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Puhaindran ME, Hamilton K, Schlumbohm S, Rich M, Mitchell D, Steensma M. Radiation-induced osteosarcoma of the hand: case report. J Hand Surg Am 2014; 39:1151-4. [PMID: 24799140 DOI: 10.1016/j.jhsa.2014.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 03/02/2014] [Accepted: 03/03/2014] [Indexed: 02/02/2023]
Abstract
Radiation-associated sarcomas represent less than 5% of all sarcomas and can arise from previously irradiated bone or soft tissue. We report a case of radiation-associated osteosarcoma that developed in the hand of a patient who had previously been treated for synovial sarcoma. Despite aggressive, multimodality treatment, the disease progressed rapidly. This case highlights the need for patients and treating physicians to be aware of this potential complication of radiotherapy to the hand.
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Affiliation(s)
- Mark E Puhaindran
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI.
| | - Kendall Hamilton
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Stacy Schlumbohm
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Maria Rich
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Deanna Mitchell
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Matthew Steensma
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore; The Orthopaedic Surgery Residency Program, Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Pediatric Hematology/Oncology, Helen DeVos Children's Hospital, Grand Rapids, MI; Spectrum Health Medical Group, Grand Rapids, MI; Van Andel Research Institute, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI
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Inoue YZ, Frassica FJ, Sim FH, Unni KK, Petersen IA, McLeod RA. Clinicopathologic features and treatment of postirradiation sarcoma of bone and soft tissue. J Surg Oncol 2000; 75:42-50. [PMID: 11025461 DOI: 10.1002/1096-9098(200009)75:1<42::aid-jso8>3.0.co;2-g] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES An analysis of the clinicopathologic features and treatment of patients with postirradiation sarcoma of bone and soft tissue was performed to guide modern evaluation and management. METHODS A retrospective analysis of 135 sarcomas in 130 patients was performed. RESULTS The mean age of the 130 patients was 48 years, and there was a female predominance because of irradiation for carcinomas of the breast and uterus. Indication for irradiation was a soft tissue lesion (such as lymphoma or breast cancer) in 58.5% of patients and a bone lesion (such as giant cell tumor or fibrous dysplasia) in 41.5%. The latent period (interval between irradiation and discovery of the sarcoma) ranged from 4-55 years (mean, 17 years). Of the lesions, 74% were stage IIB (high-grade extra-compartmental) and 24% were stage III (metastases). Ninety-four patients received their treatment at our institution. Of the 61 patients with resectable disease, 49 had amputations and 12 had limb salvage procedures. The 5-year cumulative survival rate was 68.2% for patients with peripheral (extremities, including proximal femur and hip) resectable lesions and 27.3% for patients with central (pelvis, head/neck, and ribs) resectable lesions. The local recurrence rate correlated with the surgical margin achieved: intralesional, 73%, marginal, 64%, and wide, 23%. CONCLUSIONS The prognosis for patients with peripheral resectable postirradiation sarcomas is good if a wide surgical margin can be achieved. This group of patients should be treated aggressively because they have a new cancer.
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Affiliation(s)
- Y Z Inoue
- Department of Orthopedics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
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Goralczyk R, Appold A, Luz A, Riemann S, Strauss PG, Erfle V, Schmidt J. Establishment and characterization of osteoblast-like cell lines from retrovirus (RFB MuLV)-induced osteomas in mice. Differentiation 1998; 63:253-62. [PMID: 9810704 DOI: 10.1046/j.1432-0436.1998.6350253.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cell lines were established by a two-step method from osteomas which had been induced by infection of mice with RFB MuLV, a bone-pathogenic, replication-competent murine retrovirus. The benign tumors, consisting of mature lamellar bone and surrounded by a thin periosteum, were cultured on sponges of denatured collagen type I fibres for up to 4 weeks. At this time osteoma cells had grown into the collagenous matrix. After release and further cultivation in monolayers, the cell lines established from these cultures varied in morphology; they expressed T1, collagen type I and type III, alkaline phosphatase, osteonectin and osteopontin mRNAs at variable levels, but not osteocalcin/BGP. They also showed alkaline phosphatase activity, but lacked responsiveness to parathyroid hormone. All cell lines established from infected mice expressed retroviral and c-myc mRNA and viral protein. In contrast to cells from control mice they showed an extended life span in culture. After growth in a three-dimensional (3-D) collagen sponge culture the cells formed an extracellular matrix containing collagen type I, alkaline phosphatase and osteocalcin/BGP. These data indicate that the two-step method facilitates the establishment of osteoblast-like cell lines from osteomas and calvaria of old mice, and provides means for further analyses of retrovirus-induced skeletal pathogenesis and bone induction.
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Affiliation(s)
- R Goralczyk
- Institute of Molecular Virology, GSF-National Research Center for Environment and Health, Neuherberg, Germany
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Bockstahler LE, Werner T, Festl H, Weis S, Einhaeup KM, Erfle V, Brack-Werner R. Distribution of HIV genomic DNA in brains of AIDS patients. ACTA ACUST UNITED AC 1995; 3:61-72. [PMID: 15566788 DOI: 10.1016/0928-0197(94)00023-n] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/1993] [Revised: 04/14/1994] [Accepted: 04/19/1994] [Indexed: 11/24/2022]
Abstract
BACKGROUND Data concerning the distribution of HIV in the brains of AIDS patients at different stages of viral infection might contribute towards: (1) understanding the route(s) of HIV entry into the brain and virus dissemination within the brain and (2) establishing a possible correlation between the extent of CNS damage and the distribution of virus in AIDS brains. OBJECTIVE To determine the distribution of HIV-1 genomic DNA within the brains of three deceased AIDS patients by polymerase chain reaction (PCR). STUDY DESIGN The brains of three deceased AIDS patients were examined. Two brains had limited neuropathologic findings (brains I and II), and one brain (brain III) showed primary HIV-specific neuropathologic damage. Tissues were taken from different locations within each brain, and high molecular weight DNA isolated from the tissues was assessed for HIV-1 genomic DNA by PCR. RESULTS HIV-1 genomic DNA was found in all three brains, but the amount was low: order of magnitude of 1 viral genome per 1,000 cells. Multiple PCR analyses of DNA from brain I showed that the viral genomic DNA in this brain was non-uniformly distributed; only samples taken from the brainstem were clearly positive for HIV-1. HIV-1 genomic DNA in brain II was found in portions of the lower and upper hemispheres. All but one of the brain III samples were clearly positive for HIV-1, and they had been taken from locations spread throughout this brain. CONCLUSIONS Our results suggest that in early or latent stages of HIV-infection of the brain, viral genomic DNA is localized at restricted regions. At later stages this DNA is distributed more uniformly throughout the brain. Our data are compatible with the concept of rare infection events followed by viral spreading within brain tissues.
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Affiliation(s)
- L E Bockstahler
- Molecular Biology Branch, DLS, OST, CDRH, Food and Drug Administration, Rockville, MD, USA
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Schmidt J, Heermeier K, Linzner U, Luz A, Silbermann M, Livne E, Erfle V. Osteosarcomagenic doses of radium (224Ra) and infectious endogenous retroviruses enhance proliferation and osteogenic differentiation of skeletal tissue differentiating in vitro. RADIATION AND ENVIRONMENTAL BIOPHYSICS 1994; 33:69-79. [PMID: 8202594 DOI: 10.1007/bf01255275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Cartilage tissue from embryonic mice which undergoes osteogenic differentiation during in vitro cultivation was used to study the effect of osteosarcomagenic doses of alpha-irradiation and bone-tumor-inducing retroviruses on proliferation and phenotypic differentiation of skeletal cells in a defined tissue culture model. Irradiated mandibular condyles showed dose-dependent enhancement of cell proliferation at day 7 of the culture and increased osteogenic differentiation at day 14. Maximal effects were found with 7.4 Bq/ml of 224Ra-labeled medium. Doses of 740 and 7400 Bq/ml of 224Ra-labeled medium induced increasing cell death. Retrovirus infection enhanced osteogenic differentiation and extended the viability of irradiated cells. After transplantation none of the treated tissues developed tumors in syngeneic mice.
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Affiliation(s)
- J Schmidt
- Institut für Molekulare Virologie, GSF-Forschungszentrum für Umwelt und Gesundheit GmbH, Obersohleissheim, Germany
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Abstract
The retroposon sequences, their mechanisms of transposition and the occurrence of insertional mutation in the mammalian genome are reviewed. Insertional mutations fall into two broad categories: those due to the disruption of a gene following the physical integration of a foreign DNA sequence result in loss of gene product and would be expected to be associated with a recessive mutation. A second class of insertional mutation is well documented in which upon integration the promoter/enhancer activities inherent in the retroposon genome exert their influence on neighboring genes. This promoter/enhancer activity of integrated retroposons may have effects over relatively long distances and thus limit the possibilities of establishing an association between retroposon integration and mutation. It is emphasized that a systematic search for insertional mutations in the mammalian genome involves an extensive two-dimensional array of possible retroposon sequences and mutant alleles. Present results represent only a small portion of the total array. Future studies promise to be fruitful in efforts to isolate genes through insertional tagging, to characterize the mechanisms of retroposon transposition, as well as to study the stability of the mammalian genome.
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Affiliation(s)
- J Favor
- GSF-Institut für Säugetiergenetik, Neuherberg, Germany
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Pedersen L, Behnisch W, Schmidt J, Luz A, Pedersen FS, Erfle V, Strauss PG. Molecular cloning of osteoma-inducing replication-competent murine leukemia viruses from the RFB osteoma virus stock. J Virol 1992; 66:6186-90. [PMID: 1326664 PMCID: PMC283669 DOI: 10.1128/jvi.66.10.6186-6190.1992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We report the molecular cloning of two replication-competent osteoma-inducing murine leukemia viruses from the RFB osteoma virus stock (M. P. Finkel, C. A. Reilly, Jr., B. O. Biskis, and I. L. Greco, p. 353-366, in C. H. G. Price and F. G. M. Ross, ed., Bone--Certain Aspects of Neoplasia, 1973). Like the original RFB osteoma virus stock, viruses derived from the molecular RFB clones induced multiple osteomas in mice of the CBA/Ca strain. The cloned RFB viruses were indistinguishable by restriction enzyme analysis and by nucleotide sequence analysis of their long-terminal-repeat regions and showed close relatedness to the Akv murine leukemia virus.
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Affiliation(s)
- L Pedersen
- Department of Molecular Biology, University of Aarhus, Denmark
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Strauss PG, Mitreiter K, Zitzelsberger H, Luz A, Schmidt J, Erfle V, Höfler H. Elevated p53 RNA expression correlates with incomplete osteogenic differentiation of radiation-induced murine osteosarcomas. Int J Cancer 1992; 50:252-8. [PMID: 1730519 DOI: 10.1002/ijc.2910500215] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An important role for the p53 gene in osteogenic sarcomas has been imputed by identification of somatically acquired gene alterations in human osteosarcomas and by the development of osteosarcomas in p53 transgenic mice. To study the involvement of p53 in radiation-induced osteosarcomagenesis, we have investigated gene alterations and expression of p53 in radiation-induced murine osteosarcomas and tumor-derived cell lines. Eighteen of 31 tumors and 8 of 9 cells lines showed alterations in the p53 gene region, or elevated levels of p53 RNA. Expression of the osteoblast marker gene bone gla protein was substantially reduced in tumors which simultaneously showed high steady-state levels of p53 RNA. Our data indicate that p53, in addition to its function in regulating DNA synthesis, may be involved in the control of osteogenic differentiation in osteosarcomagenesis.
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Affiliation(s)
- P G Strauss
- GSF-Forschungszentrum für Umwelt und Gesundheit GmbH, Institut für Molekulare Virologie, Neuherberg, Germany
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Pedersen L, Strauss PG, Schmidt J, Luz A, Erfle V, Jørgensen P, Kjeldgaard NO, Pedersen FS. Pathogenicity of BALB/c-derived N-tropic murine leukemia viruses. Virology 1990; 179:931-5. [PMID: 2173270 DOI: 10.1016/0042-6822(90)90171-m] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
N-tropic murine leukemia viruses have been observed in connection with radiation-induced osteosarcomagenesis in BALB/c mice. We have investigated the bone disease-inducing potential of molecularly cloned, BALB/c-derived N-tropic viruses in the random-bred NMRI mouse strain. The germ-line virus and an exogenous virus isolate were found to induce high incidences of osteopetrosis and lymphomas and a lower incidence of osteomas. Two viruses derived from somatically acquired proviruses of independent radiation-induced osteosarcomas induced lower incidence of osteopetrosis and lymphomas. Nucleotide sequence analysis of the long terminal repeat regions and RNase T1 fingerprint analysis revealed only few differences between the isolates. The possible involvement of N-tropic murine leukemia viruses in radiation-induced osteosarcomagenesis in the BALB/c mouse strain is discussed.
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Affiliation(s)
- L Pedersen
- Department of Molecular Biology and Plant Physiology, University of Aarhus, Denmark
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Janowski M, Cox R, Strauss PG. The molecular biology of radiation-induced carcinogenesis: thymic lymphoma, myeloid leukaemia and osteosarcoma. Int J Radiat Biol 1990; 57:677-91. [PMID: 1969900 DOI: 10.1080/09553009014550851] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In mice, external X- or gamma-irradiation may induce thymic lymphomas or myeloid leukaemias, while bone-seeking alpha-emitters may induce osteosarcomas and, to a lesser extent, acute myeloid leukaemia. The present paper aims to review briefly some of the experimental data with respect to the molecular mechanisms underlying these radiation-induced carcinogenic processes. Thymic lymphomagenesis proceeds through an indirect mechanism. Recombinant proviruses often occur in the tumour cell DNA, favouring the idea that they might be involved. However, there are indications that they might mediate tumour growth rather than induction. It is plausible that activation of ras oncogenes by somatic point mutations might play a role in the carcinogenic process, although at a yet undetermined stage. Myeloid leukaemogenesis is characterized by a very early, putative initiating event, consisting of non-random rearrangements and/or deletions of chromosome 2. These may be related to deletions in the developmentally important homeobox gene clusters and to rearrangements of the sequences flanking the IL-1 beta gene. Either a gene of the homeobox family or IL-1 beta might be considered as potentially involved in the induction process. Osteosarcomagenesis in mice is often associated with the expression of proviruses, and the tumours often contain somatically acquired proviruses. These viruses may contribute to tumour development by affecting various growth-suppressor genes. Viruses isolated from bone tumours, although non-sarcomagenic, induce osteopetrosis, osteomas and lymphomas upon infection of newborn mice. Osteogenic tumours frequently display amplification of a region on mouse chromosome 15, which encompasses c-myc and Mlvi-1 sequences. Enhanced transcription of various oncogenes is found in individual tumours, but no specificity for osteosarcomas has been identified. In vitro systems of skeletoblast differentiation are being developed to study tumour induction in vitro.
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Affiliation(s)
- M Janowski
- SCK/CEN, Department of Radioprotection, Mol, Belgium
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Livne E, Schmidt J, Closs EI, Silbermann M, Erfle V. Effects of leukemogenic retroviruses on condylar cartilage in vitro: an ultrastructural study. Calcif Tissue Int 1989; 44:25-35. [PMID: 2537132 DOI: 10.1007/bf02556237] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Mandibular condyles of late embryonic NMRI mice were used in an in vitro organ culture system to study the effect of bone tumor-derived murine leukemia viruses OS-5 MuLV and OA MuLV known to induce osteopetrosis and osteomas. Skeletal precursor cells present in the condylar tissue normally undergo rapid differentiation in vitro which results in new bone formation. The infection of condyles with either OS-5 MuLV or OA MuLV markedly interfered with the normal developmental pattern of the organ leading to the formation of an atypical, heavily mineralized tissue. Many spindlelike cells and pleomorphic cells were encountered, whereas fibroblastlike cells were found to penetrate an underlying collagen substratum. These observations indicate that bone tumor-inducing leukemogenic retroviruses directly affect cartilage and/or bone precursor cells resulting in pathologic developments in the skeleton.
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Affiliation(s)
- E Livne
- Rappaport Family Institute for Research in the Medical Sciences, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
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Schmidt J, Strauss GP, Schön A, Luz A, Murray AB, Melchiori A, Aresu O, Erfle V. Establishment and characterization of osteogenic cell lines from a spontaneous murine osteosarcoma. Differentiation 1988; 39:151-60. [PMID: 3243385 DOI: 10.1111/j.1432-0436.1988.tb00090.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Five clonal cell lines were established from a spontaneous BALB/c mouse osteosarcoma, and characterized. Four of these lines showed some similarities in morphology, in vitro growth properties, production of collagenous and noncollagenous extracellular matrix proteins and osteogenic differentiation. The cells formed colonies with characteristic differences in size and morphology in soft agar, and osteogenic sarcomas and metastases in syngeneic mice after transplantation. Ultrastructurally, cells in the transplant tumours showed marked osteogenic features. There were no osteoclast-like cells. The fifth cell line had somewhat different characteristics. All five lines expressed infectious endogenous murine leukemia viruses. Increased c-myc protoon-cogene expression was found in one cell line and c-fos expression at different levels in all lines. There was only very low expression of c-Ha-ras and no expression of c-Ki-ras and c-sis. DNA analysis showed the presence of newly acquired proviral genomes integrated at different sites in the cellular DNA. The results show that distinct osteogenic neoplastic subclones can be obtained from a primary mouse osteosarcoma. Although the clones exhibited an appreciable morphological, functional, and molecular diversity they retained the basic pathogenic properties of the tumour from which they were derived.
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Affiliation(s)
- J Schmidt
- Abteilung für Molekulare Zellpathologie, Gesellschaft für Strahlen- und Umweltforschung, Neuherberg/München, Federal Republic of Germany
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