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BACKGROUND Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is a growth factor commonly used to avoid leukopenia after chemotherapy. Endogenous G-CSF is produced by macrophages and granulocytes that infiltrate tumors. It has been reported that rhG-CSF stimulates the proliferation of several cell lines as well as bladder carcinoma cells. Conversely, in some hematopoietic cell lines such as U-937, WEHI-3B, and K-562 no effect or in some cases a differentiation pattern was found. Moreover, the role of rhG-CSF on the proliferation of solid tumors is not well understood. METHODS In this study, 10 ovarian carcinoma biopsies were characterized for the presence of G-CSF and G-CSF receptor by reverse transcription–polymerase chain reaction (RT-PCR) and immunohistochemical analysis. Proliferation was analyzed by ATP viability assays. RESULTS Performing RT-PCR, these biopsies and four ovarian carcinoma cell lines were analyzed for endogenous G-CSF production, which was found in some biopsies and in all cell lines. Despite the presence of the G-CSF receptor in all biopsies and cell lines, no proliferation was found after rhG-CSF incubation of the cell lines or the tumor samples for 3 and for 6 days, respectively. CONCLUSIONS Summarizing the authors' in vitro studies, rhG-CSF does not affect the proliferation of ovarian carcinoma cells in vitro. Cancer 2001;91:1372–83. © 2001 American Cancer Society.

Diagnostische und therapeutische Neuerungen sind beim Mammakarzinom deshalb nötig, da in den letzten Jahren immer kleinere Befunde einer Abklärung zugeführt werden. Es wird geschätzt, dass in Zukunft ein Viertel aller Patientinnen eine präinvasive Läsion (DCIS) und die Hälfte einen Tumor haben werden, der nicht grösser als 2 cm ist. Der vermehrte Einsatz von bildgebenden Verfahren, insbesondere der Mammographie, führt dazu, dass vermehrt präinvasive und kleine Mammatumoren entdeckt werden. Moderne, computergestützte stereotaktische Mammaexzisionsbiopsien, die auch ambulant durchführbar sind, sind deshalb dringend nötig. Zur Morbiditätssenkung der axillären Chirurgie beim Mammakarzinom werden aktuell neue Verfahren überprüft. Die Detektion des sogenannten «Sentinel lymph node» nach dem Selektionsprinzip ist deshalb morbiditätssenkend, weil bei negativem Befund nur der Pförtnerlymphknoten entfernt werden muss. Die endoskopische axilläre Lymphadenektomie nach Liposuktion stellt ebenfalls eine neue Methode der axillären Chirurgie dar, bei welcher die bessere Visualisierung der anatomischen Strukturen zur Morbiditätssenkung dank gewebeschonender Chirurgie beitragen kann. Ausserdem wird erstmals die Kombination dieser zwei neuen Methoden beschrieben und dokumentiert: die axilloskopische Bestimmung und Entfernung des Sentinel-Lymphknotens u.a. nach Isosulfanblau-Gabe. Diese kombinierte Methode ist allerdings technisch und zeitlich sehr aufwendig und weist keine offensichtlichen Vorteile gegenüber der offenen Sentineltechnik auf, weshalb sie zwar als machbar, aber für die tägliche Praxis als ungeeignet beurteilt werden muss. Die Zukunft gehört der offenen Sentineltechnik.

Photodynamic therapy (PDT) uses laser light to activate a photosensitizer that has been absorbed preferentially by cancer cells after systemic administration. A phototoxic reaction ensues resulting in cell death and tissue necrosis. Some cells, however, may survive PDT. This study was performed to determine if surviving human breast cancer cells (MCF-7) can become resistant to PDT, chemotherapy or radiotherapy. The MCF-7 cells were cultured under standard conditions prior to being exposed to the photosensitizer, 5,10,15,20-meta-tetra(hydroxyphenyl)chlorin (m-THPC), for 24 h and then irradiated with laser light (652 nm). Surviving cells were allowed to regrow by allowing a 2 week interval between each additional PDT. After the third and final treatment, colony formation assays were used to evaluate the sensitivity of cultured cells to ionizing radiation and PDT and the ATP cell viability assay tested in vitro chemosensitivity. Flow cytometry was used to analyze the cell cycle. No alterations in the cell cycle were observed after three cycles of PDT with m-THPC. Similar responses to chemotherapy and ionizing radiation were seen in control and treatment groups. The m-THPC-sensitized PDT did not induce resistance to subsequent cycles of PDT, chemo- or radiotherapy. Photodynamic therapy with m-THPC may represent a novel adjunctive treatment of breast cancer that may be combined with surgery, chemotherapy or ionizing radiation.

Study Objective . To determine the effect of different positional degrees on hemodynamics, especially central venous pressure and intraocular pressure, and a possible interrelationship, during laparoscopic surgery. Setting . University teaching hospital (Canadian Task Force classification II-1). Patients . Seven women undergoing elective gynecologic laparoscopy. Interventions . The women were monitored for heart rate, partial pressure of oxygen, end-tidal carbon dioxide, arterial blood pressure, central venous pressure, end-tidal isoflurane concentration, and intraocular pressure in several body positions during general anesthesia. Measurements and Main Results . Intraocular pressure depends on body position (r 2 =0.58) related to central venous pressure (r 2 =0.7). Heart rate and arterial blood pressure are also dependent on the body position, but to a lesser degree. Conclusion . Continuous monitoring of intraocular pressure may help detect alterations in central venous pressure during general anesthesia for laparoscopic surgery. Undesirable alterations caused by degree of Trendelenburg position may negatively affect patients with high cardiac or ophthalmic risk.

There are different stereotactic systems with different tables for breast biopsy available around the world. In three of the six described methods or tables, the patients are in the prone position, whereas the other techniques use the upright system. The Giotto system: the Mammobed in combination with a digital mammography unit The MultiCare Platinum system: the Lorad table from Hologic The Fischer table Breast biopsy with upright stereotactic image guidance by Siemens The GE system: Diamond with Delta 32 The StereoLoc II system from Hologic

Telomerase activity (TA) has been shown to correlate with poor clinical outcome in various tumour entities, indicating that tumours expressing this enzyme may be more aggressive and that TA may be a useful prognostic marker. For breast cancer, however, TA is a controversial prognostic marker; whereas some studies suggest an association between TA and disease outcome, others do not find this association. This study used tissue microarrays (breast carcinoma prognosis arrays) containing 611 samples (each 0.6 mm in diameter) from the tumour centre of paraffin-embedded breast carcinomas to analyse the catalytic subunit of telomerase, human telomerase reverse-transcriptase (hTERT), and the internal RNA component (hTR), which are the core components of the telomerase holoenzyme complex. hTERT protein expression was obtained by immunohistochemistry (human anti-telomerase antibody Ab-2, Calbiochem), and hTR RNA was measured by radioactive in situ hybridization. hTERT and hTR expression were determined semi-quantitatively and graded (scores 1-4). Clinical data, such as histological subtype, pT stage, tumour diameter, pN stage, BRE grade, tumour-specific survival (in months), patient's age and others, were available for statistical analysis. A statistically significant correlation was found between tumour-specific survival (overall survival) and hTERT expression (p0.0001) or hTR expression (p = 0.00110). Tumours with higher scores (scores 3, 4) for hTR and/or hTERT were associated with a worse prognosis. In multivariate analysis, hTERT expression was an independent prognostic factor. Previous studies, focusing on analysis of TA in smaller numbers of fresh-frozen breast carcinomas by the TRAP assay, gave controversial results with respect to TA as a prognostic marker. Using tissue microarrays from 611 breast carcinomas, this study has demonstrated that increased expression levels of the telomerase core components, hTERT and hTR, are associated with lower overall survival. These findings suggest that TA should be included in future validation studies as a prognostic marker in breast cancer.