[New radiopharmaceuticals and positron-emission tomography applications at the Masaryk Memorial Cancer Institute in Brno]. / Nová radiofarmaka a aplikace pozitronové emisní tomografie na masarykov onkologickém ustavu v Brne.

The construction and launch of the cyclotron & PET centre at the Masaryk Memorial Cancer Institute, which is run in cooperation with the Nuclear Research Institute Praha-Rez, allows the Masaryk Memorial Cancer Institute to engage in the research, development and application of new radiopharmaceuticals including compounds labelled by short-living positron emitters (especially 11C). For the immediate future, new projects are planned, e.g. using the proliferation marker 18F-fluoro-L-thymidine, or neuro-oncological studies using the proteosynthesis and amino acid transport marker 11C-methionine, and eventually also other compounds applicable outside of oncology. The existence of the PET centre at the Masaryk Memorial Cancer Institute therefore offers a wide range of possibilities to both patients and physicians in the Brno region and beyond.

Prognostic relevance of the FAB morphological criteria in chronic lymphocytic leukemia: correlations with IgVH gene mutational status and other prognostic markers.

Morphological examination is the routine first step in the diagnosis of hematological malignancies, including chronic lymphocytic leukemia (CLL). Atypical cell morphology according to the FAB criteria is known to herald disease progression. Several years ago, it was proposed that FAB morphology at diagnosis had a considerable prognostic impact. However, this proposal has not been widely adopted in practice. Thus we questioned the prognostic value of the morphological examination, which was performed retrospectively in 88 patients out of our 110 institutional registry patients (70 males and 40 females, median age 57 yrs) with CLL at diagnosis. We related the results to the more modern prognostic markers. Atypical FAB morphology was shown to correlate with IgVH gene mutation status, trisomy of chromosome 12 and deletion of 17p detected either by conventional G-banding or by fluorescence in situ hybridization (FISH) analysis. The correlation of FAB morphology with CD38 antigen expression or with the histopathological pattern of bone marrow infiltration was not significant. Overall survival (OS) data were available for 84 morphologically examined patients. The patients with atypical morphology (64 patients) had a significantly shorter OS (103 months) than the 20 patients presenting with typical CLL morphology (237 months; p=0.03). Only the mutation status of IgVH genes correlated more closely with OS (p=0.002). Of note, there was no leukemia-related death within "unmutated" cases who had typical FAB morphology (p=0.14), and vice versa, the mutation status had a significant prognostic impact within the morphologically atypical cases (p=0.01). Thus FAB morphology and the mutation status may yield complementary prognostic information. OS was affected both by the presence of cytogenetic aberrations (p=0.03) - most adversely by deletions of 17p and 11q, and by CD38 expression (p=0.003). We conclude that careful examination of peripheral blood smears according to FAB is a simple, cheap and valuable tool in the first-line assessment of prognosis of CLL patients and should not be overlooked even in 3rd millennium when more sophisticated prognostic markers are at hand. This ought to be confirmed in larger prospective studies with multivariate analysis of data.

The long-term effects of using a higher amount of iodine supplement on the efficiency of laying hens.

1. Two different levels of dietary iodine supplement (K + 0, 3.57 mg/kg; K + I, 6.07 mg/kg) were used in a 52-week experiment using 32 ISA Brown laying hens. 2. The greater iodine content in the diet impaired the egg production (K + 0, 319.9 +/- 1.31 eggs/hen; K + I, 312.4 +/- 4.19 eggs/hen), the egg weight (K + 0, 64.4 + 0.66 g; K + I, 63.1 +/- 0.61 g) and the food to egg mass ratio (K + 0, 2.13 +/- 0.023 kg/kg; K + I, 2.22 +/- 0.030 kg/kg). 3. The greater dietary iodine content had significant (P<0.05) negative effects on Haugh units, yolk index and eggshell weight.

Preventive effects of raloxifene and melatonin in N-methyl-N-nitrosourea-induced mammary carcinogenesis in female rats.

The aim of this study was to evaluate preventive effects of raloxifene (RAL), melatonin (MEL) and their combination in N-methyl-N-nitrosourea (NMU)-induced rat mammary carcinogenesis. MEL-treatment began 12 days and RAL treatment began 10 days prior to carcinogen administration and continued till the end of experiment (24 weeks after first carcinogen administration). RAL was administered subcutaneously twice a week in the dose of 5 mg/kg b.w. MEL was administered diluted in drinking water in a concentration 4 microg/ml daily from 3 p.m. to 8 a.m. At the end of experiment, tumor incidence, frequency, latency period and tumor volume as parameters of mammary carcinogenesis were evaluated. Moreover, the effect of chemopreventives on body and uterine weight, food and water intake were recorded. In RAL-treated group, tumor incidence was decreased by 67% (p < 0.001), tumor frequency per group was reduced by 90% (p < 0.0002) and latency period lengthened by 27 days in comparison with control group. After MEL-treatment tumor incidence was decreased by 19%, tumor frequency per group was decreased by 50% (p < 0.05) when compared to control animals. The effect of RAL+MEL-treatment was very similar to that of RAL-treatment. In groups with RAL administration, significant decrease (p < 0.0001) in body weight gain and relative uterine weight was recorded. As to food intake no significant differences in comparison with control group were found. Consequently, groups were pooled and in RAL-treated groups (RAL, RAL+MEL) a decrease in food intake, when compared to groups without RAL administration (control group, MEL) was recorded (p<0.04). The water intake was markedly decreased in RAL-treated groups (P < 0.0001). RAL and RAL+MEL proved to be very effective in prevention of experimental mammary carcinogenesis in female rats, isolated MEL appeared to be of lower oncostatic activity.

Histological correlation between different centers using the skin explant model to predict graft-versus-host disease following bone marrow transplantation.

Acute graft-versus-host disease (GVHD) remains the major complication of allogeneic stem cell transplantation (SCT) with an incidence of 40-60% and a mortality of up to 50%. Several assays have been developed to try to predict the development of GVHD including the mixed lymphocyte culture reaction, cytotoxic and helper T lymphocyte precursor frequency assays. In the Northern region of England we have used an in vitro skin explant model for predicting GVHD in MHC compatible bone marrow transplant recipients since 1988. The aims of the present study was to test the reproducibility of the model in two other bone marrow transplant centers in Europe. The assay consists of incubating patient skin explants with effector cells from mixed donor versus recipient lymphocyte cultures and the subsequent detection of graft-versus-host reactions by histopathological grading (0-IV) of the skin explants. 503 slides from 134 patients were evaluated. All were graded for negative GVHR grade 0-I or positive grade II-IV. Results from control and test slides significantly correlated between centers to the p value of 0.0001 by Fisher's exact probability test. These results show that the skin explant assay is reproducible between centers and supports the continued use of the assay to predict GVHD in allogeneic stem cell transplant recipients.

An in vitro skin explant assay as a predictive assay for graft-versus-host disease in a cohort of pediatric transplants.

Severe acute graft-versus-host disease (GvHD) remains a serious complication of allogeneic stem cell transplantation. An in vitro skin explant assay was used to predict the occurrence and severity of acute GvHD in a cohort of 30 pediatric patients undergoing human leucocyte antigen (HLA)-matched sibling transplants (20 patients) and matched or one antigen mismatched unrelated donor transplants (10 patients). In the cohort of HLA-matched sibling transplants, the result appeared to reflect the degree of GvHD prophylaxis. The skin explant assay correlated with GvHD outcome in 12 of 20 children, but this did not reach statistical significance (chi-square 0.95, d.f.=1, p=0.32). These results support previous observations. In this present cohort, patients were treated either with cyclosporin A (CsA) monotherapy (n=7) or with CsA plus additional methotrexate (MTX) (n=13). We have previously demonstrated that the skin explant assay was not as predictive in patients receiving CsA plus additional MTX compared to cohorts treated with CsA alone. In the group of patients treated with CsA alone, four of five patients (80%) predicted to develop GvHD developed acute GvHD of grade II or above; of two patients predicted to develop only grade 0-I GvHD, one patient developed no GvHD and the other grade II GvHD. In the CsA plus MTX group, nine patients were predicted to develop GvHD. Five of nine (55%) developed acute GvHD of grade II or above, while three of four with grade 0 or I skin explant assay results developed only grade 0-I GvHD. In a cohort of 10 patients who received unrelated donor transplants, the skin explant assay correlated with GvHD outcome in all 10 patients (Fisher's exact test p=0.008). Hence, the skin explant assay is a pretransplant in vitro GvHD predictive test that predicts the occurrence and severity of acute GvHD in pediatric unrelated donor transplants and to varying degrees, depending on the GvHD prophylaxis protocols, in HLA-matched sibling cohorts.

Effects of tamoxifen and melatonin on mammary gland cancer induced by N-methyl-N-nitrosourea and by 7,12-dimethylbenz(a)anthracene, respectively, in female Sprague-Dawley rats.

Chemopreventive effects were analysed of antioestrogen TAM and of MEL on NMU- or DMBA-induced mammary gland cancer, respectively, in female Sprague-Dawley rats. NMU was administered intraperitoneally in two doses each of 50 mg/kg b.w. between 46th-57th postnatal days. DMBA was given by gavage in one dose (20 mg per animal) between 50th-54th postnatal days. The treatment with MEL began 12 days and the treatment with TAM 10 days before carcinogen administration; both chemopreventive substances were administered until the end of the experiment (24 weeks after carcinogen application). TAM was administered subcutaneously twice a week in a dose 2.5 mg/kg b.w. MEL was given in tap water (20 mg/ml) daily between 3 p.m. to 8 a. m. The tumour incidence, tumour frequency per group and animal, latency period, tumour volume, body weight gain in the rats and weight of uterus (in the experiment with NMU) were evaluated. TAM suppressed carcinogenesis to 0% incidence like TAM+MEL in both the NMU and DMBA models. In NMU-induced mammary carcinogenesis MEL lowered the tumour volume (although statistically non-significantly) by 30% in comparison with the control group; in DMBA-induced mammary carcinogenesis it lowered the tumour volume (2.70 +/- 0.81 cm3 vs. 0.90 +/- 0.33 cm3) and lengthened (non-significantly) the latency period (by 12 days). The weight gain of animals in both NMU and DMBA models and relative uterus weight in the NMU model were significantly lower in the groups treated with TAM and TAM+MEL as compared to the control group and the group treated with MEL. Evaluation of the combined effect of TAM+MEL was not possible due to total suppression of carcinogenesis by TAM. TAM and TAM+MEL are highly effective agents in rat mammary carcinogenesis prevention, but the side effects of TAM in humans limits its use in clinical oncology.

Use of a skin explant model for predicting GVHD in HLA-matched bone marrow transplants - effect of GVHD prophylaxis.

Over the last decade we have successfully evaluated the use of a human skin explant assay for predicting acute GVHD in HLA-matched sibling transplants. In the present study, we modified GVHD prophylaxis on an individual patient basis depending on the GVHD outcome predicted by the skin explant model. We have summarised our previous data describing how the skin explant assay results correctly predict GVHD occurrence and severity in 45/56 patients (80%); P< 0.0001, chi2 19.97, df = 1. In a further cohort of 19 patients, all were predicted to develop grade II or above GVHD. These patients were given increased GVHD prophylaxis with the addition of methotrexate and a significant reduction in the expected incidence of GVHD was observed (P = 0.02; chi2 7.7, df = 1; Fisher exact test P = 0.04). The results from these studies suggest that modifying GVHD prophylaxis, based on skin explant assay results, may reduce the expected incidence and severity of GVHD. We suggest that the technique might be used for selective GVHD prophylaxis in T cell non-depleted HLA matched sibling transplants.

[The importance of tapering the intestines in congenital intestinal atresia]. / Význam taperingu streva u vrozených strevních atrézií.

Extensive intestinal resections in inborn intestinal atresias are the second most frequent cause of the short gut syndrome. Because treatment of this condition is so far minimal, prevention is of fundamental importance. One possible approach is tapering of the gut, i.e. longitudinal antimesenterial resection of the gut. At the Clinic of Paediatric Surgery in 1991-1995 30 patients with inborn atresias of the gut were operated (17 atresias of the duodenum, 11 atresias of the small intestine, 2 atresias of the large intestine). Six patients (20%) died. In 2 patients (one girl with atresia of the colon and one boy with atresia of the jejunum) developed dilatation of the gut orally from the site of resection of the atresia and a chronic subileous condition. Instead of resection of the dilated portion the gut was modelled by tapering. In both children the passage improved and the children thrive. Based on data in the literature and their own experience the authors assume that tapering of the gut should supplement primarily high jejunal atresia, apple peel syndrome and extensive dilatation of the jejunum. Tapering cannot be used above the aganglionic portion of the intestine.

Type II iodothyronine 5'-deiodinase and uncoupling protein in brown adipose tissue of human newborns.

Brown adipose tissue (BAT) is the major thermogenic organ of the human neonate. To determine whether it is also active in the peripheral conversion of T4 to T3, as shown in several animal species, interscapular BAT from 13 newborns of 25-40 weeks gestational age who survived 4 days, at most, was investigated. BAT was found to contain significant amounts of the mitochondrial uncoupling protein (UCP), the rate-limiting component of heat production. The specific content of UCP increased from 29.4 +/- 3.3 to 62.5 +/- 10.2 pmol/mg protein between 25 and 40 weeks of gestation, respectively, and the UCP/F1-ATPase molar ratio, a sensitive marker of brown fat differentiation, increased similarly. BAT was also found to contain iodothyronine 5'-deiodinase (5'D), which appears to be a type II enzyme, based on high affinity for T4 (Km, 2.9 nmol/L) and insensitivity to propylthiouracil (10% inhibition by 1 nmol/L). 5'D was active by 25 weeks gestation, and the specific activity increased from 116 +/- 15 to 417 +/- 46 fmol/h.mg protein during the period examined. The development of 5'D activity was similar to the changes in UCP content; both exhibited a major increase before 32 weeks gestation. The results indicate that thermogenic function and 5'D activity develop in human BAT rather early, during the first half of the last trimester of gestation. The activities of 5'D in human BAT are comparable with 5'D activities found in animal BAT stimulated during the perinatal period, by cold exposure, or by increased cAMP levels.

[Periodontopathies and fixed prosthetic appliances]. / Parodontopatie a fixní protetické náhrady.

The authors examined a group of 979 subjects with fixed prosthetic appliances, admitted for treatment at the periodontological department on account of periodontopathy. The group was subdivided according to sex, age, periodontological diagnosis and type of fixed prosthetic appliance. Based on the results of the initial examination, the authors compared the state of the periodontium of teeth with a prosthetic appliance and the other teeth using Russell's clinical and X-ray PI index. They investigated the oral cavity, using the OHI-S index according to Green and Vermillion and the DMF index. The results confirmed the negative influence of fixed prosthetic appliances on the periodontium and revealed the necessity of X-ray check-ups of the periodontium of teeth white these appliances.

[Interspecies differences in the reactivity of smooth tracheobronchial muscles]. / K mezidruhovým rozdílum v reaktivite hladkého tracheobronchiálního svalu.

There are considerable differences in the reactivity of tracheobronchial muscles to bronchoconstricting substances in guinea pigs and rats. The aim of the present investigation was to assess whether these functional differences have a morphological or biochemical background. Therefore specimens of this tissue were taken for histological and biochemical examination i. e. assessment of cyclic nucleotides. While in the nucleotide content no interspecific differences were found, there were some morphological differences which may explain the less marked response of smooth muscles of the rat to bronchoconstricting stimuli.

[Congenital tumor-like histiocytosis of the liver with cholestasis in a newborn infant]. / Vrozená tumoriformní histiocytôza jater s cholestázou u novorozence.

A female newborn weighing 2650 g had hepatomegaly and deepening obstructive jaundice. She died of hepatic failure three weeks later. There were grayish white periportal histiocytic nodules of 1-2 mm in diameter. Histiocytes contained a small amount of neutral lipids and PAS-positive material. Single elements had multiple nuclei arranged in circles like in Touton cells. Bile duct and ductules were among them. The picture resembled the C variant of Niemann-Pick's disease but basic histochemical tests on fixed tissue excluded this possibility. The pathogenesis of unique disease remained obscure.

Pulmonary hypertension induced by repeated pulmonary inflammation in the rat.

The effect of repeated lung inflammation on the pulmonary vascular bed was studied in rats. Nonbacterial lung inflammation was induced by repeated carrageenan instillations into the lungs. Three days after the single carrageenan injection, the mean pulmonary arterial blood pressure was only slightly raised [16.3 +/- 0.6 (mean +/- SE) Torr in controls and 19.5 +/- 0.5 Torr in rats with lung inflammation, P less than 0.001]. A substantial pulmonary hypertension was found in rats 3 days after the sixth lung inflammation (24.6 +/- 1 Torr). In this group, arterial hypoxemia, hypercapnia, and right-heart hypertrophy were found. In the 14th day of recovery after the last injection of carrageenan, the mean pulmonary artery blood pressure decreased (18.5 +/- 0.9 Torr) but remained higher than in the control group. There was no difference in cardiac output measured by dye-dilution technique between the experimental and control groups. After repeated inflammation, the media of distal pulmonary vessels thickened and the number of pulmonary arterioles with distinct media increased.

Pulmonary hypertension in rats with papain emphysema.

Lung emphysema was produced in 80 rats by tracheal chronic constriction and repeated instillations of 0.1% papain solution intratracheally. 17 animals survived 90 days of the experiment; a complete examination was performed on 14 experimental and 11 control animals. 9 rats of the experimental group had pulmonary hypertension, in 5 other rats the pulmonary arterial blood pressure was not different from that in the controls. The experimental animals with hypertension had arterial hypoxemia and increased weight of the right ventricle. All experimental rats (with and without pulmonary hypertension) had increased air spaces in the lung and thickened media of distal pulmonary vessels. After breathing 100% oxygen for 20 min, the pulmonary arterial blood pressure in animals with pulmonary hypertension decreased but did not reach the control level. The decrease of the mean pulmonary arterial blood pressure after oxygen breathing correlated well with the initial level of pulmonary hypertension and with the degree of hypoxemia during air breathing.