MTT growth assays in ovarian cancer.

The MTT (3-[4,5-dimethylthiazol-2yl]-2,5-diphenyl tetrazolium bromide) growth assay developed by Mosmann (1) offers a simple, rapid, and precise measurement of cell viability and proliferation of adherent cell lines (2). The value of this assay is in the screening of large numbers of samples. The MTT assay, a quantitative colorimetric assay is based on the living cell's ability to reduce the tetrazolium salt MTT, a pale yellow substrate to a dark-blue formazan product. The mitochondrial succinate-dehydrogenases (3) of viable cells cleave the tetrazolium ring in active mitochondria into formazan crystals. The crystals can be dissolved in acid isopropyl alcohol, mineral oil (4), or dimethyl sulfoxide (DMSO) (5). The resulting blue solution can be measured semiautomatically using a scanning multiwell spectrophotometer. Our laboratory has successfully applied the MTT-based growth assay with some modifications (6) to investigate the growth effects of human cytokines on HOC cell lines (7), but we have to keep its limitations and pitfalls in mind (see Note 1). For use in tests of floating cell lines, the MTT assay may be less optimal. Using this assay for screening of primary tumor samples may produce limited results, because cell contaminants may result in high-background values (4). However, accepting the limitations of the MTT assay, the optimum assay conditions have to be selected and adapted to the cell lines that are under investigation. The MTT-based growth assay, as described in this chapter, is a reliable and sensitive test for the determination of cell growth of human ovarian-carcinoma cells.

Interaction of MyoD family proteins with enhancers of acetylcholine receptor subunit genes in vivo.

The myogenic determination factors (MDFs) are transcriptional activators that target E boxes in many muscle-specific promoters, including those of the genes coding for the subunits of the acetylcholine receptor. It is not known, however, if in vivo a given E box in a transcriptionally active gene is occupied, either uniquely by one MDF or randomly by all MDFs. We have analyzed expression of MDF and acetylcholine receptor subunits in cultured mouse muscle cells and, using chromatin immunoprecipitation, have determined which individual MDFs reside at promoters of several receptor subunit genes. We find that before fusion, C2C12 cells express myf-5, MyoD, and myogenin, all of which take up residence at promoters of all subunits except epsilon. At this stage, herculin is present in limited amounts and is detected mainly at the gamma and delta subunit genes. On myotube formation, herculin reaches high levels; concomitantly, the epsilon subunit gene becomes a common MDF target and begins to be expressed. In general, any MDF protein that is expressed also is present on transcriptionally active receptor genes; transcriptional activity of target genes correlates with occupancy by MDF, in particular, herculin.

Natural metabolites of 1alpha,25-dihydroxyvitamin D(3) retain biologic activity mediated through the vitamin D receptor.

1alpha,25-dihydroxyvitamin D(3) (1alpha,25(OH)(2)D(3)), the active metabolite of vitamin D, mediates many of its effects through the intranuclear vitamin D receptor (VDR, NR1I1), that belongs to the large superfamily of nuclear receptors. Vitamin D receptor can directly regulate gene expression by binding to vitamin D response elements (VDREs) located in promoter or enhancer regions of various genes. Although numerous synthetic analogs of 1alpha,25(OH)(2)D(3) have been analysed for VDR binding and transactivation of VDRE-driven gene expression, the biologic activity of many naturally occurring metabolites has not yet been analyzed in detail. We therefore studied the transactivation properties of 1alpha,24R, 25-trihydroxyvitamin D(3) (1alpha,24R,25(OH)(3)D(3)), 1alpha, 25-dihydroxy-3-epi-vitamin D(3) (1alpha,25(OH)(2)-3-epi-D(3)), 1alpha,23S,25-trihydroxyvitamin D(3) (1alpha,23S,25(OH)(3)D(3)), and 1alpha-hydroxy-23-carboxy-24,25,26,27-tetranorvitamin D(3) (1alpha(OH)-24,25,26,27-tetranor-23-COOH-D(3); calcitroic acid) using the human G-361 melanoma cell line. Cells were cotransfected with a VDR expression plasmid and luciferase reporter gene constructs driven by two copies of the VDRE of either the mouse osteopontin promoter or the 1alpha,25(OH)(2)D(3) 24-hydroxylase (CYP24) promoter. Treatment with 1alpha,25(OH)(2)D(3) or the metabolites 1alpha,24R,25(OH)(3)D(3), 1alpha,25(OH)(2)-3-epi-D(3), and 1alpha,23S,25(OH)(3)D(3) resulted in transactivation of both constructs in a time- and dose-dependent manner, and a postitive regulatory effect was observed even for calcitroic acid in the presence of overexpressed VDR. The metabolites that were active in the reporter gene assay also induced expression of CYP24 mRNA in the human keratinocyte cell line HaCaT, although with less potency than the parent hormone. A ligand-binding assay based on nuclear extracts from COS-1 cells overexpressing human VDR demonstrated that the metabolites, although active in the reporter gene assay, were much less effective in displacing [(3)H]-labeled 1alpha,25(OH)(2)D(3) from VDR than the parent hormone. Thus, we report that several natural metabolites of 1alpha,25(OH)(2)D(3) retain significant biologic activity mediated through VDR despite their apparent low affinity for VDR.

Conversion problems concerning automated mapping from ICD-10 to ICD-9.

The increasing parallel use of ICD-9 and ICD-10 complicates the comparability of coded diagnoses. This is the reason why we developed a symmetric table for interactive conversion between ICD-9 and ICD-10, based on a vector space text-retrieval method that resulted in unambiguous mapping from ICD-9 to ICD-10 in 64%, from ICD-10 to ICD-9 in 87% of all three- and four-character classes of the tabular list. Out of the remaining 13% of multi-valued relations, a table for automated mapping from ICD-10 to ICD-9 was created. In 9% of cases, the selection offered no problems. A compromise between preserving information content and maintaining the logical integrity had to be found in 2.4%; in 1.6% automated mapping was impossible because of newly defined concepts and structural differences between ICD-9 and ICD-10 that are not counterbalanced by a consistent system of residual categories. We recommend that in a future revision of the ICD, compatibility with the then existing classification system should be considered.

The E protein CTF4 and acetylcholine receptor expression in development and denervation supersensitivity.

Motor activity blocks the extrasynaptic expression of many genes in skeletal muscle, including those encoding ion channels, receptors, and adhesion molecules. Denervation reinduces transcription throughout the multinucleated myofiber, restoring the developmental pattern of expression, especially of the genes coding for the acetylcholine receptor. A screen for trans-acting factors binding to the enhancer region of the alpha-subunit gene of the acetylcholine receptor identified CTF4, a ubiquitously expressed and alternatively spliced chicken homologue of the human E protein transcription factor HTF4/HEB. Expression of the CTF4 locus closely parallels that of myogenin and acetylcholine receptor during development and maturation of skeletal muscle, but transcription is not similarly regulated by neuronal cues. Alternative splicing within the region encoding the transactivation domain generates two CTF4 isoforms with different tissue distributions, but similar binding affinities for the acetylcholine receptor alpha-subunit enhancer and similar transcriptional potential when complexed to myogenin. Direct injection of a myogenin, but not a MyoD, antisense expression vector into denervated skeletal muscle caused a significant decrease in the transcriptional activation of a depolarization-sensitive reporter gene. Similarly, injection of a CTF4, but less so of an E12, antisense expression vector impaired the denervation response, further implicating the involvement of a myogenin/CTF4 heterodimer in the expression of AChR genes in vivo.

c-jun expression and growth stimulation in human ovarian carcinoma cell lines following exposure to cytokines.

We evaluated the effects of recombinant human G-CSF, rhGM-CSF, rhM-CSF and rhIL-1 alpha on proliferation and regulation of c-jun gene expression in 4 human ovarian-carcinoma (HOC) cell lines, NIH:OVCAR-3, SK-OV-3, HEY and BG-1, and in one primary ovarian tumor in vitro. The cytokines were administered in concentrations of 0.1 U/ml to 1000 U/ml. Cell growth was measured by crystal-violet- and thiazolyl-blue(MTT)-based cell counts. c-jun transcripts were measured by the solution hybridization/RNAse protection assay. RhM-CSF and rhGM-CSF showed no growth stimulation of any of the 5 cell lines tested. Results from exposure to rhG-CSF were different. The cell lines NIH:OVCAR-3, SK-OV-3, BG-1 and the primary ovarian tumor showed no proliferative response. A 2- to 3-fold increase in proliferation was observed in the HEY HOC cell line. rhIL-1 alpha led to growth stimulation in the BG-1 cell line, but showed an inhibitory effect in the NIH:OVCAR-3 cells. No effects of rhIL-1 alpha were observed in the remaining 2 cell lines nor in the primary ovarian tumor. Growth stimulation was accompanied by an increase in c-jun expression in the HEY cell line, and the BG-1 cell line. No alterations in c-jun expression were observed in the remaining 3 cell lines. Our results indicate that rhG-CSF or rhIL-1 alpha influence cell proliferation in 2 out of 5 human ovarian-tumor cell lines, accompanied by an increase in c-jun expression.

Co-cultivation of ovarian carcinoma cells with dermal fibroblasts induces fibroblast expression of sex steroid receptor transcripts and protein.

We have previously reported that stromal fibroblasts of ovarian carcinoma specimens may express estrogen (ER) and progesterone receptors (PR) when the malignant epithelial cells do not, and even when the specimens have been obtained from such non-Müllerian structures as the omentum whose fibroblasts normally express neither ER nor PR. In an attempt to investigate whether our observations of the expression of ER and PR in fibroblasts surrounding metastatic invasive epithelial ovarian carcinoma cells might result from an interaction involving malignant epithelial cells and stromal fibroblasts, we co-cultivated in vitro BG1 ovarian carcinoma cells with sex steroid receptor-negative dermal fibroblasts to determine whether carcinoma cells might induce the latter to express ER or PR protein and transcripts at levels detectable by standard immunocytochemical (ICC) and in situ hybridization (ISH) techniques. We report the in vitro induction of ER and PR transcripts and protein in previously steroid receptor-negative skin fibroblasts after co-cultivation with BG1 ovarian adenocarcinoma cells. Such observations suggest that a juxtacrine mechanism is responsible for the observed phenomenon, possibly involving ER- and PR-inducing factors (ER-IF and PR-IF).

Phase II study of pirarubicin combined with cisplatin in recurrent ovarian cancer.

Although 50%-80% of patients with advanced ovarian cancer demonstrate an objective response after platinum-based chemotherapy, a majority of these patients will ultimately experience a relapse of their disease. Effective second-line treatment for these patients is of the most importance. We performed a phase II study with cisplatin and pirarubicin (each drug 50 mg/m2 i.v. every 28 days) in 17 patients with relapsed or persistent ovarian carcinoma. All patients had received platinum-containing primary chemotherapy. Overall survival from the time of diagnosis was 38.3 months (45.3 months in relapsed ovarian carcinoma and 28.3 months in ovarian carcinoma persisting after primary chemotherapy). Survival from entrance into the study was 13.0 months (14.2 months in relapsed disease and 11.2 months in refractory disease). Time to progression was 10.3 months. An objective response was observed in 4 patients and another 3 patients had stable disease. Major toxicity consisted of emesis (grade III/IV in 60/64 courses) and myelosuppression WHO grade III/IV in 15 courses. Neurotoxicity occurred in 3 patients and nephrotoxicity in 1 patient. Alopecia occurred in 12 patients. Tachycardia and other low-grade heart toxicities were observed after 5 courses. Dose reduction was necessary because of severe myelosuppression in 4 courses and because of nephrotoxicity in 1 course. Delay of subsequent chemotherapy courses for more than 7 days was necessary after 13 courses and was always due to myelosuppression. The dose-limiting toxicity of combination chemotherapy with cisplatin and pirarubicin is myelosuppression. Response and survival rates are superior in patients with relapsed disease compared to patients with resistant ovarian carcinoma.

The evolution of culture and cohesion in the group treatment of ego impaired children.

The challenge of group treatment with ego impaired children is to provide a situation in which their maladaptive efforts to organize volatile affects and impulses can be tolerated and structured. This article addresses the process of culture building in group and how it can provide a cohesive structure for affective expression that is acceptable and tolerable to the defensive, resistant child. In particular, the author will argue that it is through the sense of normality and commonality engendered by indigenous peer culture that the members initially develop a structure and language for affiliation, play, and mutual identification. By facilitating the cohesion of indigenous peer culture, the therapist creates a sufficient holding environment to begin a dialogue involving both verbal and nonverbal communication. For children who are difficult to engage in discussion, let alone treatment, this dialogue is the essential process for creating a corrective emotional experience. Through a concise case study, the author describes the process by which the children's efforts to express and create their own culture are cultivated, managed, and understood.