Genetic analyses permit the differentiation between reactive malfunctions ('promyelocyte arrest') and arising promyelocyte leukemia in a pregnant patient with a history of a medulloblastoma.

We report the case of a 24-year-old woman with a history of radiotherapy for a cerebellar medulloblastoma 2 years prior to detection of a lymph node metastasis of the former disease and a pancytopenia in the peripheral blood. On bone marrow (BM) examination promyelocyte leukemia vs. a reactive 'promyelocyte arrest' were discussed. The translocation t(15;17) was found in some nuclei and there was a PML-RARalpha gene rearrangement detectable by RT-PCR. Furthermore, there was BM infiltration by the primary cancer. All these results led to the diagnosis of a relapse of the medulloblastoma and of a beginning promyelocyte leukemia. As the patient was pregnant, she had to be parted with the baby to facilitate intensive chemotherapy. She did not respond to a therapeutic regimen specific for promyelocytic leukemia but achieved complete remission of the medulloblastoma as well as the leukemia after the administration of polychemotherapy specific for medulloblastoma. One year later, she suffered from a relapse of her leukemia. Now nearly all cells showed a t(15;17) aberration. Immunophenotype analyses showed a shift to a more undifferentiated blast phenotype that was, however, still HLA-DR negative. The patient again received chemotherapy for leukemia but developed a sepsis 3 months later and died of pancytopenia ensuing her leukemia. There was no clinical evidence for recurrence of the medulloblastoma.

Rapid detection of radiation-induced chromosomal aberrations in lymphocytes and hematopoietic progenitor cells by mFISH.

Structural chromosome aberrations (SCAs) are sensitive indicators of a preceding exposure of the hematopoietic system to ionizing radiation. Cytogenetic investigations have therefore become routine tools for an assessment of absorbed radiation doses and their biological effects after occupational exposure or radiation accidents. Due to its speed and ease of use, fluorescence in situ hybridization (FISH) with whole chromosome painting (WCP) probes has become a method of choice to visualize SCAs. Until recently, this technique was limited to a rather small number of chromosomes, which could be tested simultaneously. As a result, only a fraction of the structural aberrations present in a sample could be detected and the overall dose effect had to be calculated by extrapolation. The recent introduction of two genome-wide screening techniques in tumor research, i.e., Spectral Karyotyping (SKY) and multicolor FISH (mFISH) now allows the detection of translocations involving any two non-homologous chromosomes. The present study was prompted by our desire to bring the power of mFISH to bear for the rapid identification of radiation-induced SCAs. We chose two model systems to investigate the utility of mFISH: lymphocytes that were exposed in vitro to 3 Gy photons and single hematopoietic progenitor cell colonies isolated from a Chernobyl victim 9 years after in vivo exposure to 5.4 Sv.In lymphocytes, we found up to 15 different chromosomes involved in rearrangements indicating complex radiation effects. Stable aberrations detected in hematopoietic cell colonies, on the other hand, showed involvement of up to three different chromosomes. These results demonstrated that mFISH is a rapid and powerful approach to detect and characterize radiation-induced SCAs in the hemopoietic system. The application of mFISH is expected to result in a more detailed and, thus, more informative picture of radiation effects. Eventually, this technique will allow researchers to rapidly delineate chromosomal breakpoints and facilitate the identification of the genes involved in radiation tumorigenesis.

Intercomparison of apoptosis morphology with active DNA cleavage on single cells in vitro and on testis tumours.

Apoptosis morphology (DNA condensation) and endonucleolytical DNA cleavage (TdT assay) were measured simultaneously on double fluorescence labelled cells employing confocal laser scanning and conventional immunofluorescence microscopy. In vitro experiments on irradiated HL-60 cells revealed a high correspondence of non-apoptotic (normal) cells without detectable DNA cleavage, versus apoptotic cells and apoptotic bodies showing DNA cleavage. Experiments performed on histological slides of testis tumours reflected a heterogeneous picture: non-apoptotic (normal) cells, apoptotic cells, and apoptotic bodies appeared either with or without detectable DNA cleavage. These data allowed the characterization and quantitation of the grade of disturbance/heterogeneity of the apoptosis programme in vivo. Furthermore, the measured apoptotic index (AI) based on apoptosis morphology was lower than the AI assessed by DNA cleavage, in contrast to published work. Taken together, these methods represent a new approach and might be suitable for improved correlation with clinical parameters. In addition, the data presented confirm frequently published doubts regarding the ability of the TdT assay to detect apoptosis as defined by morphological criteria in tumours.

Early changes in cell cycle kinetics after ionizing irradiation below 1 GY.

The present study describes a procedure for quantifying cell cycle alterations within 15 h after radiation with doses below 1 Gy. For detection and assessment of the relevant changes, 5-bromo-2'-deoxyuridine (BrdUrd)-labelling and flow cytometry were used. Using this approach, as early as 6 h after exposure of radiosensitive leukemic HL-60 cells, radiation-induced changes in cell cycle progression could be measured even with radiation doses as low as 0.25 Gy. As a result, a method to define transition rates for a single cell cycle phase or from one phase to another is described. Even minor changes can be described. Moreover, the BrdUrd assay allows for discrimination of cells irradiated in different phases of the cell cycle. Thus, it is possible to follow the progression in the cell cycle of cells either irradiated in G1, S, or G2 + M phase, respectively. Radiation effects on single cell cycle phases can be analysed separately. A detailed evaluation of the cellular response to irradiation regarding dose, time, and effect is described. The value of cell cycle parameters for assessment of various biological indicators of radiation effect is discussed.

Immunohistochemical detection of E-cadherin in differentiated thyroid carcinomas correlates with clinical outcome.

A retrospective immunohistochemical analysis of the adhesion molecule E-cadherin (E-CD) was performed in 112 differentiated thyroid carcinomas and 38 synchronous and 20 relapse metastases primarily from operations performed at the Medical School Hanover between 1982 and 1992. E-CD-specific antibody 5H9 was applied to paraffin-embedded tissues. All patients were clinically followed for a maximal period of 12 years. Lack of E-CD expression i.e., <5% of tumor cells positive) occurred in 18 of 112 (16.1%) cases, whereas the majority showed either low (24.1%), medium (35.7%), or high (24.1%) positivity. No difference was found between papillary (n = 88) and follicular (n = 24) carcinomas. Univariate statistical analysis for survival (Kaplan-Meier) showed that lack of E-CD expression (P < 0.024) is an adverse prognostic factor for differentiated thyroid carcinomas. The highest significance was seen among patients without lymph node involvement at first presentation (pN(0); P = 0.0068) and among females (P = 0.0033). Multivariate analysis (Cox model) indicated that E-CD staining is an independent prognostic factor (corrected risk factor, 3.7; P < 0.03) in addition to distant metastasis (pM1) and tumor size. A comparison of E-CD stainings between primary tumors and their metastatic lesions showed similar results in both synchronous and relapse metastases after therapy. In conclusion, E-CD immunostaining is an independent prognostic indicator for differentiated thyroid carcinomas. It may help to uncover the small group of patients with differentiated thyroid carcinomas carrying a high risk of suffering an unfavorable clinical outcome.

Evaluation of a modified micronucleus assay.

The relationship between ionizing radiation-induced cell killing and DNA damage measured by the micronucleus assay was determined in three established cell lines (L929, HL-60, and Chang). Our data revealed a dose-dependent increase of cells bearing multiple micronuclei. Cells with the same number of micronuclei were counted separately up to 50 h after irradiation. The counts of these subsets showed a parallel increase and decrease throughout the study. In order to transform the peak of the micronucleus frequency, occurring over only a brief time period into a less time dependent value, we calculated ratios between the different subsets of micronucleated cells. These ratios converged to values which were almost constant beyond 30 h after irradiation. The values showed correlations with cell survival (clonogenic assay) and radiation dose which were comparable with the correlations with the peak of the micronucleus frequency (maximum micronucleus yield) when utilizing the conventional evaluation of the micronucleus assay performed without cytochalasin B. This means that large-scale time kinetics and additional drugs like cytochalasin B can be avoided by changing the evaluation procedure of the conventional micronucleus assay. The modified assay described in this manuscript revealed apoptosis-induced limitations as recently detected for the maximum micronucleus yield assay.

Early and late G2 arrest of cells undergoing radiation-induced apoptosis or micronucleation.

Conventional flow cytometric DNA measurements combined with the microscopic detection of cells in the late G2 phase of the cell cycle (characterized by the occurrence of paired kinetochores) enabled us to differentiate and to quantify early and late G2 cells 0-40 h after irradiation using a radioresistant (L929) and a radiosensitive (HL-60) cell line. This approach provided us with (1) a new kind of G2 arrest characteristic revealing changes in the G2 phase which can not be detected by flow cytometric DNA measurements, (2) cell line dependent differences in the radiation-induced transition through G2, accompanied by the occurrence of micronucleation and apoptosis, and (3) the characterization of apoptotic cells occurring probably during early G2 and bearing a rapidly reduced number of kinetochores in contrast to mitotic cells, suggesting processes different from those that operate in mitosis.

Correlation of micronucleus and apoptosis assays with reproductive cell death.

The relationship between ionizing radiation-induced cell killing and DNA damage measured by the micronucleus and apoptosis assays was determined in three established cell lines (L929, HL-60, and Chang). Irradiation experiments revealed a dose-dependent increase of micronucleated cells until a certain dose was reached. Above this dose no further increase of the micronucleus frequency was observed, but in HL-60 and Chang cells additional DNA fragmentation was detected by morphological criteria, characteristic of apoptosis. This change was detected at different doses for the three cell lines examined, suggesting the existence of a cell-type-dependent upper limit for the employment of the micronucleus assay. However, the sum of both kinds of cellular DNA damage (e.g. micronucleation and morphological-like apoptosis) led to a significant cell-type-independent correlation with cell survival, even above the dose where micronuclei levels saturated. Therefore, a total cell damage assay, involving the inclusion of micronuclei and morphological-like apoptotic events, should be considered when evaluating the use of a predictor assay for ionizing radiation-induced cell killing, especially in conditions when apoptosis (-like) processes may occur.

Rapid physical mapping of the human trk protooncogene (NTRK1) to human chromosome 1q21-q22 by P1 clone selection, fluorescence in situ hybridization (FISH), and computer-assisted microscopy.

Physical mapping of small genomic DNA fragments or expressed sequences by in situ hybridization is typically limited by the size of the target DNA sequence. Isolation of large insert DNA clones from libraries containing the target DNA sequence facilitates physical mapping by fluorescence in situ hybridization and allows rapid assignment of genes to cytogenetic bands. Here, we demonstrate the scheme by mapping the human protooncogene trk (NTRK1), a tyrosine kinase receptor type I gene that has earlier been assigned to two different cytogenetic loci. Large DNA insert library screening was carried out by in vitro DNA amplification using oligonucleotide primers flanking exon 4 of trk. The scheme presented here can easily be generalized to map physically very small nonrepetitive genomic DNA fragments or incomplete cDNAs.

[Value of modern study methods in the early diagnosis and assessment of asbestosis]. / Zum Wert moderner Untersuchungsmethoden für Frühdiagnostik und Begutachtung der Asbestose.

Results of examinations among 31 asbestos-workers with pleural hyalinosis are presented. The hyalinosis was ascertained by means of pleuroscopy and computed tomography. The value of both methods and special function tests in asbestosis is discussed. Diagnostic and expertising of early signs in asbestosis should not rely on x-ray of thorax but include selected and suitable function tests.