Nitric oxide mediates inhibitory effect of interleukin-1beta on estrogen production in human granulosa-luteal cells

OBJECTIVE

To investigate the effect of IL-1beta on NO production and steroidogenesis in human granulosa-luteal cells obtained from women undergoing in vitro fertilization procedures.

SUBJECTS AND METHODS

To investigate the effect of IL-1beta, granulosa-luteal cells were cultured with various doses of IL-1beta (0, 0.05, 0.5, 5, 50, 100 ng/ml), IL-1beta (5 ng/ml) with NG-nitro-L-arginine-methyl ester (L-NAME), selective inhibitors of NOS, sodium nitroprusside (SNP), NO donors and Genistain, a tyrosine kinase inhibitor.

RESULTS

IL-1beta induced a dose-dependent stimulation of NO production and inhibited the production of estradiol in a significant way in a dose-dependent manner. L-NAME significantly decreased NO production and increased the production of estradiol and progesterone. SNP significantly increased NO production and caused decreases in the production of both estradiol and progesterone. Genistain decreased NO production and significantly increased the production of estradiol and progesterone. Inducible NOS (iNOS) messenger RNA was present in granulosa-luteal cells before treatment with IL-1beta.

CONCLUSIONS

IL-1beta stimulated NO production, and NO inhibited the production of estradiol.

Telomerase and proliferative activity in placenta from women with and without fetal growth restriction

OBJECTIVE

To analyze telomerase and proliferative activity in placenta from women with and without fetal growth restriction (FGR).

METHODS

Telomerase activity was analyzed in 30 first-trimester chorionic villi specimens (group A) and in 28 second- and third-trimester placenta specimens (group B) from women without FGR. Telomerase activity also was analyzed in 11 placenta specimens from women with asymmetric FGR (group C). The proliferative activity of these 69 specimens was assessed by immunohistochemical staining, using the MIB-1 monoclonal antibody.

RESULTS

Telomerase activity was detected in 28 (93.3%) of 30 chorionic villi specimens and in 18 (64.3%) of 28 placenta specimens without FGR. In contrast, no telomerase activity was exhibited in the placenta specimens from any of the 11 women with asymmetric FGR by telomeric repeat amplification protocol assay. Telomerase activity also was detected by in situ telomeric repeat amplification protocol assay in trophoblastic cells from women without FGR but not in trophoblastic cells from women with asymmetric FGR. Thus, telomerase activity was detected significantly more often in groups A and B than in group C (P < .01). The rate of proliferative activity, evident as positive MIB-1 staining in trophoblastic cells, in groups A and B (28.1+/-1.7% and 7.0 +/-2.9%, respectively) was significantly higher than that in group C (1.9+/-0.6%; P < .01).

CONCLUSION

Telomerase and proliferative activity were minimal in placenta from women with asymmetrical FGR, suggesting placental senescence with asymmetrical FGR.

Telomerase activity in human chorionic villi and placenta determined by TRAP and in situ TRAP assay

Telomerase activity (TA) was analysed in human chorionic villi and placenta in normal and abnormal pregnancy using the telomeric repeat amplification protocol (TRAP) and in situ TRAP assay. Twenty chorionic villi specimens and 25 placenta specimens from normal pregnancies were examined as well as placenta specimens from 10 cases of intrauterine growth retardation (IUGR; nine asymmetric and one symmetric). TA was detected in 18 of the 20 (90 per cent) chorionic villi specimens and in 18 of the 25 (72 per cent) placenta specimens from normal pregnancy. However, no or only weak TA was exhibited in the placenta specimens of the nine asymmetric IUGR cases. In situ TRAP assay detected TA in trophoblastic cells from normal pregnancy, but not in trophoblastic cells from cases of asymmetric IUGR.

[Early phase II trial of oral etoposide administered for 21 consecutive days in patients with cervical or ovarian cancer. ETP 21 Study Group--Cervical-Ovarian Cancer Group]

We conducted multi-site early phase II trial or oral etoposide administered for 21 consecutive days in patients with cervical or ovarian cancer in cooperation with 19 institutes. Fifty mg/body of oral etoposide was administered daily for 21 consecutive days. Cycles were repeated every 28 days. In cervical cancer, 24 patients were enrolled and 17 of them were evaluated. The overall response rate including CR and PR was 23.5% (4/17). In ovarian cancer, 18 patients out of 21 enrolled were evaluated. The overall response rate was 16.7% (3/18). The primary toxicity observed was myelosuppression such as leukopenia, neutropenia, hemoglobin decrease and thrombocytopenia. Other adverse effects were anorexia, nausea, vomitting, fatigue, alopecia and stomatitis. From these results we concluded that oral etoposide administered for 21 consecutive days was effective against cervical cancer.

[Cancer chemo-endocrine therapy and its cell biological basis]

The aim of our cell kinetic studies is to better understand the effects of chemo-endocrine therapy at the cell biological and molecular level. Cancer cell growth is characterized by uncontrolled proliferation, resulting in DNA distribution pattern in which, at any time, more cells are not G1 phase but in S, G2 and M phase of a shortened cycle. In a recent progress, flow cytometry (FCM) has become a powerful tool for the quantitative analysis of cell cycle parameters by measuring nuclear DNA content in large cell population with high speed. With the aid of FCM in earlier work about 60-80% of ovarian cancers were found to contain aneuploid cells. Now, multi-parameter FCM linked to a computer is available to measure fluorescent intensities not only no base total DNA (Propidium iodide) but also A-T (Hoechst 33342) and G-C (Mithramycin) base pairs in solid cancer nuclei. Since cisplatinum (CDDP) is the most important drug in the treatment of ovarian cancer, we have studied the relationship of CDDP cytotoxicity, pertubations cell cycle kinetis and DNA damage in ovarian adenocarcinoma cells in vitro & in vivo. We employed both CDDP sensitive cell line (KFt) and resistant cell line (KFr) derived from human serous cystoadenocarcinoma of the ovary by Kikuchi et al (JNCI 1986). Comparing cell kinetic pertubations of experimental cells demonstrates a decrease in G1 phase cells concomitant increase in S phase cells. The KFr cells had distinctly a shorter S-phase block up to 24 hrs not A-T but G-C preference in a quick response followed repairing of DNA damage to 48 hrs. However, some fractions of CDDP resistant cell population showed a later onset of G2, M phase accumulation. Comparison with the increase in early S phase cells of KFr in detailed analysis suggests only those damaged cells that are not killed immediately may proceed to G1 phase and start into DNA synthesis in S phase. Measurement of labeling index (L. I.) with Bromodeoxyuridine (BrdU) support our interpretation of differences between sensitivity and resistance to anti-cancer drug. Additionally, we discuss a targeting chemotherapy by coupling cytotoxic drugs with estrogen based on increasing DNA damage into apoptosis and interfares with DNA repair process.

Unscheduled expression of cyclins by anti-cancer drug exposure

The scheduled expressions of cyclins are observed in the normal cells or the tumor cells whose phenotype is characterized by scheduled expression of cyclins, while unscheduled expression of cyclins were reported in several leukemic and solid tumor cell lines by anti-cancer drugs. We studied the effects of cytotoxic concentrations of Taxol (TXL) on cyclin D1 and B1 expression on human ovarian cancer cell lines. In KFr13 cells, the control group showed low degree of cyclin D1 and moderate degree of cyclin B1 expression in all cell cycles, while 1 microM TXL exposure resulted remarkable cyclin D1 and B1 expression in G2+M phase cells. OVCAR-3 cells showed relatively high degree of cyclin D1 expression and mild to moderate degrees of cyclin B1 expression in control group. 1 microM TXL showed no significant changes in cyclin D1 expression, while decreased expression cyclin B1 in G0+1 and S and moderate degree of expression in G2+M.

Comparative cytogenetic studies of benign, borderline, and malignant epithelial ovarian tumors

Comparative cytogenetic studies were performed in 40 cases of untreated epithelial ovarian tumors. Of these 40 tumors, 13 were classified as benign, 3 as borderline, and 24 as malignant, according to the WHO classification for ovarian tumors. Of 13 benign ovarian tumors, 4 (30.8%) showed chromosomal abnormalities. Of 4 ovarian tumors, 3 (75%) had single chromosomal abnormalities, and the remaining tumor (25%) retained multiple chromosomal abnormalities. Of 3 borderline-malignant ovarian tumors, 2 (66.7%) showed chromosomal abnormalities. Of 2 ovarian tumors, 1 (50%) indicated single chromosomal abnormalities, and the remaining tumor (50%) revealed multiple chromosomal abnormalities. Of 24 malignant ovarian tumors, 20 (83.3%) showed chromosomal abnormalities. Of these 20 ovarian tumors, 3 (15%) had single chromosomal abnormalities, and the other 17 (85%) exhibited multiple chromosomal abnormalities. These data indicate that the rate of chromosomal abnormalities, especially multiple abnormalities, increases following the progression of malignancy in epithelial ovarian tumors.

Reconstructed three-dimensional images of flow-sorted nuclei hybridized with chromosome-specific probes

We demonstrated that the three-dimensional (3-D) locational and morphological differences of chromosome 17 are dependent on each cell cycle phase in the clinical materials. Cell suspensions prepared from hypertrophied tonsil were hybridized with chromosome 17 whole painting probe or its centromeric probe and the probes were detected with fluorescein isothiocyanate. Then the cells were sorted from G(0+1), S-, and G(2+M)-phase fractions by flow cytometry and observed by confocal laser scanning microscopy to obtain the serial optical sections. The 3-D images were obtained by assembling these sections using a computerized image analysis device. The distribution of centromeric copies was analyzed statistically, and the data values were not a population of random distribution within a sphere. The copies were observed in the periphery of the nuclei in G(0+1)- and S-phase. The 3-D images revealed that chromosome 17 was oval in shape in the G(0+1)-phase nucleus, and was changing into a flame shape in the S-phase, with arms stretching out along the nuclear membrane, and looked bush shaped in G2-phase. The eccentric distribution of chromosome 17 in G(0+1)- and S-phase nuclei may reflect the optimal efficiency of incorporating and/or releasing essential materials and products.

[Phase II study of paclitaxel (BMS-181339) in patients with ovarian cancer by 3-hour intravenous infusion]

A phase II study of Paclitaxel in patients with ovarian cancer by 3-hour intravenous infusion was undertaken by a cooperative study group of 30 institutes. Of 66 cases enrolled, 57 cases were evaluable for efficacy, and 63 cases were evaluable for safety. In spite of the fact that all cases for efficacy evaluation were previously treated with chemotherapy including platinum-based drugs, 2 cases of complete response (CR) and 15 cases of partial response (PR) were observed, with a response rate of 29.8% (The 95% confidence interval of response rate was 18.4-43.4%). Paclitaxel also showed 28.2% (11/39) response rate in patients refractory to treatment by platinum-based drugs. Histologically, the response rates were 28.9% (11/38) in serous adenocarcinoma, 40.0% (2/5) in clear cell adenocarcinoma and 25.0% (1/4) in mucinous adenocarcinoma. As the major laboratory abnormalities, leukopenia, neutropenia and decrease in hemoglobin were observed with incidence rates of 98.4% (62/63), 95.2% (59/62) and 85.7% (54/63), respectively. However, these abnormalities were clinically manageable by either withdrawal of medication, administration of antibiotics, G-CSF or metachysis etc. In addition, thrombocytopenia, elevation in GOT and GPT were seen with moderate incidence. Peripheral neuropathy was a major adverse symptom with an incidence of 79.4% (50/63), followed by alopecia, myalgia, arthralgia and fever. However, the majority of these adverse reactions were less than grade 3. From these findings, we confirmed that 3-hour intravenous infusion of Paclitaxel was a clinically useful chemotherapeutic agent in patients with ovarian cancer.

[Recent problems on the endocrine and chemotherapy]

The endometrial carcinoma, as well as the breast cancers and some kinds of ovarian cancers, was considered to a hormone dependent carcinoma. Even if we tried to do the endocrine therapy using such as medroxy progesterone acetate (MPA), we could expect only 30% of anti-tumor effects on the endometrial carcinoma. Endocrine therapy was thought to have a different action mechanisms from the other anti-cancer drugs. Whereas cisplatin (CDDP) has strongly an effectiveness for ovarian cancers, but the drug resistance of cancer cells for CDDP was causing a serious problem. This paper will be discussed about the problems of the endocrine and chemotherapy from the point of view of cell cycle analysis. Additionally, we would like to describe about the new anticancer drug such as Taxol.

Numerical and structural chromosome abnormalities in an ovarian fibrothecoma

Cytogenetic analysis of a fibrothecoma of ovary revealed numerical and structural chromosome abnormalities, i.e., 44,XX, dup(1)(p13p31),del(3)(p14) add (10p), -16, -22. This is the first report of numerical and structural abnormalities in a fibrothecoma of the ovary.

[A phase II study of BMS-181339 in patients with ovarian cancer. BMS-181339 Ovarian Cancer Study Group]

We conducted a multicenter Phase II study of BMS-181339 in patients with ovarian cancer. The facilities participating were 23 in number. The total number of cases registered for the study were 62; 57 of them entered for evaluation in drug efficacy, and 58 cases were evaluable in drug safety. All the cases were previously treated with chemotherapy including platinum-based drugs. The clinical responses of BMS-181339 were as follows: CR, 1 case; PR, 13 cases; MR, 3 cases; NC, 13 cases and PD, 27 cases. The response rate was 24.6% (95% CI: 14.1-37.8%). Histologically, the drug showed its efficacy on serous adenocarcinoma 28.2% (11/39), mucinous adenocarcinoma 20.0% (1/5) and clear cell adenocarcinoma 20.0% (1/5). In regional evaluation, the drug demonstrated its efficacy not only on endopelvic lesions 19.0% (4/21) and abdominal lesions 14.3% (2/14), but also on remote metastatic lesions such as hepatic metastasis 30.8% (4/13) and lung/pleura 33.3% (2/6). The drug also showed its efficacy on the cases 22.9% (8/35) refractory to the platinum-based drugs. Major adverse reactions were fever 63.8% (37/58), alopecia 59.3% (32/54), peripheral nerve disorders 28.1% (16/57) such as numbness of the extremities, nausea/vomiting 24.1% (14/58), arthralgia 20.7% (12/58) and diarrhea 20.7% (12/58) etc.. Abnormal alterations in laboratory test values were an incidence rates of 100% for both leukopenia and neutropenia. However, these symptoms were clinically manageable by transient withdrawal of medication, dose reduction and administration of antibiotics and G-CSF. In addition, decrease in hemoglobin 93.1% (54/58), decrease in platelet counts 31.0% (18/58), elevation in GOT 27.6% (16/58), in GPT 31.0% (18/58) and in LDH 20.7% (12/58) were seen, but no serious organopathy was observed. Thus, we confirmed that BMS-181339 was a clinically useful chemotherapeutic agent in patients with ovarian cancer.

[Comparative genomic hybridization(CGH)]

A new molecular cytogenetic method, comparative genomic hybridization(CGH), was reviewed. CGH produces a map of DNA sequence copy number on a normal metaphase spread after hybridization with the mixture of tumor DNA and normal reference DNA, which are detected with different fluorochromes, respectively. Then the ratio of two fluorochromes are analysed with digital image analyzer and reveals a real copy number of the DNA sequences. CGH surveys entire chromosomes at a time and would clarify oncogenes and tumor suppressor genes, which had not known.

[Phase III study of DWA2114R for ovarian cancer]

A phase III study of DWA2114R for ovarian cancer was carried out in CAP regimen by a cooperative study group consisting of 42 institutions. The response rate of 31 cases for DWA2114R regimen was 38.7% and out of 30 cases for CDDP regimen 46.7%. No significant differences were observed between the two regimens in efficacy, adverse reactions, and abnormalities in laboratory findings except for red blood cell and creatinine clearance, but the incidence of thrombocytopenia was likely to be lower in DWA2114R than in CDDP regimen. Since the DWA2114R regimen did not need hydration, or require diuretics, DWA2114R is more useful in the treatment of ovarian cancer than cisplatin.

Hepatoid carcinoma of the ovary: a case report

A case of a right ovarian tumor in a 64-year-old patient showing high blood levels of alpha-fetoprotein (AFP) is reported. Histologically, the tumor resembled hepatocellular carcinoma with hyaline globules. Localization of AFP was detected by the immunoperoxidase method. Electron microscopically, the rough-surfaced endoplasmic reticulum had developed into a meshwork, and the mitochondria were present within this meshwork. Because a transition from adenocarcinoma to a region resembling hepatocellular carcinoma was observed, this tumor was considered to originate as a common epithelial carcinoma. In the blood, 67% of the AFP was bound with concanavalin A (Con A), and the fraction pattern obtained by lentil agglutinin affinity chromatography (LCA) was of the germ cell type. From these results, the current case may be labeled clinicopathologically a hepatoid carcinoma of the ovary as described by Ishikura and Scully.

Glucocorticoid-induced G1 arrest and the release effect of epidermal growth factor on the human salivary gland adenocarcinoma cell

Dexamethasone (1 microM) decreased the distribution of cells in S phase (about 75%) and increased that of G1 cells (1.1-fold) in the DNA histogram of human submandibular salivary gland adenocarcinoma cells (HSG) reversibly. In synchronized cells at G1 phase, glucocorticoid delayed the initiation of DNA synthesis by about 3-4 h. The conditioned medium (50%) or exogenous human epidermal growth factor (EGF, 10 ng/ml) significantly nullified these effects by glucocorticoids. These results suggested that glucocorticoids arrested the cells at G1 phase, which implied the inhibition of production of some progressive factor, probably EGF, in the cell cycle of HSG.

Flow cytometric and biochemical analysis of dose-dependent effects of sodium butyrate on human endometrial adenocarcinoma cells

Sodium butyrate (SB) treatment was previously shown to produce seven-fold increases in estrogen hormone receptor binding sites of human endometrial adenocarcinoma (IK) cells. Flow cytometric analysis and histone gel electrophoresis were used to examine cell cycle, cell metabolism, and nuclear histone fractions in IK cells treated with different concentrations of SB. SB-treated cells stained with fluorochromes specific for DNA, RNA, or general protein were analyzed by flow cytometry (FCM). Changes in accessibility to three DNA stains and gel electrophoresis were used to analyze rearrangements in chromatin structure. SB caused an accumulation of cells in the G1 phase and inhibited DNA synthesis, but not cellular levels of RNA and protein. Hoechst accessibility to A-T rich regions on DNA was dramatically increased after removal of SB. H1 histones were dephosphorylated and core histones were acetylated during SB-treatment. Information obtained in these studies may be useful for correlating cellular and biochemical events with SB-induced increases in nuclear steroid hormone binding sites.

[A clinical study of recombinant human G-CSF in gynecological tumor patients with neutropenia due to chemotherapy (rG.CSF Clinical Study Group)]

We evaluated clinical efficacy of recombinant human granulocyte colony stimulating factor (rG-CSF), successfully expressed in Chinese hamster ovarian cell, in gynecological tumor patients (pts) with neutropenia due to chemotherapy (CT). Fifty-eight pts with advance or relapsed gynecological malignancy were entered into this study. These pts had neutropenia below 1,000/cmm by CT and in the next cycle of CT they were treated with daily rG-CSF (2 micrograms/kg/day, subcutaneously) starting from the next day of CT for 14 days. The activities of rG-CSF were evaluated using following indices calculated for each cycle: a) the absolute neutrophil count (ANC) at nadir, b) the period for restoration in ANC above 1,500/cmm, and c) the total area below the 1,000/cmm level in ANC calculated by a computer. Forty-seven out of 52 evaluable pts (90.4%) showed good response to rG-CSF. Only adverse events considered possibly due to rG-CSF were transient fever and anorexia, one case each. In conclusion, rG-CSF appears to be well tolerated by gynecological tumor patients and to considerably rescue them from neutropenia caused by intensive chemotherapy.

[Quenching effect and analysis of cell proliferation in dual-laser flow cytometry with human endometrial adenocarcinoma cells in vitro]

We analyzed the characterization of DNA synthesized cells (S phase cells) in the proliferation. It is important that the fixation and cell cycle time of S phase cells and DNA qualitative changes, etc., be examined. We used the dual-laser FCM system of the Los Alamos National Laboratory in New Mexico and analyzed the cell cycle, especially changes in S phase cells both quantitatively and qualitatively. By the bromodeoxyuridine (BrdU)/Hoechst Quenching effect, we could detect differences in electric signals by adopting the differential fluorescence correction method. (1) The effects of sodium butyrate in gene expression were dose-dependent at human endometrial adenocarcinoma cells. (2) After double staining with Mithramycin and Hoechst33342, S phase cells incorporating BrdU under quenching gave from linear relative to arched bivariate contour histograms. (3) At 24 hours G1 phase synchronization of SB 1,3 and 5mM appeared in slow cycling cells after BrdU was added. These results suggest that the effect of sodium butyrate in human endometrial adenocarcinoma cells might be understood not only from the quantitative change, but also by the qualitative change in S phase cells.

[Hyperamylasemia in endometrial adenocarcinoma]

Two patients suffering from endometrial adenocarcinoma (endometrial type) showed hyperamylasemia. The elevated level of amylase in the serum dropped to the normal range after operation in case 1. Case 2 had a recurrent tumor and continued to have a high amylase concentration in the blood. Isozyme analysis of serum-amylase showed predominant patterns of the salivary type. Tumor homogenates contained only salivary type amylase. Immunohistochemical staining revealed localizations of amylase in these tumor tissues. So it was clear that the production and secretion of salivary type amylase caused hyperamylasemia. Further study was done immunohistochemically to find the incidence of amylase-productive endometrial adenocarcinoma (endometrial type). It was shown that 56% of these tumors had amylase in neoplastic cells. Well differentiated adenocarcinoma showed a high frequency of amylase-positive findings. It was suggested that amylase measurement would provide useful information in checking the recurrence and in monitoring the therapeutic effects of endometrial adenocarcinoma.

[Combination chemotherapy of ovarian cancer with cisplatinum, aclarubicin and tegafur]

Two hundred fifty-nine patients with ovarian cancers were treated with the combination of CDDP, aclarubicin and tegafur. Ninety-seven of them had macroscopic diseases during the combination chemotherapy, and the overall anti-tumor response rate (CR + PR) for these patients was 54.6%. It was 60.0% for the 80 cases with epithelial ovarian cancer among them. The median survival time for the antitumor responders was 18 months, against 7 months for the non-responders and 18 months for 103 patients with advanced ovarian cancer (stage III-IV).

Diagnosis of benign and malignant cervical specimens by multifiberoptic microspectrophometry and by flow cytometry

Two techniques for the automation of mass screening for cervical cancer were studied. Microspectrophotometry was tried first, using a novel multifiberoptic scanning system that measured the nuclear size and DNA content of cells in routine smears restained by the Feulgen technique. Specimen diagnoses were based on the percentages of cell types present, as determined by thresholds set for the two parameters. While this method gave good results in the automated detection of severe dysplasias and carcinomas, with only 3 of 72 cases misdiagnosed as negative (4.2%), it had a 22.9% false-positive rate (misdiagnosing 24 of 105 "benign" cases) and a 30.3% false-negative rate for adenocarcinomas (10 of 33 cases misclassified). The second approach involved flow cytometric measurements of specimens that were double stained for the assessment of both the DNA and RNA content, with the results analyzed by preset windows in a two-dimensional plane. This technique gave a 6.1% false-negative rate in 49 positive specimens and a 32.3% false-positive rate in 102 benign specimens, with an overall correct classification rate of 76.2%, including adenocarcinomas.

Electron microscopic study on early decidualization of the endometrium of pregnant mice, with special reference to gap junctions

Cytological changes in mouse decidual cells during the early stages from 4.5th to 11th day of pregnancy were examined by electron microscopy with special reference to gap junctions. The most noticeable feature of decidual cells was that there was an abundance of various-shaped gap junctions such as flat, undulated, omega-shaped, and annular-shaped gap junctions. Serial sectioning revealed that annular-shaped gap junctions were separated from the decidual cell plasma membrane. Intramembranous particles (IMPs) of the gap junctions as seen by freeze-fracture displayed a well-packed arrangement and a homogeneous size. Degenerative changes first appeared in decidual cells directly contiguous with trophoblasts on the 7th day, and spread to the deeper area as clearly seen on the 8th day. Along with degeneration of decidual cells, annular-shaped gap junctions were enfolded and gradually degraded by lysosomes. IMPs of such degenerative gap junctions were irregularly arranged and heterogenous in size. The decidual tissue became thin with elongated decidual cells as the placental disc grew on the 10th day. Extremely long undulated gap junctions were present in decidual cells, and a small number of annular-shaped gap junctions were also found in the cytoplasm. The presence of abundant gap junctions as demonstrated in the present study suggests that decidual cells will be able to develop as well as to function synchronously. In addition, it is suggested that redundant gap junctions become annular-shaped to be finally degraded by lysosomes.

[Cell kinetic effects of cis-platinum on cancer cells in a culture system and in cases of cervical cancer using monoclonal antibody of BrdU]

Flow cytometric analyses were done in cervical squamous cell carcinoma cell line (SKG-IIIa) and in cancer cells of cervical cancer cases treated with CDDP using monoclonal antibody of BrdU. 1) In fundamental studies using culture system, accumulation of late S phase cells and of mid S phase cells was observed after 48 hours at the dose of 0.2 micrograms/ml and 0.5 micrograms/ml of CDDP, respectively. 2) Accumulation of early S phase cells was observed at the condition of 1 microgram/ml and 3 micrograms/ml of CDDP. All S phase cells decreased gradually thereafter 3) In clinical studies, accumulation of early S phase cells was observed in cancer cells of cervical cancer cases after intra-arterial infusion of CDDP. However, cell cycle recycling was observed in tumor cells which retained their low sensitivity to CDDP after 21-day treatment with intra-arterial infusion of CDDP.

[Relationship between the cell cycle and production of hCG in choriocarcinoma cells]

Human choriocarcinoma cells in vitro (ENAMI-1) were exposed to various concentrations of MTX (10(-8)M, 10(-7)M, 10(-6)M, 10(-4)M) for 48 hr, and after removal of MTX, cells were harvested and measured by FCM every 24 hr for 96 hr. Although the growth of cells were inhibited in MTX more than 10(-7)M in concentration, hCG-beta levels were elevated markedly. It was showed that hCG positive cells were accumulated in G1-phase by flow cytometric two color analysis with monoclonal antibody. In the presence of MTX more than 10(-7)M in concentration, the cells were accumulated in S-phase. After removal of 10(-7)M MTX, S-phase cells migrated toward G2 + M phase on the other hand in the presence of MTX more than 10(-6) M in concentration cells stopped moving to G2 + M phase. Immunoperoxidase with monoclonal antibodies against BrdU and hCG-beta has got the same phenomena resulted by FCM. It was confirmed that hCG was an useful marker for choriocarcinoma.

[Phase II study of carboplatin in cervical carcinoma]

A phase II multi-center study of carboplatin for cervical carcinoma was carried out in 22 institutes throughout Japan. The patients registered consisted of 40 women with 39 cervical carcinomas and an endometrial carcinoma, of whom 31 were evaluable. Carboplatin was administered intravenously every 4 weeks at a dose of 400 mg/m2, in cases with no prior therapies and/or P.S. 0-1, and 300 mg/m2 in cases with prior therapies and/or P.S. 2-3. The overall response rate of 31 evaluable cases was 19.4% with 2 cases of CR and 4 cases of PR. The response rates by histological classification were 18.5% (5/27) for squamous cell carcinoma and 25.0% (1/4) for adenocarcinoma. Response rates analysed by lesion sites were 12.5% for primary tumors, 30.0% for local lesions and 20.0% for metastases. The response rate among patients without prior therapies was 14.3%, while those for patients with prior radiotherapy and for prior radiotherapy and chemotherapy were 33.3% and 13.3%, respectively. Major adverse effects observed were nausea and/or vomiting (52.9%), anorexia (44.1%) and malaise (35.3%). Hematologically, thrombocytopenia, leukopenia and anemia were frequently observed (52.9%, 35.3% and 32.4%, respectively). As for renal toxicity, elevation of BUN (2.9%) or serum creatinine (2.9%) and the decrease of creatinine clearance (14.3%) were observed, but they were mild, and tolerable. These results suggest that carboplatin is one of the most useful drugs against cervical carcinoma.

A nuclear DNA study of uterine cervical dysplasia with reference to its prognostic significance

To further define the nuclear DNA content of uterine cervical dysplasia and its relationship to prognosis and epidemiological features, a retrospective study using Papanicolaou stained cytological specimen and TICAS was undertaken. 1. Dysplasia patients was common among young females who had a background of low age first pregnancy, multiple Gravidity-Parity, the complication of inflammation and the use of hormonal contraceptives and progressed rapidly. It is recommended that a test should be repeated within 2 to 3 months regardless of the severity of the dysplasia and patients should be followed up for at least 2.5 to 3 years. 2. The DNA histograms were classified into 3 types (A,B and C): Type C, which had the stem line in an aneuploidy area, showed more severe dysplastic cases. This may be due to the proliferation rate and significant alternation in the chromosomes and mitoses. Nuclear DNA analysis using TICAS and Papanicolaou stained cytological material could discriminate between the progressive group and the persistent or regressive group. In addition, the mean nuclear area might be the best indicator of prognosis in uterine cervical dysplasia.

Relationship between changes of the steroid receptor and synchronization in human endometrial adenocarcinoma cells in vitro

It has been reported that the response of target cells to steroid hormone (SH) stimulation may depend on their position in the cell cycle. The DNA and RNA contents of malignant cells of the endometrium cultured in vitro were measured using flow cytometry (FCM). We also measured estrogen receptor (ER) and progesterone receptor (PR) levels of cells at different positions in the cell cycle. The G1 and S phases of the cell cycle were investigated using cells synchronized by sodium n-butyrate (G1 block), methotrexate (S block), and excess thymidine (S block). For DNA measurements, the cells were stained with propidium iodide following RNase treatment. For RNA measurements (double-stranded RNA) the cells were treated with DNase. We found that S phase synchronization by methotrexate was 136.2% of control (100%). Using the excess thymidine block and release procedure, the S phase fraction was 185.1% of control. G1 phase synchronization by sodium n-butyrate was 134% of control. The estrogen receptor level in G1 phase synchronized cells increased to 5.94 fmol/micrograms DNA in the cytosol and 12.35 fmol/micrograms DNA in the nuclear fraction. These levels represent a sevenfold total increase over that of the control estrogen receptor level. Cells in S phase showed no significant increase in estrogen receptor levels over control cells. Based on this study, the functional increase of the steroid receptor was most significant in the G1 phase.

[Drug resistant mechanisms of platinum derivatives in a human cisplatin resistant ovarian cancer cell line]

We investigated cisplatin resistant mechanisms in a cisplatin resistant ovarian cancer cell line (KFr) by means of flow cytometric analysis for damage of cisplatin to DNA base and DNA synthetic cells. Cisplatin showed cycle delay at 0.5 microgram/ml and then cycle arrest at 1 microgram/ml in G2 + M phase. KFr cells showed relatively rapid inhibition of DNA synthesis based with G-C base damage by cisplatin however, KFr cells had a capacity to repair DNA damage by cisplatin as showing cycle progression from G2 + M phase to G1-early S phase. Of the cisplatin derivatives tested which are of current clinical interest, Carboplatin and DWA 2114 R showed cross resistance to cisplatin in KFr cells.

[Clinical study of the delivery of very low birth weight infants in Iwate Prefecture]

Over the past 4 years, 119 very low birth weight infants (VLBWI, less than 1,500g) were delivered at Iwate Medical University. We analysed clinical background of mothers and prognosis of neonates. The objective of this study was to upgrade our perinatal care tailored to regional demand. The following results were obtained. 1. Maternal transport was necessary in 90.7% of the mothers. Preterm Premature Rupture of the Membranes (PPROM) was present in 38.8% of them. 2. The percentage of mothers with a cervical dilatation of more than 4cm was significantly higher in mothers without PPROM than in those with PPROM. 3. Delivery occurred within 24 hours in 86.8% of mothers without PPROM who had a cervical dilatation of more than 4cm. 4. The percentage of cesarean sections was 16.5%. 5. Death in the neonatal period occurred in 10.8% of VLBWI, 20% of extremely low birth weight infants (ELBWI, less than 1,000g), and 42.8% of infants weighing less than 750g. 6. There was no significant difference in the incidence of intraventricular hemorrhage (IVH) between infants with cephalic presentation and infants with breech presentation, or between infants delivered vaginally and infants delivered by cesarean section. The incidence of IVH was significantly higher in infants weighing less than 1,000g than in those weighing 1,000g or more. 7. The neonatal death nate and the incidence of IVH were significantly higher in infants weighing less than 750g than in those weighing 1,000g or more. 8. The incidences of pneumonia and sepsis were significantly higher in infants with PPROM than those without PPROM.(ABSTRACT TRUNCATED AT 250 WORDS)

[Cell sorting in flow cytometry]

The aim of the presentation is to introduce a dramatic accomplishments of high technology and the current applications of medicine, particularly in the field of Gynecology and Obstetrics. An author's demonstration includes both of a brief basic concept of window and fraction sorting and some clinical applications. Cell sorting based on genotypic (neoplastic) and phenotypic markers of a benign and malignant lesions of female genital tract seems to be expressed at the cellular and molecular level in terms of degree of cell growth, differentiation and functions, which are not readily appreciated by descriptive morphology. DNA aneuploidy is a conclusive marker of malignant characteristics and a monoclonal antibodies of Bromodeoxyuridine (BrdU), an analog of thymidine, is an available identification of DNA synthetic cells. Among phenotypic cell markers, surface membrane antigens have been extensively studied on the immunological state in pregnancy, peripheral lymphocyte subsets from pregnant women by the use of monoclonal antibodies. From gynecological and obstetrical patients management perspective, a role of cell sorting technology in flow cytometry is emerging as a tool for diagnosis of cancer (DNA abnormalities and cell cycle analysis) multiparameter analysis in quantitation (DNA base pairs, RNA and protein), surface markers for immunological state in pregnancy (membrane antigen and monoclonal antibodies), prognosis (adverse impact of aneuploidy and high S percentage using BrdU with monoclonal antibody) and targeting cytotoxicity to steroid responding tumor cells (estrogen receptor and site-directed chemotherapy).

[Phase II study of carboplatin in ovarian cancer]

A phase II study of carboplatin was conducted in ovarian cancer by a cooperative study group consisting of 22 institutions nationwide. The overall response rate of 50 evaluable cases was 38.0%. The response rate in cases with no prior chemotherapy was 54.2% and that with prior chemotherapy was 23.1%. In addition, the response rate was 26.3% in cases that received prior CDDP-based chemotherapy. Histologically, the response rate was high in serous cystadenocarcinoma and endometrioid adenocarcinoma. Hematologic toxicities, particularly leukopenia and thrombocytopenia, were frequently observed, but well tolerated, while renal and neurologic toxicities were rare. These results suggested that carboplatin is useful in the treatment of ovarian cancer.

[Phase III study of carboplatin in ovarian cancer]

A phase III study of carboplatin vs cisplatin in CAP regimen for ovarian cancer was conducted by a cooperative study group consisting of 22 institutions nationwide. The response rate for 23 cases allocated to carboplatin regimen group was 34.8% and 42.1% for 19 cases allocated to cisplatin regimen group. No significant difference was observed between these two regimens in response rates, and no significant differences were noted between the two regimens in each of the clinical toxicities and abnormalities in laboratory findings. Since the carboplatin regimen group did not require hydration, or the use diuretics or antiemetics, these results suggested that carboplatin is more useful in the treatment of ovarian cancer than cisplatin.

Retrospective DNA analysis by rapid high resolution cytometry in cases with cervical cancer before and after radiotherapy

DNA analyses of nuclei of squamous cells on 86 cases with squamous cells carcinoma of the uterine cervix, who had been treated with radiotherapy, were studied in 95 specimens. Forty-three specimens taken from invasive cancer cases before radiotherapy and 52 smears taken from the patients with cervical cancer after radiotherapy were examined by rapid high-resolution cytometry. The biologic behavior in this retrospective study was known, and the cases were classified into "poor" and "good" prognostic groups depending on their five year survival rates. In the poor prognostic group, the smears taken prior to radiotherapy showed a significantly lower 5N-exceeding rate (5NER) and a smaller Nuclear area than did those of the good prognostic group. The smears taken from the cases of recurrent cancer and postradiation dysplasia with poor prognosis showed significantly lower 5NER and a smaller Nuclear area than did those from cases of postradiation dysplasia and radiation changes in patients with a good prognosis after radiotherapy.

[Recent progress in cancer therapy in gynecology--endometrial cancer]

The relative incidence of endometrial carcinoma is obviously increasing as a disease of post-menopausal women with the ageing of the population in Japan. Growth of malignant endometrium tends to develop there both into the muscle and into the cavity. However, diagnosis in most cases is made by stage 1a (39.7%) and 1 b (19.0%) in FIGO classification. In the treatment of endometrial carcinoma, even after a simple hysterectomy in 89.2% of total cases 5-year cure rate may be reached to 80%, which has compared well with the 60% cure rate for cervical cancer. Some fractions of endometrial adenocarcinoma are estrogen-dependent and could therefore respond to antagonistic influences of progestogens. In a recent understanding, above theoretical grounds for hormone dependency and responsiveness of endometrial malignant lesions has been substantiated by data provided by steroid receptor determination. The high estrogen and progesterone receptor concentrations found in 70% of endometrial adenocarcinoma support the principle that endometrial adenocarcinoma is related to abnormal estrogenic stimulation. Those cancer are used as a model for in vitro and clinical evaluation of progestogen therapy.

[Scanning electron microscopic studies on the cell surface and cell synchronized culture of human endometrial adenocarcinoma (HEC-1) cells]

The cell cycle of cultured human endometrial adenocarcinoma cells were observed with a SEM using the synchronous culture method and the following results were obtained. In the M phase, the cells changed morphologically to become a minimum size and rounded in shape. Filopodia became thin and straight and reached their maximum length. Moreover, blebs reaches their greatest number. In the G0+1 phase, the cells developed from a round shape to an oval shape, and finally became polymorphic. The ends of the filopodia degenerated and became shortened. The number of blebs was decreased only in this stage. During the S phase, the cells became slender and reached maximum size. Short filopodia reappeared. No blebs but the largest microvilli were found. When we compared the late G1 with the early G2 phase, we found polymorphism of the cells and coexistence of microvilli and blebs common to both phases. However, ruffles were observed only in the former phase, while in the latter phase renewal of short filopodia together with thick and bent filopodia was evident. When we compared the late G2 with the early G1 phase, we found that the cells were small in size and round shape, and that the existence of blebs was common to both phases. However, the tips of the filopodia were destroyed in the latter phase, while in the former phase thick and bent filopodia were observed.

[Previous cytology in patients with carcinoma of the cervix]

The cytologic history of 317 patients with uterine cancer, in a mass survey using mobile units, was reviewed. They included 152 cases of carcinoma in situ of the cervix, 151 cases of invasive epidermoid carcinoma of the cervix, 11 cases of adenocarcinoma of the cervix, one case of verrucous squamous cell carcinoma and 2 cases of adenocarcinoma of the endometrium. There was no history of cytology in 17.1% of CIS or in 29.8% of invasive epidermoid carcinoma in the preceding 3 years (same order in the following); in the preceding 5 years the figures were 24.3% and 23.6% respectively. Suspicious or positive cytology noted more than once were 22.2% and 21.7% in the preceding 3 years, and 24.3% and 23.6% of the cases in the preceding 5 years. At least 2 negative Papanicolaou smears were 19.1% and 20.5% in the preceding 3 years, and 28.3% and 28.5% of the cases in the preceding 5 years. The yearly rate of suspicious and/or positive cytology in the preceding 5 years fluctuated between 13.5% and 30.4% in CIS, and between 9.1% and 23.0% in invasive epidermoid carcinoma. They showed no significant rise or trend. Verrucous squamous cell carcinoma as well as adenocarcinoma of the cervix and of the endometrium not infrequently showed successive negative cytology.