Cooperative trials of Hodgkin's lymphoma in the Federal Republic of Germany.
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Adolescent↗
Biomedical subjects
M Löffler
Publications and source records attributed to M Löffler.
Increased level of histone H1(0) messenger RNA in hypoxic Ehrlich ascites tumor cells.
We have investigated the expression of the H1 histone subtype H1(0) gene in Ehrlich ascites tumor cells (EAT) under varied conditions of oxygen supply. Our results show that proliferating EAT cells express H1(0) mRNA at a basal level under normoxic conditions. Severe hypoxia leads to a cessation of cell growth and causes an accumulation of cells in G1. Here, we show that the level of H1(0) histone mRNA increases within a few hours after the onset of hypoxia.
Animals↗
[Radiotherapeutic quality assurance in the Hodgkin's disease study HD4 supported by the BMFT (Bundesministerium für Forschung und Technologie)].
In the German Hodgkin Study Group a radiotherapy assurance program is being carried out at the radiotherapeutic reference centre in Göttingen since April 1988: 74 patients were entered from 27 radiotherapeutic institutions. 18 of them participated in a quality assurance program and submitted the data of 29 patients: In 21 of the 29 patients the protocol was followed correctly. Physical aspects of quality control showed two major deviations from the protocol: one center used photon energies of more than 15 MVX without mould; another had a anterior-posterior loading of 3:1. The radiation oncology assessment detected six inadequate treatments: The safety margin was inappropriate in three of 26 mantle fields. Another center used a multiple field technique, and in two patients the paraaortic region was not irradiated.
Cobalt Radioisotopes↗
[Aspects of family-oriented diagnosis in compulsory legal family expert assessment].
In forensic psychology, recommendations that courts request when granting one of the parents the right of child upbringing after a divorce pose a problem for the person who is required to give such expert judgment. The authors describe the difficult situation he faces when having to decide for and, at the same time, against one of the parents. A good knowledge of family psychology and pathopsychology is essential, and for drawing up the expertise and stating his reasons, the expert requires methodical resources. The authors describe four procedures of relational diagnosis and recommend the combined use of these in conjunction with methods that have been employed so far.
Child↗
The bispyridinium-dioxime HLö-7. A potent reactivator for acetylcholinesterase inhibited by the stereoisomers of tabun and soman.
Purification of (+)-tabun was accomplished by treatment with electric eel acetylcholinesterase (AChE) in order to bind contaminating (-)-tabun and with purified (+)-tabun shown similar properties in reactivation reactions with oximes (pH 7.5, 25 degrees). The bispyridinium-2,4-dioxime HLö-7 is a substantially active reactivator for these inhibited enzymes as well as for human erythrocyte AChE inhibited with (-)-tabun. In contrast, the corresponding bispyridinium-2-monooxime HI-6 does not show any activity at similar reaction conditions. HLö-7 is also much more active than HI-6 when used as a reactivator for electric eel AChE inhibited by some N-unsubstituted derivatives of tabun. Surprisingly, HLö-7 is highly active in reactivating human erythrocyte and rat diaphragm AChE inhibited by C(+)P(+/-)-and C(-)P(+/-)-soman, i.e. at least as active as HI-6, which is the most potent reactivator for soman-inhibited AChE reported so far. To our knowledge, HLö-7 is the first compound reported in literature that shows a potent reactivating activity towards both tabun-inhibited AChE and soman-inhibited AChE.
Acetylcholinesterase↗
Simultaneous analysis of mitochondrial activity and DNA content in Ehrlich ascites tumor cells by dual parameter flow cytometry.
Ehrlich ascites tumor cells were permeabilized using low concentrations of digitonin, 8 micrograms/10(6) cells. Permeabilization was monitored by the assay of lactate dehydrogenase released into the incubation medium and of hexokinase partially bound to mitochondria. Integrity of the cellular organelles was unaffected as determined by assay of the mitochondrial enzyme glutamate dehydrogenase. Cells were stained with rhodamine 123 as a mitochondrial specific dye and propidium iodide/mithramycin as DNA specific dyes. The green fluorescence of bound rhodamine 123 versus red fluorescence of DNA in individual cells was analysed by dual parameter flow cytometry. Incubation of cells with inhibitors of mitochondrial energy metabolism, such as, potassium cyanide and carbonyl cyanide m-chlorophenylhydrazone abolished binding of rhodamine 123. Flow cytometric data allowed a correlation between cell position in the mitotic cycle with total mitochondrial activity. In addition, comparison of the characteristics of propidium iodide and ethidium bromide staining further elucidated the molecular basis of the staining with the positively-charged fluorescent dye rhodamine 123.
Animals↗
Chemotherapy of Hodgkin's lymphoma with alternating cycles of COPP (cyclophosphamide, vincristin, procarbazine, prednisone) and ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine). Results of the HD1 and HD3 trials of the German Hodgkin Study Group.
Untreated patients with Hodgkin's lymphoma in stages I-IIIA with risk factors (large mediastinal mass, massive splenic involvement, extranodal disease) were entered into the HD1 protocol and received a combined chemo-radiotherapy [2 X (COPP + ABVD) + 40 Gy extended field irradiation (EF) vs 2 X (COPP + ABVD) + 20 Gy EF]. Patients in stages IIIB/IV (HD3 protocol) received induction chemotherapy [3 X (COPP + ABVD)] and were randomized into consolidation by radiotherapy [20 Gy involved field irradiation (IF)] vs chemotherapy [1 X (COPP + ABVD)]. Seventy-three of 89 evaluable patients (82%) treated according to the HD1 protocol achieved a complete remission. Freedom from progression and survival of patients in stages I-IIIA with risk factors treated according to HD1 were no worse than those of patients in stages I and II without risk factors who received only radiotherapy. Eighty-six of 137 patients (63%) treated according to the HD3 protocol achieved complete remission after induction chemotherapy with COPP + ABVD. This is significantly better than the 31% complete remission rate observed in a previous pilot study with COPP alone (P less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 X CEVD in case of persisting disseminated disease), a total of 76% complete remissions in stages IIIB/IVAB were achieved. A high erythrocyte sedimentation rate (greater than 80 mm h-1) was the most significant risk factor for achieving freedom from progression.
Adolescent↗
The biosynthetic pathway of pyrimidine (deoxy)nucleotides: a sensor of oxygen tension necessary for maintaining cell proliferation?
Culture experiments on Ehrlich ascites tumor cells revealed that a low oxygen tension (about 20% in normoxic atmosphere) induced an increase in the length of the growth cycle. The relative growth of aerobic control cells after transfer to the second in vitro passage was 145% within 24 h, and reduced to 50% at 1% O2 and about 30% at 0.1% O2. The increase in protein and DNA content of these hypoxic cultures was equally impaired. Also, the cell cycle traverse as analyzed by flow cytometry was affected predominantly at the G1/early S stage. Uptake of labeled thymidine into acid-insoluble material of hypoxic cells was below that of controls whereas incorporation of uridine exceeded that of normoxic controls. Supplementation of cells cultured under 0.1 and 1% O2 with 0.1 mM uridine or 0.1 mM deoxycytidine + 0.01 mM deoxyadenosine and deoxyguanosine improved all growth parameters; deoxynucleosides were more effective than uridine in cells under 0.1% O2 whereas in cells cultured under 1% O2 similar effects of both were observed. This points to an insufficient supply of nucleic acid precursors even under moderate limitations of oxygen tension and not only under strict hypoxia. Whereas a 12-h cultivation time at 0.1% O2 hardly impaired cell growth after reoxygenation, a cultivation time of 24 h considerably reduced the cellular capability to recover. This was alleviated by addition of (deoxy)nucleosides from the beginning of hypoxic culture. The results are interpreted as supporting the concept that the biosynthetic pathway of pyrimidine (deoxy)nucleotides--because of two oxygen-dependent enzymes, dihydroorotate dehydrogenase and ribonucleotide reductase--is a potential transducer of environmental limitations in oxygen tension to the proliferative capacity of cells.
Animals↗
[Therapy of Hodgkin's lymphomas. Results of the German Hodgkin's Disease Study Group].
Between July 1983 and May 1987 143 untreated patients with Hodgkin's lymphoma in stages I-IIIA with risk factors qualified for the HD1 protocol, and 230 patients in stages IIIB/IV qualified for HD3. Patients in HD1 received a combined chemo-radiotherapy (2 x COPP + ABVD + 20 Gy EF vs. 40 Gy EF). Patients in HD3 received induction chemotherapy (3 x COPP + ABVD) and were randomized into consolidation by radiotherapy (20 Gy IF) vs. chemotherapy (1 x COPP + ABVD). In HD1, 73 of 89 evaluable patients (82%) achieved a complete remission. The survival of patients in stages I-IIIA with risk factors treated according to HD1 is as good as the survival of patients in stages I and II without risk factors. In HD3, 86 of 137 patients (63%) achieved complete remission after induction chemotherapy with 3 x COPP + ABVD. This is significantly better than the 31% complete remission rate observed in a pilot study with COPP alone (p less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 x CEVD in case of persisting disseminated disease), a total of 76% complete remissions in stages IIIB/IVAB were achieved. An ESR greater than 80 mm/h was the most significant single risk factor in stages IIIB/IV for induction of CR and freedom from progression.
Adolescent↗
Restimulation of cell cycle progression by hypoxic tumour cells with deoxynucleosides requires ppm oxygen tension.
Continuous exposure of Ehrlich ascites tumour cells to argon-CO2 under in vitro conditions caused rapid cessation of cell proliferation. On fixing the O2 level at 10 ppm in the protective atmosphere (0.001% in comparison with about 20% in normoxic atmosphere), G1 and early S cells remained stationary while G2 cells continued to pass from G2 into mitosis, to remain in a non-growing state in G1 of the subsequent cycle. Re-aeration of cells following 12 h hypoxia induced up to 25% of the population to continue DNA synthesis without a preceding cell division, as revealed by flow-cytometric analysis. Supplementation of cells cultured under hypoxia with a combination of deoxynucleosides (100 microM deoxycytidine, 10 microM deoxyadenosine, 10 microM deoxyguanosine) was found to stimulate reprogression through the cycle, provided the residual oxygen tension in the protective atmosphere exceeded 40 ppm. The increase in the number of cells with a DNA content of more than 4 C and in the number of binucleate cells observed after re-aeration of hypoxic cells was not prevented by deoxynucleosides or by uridine, which were present in the medium either during hypoxia of from the beginning of reoxygenation. These results indicate that the development of polyploidy as a result of oxygen deficiency cannot be influenced by improvement of RNA and DNA synthetic precursors.
Anaerobiosis↗
Cytokinetic studies on the switch from glucose to uridine metabolism, and vice versa, of Ehrlich ascites tumour cells in vitro.
Glucose is normally required as the energy source and for the proliferation of neoplastic cells. For Ehrlich ascites tumour cells, kept under glucose-free culture conditions, this requirement was alleviated by uridine, indicating that the supply of ribose is obligatory for sustaining growth capacity. In a 96-hr culture experiment with mouse-derived cells, the increase in cell number from cultures supplemented with 5 mM uridine was 50-70%, whilst lactate production was 5% that of controls. An increase in the number of multinucleate cells was observed from cell-smears; DNA histograms indicated the presence of cells with a DNA content higher than 4c and an increased portion of cells in G2 phase. For precise determination of changes in cell cycle distribution on transfer of cells from glucose-supplemented to glucose-free conditions, the progression of phase-accumulated cells (by centrifugal elutriation) was monitored by DNA distribution analysis; G2 cells continued the cycle at a rate comparable to controls but were delayed, in the following cycle, predominantly in S and G2 phases. This was also observed with G1 cells from a G1-accumulated fraction in the first cycle. The addition of glucose to cells kept for some hours in glucose-free, uridine-supplemented medium resulted in an immediate increase in mitotic index (amplification by the colcemid method). The results are interpreted and support our concept that the delivery of compounds, necessary for normal growth, i.e. hexoses for glycoproteins and glycolipids, are limited as a consequence of the 'metabolic channelling' of pentose from uridine in Ehrlich ascites tumour cells. Therefore, the constantly lowered growth-rate in uridine-supplemented cells observed with long-term culture experiments could reflect an adaptation of growth-cycle to these limitations.
Animals↗
[Therapy studies of the German Hodgkin's Study Group. Intermediate results of the study protocols HD1, HD2, and HD3].
Between July 1983 and September 1986 358 untreated patients with Hodgkin's lymphoma qualified for the protocols HD1 (stages I to IIIA with risk factors), HD2 (stage IIIA), and HD3 (stages IIIB and IVAB). Patients in HD1 received a combined chemo-radiotherapy (2 X COPP/ABVD + 40 Gy EF vs. 2 X COPP/ABVD + 20 Gy EF). Patients in HD2 were randomized into radiotherapy (TNI 40 Gy) vs. combined chemo-radiotherapy (2 X COPP/ABVD + 20 Gy IF). Patients in HD3 received induction chemotherapy (3 X COPP/ABVD) and were randomized into consolidation by radiotherapy (20 Gy IF) vs. chemotherapy (1 X COPP/ABVD). In HD1, 51 out of 65 evaluable patients (78%) achieved a complete remission. The survival of HD1 patients is as good as the survival of patients in stages I and II without risk factors. In HD3, 58 out of 93 patients (62%) achieved complete remission after induction chemotherapy with COPP/ABVD. This is significantly better than the 31% complete remission rate observed in a pilot study with COPP alone (p less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 X CEVD in case of persisting disseminated disease), a total of 71% complete remissions in stages IIIB/IVAB were achieved. The progression-free survival of HD3 patients who received consolidation therapy is significantly longer than of patients who refused consolidation therapy.
Antineoplastic Combined Chemotherapy Protocols↗
[Intermediate results of therapy studies HD1, HD2 and HD3 of the German Hodgkin Study Group].
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Antineoplastic Combined Chemotherapy Protocols↗
Towards a further understanding of the growth-inhibiting action of oxygen deficiency. Evaluation of the effect of antimycin on proliferating Ehrlich ascites tumour cells.
The effect of 1 microM antimycin on the proliferative properties, metabolism and basic cell composition of Ehrlich ascites tumour cells cultured in the second in vitro passage was studied. Continuous drug exposure of asynchronous cells caused rapid cessation of cell growth, characterized by the cell number and DNA, RNA and protein content of cultures. Cells cease to consume oxygen and enhance their glycolytic activity. Uptake of labelled thymidine into acid-insoluble material was far below that of the controls, whereas incorporation of labelled uridine exceeded that of controls, as was also observed with other inhibitors of the respiratory chain (sodium cyanide, 2-thenoyltrifluoroacetone, or anaerobiosis). The influence of antimycin on cells at different stages of the cell cycle was tested using cells enriched in either G1, S or G2 phase by centrifugal elutriation. DNA histograms (flow cytometry) and pulse-labelling index curves gave detailed insight into cell-cycle progression of antimycin-treated cells: G1 and early S cells remained stationary; G2 cells still passed from G2 into mitosis to remain subsequently in a non-growing state in G1; S cells were either slowed or halted. Supplementation of antimycin-containing cultures with exogenous pyrimidine nucleosides stimulated reprogression of G1 cells without changing their ATP content. The results of the current experiments are interpreted as supporting the concept that growth cessation of G1 cells under respiratory insufficiency is not predominantly caused by impairment of respiratory phosphorylation but may be the consequence of a lack of precursors for DNA and RNA synthesis.
Adenosine Diphosphate↗
Uridine, but not cytidine can sustain growth of Ehrlich ascites tumor cells in glucose-deprived medium with altered proliferation kinetics.
Cell cycle kinetics and energy metabolism of Ehrlich ascites tumor cells grown in glucose-deprived medium supplemented with uridine, were investigated in order to extend our knowledge about the significance of the metabolic conversion of glucose for cell cycle progression of these cells. Viability (dye exclusion test) of uridine supplemented cells was not affected, although growth was reduced to 50 to 60% of the controls. Uridine did not significantly impair growth of controls in standard medium up to 20 mM. Studies on cell cycle progression using flow cytometry (BrdU-H33258 technique) revealed an accumulation of cells in G2M phase, which can be explained by a delay in the passage of G2M-compartment of about 12 +/- 2 h. After a 24 h culture period, 60% of the cell populations were found in G2M (30% in control cultures). This fraction increased to about 70% in the following passage. Protein and DNA synthesis corresponded to the proliferation rate. Oxygen uptake was increased by about 50%, glutamine consumption by 30%, lactate production was reduced to below 10% of the controls. The ATP/ADP concentration ratio was found in a physiological range of 4 to 6. It was calculated that cells grown in standard medium produced 60% of ATP via oxidative pathways and 40% via glycolysis; however, in glucose-free, uridine-supplemented medium the values are more than 90% and less than 10%. No significant differences in total ATP production were observed. Growth of the cells in glucose-deprived medium could not be sustained by cytidine. All our data substantiate the present concept that glycolytic ATP-production is not essential for maintenance of viability and growth of these cells.
Animals↗
[Characteristics of the personality structure of children with minimal brain damage--a study of 12-year-olds using a multidimensional personality test (HSPQ)].
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Attention Deficit Disorder with Hyperactivity↗
[Determination of prosocial attitudes of mothers for the evaluation of familial socialization for brain-damaged children].
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Brain Damage, Chronic↗
Characterization of the deoxynucleoside-dependent reversal of hypoxia-induced inhibition of cell cycle progression in Ehrlich ascites tumor cells.
Studies on Ehrlich ascites tumor cells enriched in different cell cycle compartments by centrifugal elutriation have shown that after exclusion of oxygen, G1- and early S-phase cells are restricted from further cell cycle progression. On addition of a balanced mixture of deoxypyrimidine and deoxypurine nucleosides to these anaerobic cultures (70% in G1-phase, as determined by flow cytometry), the cells resumed DNA synthesis and passed through the cycle. After 24 h, 19% of the cell population was still in G1. This cell cycle traverse does not seem to depend on RNA and protein synthesis. Using colcemid, mitotic activities became more evident in the presence of deoxynucleosides 20 h after establishing the protective atmosphere (argon/CO2). In the absence of colcemid binucleate cells could be detected. This was not observed in unsupplemented anaerobic cells. The ultrastructural changes of mitochondria in anaerobic cells resembled those in nucleoside-stimulated anaerobic cells: enlargement in profiles is accompanied by a simplification of cristae and a pallor of the intramatrical compartment. In addition, two different appearances of mitochondrial structures were visible if cells were cultured in the presence of deoxynucleosides.
Animals↗