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Biomedical subjects

S A Simpson

Publications and source records attributed to S A Simpson.

At least 37 records · Page 2Linked to original sources
PubMed1995

Acute reaction parameters for human oropharyngeal mucosa.

The purpose of this study was to determine the influence of changes in dose rate over the range 0.8-240 Gy/h on acute oropharyngeal mucosal reactions in human subjects, and to estimate the values of the important parameters that influence these reactions. Sixty-one patients requiring radiotherapy to palliate incurable head and neck cancer were treated on a telecaesium unit, using opposing lateral portals to total midline doses, varying between 30 and 42 Gy in 10 daily fractions over 2 weeks, at dose rates of 0.8, 1.8, 3.0 and 240 Gy/h according to a central composite study design. The severity and time course of reactions were charted at least twice weekly for each patient, using the EORTC/RTOG acute mucosal reaction grading system. Duration of reaction at each grade was observed to provide a more sensitive reflection of effect than the proportion of patients reaching any particular reaction grade. Analysis of duration by direct and indirect methods suggest alpha/beta ratios in the range 7-10 Gy and half-time (t1/2) values in the range 0.27-0.5 h, if mono-exponential repair kinetics are assumed. The t1/2 values are short and raise the question as to whether the repair kinetics of this tissue are well described by a mono-exponential function. Further prospective studies involving multiple daily fraction treatment regimes delivered at high dose rate, in which interfraction interval is deliberately varied, are needed to find out whether the parameters derived from this project are applicable to fractionated treatment courses at high dose rate.

Carcinoma, Squamous Cell↗
PubMed1995

Factors influencing the degree of erythematous skin reactions in humans.

Dose-response relationships have been studied using an ordinal visual scale and reflectance spectrophotometry data from 123 treatment sites on 110 patients treated with 10 dose fractions over 12-14 days. Dose rates varied between 3 and 240 Gy/h and total doses of between 25 and 41 Gy were given using teletherapy apparatus. We found qualitative scoring of erythematous skin reactions to be subject to considerable inter- and intra-observer variation. Reflectance spectrophotometry provided more reproducible information, some of which was undetectable by naked eye. Baseline erythema readings were significantly higher in male patients and at anatomical sites of previous heavy UV exposure. In addition, a pronounced decline in erythema readings during the second week of therapy and 'reciprocal vicinity' (abscopal) effects adjacent to the field, undetected by the eye, were observed in a subset of patients. Meaningful dose-response relationships could be derived only from reflectance data with peak change from the pretreatment baseline measure providing the best discrimination. Peak erythema measures following treatment were found to depend on the age and gender of the patient as well as the treatment site and its baseline erythema measurement. This was independent of the total dose administered or the instantaneous dose rate at which it was delivered. The rate of erythema development was also dose rate dependent but only weakly dependent on the biological dose intensity (Gy equiv./day) of the treatment course. The data raise the question of whether irradiation-induced erythema is exclusively a secondary phenomenon occurring as a result of basal cell killing. The short repair half time value of 0.06 h obtained by direct analysis is perplexing and may reflect a dose rate-dependent physiological vasodilatory response to irradiation and/or a multi-component cellular repair process.

Aged↗
PubMed1995

Superoxide dismutase mutations in an unselected cohort of Scottish amyotrophic lateral sclerosis patients.

Mutations in the Cu/Zn superoxide dismutase (SOD1) gene are responsible for some cases of familial amyotrophic lateral sclerosis (ALS). We have shown that SOD1 mutations can also occur in apparently sporadic ALS. To establish how often this happens we have undertaken a study of the prevalence of SOD1 mutations in an unselected cohort of Scottish ALS patients, with both sporadic (n = 57) and familial (n = 10) disease. Single strand conformation polymorphism analysis was used to scan for new mutations, and selective restriction enzyme digestion to screen for 11 of the 20 SOD1 mutations published to date. We detected mutations in five (50%) of the familial ALS patients and also in four (7%) of the sporadic patients. One mutation, ile113thr, seems to be particularly prevalent in the Scottish population since it was detected in a total of 6/67 (9%) unrelated cases.

Aged↗
PubMed1995

Cognitive performance in UK sample of presymptomatic people carrying the gene for Huntington's disease.

This paper presents an investigation of cognitive ability in 30 subjects at risk for Huntington's disease. Those shown to be at high or low risk for this disease are compared on a wide range of neuropsychological measures. Results indicate only one significant difference between the two groups; those who carry the gene show a higher level of performance on the Corsi Supraspan task. It is suggested, however, that minimal deficits are apparent in the at risk gene carrying group but that current measures of assessment are not sensitive enough to identify them.

Cognition↗
PubMed1993

Low dose rate teletherapy and tumour response.

Tumour responses in 25 patients with locally advanced head and neck cancer, treated on an experimental fractionated low dose rate (FLDR) teletherapy program are reported. Treatment was given at dose rates ranging from 1.8 to 3 Gy/h to a range of total doses from 32-38 Gy, with palliative intent. The total doses delivered have been predicted by the linear quadratic formula to be equivalent to 33-41 Gy using conventionally fractionated high dose rate treatment, in terms of acute normal tissue effects. A complete response rate (no visible or palpable disease 2 months after treatment) was observed in 28% of cases. Analysis of these response rates suggests that the linear quadratic formula may underestimate the anti-tumour effect of FLDR teletherapy at the various dose rates and total dose permutations in this study.

Carcinoma, Squamous Cell↗
PubMed1993

Huntington's disease in Grampian region: correlation of the CAG repeat number and the age of onset of the disease.

The identification of an unstable trinucleotide repeat as the mutation responsible for Huntington's disease (HD) has given the hope that additional information can be provided about age of onset and mode of action of the mutated gene. We present in this paper results of a clinical and molecular study of 82 patients affected with HD from 46 pedigrees within the Grampian region, Scotland. Our results show a correlation between age of onset and size of the CAG expansion. This study has produced no overlap in mutation size between affected and unaffected alleles. The sex of the parent transmitting the mutated allele and the size of the normal allele have no significant effect on the clinical features of the disease. In the three juvenile cases the affected parent was the father but the number of cases is too small to produce statistical significance. An increase in the CAG repeat size is shown in the transmission of the gene in five cases, accompanied by an earlier age of onset in four; in three of these cases, the affected parent was the father. Eleven sib pairs were studied and there is a negative correlation between the difference in age at onset and the difference in repeat size. Thus there is some evidence of a relationship, but this is not statistically significant because of the small numbers involved. The presence of the same or different normal allele had no effect on age of onset in this small group. We suggest that additional factors, as yet unrecognised, influence the age of onset and clinical presentation of HD.

Adolescent↗
PubMed1993

Predictive testing for Huntington's disease: after the gene. The United Kingdom Huntington's Disease Prediction Consortium.

The discovery of a mutation responsible for Huntington's disease (HD) offers the possibility of accurate predictive testing, as well as hope for treatment or prevention of this disease. We urge caution in the use of this new test as considerable ethical and counselling problems still exist, and new issues have arisen. The current guidelines for predictive testing should still apply, since it remains vital that subjects and their families have time to come to terms with the diagnosis of HD, and the implications of testing. Mutation analysis may allow the diagnosis of HD in isolated cases, or reverse a test result produced using linkage. Problems will arise as those at 25% risk may now receive a result despite the lack of support of their parent at 50% risk who may not wish to have their own status defined. In addition, couples who seek the exclusion test in pregnancy may find it difficult to investigate the pregnancy without producing information on themselves. Different centres should cooperate in maintaining the confidentiality of family members, ensuring that adequate counselling is given before results are produced which may affect the wider family.

Family↗
PubMed1993

Age at onset in Huntington's disease and methylation at D4S95.

Age at onset in Huntington's disease (HD) is variable and is influenced by parental sex, paternal age, and genetic background. Several recent models have tried to explain this variable expressivity by invoking parental imprinting and related aspects of epigenetic inheritance. Some of these mechanisms may result in variable DNA methylation at or near the HD gene. We show here that methylation at D4S95, a locus tightly linked to the HD gene, is highly variable. A comparison between patients with early onset HD, late onset HD, and normal controls showed no significant correlation between methylation and age at onset. However, we found a significant association of the age of the patient with demethylation at D4S95. Older persons tend to have lower levels of methylation at this locus. This observation is of interest with regard to studies that show an effect of paternal age, or more generally of 'ageing genes', on age at onset in HD.

Adolescent↗
PubMed1992

One hundred requests for predictive testing for Huntington's disease.

In Grampian region, the first 100 requests for predictive testing for Huntington's disease have been analysed. Forty-five presymptomatic predictive test results have been given, eleven families have made a decision to undergo prenatal exclusion tests, and so far eleven pregnancies have been investigated using chorion villus biopsy. This paper presents the protocol used and a descriptive analysis of those receiving results, those choosing to leave the programme, and those unable to complete it because of an unsuitable family structure or unco-operative relatives.

Adult↗
PubMed1985

Compartmentation of glycogen metabolism in the liver.

The incorporation of radioactivity into liver glycogen has been shown not only to be a metabolically inhomogeneous process but also to depend critically on the nature of the precursor. D-Galactose is incorporated into glycogen by a mechanism which is separate from that associated with the incorporation of D-glucose. D-Galactose is favoured for incorporation into high-molecular-weight glycogen and consequently is affected more by treatment of the animal with the antibiotic tunicamycin, since high-molecular-weight glycogen is preferentially found in the lysosomal compartment.

Animals↗
PubMed1984

Canine postradiation plasma glucose variations.

One of the observations of endotoxic or septic shock in canines is the report of concurrent hypoglycemia. Canines exposed to supralethal gamma radiation also develop acute systemic hypotension. This study was performed in order to determine if hypoglycemia develops in the canine concurrent with radiation-induced hypotension. Systemic arterial mean blood pressure (MBP) was measured via femoral arterial catheter. Blood for plasma glucose determinations was obtained from the systemic arterial circulation at the level of the abdominal aorta and from the hepatic portal vein. Plasma glucose levels were determined on a Beckman Glucose Analyzer which employs the enzymatic reaction of beta-D-glucose and oxygen. Glucose levels and MBP were monitored for one hour before and for one hour after exposure to 100 Gy, whole-body, gamma radiation or sham radiation for the control animals. Concurrent with postradiation hypotension, we measured a significant decrease in plasma glucose levels in both the systemic arterial circulation and in the hepatic portal vein. Arterial glucose levels in the sham radiated animals showed a slight rise two minutes after sham radiation, falling back to pretreatment, base line levels four minutes later and remaining at that level for the remainder of the hour. Arterial levels in the radiated animals showed a sharp decline two minutes postradiation, falling even further to twenty percent below preradiation levels by one hour postradiation. Venous blood glucose levels in sham radiated animals showed an initial increase and a gradual decrease to five percent below pretreatment base line levels; while glucose levels in radiated animals showed an immediate postradiation decrease continuing to twenty percent below preradiation levels by one hour postradiation. These findings suggest impaired hepatic gluconeogenesis, resulting in postradiation hypoglycemia.

Animals↗