Vasodilator correction of hypotension in the postoperative period

This case is unusual in that hypotension, as opposed to hypertension, was a consequence of increased sympathetic tone in the postoperative period, but it illustrates the well known fact that patients in compensated congestive heart failure do poorly when faced with an elevated myocardial oxygen need from either increased rate or afterload. Vasodilator therapy was effective in immediately reducing afterload and systolic regurgitant fraction, thereby increasing oxygen supply and lowering myocardial oxygen consumption.

Hemodynamic and plasma catecholamine responses to hyperthermic cancer therapy in humans

Cancer patients, treated with hyperthermia (to 41.5 degrees C) under thiopental and fentanyl anesthesia, had smaller increases in heart rate and cardiac index and lesser decreases in mean arterial pressure than those reported in normal volunteers. At basal body temperature anesthesia did not alter catecholamine levels. Increasing body temperature to 39.5 degrees C and 41.5 degrees C resulted in parallel increases in heart rate and cardiac index that were directly related to the increases in plasma norepinephrine levels. At basal temperature cutaneous venous plasma norepinephrine levels exceeded those of arterial; mixed-venous plasma levels were intermediate. At 39.5 degrees C and 41.5 degrees C there were sequential increases in plasma norepinephrine. The increases in mixed-venous and arterial norepinephrine were significantly greater than in cutaneous venous blood. The differential increases in norepinephrine levels in cutaneous venous, mixed-venous, and arterial blood indicate that during hyperthermia sympathetic nerve activity in skin is decreased while that in other areas is increased, suggesting that alterations in sympathetic activity modulate the hemodynamic changes that attend hyperthermia in man.

Systemic thermotherapy (whole body hyperthermia)

This is an article reviewing the literature and our experience to date (six months) in the treatment of cancer using whole body hyperthermia in the first 60 patients. WBHT is an effective method of treating cancer. Patients were treated for a total of eight hours, 180 degrees F for two hours. WBHT was induced by means of two high-flow water filled blankets. Toxicity included fatigue, nausea, diarrhea and first degree burns. There was no evidence of visceral damage. There were no mortalities during the procedure. Objective responses were 50%, subjective responses were 65%. The literature demonstrates and our study confirms that under closely monitored conditions, WBHT is a feasible, safe and active anti-cancer therapy. WBHT may be safely used as an adjunct to other active cancer therapies including X-ray therapy and chemotherapy.

Extraction of human plasma or sera by heat treatment for a solid-phase radioimmunoassay of carcinoembryonic antigen

Heat treatment and a solid-phase radioimmunoassay are combined to give a relatively simple and rapid procedure for assay of carcinoembryonic antigen in plasma or serum. The new way we describe to extract this antigen is an alternative to the conventional method of extraction with perchloric acid. Heating plasma or serum samples in acetate buffer (0.16 mol/L, pH 5.0) at 70 degrees C for 15 min precipitates out most of the heat-labile, nonspecific plasma proteins, but leaves most of the antigen in solution, with its immunochemical properties apparently unaffected. Comparison between the heat treatment and the perchloric acid extraction yielded comparable values when tested either by solid-phase radioimmunoassay or by the zirconyl phosphate precipitation method. An added advantage of our method is that it gives the same assay values for both plasma and serum. Results for a group of pathological plasma samples, assayed by both our method and the perchloric acid-zirconyl phosphate precipitation method, gave a correlation coefficient of 0.90.

Hyperthermia potentiates doxorubicin-related cardiotoxic effects

The intercurrent administration of doxorubicin hydrochloride to a patient undergoing whole-body hyperthermia for the treatment of metastatic cancer repeatedly produced ventricular irritability and cardiac dysfunction. Individually, doxorubicin and hyperthermia were tolerated by the patient without incident. Catecholamine determinations showed that the administration of doxorubicin under hyperthermic conditions increased the liberation of both epinephrine and norepinephrine. The acute synergistic cardiotoxic effects occurred with doxorubicin dosages that were severalfold less than those associated with only mild and transient ECG disturbances under normothermic conditions.

Nature of human serum blood group T antibodies

Antibodies against blood group substance T in normal human sera consist of two types, depending upon whether or not the molecules remain immunochemically active at 37 degrees C. The two agglutinins were isolated by means of T antigen-coupled Sepharose 48 affinity chromatography. Temperature-sensitive agglutinin was eluted from the affinity column at 37 degrees C, while temperature-independent agglutinin remained bound to the antigen. Subsequently, the latter was dissociated from the column in the presence of 2.5 M MgCl2. Examination of six normal sera revealed that the levels of temperature-independent agglutinin was about twice that of temperature-sensitive agglutinin. More than 90% of anti-T agglutinins in normal sera were of the IgM class, in 8 of 11 samples studied. No direct relationship appeared to exist between anti-T titers and blood type. Thermal effects on hemagglutination, at least for anti-T agglutinin interacting with T antigen bearing red cells, is primarily due to the molecular characteristics of the agglutinin and not to the conformational change of the red cell membranes.

A simplified solid-phase radioimmunoassay for carcinoembryonic antigen

A simple and rapid solid-phase radioimmunoassay for the measurement of carcinoembryonic antigen (CEA) levels in sera or plasma is described. The procedure involves perchloric acid (PCA) extraction of the samples, followed by a rapid neutralization of excess acid with alkaline buffer solution. The PCA extracts are assayed uing antibody-coated plastic tubes and radio-labeled anti-CEA antibody as a marker. The assay may be completed in one day. The solid-phase direct-binding assay demonstrated a sensitivity of 0.5 ng CEA/ml plasmin and a marked tolerance to variations in pH and ionic strength of the system. A fair correlation between the CEA levels determined by the solid-phase radioimmunoassay and zirconium phosphate gel method was observed.

Carcinoembryonic antigen-like substances in human cavity fluids

Pleural and peritoneal fluids from humans with pathological diseases were examined for the presence of carcinoembryonic antigen-like substances (CEA-LS). Among eight samples tested by a solid phase radioimmunoassay, two pleural fluids and one peritoneal fluid showed significantly elevated CEA-activity. The substances responsible for the CEA-activity were isolated by perchloric acid-extraction followed by two successive Sephadex G-200 chromatography into two pools, Pool I (PI) and Pool II (PII). According to their sedimentation properties, PII was slightly smaller than CEA from tumor tissue-extract (CEA-TTE), while PI was larger than CEA-TTE and approximately twice the size of PII. Micro-double diffusion and antibody binding studies showed that CEA-LS possessed identical antigenic determinants as CEA-TTE, which did not cross-react with normal colon antigen (NCA).