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Biomedical subjects

W A Brock

Publications and source records attributed to W A Brock.

At least 19 recordsLinked to original sources
PubMed1992

Intrinsic radiosensitivity of normal human fibroblasts and lymphocytes after high- and low-dose-rate irradiation.

The existence of heritable radiosensitivity syndromes and clinical observations in radiotherapy patients suggests that human cellular radiosensitivity differs among individuals. We report here an in vitro study of radiosensitivity in 30 fibroblast and 29 lymphocyte cultures obtained from cancer patients and controls. In 25 cases, both fibroblasts and lymphocytes were obtained from the same donors. Fibroblasts were cultured from skin biopsy samples, and peripheral T-cell lymphocytes were cultured from blood. Clonogenic survival assays were performed by using high- and low-dose-rate irradiation; lymphocytes were in G0 phase and fibroblasts in confluent plateau phase. Various end points were calculated and compared (i.e., surviving fraction at 2 Gy, initial slope of the survival curve, and doses resulting in 10 and 1% survival, respectively). Depending on the end point, the coefficient of variation of the survival parameters ranged from 31 to 68% for lymphocytes and 21 to 41% for fibroblasts following high-dose-rate irradiation. Similar ranges were obtained after low-dose-rate irradiation. Variance analysis performed on replicate assays in cultures derived from the same patient showed that variation due to technical or sampling errors was significantly lower than variation between individuals (P = 0.00034 and 0.014 for fibroblasts and lymphocytes, respectively). No correlation was observed between the radiosensitivity of lymphocyte and fibroblast cultures derived from the same donors. We conclude that there is significant variation in normal cell radiosensitivity among individuals. On the other hand, comparisons of lymphocyte and fibroblast radiosensitivities suggest that tissue-specific characteristics, such as differentiation status, may variably modulate radiosensitivity.

Breast Neoplasms↗
PubMed1992

Can modest escalations of dose be detected as increased tumor control?

Clinically defined groups of tumors are usually characterized by shallow dose-response curves, and this results from heterogeneity among individual dose-response curves, each of which is very likely quite steep. A review of published results for human tumors indicates that a 10% escalation of dose to tumors controlled at the 50% level, where changes in outcome are most likely to be detected, will be detectable in a population of unselected patients only in sizable clinical trials (130-300 patients per dose level). With a few exceptions, a dose escalation of 20% will be detectable in much smaller trials (50-130 patients per dose level). Therefore, clinical trials of improved treatment modalities will be confounded by patient heterogeneity, and modest improvements may go undetected in all but the largest trials. Mathematical modeling was used to study the effect on the steepness of the dose-response curve of selecting patients on the basis of the radiosensitivity measure SF2 (surviving fraction at 2 Gy). If SF2 is a faithful predictor of response in a group of tumors, then heterogeneity could be reduced by excluding the patients with the most sensitive (controlled with near certainty) and most resistant (recurring with near certainty) tumors. The resulting "stochastic fraction" (tumors for which treatment outcome is probabilistic) would be characterized by a steep dose response, and the number of patients required to demonstrate the effect of dose escalation would be substantially reduced (by about 50%).

Dose-Response Relationship, Radiation↗
PubMed1992

Radiosensitivity measurement of keratinocytes and fibroblasts from radiotherapy patients.

Genetic diversity is believed to influence cellular radiosensitivity and individual variability in normal tissue reactions to radiotherapy. To measure normal cell radiosensitivity in vitro, we investigated a culture technique that yields keratinocyte and fibroblast cell cultures from small skin biopsy samples (average weight 32 mg). This technique uses 3T3 NIH cells as feeder cells, culture medium containing dialyzed fetal calf serum, low calcium, and various growth factors for keratinocyte growth. A calcium concentration of 4 x 10(-3) M and the use of lethally irradiated NIH 3T3 feeder cells were critical to the success of this method. Primary keratinocyte cultures were successfully obtained from nine biopsy specimens, and radiosensitivity measurements were obtained in six of the resulting strains. Keratinocytes were, in general, more radioresistant than fibroblasts derived from the same specimen. We conclude that radiosensitivity assessment of keratinocyte and fibroblast cultures derived from small punch biopsy specimens is feasible. Further studies can now be carried out to determine the degree of variability between individuals and the relationship between in vitro keratinocyte and fibroblast radiosensitivity and their value in predicting normal tissue responses to radiotherapy.

Cell Survival↗
PubMed1992

The hybrid spheroid clonogenic assay for the intrinsic radio- and chemo-sensitivities of human tumors.

The Hybrid Spheroid assay is based on packaging tumor cells into agglomerates of non-proliferating, but metabolically active, HeLa cells. These agglomerates provide an in vivo-like environment for entrapped test cells. Clonogenicity is determined by varying the number of test cells per hybrid spheroid so that some, but not all, spheroids give rise to macrocolonies. From the fraction of noncolony forming spheroids and the Poisson distribution, the average number of clonogens per spheroid can be calculated. The clonogenicity and radiation survival curves of cells derived from human tumors (of the maxilla, tongue, larynx, mouth floor, lung, breast, ovary, and colon) were so determined. Plating efficiency was increased in these normally poorly plating tumor cells, thus enabling survival measurements which are not practical using conventional methods. The Hybrid Spheroid assay has also been applied to determine the chemosensitivity of colon cancer cells.

Cell Aggregation↗
PubMed1991

Effect of thiols on micronucleus frequency in gamma-irradiated mammalian cells.

The effects of the thiols cysteamine, WR-1065, and WR-255591 on radiation-induced micronucleus (MN) frequency and cell killing were compared in cultured Chinese hamster ovary cells. MN were measured using the cytochalasin B assay of Fenech and Morley (1985), which minimizes the effect of cytokinetic perturbations on MN expression. The dose-response curves for MN induction were curvilinear both for control cells at doses between 1.5 and 4.5 Gy and for thiol-treated cells at doses between 3 and 9 Gy. Protection against MN induction by each thiol was independent of radiation dose. Furthermore, there was a close correlation between the degree of modification of MN induction and cell survival by each thiol, i.e., the MN frequency closely predicted the survival level regardless of the presence of absence of the thiols. A similar predictive relationship has also been reported by us for cell survival and DNA double-strand break (DSB) induction in this cell line following treatment with these same thiols. Collectively, these data support the hypothesis that, for DNA-repair-proficient mammalian cells treated with radiomodifying agents that do not alter DNA-repair processes, MN and DSB induction are predictive of the level of radiation lethality and of each other.

Animals↗
PubMed1991

Estimation of clonogenic cell fraction in primary cultures derived from human squamous cell carcinomas.

Tumor clonogenic cell content is believed to play an important role in the outcome of radiotherapy. However, there is no proven method to assess the number of clonogens in human tumors accurately. All currently available assays employ in vitro plating efficiency or in vivo TD50 (the average number of cells needed to induce tumors in 50% of injected mice) to estimate the tumor clonogenic ability. In this study, a monolayer mass primary culture system was used to estimate the clonogenic cell fraction in human tumors. For this purpose, 25 growth curves were performed for 25 tumor specimens derived from 21 head and neck and 4 cervical squamous cell carcinomas. The exponential portion of each growth curve was extrapolated through the ordinate (day 0) to estimate the clonogenic cell fraction; this method is only an estimate because it assumes no lag phase before exponential growth of clonogenic cells. The mean clonogenic cell fraction, expressed as clonogens/tumor cells inoculated, was relatively low (mean: 0.71%, range: 0.11-9.28), and the variation was wide (coefficient of variation = 148%). On the other hand, the doubling time of the growing population was 1.46 days and exhibited a very narrow range (0.98-2.24, coefficient of variation = 24%). The mean and range of clonogenic cell fraction were found to be in agreement with published values of soft agar colony forming efficiencies in both murine and human tumors. However, further investigation is necessary to determine how accurately this method measures the relative clonogenic cell content in human tumors. Clinical correlations between clonogenic cell fraction values and the response to radiotherapy are still too early to determine.

Carcinoma, Squamous Cell↗
PubMed1990

Transitional cell carcinoma of bladder in children.

Transitional cell carcinoma of the bladder occurs rarely during the first two decades of life. The malignancy is usually low grade and noninvasive, with a low recurrence rate. Transurethral resection or fulguration is the treatment of choice, and the prognosis is favorable. We present 4 patients, aged two to eighteen years, with transitional cell carcinoma of the bladder and review the literature.

Adolescent↗
PubMed1990

Cellular radiosensitivity of primary head and neck squamous cell carcinomas and local tumor control.

The low dose survival parameters of human tumor cell lines have been shown to correlate with the perceived clinical radiosensitivity of different tumor histologic types. This conclusion has been generated from the analysis of a large number of cell lines and has, therefore, served as the basis for attempts to develop predictive assays of tumor radiocurability. In this study, the tumors from 72 patients with head and neck squamous cell carcinoma have been grown in an adhesive tumor cell assay system and their sensitivity to radiation has been measured. All patients in this study were treated with post-operative radiotherapy, the surgical margins were negative, and any patient that had received chemotherapy was excluded. The average S2 (survival at 2.0 Gy) value of the 72 cultures was 0.33, with the values ranging from 0.11 to 0.91. All patients were evaluated for local tumor control. They have been followed for about 1 year and continued follow-up is still in progress. The average survival at 2.0 Gy of cultures derived from the 12 patients that have had recurrences so far is slightly higher (0.40) than that from those who appear so far to have local tumor control (0.30). Although the general trend is that recurrent tumors yield primary cultures that are slightly more resistant, the difference is not statistically significant.

Carcinoma, Squamous Cell↗
PubMed1990

Advances in the percutaneous management of the ureteropelvic junction and other obstructions of the urinary tract in children.

In conclusion, endopyelotomy has been developed over the past several decades on the basis of sound laboratory and clinical research. The success rates have been similar to those of the standard open pyeloplasty, and the procedure is not associated with undue complications. Endopyelotomy has several distinct advantages over open surgery, including the decreased morbidity and associated expense of an open operation, minimal interference with the blood supply of the ureter, and avoidance of removal of the ureter from its natural sheath, preventing the tendency to adhere to adjacent structures and thus kink. As the instrumentation available for percutaneous renal surgery has improved and been miniaturized, the techniques developed in adults have been progressively applied to younger and smaller children. There seems to be little doubt that a comparison of morbidity and socioeconomic factors associated with a successful endopyelotomy versus an open pyeloplasty in adults heavily favors the percutaneous procedures, and judicious application to children would seem warranted. However, the changing presentation of ureteropelvic junction obstruction in children that has resulted from the widespread use of prenatal ultrasonography may make the question moot. Open infant pyeloplasty is a highly successful procedure, accompanied by minimal morbidity and accomplished in a 2- to 3-day hospital stay. The socioeconomic factors are obviated in the infant, who already requires constant maternal care. However, endopyelotomy deserves consideration in the older child, especially if the obstruction is secondary in nature after a previous open procedure.

Child↗
PubMed1989

Epidermal growth factor effect on serum-free growth of primary and metastatic human tumors.

The effect of epidermal growth factor (EGF) on the in vitro growth of human malignant tumors was compared in serum-supplemented (n = 54) and serum-free (N = 41) media at clonal density to determine the true EGF dependency of tumors. In the complete absence of serum at a 1,000 cells/cm2 seeding inoculation (approximately 100-200 adherent cells), EGF increased growth by greater than 50% in 27 of 41 specimens (66%), and growth increased by 100% or more in 18 of these EGF-sensitive tumors. In 12 serum-free cultures (29%), in vitro growth failed to occur without EGF. With 10% serum supplementation and a lower cell density (250 cells/cm2), EGF increased growth by greater than 50% in 34 of 54 specimens (63%), of which 25 had more than a 100% increase. The maximum growth induced by EGF in serum was usually seen in those tumors already capable of moderate in vitro growth. No difference in response to EGF was detected between specimens from primary tumors (n = 24) and those from metastases (n = 30). Under the stringent culture conditions of complete absence of serum and with tumors seeded at a low cell number, EGF stimulated most primary or metastatic human tumors to establish and sustain short-term in vitro growth successfully.

Blood↗
PubMed1989

Association of foreign DNA sequence with male sterility and translocation in a line of transgenic mice.

We have analyzed a line of transgenic mice derived from injection of a cloned human interferon cDNA. This line manifests total male sterility of males carrying the human sequence, while male littermates not harboring the foreign DNA are fertile. All females are fertile. Karyotypes of transgenic animals show 2:12 translocation. The microinjected sequence maps to one of the translocation chromosomes composed of a large portion of chromosome 12 to which has been translocated a segment of chromosome 2. Analysis of the sterile males reveals significant abnormalities of spermatogenesis and faulty chromosome synapsis that involves the translocation chromosomes. These findings show that transfer of foreign DNA into mouse embryos may lead to chromatin breakage and infertility of transgenic animals.

Animals↗
PubMed1989

Ectopic ureteroceles: surgical management with preservation of continence--review of 60 cases.

During the last 19 years we treated 60 children with ectopic ureteroceles. There was a 4 to 1 female-to-male predominance. Of the patients 47 per cent presented before age 6 months, 66 per cent were diagnosed after a urinary tract infection and 6 were identified antenatally. Based upon a review of the literature and our data, we believe that "total correction" (a single operation designed to correct abnormalities of the upper and lower urinary tract) is superior in most instances to an approach in which just the upper urinary tract pathological condition is treated. Only 4 (14 per cent) of 28 patients in whom "total correction" was used required a second operation (all because of persistent reflux) while 14 of 19 patients (74 per cent) treated with an upper urinary tract procedure intended as definitive therapy have either undergone further surgery or have a residual abnormality that may require further surgery. Marsupialization rather than enucleation of the ectopic ureterocele is effective and safe, risking neither injury to the bladder neck or sphincteric mechanism nor resulting in a vesicovaginal fistula.

Child↗
PubMed1989

Heterogeneity in radiation sensitivity within human primary tumour cell cultures as detected by the SCE assay.

The ability of the sister chromatid exchange (SCE) assay to detect heterogeneity in intrinsic radiation sensitivity was investigated. In order to identify tumour cell subpopulations, frequency histograms of cis-diamminedichloroplatinum (II) (cPt)-induced SCEs were generated and compared to those from cultures that had been irradiated 96 h before drug treatment. The results suggested that subpopulations with different radiosensitivities were present in nine of 18 human primary tumour cell cultures evaluated. When the effects of prior irradiation on the subsequent X-ray survival response and on cPt-induced SCE frequency histograms were compared, a good correlation was obtained between the two assays regarding the prediction of heterogeneity in radioresponse. These results suggest that primary cultures can contain both radiation-sensitive and radiation-resistant cells, and thus heterogeneity in intrinsic radiosensitivity may exist in human solid tumours.

Animals↗
PubMed1989

Radiosensitivity of human head and neck squamous cell carcinomas in primary culture and its potential as a predictive assay of tumor radiocurability.

The intrinsic radiosensitivity of human tumor cell cultures correlates with the clinical radiosensitivity of several different tumor histologies, as evidenced by analyses of low dose parameters of radiation survival curves generated from a large number of cell lines. Such radiosensitivity has therefore served as a basis of attempts to develop predictive assays of tumor radiocurability. In this study, the tumors from 72 patients with head and neck squamous carcinoma have been grown in an adhesive tumor-cell assay system and radiosensitivity (S2: survival at 2.0 Gy) values have been measured. The characteristics of these cultures, such as growth rate, clonogenicity and growth enhancement by epidermal growth factor, do not correlate with S2. The average S2 value of the 72 cultures is 0.33, which is lower than for cultures derived from melanomas and lung adenocarcinomas. Twenty-six patients followed up for at least 15 months have been evaluated for local tumor control. The average S2 value of the seven patients with recurrences in this group is slightly higher (0.43) than that from the other patients (0.30). There is considerable overlap of S2 values in the two groups, and more patients must be evaluated before the groups can be compared statistically.

Carcinoma, Squamous Cell↗
PubMed1989

Urethral strictures after hypospadias repair.

Over a 16 years period, we have treated 34 cases of urethral stricture after hypospadias repair. Seventeen patients were successfully treated with one procedure, while 16 patients required two or more procedures; one patient was lost to follow-up. Eighteen patients who presented with symptoms attributable to their stricture within 3 months of their original operation for hypospadias were designated as having early strictures. Those strictures presenting later than 3 months were termed late strictures. Manipulative therapy (dilation, direct vision internal urethrotomy) was successful in 46% of early strictures, but in only 16% of late strictures. Open surgical procedures were employed primarily in some cases or after failed manipulation in others and were successful in 82% of cases. All 4 failures of open procedures were salvaged with manipulative therapy. We conclude that treatment of post hypospadias repair urethral strictures should initially be manipulative. Open surgical repair will usually be successful but should be reserved for difficult strictures, late strictures, or failures of manipulation.

Adolescent↗
PubMed1988

Antitumor activity against human tumor samples of cis-diamminedichloroplatinum(II) and analogues at equivalent in vitro myelotoxic concentrations.

We compared the antitumor activity of cis-diamminedichloroplatinum(II) (cisplatin; CDDP) with three CDDP analogues: cis-diammine-1,1-cyclobutanedicarboxylateplatinum(II) (CBDCA), N-methyliminodiacetato-1,2-diamino(cyclohexane)platinum(II) (MIDP), and N-(2-hydroxyethyl)-iminodiacetato-1,2-diamino(cyclohexane)platinum (II) (HIDP). Fresh human tumor samples in the adhesive tumor culture system were utilized for this comparison. The equitoxic concentrations of all four drugs were derived based on their inhibitory activity against human bone marrow samples. For these normalized concentrations, CDDP proved to have a higher cytotoxic activity than its analogues. CBDCA's in vitro activity had a significant correlation with CDDP activity (r = 0.67) in vitro. However, the structurally similar substances MIDP and HIDP demonstrated a much greater degree of association (r = 0.90). Our data suggest that CBDCA, HIDP, and MIDP have overall less activity than CDDP when tested at equitoxic in vitro concentrations. Close association between CDDP and CBDCA also reflects known clinical experience with these two drugs, suggesting the method of comparison used here is probably appropriate. These conclusions, however, must be validated by clinical trials.

Bone Marrow↗