Medullary carcinomas of the thyroid. General review apropos of 3 further cases

The authors report of three cases of medullary carcinoma of the thyroid and, from a review of the literature, study the definition, frequency, embryological and etiological characteristics of this disease. The physiology of thyrocalcitonin, the concept of the APUD system the secretion of active substances by the tumour cells are considered. The macroscopic and microscopic characteristics and its mode of spread are described. The two main clinical forms, the sporadic form and the familial form are described together with the other endocrine involvements. Among the factors in positive diagnosis, accent is placed on per-operative histological examination and on biological tests of familial detection. Among the forms of treatment the essential place of surgery explains partly the relatively favourable course and prognosis of the malignant disease.     

The incidence of cytogenetically abnormal rogue cells in peripheral blood

PURPOSE: To compare the occurrence of cytogenetically abnormal rogue cells, characterized by a high frequency of chromosome-type aberrations, in people exposed to ionizing radiation and in non-exposed subjects. MATERIALS AND METHODS: Data on rogue cells from a total of nine cytogenetic studies on radiation-exposed populations and controls were collected from three laboratories in the United Kingdom, France and Finland. The studies were conducted on first-division metaphases of peripheral blood lymphocytes. Solid Giemsa-stained, G- or R-banded and FISH chromosome-painted material was included. RESULTS: Rogue cells were found both from controls and from exposed subjects. The highest incidence of these cells was observed in a control group of young trainees (1:400), whereas the lowest incidence of rogue cells (1:36 500) was demonstrated in a follow-up study of people accidentally exposed to high levels of ionizing radiation. Rogue cells were found to be distributed non-randomly among individuals; the highest individual frequency was 1 in 50 analysed metaphases. CONCLUSIONS: The origin of rogue cells is still unclear. The incidence of rogue cells showed a large variability between studies and individuals. No correlation between long-term radiation exposure and the occurrence of rogue cells was demonstrated. Although the presence of rogue cells in astronauts after a 6 month space flight may be attributable to high-LET radiation, the frequencies were not remarkable when compared with those in the other studies in this review.     

Genetic predisposition and radiation sensitivity of tumors

BACKGROUND: Studies on normal tissue radiation sensitivity have demonstrated profound differences of individual sensitivities. A number of genetic syndromes associated with abnormal radiation sensitivity have been described. Significant differences have also been detected in persons without known genetic disorders. The question arises as to whether tumors originating from normal tissues with abnormal radiation sensitivity share this abnormal sensitivity and as to whether a general correlation between normal tissue sensitivity and tumor tissue sensitivity can be substantiated. METHODS: Experimental and clinical data derived from own investigations and an extensive review of the literature was used to answer the question. RESULTS: Experimental studies on normal and tumor tissues of SCID-and C3H-mice demonstrated that the 2.7-fold enhanced radiation sensitivity of SCID normal tissues is also found in SCID tumors. Clinical investigations on cervical carcinoma and breast cancer patients revealed higher local control rates in patients with more pronounced acute side effects. A weak trend towards the same relationship was found in head and neck cancer patients. Case reports on unusually severe acute radiation side effects or unexpected tumor remissions as well as few reports on radiotherapy in ataxia telangiectasia (AT) patients suggest a correlation between normal- and tumor-tissue radiation sensitivity. Studies on fibroblasts and tumor cells from the same patient support this hypothesis in soft tissue sarcoma patients, but do not so for head and neck cancer patients. Tumor cells exhibit a considerably higher variation of radiation sensitivities than normal tissue cells. CONCLUSIONS: Experimental and clinical data are compatible with the hypothesis that normal tissue radiation sensitivity predicts for tumor tissue sensitivity. However, in view of the larger heterogeneity of tumor cell radiation sensitivity as compared to normal tissue radiation sensitivity, the development of a clinically useful predictive test for tumor sensitivity based on normal cell sensitivity appears to be unrealistic.     

Changes in radiation sensitivity and steroid receptor content induced by hormonal agents and ionizing radiation in breast cancer cells in vitro

Possible influences of tamoxifen and estradiol on in vitro radiation sensitivity and cellular receptor content after irradiation and/or tamoxifen treatment were studied in breast cancer cell lines; estrogen receptor (ER) and progesterone receptor (PgR) positive cell lines MCF-7 and MCF-7/TAM(R)-1 and the ER and PgR negative cell line MDA-MB-231. The tamoxifen resistant MCF-7/TAM(R)-1 cells were more resistant to ionizing radiation than the MCF-7 and MDA-MB-231 cells. Exposure to tamoxifen made the MCF-7 cells more radiation resistant, while estradiol made the MDA-MB-231 cells more radiation sensitive. A radiation dose of 6 Gy reduced the ER content in cytosol in both MCF-7 and MCF-7/TAM(R)-1 cells, but brought no alterations to the PgR content. In MCF-7/TAM(R)-1 cells tamoxifen exposure significantly increased the ER and reduced the PgR content, an effect not observed in the MCF-7 cells. To conclude, the present study indicates that irradiation and tamoxifen may modify the ER and PgR content in cytosol in breast cancer cells. Hormonal treatment may alter the radiation sensitivity, even in ER negative cells, suggesting that hormonal agents may act both via receptor and non-receptor binding mechanisms.     

Malignant APUDoma (carcinoid) of the anterior mediastinum. Simplified methods of demonstrating biogenic amines in endocrine neoplasms

Endocrine neoplasms of the thymus and mediastinum are uncommon. This report describes such a carcinoma and the difficulty in determining its true nature. A simple modification of the technique for formaldehyde-fume-induced fluorescence (FIF) demonstrated biogenic amines in the cells. Electron microscopy and histochemical findings confirmed the close relationship of these neoplasms with neural-crest cells capable of amine precursor uptake and decarboxylation (APUD). The FIF technique is also a more sensitive method of detecting these tumors, since it has less of the sampling problems of electron microscopy, and the fluorescent granules are more easily seen than those stained by the usual methods. The techniques are simple enough for screening all poorly differentiated carcinomas in this area to determine a more accurate incidence figure.     

Effects of ionizing radiation on proliferation and differentiation of osteoblast-like cells

Diagnostic radiation for immediate post-surgical assessment of osseointegrated dental implants has been discouraged, due to the possibility of detrimental effects of ionizing radiation on healing and remodeling of bone. To assess this possibility, we investigated the effects of ionizing radiation on proliferation and differentiation of osteoblasts using osteoblast-like cells isolated from the calvariae of newborn rats (ROB) and a clonal osteoblastic cell line (MC3T3-E1). The cells were exposed on day 3 to a single dose of x-rays at either 40, 100, 400, or 4000 mGy, respectively, from a linear accelerator radiotherapeutic machine (Linac) or a 40-mGy dose from a diagnostic chest x-ray machine. The effects of radiation on cell growth and alkaline-phosphatase-specific (ALP) activity were evaluated at three-day intervals after irradiation up to day 12 in ROB cells, and evaluated at day 12 in MC3T3-E1 cells. At the culture end-point, the effects on formation of bone-like nodules were also evaluated in both ROB and MC3T3-E1 cells. Exposure of 4000 mGy differentially affected the two cell types. It inhibited cell growth and alkaline phosphatase activity, and inhibited DNA content in MC3T3-E1 cells. This irradiation also strongly inhibited the formation of bone-like nodules in ROB cells. On the other hand, exposure of 40-, 100-, and 400-mGy (Linac) and 40-mGy (diagnostic quality) irradiation induced no significant changes in cell growth, alkaline phosphatase activity, and formation of bone-like nodules in ROB cells. These doses also induced no significant changes in DNA content and ALP activity in MC3T3-E1 cells. These results indicate that ionizing radiation at a single dose of up to 400 mGy induces no significant changes in cell growth and differentiation of osteoblast-like cells, at least in vitro. Higher radiation doses (4000 mGy) may exert different effects on cell proliferation and cell differentiation of osteoblasts, depending on the cell types affected. Thus, diagnostic radiation seems to have less effect on proliferation and differentiation of osteoblasts.     

Detection of cyanobacterial toxins (microcystins) in cell extracts by micellar electrokinetic chromatography

Recently, use of the suicide gene, cytosine deaminase (CD), has shown a selective antitumor activity of 5-fluorocytosine (5-FC) on human colorectal carcinoma cells grown in vitro and in vivo. We hypothesized that the radiosensitivity of human colorectal carcinoma cells transduced with a retroviral vector encoding the bacterial CD gene would be selectively enhanced by the nontoxic prodrug 5-FC. The radiobiological rationale of using suicide gene therapy is based on the fact that a toxic metabolite of 5-FC, 5-fluorouracil, is a well-known radiation enhancer for the treatment of gastrointestinal and other tumors. 5-FC was found to enhance selectively the radiation cytotoxicity of human colorectal carcinoma cells expressing the CD gene. Colorectal carcinoma cells transduced with the CD gene (WiDr-CD) were highly sensitive to radiation compared with parental cells (WiDr) when exposed to 20 microgram/ml 5-FC for 72 h prior to irradiation. The sensitization enhancement ratio was 2.38. This magnitude of radiation enhancement is comparable to that obtained with 5-fluorouracil. These results suggest that the addition of radiation would substantially improve the therapeutic potential of CD gene therapy for the treatment of locally advanced colorectal carcinomas.     

Effects of near-infrared radiation on the epidermal proliferation and cutaneous immune function in mice

While ultraviolet radiation alters various cutaneous cell functions, little is known about the photobiological effects of infrared radiation (IR) on the skin except its local thermal effect. This study demonstrated that single exposure of mouse skin to near IR (0.7-1.3 microns) reversibly suppressed the proliferating activity of the epidermis, the density of Langerhans cells, and the ability of skin to induce contact hypersensitivity reaction. During the exposure, the ear surface temperature was elevated from a mean of 27 to 31.2 degrees C. The results suggest that near IR can modulate the epidermal proliferation and part of the skin immune system, with a mild thermal effect.     

Comparison between the in vitro intrinsic radiation sensitivity of human soft tissue sarcoma and breast cancer cell lines

The purpose of this study is to evaluate the radiation sensitivity of human soft tissue sarcoma cell lines in vitro and to compare with that of human breast carcinoma and glioblastoma cell lines. The intrinsic radiation sensitivity parameters of seven human soft tissue sarcomas and eight breast carcinoma cell lines were investigated in vitro by clonogenic assays for single-dose irradiation under aerobic conditions on cells in exponential phase of growth. The results for sarcoma cell lines showed that the mean surviving fraction at 2 Gy (SF2) was 0.39 (SD +/- 0.09) with a range of 0.24 to 0.53, and the average mean inactivation dose (MID) was 1.92 (SD +/- 0.35) range from 1.36 Gy to 2.49 Gy. These values were not different from that of breast cell lines examined concurrently and using the same experimental methods (mean SF2 0.38, SD +/- 0.09; MID 1.9 Gy, SD +/- 0.37). However radiobiological parameters of nine karyotyped human malignant glioma cell lines determined earlier in this laboratory were significantly higher (mean SF2 0.50 +/- 0.14; mean MID 2.61 +/- 0.60). In conclusion, the data presented here do not support the view that cells of sarcomas show unusual radiation resistance. To the extent that the in vitro determined cellular radiation sensitivity reflects the tumor response in vivo, the success rate for radiation applied against sarcoma and breast carcinoma of comparable size could be similar.     

The Peperomia mitochondrial coxI group I intron: timing of horizontal transfer and subsequent evolution of the intron

PURPOSE: To review the results of recent studies on radiation-induced germline instability at mammalian minisatellite loci. RESULTS: Evidence has been obtained recently that germline mutation at minisatellites is remarkably sensitive to ionizing radiation, in both mice and humans. In mice, an elevated mutation rate was found after acute irradiation of pre-meiotic spermatogonia, with a doubling dose of 0.33 Gy, a value close to those obtained in mice after acute spermatogonia irradiation using other systems for mutation detection. In humans, analysis of germline mutation rate at minisatellites among children born in areas of the Mogilev district of Belarus, which was heavily polluted after the Chernobyl accident, has shown a twofold higher mutation rate in exposed families compared with non-irradiated families from the United Kingdom. Within the Belarus cohort, the mutation rate was significantly greater in families exposed to a higher parental radiation dose, consistent with radiation induction of germline mutation. The data in this study also demonstrate the indirect nature of radiation-induced germline mutation at mammalian minisatellite loci suggesting a strong similarity with the phenomenon of genomic instability in somatic cells. CONCLUSIONS: Minisatellite loci provide a powerful system for the efficient monitoring of germline mutation in humans and are capable of detecting induced mutations in relatively small population samples.     

A comparison of porosity, fabric and fractal dimension as predictors of the Young''s modulus of equine cancellous bone

Ependymomas are rare neuroectodermal tumors arising from ependymal cells of the ventricular system, choroid plexus, filum terminale, and central canal of the spinal cord (1,2). This review focuses on intracranial ependymomas with special emphasis on pathology, etiology, cytogenetic characteristics, and adjuvant radiation therapy. Recent advances in neurosurgical technique, radiation therapy, and molecular biology have affected management of these tumors and have the potential to increase long-term cure rates. The role of highly advanced radiation therapy techniques such as stereotactic radiosurgery will need to be better defined.     

Inhibitory effect of folinic acid on radiation-induced micronuclei and chromosomal aberrations in V79 cells

Folinic acid (FA), clinically called leucovorin, has been widely used as a nutrient supplement in dietary intake and is capable of inhibiting cytotoxicity and chromosomal damage induced by chemicals. However, data on its antigenotoxic effect on radiation-induced chromosomal damage are limited. The present study was, therefore, performed to investigate the effect of FA on radiation-induced (X-rays and UV radiation) micronuclei (MN) and structural chromosomal aberrations (SCA) concurrently in V79 Chinese hamster lung cells. Exponentially growing cells were exposed to five doses of X-rays (1-12 Gy) and UV radiation (50-800 microJ x 10(2)/cm2) and post-treated with 5 or 50 micrograms FA/ml of culture medium for 16 h. The slides were analyzed for the presence of MN and SCA using standard procedures. The results showed that X-ray treatment alone produced dose-related cytotoxicity as measured by nuclear division index (NDI) and mitotic index (MI). X-rays produced a clear dose-related clastogenicity as measured by percent of micronucleated binucleated cells (MNBN) (5-79%) and percent of aberrant cells (11-92%). FA at 5 micrograms/ml slightly decreased X-ray induced chromosomal damage in both assays; however, the inhibition was significant (12-46% of MNBN, 14-48% in aberrant cells) only when X-ray-treated cultures were post-treated with 50 micrograms FA/ml. Post-treatment of FA had no effect on X-ray induced cytotoxicity as measured by NDI and MI. A similar a dose-related increase in % MNBN (0.5-10.3%) and percent aberrant cells (6-35%) was produced by UV radiation treatment alone. There were significant percentages of MNBN and aberrant cell inhibitions at both 5 and 50 micrograms/ml in both assays. As in the case of X-ray-treated cells, there was a clear dose-related cytotoxicity in UV-treated cells alone. No reduction in NDI or MI was found when UV-exposed cells were post-treated with 5 or 50 micrograms of FA. These data demonstrate the beneficial effect of FA in decreasing radiation-induced chromosomal damage.     

Effects of ionizing radiation on cartilage: emphasis on effects on the extracellular matrix

In this report, we review data dealing with radiation effects on cartilage. More specifically, we emphasize on alterations caused in the extra-cellular cartilage matrix. Although radiation studies predominantly describe the effect on the structure of DNA and on the mitotic activity of cells, alterations caused by the effect on the non-mitotic activity can also be important. Cartilage, having an extracellular matrix composed of 2 major components, aggrecan and collagen, provides a good model to study this kind of radiation effects. The following topics concerning literature data are summarized: effects on the amount of matrix synthesized, effects on the activity of certain enzymes and effects on the structure and morphology of the matrix. Some new findings concerning the radiation effect on the size distribution of aggrecan-aggregate populations, de novo synthesized by chondrocyte cultures, either derived from calcifying or from non-calcifying cartilage, are given.     

Effect of in vivo exposure to iodine-131 on the frequency and persistence of micronuclei in human lymphocytes

The validity of the micronucleus test as a biomarker of chromosome damage in dividing mammalian cells is well established. This assay was used to study the response of peripheral lymphocytes of a 34-yr-old male patient following treatment with 131I ablative radiation therapy following a total thyroidectomy. Coincidentally, 8 mo before diagnosis, the patient had provided a blood sample for an in vitro study of micronucleus induction following exposure to graded doses of x-rays. The background frequency in the unexposed culture showed a mean count of 6.0 micronuclei per 1000 binucleated (first division) lymphocytes, while mean values of 18.5, 29.0, 41.0, 61.0 and 75.5 micronuclei/1000 cells were observed following x-ray doses of 5, 10, 15, 20, and 25 cGy, respectively. These data fit a nonthreshold, linear dose-response function (y = 2.78x + 3.71; r = .99). Eight months after the in vitro x-ray study, the subject was diagnosed with thyroid cancer. Surgery was performed, and 5 wk later the patient received 1.78 GBq (48 mCi) of 131I as adjuvant radiation therapy. Blood was drawn 11 d after the radiation treatment and at monthly intervals thereafter to analyze the frequency and persistence of micronuclei. The first posttreatment sample showed 35.5 micronuclei per 1000 binucleate cells. Based on the linear dose-response equation from the earlier study, the sixfold increase in micronucleus frequency suggests a dose to the peripheral blood of approximately 11 cGy. The cytogenetic dose estimate compares to approximately 30 cGy using a new model based on external whole-body counting data. Nine consecutive monthly samples have been analyzed to date. Although the micronucleus count has fluctuated (four- to sixfold above background), the frequency after 8 mo is equivalent to the first posttreatment sample. Data show that radiation-induced cellular lesions persist for months following relatively brief radiation exposure to a medical isotope. Results of this study support the conclusion that the lymphocyte micronucleus test is a rapid, sensitive, and perhaps quantitative biomarker of low-dose (< 25 cGy) radiation exposure.     

Nitric oxide and peroxynitrite released by ultraviolet B-irradiated human endothelial cells are possibly involved in skin erythema and inflammation

In this study we attempted to demonstrate whether endothelial cell nitric oxide synthase (eNOS) and xanthine oxidase (XO) could be activated to release nitric oxide (NO) and peroxynitrite (ONOO-) following exposure to ultraviolet B (UVB) radiation and to define whether this light-induced response could be involved in the pathogenesis of sunburn erythema and inflammation. Treatment of human endothelial cells with UVB (290-320 nm) radiation (up to 100 mJ/cm2) resulted in an increase of both NO and ONOO- release that was inhibited by NG-monomethyl-L-arginine (L-NMMA). Treatment of cell cytosol with various doses of UVB radiation (up to 20 mJ/cm2) resulted in a threefold increase of XO activity that was inhibited (approximately 90% by oxypurinol. In reconstitution experiments, when purified eNOS was added to purified XO, an almost fourfold increase in ONOO- production at 20 mj/cm2 UVB radiation was observed. UVB radiation (100 mg/cm2) decreased cell membrane fluidity, indicating changes in the physicochemical characteristics of the membranes. In in vivo experiments, when human volunteers were subjected to UVB light, a protection factor (PF) of 3.90 +/- 0.85 was calculated when an emulsified cream formulation containing nitro-L-arginine (L-NA; 2%) and L-NMMA (2%) was applied to their skin. The present studies indicate that UVB radiation acts as a potent stimulator of eNOS and XO in human endothelial cells. The cytotoxic effects of NO and ONOO- may be the main factors in the integrated response of the skin leading to vasodilatation, the first key event of erythema production and the inflammation process.     

Cell cycle regulation in irradiated and nonirradiated cells

Exposure of cells to ionizing radiation induces damage in the DNA. The adverse consequences of such exposures depend on the amount of the DNA damage induced as determined by the absorbed dose, as well as by its form as determined by the linear energy transfer. In addition to physical determinants, biological factors critically affect radiation response. Cells have the ability to sense DNA damage, and to activate repair pathways that efficiently remove such damage and restore the integrity of the DNA. Highly sophisticated mechanisms further enable cells to actively stall growth and division after sensing DNA damage. Such inhibitory processes, termed checkpoints, may optimize repair and minimize the adverse consequences of DNA damage. We review the fundamental principles underlying checkpoints as they have emerged from active research in the last few years and discuss briefly their relevance to the practice of medical and radiation oncology.     

In situ hybridization studies of matrix metalloproteinase-3, tissue inhibitor of metalloproteinase-1 and type IV collagen in diabetic nephropathy

The effects of UV radiation on humans and animals are receiving increasing attention and much interest has recently been focused on the environmental effects of UV A and UV B. This study compares the in vitro effects of UV A and UV B on the clonogenic survival of two human skin keratinocyte cell lines, HaCaT which are immortal but not tumorigenic and HPV-G transfected keratinocytes which form non malignant tumours in nude mice. The effects were also studied on an EPC fish cell line. The aim of the work was to establish if similar initial and delayed survival responses occurred in both species. The cells were exposed to ultraviolet lamps emitting maximally at 365 nm (UV A) and 302 nm (UV B). Clonogenic survival was determined at appropriate times post exposure. Results for the initial survival curves show that the HaCaT and HPV-G cells did not show any appreciable difference in their response to UV A but the EPC cells were more sensitive at doses < 3000 Jm-2. The EPC cells were more sensitive to UV B at doses < 200 Jm-2 in comparison to the human HaCaT and HPV-G cells with the HPV-G cells showing the most sensitivity to UV B at doses > 200 Jm-2. The possible contribution of lethal mutations (delayed cell death) to the UV radiation response in the HaCaT and EPC cell lines was examined. The results showed that lethal mutations were expressed in the HaCaT cells following exposure to UV A and UV B but no lethal mutations were expressed in the EPC cells.     

The methodological aspects of experimental modelling and of assessing the hereditary sequelae of the irradiation of one and both parents

The paper summarises some methodological approaches which may be used in experimental modelling and study of hereditary radiation effects in mammals. These approaches are aimed to the elucidation of the possible specific character (aggravation) of radiation damage in the offspring determined by the participation of two exposed parents in conception. The main attention is drawn to the dependence of hereditary radiation effects yield on the stages of the cell cycle of the parent germ cells at the moment of exposure and to criteria of evaluation of radiation damage in the offspring during the ontogenetic development.