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S A Roberts

Publications and source records attributed to S A Roberts.

At least 37 records · Page 2Linked to original sources

Intestinal crypt clonogens: a new interpretation of radiation survival curve shape and clonogenic cell number.

Estimates of the clonogen content (number of microcolony-forming cells) of murine intestinal crypts using microcolony assays show an apparent dependence on the radiation dose used in the assay of clonogen content. Crypt radiation survival curves often show increased curvature beyond that expected on the basis of the conventional linear-quadratic model. A novel form of crypt survival curve shape is proposed based on two contributory mechanisms of crypt killing. Six previously published sets of microcolony data were re-analysed using a dual-kill model, where target cells are killed by two contributory mechanisms, each described by a linear-quadratic function of dose. The data were analysed as two series--high-dose rate and low-dose rate irradiation. The data were fitted to the models using direct maximization of a quasi-likelihood, explicitly allowing for overdispersion. The dual-kill model can reproduce both the apparent dose-dependence of the clonogen estimates and the high-dose curvature of the dose-response curves. For both series of data the model was a significantly better fit to the data than the standard linear-quadratic model, with no evidence of any systematic lack of fit. The parameters of the clonogenic cell component of the model are consistent with other studies that suggest a low clonogen number (somewhat less than five) per crypt. The model implies that there is a secondary mechanism decreasing clonogen survival, and hence increasing clonogen number estimates, at high doses. The mechanisms underlying the modification of the dose-response are unclear, and the implied mechanisms of, for example, slow growth, induced either directly in the surviving cells or indirectly through stromal injury or bystander effects are only speculative. Nevertheless, the model fits the data well, demonstrating that there is greater kill at high doses in these experimental series than would be expected from the conventional linear-quadratic model. This alternative model, or another model with similar behaviour, needs to be considered when analysing in detail and interpreting microcolony data as a function of dose. The implied low number of < or = 5 of these regenerative and relatively radioresistant clonogenic cells is distinct from a similar number of much more radiosensitive precursor stem cells which undergo early apoptosis after doses around 1 Gy.

Animals↗

Interventional endoscopic ultrasound.

Endoscopic ultrasound (EUS) has been used in clinical practice for the past two decades, mainly for staging upper gastrointestinal tract tumours. More recently the technique has been used to guide interventional procedures, particularly EUS-guided biopsy. In this review we describe the equipment and technique required for interventional EUS. We also discuss with illustrations the current clinical applications, potential complications and developments for the future.

Adrenal Gland Diseases↗

Influence of intrinsic radiosensitivity on the survival of breast cancer patients.

PURPOSE: The association between enhanced intrinsic radiosensitivity, measured by the level of chromosome damage induced in either the G2 or G0 phases of the cell cycle, and the risk of breast cancer has been well demonstrated. Although not originally designed for this purpose, early studies are now sufficiently mature (median follow-up 4.2 years) to enable an assessment of the impact of radiosensitivity on patient outcome. MATERIALS AND METHODS: Breast cancer patients assessed in previous studies of G2 and G0 lymphocyte chromosomal radiosensitivity between 1993 and 1997 were identified. Tumour characteristics, recurrence and survival data were obtained from clinical records and outcomes were compared between those identified as having normal and elevated radiosensitivity in the two assays. RESULTS: There was a significant association between G0 sensitivity and tumour grade (p=0.03), but otherwise there were no associations in these series between radiosensitivity in the two assays and tumour characteristics. Overall survival in this cohort of patients was high (94% at 5 years) and there was no association between the G2 or G0 assay results and outcome as measured by cancer-specific survival or local recurrence. CONCLUSIONS: Radiosensitivity, as measured by these two assays, was not a strong prognostic factor following standard radiotherapy treatment. However, the statistical power of the present study was limited and modest prognostic utility could not be discounted. Further studies designed specially to investigate outcome are needed, possibly in association with trials of altered radiotherapy fractionation.

Aged↗

Less G(2) arrest in irradiated cells of breast cancer patients than in female controls: a contribution to their enhanced chromosomal radiosensitivity?

PURPOSE: To determine if the efficacy of G(2) checkpoint control (measured as the degree of mitotic inhibition) was reduced in breast cancer patients (n=129) compared with healthy controls (n=105) after exposure of lymphocytes to X-rays. We had previously shown that the average level of radiation-induced chromosome damage was higher in G(2) lymphocytes of these patients than in the controls, and it was proposed that this was a marker of low penetrance predisposition to cancer. MATERIALS AND METHODS: Proliferating lymphocytes were X-irradiated (50 cGy) and sampled at 90 min post-irradiation, which was the time of maximum mitotic inhibition of G(2) cells, expressed as the extent of reduction in the mitotic index in irradiated compared with unirradiated cells. RESULTS: Repeated measurements on 28 controls showed that there were reproducible differences in mitotic inhibition between individuals. Inhibition was significantly greater in female than in male controls (p=0.014), but less in patients than in female controls (p=0.009). There was a weak inverse correlation between the extent of inhibition and the amount of chromosome damage in all females (r=-0.15, p=0.043). CONCLUSIONS: The lesser mitotic inhibition in patients than in female controls might contribute to their greater mean G(2) chromosomal radiosensitivity. However, this hypothesis is not easily reconciled with other observations that (1) the significant difference in inhibition between the sexes in controls was not accompanied by any gender difference in radiosensitivity and (2) there was an inverse correlation between inhibition and age in controls, yet no age-related increase in radiosensitivity. There might, therefore, be no causal relationship between G(2) mitotic inhibition and chromosomal radiosensitivity.

Adult↗

The biochemical detection of biliary etiology of acute pancreatitis on admission: a revisit in the modern era of biliary imaging.

INTRODUCTION: Compared with traditional radiologic methods for the detection of cholelithiasis, early transient hypertransaminasemia had provided a useful prediction of biliary etiology in patients with acute pancreatitis. AIM: To investigate whether this application remains valid in the modern era of imaging for microlithiasis. METHODOLOGY: The biochemical detection (LFT) of cholelithiasis was based on an increase in serum alanine transaminase of >or=80 IU/L (normal range, 0-45 IU/L) within 24 hours of admission. We have taken the collective findings of abdominal ultrasound (USS), endoscopic ultrasound (EUS), and postmortem examination to represent the denominator for the diagnosis of cholelithiasis against which comparison with LFT was made. RESULTS: Of 68 patients with acute pancreatitis who were treated between October 2000 and December 2001, cholelithiasis was the etiological factor in 44 patients (65%). EUS detected microlithiasis in 5 of 10 patients examined. The etiology remained idiopathic in 3 patients (4.4%). The sensitivity, specificity, and positive and negative predictive values for USS were 86%, 100%, 100%, and 80% respectively; for LFT, they were 91%, 100%, 100%, and 86%; and for USS and LFT combined, they were 98%, 100%, 100%, and 96%, respectively. CONCLUSIONS: In patients with acute pancreatitis, the biochemical analysis within 24 hours of admission provided a simple, rapid, and more accurate prediction of cholelithiasis than USS. The combination of LFT and USS detected or excluded a biliary etiology in almost all patients.

Acute Disease↗

Testosterone inhibits the prostaglandin F2alpha-mediated increase in intracellular calcium in A7r5 aortic smooth muscle cells: evidence of an antagonistic action upon store-operated calcium channels.

Testosterone-induced vasodilatation is proposed to contribute to the beneficial effects associated with testosterone replacement therapy in men with cardiovascular disease, and is postulated to occur via either direct calcium channel blockade, or through potassium channel activation via increased production of cyclic nucleotides. We utilised flow cytometry to investigate whether testosterone inhibits the increase in cellular fluorescence induced by prostaglandin F(2alpha) in A7r5 smooth muscle cells loaded with the calcium fluorescent probe indo-1-AM, and to study the cellular mechanisms involved. Two-minute incubation with testosterone (1 microM) significantly inhibited the change in cellular fluorescence in response to prostaglandin F(2alpha) (10 microM) (3.6+/-0.6 vs 7.6+/-1.0 arbitrary units, P=0.001). The change in cellular fluorescence in response to prostaglandin F(2alpha) (10 microM) was also significantly attenuated in the absence of extracellular calcium (3.6+/-0.3 vs 15.6+/-0.7 arbitrary units, P=0.0000002), and by a 2-min incubation with the store-operated calcium channel blocker SK&F 96365 (50 microM) (4.7+/-0.8 vs 8.1+/-0.4 arbitrary units, P=0.003). The response was insensitive to similar incubation with the voltage-operated calcium channel blockers verapamil (10 microM) (12.6+/-1.2 vs 11.9+/-0.2 arbitrary units, P=0.7) or nifedipine (10 microM) (13.9+/-1.3 vs 13.3+/-0.5 arbitrary units, P=0.7). Forskolin (1 microM) and sodium nitroprusside (100 microM) significantly increased the cellular concentration of cyclic adenosine monophosphate and cyclic guanosine monophosphate respectively, but testosterone (100 nM-100 microM) had no effect. These data indicate that the increase in intracellular calcium in response to prostaglandin F(2alpha) occurs primarily via extracellular calcium entry through store-operated calcium channels. Testosterone inhibits the response, suggesting an antagonistic action upon these channels.

Animals↗

Development of a novel rapid assay to assess the fidelity of DNA double-strand-break repair in human tumour cells.

Cellular survival following ionising radiation-mediated damage is primarily a function of the ability to successfully detect and repair DNA double-strand breaks (DSBs). Previous studies have demonstrated that radiosensitivity, determined as a reduction in colony forming ability in vitro, may be related to the incorrect repair (misrepair) of DSBs. The novel rapid dual fluorescence (RDF) assay is a plasmid-based reporter system that rapidly assesses the correct rejoining of a restriction-enzyme produced DSBs within transfected cells. We have utilised this novel assay to determine the fidelity of DSB repair in the prostate tumour cell line LNCaP, the bladder tumour cell line MGH-U1 and a radiosensitive subclone S40b. The two bladder cell lines have been shown in previous studies to differ in their ability to correctly repair plasmids containing a single DSB. Using the RDF assay we found that a substantial portion of LNCaP cells [80.4 +/- 5.3(standard error)%] failed to reconstitute reporter gene expression; however, there was little difference in this measure of DSB repair fidelity between the two bladder cell lines (48.3 +/- 3.5% for MGH-U1; 39.9 +/- 8.2% for S40b). The RDF assay has potential to be developed to study the relationship between DSB repair fidelity and radiosensitivity as well as the mechanisms associated with this type of repair defect.

Cell Survival↗

Chromosomal radiosensitivity in young cancer patients: possible evidence of genetic predisposition.

PURPOSE: To investigate the G2 chromosomal radiosensitivity of patients with cancers diagnosed when the patients are less than 20 years of age. Earlier studies demonstrated an enhanced sensitivity in substantial proportions of patients with breast or colorectal cancer, and in early onset head and neck cancer cases. Heritability of chromosomal radiosensitivity in families of breast cancer patients was also demonstrated. It is suggested that elevated sensitivity in this assay could be a marker of genetic predisposition to cancer, mediated through inherited genetic determinants of low penetrance. MATERIALS AND METHODS: Stimulated lymphocytes were exposed to 0.5 Gy X-rays in the G2-phase of the cell cycle and chromatid aberrations were scored in metaphase cells. RESULTS: The assay was performed on 32 patients with early onset cancers (aged 0.5-19 years) of various types and their sensitivity was compared with that of 41 young normal controls (0.25-19 years) and 32 adult normals (20-60 years). The proportion of cases showing enhanced sensitivity in the three groups was 44, 15 and 10%, respectively. The difference between the young patients and normals was highly significant (p = 0.004). CONCLUSIONS: The results suggest the possibility that a substantial proportion of early onset cancers are associated with the inheritance of predisposing genes of low penetrance. However, support for this hypothesis requires that the heritability of chromosomal radiosensitivity be demonstrated in family members. In addition, a larger study is now required to investigate the chromosomal radiosensitivity of specific early onset cancers.

Adolescent↗

Role of damage-sensing/processing genes in the radiation response of haemopoietic in vitro colony-forming cells.

PURPOSE: To characterize the role of various cellular damagesensing, processing and survival genes in the in-vitro radiosensitivity of haemopoietic colony-forming cells. MATERIALS AND METHODS: Bone marrow cells from a range of different gene-knockout mice were irradiated in vitro with graded radiation doses and assayed for colony-forming efficiency. RESULTS: Colony-forming efficiency in the nulls was often lower by up to threefold compared with the wild-types. This was noticeable in particular for the atm, bax and p21 nulls. Radiosensitivity was markedly increased in the scid mouse (about 2.3-fold), more than in the atm null mouse (about 1.7-fold). There was resistance in the p53 nulls compared with the wild-types, using two different background strains, that gave similar results. There was slight sensitization in the p21 nulls. In the bcl-2 nulls, there was sensitization at low dose, but not at high dose. In contrast, in the bax nulls, there was protection at low dose, but again not at high dose. The heterozygotes for p53, bcl-2 and bax responded similarly to the wild types, so that no gene dosage effects were identified. CONCLUSIONS: These studies are the first to elucidate the role of as many as six relevant genes in the radiosensitivity of a single cell type. They show the greater importance of 'survival' genes at lower cytotoxic doses of radiation compared with the greater importance of 'damage-sensing' genes at higher doses.

Animals↗

Tumor apoptosis in cervical cancer: its role as a prognostic factor in 42 radiotherapy patients.

To investigate tumor apoptosis as a prognostic factor for outcome following radiation therapy, comparisons were made of apoptotic index (AI) as a predictor of short- vs. long-term response and pretreatment vs. radiation-induced apoptosis. Forty-two patients with proven squamous cell carcinoma of the uterine cervix were treated by radiation alone. Apoptosis was measured by light microscopic observation of hematoxylin and eosin-stained sections from biopsies taken before treatment and 4 and 24 hr after 2 Gy. Patients were evaluated at the end of the external radiation for determination of short-term response and for long-term outcome as well (median follow-up of 27 months). Patients with high spontaneous AI showed poor short-term response, local control, and survival. The significance of AI as a predictor of short-term response was lost after allowing for differences in tumor size. The positive predictive value of AI for local control and survival was independent of tumor size and stage. High AI was associated with poor local control and long-term prognosis in advanced squamous cell carcinoma of the cervix. The in vivo radiation-induced AI after 4 or 24 hr did not predict radiation therapy outcome.

Adult↗

Ligand-induced heme ruffling and bent no geometry in ultra-high-resolution structures of nitrophorin 4.

The nitrophorins are a family of proteins that use ferric heme to transport nitric oxide (NO) from the salivary glands of blood-sucking insects to their victims, resulting in vasodilation and reduced blood coagulation. We have refined atomic resolution structures of nitrophorin 4 (NP4) from Rhodnius prolixus complexed with NO (1.08 A) and NH(3) (1.15 A), yielding a highly detailed picture of the iron coordination sphere. In NP4-NO, the NO nitrogen is coordinated to iron (Fe-N distance = 1.66 A) and is somewhat bent (Fe-N-O angle = 156 degrees ), with bending occurring in the same plane as the proximal histidine ring. The Fe(NO)(heme)(His) coordination geometry is unusual but consistent with an Fe(III) oxidation state that is stabilized by a highly ruffled heme. Heme ruffling occurs in both structures, apparently due to close contacts between the heme and leucines 123 and 133, but increases on binding NO even though the steric contacts have not changed. We also report the structure of NP4 in complexes with histamine (1.50 A) and imidazole (1.27 A). Unexpectedly, two mobile loops that rearrange to pack against the bound NO in NP4-NO, also rearrange in the NP4-imidazole complex. This conformational change is apparently driven by the nonpolar nature of the NO and imidazole (as bound) ligands. Taken together, the desolvation of the NO binding pocket through a change in protein conformation, and the bending of the NO moiety, possibly through protein-assisted heme ruffling, may lead to a nitrosyl-heme complex that is unusually resistant to autoreduction.

Animals↗

Lymphocyte radiosensitivity is a significant prognostic factor for morbidity in carcinoma of the cervix.

PURPOSE: To study the relationship between pretreatment peripheral blood lymphocyte radiosensitivity and morbidity following radiation therapy. METHODS AND MATERIALS: A prospective study was carried out in which patients with carcinoma of the cervix underwent radiation therapy. Intrinsic radiosensitivity was measured on pretreatment peripheral blood lymphocytes, using a limiting dilution clonogenic assay. Late morbidity was assessed using the Franco-Italian glossary. Results were correlated in an actuarial analysis. RESULTS: There were no correlations between the measured lymphocyte radiosensitivity (SF2) and colony-forming efficiency, patient age, tumor grade, or disease stage. For 83 patients, lymphocyte SF2 was a significant prognostic factor for the probability of developing both any (p = 0.002) and Grade 3 (p = 0.026) morbidity. In 174 patients, stage showed borderline significance as a prognostic factor for morbidity (p = 0.056). However, the type of treatment (intracavitary alone, intracavitary plus parametrial irradiation, single insertion plus whole-pelvis irradiation) was significantly associated with the probability of developing late complications (p = 0.013). There was a weak significant inverse correlation between lymphocyte SF2 and grade of morbidity (r = -0.34, p = 0.002). CONCLUSION: These data highlight the importance of normal cell radiosensitivity as a factor determining radiation therapy response. They also show that peripheral blood lymphocyte SF2 is a highly significant prognostic factor for the probability of developing late radiation morbidity, and that carcinoma of the cervix is a good model for testing radiobiologic principles in the clinic.

Age Factors↗

Pneumococcal bacteraemia and opportunities for prevention.

AIMS: Despite availability of active antimicrobial agents for its treatment, the mortality from pneumococcal bacteraemia (PB) may reach 30% to 40% in high-risk groups. Greater vaccine use may reduce the incidence of PB. The aim of this study was to determine the proportion of patients with PB who had indications for, but had not received, pneumococcal vaccination. METHODS: From December 1998 to March 2000, all episodes of PB in adults in four Auckland hospitals were followed prospectively. Underlying disease, outcome, and pneumococcal vaccination history were recorded. RESULTS: 96 patients had PB: the median age was 63 years, range 16 to 93 years. 42 (44%) were > or = 65 years. The relative risk (RR) of acquiring PB for Maori and Pacific Island people was more than two times that of both European and other ethnic groups: RR 2.3 (95% CI 1.5 - 3.6) and 2.4 (1.6 - 3.8), respectively. The most common presentation was pneumonia; 84 (88%), of which 74 (88%) were community acquired. Five (5%) patients had meningitis. The overall mortality was 18%. Eleven (11%) pneumococcal isolates had intermediate susceptibility to penicillin and six (6%) were resistant. 69 (72%) patients had one or more condition for which pneumococcal vaccination is recommended but only two (2%) patients had received it. 82 (85%) patients were infected with serotypes included in the current pneumococcal vaccine. CONCLUSIONS: Most adult patients with PB have underlying medical conditions for which vaccination is recommended but only rare patients get vaccinated. Emerging antimicrobial resistance is a further incentive to increase the use of pneumococcal vaccination. Greater use of pneumococcal vaccine will probably require a change in its funding status, similar to the current policy for influenza vaccine. It may also be appropriate to consider targeted use of the vaccine in Maori and Pacific Island people given their higher rates of disease.

Adolescent↗

Chromosomal radiosensitivity as a marker of predisposition to common cancers?

We previously found that 40% of breast cancer patients showed enhanced sensitivity to X-ray induced chromosome damage in G(2)lymphocytes and suggested that this might indicate a low penetrance predisposition to breast cancer, for which there is good epidemiological evidence. We have now tested the hypothesis that elevated G(2)radiosensitivity is a marker of such predisposition to other common cancers. We tested patients with colorectal cancer, for which there is also good epidemiological evidence of inherited risk in a substantial proportion of cases, and patients with cancers having a strong environmental aetiology (lung and cervix). We also repeated our study of breast cancer cases and tested patients with chronic diseases other than cancer. The results support our hypothesis, in that 30% (12/37) of colorectal cases showed enhanced sensitivity compared with 9% (6/66) of normal healthy controls (P = 0.01), whereas the proportions of sensitive cervix (11%, 3/27, P = 0.72) and lung cancer cases (23%, 8/35, P = 0.07) were not significantly above normals. We confirmed the enhanced sensitivity of 40% (12/31, P = 0.001) of breast cancer patients and found that patients with non-malignant disease had a normal response in the assay (12%, 4/34, P = 0.73). We suggest that enhanced G(2)chromosomal radiosensitivity is a consequence of inherited defects in the ability of cells to process DNA damage from endogenous or exogenous sources, of a type that is mimicked by ionizing radiation, and that such defects predispose to breast and colorectal cancer.

Adult↗