WBV and the consequences for (temporary) disability, due to lack of cohort studies with sufficiently long follow-up periods. MethodsA systematic review of the literature was performed to assess associations between exposure to WBV and LBP, sickness absence due to low-back disorders and permanent disability. A meta-analysis was used to estimate the prevalences of LBP and sickness absence due to low-back disorders in occupational populations, depending on relevant exposure characteristics. These prevalences were converted into probabilities for transitions between no complaints, LBP, sickness due to LBP, and disability. A Markov model was applied to evaluate a hypothetical cohort of workers without LBP at the start of the cohort and a follow-up of 40 years (40 cycles of 1 year) to reflect a long-life career with continuous exposure to WBV. ResultsIn this hypothetical cohort it was estimated that among workers with the highest exposure to WBV on average about 47 weeks of their working life were lost due to sick leave because of LBP, which is approximately 2.5% of their working life. When all workers on prolonged sick leave for 52 weeks would remain disabled for the rest of their working life, a maximum of 23.4% of their working life could be lost due to high WBV exposure. Among workers without or low exposure to WBV the corresponding losses were 0.8% and 7.8%, respectively. ConclusionThe approach to assess years of work lost due to an occupational exposure may provide a more adequate description for stakeholders than the traditional measures of relative risk or attributable risk fraction. The concept of work years lost may also facilitate a better appreciation of the potential benefits of preventive measures.

Burdorf, A.; Hulshof, C. T. J.

2006-12-01

319

Novel active vibration absorber with magnetorheological fluid  

NASA Astrophysics Data System (ADS)

Disturbing vibrations diminish the performance of technical high precision devices significantly. In search of a suitable solution for reducing these vibrations, a novel concept of active vibration reduction was developed which exploits the special properties of magnetorheological fluids. In order to evaluate the concept of such an active vibration absorber (AVA) a demonstrator was designed and manufactured. This demonstrator generates a force which counteracts the motion of the vibrating body. Since the counterforce is generated by a centrifugal exciter, the AVA provides the capability to compensate vibrations even in two dimensions. To control the strength of the force transmitted to the vibrating body, the exciter is based on a tunable MR coupling. The AVA was integrated in an appropriate testing device to investigate its performance. The recorded results show a significant reduction of the vibration amplitudes by an order of magnitude.

Gerlach, T.; Ehrlich, J.; Böse, H.

2009-02-01

320

Clinical significance of discordant findings between pre-therapy 123I and post-therapy 131I whole body scan in patients with thyroid cancer  

PubMed Central

Radioactive therapy with 131I (RAI) is commonly used during the management of patients with differentiated thyroid cancer (DTC). The aim of this study was to determine the clinical significance of discordant findings between pre-RAI whole body scan (WBS) with 123I and post-RAI WBS in the management of DTC. We retrospectively evaluated 342 individuals between 2002 and 2008 who had a diagnosis of DTC and underwent RAI. All had WBS one day before RAI and WBS one week after RAI. Patients were divided into 3 groups: 1) RAI-naive subjects without known distant metastatic disease (M1); 2) patients with history of prior RAI and persistent disease (except M1); and 3) patients with known M1. In Group 1 (n=311), 7% of patients (n=22) had discordant scans, but in only 4 of these cases did this represent true disease (3 unsuspected lung and 1 mediastinal node metastasis). In the remaining 18 patients, discordant findings corresponded to physiologic or other benign causes. In group 2 (n=23), 7 subjects (30%) had discordant findings and all of the discrepant sites consisted of loco-regional nodal disease in the neck/upper mediastinum (n=6) and M1 in lung (n=1). In group 3 (n=8), 5 patients (62%) showed discordant uptake in lung and bone which corresponded to the locations of known M1. A total of 12 patients with iodine-avid M1 were identified on post-RAI WBS (3.5% of entire cohort). Pre-RAI WBS was only concordant in 3 of these cases (25%). In conclusion, the significance of pre and post-RAI WBS is highly influenced by the clinical setting. Unsuspected distant metastatic disease is infrequent in RAI-naive patients without known M1, where most discordant findings are usually due to benign explanations, and represent false positive findings in this group. In contrast, in patients with history of previous RAI or known M1, discordant results likely correspond to true disease. In our study, pre-RAI scans showed a low yield to detect iodine-avid distant metastatic disease when compared to post-RAI scans. PMID:23724150

Bravo, Paco E; Goudarzi, Behnaz; Rana, Uzma; Filho, Paulo Togni; Castillo, Raymond; Rababy, Christopher; Ewertz, Marjorie; Ziessman, Harvey A; Cooper, David S; Ladenson, Paul W; Wahl, Richard L

2013-01-01

321

Volumetric-Modulated Arc Therapy for Stereotactic Body Radiotherapy of Lung Tumors: A Comparison With Intensity-Modulated Radiotherapy Techniques  

SciTech Connect

Purpose: To demonstrate the potential of volumetric-modulated arc therapy (VMAT) compared with intensity-modulated radiotherapy (IMRT) techniques with a limited number of segments for stereotactic body radiotherapy (SBRT) for early-stage lung cancer. Methods and Materials: For a random selection of 27 patients eligible for SBRT, coplanar and noncoplanar IMRT and coplanar VMAT (using SmartArc) treatment plans were generated in Pinnacle{sup 3} and compared. In addition, film measurements were performed using an anthropomorphic phantom to evaluate the skin dose for the different treatment techniques. Results: Using VMAT, the delivery times could be reduced to an average of 6.6 min compared with 23.7 min with noncoplanar IMRT. The mean dose to the healthy lung was 4.1 Gy for VMAT and noncoplanar IMRT and 4.2 Gy for coplanar IMRT. The volume of healthy lung receiving >5 Gy and >20 Gy was 18.0% and 5.4% for VMAT, 18.5% and 5.0% for noncoplanar IMRT, and 19.4% and 5.7% for coplanar IMRT, respectively. The dose conformity at 100% and 50% of the prescribed dose of 54 Gy was 1.13 and 5.17 for VMAT, 1.11 and 4.80 for noncoplanar IMRT and 1.12 and 5.31 for coplanar IMRT, respectively. The measured skin doses were comparable for VMAT and noncoplanar IMRT and slightly greater for coplanar IMRT. Conclusions: Coplanar VMAT for SBRT for early-stage lung cancer achieved plan quality and skin dose levels comparable to those using noncoplanar IMRT and slightly better than those with coplanar IMRT. In addition, the delivery time could be reduced by {<=}70% with VMAT.

Holt, Andrea; Vliet-Vroegindeweij, Corine van; Mans, Anton; Belderbos, Jose S. [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Damen, Eugene M.F., E-mail: e.damen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

2011-12-01

322

Impact of inhomogeneity corrections on dose coverage in the treatment of lung cancer using stereotactic body radiation therapy  

SciTech Connect

The purpose of this study is to assess the real target dose coverage when radiation treatments were delivered to lung cancer patients based on treatment planning according to the RTOG-0236 Protocol. We compare calculated dosimetric results between the more accurate anisotropic analytical algorithm (AAA) and the pencil beam algorithm for stereotactic body radiation therapy treatment planning in lung cancer. Ten patients with non-small cell lung cancer were given 60 Gy in three fractions using 6 and 10 MV beams with 8-10 fields. The patients were chosen in accordance with the lung RTOG-0236 protocol. The dose calculations were performed using the pencil beam algorithm with no heterogeneity corrections (PB-NC) and then recalculated with the pencil beam with modified Batho heterogeneity corrections (PB-MB) and the AAA using an identical beam setup and monitor units. The differences in calculated dose to 95% or 99% of the PTV, between using the PB-NC and the AAA, were within 10% of prescribed dose (60 Gy). However, the minimum dose to 95% and 99% of PTV calculated using the PB-MB were consistently overestimated by up to 40% and 36% of the prescribed dose, respectively, compared to that calculated by the AAA. Using the AAA as reference, the calculated maximum doses were underestimated by up to 27% using the PB-NC and overestimated by 19% using the PB-MB. The calculations of dose to lung from PB-NC generally agree with that of AAA except in the small high-dose region where PB-NC underestimates. The calculated dose distributions near the interface using the AAA agree with those from Monte Carlo calculations as well as measured values. This study indicates that the real minimum PTV dose coverage cannot be guaranteed when the PB-NC is used to calculate the monitor unit settings in dose prescriptions.

Ding, George X.; Duggan, Dennis M.; Lu Bo; Hallahan, Dennis E.; Cmelak, Anthony; Malcolm, Arnold; Newton, Jared; Deeley, Matthew; Coffey, Charles W. [Department of Radiation Oncology, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, B-902, TVC, Preston Research Building, Nashville, Tennessee 37232-5671 (United States)

2007-07-15

323

Guaranteed epsilon-optimal treatment plans with the minimum number of beams for stereotactic body radiation therapy  

NASA Astrophysics Data System (ADS)

Stereotactic body radiation therapy (SBRT) is characterized by delivering a high amount of dose in a short period of time. In SBRT the dose is delivered using open fields (e.g., beam’s-eye-view) known as ‘apertures’. Mathematical methods can be used for optimizing treatment planning for delivery of sufficient dose to the cancerous cells while keeping the dose to surrounding organs at risk (OARs) minimal. Two important elements of a treatment plan are quality and delivery time. Quality of a plan is measured based on the target coverage and dose to OARs. Delivery time heavily depends on the number of beams used in the plan as the setup times for different beam directions constitute a large portion of the delivery time. Therefore the ideal plan, in which all potential beams can be used, will be associated with a long impractical delivery time. We use the dose to OARs in the ideal plan to find the plan with the minimum number of beams which is guaranteed to be epsilon-optimal (i.e., a predetermined maximum deviation from the ideal plan is guaranteed). Since the treatment plan optimization is inherently a multi-criteria-optimization problem, the planner can navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing epsilon-optimality. We use mixed integer programming (MIP) for optimization. To reduce the computation time for the resultant MIP, we use two heuristics: a beam elimination scheme and a family of heuristic cuts, known as ‘neighbor cuts’, based on the concept of ‘adjacent beams’. We show the effectiveness of the proposed technique on two clinical cases, a liver and a lung case. Based on our technique we propose an algorithm for fast generation of epsilon-optimal plans.

Yarmand, Hamed; Winey, Brian; Craft, David

2013-09-01

324

Guaranteed epsilon-optimal treatment plans with the minimum number of beams for stereotactic body radiation therapy.  

PubMed

Stereotactic body radiation therapy (SBRT) is characterized by delivering a high amount of dose in a short period of time. In SBRT the dose is delivered using open fields (e.g., beam's-eye-view) known as 'apertures'. Mathematical methods can be used for optimizing treatment planning for delivery of sufficient dose to the cancerous cells while keeping the dose to surrounding organs at risk (OARs) minimal. Two important elements of a treatment plan are quality and delivery time. Quality of a plan is measured based on the target coverage and dose to OARs. Delivery time heavily depends on the number of beams used in the plan as the setup times for different beam directions constitute a large portion of the delivery time. Therefore the ideal plan, in which all potential beams can be used, will be associated with a long impractical delivery time. We use the dose to OARs in the ideal plan to find the plan with the minimum number of beams which is guaranteed to be epsilon-optimal (i.e., a predetermined maximum deviation from the ideal plan is guaranteed). Since the treatment plan optimization is inherently a multi-criteria-optimization problem, the planner can navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing epsilon-optimality. We use mixed integer programming (MIP) for optimization. To reduce the computation time for the resultant MIP, we use two heuristics: a beam elimination scheme and a family of heuristic cuts, known as 'neighbor cuts', based on the concept of 'adjacent beams'. We show the effectiveness of the proposed technique on two clinical cases, a liver and a lung case. Based on our technique we propose an algorithm for fast generation of epsilon-optimal plans. PMID:23920378

Yarmand, Hamed; Winey, Brian; Craft, David

2013-09-01

325

Stereotactic Body Radiation Therapy for Prostate Cancer: What is the Appropriate Patient-Reported Outcome for Clinical Trial Design?  

PubMed Central

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly utilized as primary treatment for clinically localized prostate cancer. Consensus regarding the appropriate patient-reported outcome (PRO) endpoints for clinical trials evaluating radiation modalities for early stage prostate cancer is lacking. To aid in clinical trial design, this study presents PROs over a 36-month period following SBRT for clinically localized prostate cancer. Methods: Between February 2008 and September 2010, 174 hormone-naïve patients with clinically localized prostate cancer were treated with 35–36.25?Gy SBRT (CyberKnife, Accuray) delivered in 5 fractions. Patients completed the validated Expanded Prostate Cancer Index Composite (EPIC)-26 questionnaire at baseline and all follow-ups. The proportion of patients developing a clinically significant decline in each EPIC domain score was determined. The minimally important difference (MID) was defined as a change of one-half the standard deviation from the baseline. Per Radiation Therapy Oncology Group (RTOG) 0938, we also examined the patients who experienced a decline in EPIC urinary domain summary score of >2 points (unacceptable toxicity defined as ?60% of all patients reporting this degree of decline) and EPIC bowel domain summary score of >5 points (unacceptable toxicity defined as >55% of all patients reporting this degree of decline) from baseline to 1?year. Results: A total of 174 patients at a median age of 69?years received SBRT with a minimum follow-up of 36?months. The proportion of patients reporting a clinically significant decline (MID for urinary/bowel are 5.5/4.4) in EPIC urinary/bowel domain scores was 34%/30% at 6?months, 40%/32.2% at 12?months, and 32.8%/21.5% at 36?months. The patients reporting a decrease in the EPIC urinary domain summary score of >2 points was 43.2% (CI: 33.7%, 54.6%) at 6?months, 51.6% (CI: 43.4%, 59.7%) at 12?months, and 41.8% (CI: 33.3%, 50.6%) at 36?months. The patients reporting a decrease in the EPIC bowel domain summary score of >5 points was 29.6% (CI: 21.9%, 39.3%) at 6?months, 29% (CI: 22%, 36.8%) at 12?months, and 22.4% (CI: 15.7%, 30.4%) at 36?months. Conclusion: Following prostate SBRT, clinically significant urinary symptoms are more common than bowel symptoms. Our prostate SBRT treatment protocol meets the RTOG 0938 criteria for moving forward to a Phase III trial comparing it to conventionally fractionated radiation therapy. Notably, between 12 and 36?months, the proportion of patients reporting a significant decrease in both EPIC urinary and bowel domain scores declined, suggesting a late improvement in these symptom domains. Further investigation is needed to elucidate (1) which EPIC domains bear the greatest influence on post-treatment quality of life and (2) at what time point PRO endpoint(s) should be assessed. PMID:25874188

Woo, Jennifer Ai-Lian; Chen, Leonard N.; Wang, Hongkun; Cyr, Robyn A.; Bhattasali, Onita; Kim, Joy S.; Moures, Rudy; Yung, Thomas M.; Lei, Siyuan; Collins, Brian Timothy; Suy, Simeng; Dritschilo, Anatoly; Lynch, John H.; Collins, Sean P.

2015-01-01

326

Effects of Mind-Body Therapy on Quality of Life and Neuroendocrine and Cellular Immune Functions in Patients with Ulcerative Colitis  

Microsoft Academic Search

Background: The aim of this study was to investigate the effects of mind-body therapy on neuroendocrine and cellular immune measures, health-related quality of life and disease activity in patients with ulcerative colitis (UC) in remission. Methods: Thirty UC patients in remission or with low disease activity were randomly assigned to an intervention group (n = 15) or a usual-care waiting

Sigrid Elsenbruch; Jost Langhorst; Kalina Popkirowa; Twyla Müller; Rainer Luedtke; Ulla Franken; Anna Paul; Günther Spahn; Andreas Michalsen; Onno E. Janssen; Manfred Schedlowski; Gustav Dobos

2005-01-01

327

Effects of testosterone replacement therapy on cortical and trabecular bone mineral density, vertebral body area and paraspinal muscle area in hypogonadal men  

Microsoft Academic Search

Loss of bone and muscle mass are major findings of male hypogonadism. In order to determine the long-term effect of testosterone replacement therapy on spinal bone and muscles, the trabecular and cortical bone mineral density, vertebral body area and paraspinal muscle area were assessed by quantitative computed tomography in 32 testosterone-substituted patients, aged 18-74 years, with idiopathic hypogonadotropic hypogonadism (n

Eckhard Leifke; Hans-Christian Korner; Thomas M Link; Hermann M Behre; Peter E Peters; Eberhard Nieschlag

1998-01-01

328

Volume Modulated Arc Therapy (VMAT) for pulmonary Stereotactic Body Radiotherapy (SBRT) in patients with lesions in close approximation to the chest wall  

PubMed Central

Purpose: Chest wall pain and discomfort has been recognized as a significant late effect of radiation therapy in historical and modern treatment models. Stereotactic Body Radiotherapy (SBRT) is becoming an important treatment tool in oncology care for patients with intrathoracic lesions. For lesions in close approximation to the chest wall with motion management, SBRT techniques can deliver high dose to the chest wall. As an unintended target of consequence, there is possibility of imposing significant chest wall pain and discomfort as a late effect of therapy. The purpose of this paper is to evaluate the potential role of Volume Modulated Arc Therapy (VMAT) technologies in decreasing chest wall dose in SBRT treatment of pulmonary lesions in close approximation to the chest wall. Materials and Methods: Ten patients with pulmonary lesions of various sizes and tomography in close approximation to the chest wall were selected for retrospective review. All volumes including tumor target, chest wall, ribs, and lung were contoured with maximal intensity projection maps and four-dimensional computer tomography planning. Radiation therapy planning consisted of static techniques including Intensity Modulated Radiation Therapy compared to VMAT therapy to a dose of 60 Gy in 12 Gy fraction dose. Dose volume histogram to rib, chest wall, and lung were compared between plans with statistical analysis. Results: In all patients, dose and volume were improved to ribs and chest wall using VMAT technologies compared to static field techniques. On average, volume receiving 30 Gy to the chest wall was improved by 74%; the ribs by 60%. In only one patient did the VMAT treatment technique increase pulmonary volume receiving 20 Gy (V20). Conclusions: VMAT technology has potential of limiting radiation dose to sensitive chest wall regions in patients with lesions in close approximation to this structure. This would also have potential value to lesions treated with SBRT in other body regions where targets abut critical structures. PMID:23440876

Ding, Linda; Lo, Yuan-Chyuan; Kadish, Sidney; Goff, David; Pieters, Richard S.; Graeber, Geoffrey; Uy, Karl; Quadri, Syed; Moser, Richard; Martin, Kevin; Day, John; FitzGerald, Thomas J.

2013-01-01

329

Vibration by relativistic effects  

E-print Network

Relativity, time reversal invariance in mechanics and principle of causality can be in the bases of a type of vibration of the extensive objects. It is because, the detailed analysis of the relativistic movement of an extensive body entail that all the objects must have inherent a vibratory movement to their own size. Such effect does not happen when it works with point particles thus is not stranger who happens unnoticed in the traditional studies. Also we can find relation between the form of vibration of the extensive objects and the energy that calculates by quantum considerations.

Enrique Oradaz Romay

2005-12-27

330

a Comparison of Evaluations and Assessments Obtained Using Alternative Standards for Predicting the Hazards of Whole-Body Vibration and Repeated Shocks  

NASA Astrophysics Data System (ADS)

There are three current standards that might be used to assess the vibration and shock transmitted by a vehicle seat with respect to possible effects on human health: ISO 2631/1 (1985), BS 6841 (1987) and ISO 2631-1 (1997). Evaluations have been performed on the seat accelerations measured in nine different transport environments (bus, car, mobile crane, fork-lift truck, tank, ambulance, power boat, inflatable boat, mountain bike) in conditions that might be considered severe. For each environment, limiting daily exposure durations were estimated by comparing the frequency weighted root mean square (i.e., r.m.s.) accelerations and the vibration dose values (i.e.,VDV), calculated according to each standard with the relevant exposure limits, action level and health guidance caution zones. Very different estimates of the limiting daily exposure duration can be obtained using the methods described in the three standards. Differences were observed due to variations in the shapes of the frequency weightings, the phase responses of the frequency weighting filters, the method of combining multi-axis vibration, the averaging method, and the assessment method. With the evaluated motions, differences in the shapes of the weighting filters results in up to about 31% difference in r.m.s. acceleration between the “old” and the “new” ISO standard and up to about 14% difference between BS 6841 and the “new” ISO 2631. There were correspondingly greater differences in the estimates of safe daily exposure durations. With three of the more severe motions there was a difference of more than 250% between estimated safe daily exposure durations based on r.m.s. acceleration and those based on fourth power vibration dose values. The vibration dose values provided the more cautious assessments of the limiting daily exposure duration.

Lewis, C. H.; Griffin, M. J.

1998-08-01

331

VIBRATIONS IN DYNAMIC DRIVING SIMULATOR: STUDY AND IMPLEMENTATION.  

E-print Network

. The human body is a strongly damped system and therefore, when a part of it is excited at its natural Assistance Systems (ADAS) conception and their impact on human comportment in critical driving situation be the optimal intensities of vibration? 2.1. The whole body vibration Human vibration is defined as the effect

Boyer, Edmond

332

ExacTrac Snap Verification: A New Tool for Ensuring Quality Control for Lung Stereotactic Body Radiation Therapy  

SciTech Connect

Purpose: The intrafraction verification provided by ExacTrac X-ray 6D Snap Verification (ET-SV) allows the tracking of potential isocenter displacements throughout patient position and treatment. The aims of this study were (1) to measure the intrafraction variations of the isocenter position (random errors); (2) to study the amplitude of the variation related to the fraction duration; and (3) to assess the impact of the table movement on positioning uncertainties. Methods and Materials: ET-SV uses images acquired before or during treatment delivery or both to detect isocenter displacement. Twenty patients treated with stereotactic body radiation therapy (SBRT) for lung tumors underwent SV before or during each beam. Noncoplanar beams were sometimes necessary. The time between the setup of the patient and each SV was noted, and values of deviations were compiled for 3 SV time groups: SV performed at {<=}10 min (group 1), between 11 and 20 min (group 2), and {>=}21 min (group 3). Random errors in positioning during the use of noncoplanar fields were noted. Results: The mean isocenter deviation {+-}SD was 2 {+-} 0.5 mm (range, 1-8 mm). The average deviations {+-}SD increased significantly from 1.6 {+-} 0.5 mm to 2.1 {+-} 0.8 mm and 2.2 {+-} 0.6 mm for groups 1, 2, and 3 (P=.002), respectively. Percentages of deviation {>=}3 mm were 7.06%, 22.83%, and 28.07% and 1.08%, 4.15%, and 8.4% for {>=}5 mm (P<.0001). For 11 patients, table rotation was necessary. The mean isocenter deviation {+-}SD increased significantly from 1.9 {+-} 0.5 mm before table rotation to 2.7 {+-} 0.5 mm (P=.001) for the first beam treated after rotation. Conclusions: SV detects isocenter deviations, which increase in amplitude and frequency with the fraction duration, and enables intrafraction verification for SBRT (taking into account clinical condition and technical issues). SV gives accurate targeting at any time during irradiation and may raise confidence to escalate the dose. SV appears to be an important tool for ensuring the quality control of SBRT.

Udrescu, Corina [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France)] [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Mornex, Francoise, E-mail: francoise.mornex@chu-lyon.fr [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France)] [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France); Tanguy, Ronan; Chapet, Olivier [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France)] [Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Pierre Benite (France)

2013-01-01

333

Radiation-Induced Rib Fractures After Hypofractionated Stereotactic Body Radiation Therapy: Risk Factors and Dose-Volume Relationship  

SciTech Connect

Purpose: The purpose of this study was to clarify the incidence, the clinical risk factors, and the dose-volume relationship of radiation-induced rib fracture (RIRF) after hypofractionated stereotactic body radiation therapy (SBRT). Methods and Materials: One hundred sixteen patients treated with SBRT for primary or metastatic lung cancer at our institution, with at least 6 months of follow-up and no previous overlapping radiation exposure, were included in this study. To determine the clinical risk factors associated with RIRF, correlations between the incidence of RIRF and the variables, including age, sex, diagnosis, gross tumor volume diameter, rib-tumor distance, and use of steroid administration, were analyzed. Dose-volume histogram analysis was also conducted. Regarding the maximum dose, V10, V20, V30, and V40 of the rib, and the incidences of RIRF were compared between the two groups divided by the cutoff value determined by the receiver operating characteristic curves. Results: One hundred sixteen patients and 374 ribs met the inclusion criteria. Among the 116 patients, 28 patients (46 ribs) experienced RIRF. The estimated incidence of rib fracture was 37.7% at 3 years. Limited distance from the rib to the tumor (<2.0 cm) was the only significant risk factor for RIRF (p = 0.0001). Among the dosimetric parameters used for receiver operating characteristic analysis, the maximum dose showed the highest area under the curve. The 3-year estimated risk of RIRF and the determined cutoff value were 45.8% vs. 1.4% (maximum dose, {>=}42.4 Gy or less), 51.6% vs. 2.0% (V40, {>=}0.29 cm{sup 3} or less), 45.8% vs. 2.2% (V30, {>=}1.35 cm{sup 3} or less), 42.0% vs. 8.5% (V20, {>=}3.62 cm{sup 3} or less), or 25.9% vs. 10.5% (V10, {>=}5.03 cm{sup 3} or less). Conclusions: The incidence of RIRF after hypofractionated SBRT is relatively high. The maximum dose and high-dose volume are strongly correlated with RIRF.

Asai, Kaori [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Shioyama, Yoshiyuki, E-mail: shioyama@radiol.med.kyushu-u.ac.jp [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Nakamura, Katsumasa; Sasaki, Tomonari; Ohga, Saiji; Nonoshita, Takeshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Yoshitake, Tadamasa [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Ohnishi, Kayoko [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan)] [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Terashima, Kotaro; Matsumoto, Keiji [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Hirata, Hideki [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)] [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)

2012-11-01

334

Recursive Partitioning Analysis Index Is Predictive for Overall Survival in Patients Undergoing Spine Stereotactic Body Radiation Therapy for Spinal Metastases  

SciTech Connect

Purpose: To generate a prognostic index using recursive partitioning analysis (RPA) for patients undergoing spine stereotactic body radiation therapy (sSBRT) for spinal metastases (sMet). Methods and Materials: From an institutional review board-approved database, 174 patients were treated for sMet with sSBRT between February 2006 and August 2009. Median dose was 14 Gy (range, 8-24 Gy), typically in a single fraction (range, 1-5). Kaplan-Meier analysis was performed to detect any correlation between survival and histology. Histologies were divided into favorable (breast and prostate), radioresistant (renal cell, melanoma and sarcoma), and other (all other histologies). RPA was performed to identify any association of the following variables with overall survival (OS) following sSBRT: histology, gender, age, Karnofsky performance status (KPS), control of primary, extraosseous metastases, time from primary diagnosis (TPD), dose of sSBRT ({<=}14 Gy vs. >14 Gy), extent of spine disease (epidural only, bone and epidural, bone only), upfront or salvage treatment, presence of paraspinal extension, and previous surgery. Results: Median follow-up was 8.9 months. Median OS time from sSBRT was 10.7 months. Median OS intervals for favorable histologies were 14 months, 11.2 months for radioresistant histologies, and 7.3 months for other histologies (p = 0.02). RPA analysis resulted in three classes (p < 0.0001). Class 1 was defined as TPD of >30 months and KPS of >70; Class 2 was TPD of >30 months and KPS of {<=}70 or a TPD of {<=}30 months and age <70 years old; Class 3 was TPD of {<=}30 months and age {>=}70 years old. Median OS was 21.1 months for Class 1 (n = 59), 8.7 months for Class 2 (n = 104), and 2.4 months for Class 3 (n = 11). Conclusion: sSBRT patients treated for sMet have a wide variability in OS. We developed an RPA classification system that is predictive of OS. While many patients are treated for palliation of pain or to avoid symptomatic progression, this index may be used to predict which patients may benefit most from sSBRT.

Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Koyfman, Shlomo A.; Woody, Neil [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Angelov, Lilyana [Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Soeder, Sherry L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Reddy, Chandana A. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Rybicki, Lisa A. [Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Djemil, Toufik [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Suh, John H. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States)

2012-04-01

335

Stereotactic Body Radiation Therapy for Locally Advanced and Borderline Resectable Pancreatic Cancer Is Effective and Well Tolerated  

SciTech Connect

Purpose: Stereotactic body radiation therapy (SBRT) provides high rates of local control (LC) and margin-negative (R0) resections for locally advanced pancreatic cancer (LAPC) and borderline resectable pancreatic cancer (BRPC), respectively, with minimal toxicity. Methods and Materials: A single-institution retrospective review was performed for patients with nonmetastatic pancreatic cancer treated with induction chemotherapy followed by SBRT. SBRT was delivered over 5 consecutive fractions using a dose painting technique including 7-10 Gy/fraction to the region of vessel abutment or encasement and 5-6 Gy/fraction to the remainder of the tumor. Restaging scans were performed at 4 weeks, and resectable patients were considered for resection. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Results: Seventy-three patients were evaluated, with a median follow-up time of 10.5 months. Median doses of 35 Gy and 25 Gy were delivered to the region of vessel involvement and the remainder of the tumor, respectively. Thirty-two BRPC patients (56.1%) underwent surgery, with 31 undergoing an R0 resection (96.9%). The median OS, 1-year OS, median PFS, and 1-year PFS for BRPC versus LAPC patients was 16.4 months versus 15 months, 72.2% versus 68.1%, 9.7 versus 9.8 months, and 42.8% versus 41%, respectively (all P>.10). BRPC patients who underwent R0 resection had improved median OS (19.3 vs 12.3 months; P=.03), 1-year OS (84.2% vs 58.3%; P=.03), and 1-year PFS (56.5% vs 25.0%; P<.0001), respectively, compared with all nonsurgical patients. The 1-year LC in nonsurgical patients was 81%. We did not observe acute grade ?3 toxicity, and late grade ?3 toxicity was minimal (5.3%). Conclusions: SBRT safely facilitates margin-negative resection in patients with BRPC pancreatic cancer while maintaining a high rate of LC in unresectable patients. These data support the expanded implementation of SBRT for pancreatic cancer.

Chuong, Michael D. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Springett, Gregory M. [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Freilich, Jessica M.; Park, Catherine K. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Weber, Jill M. [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Mellon, Eric A. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Hodul, Pamela J.; Malafa, Mokenge P.; Meredith, Kenneth L. [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Gastrointestinal Tumor Program, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Hoffe, Sarah E. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Shridhar, Ravi, E-mail: ravi.shridhar@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida (United States)

2013-07-01

336

Therapist-guided, Internet-based cognitive–behavioural therapy for body dysmorphic disorder (BDD-NET): a feasibility study  

PubMed Central

Objectives Cognitive–behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way to increase access to CBT is to administer treatment remotely via the Internet. This study piloted a novel therapist-supported, Internet-based CBT program for BDD (BDD-NET). Design Uncontrolled clinical trial. Participants Patients (N=23) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive–compulsive and related disorders. Suitable patients were offered secure access to BDD-NET. Intervention BDD-NET is a 12-week treatment program based on current psychological models of BDD that includes psychoeducation, functional analysis, cognitive restructuring, exposure and response prevention, and relapse prevention modules. A dedicated therapist provides active guidance and feedback throughout the entire process. Main outcome measure The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS). Symptom severity was assessed pretreatment, post-treatment and at the 3-month follow-up. Results BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS (p=<0.001) with a large within-group effect size (Cohen's d=2.01, 95% CI 1.05 to 2.97). At post-treatment, 82% of the patients were classified as responders (defined as?30% improvement on the BDD-YBOCS). These gains were maintained at the 3-month follow-up. Secondary outcome measures of depression, global functioning and quality of life also showed significant improvements with moderate to large effect sizes. On average, therapists spent 10?min per patient per week providing support. Conclusions The results suggest that BDD-NET has the potential to greatly increase access to CBT, at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight. A randomised controlled trial of BDD-NET is warranted. Trial registration number Clinicaltrials.gov registration ID NCT01850433. PMID:25256187

Enander, Jesper; Ivanov, Volen Z; Andersson, Erik; Mataix-Cols, David; Ljótsson, Brjánn; Rück, Christian

2014-01-01

337

Regional Normal Lung Tissue Density Changes in Patients Treated With Stereotactic Body Radiation Therapy for Lung Tumors  

SciTech Connect

Purpose: To describe regional lung tissue density changes in normal lung tissue of patients with primary and metastatic lung tumors who received stereotactic body radiation therapy (SBRT). Methods and Materials: A total of 179 post-SBRT follow-up computed tomography (CT) scans of 62 patients who received SBRT between 2003 and 2009 were studied. Median prescription dose was 54 Gy (range, 30-60 Gy) in 3 to 5 fractions. SBRT-induced lung density changes on post-SBRT follow-up CT were evaluated at approximately 3, 6, 12, 18, 24, and 30 months after treatment. Dose-response curves (DRC) were generated for SBRT-induced lung damage by averaging CT number (HU) changes for regions of the lungs receiving the same dose at 5-Gy intervals. Results: For all follow-up interval periods, CT numbers linearly increased with dose until 35 Gy and were constant thereafter. For 3, 18, 24, and 30 months, the rate of relative electron density increase with dose was approximately 0.24% per Gy. At 6 months, the rate was also similar below 20 Gy but then rose to 0.6% per Gy above this threshold. After 6 months, DRCs were mostly time-independent. When split between patients treated with 3 fractions of 12 to 20 Gy (median, 20 Gy; average tumor volume, 12 {+-} 16 cm{sup 3}) and with >3 fractions of 6 to 12.5 Gy (median, 9 Gy; average tumor volume, 30 {+-} 40 cm{sup 3}), DRCs differed significantly. In both cases, CT changes at 3, 18, 24, and 30 months were identical to those of the population DRC; however, patients who received >3 fractions showed 6-month CT changes that were more than twice those for the group that received 3 fractions. Conclusions: This analysis of SBRT-induced normal lung density changes indicates that lung normal tissue has more pronounced self-limited acute effects than late effects. Differences in acute CT changes following treatments in 3 fractions were considerably less than for treatments in >3 fractions.

Diot, Quentin, E-mail: quentin.diot@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Kavanagh, Brian; Schefter, Tracey; Gaspar, Laurie; Stuhr, Kelly; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

2012-11-15

338

Vibrational Coupling  

SciTech Connect

By homing in on the distribution patterns of electrons around an atom, a team of scientists team with Berkeley Lab's Molecular Foundry showed how certain vibrations from benzene thiol cause electrical charge to "slosh" onto a gold surface (left), while others do not (right). The vibrations that cause this "sloshing" behavior yield a stronger SERS signal.

None

2011-01-01

339

Good Vibrations  

NSDL National Science Digital Library

In this activity, learners experiment with their voices and noisemakers to understand the connections between vibrations and the sounds created by those vibrations. This resource includes three quick demonstration activities that can be used independently or as a group to introduce learners to the basic elements of sound.

OMSI

2004-01-01

340

Versatility of the Novalis system to deliver image-guided stereotactic body radiation therapy (SBRT) for various anatomical sites.  

PubMed

Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) programs to treat brain tumors were implemented when we first acquired the Brainlab Novalis system in 2003. Two years later, we started an extra-cranial stereotactic radio-ablation or more appropriately a stereotactic body radiation therapy (SBRT) program using the Brainlab Novalis image-guided system at The Methodist Hospital in Houston, Texas. We hereby summarize our initial experience with this system in delivering image-guided SBRT to a total of 80 patients during our first year of clinical implementation, from February 2005 to January 2006. Over 100 lesions in more than 20 distinct anatomical sites were treated. These include all levels of spine from cervical, thoracic, lumbar, and sacral lesions. Spinal lesions encompass intramedullary, intradural, extradural, or osseous compartments. Also treated were lesions in other bony sites including orbit, clavicle, scapula, humerus, sternum, rib, femur, and pelvis (ilium, ischium, and pubis). Primary or metastatic lesions located in the head and neck, supraclavicular region, axilla, mediastinum, lung (both central and peripheral), abdominal wall, liver, kidney, para-aortic lymph nodes, prostate, and pelvis were also treated. In addition to primary radiotherapy, SBRT program using the Brainlab Novalis system allows re-irradiation for recurrence and "boost" after conventional treatment to various anatomical sites. Treating these sites safely and efficaciously requires knowledge in radiation tolerance, fraction size, total dose, biologically equivalent dose (BED), prior radiotherapy, detailed dose volume histograms (DVH) of normal tissues, and the radiosensitive/radioresistant nature of the tumor. Placement of radio-opaque markers (Visicoil, Radiomed) in anatomical sites not in close proximity to bony landmarks (e.g., kidney and liver) helps in measuring motion and providing image guidance during each treatment fraction. Tumor/organ motion data obtained using 4D-CT while the patient is immobilized in the body cast aids in planning treatment margin and determining the need for respiratory motion control, e.g., abdominal compressor, gating, or active breathing control. The inclusion of PET/CT to the Brainlab treatment planning system further refines the target delineation and possibly guides differential fraction size prescription and delivery. The majority of the patients tolerated the SBRT treatment well despite the longer daily treatment time when compared to that of conventional treatment. All patients achieved good pain relief after SBRT. Compared to conventional standard radiotherapy of lower daily fraction size, we observed that the patients achieved faster pain relief and possibly more durable symptom control. Very high local control with stable disease on imaging was observed post SBRT. Our initial experience shows that the Brainlab Novalis system is very versatile in delivering image-guided SBRT to various anatomical sites. This SBRT approach can be applied to either primary or metastatic lesions in the primary, "boost," or re-irradiation settings. The understanding of fraction size, total dose, BED, and DVH of normal tissues is very important in the treatment planning. Appropriate use of immobilization devices, radio-opaque markers for image-guidance, 4D-CT for tumor/organ motion estimates, and fusion of planning CT scans with biological/functional imaging will further improve the planning and delivery of SBRT, hopefully leading to better treatment outcome. PMID:17668943

Teh, Bin S; Paulino, Arnold C; Lu, Hsin H; Chiu, J Kam; Richardson, Susan; Chiang, Stephen; Amato, Robert; Butler, E Brian; Bloch, Charles

2007-08-01

341

Actively controlled vibration welding system and method  

DOEpatents

A vibration welding system includes a controller, welding horn, an active material element, and anvil assembly. The assembly may include an anvil body connected to a back plate and support member. The element, e.g., a piezoelectric stack or shape memory alloy, is positioned with respect to the assembly. The horn vibrates in a desirable first direction to form a weld on a work piece. The element controls any vibrations in a second direction by applying calibrated response to the anvil body in the second direction. A method for controlling undesirable vibrations in the system includes positioning the element with respect to the anvil assembly, connecting the anvil body to the support member through the back plate, vibrating the horn in a desirable first direction, and transmitting an input signal to the element to control vibration in an undesirable second direction.

Cai, Wayne W.; Kang, Bongsu; Tan, Chin-An

2013-04-02

342

Moderate to severe nausea in radioactive iodine (RAI) therapy is associated with the RAI dose per body weight and was not prevented by ramosetron.  

PubMed

To retrospectively analyze the individual risk factors for radioactive iodine (RAI)-associated nausea and vomiting, and to examine the anti-emetic effect of ramosetron (5-hydroxytryptamine-3 receptor antagonist) in RAI therapy. Patients with differentiated thyroid carcinoma who underwent first-time RAI therapy at Nagasaki University Hospital between January 2009 and 2013 were included (N = 81). As a routine treatment, all patients were administered 30 mg of domperidone per day. Patients who underwent RAI therapy between April 2011 and January 2013 were also administered 0.1 mg of ramosetron per day in addition to domperidone. Nausea and vomiting were evaluated based on Common Terminology Criteria for Adverse Events version 4.0. RAI-associated nausea and vomiting of any grade were seen in 37.0 and 6.2 % of patients in total, respectively. Moderate to severe nausea (grade 2–3) was seen in 22.2 % of patients and associated with the dose of RAI per body weight (odds ratio = 1.046, p = 0.013), but not with the use of ramosetron, in multivariate logistic regression analysis. We have identified the dose of RAI per body weight to be an individual risk factor associated with moderate to severe RAI-associated nausea. This study failed to show that the combined use of ramosetron and domperidone reduced the frequency of RAI-associated nausea and vomiting. PMID:24078409

Ikeoka, Toshiyuki; Ando, Takao; Imaizumi, Misa; Ueki, Ikuko; Usa, Toshiro; Kawakami, Atsushi

2014-05-01

343

Ghrelin Therapy Improves Survival after Whole-Body Ionizing Irradiation or Combined with Burn or Wound: Amelioration of Leukocytopenia, Thrombocytopenia, Splenomegaly, and Bone Marrow Injury  

PubMed Central

Exposure to ionizing radiation alone (RI) or combined with traumatic tissue injury (CI) is a crucial life-threatening factor in nuclear and radiological events. In our laboratory, mice exposed to 60Co-?-photon radiation (9.5?Gy, 0.4?Gy/min, bilateral) followed by 15% total-body-surface-area skin wounds (R-W CI) or burns (R-B CI) experienced an increment of ?18% higher mortality over a 30-day observation period compared to RI alone. CI was accompanied by severe leukocytopenia, thrombocytopenia, erythropenia, and anemia. At the 30th day after injury, numbers of WBC and platelets still remained very low in surviving RI and CI mice. In contrast, their RBC, hemoglobin, and hematocrit were recovered towards preirradiation levels. Only RI induced splenomegaly. RI and CI resulted in bone-marrow cell depletion. In R-W CI mice, ghrelin (a hunger-stimulating peptide) therapy increased survival, mitigated body-weight loss, accelerated wound healing, and increased hematocrit. In R-B CI mice, ghrelin therapy increased survival and numbers of neutrophils, lymphocytes, and platelets and ameliorated bone-marrow cell depletion. In RI mice, this treatment increased survival, hemoglobin, and hematocrit and inhibited splenomegaly. Our novel results are the first to suggest that ghrelin therapy effectively improved survival by mitigating CI-induced leukocytopenia, thrombocytopenia, and bone-marrow injury or the RI-induced decreased hemoglobin and hematocrit. PMID:25374650

Kiang, Juliann G.; Zhai, Min; Liao, Pei-Jyun; Elliott, Thomas B.; Gorbunov, Nikolai V.

2014-01-01

344

Comparative Effect of Massage Therapy versus Kangaroo Mother Care on Body Weight and Length of Hospital Stay in Low Birth Weight Preterm Infants  

PubMed Central

Background. Massage therapy (MT) and kangaroo mother care (KMC) are both effective in increasing the weight and reducing length of hospital stay in low birth weight preterm infants but they have not been compared. Aim. Comparison of effectiveness of MT and KMC on body weight and length of hospital stay in low birth weight preterm (LBWPT) infants. Method. 30 LBWPT infants using convenience sampling from Neonatal Intensive Care Unit, V.S. hospital, were randomly divided into 2 equal groups. Group 1 received MT and Group 2 received KMC for 15 minutes, thrice daily for 5 days. Medically stable babies with gestational age < 37 weeks and birth weight < 2500?g were included. Those on ventilators and with congenital, orthopedic, or genetic abnormality were excluded. Outcome measures, body weight and length of hospital stay, were taken before intervention day 1 and after intervention day 5. Level of significance was 5%. Result. Data was analyzed using SPSS16. Both MT and KMC were found to be effective in improving body weight (P = 0.001, P = 0.001). Both were found to be equally effective for improving body weight (P = 0.328) and reducing length of hospital stay (P = 0.868). Conclusion. MT and KMC were found to be equally effective in improving body weight and reducing length of hospital stay. Limitation. Long term follow-up was not taken. PMID:24976830

Rangey, Priya Singh

2014-01-01

345

Alterations in body composition and fat distribution in growth hormone—Deficient prepubertal children during growth hormone therapy  

Microsoft Academic Search

Growth hormone (GH) deficiency in children results in increased body fat, reduced fat-free mass (FFM) including muscle (protein) and bone, and abdominal obesity. Thus, proper GH secretion likely has major developmental influences on later health risks including cardiovascular diseases and osteoporosis. However, the in vivo control of the development of the body composition and fat distribution by GH has not

J. N. Roemmich; M. G. Huerta; S. M. Sundaresan; A. D. Rogol

2001-01-01

346

An Empirical Model of Body Image Disturbance Using Behavioral Principles Found in Functional Analytic Psychotherapy and Acceptance and Commitment Therapy  

ERIC Educational Resources Information Center

The literature examining body image disturbance and Body Dysmorphic Disorder (BDD) is fraught with competing theoretical constructions of the etiology and nosology of these problems. Recent studies on various forms of psychopathology suggest that intrapersonal processes, including experiential avoidance, and interpersonal processes such as…

Callaghan, Glenn M.; Duenas, Julissa A.; Nadeau, Sarah E.; Darrow, Sabrina M.; Van der Merwe, Jessica; Misko, Jennifer

2012-01-01

347

Prognostic Value of Components of Body Composition in Patients Treated with Targeted Therapy for Advanced Renal Cell Carcinoma: A Retrospective Case Series  

PubMed Central

Background To evaluate the association between various components of body composition and overall survival of patients treated with targeted therapies for advanced renal cell carcinoma. Methods This retrospective study included 124 Chinese patients with advanced renal cell carcinoma who had been treated with targeted therapy from 2008 to 2012 at Fudan University Cancer Center. The L3 plane from a computed tomography scan was analyzed. Area and density were recorded as quantitative and quality measures. Univariate and multivariate Cox proportion hazard regression models were constructed to calculate the crude and adjusted hazard ratio (HR) of various components of body composition for overall survival. X-tile software was used to search for optimal cutoffs for male and female patients and the concordance index evaluated incremental changes in prognostication. Results After adjusting for age, sex and Heng risk stratification, only visceral adipose tissue index (HR 0.981, p = 0.002) and subcutaneous adipose tissue index (HR 0.987, p = 0.048) were independently associated with overall survival. Visceral adipose tissue remained a significant prognostic factor (HR 0.997, p = 0.005) when the influence of body mass index was included. Using defined cutoffs, patients with low VAT had double the death rate (p = 0.007). Visceral adipose tissue also added significant benefit to Heng risk stratification. Further exploratory analysis revealed that visceral adipose tissue may be an indicator of nutritional status in patients with advanced renal cell carcinoma. Conclusion Radiologic measurement of VAT is an independent prognostic factor for Asian patients treated with targeted therapy for advanced renal cell carcinoma. PMID:25668688

Gu, Weijie; Zhu, Yao; Wang, Hongkai; Zhang, Hailiang; Shi, Guohai; Liu, Xiaohang; Ye, Dingwei

2015-01-01

348

Clinical Characteristics and Management of Late Urinary Symptom Flare Following Stereotactic Body Radiation Therapy for Prostate Cancer  

PubMed Central

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly utilized as primary treatment for clinically localized prostate cancer. While acute post-SBRT urinary symptoms are well recognized, the late genitourinary toxicity of SBRT has not been fully described. Here, we characterize the clinical features of late urinary symptom flare and recommend conservative symptom management approaches that may alleviate the associated bother. Methods: Between February 2008 and August 2011, 216 men with clinically localized prostate cancer were treated definitively with SBRT at Georgetown University Hospital. Treatment was delivered using the CyberKnife with doses of 35–36.25?Gy in five fractions. The prevalence of each of five Common Terminology Criteria for Adverse Events (CTCAE) graded urinary toxicities was assessed at each follow-up visit. Medication usage was documented at each visit. Patient-reported urinary symptoms were assessed using the American Urological Association (AUA) symptom score and the Expanded Prostate Cancer Index Composite (EPIC)-26 at 1, 3, 6, 9, 12, 18, and 24?months. Late urinary symptom flare was defined as an increase in the AUA symptom score of ?5 points above baseline with a degree of severity in the moderate to severe range (AUA symptom score ?15). The relationship between the occurrence of flare and pre-treatment characteristics were examined. Results: For all patients, the AUA symptom score spiked transiently at 1?month post-SBRT. Of the 216 patients, 29 (13.4%) experienced a second transient increase in the AUA symptom score that met the criteria for late urinary symptom flare. Among flare patients, the median age was 66?years compared to 70 for those without flare (p?=?0.007). In patients who experienced flare, CTCAE urinary toxicities including dysuria, frequency/urgency, and retention peaked at 9–18?months, and alpha-antagonist utilization increased at 1?month post-treatment, rose sharply at 12?months post-treatment, and peaked at 18?months (85%) before decreasing at 24?months. The EPIC urinary summary score of flare patients declined transiently at 1?month and experienced a second, more protracted decline between 6 and 18?months before returning to near baseline at 2-year post-SBRT. Statistically and clinically significant increases in patient-reported frequency, weak stream, and dysuria were seen at 12?months post-SBRT. Among flare patients, 42.9% felt that urination was a moderate to big problem at 12?months following SBRT. Conclusion: In this study, we characterize late urinary symptom flare following SBRT. Late urinary symptom flare is a constellation of symptoms including urinary frequency/urgency, weak stream, and dysuria that transiently occurs 6–18?months post-SBRT. Provision of appropriate anticipatory counseling and the maintenance of prophylactic alpha-antagonists may limit the bother associated with this syndrome. PMID:24904833

Woo, Jennifer A.; Chen, Leonard N.; Bhagat, Aditi; Oermann, Eric K.; Kim, Joy S.; Moures, Rudy; Yung, Thomas; Lei, Siyuan; Collins, Brian T.; Kumar, Deepak; Suy, Simeng; Dritschilo, Anatoly; Lynch, John H.; Collins, Sean P.

2014-01-01

349

Quantification and Minimization of Uncertainties of Internal Target Volume for Stereotactic Body Radiation Therapy of Lung Cancer  

SciTech Connect

Purpose: To quantify uncertainties in delineating an internal target volume (ITV) and to understand how these uncertainties may be individually minimized for stereotactic body radiation therapy (SBRT) of early stage non-small cell lung cancer (NSCLC). Methods and Materials: Twenty patients with NSCLC who were undergoing SBRT were imaged with free-breathing 3-dimensional computed tomography (3DCT) and 10-phase 4-dimensional CT (4DCT) for delineating gross tumor volume (GTV){sub 3D} and ITV{sub 10Phase} (ITV3). The maximum intensity projection (MIP) CT was also calculated from 10-phase 4DCT for contouring ITV{sub MIP} (ITV1). Then, ITV{sub COMB} (ITV2), ITV{sub 10Phase+GTV3D} (ITV4), and ITV{sub 10Phase+ITVCOMB} (ITV5) were generated by combining ITV{sub MIP} and GTV{sub 3D}, ITV{sub 10phase} and GTV{sub 3D}, and ITV{sub 10phase} and ITV{sub COMB}, respectively. All 6 volumes (GTV{sub 3D} and ITV1 to ITV5) were delineated in the same lung window by the same radiation oncologist. The percentage of volume difference (PVD) between any 2 different volumes was determined and was correlated to effective tumor diameter (ETD), tumor motion ranges, R{sub 3D}, and the amplitude variability of the recorded breathing signal (v) to assess their volume variations. Results: The mean (range) tumor motion (R{sub SI}, R{sub AP}, R{sub ML}, and R{sub 3D}) and breathing variability (v) were 7.6 mm (2-18 mm), 4.0 mm (2-8 mm), 3.3 mm (0-7.5 mm), 9.9 mm (4.1-18.7 mm), and 0.17 (0.07-0.37), respectively. The trend of volume variation was GTV{sub 3D} =}0.503, P{<=}.047). The PVDs for pairs of ITV2 vs ITV5 and ITV5 vs ITV4 negatively correlated with ETD (r=0.502, -0.626; P=.047, .010). No other correlation was found. Conclusion: Uncertainties in individualized ITVs for SBRT of early stage NSCLC could effectively be minimized by combining information from 3DCT, 4DCT, and MIP. If these images cannot be efficiently contoured, a combination of ITV{sub MIP} and GTV{sub 3D} could be an effective alternative.

Ge Hong [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States) [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Department of Radiation Oncology, Henan Cancer Hospital, the Affiliated Cancer Hospital of Zhengzhou University, Henan (China); Cai Jing; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)] [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin Fangfang, E-mail: fangfang.yin@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

2013-02-01

350

Cochlear Damages Caused by Vibration Exposure  

PubMed Central

Background Many industrial devices have an excessive vibration which can affect human body systems. The effect of vibration on cochlear histology has been as a debatable problem in occupational health and medicine. Objectives Due to limitation present in human studies, the research was conducted to survey the influence of vibration on cochlear histology in an animal model. Materials and Methods Twelve albino rabbits were experimented as: Vibration group (n = 6; exposed to 1.0 m.s-2 r.m.s vertical whole-body vibration at 4 - 8 Hz for 8 hours per day during 5 consecutive days) versus Control group (n = 6; the same rabbits without vibration exposure). After finishing the exposure scenario, all rabbits were killed by CO2 inhalation; their cochleae were extracted and fixed in 10% formaldehyde for 48 hours, decalcified by 10% nitric acid for 24 hours. Specimens were dehydrated, embedded, sectioned 5 µm thick and stained with Hematoxylin and Eosin for light microscopy observations. Results Severely hydropic degenerated and vacuolated inner hair cells (IHCs) were observed in vibration group compared to the control group. Inter and intracellular edema was appeared in supporting cells (SC). Nuclei of outer hair cells (OHCs) seemed to be pyknotic. Slightly thickened basilar membrane (BM) was probably implied to inter cellular edematous. Tectorial Membrane (TM) was not affected pathologically. Conclusions Whole-body vibration could cause cochlear damages in male rabbits, though vibration-induced auditory functional effects might be resulted as subsequent outcome of prolonged high level vibration exposures. PMID:24616783

Moussavi Najarkola, Seyyed Ali; Khavanin, Ali; Mirzaei, Ramazan; Salehnia, Mojdeh; Muhammadnejad, Ahad

2013-01-01

351

Comparative Efficacies of Cloxacillin-Daptomycin and the Standard Cloxacillin-Rifampin Therapies against an Experimental Foreign-Body Infection by Methicillin-Susceptible Staphylococcus aureus  

PubMed Central

We compared the efficacies of daptomycin (doses equivalent to 8 to 10 mg/kg of body weight/day in humans) and cloxacillin alone with those of cloxacillin-rifampin and cloxacillin-daptomycin combinations, using a tissue cage methicillin-susceptible Staphylococcus aureus (MSSA) infection model. Monotherapies were less effective than combinations (P < 0.05), and daptomycin resistance emerged. Cloxacillin-daptomycin proved as effective as cloxacillin-rifampin and prevented the appearance of resistance; this combination may be an alternative anti-MSSA therapy, which may offer greater benefits in the early treatment of prosthetic joint infections (PJI). PMID:24957833

Murillo, Oscar; Ribera, Alba; Vivas, Mireia; Garcia-Somoza, Dolors; Tubau, Fe; Cabo, Javier; Ariza, Javier

2014-01-01

352

Coupled vibrations of a partially fluid-filled cylindrical container with an internal body including the effect of free surface waves  

NASA Astrophysics Data System (ADS)

Internal bodies (baffles) are used as damping devices to suppress the fluid sloshing motion in fluid-structure interaction systems. An analytical method is developed in the present article to investigate the effects of a rigid internal body on bulging and sloshing frequencies and modes of a cylindrical container partially filled with a fluid. The internal body is a thin-walled and open-ended cylindrical shell that is coaxially and partially submerged inside the container. The interaction between the fluid and the structure is taken into account to calculate the sloshing and bulging frequencies and modes of the coupled system using the Rayleigh quotient, Ritz expansion and Galerkin method. It is shown that the present formulation is an appropriate and new approach to tackle the problem with good accuracy. The effects of fluid level, number of nodal diameters, internal body radius and submergence ratio on the dynamic characteristics of the coupled system are also investigated.

Askari, E.; Daneshmand, F.; Amabili, M.

2011-10-01

353

Chronic stress and insulin resistance-related indices of cardiovascular disease risk, part 2: a potential role for mind-body therapies.  

PubMed

Cardiovascular disease (CVD) is the leading cause of death and disability in the industrialized world, and its prevalence is rapidly increasing among developing nations. The increasing global prevalence of CVD reflects in part the concurrent rise in insulin resistance, obesity, dyslipidemia, and other atherogenic changes associated with insulin resistance syndrome (IRS). Evidence suggests that chronic stress and related psychosocial factors also play an important role in the development and progression of IRS-related states and ultimately, in the pathogenesis of CVD. Designed to address these interrelated psychological and physiological components of health, yoga and other traditional mind-body therapies may offer particular promise in both the primary and secondary prevention of CVD. In this article, we review the evidence regarding the potential benefits of specific mind-body modalities for CVD risk reduction and discuss possible mechanisms underlying these observed effects. PMID:17900042

Innes, Kim E; Vincent, Heather K; Taylor, Ann Gill

2007-01-01

354

Vibration generators  

SciTech Connect

Apparatus for generating vibrations in a medium, such as the ground, comprises a first member which contacts the medium, means , preferably electromagnetic, which includes two relatively movable members for generating vibrations in the apparatus and means operatively connecting the said two members to said first member such that the relatively amplitudes of the movements of said three members can be adjusted to match the impedances of the apparatus and the medium.

Lerwill, W.E.

1980-09-16

355

Production, Delivery and Application of Vibration Energy in Healthcare  

NASA Astrophysics Data System (ADS)

In Rehabilitation Medicine therapeutic application of vibration energy in specific clinical treatments and in sport rehabilitation is being affirmed more and more.Vibration exposure can have positive or negative effects on the human body depending on the features and time of the characterizing wave. The human body is constantly subjected to different kinds of vibrations, inducing bones and muscles to actively modify their structure and metabolism in order to fulfill the required functions. Like every other machine, the body supports only certain vibration energy levels over which long term impairments can be recognized. As shown in literature anyway, short periods of vibration exposure and specific frequency values can determine positive adjustments.

Abundo, Paolo; Trombetta, Chiara; Foti, Calogero; Rosato, Nicola

2011-02-01

356

Effect of balance exercise in combination with whole-body vibration on muscle activity of the stepping limb during a forward fall in older women: A randomized controlled pilot study.  

PubMed

This study investigated the effects of balance exercise combined with whole-body vibration (WBV) on step performance and lower limb muscle activity during simulated forward falls using the tether-release method in older women. Twenty older women were assigned to either a WBV plus balance exercise group (WBV, n=10) or a balance exercise without vibration group (standard balance exercise group [STE], n=10). WBV performed weight-bearing exercises on a WBV platform combined with other balance exercises as a home program, whereas STE performed the same exercises without WBV. The exercise volume was equal in both intervention groups (3×/week for 12 weeks×30min/session). The EMG and kinematic data of the stepping leg from the balance recovery step were examined before and after the intervention. While both groups extended step length during forward falls after the intervention, only WBV increased step velocity. EMG analysis of the balance recovery step showed that both groups increased peak EMG of knee flexor and extensor muscles after intervention. After intervention, WBV increased peak EMG of the plantar flexors, which are used to exert the push-off forces just before the leg swing. Balance exercise in older women resulted in significant improvements in the balance recovery step after a simulated forward fall. WBV also had the additional benefit of improved step velocity, which was reflected in increased activity of the plantar flexors in the stepping leg. PMID:25482957

Ochi, Akira; Abe, Tomokazu; Yamada, Kazumasa; Ibuki, Satoko; Tateuchi, Hiroshige; Ichihashi, Noriaki

2015-01-01

357

Oxygen Therapy  

MedlinePLUS

Oxygen therapy is a treatment that provides you with extra oxygen. Oxygen is a gas that your body needs to function. Normally, your lungs absorb oxygen from the air you breathe. But some conditions ...

358

PAHA study: Psychological Active and Healthy Aging: psychological wellbeing, proactive attitude and happiness effects of whole-body vibration versus Multicomponent Training in aged women: study protocol for a randomized controlled trial  

PubMed Central

Background Evidence demonstrates that physical exercise and psychological wellbeing are closely interlinked, particularly in older-aged women. However, research investigating how different forms of exercise influence mental health in older-aged women is underdeveloped. Methods/Design A randomized controlled trial (N?=?300) will assess the relative effectiveness of two different exercise programs (whole-body vibration and Multicomponent Training) for improving psychological wellbeing in older-aged women. The following outcomes will be assessed at three time points (that is, pre, post, and follow-up): psychological wellbeing, proactive attitude, quality of life, and happiness. Discussion Results will have important implications for preventing psychological and physiological disease in older-aged women and for managing health-related costs for this population group. Trial registration Number NCT01966562 on Clinical Gov database the 8 October 2013 PMID:24886107

2014-01-01

359

Long-Term Effects of Growth Hormone Therapy on Bone Mineral Density, Body Composition, and Serum Lipid Levels in Growth Hormone Deficient Children: A 6Year Follow-Up Study  

Microsoft Academic Search

Aim: To study the effects of growth hormone (GH) deficiency (GHD) and GH replacement therapy (GHRx) on bone mineral density (BMD) and body composition. Methods: 59 GHD children participated (age range 0.4–16.9 years); the follow-up period was 6 years. Lumbar spine BMD (BMDLS), total-body BMD (BMDTB), and body composition were measured prospectively using dual-energy X-ray absorptiometry. Results: Mean BMDLS and

Inge M. van der Sluis; Annemieke M. Boot; Wim C. Hop; Yolanda B. de Rijke; Eric P. Krenning; Sabine M. P. F. de Muinck Keizer-Schrama

2002-01-01

360

The acute effects of body position strategies and respiratory therapy in paralyzed patients with acute lung injury  

Microsoft Academic Search

BACKGROUND: Routine turning of critically ill patients is a standard of care. In recent years, specialized beds that provide automated turning have been introduced. These beds have been reported to improve lung function, reduce hospital-acquired pneumonia, and facilitate secretion removal. This trial was designed to measure the physiological effects of routine turning and respiratory therapy in comparison with continuous lateral

Kenneth Davis Jr; Jay A Johannigman; Robert S Campbell; Ann Marraccini; Fred A Luchette; Scott B Frame; Richard D Branson

2001-01-01

361

The Potential Benefits and Inherent Risks of Vibration as a Non-Drug Therapy for the Prevention and Treatment of Osteoporosis  

PubMed Central

The delivery of mechanical signals to the skeleton using vibration is being considered as a non-drug treatment of osteoporosis. Delivered over a range of magnitudes and frequencies, vibration has been shown to be both anabolic and anti-catabolic to the musculoskeletal tissues, yet caution must be emphasized as these mechanical signals, particularly chronic exposure to higher intensities, is a known pathogen to many physiological systems. In contrast, accumulating preclinical and clinical evidence indicates that low intensity vibration (LIV) improves bone quality through regulating the activity of cells responsible for bone remodeling, as well as biasing the differentiation fate of their mesenchymal and hematopoietic stem cell progenitors. In vitro studies provide insights into the biologic mechanisms of LIV, and indicate that cells respond to these low magnitude signals through a distinct mechanism driven not by matrix strain but acceleration. These cell, animal and human studies may represent the foundation of a safe, non-drug means to protect and improve the musculoskeletal system of the elderly, injured and infirm. PMID:23371467

Chan, M. Ete; Uzer, Gunes; Rubin, Clinton T.

2013-01-01

362

Random Vibrations  

NASA Technical Reports Server (NTRS)

Ares I Zonal Random vibration environments due to acoustic impingement and combustion processes are develop for liftoff, ascent and reentry. Random Vibration test criteria for Ares I Upper Stage pyrotechnic components are developed by enveloping the applicable zonal environments where each component is located. Random vibration tests will be conducted to assure that these components will survive and function appropriately after exposure to the expected vibration environments. Methodology: Random Vibration test criteria for Ares I Upper Stage pyrotechnic components were desired that would envelope all the applicable environments where each component was located. Applicable Ares I Vehicle drawings and design information needed to be assessed to determine the location(s) for each component on the Ares I Upper Stage. Design and test criteria needed to be developed by plotting and enveloping the applicable environments using Microsoft Excel Spreadsheet Software and documenting them in a report Using Microsoft Word Processing Software. Conclusion: Random vibration liftoff, ascent, and green run design & test criteria for the Upper Stage Pyrotechnic Components were developed by using Microsoft Excel to envelope zonal environments applicable to each component. Results were transferred from Excel into a report using Microsoft Word. After the report is reviewed and edited by my mentor it will be submitted for publication as an attachment to a memorandum. Pyrotechnic component designers will extract criteria from my report for incorporation into the design and test specifications for components. Eventually the hardware will be tested to the environments I developed to assure that the components will survive and function appropriately after exposure to the expected vibration environments.

Messaro. Semma; Harrison, Phillip

2010-01-01

363

Mindful Awareness in Body-oriented Therapy as an Adjunct to Women’s Substance Use Disorder Treatment: A Pilot Feasibility Study  

PubMed Central

This study examined Mindful Awareness in Body-oriented Therapy (MABT) feasibility as a novel adjunct to women’s substance use disorder (SUD) treatment. An individual therapy, MABT combines manual and mind-body approaches to develop interoception and self-care tools for emotion regulation. A 2-group RCT repeated measures design was used, comparing MABT to treatment-as-usual (TAU) on relapse to substance use and related health outcomes. Sixty-one women were screened for eligibility and 46 enrolled. Participants randomized to MABT received 8 weekly MABT sessions. Results showed moderate to large effects, including significantly fewer days on substance use, the primary outcome, for MABT compared to TAU at post-test. Secondary outcomes showed improved eating disorder symptoms, depression, anxiety, dissociation, perceived stress, physical symptom frequency, and bodily dissociation for MABT compared to TAU at 9 month follow-up. In conclusion, it is feasible to implement MABT in women’s SUD treatment and results suggest that MABT is worthy of further efficacy testing. PMID:22119181

Price, Cynthia J.; Wells, Elizabeth A.; Donovan, Dennis M.; Rue, Tessa

2011-01-01

364

Forcing lateral electron disequilibrium to spare lung tissue: a novel technique for stereotactic body radiation therapy of lung cancer  

NASA Astrophysics Data System (ADS)

Stereotactic body radiation therapy (SBRT) has quickly become a preferred treatment option for early-stage lung cancer patients who are ineligible for surgery. This technique uses tightly conformed megavoltage (MV) x-ray beams to irradiate a tumour with ablative doses in only a few treatment fractions. Small high energy x-ray fields can cause lateral electron disequilibrium (LED) to occur within low density media, which can reduce tumour dose. These dose effects may be challenging to predict using analytic dose calculation algorithms, especially at higher beam energies. As a result, previous authors have suggested using low energy photons (<10 MV) and larger fields (>5 × 5 cm2) for lung cancer patients to avoid the negative dosimetric effects of LED. In this work, we propose a new form of SBRT, described as LED-optimized SBRT (LED-SBRT), which utilizes radiotherapy (RT) parameters designed to cause LED to advantage. It will be shown that LED-SBRT creates enhanced dose gradients at the tumour/lung interface, which can be used to manipulate tumour dose, and/or normal lung dose. To demonstrate the potential benefits of LED-SBRT, the DOSXYZnrc (National Research Council of Canada, Ottawa, ON) Monte Carlo (MC) software was used to calculate dose within a cylindrical phantom and a typical lung patient. 6 MV or 18 MV x-ray fields were focused onto a small tumour volume (diameter ˜1 cm). For the phantom, square fields of 1 × 1 cm2, 3 × 3 cm2, or 5 × 5 cm2 were applied. However, in the patient, 3 × 1 cm2, 3 × 2 cm2, 3 × 2.5 cm2, or 3 × 3 cm2 field sizes were used in simulations to assure target coverage in the superior-inferior direction. To mimic a 180° SBRT arc in the (symmetric) phantom, a single beam profile was calculated, rotated, and beams were summed at 1° segments to accumulate an arc dose distribution. For the patient, a 360° arc was modelled with 36 equally weighted (and spaced) fields focused on the tumour centre. A planning target volume (PTV) was generated by considering the extent of tumour motion over the patient's breathing cycle and set-up uncertainties. All patient dose results were normalized such that at least 95% of the PTV received at least 54 Gy (i.e. D95 = 54 Gy). Further, we introduce ‘LED maps’ as a novel clinical tool to compare the magnitude of LED resulting from the various SBRT arc plans. Results from the phantom simulation suggest that the best lung sparing occurred for RT parameters that cause severe LED. For equal tumour dose coverage, normal lung dose (2 cm outside the target region) was reduced from 92% to 23%, comparing results between the 18 MV (5 × 5 cm2) and 18 MV (1 × 1 cm2) arc simulations. In addition to reduced lung dose for the 18 MV (1 × 1 cm2) arc, maximal tumour dose increased beyond 125%. Thus, LED can create steep dose gradients to spare normal lung, while increasing tumour dose levels (if desired). In the patient simulation, a LED-optimized arc plan was designed using either 18 MV (3 × 1 cm2) or 6 MV (3 × 3cm2) beams. Both plans met the D95 dose coverage requirement for the target. However, the LED-optimized plan increased the maximum, mean, and minimum dose within the PTV by as much as 80 Gy, 11 Gy, and 3 Gy, respectively. Despite increased tumour dose levels, the 18 MV (3 × 1 cm2) arc plan improved or maintained the V20, V5, and mean lung dose metrics compared to the 6 MV (3 × 3 cm2) simulation. We conclude that LED-SBRT has the potential to increase dose gradients, and dose levels within a small lung tumour. The magnitude of tumour dose increase or lung sparing can be optimized through manipulation of RT parameters (e.g. beam energy and field size).

Disher, Brandon; Hajdok,