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Biomedical subjects

G Workman

Publications and source records attributed to G Workman.

5 recordsLinked to original sources

Gene expression profiling of human ovarian tumours.

There is currently a lack of reliable diagnostic and prognostic markers for ovarian cancer. We established gene expression profiles for 120 human ovarian tumours to identify determinants of histologic subtype, grade and degree of malignancy. Unsupervised cluster analysis of the most variable set of expression data resulted in three major tumour groups. One consisted predominantly of benign tumours, one contained mostly malignant tumours, and one was comprised of a mixture of borderline and malignant tumours. Using two supervised approaches, we identified a set of genes that distinguished the benign, borderline and malignant phenotypes. These algorithms were unable to establish profiles for histologic subtype or grade. To validate these findings, the expression of 21 candidate genes selected from these analyses was measured by quantitative RT-PCR using an independent set of tumour samples. Hierarchical clustering of these data resulted in two major groups, one benign and one malignant, with the borderline tumours interspersed between the two groups. These results indicate that borderline ovarian tumours may be classified as either benign or malignant, and that this classifier could be useful for predicting the clinical course of borderline tumours. Immunohistochemical analysis also demonstrated increased expression of CD24 antigen in malignant versus benign tumour tissue. The data that we have generated will contribute to a growing body of expression data that more accurately define the biologic and clinical characteristics of ovarian cancers.

Adenocarcinoma, Clear Cell↗

Dosimetric considerations in the treatment of inoperable endometrial carcinoma by a high dose rate afterloading packing technique.

A series of 23 patients with early adenocarcinoma of the endometrium who underwent a total of 37 modified Heyman packings treated on a high dose rate Microselectron has been reviewed. Using computed tomography (CT), the uterine wall thickness was measured retrospectively and doses calculated at a number of points on the uterine serosa and related normal tissues. The mean and maximum fundal serosal doses were found to be highest posteriorly and the sigmoid colon was adjacent to the posterior surface of the uterus in all instances. By superimposing the isodose distribution on CT sections of the uterus, it is now possible to prescribe to a serosal dose, or, in patients too heavy for the CT scanner, a dose can be prescribed to a point S, which is a reasonable approximation to the serosal position. Since the initial study, a further ten patients have been treated by the same method and, where relevant, data from all 33 patients have been used.

Adenocarcinoma↗

Replacement of hairpin and loop implants by optimised straight line sources.

Remote after loading is desirable for all forms of brachytherapy but is difficult in the oral cavity because the tight curvature at the top of implanted loops impedes passage of the source. For this reason we investigated differential loading of straight catheters to simulate a conventional loop or hairpin. Using a pulsed brachytherapy remote after loader the top four dwell positions of straight catheters were given two to four times the dwell time of other source positions. This raised the reference isodose to cover the surface mucosa without significantly changing either the total volume treated or the volume receiving > 150% of reference dose when compared with conventional loop implants of equivalent source length and separation. This optimised straight line implant should therefore be amenable to remote afterloading and have similar dose/volume characteristics to loops.

Brachytherapy↗

Calibration of a Microselectron HDR iridium 192 source.

A method for the calibration of the output, in terms of an air kerma rate, of the high activity miniature iridium 192 sources used in the Microselectron HDR afterloading unit is described. An air kerma rate is measured using a calibrated thimble chamber in an "in-air" calibration jig. The results are compared with an air kerma rate derived from the manufacturer's test certificate. In some cases, the ionization chamber measurements have been followed by a further calibration check using thermoluminescent dosimetry. Other checks carried out when a new source is received are also briefly described.

Brachytherapy↗