Electrically detected displacement assay (EDDA): a practical approach to nucleic acid testing in clinical or medical diagnosis.

This paper introduces the electrically detected displacement assay (EDDA), a electrical biosensor detection principle for applications in medical and clinical diagnosis, and compares the method to currently available microarray technologies in this field. The sensor can be integrated into automated systems of routine diagnosis, but may also be used as a sensor that is directly applied to the polymerase chain reaction (PCR) reaction vessel to detect unlabeled target amplicons within a few minutes. Major aspects of sensor assembly like immobilization procedure, accessibility of the capture probes, and prevention from nonspecific target adsorption, that are a prerequisite for a robust and reliable performance of the sensor, are demonstrated. Additionally, exemplary results from a human papillomavirus assay are presented.

DNA-arrays with electrical detection: a label-free low cost technology for routine use in life sciences and diagnostics.

Fast and highly parallel DNA analysis are essential for improved biomedical research and development. Currently fluorescence-based methods are state of the art in DNA microarray analysis. The necessity to modify the target DNA with labels is costly, laborious and requires skilled personnel. Moreover, false positive calls from unspecific adsorption are possible and it is difficult to discriminate perfect matching target sequences from those with a single mismatch. In this paper a new and simple electrochemical approach for hybridisation detection without the need of labelling the target DNA is described. The EDDA (Electrically Detected Displacement Assay) method uses a solution of short redox-labelled signalling oligonucleotides (oligonucleotides carrying a covalently attached redox active compound like ferrocene) to characterize the hybridisation state of label-free capture probe DNA immobilised on gold electrodes. The number of capture probes associated with signalling oligonucleotides is determined by chronocoulometry. This technique allows to separate the electrochemical response of capture probe associated signal probes from the response of freely diffusing signalling probes. In the absence of the complementary target sequences the redox-labelled signalling probes at the surface give rise to an instantaneous increase of the detection signal, while freely diffusing signalling probes show a significantly delayed response. Hybridisation with targets complementary to the capture probe displace the loosely associated signalling probes thereby decreasing the instantaneous signal. Besides an introduction to the EDDA technology, data validating the method for biological material will be presented and an outlook to the detection of single nucleotide polymorphisms (SNPs) is given.

Determination of Q(A)-content in bacterial reaction centers: an indispensable requirement for quantifying B-branch charge separation

We have been able to determine the occupancy of the quinone site at the A-branch (Q(A)) of a reaction center preparation with an accuracy of 2%. This is achieved by accumulating the P(+)Q(-)(A) state after multiple actinic excitation and monitoring the extent of the 30 ms ground state bleaching. This bleaching is corrected for deviations from complete saturation due to competing charge separation to the B-branch. On the other hand, knowledge of the Q(A) content is indispensable for determining the yield of B-branch charge separation from nanosecond transients associated with the recombination of P(+)H(-)(B), which have to be corrected for the nanosecond signal originating from P(+)H(-)(A) of RCs having lost Q(A).

Maintenance treatment with medroxyprogesterone acetate in patients with advanced breast cancer responding to chemotherapy: results of a randomized trial. Essen Breast Cancer Study Group.

The purpose of this randomized phase III trial was to study whether medroxyprogesterone acetate (MPA) maintenance treatment prolongs the time to progression in advanced breast cancer patients responding to an induction chemotherapy. Patients with progressive advanced breast cancer previously untreated with anthracylines and progestins were given epirubicin (30 mg/m2) and ifosfamide (2 g/m2) on days 1 and 8 at 3-weekly intervals. Patients without disease progression after 6 cycles of chemotherapy were randomly assigned to receive, until progression, either no treatment or MPA at a daily total dose of 500 mg. Ninety patients were randomized: 46 to the MPA arm and 44 to the observation arm. Median time to progression was longer in the MPA arm: 4.9 months versus 3.7 months in the intent-to-treat analysis (p = 0.02), and 4.9 months versus 3.0 months in the secondary efficacy analysis (p = 0.012). Seven patients were removed from MPA due to side effects. The changes in patient-rated quality of life scores were similar in both groups. The median length of survival from randomization was 17.4 months for patients receiving MPA and 18.3 months for patients randomized to observation (p = 0.39). In conclusion, in patients with advanced breast cancer achieving remission or non-progression with 6 cycles of epirubicin and ifosfamide chemotherapy, MPA maintenance treatment led to a significant, though modest, prolongation of the time to progression without affecting overall survival of the study patients.

Triplet energy transfer in bacterial photosynthetic reaction centres.

[3-vinyl]-132-OH-bacteriochlorophyll a has been selectively exchanged against native bacteriochlorophyll a in the monomer binding sites at the A- and B-branch of the photosynthetic reaction centre from Rhodobacter sphaeroides. Transient absorption difference measurements were performed on these samples over a temperature range from 4.2 to 300 K with 20 ns time resolution. Specifically the decay of the primary donor triplet state, 3P870, as well as the rise and decay rates of the carotenoid triplet state, 3Car (spheroidene), were measured. The observed rates revealed a thermally activated carotenoid triplet formation corresponding to the decay of the primary donor triplet state. The activation energies for the triplet energy transfer process were 100(+/-10) cm-1 for reaction centers from wild-type Rhodobacter sphaeroides 2.4.1, with and without exchange of the monomeric bacteriochlorophyll on the electron transfer-active branch, BA. For reaction centers from Rhodobacter sphaeroides R26.1 with both monomers exchanged against [3-vinyl]-132-OH-bacteriochlorophyll a, and subsequent spheroidene reconstitution the activation energy was 460(+/-20) cm-1. These activation energies correspond to the energy difference between the triplet states of the accessory BChl monomer, BB, and the primary donor when native BChl a or [3-vinyl]-132-OH-BChl a is present in the BB binding site. In all samples the 3Car formation rates were bi-phasic over a large temperature range. A fast temperature-independent rate was observed on the wavelength of the carotenoid triplet-triplet absorption which dominated at very low temperatures. Additionally, a slower temperature-independent 3Car formation rate was observed at low temperatures which could be explained with the assumption of heterogeneity in the energy barrier (3BB) and/or the primary donor triplet state (3P870). A tunneling mechanism as proposed earlier by Kolaczkowski (PhD thesis, Brown University, 1989) is not only unnecessary but also incompatible with the available experimental data.

Triplet state energy transfer between the primary donor and the carotenoid in Rhodobacter sphaeroides R-26.1 reaction centers exchanged with modified bacteriochlorophyll pigments and reconstituted with spheroidene.

The dynamics of triplet energy transfer between the primary donor and the carotenoid were measured on several photosynthetic bacterial reaction center preparations from Rhodobacter sphaeroides: (a) wild-type strain 2.4.1, (b) strain R-26.1, (c) strain R-26.1 exchanged with 13(2)-hydroxy-[Zn]-bacteriochlorophyll at the accessory bacteriochlorophyll (BChl) sites and reconstituted with spheroidene and (d) strain R-26.1 exchanged with [3-vinyl]-13(2)-hydroxy-bacteriochlorophyll at the accessory BChl sites and reconstituted with spheroidene. The rise and decay times of the primary donor and carotenoid triplet-triplet absorption signals were monitored in the visible wavelength region between 538 and 555 nm as a function of temperature from 4 to 300 K. For the samples containing carotenoids, all of the decay times correspond well to the previously observed times for spheroidene (5 +/- 2 microseconds). The rise times of the carotenoid triplets were found in all cases to be biexponential and comprised of a strongly temperature-dependent component and a temperature-independent component. From a comparison of the behavior of the carotenoid-containing samples with that from the reaction center of the carotenoidless mutant Rb. sphaeroides R-26.1, the temperature-independent component has been assigned to the buildup of the primary donor triplet state resulting from charge recombination in the reaction center. Arrhenius plots of the buildup of the carotenoid triplet states were used to determine the activation energies for triplet energy transfer from the primary donor to the carotenoid. A model for the process of triplet energy transfer that is consistent with the data suggests that the activation barrier is strongly dependent on the triplet state energy of the accessory BChl pigment, BChlB.

Epirubicin and ifosfamide in metastatic breast cancer.

In a randomized, phase II trial, we evaluated the effectiveness of continued chemotherapy with epirubicin/ ifosfamide versus unmaintained treatment interruption in advanced metastatic breast cancer. Three hundred fifty-seven patients were enrolled and 331 were evaluable for response. Complete response was achieved in 25 patients (8%) and partial response in 121 patients (37%). Pretreatment status correlated significantly with response (complete and partial response). While 54% of unpretreated patients responded, only 42% of the patients responded who had been pretreated with adjuvant chemotherapy and 33% who had been pretreated in the metastatic stage of disease; 69 patients (21%) had disease progression. Of 11 patients pretreated in both the adjuvant and metastatic setting, only two responded. Toxicity of treatment was mild, with leukopenia being the treatment-limiting factor. Thrombocyte levels were not altered significantly by treatment. Thus, there seems to be room for dose escalation using granulocyte colony-stimulating factor. There was no considerable cardiotoxicity, central nervous system toxicity, or cystitis observed. The low rate of cardiotoxicity appeared to be related to dose fractionation of epirubicin. After randomization of patients to treatment interruption versus continuation of chemotherapy, a longer relapse-free survival was observed for patients who continued chemotherapy (mean relapse-free survival, 2+ months); however, this did not translate into prolonged survival. The cumulative scores of toxicity and quality of life parameters showed increasing superiority for treatment interruption. Therefore, a strategy of treatment until maximum response and subsequent treatment interruption seems to be superior to treatment continuation.

Carotenoid triplet state formation in Rhodobacter sphaeroides R-26 reaction centers exchanged with modified bacteriochlorophyll pigments and reconstituted with spheroidene.

Triplet state electron paramagnetic resonance (EPR) experiments have been carried out at X-band on Rb. sphaeroides R-26 reaction centers that have been reconstituted with the carotenoid, spheroidene, and exchanged with 13(2)-OH-Zn-bacteriochlorophyll a and [3-vinyl]-13(2)-OH-bacteriochlorophyll a at the monomeric, 'accessory' bacteriochlorophyll sites BA,B or with pheophytin a at the bacteriopheophytin sites HA,B. The primary donor and carotenoid triplet state EPR signals in the temperature range 95-150 K are compared and contrasted with those from native Rb. sphaeroides wild type and Rb. sphaeroides R-26 reaction centers reconstituted with spheroidene. The temperature dependencies of the EPR signals are strikingly different for the various samples. The data prove that triplet energy transfer from the primary donor to the carotenoid is mediated by the monomeric, BChlB molecule. Furthermore, the data show that triplet energy transfer from the primary donor to the carotenoid is an activated process, the efficiency of which correlates with the estimated triplet state energies of the modified pigments.

[Type identity of the swine parasites Globocephalus longemucronatus and G. urosubulatus (Nematoda, Strongyloidea)]. / Zur Artidentität der Schweineparasiten Globocephalus longemucronatus und G. urosubulatus (Nematoda, Strongyloidea).

On the basis of a critical analysis of the literature and of our own investigations, it is pointed out that the two hookworm species known from European swine, namely Globocephalus longemucronatus Molin, 1861 and G. urosobulatus (Alessandrini, 1909), are identical. All the differences hitherto used to distinguish these species are shown to be due to incorrect descriptions of the taxonomic characters or to misinterpretations of statements made by former authors. Accordingly, only one species of Globocephalus occurs in Europe, which has to be named G. longemucronatus Molin, 1861, with Crassisoma urosubulatum Alessandrini, 1909 as its junior synonym. A short diagnosis of this species is given.

[Agranulocytosis and metamizole]. / Agranulozytose und Metamizol.

Among 78 000 patients hospitalized over a period of 11 years there were 12 with agranulocytosis drug- or allergy-induced. It is often difficult to be certain of the aetiology, because drug combinations or several drugs simultaneously are often prescribed. A definite relationship could not be proven, although it seemed possible, between six cases of agranulocytosis and the intake of metamizole. Taking into account two deaths and four relatively mild cases assumed to be the result of metamizole treatment, this incidence is similar to that reported in the literature. Alternative drugs have not been proven to cause fewer side-effects. These results suggest that there is no reason at present to stop the use of metamizole.

[Hodgkin's disease--change of the therapy concept?]. / Morbus Hodgkin--Wandlung des Therapiekonzepts?

The sometimes too schematically handled therapeutic proceeding in Hodgkin's disease today has been replaced by a more individual strategy. Due to stage-oriented therapeutic regimes today 80-90% of all Hodgkin's disease patients may reach survival periods of 5 years. Therefore the possibility of a definite cure has been achieved. Even in the advanced stages III and IV of the disease, half of the patients is supposed to reach a 5-year survival time. However, one has to observe with great attention in the future, how the gained duration of life as a consequence of combined chemo- and radiotherapy may be abolished by side-effects and risks due to the aggressive therapy.

Comparison of ftorafur with 5-fluorouracil in combination chemotherapy of advanced gastrointestinal carcinoma.

The aim of the study was to compare the combination 5-FU-carmustine with ftorafur-carmustine in the treatment of advanced gastrointestinal cancer. To this end, a prospective, multicenter, randomized trial was initiated. Part I of this trial showed that similar response rates can be obtained with 5-FU-carmustine and ftorafur-carmustine in 109 patients (32.7% versus 26.3%). However, median survival was better in patients treated with 5-FU-carmustine (307 days versus 163 days). Part II of the trial revealed that neither a higher dosage of ftorafur (2 g/m2/day X 5 days) nor the addition of vincristine to both regimens changed the previously obtained results significantly. Again, median survival was found to be better in patients treated with 5-FU combination chemotherapy (304 days versus 144 days). Both the 5-FU and the ftorafur combination were tolerated reasonably well. The results suggest that combination chemotherapy including 5-FU is superior to ftorafur at the applied dosages in terms of survival.

[Cytostatic treatment of hypernephroid renal carcinoma (author's transl)]. / Zytostatische Therapie des hypernephroiden Nierenkarzinoms.

Thirty patients with metastasing hypernephroid renal carcinoma were treated with sequential cytostatic combinations of vincristine and ifosfamide (Holoxan¿). Two complete and two partial remissions and arrest of tumour growth in two cases were achieved. These results justify use of at least time-limited chemotherapy so as not to miss a chance of long-term remission in tumour patients.

[Ceruletid (caerulein) treatment in cytostatic atonic gut and paralytic ileus (author's transl)]. / Ceruletid-Behandlung bei zytostatika-bedingter Darmatonie und paralytischem Ileus.

Three patients had as a side effect of cytostatic treatment severe intestinal atonia which in two cases led to paralytic ileus. With ceruletid (Takus) rapid normalisation of intestinal peristalsis was achieved in all three patients.