Biomedical subjects
Publications and source records attributed to D J Brenner.
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We report on the prevalence and relative biological effectiveness (RBE) for various stages of lens opacification in rats induced by very low doses (2 to 250 mGy) of medium-energy (440 keV) neutrons, compared to those for X rays. Neutron doses were delivered either in a single fraction or in four separate fractions and the irradiated animals were followed for over 100 weeks. At the highest observed dose (250 mGy) and at early observation times, there was evidence of an inverse dose-rate effect; i.e., a fractionated exposure was more potent than a single exposure. Neutron RBEs relative to X rays were estimated using a non-parametric technique. The results were only weakly dependent on time postirradiation. At 30 weeks, for example, 80% confidence intervals for the RBE of acutely delivered neutrons relative to X rays were 8-16 at 250 mGy, 10-20 at 50 mGy, 50-100 at 10 mGy and 250-500 at 2 mGy. The results are consistent with the estimated neutron RBEs in Japanese A-bomb survivors, though broad confidence bounds are present in the Japanese results. Our findings are also consistent with data reported earlier for cataractogenesis induced by heavy ions in rats, mice, and rabbits. We conclude from these results that, at very low doses (<10 mGy), the RBE for neutron-induced cataractogenesis is considerably larger than the RBE of 20 commonly used, and use of a significantly larger value for calculating equivalent dose would be prudent.
PURPOSE: At present, the linear-quadratic model for cellular response to radiation can incorporate sublethal damage repair and repopulation. We suggest an extension, termed LQR, to include also the other two "Rs" of radiobiology, cell cycle redistribution, and reoxygenation. METHODS AND MATERIALS: In this approach, redistribution and reoxygenation are both regarded as aspects of a single phenomenon, which we term resensitization. After the first portion of a radiation exposure has decreased the average radiosensitivity of a diverse cell population by preferentially sparing less sensitive cells, resensitization gradually restores the average sensitivity of the population towards its previous value. The proposed LQR formula is of the same form as the original LQ formula, but with two extra parameters, an overall resensitization magnitude and a characteristic resensitization time. The LQR model assumes that resensitization is monotonic rather than oscillatory in time, i.e., always tends to increase average cellular sensitivity as overall time increases. We argue that this monotonicity assumption is likely to hold in clinical situations, though a possible extension is discussed to account for oscillatory decay of resensitization effects. RESULTS: The LQR model gives reasonable fits to relevant experimental data in the literature, reproducing an initial rise in cell survival, due to repair, as the treatment time is increased, followed by a resensitization-related decrease in survival due to redistribution and/or reoxygenation for treatment times of the order of the cell cycle time, and a final survival increase due to repopulation as the treatment time is increased still further. CONCLUSION: The LQR model is a simple and potentially useful extension of the LQ model for computing more realistic isoeffect relations for early responding tissues, including tumors, when comparing different radiotherapeutic protocols.
BACKGROUND: Bartonella (Rochalimaea) quintana is a fastidious gram-negative bacterium known to cause trench fever, cutaneous bacillary angiomatosis, and endocarditis. Between January and June 1993 in Seattle, we isolated B. quintana from 34 blood cultures obtained from 10 patients not known to be infected with the human immunodeficiency virus (HIV). METHODS: After identifying the isolates as B. quintana by direct immunofluorescence and DNA-hybridization studies, we determined strain hybridization with studies of restriction-fragment-length polymorphisms (RFLPs) of the intergenic spacer (noncoding) region of ribosomal DNA amplified by the polymerase chain reaction (PCR). To characterize the epidemiologic and clinical features of bartonella infections in these patients, we performed a retrospective case-control study using as controls 20 patients with blood cultures obtained at approximately the same time as those obtained from the index patients. RESULTS: B. quintana isolates from the 10 patients were indistinguishable by PCR-RFLP typing. All 10 patients had chronic alcoholism, and 8 were homeless (P = 0.001 for both comparisons with controls). The six patients who underwent HIV testing were seronegative. At the time of their initial presentation, seven patients had temperatures of at least 38.5 degrees C. Six patients had three or more blood cultures that were positive for B. quintana, and in four of these patients B. quintana was isolated from blood cultures obtained 10 or more days apart. Subacute endocarditis developed in two patients and required surgical removal of the infected aortic valve in one of them. Nine patients recovered; one died of sepsis from Streptococcus pneumoniae infection. CONCLUSIONS: B. quintana is a cause of fever, bacteremia, and endocarditis in HIV-seronegative, homeless, inner-city patients with chronic alcoholism.
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Twenty-three of 2446 strains of Enterobacteriaceae isolated from mollusks were identified as Ewingella americana both biochemically and by DNA hybridization with strain S6/1111. The biochemical characteristics of the new strains showed few differences from previously reported strains obtained from human clinical specimens. These are the first strains of E. americana isolated from animals.
If a population of cycling cells is exposed to a fixed dose of ionizing radiation delivered over time T, it is sometimes observed that increasing T increases the amount of cell killing. This is essentially because at first the radiation preferentially kills cells in a sensitive portion of the cycle and the surviving, more resistant cells then have time to reach more sensitive stages. We refer to this effect as population resensitization, caused by redistribution within the cell cycle. We investigate the effect theoretically by employing the McKendrick-von Foerster equation for age-structured proliferating cell populations, generalized by introducing a radiation damage term. Within our formalism, we show that population resensitization occurs whenever: (a) prior to irradiation the cell population has the stable age-distribution approached asymptotically by an unirradiated population, and (b) T is sufficiently small. Examples and other cases are outlined. The methods of Volterra integral equations, renewal theory, and positive semigroup theory are applied. The effect of varying T is evaluated by considering the ultimate amplitude of the stable age-distribution population at times much greater than both the irradiation duration and the average cell-cycle time. The main biological limitations of the formalism are the following: considering only radiation damage which is not subject to enzymatic repair or quadratic misrepair, using an overly naive method of ensuring loss of cell cycle synchrony, neglecting nonlinear effects such as density inhibition of growth, and neglecting radiatively induced perturbations of the cell cycle. Possible methods for removing these limitations are briefly discussed.
Monte Carlo simulations are used to analyze the reshuffling of chromosome segments which occurs when DNA is damaged by ionizing radiation. Programs are based on either Sax's classic breakage-and-reunion model or Revell's exchange model for chromosome aberrations. The simulations quantify the predictions of the two models in complete detail, using only one adjustable parameter which corresponds to total radiation dose. While testing subroutines, new analytic results on the chromosome/arm/break method of classifying aberrations were obtained. The model predictions were tested by using three-color fluorescence in situ hybridization (FISH) 'chromosome painting' on human lymphocyte cells irradiated with gamma-rays. Some of the per-cell aberration frequencies were observed to be intermediate between the predictions of the two models. This result indicates proximity 'effects', due to localization of chromosome interactions in space and time. Predictions based on chromosome arm lengths were found to be in good agreement with experiment. Monte Carlo simulations are a powerful, flexible way to compare models of chromosome aberration production with experiments quantitatively, using a minimum of theoretical presumptions.
Bartonella quintana (formerly Rochalimaea quintana) is a recently recognized cause of apparent "culture-negative" endocarditis. We describe a 39-year-old, homeless man who developed aortic valve endocarditis caused by B. quintana. He had a history of alcoholism and was seronegative for the human immunodeficiency virus. We established that B. quintana was the cause of the endocarditis on the basis of the isolation of B. quintana from blood cultures, the compatibility of histochemical stains of cardiac valve tissue, the reactivity of the polymerase chain reaction specific for B. quintana on cardiac valve tissue, and the failure to isolate an alternative causative organism despite extensive efforts. This is the second report of endocarditis caused by B. quintana and the fourth report of endocarditis caused by a Bartonella species. On the basis of the findings of this report and those of other recent reports, further study is warranted to determine the overall role of Bartonella species in apparent culture-negative endocarditis.
The current type strain of Proteus vulgaris, NCTC 4175 (= ATCC 13315), differs substantially from typical strains of this species both biochemically and chemotaxonomically. DNA relatedness studies revealed that strains previously classified as P. vulgaris belong to six genomospecies. One of these genomospecies contains strains that are negative in indole, salicin, and esculin reactions (biogroup 1) and has been named Proteus penneri. A second genomospecies, which is most frequently isolated from human urine, contains typical P. vulgaris strains that are positive in indole, salicin, and esculin reactions (biogroup 2). The members of the remaining four genomospecies are indole positive and negative in salicin and esculin reactions (biogroup 3). Of 36 biogroup 3 strains studied, only strain NCTC 4175T (T = type strain) and one other strain, CDC 1732-80, belong to genomospecies 3. To retain NCTC 4175 as the type strain of P. vulgaris would restrict this species to these two strains, whose origins are unknown. This would mean that hundreds of strains for which the description of P. vulgaris was written and which have been representatives of this species for the past 50 years would have to be renamed as members of a new species. To prevent this confusion, we request that biogroup 2 reference strain ATCC 29905 (= CDC PR1) replace NCTC 4175 as the type strain of P. vulgaris.
CDC nonoxidizer group 2 (NO-2) currently consists of 15 gram-negative, rod-shaped, oxidase-negative, asaccharolytic, brown soluble pigment-producing strains isolated from blood cultures, usually from young adults. On the basis of their cellular fatty acid profiles, NO-2 strains formed a single group that was identical with the profile of Bordetella avium. 16S rRNA sequencing of one NO-2 strain and the type strains of B. pertussis, B. parapertussis, B. bronchiseptica, and B. avium showed a high degree of homology (> or = 98% over 1,525 bases). The NO-2 guanine-plus-cytosine content (61.5 to 62.3 mol%) and major ubiquinone analysis (ubiquinone-8) results were both consistent with those for the genus Bordetella. DNA relatedness studies (hydroxyapatite method) confirmed a close relatedness between NO-2 and Bordetella species and demonstrated that NO-2 strains were a single new species. The name B. holmesii sp. nov. is proposed for CDC group NO-2.
Four slightly yellow-pigmented, alpha-hemolytic, gram-negative coccobacilli, three from wound specimens and one from multiple blood cultures of a patient with endocarditis, were identified as Neisseria elongata subsp. glycolytica on the basis of their overall biochemical and genetic similarities to this subspecies. These strains resembled N. elongata in their guanine-plus-cytosine contents (55.6 to 57.1 mol%) and in their overall cellular fatty acid profiles, which are characterized by large amounts of 16:0, 16:1 omega 7c, and 18:1 omega 7c fatty acids. Their identities were confirmed by species-level DNA relatedness (hydroxyapatite method) to the type strains of all three N. elongata subspecies. The biochemical profiles and cultural characteristics of these strains resembled those of the type strain of N. elongata subsp. glycolytica except for the production of a weak yellow growth pigment and alpha-hemolysis on sheep blood agar. They differed from N elongata subsp. elongata by the production of catalase, by the production of alpha-hemolysis on sheep blood agar, and by acid production from D-glucose. They differed from N. elongata subsp. nitroreducens by the production of catalase and an inability to reduce nitrate. These studies suggest a pathogenic potential for N. elongata subsp. glycolytica, usually considered to be a transient colonizer in humans.
By DNA-DNA hybridization, we classified 26 human strains, 4 dog and cat strains, and 4 hamster strains putatively identified as Helicobacter cinaedi as well as 2 human strains and 2 animal strains of Helicobacter fennelliae. All but one human strain belonged to the same hybridization group as the type strain of H. cinaedi. The animal strains also appeared to belong to this hybridization group. Both human strains of H. fennelliae were shown to be H. fennelliae by DNA-DNA hybridization, but both animal strains were less than 15% related to the type strain. All strains were also characterized by plasmid profiles and ribotyping. Plasmids were found in 23% of the human strains, 100% of the hamster strains, and 33% of the dog and cat strains. Human strains were essentially identical by ribotyping, but were clearly differentiated from the hamster and dog and cat strains. Some strains may be difficult to culture on primary isolation; we found that our strains grew well on anaerobic CDC agar, brucella agar, and tryptic soy agar II. Our H. cinaedi and H. fennelliae strains differed from those previously described because some were resistant to cephalothin: some H. cinaedi strains were also resistant to nalidixic acid. All isolates were also characterized by antimicrobial susceptibility testing. We found that human strains of H. cinaedi were more resistant to clindamycin and erythromycin than were animal isolates; 19% of the human strains were resistant to ciprofloxacin. Therefore, we recommend that antimicrobial susceptibility results be obtained before initiating therapy for H. cinaedi and H. fennelliae infections.
We noted that a number of enterococcal strains isolated from human clinical specimens resembled Enterococcus faecium but were able to produce acid from glycerol, raffinose, and/or sorbitol, while others failed to form acid from mannitol. An additional concern was that many of these strains with atypical phenotypic characteristics also appeared to acquire vancomycin resistance. In order to determine if such atypical strains were variants of E. faecium or new Enterococcus species, 35 E. faecium or E. faecium-like strains (grouped into 10 phenotypes on the basis of the results of the following tests: capacity to form acid from glycerol, mannitol, raffinose, or sorbitol and susceptibility to vancomycin) and four strains of Enterococcus faecalis were taken from our culture collection, analyzed for their whole-cell protein profiles by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and identified to the species level by DNA-DNA reassociation experiments. All E. faecium-like strains, including four mannitol-negative variants, conformed to at least two of three DNA-DNA relatedness criteria: they were 70% or more related to the type strain of E. faecium at optimal conditions, they had less than 5% divergence within the related sequences, and they had a relatedness of 60% or greater under stringent conditions. The protein profiles of atypical strains were similar to those of typical strains and were easily distinguishable from those of E. faecalis and other enterococcal species. The five E. faecalis strains were 12 to 16% related to the E. faecium type strain. These results indicate that the phenotypic description of E. faecium should include all of these variable characteristics.
An unusual bacterial pathogen of laboratory mice has been previously classified as an atypical biotype of Citrobacter freundii. Designated C. freundii biotype 4280, this bacterium is the etiologic agent of transmissible murine clonic hyperplasia. An eaeA gene has been shown to be present in this organism and to be necessary for virulence in laboratory mice. However, other biotypes of C. freundii lack DNA homology with the eaeA gene. Because of the recent reclassification in which five named species and three unnamed species, all previously considered C. freundii, were described, we determined the taxonomic status of C. freundii biotype 4280. With a battery of biochemical tests and DNA relatedness studies, three isolates of C. freundii biotype 4280 were shown to be members of an unnamed Citrobacter species, designated species 9. In total, six isolates of Citrobacter species 9, but none of the type strains of the other eight named species or of the two remaining unnamed species of Citrobacter, were shown to possess DNA homology with both the eaeA and the eaeB genes. Species 9 was named Citrobacter rodentium sp. nov.
Most chromosome aberrations produced by ionizing radiation develop from DNA double-strand breaks (DSBs). Published data on the yield and variance of excess acentric fragments after in vitro irradiation of human lymphocytes were compared with corresponding data on dicentrics. At low LET the number of excess acentric fragments is about 60% of the number of dicentrics, independent of dose and perhaps of dose rate, suggesting that dicentrics and excess acentric fragments arise from similar kinetics rather than from fundamentally different reactions. Only a weak dependence of the ratio on LET is observed. These results are quantified using generalizations of models for pairwise DSB interactions suggested by Brewen and Brock based on data for marsupial cells. By allowing singly incomplete and some "doubly incomplete" exchanges, the models can also account for the experimental observation that the dispersion for excess acentric fragments, a measure of cell-to-cell variance, is systematically larger than the dispersion for dicentrics. Numerical estimates of an incompleteness parameter are derived.
Epidemiological studies have established an association between exposure to radon and carcinoma of the lung. However, based on data for either lung cancer in uranium miners exposed to radon or bronchial epithelial carcinomas in Japanese A-bomb survivors, it has not been possible to assign estimates of risk of lung cancer for the general population exposed to radon in their homes. Based on past success with the excellent quantitative properties of the C3H 10T1/2 in vitro oncogenic transformation assay system, the relative biological effectiveness (RBE) for radiation-induced transformation for charged particles of defined LET has been determined. As the LET of the radiation was increased, the rate of induction of oncogenic transformation increased and the RBEm approached 20. At higher LETs, RBE dropped precipitously. The rapid drop in effectiveness for alpha particles with LETs between 120 and 265 keV/microns implies a lower quality factor than the 20-25 currently considered appropriate when estimating lung cancer mortality.
Domestic radon risk estimates are typically based either on data for uranium miners or on data derived from A-bomb survivors; comparison of domestic radon risk estimates derived from these two disparate sources represents an important test of their reliability. There is currently a significant discrepancy of about a factor of three between domestic radon risk estimates generated with these two independent methods. To base such risk estimates on the data for A-bomb survivors, who were exposed mainly to low-LET radiation, requires a quality factor for alpha particles from random progeny; the final risk estimate is then directly proportional to this quality factor. We have used the most extensive quantitative in vitro data set currently available at high LET for an oncogenic end point, to make the best estimate we can that could be used as a basis for a quality factor. Our best estimates of values appropriate for the quality factor for radom progeny are significantly lower than those currently used (20-25) in estimating lung cancer mortality due to randon. Specifically, our best estimate for home dwellers is around 10. In addition, because of the different geometry in the bronchial epithelia of nonsmokers compared to smokers, our best estimate of an appropriate quality factor for home dwellers is about 18% greater than that for miners; thus our best estimate of the "effective K factor" to convert to effective dose/WLM in home dwellers from effective dose/WLM in miners would be increased by this factor. Based on a quality factor of approximately 10, the dosimetrically based estimate of radon-induced mortality would be approximately 35,000 per year in the U.S. rather than the value of approximately 70,000 obtained using a quality factor of 20. The value of 35,000, while larger than the values based on data for miners (approximately 20,000), is much smaller than previous estimates of approximately 70,000 based on dosimetric methods; thus risk estimates based on the two approaches, dosimetric and epidemiological, may be partially reconciled. Finally, a quality factor of 10 would reduce the proportion of the collective effective dose caused by radon progeny from the currently accepted value of 55% down to about 38%.