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W M Roberts

Publications and source records attributed to W M Roberts.

At least 19 recordsLinked to original sources
PubMed2001

Rapidly inactivating and non-inactivating calcium-activated potassium currents in frog saccular hair cells.

1. Using a semi-intact epithelial preparation we examined the Ca(2+)-activated K(+) (K(Ca)) currents of frog (Rana pipiens) saccular hair cells. After blocking voltage-dependent K(+) (K(V)) currents with 4-aminopyridine (4-AP) an outward current containing inactivating (I(transient)) and non-inactivating (I(steady)) components remained. 2. The contribution of each varied greatly from cell to cell, with I(transient) contributing from 14 to 90 % of the total outward current. Inactivation of I(transient) was rapid (tau approximately 2-3 ms) and occurred within the physiological range of membrane potentials (V(1/2) = -63 mV). Recovery from inactivation was also rapid (tau approximately 10 ms). 3. Suppression of both I(transient) and I(steady) by depolarizations that approached the Ca(2+) equilibrium potential and by treatments that blocked Ca(2+) influx (application Ca(2+)-free saline or Cd(2+)), suggest both are Ca(2+) dependent. Both were blocked by iberiotoxin, a specific blocker of large-conductance K(Ca) channels (BK), but not by apamin, a specific blocker of small-conductance K(Ca) channels. 4. Ensemble-variance analysis showed that I(transient) and I(steady) flow through two distinct populations of channels, both of which have a large single-channel conductance (~100 pS in non-symmetrical conditions). Together, these data indicate that both I(transient) and I(steady) are carried through BK channels, one of which undergoes rapid inactivation while the other does not. 5. Inactivation of I(transient) could be removed by extracellular papain and could later be restored by intracellular application of the 'ball' domain of the auxiliary subunit (beta2) thought to mediate BK channel inactivation in rat chromaffin cells. We hypothesize that I(transient) results from the association of a similar beta subunit with some of the BK channels and that papain removes inactivation by cleaving extracellular sites required for this association.

4-Aminopyridine↗
PubMed2001

Experience with 2-chlorodeoxyadenosine in previously untreated children with newly diagnosed acute myeloid leukemia and myelodysplastic diseases.

PURPOSE: To develop more effective chemotherapy regimens for childhood acute myelogenous leukemia (AML). PATIENTS AND METHODS: Between June 1991 and December 1996, we administered the nucleoside analog 2-chlorodeoxyadenosine (2-CDA) to 73 children with primary AML and 20 children with secondary AML or myelodysplastic syndrome (MDS). Patients received one or two 5-day courses of 2-CDA (8.9 mg/m(2)/d) given by continuous infusion. All patients then received one to three courses of daunomycin, cytarabine, and etoposide (DAV) remission induction therapy. RESULTS: Seventy-two patients with primary AML were assessable for response. Their rate of complete remission (CR) was 24% after one course of 2-CDA, 40% after two courses of 2-CDA, and 78% after DAV therapy. Of the 57 patients who entered CR, 11 subsequently underwent allogeneic bone marrow transplantation (BMT), and 40 underwent autologous BMT. Twenty-nine patients remain in continuous CR after BMT. Two patients remain in CR after chemotherapy only. The 5-year event-free survival (EFS) estimate was 40% (SE = 0.080%). Patients with French-American-British (FAB) M5 AML had a higher rate of CR after treatment with 2-CDA (45% after one course and 70.6% after two courses) than did others (P =.002). In contrast, no patient with FAB M7 AML (n = 10) entered CR after treatment with 2-CDA. Similarly, no patient with primary MDS (n = 6) responded to 2-CDA. Seven patients with secondary AML or MDS (n = 14) had a partial response to one course of 2-CDA. CONCLUSION: This agent was well tolerated, and its toxicity was acceptable. Future trials should examine the effectiveness of 2-CDA given in combination with other agents effective against AML.

Adolescent↗
PubMed2001

Sodium channel distribution on uninnervated and innervated embryonic skeletal myotubes.

Acetylcholine receptor (AChR) and sodium (Na(+)) channel distributions within the membrane of mature vertebrate skeletal muscle fibers maximize the probability of successful neuromuscular transmission and subsequent action potential propagation. AChRs have been studied intensively as a model for understanding the development and regulation of ion channel distribution within the postsynaptic membrane. Na(+) channel distributions have received less attention, although there is evidence that the temporal accumulation of Na(+) channels at developing neuromuscular junctions (NMJs) may differ between species. Even less is known about the development of extrajunctional Na(+) channel distributions. To further our understanding of Na(+) channel distributions within junctional and extrajunctional membranes, we used a novel voltage-clamp method and fluorescent probes to map Na(+) channels on embryonic chick muscle fibers as they developed in vitro and in vivo. Na(+) current densities on uninnervated myotubes were approximately one-tenth the density found within extrajunctional regions of mature fibers, and showed several-fold variations that could not be explained by a random scattering of single channels. Regions of high current density were not correlated with cellular landmarks such as AChR clusters or myonuclei. Under coculture conditions, AChRs rapidly concentrated at developing synapses, while Na(+) channels did not show a significant increase over the 7 day coculture period. In vivo investigations supported a significant temporal separation between Na(+) channel and AChR aggregation at the developing NMJ. These data suggest that extrajunctional Na(+) channels cluster together in a neuronally independent manner and concentrate at the developing avian NMJ much later than AChRs.

Animals↗
PubMed2000

Calretinin modifies presynaptic calcium signaling in frog saccular hair cells.

To determine whether the concentrations of calcium-binding proteins present in some neurons and sensory cells are sufficient to influence presynaptic calcium signaling, we studied the predominant calcium-binding protein in a class of sensory hair cells in the frog ear. Based on antibody affinity and molecular weight, we identified this protein as calretinin. We measured its cytoplasmic concentration to be approximately 1.2 mM, sufficient to bind approximately 6 mM Ca2+. Calcium signaling was altered when the diffusible cytoplasmic components were replaced by an intracellular solution lacking any fast calcium buffer, and was restored by the addition of 1.2 mM exogenous calretinin to the intracellular solution. We conclude that calretinin, when present at millimolar concentration, can serve as a diffusionally mobile calcium buffer/transporter capable of regulating calcium signaling over nanometer distances at presynaptic sites.

Animals↗
PubMed1999

Outpatient treatment of fever and neutropenia for low risk pediatric cancer patients.

BACKGROUND: Fever and neutropenia (F&N) is a common complication of cancer chemotherapy. It is conveniently managed by hospitalization and empiric administration of parenteral antibiotics. This study attempted to determine whether pediatric cancer patients with F&N identified as low risk for morbidity and mortality by clinical criteria at the time of presentation could be treated safely as outpatients. METHODS: Seventy-three episodes of F&N in 41 patients were studied prospectively over 2 years. Eligibility criteria included age > or =2 years, reliable caretakers, and residence within 1 hour of the hospital. Exclusion criteria included hemodynamic instability, dehydration, severe mucositis, pneumonia, leukemia/lymphoma induction therapy, bone marrow transplantation, or other serious comorbidity. Patients were evaluated, received a single dose of intravenous ceftazidime, and were observed for 3-16 hours. They were randomized to receive either oral ciprofloxacin or intravenous ceftazidime as outpatients. Patients were seen daily until they had been afebrile for at least 48 hours and had a rising absolute phagocyte count of >500 cells/microL. RESULTS: Sixty-three of 73 episodes (86%) were successfully managed on an outpatient basis. For 31 of 33 episodes in the ceftazidime arm, the patients remained outpatients, compared with 32 of 40 in the ciprofloxacin arm; this difference was not statistically significant. On average, patients remained febrile for 2.7 days and were treated for 4.7 days. Seventy-seven percent of episodes required no modification of initial antibiotic therapy. Of the 10 patients who were hospitalized, 4 had prolonged fever and 3 had emesis. Protracted neutropenia was associated with the need for hospitalization. There were no deaths, intensive care unit transfers, or serious complications. CONCLUSIONS: Carefully selected low risk children with fever and neutropenia can be treated safely as outpatients. Close daily medical scrutiny is required.

Adolescent↗
PubMed1999

Synaptic vesicle populations in saccular hair cells reconstructed by electron tomography.

We used electron tomography to map the three-dimensional architecture of the ribbon-class afferent synapses in frog saccular hair cells. The synaptic body (SB) at each synapse was nearly spherical (468 +/- 65 nm diameter; mean +/- SD) and was covered by a monolayer of synaptic vesicles (34.3 nm diameter; 8.8% coefficient of variation), many of them tethered to it by approximately 20-nm-long filaments, at an average density of 55% of close-packed (376 +/- 133 vesicles per SB). These vesicles could support approximately 900 msec of exocytosis at the reported maximal rate, which the cells can sustain for at least 2 sec, suggesting that replenishment of vesicles on the SB is not rate limiting. Consistent with this interpretation, prolonged K+ depolarization did not deplete vesicles on the SB. The monolayer of SB-associated vesicles remained after cell lysis in the presence of 4 mM Ca2+, indicating that the association is tight and Ca2+-resistant. The space between the SB and the plasma membrane contained numerous vesicles, many of which ( approximately 32 per synapse) were in contact with the plasma membrane. This number of docked vesicles could support maximal exocytosis for at most approximately 70 msec. Additional docked vesicles were seen within a few hundred nanometers of the synapse and occasionally at greater distances. The presence of omega profiles on the plasma membrane around active zones, in the same locations as coated pits and coated vesicles labeled with an extracellular marker, suggests that local membrane recycling may contribute to the three- to 14-fold greater abundance of vesicles in the cytoplasm (not associated with the SB) near synapses than in nonsynaptic regions.

Animals↗
PubMed1998

Electrical properties of frog saccular hair cells: distortion by enzymatic dissociation.

Although it is widely accepted that the electrical resonance seen in many types of auditory and vestibular hair cells contributes to frequency selectivity in these sensory systems, unexplained discrepancies in the frequency (f) and sharpness (Q) of tuning have raised serious questions. For example, enzymatically dissociated hair cells from bullfrog (Rana catesbeiana) sacculus resonate at frequencies well above the range of auditory and seismic stimuli to which the sacculus is most responsive. Such disparities, in addition to others, have led to the proposal that electrical resonance alone cannot account for frequency tuning. Using grassfrog (Rana pipiens) saccular hair cells, we show that the reported discrepancies in f and Q in this organ can be explained by the deleterious effects of enzyme (papain) exposure during cell dissociation. In patch-clamp studies of hair cells in a semi-intact epithelial preparation, we observed a variety of voltage behaviors with frequencies of 35-75 Hz. This range is well below the range of resonant frequencies observed in enzymatically dissociated hair cells and more in tune with the frequency range of natural stimuli to which the sacculus is maximally responsive. The sharpness of tuning also agreed with previous studies using natural stimuli. In contrast to results from enzymatically dissociated hair cells, both a calcium-activated K+ (KCa) current and a voltage-dependent K+ (KV) current contributed to the oscillatory responses of hair cells in the semi-intact preparation. The properties of the KCa and the Ca2+ current were altered by enzymatic dissociation. KV and a small-conductance calcium-activated K+ current were apparently eliminated.

4-Aminopyridine↗
PubMed1998

A novel voltage clamp technique for mapping ionic currents from cultured skeletal myotubes.

The biophysical properties and cellular distribution of ion channels largely determine the input/output relationships of electrically excitable cells. A variety of patch pipette voltage clamp techniques are available to characterize ionic currents. However, when used by themselves, such techniques are not well suited to the task of mapping low-density channel distributions. We describe here a new voltage clamp method (the whole cell loose patch (WCLP) method) that combines whole-cell recording through a tight-seal pipette with focal extracellular stimulation through a loose-seal pipette. By moving the stimulation pipette across the cell surface and using a stationary whole-cell pipette to record the evoked patch currents, this method should be suitable for mapping channel distributions, even on large cells possessing low channel densities. When we applied this method to the study of currents in cultured chick myotubes, we found that the cell cable properties and the series resistance of the recording pipette caused significant filtering of the membrane currents, and that the filter characteristics depended in part upon the distance between the stimulating and recording pipettes. We describe here how we determined the filter impulse response for each loose-seal pipette placement and subsequently recovered accurate estimates of patch membrane current through deconvolution.

Animals↗
PubMed1998

Bone marrow transplantation in Shwachman-Diamond syndrome: report of two cases and review of the literature.

Patients with Shwachman-Diamond syndrome (SDS) have an increased frequency of myelodysplasia and leukemic transformation. We described two patients who received allogeneic stem cell transplantation and developed multiple complications, including seizure, hyperglycemia and renal tubular acidosis. A review of the literature showed that patients with SDS appeared to have an increased incidence of various transplant-associated problems. These patients frequently have underlying organ dysfunction and should be managed with extreme caution when treated with allogeneic stem cell transplantation.

Bone Marrow Transplantation↗
PubMed1997

Measurement of residual leukemia during remission in childhood acute lymphoblastic leukemia.

BACKGROUND: Complete remission of B-precursor acute lymphoblastic leukemia (ALL) has traditionally been defined as the near absence of lymphoblasts in a light-microscopical examination of stained bone marrow smears, but a patient in remission may still harbor up to 10(10) leukemia cells. We investigated whether there is a relation between the outcome of treatment and submicroscopic evidence of residual disease. METHODS: We conducted a prospective study of patients during a first clinical remission using a quantitative polymerase-chain-reaction (PCR) assay capable of detecting 1 viable leukemia cell among 200,000 normal marrow mononuclear cells and a clonogenic blast-colony assay. Bone marrow specimens from 24 children were sequentially evaluated during a five-year period, and the results were compared with the clinical outcome. RESULTS: Seven patients relapsed and 17 remained in remission 2 to 35 months after the completion of treatment. The levels of residual leukemia-cell DNA in the two groups were significantly different (P<0.001; 95 percent confidence interval for the difference in the mean log-transformed ratio of leukemia-cell DNA to normal bone marrow-cell DNA, 0.38 to 1.28). Autoregression analyses identified trends for individual patients that were associated with relapse. Despite continued remission in 17 patients, evidence of residual leukemia was detected by PCR in 15 and by both PCR and blast-colony assays in 7. CONCLUSIONS: Molecular signs of residual leukemia can persist up to 35 months after the cessation of chemotherapy in children with ALL in remission. This suggests that eradication of all leukemia cells may not be a prerequisite for cure.

Bone Marrow↗
PubMed1997

Systemic hemophagocytosis masking the diagnosis of large cell non-Hodgkin lymphoma.

An 11-year-old female presented with clinical features suggestive of malignant histiocytosis: fever, weight loss, subcutaneous nodules, pulmonary infiltrates, adenopathy, and hepato-splenomegaly. On biopsy, lymph node and bone marrow demonstrated necrosis and extensive hemophagocytosis with no definitive evidence of malignancy: the subcutaneous nodules, however, demonstrated large-cell non-Hodgkin lymphoma. This clinicopathologic picture has been reported in adults, but not in children. Although serum G-CSF, M-CSF, and TNF levels were not elevated in this child, it is possible that other cytokines induced either directly or indirectly by the subcutaneous lymphoma resulted in hemophagocytosis.

Bone Marrow↗
PubMed1996

Detection of minimal residual disease in all: biology, methods, and applications.

The PCR technique appears to be the most sensitive method for detecting residual disease in ALL and can be applied to a high percentage of cases by amplifying sequences of the antigen-receptor genes. The PCR studies to date suggest that this sensitive technique can detect residual disease in virtually all patients during the first year of treatment. The residual disease becomes undetectable in the majority of patients by the end of treatment; however, a subset of patients remain PCR positive at a time when therapy is electively discontinued. The development of a highly accurate quantitative PCR technique may allow the possibility of distinguishing the patterns of residual disease for patients who will be cured by treatment from those who relapse. If such a pattern can be discerned, then an immediate benefit for PCR monitoring will be that clinicians will have the opportunity to test whether treating patients at the time of 'molecular relapse' will help to improve the cure rate for this disease. The PCR studies of remission marrows at the end of treatment raise a number of questions about the biology of disease persistence in patients who remain in extended 'remission.' A commitment to obtaining and analyzing bone marrow specimens in patients who have completed therapy is necessary to discern whether novel strategies, such as immunomodulatory manipulations, are needed to control or eradicated residual disease in patients who have completed planned chemotherapy. Thus, the long-term benefit of residual disease monitoring by PCR may be a better understanding of the biology and definition of 'cure' in ALL.

Child↗
PubMed1996

The clinical significance of residual disease in childhood acute lymphoblastic leukemia as detected by polymerase chain reaction amplification by antigen-receptor gene sequences.

The polymerase chain reaction (PCR) has been applied to detect occult leukemia cells in children with acute lymphoblastic leukemia who are otherwise considered in complete remission by traditional morphological examination of bone marrow specimens. To determine whether PCR provides unique prognostic information of use for the clinical investigator, we reviewed the 20 clinical studies published to date. From this review, it is evident that discrepancies exist for the detection of residual disease for patients who remain in complete remission and for those who relapse. However, because of the fundamentally different approaches used to apply the PCR method to each of these studies, an entirely different interpretation can be reached when critical technical factors are considered. The combined data from the various studies suggest that a consistent pattern for residual disease disappearance over many months exists for patients who remain in extended complete remission and a pattern of residual disease persistence and reappearance preceding clinical findings exists for the majority of those who ultimately relapse in the bone marrow.

Bone Marrow↗
PubMed1995

Accurate quantitation of residual B-precursor acute lymphoblastic leukemia by limiting dilution and a PCR-based detection system: a description of the method and the principles involved.

The detection of residual leukemia cells in the bone marrow of patients during morphologic remission has been greatly facilitated by use of the polymerase chain reaction (PCR) to amplify leukemia-specific sequences. While the current PCR strategies for estimating the amount of residual leukemia claim a detection sensitivity of one leukemia cell amongst 10(5) or 10(6) normal cells, a rigorous assessment of the relative error associated with these techniques has not been presented. We have developed a method of estimating the amount of residual leukemia in remission marrows that is analogous to the limiting dilution assays used to determine the frequency of immunocompetent cells in a responder cell population. Using this method we measured the fraction of all-or-none (i.e. positive or negative) reactions of the PCR amplification of the leukemia-specific IgH gene rearrangement in replicate samples of serial dilutions of DNA obtained from diagnostic bone marrow specimens from 15 children with B-precursor acute lymphoblastic leukemia (ALL). A sigmoid curve representing the fraction of positive PCR reactions at a given dilution of leukemia DNA was found to be the best fit to the data. The narrowness of the log-linear region of this curve prevents the direct application of the analysis methodology that has previously been described for limiting dilution assays. However, the residual leukemia burden during morphological remission in these 15 patients and in two additional patients who experienced relapse could be estimated by the described dilution analysis method using the best-fit equation. Furthermore, the data generated for diagnostic, remission and relapse marrow samples exhibited a small interspecimen variation. The results suggest that this method can reliably estimate residual leukemia over a range of five orders of magnitude. Although the PCR reaction appears to be one of the most sensitive methods for detecting residual leukemia, all techniques based on this procedure, including our own, must exhibit limitations inherent to the amplification process. Our estimates or relative error suggest that a realistic limit for the PCR estimation of residual leukemia lies in the range of one leukemia cell per 10(5) normal cells. The suggested method is rapid, technically simple and relatively inexpensive. Furthermore, the principles that it is based upon can be applied to any PCR-based strategy.

Bone Marrow Examination↗
PubMed1995

Monitoring residual disease in acute lymphoblastic leukemia: therapeutic implications.

The polymerase chain reaction (PCR) has been applied to detect occult leukemia (ALL) cells in patients with acute lymphoblastic leukemia who are otherwise considered in complete remission by traditional morphological examination of bone marrow specimens. The combined data from the clinical studies published to date suggest that a consistent pattern for residual disease disappearance over many months exists for patients who remain in complete remission for an extended period of time. Conversely, a pattern of residual disease persistence and reappearance preceding clinical findings exists for the majority of patients who ultimately relapse. The ability to detect residual ALL disease near the end of chemotherapy or after the completion of treatment in some patients who otherwise are deemed likely to be cured of their malignancy raises the possibility that mechanisms other than leukemia cell cytotoxicity are influencing the outcome for this disease.

Antineoplastic Agents↗
PubMed1994

Clinicopathologic features and treatment outcome of children with large-cell lymphoma and the t(2;5)(p23;q35).

The t(2;5)(p23;q35) was detected in 9 of the 18 cases of large-cell lymphoma with an abnormal karyotype among 115 children with large-cell lymphoma treated at St Jude Children's Research Hospital from 1975 to 1993. When the cases containing the t(2;5) were classified according to the National Cancer Institute Working Formulation, 7 were large-cell, immunoblastic and 2 were diffuse large cell; according to the Kiel classification system, 6 were anaplastic large cell, 2 immunoblastic, and 1 centroblastic. CD30 expression was documented in 6 of 8 cases tested. All patients had nodal disease and 6 had extranodal involvement (bone in 4 cases and skin in 3). Eight of nine had advanced disease at diagnosis (stage Ill in 7 and stage IV in 1). Complete remission (CR) was attained in all patients and 6 remain in first CR for 19+ to 97+ months. Three relapsed, but successfully obtained second remissions; 2 are 58+ and 80+ months after retrieval therapy for local recurrences, and 1 patient died of recurrent disease. The t(2;5)(p23;q35) is associated with, but not limited to, anaplastic histology, a CD30+ T-cell phenotype, advanced stage disease with nodal (+/- extranodal) involvement, and chemosensitivity at diagnosis and relapse.

Adolescent↗
PubMed1994

Complete hematologic remissions induced by 2-chlorodeoxyadenosine in children with newly diagnosed acute myeloid leukemia.

The majority of children with acute myeloid leukemia (AML) who are treated exclusively with chemotherapy die of progressive disease. Improvement in outcome will likely require new active drugs capable of eradicating resistant blast cells early in the clinical course. We therefore assessed the cytoreductive potential of 2-chlorodeoxyadenosine (2-CdA), a halogenated purine analogue, in 22 consecutive children with newly diagnosed AML. The drug was administered as a single 120-hour continuous infusion (8.9 mg/m2 of body surface area per day) before the introduction of standard remission induction therapy. Six patients (27%) had complete hematologic remissions by a median of 21 days after treatment with the nucleoside (range, 14 to 33 days). Seven others had partial responses, yielding a total response rate of 59%. The drug also eliminated leukemic cells from cerebrospinal fluid in 4 of the 6 patients tested. Concentrations of 2-CdA in cerebrospinal fluid on day 5 after the initiation of treatment ranged from 12.4% to 38.0% (mean, 22.7%) of the steady-state plasma concentrations. Severe but reversible myelosuppression and thrombocytopenia developed in all patients. Analysis of factors that may have influenced the complete remission rate suggested a better outcome in patients with myeloblastic leukemia (M0-M2 subtypes in the revised French-American-British classification system). These results demonstrate clinically significant activity by 2-CdA against previously untreated AML in children, including leukemic blast cells in the central nervous system. Its use in combination chemotherapy may improve the outlook for patients with this often fatal hematologic cancer.

Adolescent↗