Malignant metastatic disease of the eye: management of an uncommon complication

Twenty-four patients with metastatic cancer of the choroid were seen in the Department of Therapeutic Radiology, Rush-Presbyterian--St. Luke's Medical Center, Chicago, between 1964 and 1975. One fourth of the patients had involvement in both eyes, for a total of 30 eyes involved with metastatic cancer. The most common site of the primary carcinoma was the breast. Most of the patients had inadequate vision, proptosis, pain, heaviness, and double vision. Retinal detachment was a common finding. All the patients received a palliative course of radiotherapy to the posterior chamber of the eye; between 2100--3000 rad in 7/10 fractions were given. Of the patients, 33% had complete recovery of symptoms, and 37% had only partial recovery; 30% showed no response to therapy. Survival period from the time of radiotherapy to death varied from one to 21 months, with a median of four months and a mean of 6.6 months. All patients responding to therapy showed marked improvement in their quality of life until death.

Results of re-irradiation for cerebral metastases

After an initial course of radiation, 56 patients with cerebral metastases had their brain retreated at least once for recurrent neurologic symptoms. The most common primary was from either the lung or breast. The frequent symptoms were headache, weakness, seizures, visual problems, and/or mental changes. Forty-two (75%) of these patients responded to the second course of treatment. The median duration of response was 10 weeks and median survival was 14 weeks.

Extranodal non-Hodgkin's lymphoma

From 1964 to 1977, 42 patients with Stages I and II non-Hodgkin's lymphoma involving the extranodal sites were seen and treated with curative intent by radiotherapy in the Department of Therapeutic Radiology at Rush-Presbyterian-St. Luke's Medical Center. The initial pathologic specimen was reclassified according to the criteria of Rappaport et al. Diffuse histology was the most common histologic type found in 80% of the patients. The five-year actuarial survival and disease-free survival rates were found to be almost identical at 74% for Stage I and 38% for Stage II patients. The most common sites of origin were in the head and neck area in 19 patients and gastrointestinal tract in 15 patients. The sites of involvement in the head and neck area were many and varied, with parotid and nasal cavity being the most frequent. Survival rates and disease-free survival rates for different histologic types, various sites, and their patterns of recurrence are presented.

Ovine placental lactogen in the cotyledonary and intercotyledonary placenta of the ewe

Antibodies raised against purified ovine placental lactogen were used to demonstrate the cellular localization of the hormone in tissues of the ewe placenta and chorionic membranes by immunofluorescence and immunoperoxidase techniques. Although binucleate cells have been shown to appear as early as Day 16 of pregnancy, ovine placental lactogen was not detected in the trophoblast until Day 22, and in substnatial numbers of cells until Day 80, of gestation. In the more mature placenta, lactogen-immunoreactive material was demonstrated in (a) binucleate cells of the fetal trophoblast, (b) uninucleate cells associated with the maternal epithelium syncytium and (c) binucleate cells of the chorionic membranes.

Pattern of recurrences in endometrial carcinoma and their management

During the period 1961-1971, 177 surgical candidates with clinical Stage I adenocarcinoma of the endometrium were treated. The pattern of recurrence according to the initial mode of treatment and the high risk factors predisposing to recurrence are presented. The incidence of vaginal vault recurrence was reduced from 7.4% with surgery to 1.2% by the use of adjunctive radiotherapy. Management of recurrence according to site is outlined. The local control rate for patients with local recurrence was 44% and the five-year survival rate after recurrence was 33%.

Continuous measurement of tissue pH in the human fetal scalp

A method for continuous measurement of scalp tissue pH is described. The tissue pH probe was found to be robust and values for tissue pH were close to those for scalp blood pH. Combining the pH and fetal heart fate (FHR) electrodes in the one mechanical assembly facilitated application to the fetal scalp in early labour but the combined assembly electrode was found to have some disadvantages and manufacture of a separate tissue PH electrode is recommended. Continuous monitoring of scalp tissue pH enables closer study of the physiological basis of changes in fetal acid base status and should prove useful to the obstetrician in management of high risk pregnancies during labour.

Purification and some properties of ovine placental lactogen

A method has been described for the purification of ovine placental lactogen (oPL) involving the use of freshly obtained sheep foetal cotyledons. Tissue was extracted with 0.1 M-ammonium bicarbonate and the supernatant fraction, adjusted to pH 7, was brought to 60% saturation with ammonium sulphate. The resulting precipitate was then subjected to a sequence of chromatographic steps using columns of Sephadex G-100 and carboxymethylecellulose. During each stage of the purification, the lactogenic activity was monitored with a pregnant rabbit mammary gland radioreceptor assay. The yield of oPL corresponded to 8 mg/kg wet foetal tissue and the oPL possessed lactogenic activity equivalent to 1 mg ovine prolactin/mg protein and GH-like activity equivalent to 0.8 mg human GH/mg protein. The biological activity of oPL was confirmed using a rabbit intraductal mammary gland assay in vivo. After polyacrylamide gel electrophoresis at pH 8.9, oPL was resolved into one major band (isoelectric point 8.2--8.4) and four minor components, which were thought to be deamidation products of oPL. Microimmunoelectrophoresis and immunodiffusion studies confirmed that the preparation of oPL was free from serum protein contaminants.

Studies of immunoglobulin M and malarial antibodies in Nigerians

Measurements of immunoglobulin M, in 111 healthy adult Nigerians have been presented. IgM values ranged between 10 and 518 mg per 100 ml with a mean of 213.2 mg per 100 ml. Using the indirect immunofluorescent antibody test, 53.7 per cent of the 111 symptomless subjects in the study had demonstrable malarial antibodies of titres greater than 10,000. The implications of the observations in a holoendemic malarial zone are briefly discussed.

Immunofluorescence localization of ovine placental lactogen

Immunoreaction to ovine placental lactogen was found in binucleate and uninucleate cells of the fetal trophoblast.

Early nodal and extra-nodal non-Hodgkin's lympnomas

There were 54 Stage I and 38 Stage II patients with non-Hodgkin's lymphomas treated with curative radiotherapy between 1964 and 1975. The initial biopsy material was reclassified according to the criteria of Rappaport el at.10 The frequency of nodular vs diffuse histological pattern was 26% vs 74%. The survival and recurrence free survival were significantly superior for the nodular pattern as compared with diffuse in both Stages I and II. The sites of first recurrence were evaluated. Fourteen out of 20 Stage I and 18 out of 26 Stage II patients recurred in one of the nodal areas only as their first site of recurrence. In 50%, this was in contiguous lymph node areas only. Extra-nodal non-Hodgkin's lymphomas survival and recurrence-free survival rates at five years were identical.

Uptake of 125-I-labelled human placental lactogen and human placental lactogen by the tissues of normal and lactating rats

The rate of clearance from the circulation and uptake into tissues of radioactive label was studied after i.v. injection of 125-I-labelled human placental lactogen (HPL) into rats at various stages of pregnancy. The half-life was obtained for the disappearance of the trichloroacetic acid-precipitable material from the plasma. The half-life, t1/2(S), calculated over the first 5 min after injection of the hormone was 5.4 equals or minus 1.1 (S.D.) min, while a half-life, t1/2(L), of 27.9 equals or minus 2.3 min was obtained from the decay period of 15-35 min. In the non-pregnant and pregnant rat the highest ratio of the radioactivity in an organ to that in the blood was 12-14:1 in the kidney. That the kidney is mainly involved in the uptake of exogenous HPL is further confirmed by the application of the histochemical immunoperoxidase technique. Human placental lactogen was localized in the cells of the proximal tubules of the cortex and to a lesser extent in the tubular lumen and the tubules of the medulla region. UPTAKE OF HPL in vivo occurs in the mammary gland tissue of the post-partum rat and reaches a maximum uptake between 15 and 30 min after injection of the hormone. Furthermore, specific uptake of HPL was observed on the alveolar cell membranes after the incubation of paraffin-embedded sections of formalin-fixed mammary gland and subsequent treatment by the peroxidase-labelled antibody method. These findings support the work of others who have demonstrated the presence of specific membrane receptors in the mammary gland for hormones with prolactin-like activity.

Metrifonate in urinary schistosomiasis. A field trial in northern Nigeria

A field trial of metrifonate in the form of Bilarcil tablets (Bayer) was carried out in 39 northern Nigerian schoolchildren heavily infected with Schistosoma haematobium. Three oral doses of 7.5 mg/kg were given at four-week intervals. The drug proved effective (mean reduction in egg counts eight weeks after completion of treatment 94.5%) and was excellently tolerated. Its use on a larger scale is suggested.

Arthropod-borne viral infections of man in Nigeria, 1964-1970

During the years 1964 to 1970, 171 arboviruses of 15 different types were isolated from humans in Nigeria. Isolation rates were highest in 1969, and lowest in 1965 and 1967. Monthly arbovirus activity was highest in the rainy season months of June, July and August and lowest in the dry months of January and February. Viruses were isolated from all age groups, with the majority from children one to four years old. The viruses isolated in largest numbers were chikungunya and yellow fever, which caused epidemics in 1969, and dengue types 1 and 2 and Tataguine, which are endemic in Ibadan. Bwamba virus was isolated in 1964 and 1969, and Bunyamwera group viruses were encountered for the first time in 1969. Other viruses recovered less frequently were Zika, Igbo-Ora (an agent related to o'nyong-nyong), two viruses related to the Uganda mosquito virus Ug MP 359, Dugbe, Thogoto, Lebombo and Shuni. Several of these are new agents and have not previously been isolated from man. Clinical details are presented where available.

Distribution of radioactivity in tissues after the intravenous injection of free and acrylic particle bound-porcine 125I-neurophysin-I into rats and rabbits

Porcine neurophysin-I iodinated with Na125I was injected intravenously into rats and rabbits, and the rate of disappearance of radioactivity from the peripheral system was measured. Radioactively-labeled neurophysin bound to polymethylmethacrylic particles was similarly infected into the animals. The half-time for the loss of radioactivity from samples of whole blood was 6.1--6.4 min as determined over the first 5 min after administration of the protein. There was no significant difference in the half-time calculated when the radioactivity present in the trichloroacetic acid-insoluble material present in the se-um was measured. 15 min after the injection of labeled protein there was a maximum and massive uptake of radioactivity in the kidney consistent with this tissue's being important in the degradation of neurophysin. Immunoperoxidase histochemical techniques were applied to formalin-fixed kidney slices and demonstrated the presence of neurophysin-like material localized in the cells of proximal tubules of the cortex and medulla. On binding neurophysin to acrylic particles there was approximately a 10-fold increase in the uptake of radioactivity in the lungs and a 33% reduction in activity in the kidneys, as measured at the 15-min time interval. Of the other tissues studied, excluding the thyroid gland and lungs, the uterus demonstrated the greatest uptake of radioactivity of fat tissue had the least accumulation of radioactive label.

Rheumatic heart disease in children in developing countries

The features of rheumatic heart disease in 31 Nigerian children aged 5-11 years are presented. The majority of these children sought medical attention when they were in advanced cardiac failure. In approximately 23% of the children a past history of acute rheumatic fever was obtained. It is suggested that in developing countries, skin ulcers may be as important a focus of beta-haemolytic streptococcal infection as the throat is in developed countries in the aetiology of acute rheumatic fever. Rheumatic heart disease in developing countries present two main problems, namely, diagnosis and management including prophylaxis. The differential diagnosis of rheumatic heart disease in some tropical countries and the factors which affect the management of the disease are discussed.