Thesis (PhD)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The factors which control radiosensitivity are of vital importance for the understanding of cell inactivation and for cancer therapy. Cell cycle blocks, total induced DNA damage, DNA repair, apoptosis and chromatin structure are likely to playa role in the responses leading to cell death. I have examined aspects of irradiation-induced G2/M blocks in DNA damage and repair. In HT29, L132 and ATs4 cells the total amount of induced DNA damage by isodoses of 4.5 Gy, 5 Gy and 2 Gy was found to be 14 %, 14 % and 12 % respectively. Most of the DNA repair was completed before the G2/M maximum and only 3 % of DNA damage remains to be restored in the G2/M block. The radiosensitivity in eleven cell lines was found to range from SF2 of 0.02 to 0.61. By FADU assay the undamaged DNA at 5 Gy was found to range from 56% to 93%. The initial DNA damage and radiosensitivity were highly correlated (r2=0. 81). After 5 Gy irradiation and 12 hours repair two groups of cell lines emerged. The group 1 cell lines restored undamaged DNA to a level ranging from 94 % to 98 %. The group 2 cell lines restored the undamaged DNA to a level ranging from 77 % to 82 %. No correlation was seen between residual DNA damage remaining after 12 hours repair and radiosensitivity. In CHO-K1 cells chromatin condensation induced by Nocodazole was found to marginally increase the radiosensitivity as shown by the change of the mean inactivation dose (D) from 4.446 to 4.376 Gy. Nocodazole also increased the initial DNA damage, induced by 5 Gy, from 7 % to 13 %. In xrs1 cells these conditions increased the radiosensitivity from D of 1.209 to 0.7836 Gy and the initial DNA damage from 43 % to 57 %. Disruption of chromatin structure with a hypertonic medium was found to increase radiosensitivity in CHO-K1 cells from D of 4.446 to 3.092 Gy and the initial DNA damage from 7 % to 15 %. In xrs1 cells these conditions caused radiosensitivity to decrease from D of 1.209 to 1.609 Gy and the initial DNA damage from 43 % to 36 %. Repair inhibition by Wortmannin increased the radiosensitivity in CHO-K1 from a D of 5.914 Gy in DMSO controls to a D 3.043 Gy. In xrs1 cells repair inhibition had no effect on radiosensitivity. Significant inhibition of repair was seen in CHO-K1 at 2 hours (p<0.0001) and at 20 hours (p=0.0095). No inhibition of repair was seen in xrs1 cells at 2 hours (p=0.6082) or 20 hours (p=0.6069). While DNA repair must be allocated to the post-irradiation period, the G2/M block seen in p53 mutants reaches a maximum only 12 hours post-irradiation when most of the repair is completed. As the G2/M block resolves and cells reenter cycle 28 hours after the G2 maximum it appears that repair processes cannot be the only reason for the G2IM cell cycle arrest. At low doses of irradiation initial DNA damage correlates with radiosensitivity. This suggests that the initial DNA damage is a determinant for radiosensitivity. Repair of DNA double-strand breaks by the non-homologous end joining (NHEJ) mechanism, identified by inhibition with Wortmannin, was shown to influence residual DNA damage and cell survival. Both the initial DNA damage and DNA repair were found to be influenced by chromatin structure. Chromatin structure was modulated by high salt and by Nocodazole, and has heen identified as a parameter which influences radiosensitivity. / AFRIKAANSE OPSOMMING: Die faktore wat betrokke is in die meganisme van stralings-sensitisering is van hoogs belang vir die begrip van sel inaktiveering en kanker terapie. Sel siklus blokke, totale geïnduseerde DNS skade, DNS herstel, apoptose en chromatien struktuur is moontlike rol vertolkers in die sellulêre response wat ly tot seldood. Ek het die aspekte van stralings-geïnduseerde G2/M blokke in DNS skade en DNS herstelondersoek. Die hoeveelheid geïnduseerde DNS skade, deur ooreenstemmende stralings-dosisse, in HT29, L132 en ATs4 selle is 14 %, 14 % en 12 %. Meeste van die DNS herstel is klaar voordat die G2/M maksimum beryk word en net 3 % DNS skade blyoor om herstel te word in die G2/M blok. Die stralings-sensitiwiteit in elf sel lyne varieer tussen 'n SF2 van 0.02 en 0.61. Deur die gebruik van die FADU metode is gevind dat die onbeskadigde DNS na 5 Gy bestraling varieer tussen 56 % en 93 %. Die totale geïnduseerde DNS skade en stralings-sensitiwiteit was hoogs gekorreleer (r2=0.81). Na 5 Gy bestraling en 12 ure herstel kan die sel lyne in twee groepe gegroepeer word. Die groep 1 sellyne herstel die onbeskadigde DNS terug na 'n vlak wat varieer tussen 94 % en 98 %. Die groep 2 sel lyne herstel die onbeskadigde DNS terug tot op 'n vlak wat varieer tussen 77 % en 82 %. Geen korrelasie is gesien tussen oorblywende DNS skade en stralings-sensitiwiteit na 12 ure herstel nie. In die CHO-K1 sel lyn, chromatien kompaksie geïnduseer deur Nocodazole, vererger die stralings- sensitiwiteit soos gesien deur die gemiddelde inaktiveerings dosis (D) wat verlaag het van 4.446 tot 4.376. Nocodazole het ook die totale DNS skade verhoog van 7 % tot 13 %. Onder dieselfde kondisies, in die xrs1 sel lyn, is 'n verergering van stralings-sensitiwiteit (D) gesien van 1.209 tot 0.7836 en verhoog ONS skade van 43 % tot 57 %. Die ontwrigting van die chromatien struktuur deur die gebruik van hipertoniese medium het die stralings-sensitiwiteit (D) vererger in CHO-K1 selle van 4.446 tot 3.092. Die totale ONS skade is verhoog van 7 % tot 15 %. Onder dieselfde kondisies, in die xrs1 sellyn, verbeter die stralings-sensitiwiteit (D) van 1.209 tot 1.609 en die totale ONS skade verminder van 43 % tot 36 %. ONS herstel inaktiveering in die teenwoordigheid van Wortmannin het die stralings-sensitiwiteit (D) in CHO-K1 selle vererger van 5.914 in DMSO verwysings kondisies tot 3.043. Die ONS herstel inaktiveering in xrs1 selle het geen uitwerking gehaat op stralingssensitiwiteit nie. Noemenswaardige inaktiveering van ONS herstel is gesien in CHO-K1 selle na 2 ure (p<0.0001) en na 20 ure (p=0.0095). Geen inaktiveering is gesien in xrs1 selle na 2 ure (p=0.6082) of na 20 ure (p=0.6069) nie. TerwylONS herstel moet plaasvind na die bestralings periode, beryk die G2/M blok in p53 gemuteerde selle sy maksimum 12 ure na bestraling terwyl meeste van die ONS herstel alreeds voltooi is. Aangesien die G2/M blok eers 28 ure later begin sirkuleer moet die G2/M blok nog 'n funksie vervul anders as ONS herstel. By lae dosisse van bestraling korreleer die totale geïnduseerde ONS skade met stralings-sensitiwiteit. Dit dui daarop dat die totale ONS skade 'n bepalende faktor moet wees in stralings-sensitiwiteit. Die herstel van ONS skade deur die nie-homoloë eindpunt samevoeging (NHES) meganisme, geïdentifiseer deur inaktiveering deur Wortmann in, het 'n invloed op oorblywende ONS skade en sellulêre oorlewing. Beide die totale ONS skade en ONS herstel was beïnvloed deur die chromatien struktuur. Chromatien struktuur was gemoduleer deur hoë sout konsentrasies en deur Nocodazole, en is geïdentifiseer as a belangrike parameter wat stralings-sensitiwiteit beïnvloed.

Dissertation (PhD)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: The purpose of this investigation was to explore the multiple variables involved in TACT® image generation in an attempt to optimize this imaging modality for the diagnostic task of primary dental caries detection. The work is divided in seven phases in which the variables are evaluated individually. Teeth from the study samples were mounted in dental stone and imaged with a solid state digital radiography sensor. As a requisite of TACT® imaging, multiple images of the teeth were acquired from different projection angles. These resulting basis images were then used to generate TACT® slices. Variables tested in the investigation included the number of iterative restorations to which the slices were submitted, the number of basis images, the angle formed between the basis images, the two- and three-dimensional distribution of the basis projections in space, and the method through which the slices were reconstructed. For all phases, observers were asked to assess the presence or absence of primary caries in the teeth imaged using the TACT® slices treated with the different variables. Finally, to determine whether the best combination of variables produced a significant improvement in diagnostic performance, a comparison with conventional digital radiography images was carried out. No statistically significant differences were found in caries detection between TACT® slices submitted to different numbers of iterative restorations, reconstructed from basis images bearing different angular disparities, spatial distributions (in both two and three dimensions), or through different reconstruction methods. A statistically significant difference was detected between TACT® slices reconstructed from different numbers of basis projections. The final comparison showed that TACT® was not statistically superior to conventional digital radiography for the task of caries detection. The results of this investigation suggest that, although TACT® has been shown to be useful in many tasks performed in dentistry, its application in caries detection is not essential inasmuch as there are modalities that are simpler, more practical, less expensive, and that submit the patient to smaller radiation doses. Keywords: TACT, tomosynthesis, image reconstruction, digital radiography, caries detection, ROC analysis, analysis of variance / AFRIKAANSE OPSOMMING: Die doel van hierdie proefskrif was om die veelvuldige veranderlikes wat betrokke is by gewysigde spleet rekenaartomografie (Tuned Aperture Computed Tomography (TACT)) te ondersoek in 'n poging om die beeldingsmodaliteit te optimaliseer in die diagnostiese opsporing van primere karies. Die proefskrif bestaan uit 'n ekstensiewe literatuur oorsig en word in 7 fases aangebied waarin die veranderlikes individueel geevalueer word. Tande is in gips ingebed en radiografiese opnames is gemaak met behulp van 'n digitale radiografiese sensor. As 'n voorvereiste vir TACT beelding is veelvuldige beelde uit verskillende projeksiehoeke van die tande gemaak. Die resulterende basisbeelde is dan gebruik om TACT snitte te produseer. Veranderlikes wat in die proefskrif getoets is, sluit die volgende in: 'n aantal herhalende herstellings waaraan die snitte blootgestel is, die aantal basisbeelde, die hoek gevorm tussen die basisbeelde, die 2 en 3 dimensionele verspeiding van die basis projeksies in die ruimte en die metodes waardeur die snitte gerekonstrueer is. In aIle fases is waarnemers gevra om die teenwoordigheid of afwesigheid van primere karies te evalueer wat met TACT afgeneem is met in ag neming van die verskillende veranderlikes. Ten slotte, om te bepaal of die beste kombinasie van veranderlikes 'n aansienlike verbetering in diagnostiese prestasies sou meebring, is 'n vergelyking met konvensionele digitale radiografiese beelding uitgevoer. Geen statistiese beduidende verskille is waargeneem in die opsporing van karies tussen TACT snitte wat blootgestel is aan verskillende aantal herhalende herstellings, rekonstruksie van basis beelding met verskillende hoek veranderinge, ruimtelike verspreiding (beide 2 en 3 dimensioneel) of deur verskillende rekonstruksie metodes nie. 'n Statistiese beduidende verskil is waargeneem tussen TACT snitte wat van 'n verskeidenheid basis projeksies gerekonstrueer is. Die finale vergelyking het aangetoon dat TACT nie statisties beter is as konvensionele radiografie in die opsporing van karies nie. Die resultate van hierdie proefskrif het getoon dat alhoewel TACT bruikbaar is in vele prosedures wat in die tandheelkunde uitgevoer word, is die toepassing daarvan in die diagnose van karies nie noodsaaklik nie, omdat daar in die tandheelkunde modaliteite beskikbaar is, wat meer eenvoudig, meer prakties en goedkoper is, met 'n laer stralingsdosis vir die pasient.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background Occult blood loss from the gastrointestinal tract (GIT), causing iron deficiency often with anaemia, can be diagnostically and therapeutically challenging. This is because the endoscopic and radiologic tests may be negative due to the slow, chronic and intermittent nature of the gastrointestinal bleeding, making timing key in detection and localisation of the bleed. These limitations can be approached using two different radioactive isotopes. Firstly, we tested the sensitivity of extending Cr-51 RBC for 21 days relative to 5 days to detect GIT bleeding and its use to optimise timing of a Tc-99m RBC study for GIT blood loss localisation. Finally, we tested if the information provided by the Tc-99m RBC study aided gastroenterologic intervention for anatomical localisation of a lesion. Method In this retrospective review, after obtaining institutional and ethics committee approval, records of patients referred for evaluation of possible GIT blood loss were reviewed. In each; daily appearance of radiochromium in stool was measured in the whole body counter. In those cases exceeding 50 ml/day, a technetium-99m (Tc-99m) localization study was performed. These studies were correlated with clinical findings. Results A total of 59 Cr-51 RBC studies were carried out in 36 females and 21 males (n = 57). In 32 (54%) the radiochromium results were positive with 75% of the bleeding incidences occurring after 5 days of stool collection. Of 17 cases in whom Tc-99m RBC imaging studies were performed, 14 (82%) were positive with specific anatomical sites successfully defined in twelve. In all patients with blood loss of >100 ml/24h, Tc-99m RBC were positive and localised. Ten of the 17 Tc-99m RBC studies were further investigated and half diagnosed with small-bowel angiodysplasia. Conclusion This sequential twin isotope method is practical in revealing otherwise silent intestinal haemorrhage. Although it has good patient acceptability and clinical as well as diagnostic utility in management, further studies are required to clearly establish a cut-off level of blood loss for performing imaging studies and the impact of the findings on the overall patient management. / AFRIKAANSE OPSOMMING: Agtergrond Die evaluasie van okkulte bloedverlies uit die gastro-intestinale kanaal (GIT), met gevolglike ystertekort anemie, kan diagnosties en terapeuties uitdagend wees. Dit is omdat endoskopiese en radiologiese ondersoeke negatief mag wees as gevolg van die stadige, chroniese en intermitterende aard van die gastro-intestinale bloeding, wat die presiese tydstip van opsporing en lokalisering van die bloeding krities belangrik maak. Hierdie beperkings kan aangespreek word deur twee verskillende radioaktiewe isotope te gebruik. Eerstens is die sensitiwiteit van die verlenging van die Cr-51 RBS studie tot 21 dae in plaas van 5 dae om die GIT bloeding op te spoor, getoets, asook die gebruik daarvan om die optimale tyd vir ‘n Tc-99m RBS studie om die GIT bloedverlies te lokaliseer, vas te stel. Laastens is getoets of die inligting van die Tc-99m RBS studie wel bygedra het tot die gastroenterologiese ingreep om die letsel anatomies te lokaliseer. Metode Na institusionele en etiese komitee toestemming is inligting van pasiënte wat vir die evaluering van ‘n moontlike GI bloedverlies verwys is, in hierdie retrospektiewe oorsig nagegaan. Die daaglikse voorkoms van radioaktiewe chroom in stoelgangmonsters is in ‘n heelliggaamteller gemeet. In gevalle waar dit 50 ml/dag oorskry het, is ‘n tegnesium 99m (Tc 99m) studie gedoen. Hierdie studies is met die kliniese bevindinge gekorreleer. Resultate ‘n Totaal van 59 Cr-51 RBS studies is in 36 vroue en 21 mans (n = 57) gedoen. Die gemerkte chroomstudies was positief in 32 (54%), met 75% van die bloedings wat meer as 5 dae na versameling van die stoelgang plaasgevind het. In veertien (82%) van die 17 gevalle waar Tc-99m RBS studies gedoen is, was die studies positief. Spesifieke anatomiese gebiede van bloeding kon in 12 hiervan suksesvol bevestig word. Tc-99m RBS studies was positief in al die pasiënte met ‘n bloedverlies van >100 ml/24h, en kon gelokaliseer word. Tien van die 17 Tc-99m RBS studies is verder ondersoek en die helfte daarvan gediagnoseer met dunderm angiodisplasie. Gevolgtrekking Die opeenvolgende twee isotoopmetode om andersins asimptomatiese dermbloeding op te spoor, is prakties uitvoerbaar. Alhoewel die studies goed deur pasiënte aanvaar is, en ook van kliniese en diagnostiese waarde in die hantering van die pasiënte is, is verdere studies nodig om die afsnypunt vir die hoeveelheid bloedverlies om beeldingstudies uit te voer, sonder twyfel vas te stel, asook om die impak van die bevindings op ‘n groter pasiëntpopulasie vas te stel.