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This study evaluates the performance and planning efficacy of the Auto-Planning (AP) module in the clinical version of Pinnacle 9.10 (Philips Radiation Oncology Systems, Fitchburg, WI, USA). Twenty automated intensity-modulated radiotherapy (IMRT) plans were compared with the original manually planned clinical IMRT plans from patients with oropharyngeal cancer. Auto-Planning with IMRT offers similar coverage of the planning target volume as the original manually planned clinical plans, as well as better sparing of the contralateral parotid gland, contralateral submandibular gland, larynx, mandible, and brainstem. The mean dose of the contralateral parotid gland and contralateral submandibular gland could be reduced by 2.5 Gy and 1.7 Gy on average. The number of monitor units was reduced with an average of 143.9 (18%). Hands-on planning time was reduced from 1.5–3 h to less than 1 h. The Auto-Planning module was able to produce clinically acceptable head and neck IMRT plans with consistent quality.

Advanced stage non-small cell lung cancer (AS-NSCLC) is generally treated with concurrent chemoradiotherapy using a radiation dose of 60–66 Gray (Gy) in 30–33 fractions over six-seven weeks [1]. Intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) are widely used treatment techniques [2]. Radiation treatment plans are becoming increasingly complex [3] and manual optimization of treatment plans is time-consuming and the quality of the plan is operator dependent [4]. The increasing complexity of treatment plans complicates the optimization procedure and thereby augments the rate of inconsistency between manually derived treatment plans [3], [5]. Several trial-and-error optimization processes are usually required to achieve clinically acceptable plans. More manual actions could influence consistency and plan quality of the manual treatment plans [3], [4]. The experience of the planner has a large impact on plan quality and dissemination of best practices could help improve these variations [6]. Aforementioned drawbacks of manual treatment planning might be overcome by automating treatment planning. Most treatment planning systems currently have integrated an automated treatment planning solution. In addition, there are also in-house developed automated treatment planning systems [7]. Automated treatment planning methods are aimed to reduce the inter-planner variability and the planning time during the optimization process and to improve plan quality. Different sites investigated were already investigated such as head and neck (H&N) [4], [5], [8], [9], prostate [10] and oesophagus [11]. Automated treatment plans for AS-NSCLC radiation therapy are not much represented yet. The location of a tumor in the lung varies more than the location of a tumor in the H&N area or the prostate. This variability may cause a difference in the result of automated treatment planning techniques. Della Gala et al. [7] investigated different radiation techniques for AS-NSCLC by comparing originally manually planned IMRT treatment plans versus automated VMAT treatment plans with their in-house developed treatment planning system Erasmus-iCycle. In this study we have investigated, if automated treatment planning is able to create treatment plans with consistent quality using a single optimization preset including beam set-up, dose prescription, objectives and priorities for organs at risk (OARs), and planning target volumes (PTVs) for AS-NSCLC. A comparison is presented between automated and manually generated VMAT treatment plans for AS-NSCLC.

Correction to: Strahlenther Onkol 2017 https://doi.org/10.1007/s00066-017-1187-9 Unfortunately, parts of the ‘Materials and Methods section’ and a sentence in the ‘Discussion section’ had to be corrected. On page 3, left column, the complete first paragraph was corrected and now reads as follows: Auto-P

Normal rat kidney (NRK) fibroblasts have electrophysiological properties and intracellular calcium dynamics that are dependent upon their growth stage. In the present study we show that this differential behavior coincides with a differential calcium entry that can be either capacitative or non-capacitative. Confluent cells made quiescent by serum deprivation, which have a stable membrane potential near − 70 mV and do not show spontaneous intracellular calcium oscillations, primarily exhibit the capacitative mechanism for calcium entry, also called store-operated calcium entry (SOCE). When the quiescent cells are grown to density-arrest in the presence of EGF as the sole polypeptide growth factor, these cells characteristically fire spontaneously repetitive calcium action potentials, which propagate throughout the whole monolayer and are accompanied by intracellular calcium transients. These density-arrested cells appear to exhibit in addition to SOCE also receptor-operated calcium entry (ROCE) as a mechanism for calcium entry. Furthermore we show that, in contrast to earlier studies, the employed SOCs and ROCs are permeable for both calcium and strontium ions. We examined the expression of the canonical transient receptor potential channels (Trpcs) that may be involved in SOCE and ROCE. We show that NRK fibroblasts express the genes encoding Trpc1, Trpc5 and Trpc6, and that the levels of their expression are dependent upon the growth stage of the cells. In addition we examined the growth stage dependent expression of the genes encoding Orai1 and Stim1, two proteins that have recently been shown to be involved in SOCE. Our results suggest that the differential expression of Trpc5, Trpc6, Orai1 and Stim1 in quiescent and density-arrested NRK fibroblasts is responsible for the difference in regulation of calcium entry between these cells. Finally, we show that inhibition or potentiation of SOCE and ROCE by pharmacological agents has profound effects on calcium dynamics in NRK fibroblasts.

Contains fulltext : 152450.pdf (Publisher’s version ) (Open Access) BACKGROUND: To report on the acute toxicity in children with medulloblastoma undergoing intensity-modulated radiation therapy (IMRT) with daily intrafractionally modulated junctions. METHODS: Newly diagnosed patients, aged 3-21, with standard-risk (SR) or high-risk (HR) medulloblastoma were eligible. A dose of 23.4 or 36.0Gy in daily fractions of 1.8Gy was prescribed to the craniospinal axis, followed by a boost to the primary tumor bed (54 or 55.8Gy) and metastases (39.6-55.8Gy), when indicated. Weekly, an intravenous bolus of vincristine was combined for patients with SR medulloblastoma and patients participating in the COG-ACNS-0332 study. Common toxicity criteria (CTC, version 2.0) focusing on skin, alopecia, voice changes, conjunctivitis, anorexia, dysphagia, gastro-intestinal symptoms, headache, fatigue and hematological changes were scored weekly during radiotherapy. RESULTS: From 2010 to 2014, data from 15 consecutive patients (SR, n = 7; HR, n = 8) were collected. Within 72 h from onset of treatment, vomiting (66 %) and headache (46 %) occurred. During week 3 of treatment, a peak incidence in constipation (33 %) and abdominal pain/cramping (40 %) was observed, but only in the subgroup of patients (n = 9) receiving vincristine (constipation: 56 vs 0 %, P = .04; pain/cramping: 67 vs 0 %, P = .03). At week 6, 73 % of the patients developed faint erythema of the cranial skin with dry desquamation (40 %) or moist desquamation confined to the skin folds of the auricle (33 %). No reaction of the skin overlying the spinal target volume was observed. CONCLUSIONS: Headache at onset and gastro-intestinal toxicity, especially in patients receiving weekly vincristine, were the major complaints of patients with medulloblastoma undergoing craniospinal irradiation with IMRT.

Item does not contain fulltext PURPOSE: To develop a treatment technique for craniospinal irradiation using intensity-modulated radiotherapy (IMRT) with improved dose homogeneity at the field junction(s), increased target volume conformity, and minimized dose to the organs at risk (OARs). METHODS AND MATERIALS: Five patients with high-risk medulloblastoma underwent CT simulation in supine position. For each patient, an IMRT plan with daily intrafractionally modulated junction(s) was generated, as well as a treatment plan based on conventional three-dimensional planning (3DCRT). A dose of 39.6 Gy in 22 daily fractions of 1.8 Gy was prescribed. Dose-volume parameters for target volumes and OARs were compared for the two techniques. RESULTS: The maximum dose with IMRT was 107) were

Contains fulltext : 70278.pdf (Publisher’s version ) (Closed access) Contains fulltext : 70278.pdf (Author’s version preprint ) (Open Access) We have investigated synchronization and propagation of calcium oscillations, mediated by gap junctional excitation transmission. For that purpose we used an experimentally based model of normal rat kidney (NRK) cells, electrically coupled in a one-dimensional configuration (linear strand). Fibroblasts such as NRK cells can form an excitable syncytium and generate spontaneous inositol 1,4,5-trisphosphate (IP(3))-mediated intracellular calcium waves, which may spread over a monolayer culture in a coordinated fashion. An intracellular calcium oscillation in a pacemaker cell causes a membrane depolarization from within that cell via calcium-activated chloride channels, leading to an L-type calcium channel-based action potential (AP) in that cell. This AP is then transmitted to the electrically connected neighbor cell, and the calcium inflow during that transmitted AP triggers a calcium wave in that neighbor cell by opening of IP(3) receptor channels, causing calcium-induced calcium release (CICR). In this way the calcium wave of the pacemaker cell is rapidly propagated by the electrically transmitted AP. Propagation of APs in a strand of cells depends on the number of terminal pacemaker cells, the L-type calcium conductance of the cells, and the electrical coupling between the cells. Our results show that the coupling between IP(3)-mediated calcium oscillations and AP firing provides a robust mechanism for fast propagation of activity across a network of cells, which is representative for many other cell types such as gastrointestinal cells, urethral cells, and pacemaker cells in the heart. 14 p.

Contains fulltext : 69487.pdf (Author’s version postprint ) (Open Access) Contains fulltext : 69487.pdf (Publisher’s version ) (Closed access) Cultures of normal rat kidney (NRK) fibroblasts may display spontaneous calcium action potentials which propagate throughout the cellular monolayer. Pacemaking activity of NRK cells was studied by patch clamp electrophysiology and vital calcium imaging, using a new experimental approach in which a ring was placed on the monolayer in order to physically separate pacemakers within or under the ring and follower cells outside the ring. Stimulation of cells inside the ring with IP(3)-generating hormones such as prostaglandin F(2alpha) (PGF(2alpha)) resulted in the induction of periodic action potentials outside the ring, which were abolished when the L-type calcium channel blocker nifedipine was added outside the ring, but not inside the ring. PGF(2alpha)-treated cells displayed asynchronous IP(3)-mediated calcium oscillations of variable frequency, while follower cells outside the ring showed synchronous calcium transients which coincided with the propagating action potential. Mathematical modelling indicated that addition of PGF(2alpha) inside the ring induced both a membrane potential gradient and an intracellular IP(3) gradient, both of which are essential for the induction of pacemaking activity under the ring. These data show that intercellular coupling between PGF(2alpha)-treated and non-treated cells is essential for the generation of a functional pacemaker area whereby synchronization of calcium oscillations occurs by activation of L-type calcium channels. 12 p.

Oscillatory activity of cells has been the topic of many studies. Oscillatory activity can be due to action potential firing corresponding to the well‐known Hodgkin‐Huxley (HH) type dynamics of ion‐channels in the cell membrane or due to IP3‐mediated calcium oscillations in the endoplasmic reticulum (ER) causing periodic oscillations of calcium transients in the cytosol. In this study we show that coupling of these two oscillatory mechanisms may reveal a complex, rich spectrum of both stable and unstable states of cells with hysteresis. The predicted bi‐stability corresponds to experimentally observed states. This illustrates that the different behavior of cells is not the consequence of differentiation in cells with different properties, but rather reflects different states of a single cell type.

Many cells reveal oscillatory behavior. Some cells reveal action-potential firing resulting from Hodgkin-Huxley (HH) type dynamics of ion channels in the cell membrane. Another type of oscillation relates to periodic inositol triphospate (IP3)-mediated calcium transients in the cytosol. In this study we present a bifurcation analysis of a cell with an excitable membrane and an IP3-mediated intracellular calcium oscillator. With IP3 concentration as a control parameter the model reveals a complex, rich spectrum of both stable and unstable solutions with hysteresis corresponding to experimental data. Our results reveal the emergence of complex behavior due to interactions between subcomponents with a relatively simple dynamical behavior.

In many biological systems, cells display spontaneous calcium oscillations (CaOs) and repetitive action-potential firing. These phenomena have been described separately by models for intracellular inositol trisphosphate (IP3)-mediated CaOs and for plasma membrane excitability. In this study, we present an integrated model that combines an excitable membrane with an IP3-mediated intracellular calcium oscillator. The IP3 receptor is described as an endoplasmic reticulum (ER) calcium channel with open and close probabilities that depend on the cytoplasmic concentration of IP3 and Ca 21 . We show that simply combining this ER model for intracellular CaOs with a model for membrane excitability of normal rat kidney (NRK) fibroblasts leads to instability of intracellular calcium dynamics. To ensure stable long-term periodic firing of action potentials and CaOs, it is essential to incorporate calcium transporters controlled by feedback of the ER store filling, for example, store-operated calcium channels in the plasma membrane. For low IP3 concentrations, our integrated NRK cell model is at rest at � 70 mV. For higher IP3 concentrations, the CaOs become activated and trigger repetitive firing of action potentials. At high IP3 con- centrations, the basal intracellular calcium concentration becomes elevated and the cell is depolarized near � 20 mV. These predictions are in agreement with the different proliferative states of cultures of NRK fibroblasts. We postulate that the stabilizing role of calcium channels and/or other calcium transporters controlled by feedback from the ER store is essential for any cell in which calcium signaling by intracellular CaOs involves both ER and plasma membrane calcium fluxes.

Contains fulltext : 57338.pdf (author's version ) (Closed access) A central problem in motor control relates to the coordination of the arm's many degrees of freedom. This problem concerns the many arm postures (kinematics) that correspond to the same hand position in space and the movement trajectories between begin and end position (dynamics) that result in the same arm postures. The aim of this study was to compare the predictions for arm kinematics by various models on human motor control with experimental data and to study the relation between kinematics and dynamics. Goal-directed arm movements were measured in 3-D space toward far and near targets. The results demonstrate that arm postures for a particular target depend on previous arm postures, contradicting Donders's law. The minimum-work and minimum-torque-change models, on the other hand, predict a much larger effect of initial posture than observed. These data suggest that both kinematics and dynamics affect postures and that their relative contribution might depend on instruction and task complexity.