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Biomedical subjects

S A Roberts

Publications and source records attributed to S A Roberts.

At least 145 records · Page 8Linked to original sources
PubMed1994

The crypt cycle in mouse small intestinal epithelium.

We have used a mutation-induced marker system in the intestine of mice heterozygous at the Dlb-1 locus, which determines the expression of binding sites for the lectin Dolichos biflorus agglutinin, and the frequency of clustering of mutated crypts with time as a means of investigating the frequency of the crypt fission process and the crypt cycle. Whole-mount preparations from heterozygous Dlb-1b/Dlb-1a mice were stained with a peroxidase conjugate of Dolichos biflorus agglutinin. Mutations at the Dlb-1b locus in crypt stem cells result in loss of DBA-Px binding in these cells and subsequently their progeny, which eventually results in a rare isolated single, unstained crypt. The subsequent development of pairs, triplets and clusters of negative staining crypts has been assumed to be the result of crypt fission. The frequency of these fission events has been measured in control untreated mice. These negative crypts are the result of spontaneous mutations. We have also looked at mutated crypts after treatment with N-nitroso-N-ethylurea or N-methyl-N'-nitro-N-nitrosoguanidine of young adult mice, which elevates the number of mutations. Our results suggest that the crypt cycle in control animals is very long, 187 +/- 44 weeks (3.6 years, i.e. essentially the life of a laboratory mouse). This implies that about a third of the crypts may divide once in the life of a mouse. After sufficient time for conversion of mixed crypts to monophenotypic crypts after mutagen treatment several clusters of negative crypts were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

The influence of radiotherapy treatment time on the control of laryngeal cancer: a direct analysis of data from two British Institute of Radiology trials to calculate the lag period and the time factor.

This study analyses node-negative laryngeal tumour control data from two clinical trials conducted by the British Institute of Radiology in order to determine the time factors and the presence or absence of a lag period before the time factor takes effect. A direct maximum likelihood approach is used to fit a double-logarithmic model including a repopulation term which commences after an initial lag period, Tk. The analysis yields a time factor of 0.8 Gy per day (95% confidence interval 0.5-1.1 Gy per day) as the extra dose required to counteract the reduction in tumour control probability (TCP) with extension of the treatment time. The latter reduction amounted to between 5 and 12% TCP per week, depending on the stage and time period. With this dataset, where few patients were treated for short times, no statistically significant lag phase can be demonstrated. However, the best estimate of Tk is 21 days (95% confidence interval 0-27 days), which is consistent with estimates from other studies on other datasets. If a lag phase exists, this study would indicate that the duration is less than 27 days. Other studies have used retrospective data and are subject to a number of potential biases. The present study, using data from multicentre prospective randomized clinical trials, is free from some of these sources of bias. The fact that very similar estimates of the radiobiological parameters are obtained lends credence to these other studies and suggests that the potential biases may be small in practice.

Clinical Trials as Topic↗
PubMed1994

Cell migration in the small and large bowel shows a strong circadian rhythm.

Migration velocity estimates have been determined at each position along the crypt length for both the small and large intestine of the mouse at 6 different times of the day. Measurements also have been made of crypt circumference and length. Dramatic, and significant (P < 0.001), changes in migration velocity as a function of time of day were observed in the small intestine with a maximum 0.84 cell positions (cp) per hour at 0900 h and a minimum of -0.46 cp/h at 1700 h, although the negative velocity was probably artefactual. The 24-h mean velocity rose smoothly as a function of cell position to a peak of 0.45 cp/h at cell position 17 (around the top of the proliferative zone). Much more modest changes were seen in the percent of 3HTdR labelled cells (minimum 30.8%, maximum 38.3%, P < 0.001) and crypt circumference (minimum 16.9 cells, maximum 17.9 cells, P = 0.003). The migration velocity was rather less well determined in the large intestine with a peak in the 24-h mean velocity (0.26 cp/h) occurring at cell position 10. At this position significant circadian variation was detected (minimum -0.39 cp/h, maximum 0.75 cp/h, P = 0.006). Changes were seen in the percent of labelled cells (minimum 9.4%, maximum 22.3%, P < 0.001) and crypt circumference (minimum 18.3 cells, maximum 19.2 cells, P < 0.001). In both tissues it is suggested that the combination of the modest changes in cell proliferation rates in conjunction with the changes in crypt cell number can account for the large amplitude in variation of crypt output, and that the reservoir effects of changes in crypt geometry are an essential part of the process governing the maintenance of intestinal cell numbers.

Animals↗
PubMed1994

Radiation-induced G2 delay and spontaneous chromosome aberrations in ataxia-telangiectasia homozygotes and heterozygotes.

The extent of cell cycle delay of lymphocytes X-irradiated in G2 phase was measured by mitotic inhibition determinations in 66 controls, 14 ataxia-telangiectasia (A-T) homozygotes and 27 obligate heterozygotes. Homozygotes had a significantly reduced mitotic index (MI) in unirradiated samples and showed significantly less radiation-induced mitotic inhibition than controls. This confirms our earlier disputed observations on A-T fibroblasts and demonstrates a G2 check-point defect in addition to the well-known defects in S phase and at the G1-S phase transition. There are two separate and opposite abnormal G2 responses of A-T cells; a primary event in which cells in G2 at the time of irradiation suffer less delay than controls, and a secondary event in which cells irradiated at earlier stages of the cycle are more delayed when they pass into G2. The MI of unirradiated heterozygote cells and the extent of mitotic inhibition were indistinguishable from controls. Spontaneous unstable chromosome aberrations were, as previously reported, significantly higher in homozygotes than in controls. This was true for breaks, but not for gaps. There was a suggestion of an increase in breaks in heterozygotes, but a much larger study would be required to confirm or refute this.

Adolescent↗
PubMed1993

Effectiveness and costs of digoxin treatment for atrial fibrillation and flutter.

Clinical outcomes and costs associated with the use of digoxin in atrial fibrillation and flutter were evaluated in a prospective, observational study at 18 academic medical centers in the United States. Data were collected on 115 patients (aged > 18 years) with atrial fibrillation or flutter who were treated with digoxin for rapid ventricular rate (> or = 120 beats/min). The median time to ventricular rate control (i.e., resting ventricular rate < 100 beats/min, decrease in ventricular rate of > 20%, or sinus rhythm) was 11.6 hours from the first dose of digoxin for all evaluable patients (n = 105) and 9.5 hours for those only receiving digoxin (n = 64). Before ventricular rate control, the mean +/- SD dose of digoxin administered was 0.80 +/- 0.74 mg, and a mean of 1.4 +/- 1.8 serum digoxin concentrations were ordered per patient. Concomitant beta-blocker or calcium antagonist therapy was instituted in 47 patients (41%); in 19 of these, combination therapy was initiated within 2 hours. Adenosine was administered to 13 patients (11%). Patients spent a median of 4 days (range 1 to 25) in the hospital; 28% spent time in a coronary/intensive care unit and 79% in a telemetry bed. Loss of control (i.e., resting ventricular rate returned to > 120 beats/min) occurred at least once in 50% of patients and was associated with a longer hospital stay (p < 0.05). Based on 1991 data, the estimated mean hospital bed cost for patients with atrial fibrillation or flutter was $3,169 +/- $3,174.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

The delay before onset of accelerated tumour cell repopulation during radiotherapy: a direct maximum-likelihood analysis of a collection of worldwide tumour-control data.

The worldwide collection of control data for head and neck tumours presented by Withers et al. (Withers, H.R., Taylor, J.M.G. and Maciejewski, B. Acta Oncol. 27: 131-146, 1988) was reanalysed using a model which includes an explicit lag phase before the onset of tumour clonogen repopulation. A direct maximum-likelihood approach was used and the methodology extended to include the computation of profile-likelihood confidence limits. A statistically significant (p = 0.02) lag of 29 days was obtained with 95% confidence limits covering the range 17-31 days. However, the confidence interval was disconnected, and excluded the period 21-23 days. The analysis gave a time factor of 0.66 Gy/day. The mean values confirm the conclusions drawn by the original authors using a two-stage (indirect) method, and the values are similar to those calculated here for another data set comprising 496 patients (lag period = 26 (19-33) days). However, the data set itself is retrospective, and potentially subject to a number of biases. Therefore any clinical conclusions can only be tentative. A new feature of the methodology is the computation of profile-likelihood confidence limits and this will be useful in future direct analyses of clinical data of this type. The more usually computed normal approximation to the confidence limits have been shown to be inadequate in this analysis, and either profile-likelihood limits or likelihood ratio tests must be employed to determine the significance of the model parameters.

Head and Neck Neoplasms↗
PubMed1993

An assessment of the reliability and reproducibility of measurement of potential doubling times (Tpot) in human colorectal cancers.

An assessment has been made of the reproducibility of measuring tumour proliferation using in vivo iododeoxyuridine (IUdR) labelling and flow cytometry. The variation that occurs between different institutions (Paterson Institute for Cancer Research, Manchester and the Gray Laboratory, Northwood), different observers and different runs on the same flow cytometer have been measured on 139 samples from 53 patients with colorectal cancer. The results demonstrate that the IUdR technique for measuring tumour proliferation is reproducible. Correlations were seen between measurements of Tpot obtained by different individuals and on separate machines. However, direct comparisons of the measured parameters showed that there were highly significant differences in the values obtained between institutes and observers (P < 0.001). Despite these variations, there were still significant detectable differences in Tpot measurements between individual tumours (P < 0.001). Analysis of the results obtained by running the same samples on two separate occasions on the same machine showed that the technique was highly reproducible and that the staining procedure was stable. Eighty per cent of the samples were similarly assigned to either above or below the median Tpot value, regardless which observer/laboratory combination was utilised. These data suggest that large clinical trials using Tpot should employ a single centre and a single individual to prepare, run and analyse samples.

Adenocarcinoma↗
PubMed1993

Intra-tumoral heterogeneity of tumour potential doubling times (Tpot) in colorectal cancer.

Intra-tumoural heterogeneity of proliferation has been assessed by taking multiple biopsies from 30 colorectal cancers. Following in vivo IUDR labelling, dual parameter flow cytometry was used to measure tumour DNA index (DI) and labelling index (LI) and to derive DNA synthesis time (Ts) and potential doubling time (Tpot). Heterogeneity was seen for all parameters under investigation. Overall coefficients of variation (CV) and logarithmic transformation of Ts and Tpot (due to their non-gaussian distributions) indicate that LI (CV 25%) was the most variable parameter. Intra-tumoral heterogeneity in Tpot (lnTpot CV = 22%) was less than inter-individual variation (CV = 63%), suggesting that this variation should not be a limitation to the possible usefulness of this technique as an independent prognostic indicator. Correlations of Tpot values were examined between the shortest, the median and the value for a pooled homogenate sample from a single tumour. Using an homogenate, it was possible to accurately predict classification of tumour Tpot values as being below the median ('fast tumours') in 15 of 19 cases (79%). The data suggest that assaying an homogenate may allow a more rapid analysis of a multiply sampled tumour.

Adenocarcinoma↗
PubMed1993

Intrinsic radiosensitivity and prediction of patient response to radiotherapy for carcinoma of the cervix.

The intrinsic radiosensitivity of cervical carcinoma has been measured using a soft agar clonogenic assay. All patients received radical radiotherapy alone with a minimum of 2 years post-treatment follow-up. Only women with stage I, II and III disease were included in the analysis. Values for cell surviving fraction at 2 Gy (SF2) were obtained for 88 tumours with an assay success rate of 73%. The 53 patients alive and well at the time of analysis had tumours with a mean SF2 that was significantly lower than the value from the 22 patients with locoregional failure (P < 0.01). Patients with radioresistant tumours (SF2 > 0.40, the median) had a significantly lower 3 year survival level than those with sensitive tumours (SF2 < or = 0.40) (P = 0.002). Also the frequency of local recurrence was higher (P = 0.001) whether these were central (P = 0.009) or peripheral (P = 0.046). Cell surviving fraction at 3.5 Gy was obtained for 46 tumours and the 3 year patient survival rate was significantly higher for those with SF3.5 values less than the median (P = 0.043). There was, however, no difference in the level of local recurrence (P = 0.24). The ability to grow in culture was not associated with significantly poorer patient survival (P = 0.56) or failure to control the primary disease (P = 0.17). While high colony forming efficiencies were associated with an increased rate of local recurrence (P = 0.029) they did not predict for overall patient survival (P = 0.32). These data suggest that, for cervical carcinoma treated with radical radiotherapy, intrinsic radiosensitivity is important in determining treatment outcome.

Adult↗
PubMed1993

Determination of cell dose-survival relationships from endpoint dilution assays.

Methods for fitting radiation survival curves to data obtained from endpoint-dilution assays are described. It is shown that for functional forms such as the linear-quadratic model the problem can be recast as a generalized linear model (GLM) and the data fitted using standard software. For functional forms which are not capable of being linearized, such as the multitarget model, the direct maximum likelihood (DML) techniques of Thames et al. (1986) can be used. Both these techniques produce exact maximum likelihood parameter estimates. Compared with the weighted least-squares (WLS) approach traditionally employed, these approaches avoid the need to approximate the binomial distribution of the number of negative wells by a normal distribution, and avoid the biases introduced by the need for arbitrary treatment of data points with 0 or 100% negative wells. The results of fittings using the novel GLM and DML approaches are compared with those obtained using the WLS method on a large series of datasets. For most datasets the WLS method performs well, compared with the exact method, but in a small number of cases the WLS predicted parameter estimates can be in error by as much as their estimated standard errors. A method for the use of a concurrent control to correct for interexperimental variation is outlined. The methods have been implemented in a Fortran computer program using the NAG subroutine library.

Cell Survival↗
PubMed1993

Use of low-dose rate irradiation to measure the intrinsic radiosensitivity of human T-lymphocytes.

A comparison has been made of high (1.55 Gy min-1) and low dose-rate (0.0098 Gy min-1) irradiation in determining the intrinsic radiosensitivity of peripheral blood lymphocytes from normal individuals. Samples from 19 people were assessed using a limiting dilution assay and used to investigate the variability associated with evaluation of lymphocyte radiosensitivity after both high and low dose-rate irradiation. Repeat experiments on a single sample from one donor stored over a period of 6 months have been used to compare assay variability using the different dose-rates. Multiple samples taken from a single person over a period of 5 months were assayed at low dose-rate to assess intraindividual variation in measured in vitro radiosensitivity. At high dose-rate significant interexperimental variation in the measured parameters was demonstrated and, after allowing for this variability, no significant interindividual differences were found. At low dose-rate, sparing of cell kill was seen for all lymphocytes and led to an increase in the spread of data between individuals such that interindividual differences reached statistical significance for surviving fraction at 4 Gy, alpha (linear fit) and D with p < 0.004 for all parameters.

Cell Survival↗
PubMed1993

Use of an internal standard in comparative measurements of the intrinsic radiosensitivities of human T-lymphocytes.

A study has been made of the intrinsic radiosensitivity of peripheral blood lymphocytes from normal individuals. Cell survival following in vitro high (1.55 Gy min-1) and low (0.0098 Gy min-1) dose-rate irradiation was obtained for single lymphocyte samples from three individuals in six experiments. Despite wide interexperimental variability the ranking of intrinsic radiosensitivity for these individuals was reproducible. Further studies were carried out using low dose-rate irradiation only, on: (1) single lymphocyte samples from 18 people; (2) 14 samples taken on different occasions from one of these donors over a period of 5 months; and (3) a large store of lymphocytes from another individual. The latter was assayed in every experiment and served as an internal standard to which results could be normalized. In comparison with uncorrected values, the normalized results for the 14 samples from the single individual showed a reduction in the spread of data while those for the 18 different donors were unchanged. An analysis of variance was carried out on a larger data set of 38 measurements which included repeat assays on several of the samples (two samples from the multiply-sampled individual and five samples from other donors were assayed twice). In comparison with the uncorrected values, the normalized results showed a reduction in experimental variability such that the coefficient of variation (CV) for surviving fraction at 4 Gy for the multiple samples from a single individual decreased from 41 to 19%. In contrast, there was little change in the variation between 18 individuals with CVs of 56 and 62%, respectively, for uncorrected and normalized results. These data suggest that the use of an internal standard for the determination of the intrinsic radiosensitivity of individuals using peripheral blood lymphocytes should aid the development and evaluation of predictive tests for the radiotherapy of cancer.

Cell Survival↗
PubMed1993

Study of the proliferation in human gastric mucosa after in vivo bromodeoxyuridine labelling.

Studies to measure human gastric crypt or gland cell proliferation may have a number of practical clinical applications in relation to both benign and malignant gastric conditions. Bromodeoxyuridine (BrdUrd) labels human gastric mucosal cells in the S phase. Computer aided data analysis of labelled mucosa allows static proliferative indices to be estimated, including the crypt labelling index (LI), the peak labelling position, the distribution of labelled cells and indirectly the crypt growth fraction. Multiparameter flow cytometric analysis of labelled nuclei allows the S phase duration (Ts) of mucosal cells to be estimated. Specimens of histologically normal gastric body (GB, n = 16) and antral mucosa (GA, n = 10) were obtained from 25 patients with gastric carcinomas who received a bolus dose of 250 mg BrdUrd between 3.0 and 15.7 hours before surgery. Tissue sections were stained by an immunohistochemical method and subjected to detailed counting of up to 50 longitudinal crypts per specimen. The total crypt labelling index was calculated by a grid counting method. A significant difference existed between the proliferative compartments of gastric antral and body mucosa measured by a number of criteria. The median lengths of the crypts were 137 cells (GB) and 188 cells (GA). The median peak labelling positions were cell 26 (GB) and cell 61 (GA) from the crypt orifice. The mean crypt labelling indices were 2.8% (GB) and 4.8% (GA). The mean Ts of GA cells was 7.7 hours and of GB cells was 10.8 hours.

Adult↗
PubMed1992

Reduction in apoptosis relative to mitosis in histologically normal epithelium accompanies fibrocystic change and carcinoma of the premenopausal human breast.

The aims of this study in 227 premenopausal women were (a) to determine the mitotic index (MI), the thymidine labelling index (LI), and the apoptotic index (AI) within the epithelial cells of histologically 'normal' human breast biopsy material removed away from the site of either a fibroadenoma or a carcinoma; and (b) to relate differences in the kinetic indices of the 'normal' epithelium to the pathology in the same breast diagnosed as fibroadenoma alone (125 patients), fibroadenoma with accompanying mild fibrocystic change (79 patients), or carcinoma (23 patients). Ratios of the average indices (AI/MI, AI/LI, MI/LI) were also calculated to minimize uncertainties related to the total cell population counted, the denominator in the LI, MI, and AI. All indices and ratios of indices were corrected for age, averaged over the cycle, and expressed as log-transformed values for analysis. Significant (P less than 0.001) reductions in AI and in apoptosis relative to mitosis (reduced AI/MI) were found in 'normal' epithelium from breasts having fibrocystic change (AI = 0.17 +/- 0.02; AI/MI = 1.01 +/- 0.18) and carcinoma (AI = 0.19 +/- 0.04; AI/MI = 0.88 +/- 0.29), compared with breast with fibroadenoma alone (AI = 0.27 +/- 0.03; AI/MI = 1.29 +/- 0.39). In the absence of significant differences in MI and LI between the 'normal' tissue groups, this finding raises the possibility that reduced epithelial cell apoptosis might be causally associated with the development of fibrocystic change and with an increased risk of development of carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenofibroma↗
PubMed1992

The effect of increasing the treatment time beyond three weeks on the control of T2 and T3 laryngeal cancer using radiotherapy.

Local control of cancer by radiotherapy may be prejudiced by accelerated tumour clonogen repopulation particularly during protracted treatment schedules. A series of 496 cases of T2 and T3 larynx cancer treated here by radiotherapy has been studied to examine the impact on local control of treatment durations ranging from 9 to 41 days. Data were analysed using a linear-quadratic formulation describing the fractionation sensitivity, with the incorporation of a parameter relating to treatment time. Using combined T2 and T3 data, the increase in dose required to maintain a constant local control (the time factor) was between 0.5 and 0.6 Gy per day. These values are similar to those reported for 4 weeks or more in the literature. Also, the calculated dose to control 50% of tumours, given over the standard Christie duration of 21 days, was on the line projected back from literature data over 28-66 days. The present data are consistent with the presence of such a time factor following a lag phase of not more than 3 weeks after starting radiotherapy. Hence, further consideration should be given to using shorter overall treatment times in radiotherapy for head and neck cancer.

Carcinoma↗
PubMed1992

Spermatogonial apoptosis has three morphologically recognizable phases and shows no circadian rhythm during normal spermatogenesis in the rat.

In this study we examined the possibility that regular or circadian fluctuations occur in the frequency of spontaneous spermatogonial apoptosis. Apoptosis of A2, A3 and A4 type spermatogonia occurring spontaneously in the normal rat testis was studied by light and electron microscopy. Normal and apoptotic A3 spermatogonia were quantified in 36 animals killed at two-hourly intervals over a 24 h period. Three sequential phases of spermatogonial apoptosis were defined and quantified separately: (i) an early phase in which cells showed margination of nuclear chromatin, (ii) an intermediate phase in which phagocytosed apoptotic bodies were partly degraded and (iii) a late phase in which only debris of degraded apoptotic bodies was evident. Groups of spermatogonia linked by intercellular bridges underwent apoptosis synchronously. Normal and apoptotic A3 spermatogonia occurred at a mean frequency of 33.4 and 9.6 per 10 seminiferous tubule profiles respectively; there was a large variation in these frequencies between animals, but no peaks or circadian periodicity were detected. Progressive degradation of apoptotic bodies was evident, the average ratios of intermediate and late bodies to early bodies being 1.5 and 3.5, respectively. Absence of a circadian rhythm in these data does not exclude the possibility that initiation of apoptosis in susceptible spermatogonial clones is synchronous, and that affected clones undergo lag periods of differing duration before expressing morphological apoptosis.

Animals↗