Stereotaxic intracavitary irradiation for cystic craniopharyngiomas

Stereotaxic intracavitary irradiation with instillation of phosphorus-32 (32P) colloidal chromic phosphate was performed in nine patients with cystic craniopharyngiomas. Serial neurological, ophthalmological, neuroendocrinological, and radiological examinations were performed before and after treatment. Dosimetry was determined based on a computerized tomography (CT) estimation of tumor volume, and was calculated to provide a tumoricidal dose (200 to 300 Gy) to the cyst wall. The follow-up period ranged from 14 to 45 months (mean 27 months). After treatment, all nine patients showed improvement of symptoms and radiological evidence of cyst regression. Because of an expanding solid component producing recurrent symptoms, one patient required a craniotomy 14 months after isotope instillation. Three of five patients with impaired visual acuity before surgery had significant improvement in acuity after treatment. Preoperative visual field defects in eight patients improved in four after 32P therapy. Of seven patients with preoperative endocrine abnormalities, one individual showed almost complete normalization and another had improvement in endocrine function. Patients who exhibited residual neuroendocrine function before isotope instillation developed no significant deterioration in endocrine status during the follow-up period. The findings suggest that stereotaxic intracavitary irradiation is a safe and effective treatment which should be considered as the initial surgery for cystic craniopharyngiomas.

Radioimmunolocation of a heterotransplanted human choriocarcinoma (BeWo) using monoclonal anti-SSEA-1: pharmacokinetics

Stage-Specific Embryonic Antigen-1 (SSEA-1), originally discovered on mouse teratocarcinomas, has since been found on some human non-seminomatous germ-cell tumors and adenocarcinomas, as well as on some adult mouse and human tissues. A monoclonal antibody to this antigen (anti-SSEA-1; IgM, kappa) was used for radioimmunolocation. Nude mice bearing the human choriocarcinoma BeWo, which is SSEA-1 positive, were injected using a mixture of [131I]anti-SSEA-1 and [125I]MOPC 104E, an unselected myeloma protein of the same heavy-chain isotype. Animals were sacrificed at 24 hour intervals; the radioactive deposition due to both antibodies was determined for both tumors and normal organs. Accumulation of anti-SSEA-1 in the tumor was consistantly rapid and specific, while little accumulation of the unselected myeloma protein occurred. At five days after injection, an average of 3% of the initial dose of specific antibody was retained per gram of tumor; the tumor/blood ratio was 11, tumor/muscle was 80. Gamma-camera imaging allowed ready location of the tumors. Tumors could also be imaged using F(ab')2 antibody fragments.

Bone and mineral status of patients beginning total parenteral nutrition

Total parenteral nutrition (TPN) is commonly used to provide nutrition in the seriously ill. Osteomalacia has been described with long-term TPN and the administered solutions and/or vitamin D metabolites have been blamed for the occurrence of osteomalacia. These studies however were performed on patients on long-term TPN programs. We in contrast measured the serum calcium (Ca), ionized calcium (Ca2+), phosphate (Pi), bone GLA protein (BGP), alkaline phosphatase (ALK-P), 25(OH)D, 1,25(OH)2D, the iPTH (carboxyl terminal) in 25 malnourished patients just beginning TPN therapy. The patients ranged from 25 to 80 yr of age and suffered from a variety of diseases. No patient had symptoms, recent fractures, or radiographic evidence of osteomalacia. The results of our study revealed significantly lower 25(OH)D (p less than 0.001), Pi (p less than 0.01), and Ca (p less than 0.01), but higher iPTH (p less than 0.002) values when compared to normals. BGP, 1,25(OH)2D and Ca2+ and ALK-P were not significantly different. We conclude that patients requiring TPN have low serum 25(OH)D values reflecting their nutritional status with a compensatory increase in PTH secretion to maintain their serum Ca2+ levels. The normal BGP levels may indicate depressed bone formation and skeletal resistance to PTH in the very ill patient. The cause of osteomalacia in these patients may therefore be multifactorial and not only related to the TPN infusions.

Tumor location and drug targeting using a monoclonal antibody (anti-SSEA-1) and antigen-binding fragments

Both murine and heterotransplanted human nonseminomatous germ-cell tumors have been successfully located by external scintigraphy using radioiodinated anti-SSEA-1, a monoclonal IgM, and its pepsin-derived antigen-binding fragment, F(ab')2 mu. Antibody localization in the tumor is mainly due to antigenic specificity, rather than to nonspecific trapping, and depends strongly on the amount of time after injection. The antibody has been used for drug targeting in vitro and in vivo.

Comparison of computerized tomographic and radionuclide methods in determining intracranial cystic tumor volumes

The dosimetry of radioactive phosphorus (32P) for intracavitary treatment of cystic brain tumors is dependent upon accurate determination of the cyst volume. The authors have used both high-resolution computerized tomography (CT) scanning and an isotope dilution technique with technetium-99m (99mTc) sulfur colloid to determine cyst volumes in an experimental model and in six patients with intracerebral cystic tumors. In six separate comparisons using an experimental phantom "cyst," no significant differences between CT and 99mTc values were detected. In six patients with cystic neoplasms varying from 3 to 6.7 ml in volume, the percent differences between values obtained by CT and isotope dilution ranged from -17.26% to +13.13%. In individual patients, these differences proved to be of little significance for planning dosimetry. In both experimental and clinical trials comparing isotope dilution and CT measurement techniques, the CT technique using the standard software of the scanner and 5-mm thick slices proved to be a highly accurate method of determining cyst volume. The authors now base dosimetric calculations for intracavitary radiation with 32P on CT technique alone.

Involvement of Golgi apparatus and a restructured nuclear envelope during biogenesis and transport of herpes simplex virus glycoproteins

Following infection of BHK-21 cells with Herpes simplex virus type 1 (HSV-1), progeny nucleocapsids in the nucleus acquire a glycoprotein-rich envelope by budding through host-cell nuclear membranes. To investigate the nature of the glycoprotein products assembled in the virion at the nuclear envelope, infected cells were pulse-labeled with [3H]-mannose, an oligosaccharidal core sugar, or [3H]-fucose, a terminal sugar. After various chase periods, the incorporation of these sugars was monitored by electron microscope radioautography. The results show that HSV glycoproteins accumulate very rapidly in nuclear membranes, where they exist only as core-glycosylated precursors, i.e., containing [3H]-mannose but not [3H]-fucose. [3H]-fucose grains are seen mainly over Golgi membranes and over virions located in the Golgi and in other cytoplasmic vesicular structures. Our data support a model where addition of terminal sugars (e.g., fucose) to HSV-1 glycoprotein precursors can occur at the surface of newly enveloped viral particles as the virions themselves egress from the cell via the Golgi apparatus.

Tumor location using F(ab')2 mu from a monoclonal IgM antibody: pharmacokinetics

A monoclonal IgM antibody (anti-SSEA-1) and its divalent antigen-binding peptic fragment [F(ab')2 mu] were compared as in vivo tumor localization reagents in mouse teratocarcinomas. F(ab')2 mu is cleared more rapidly than whole antibody from the whole body, blood, and all tested organs (t1/2 for whole antibody approximately 18 hr; t1/2 for F(ab')2 mu, 12 hr). A corresponding average improvement in tumor-to-tissue ratio is observed 48 hr after injection and earlier. However, the affinity of the F(ab')2 mu for antigen is much lower, and a smaller fraction of the antibody fragment is retained in the tumor than with whole antibody. The fragment was not retained by animals bearing nonantigenic tumors.

Stereotactic intracavitary irradiation of cystic neoplasms of the brain

Ten patients with intracranial cystic tumors underwent stereotactic intracavitary irradiation using 32P colloidal chromic phosphate. Accurate dosimetry (25,000-30,000 rad to the cast wall) was achieved by volume estimation using computed tomography. Between 1 and 15 months after surgery both craniopharyngioma and astrocytoma cysts regressed. Neurological, visual, and endocrinological deficits either stabilized or improved. Intracavitary irradiation should be the primary method of treating solitary cystic tumors of the brain.

Tumor immunity in rat lymph nodes following transplantation

Inguinal lymph nodes in the Buffalo rat were autotransplanted to the popliteal fossa by an intact vascular pedicle or by microvascular anastomosis. These revascularized nodes had normal histology and made spontaneous afferent and efferent lymphatic reconnection with surrounding lymphatic vessels, as documented by ink and silicone rubber injection studies. Lymphoscintigraphy with 99mTc antimony sulfide colloid correctly predicted the 44 of 120 node transplants that had made afferent reconnection. To demonstrate immunologic activity of lymph nodes following transplantation, a cellular adherance assay was employed to detect cell-mediated cytotoxicity of lymph node cells isolated from rats sensitized to an allogeneic gliosarcoma. Cytotoxicity was detected in nontransplanted regional nodes sensitized to tumor (p less than 0.01) and in nodes transplanted by vascular pedicle and then sensitized to tumor (p less than 0.001). This study demonstrates that lymph nodes can be transplanted with restoration of functional lymphatic anatomy, and that following transplantation, lymph nodes retain the ability to mount an immune response against tumor.

Intracellular transport of the transmembrane glycoprotein G of vesicular stomatitis virus through the Golgi apparatus as visualized by electron microscope radioautography

The intracellular migration of G protein in vesicular stomatitis virus-infected cells was visualized by light and electron microscope radioautography after a 2-min pulse with [3H]mannose followed by nonradioactive chase for various intervals. The radioactivity initially (at 5-10 min) appeared predominantly in the endoplasmic reticulum, and the [3H]mannose-labeled G protein produced was sensitive to endoglycosidase H. Silver grains were subsequently (at 30-40 min) observed over the Golgi apparatus, and the [3H]mannose-labeled G protein became resistant to endoglycosidase H digestion. Our data directly demonstrate the intracellular transport of a plasmalemma-destined transmembrane glycoprotein through the Golgi apparatus.

Protein adsorption in vitro onto biomaterial surfaces covered with ULTI carbon

A study is presented which describes the adsorption in vitro of albumin and fibrinogen onto a mini-shunt oxygenation unit. The unit is characterized by flow through 10 etched microchannel conduits with a microporous membrane and conduits are pretreated with a uniform layer of ULTI carbon and evaluated for the steady-state and time varying kinetics of protein adsorption. Corresponding results for oxygenator components not pretreated with ULTI carbon are also included.

Localization of I-131-labeled tumor-specific monoclonal antibody in the tumor-bearing BALB/c mouse

One of the most frequent indications for patient imaging is the need to establish the presence or absence of malignant disease. Considerable effort has been invested in attempting to develop tumor-specific radiopharmaceuticals. We report the localization of an iodine-131-labeled, hybridoma-derived monoclonal antibody in the MH-15 teratocarcinoma-bearing BALB/c mouse. Tumor-to-muscle and tumor-to-blood ratios of 150:1 and 15:1, respectively, were observed at 5 days after administration of 15 microCi of labeled antibody. The relationship between the optimal imaging time and localization kinetics is discussed.

Radiopharmacist profile--baseline 1974-1975

The results of a baseline October 1974 to March 1975 survey are analyzed to describe what constitutes radiopharmacists' education, training, and professional practice. Frequency distributions for the following descriptors are presented: age, location, highest degree earned, major radiopharmaceutical training, years of experience, time devoted to radiopharmacy, principal place of work, salary, and major appointment or responsibility. Preliminary examination of the possible association of some of these descriptors is made; a radiopharmacist profile is presented.

Influence of dimercaprol (2,3-dimercapto-1-propanol) on the pharmacokinetics of 111In-bleomycin in the P-1798 lymphoma-bearing BALB/c mouse

The pharmacokinetics of 111 indium-labeled bleomycin were altered in the P-1798 tumor-bearing BALB/c mouse when pretreated with the dithiol 2,3-dimercapto-1-propanol (Bal). 1 mg of BAL administered 1 h prior to 20 microCi of 111In-bleomycin resulted in 2:1 tumor loading and 3:1 liver loading of 111In-bleomycin over controls (p less than or equal to 0.05 at the 2- to 3-hour interval). Muscle uptake during this interval remained at unity.

Coagulation studies of patients taking low-dose heparin during and after major gynecologic surgery

In February, 1975, a prospective, randomized study of 75 patients undergoing major gynecologic surgery was undertaken. Patients were randomly assigned to three groups regardless of diagnosis and surgery contemplated. Coagulation studies were performed preoperatively and postoperatively in a control group, a receiving 2,000 U heparin/12 hr subcutaneously, and a third group receiving 5,000 U/12 hr via the same route. There was a statistically significant increase noted in fibrin degradation products in the group treated with 5,000 U heparin/12 hr as compared to the control group. Excessive bleeding intraoperatively or postoperatively was not encountered.

Tumor location detected with radioactively labeled monoclonal antibody and external scintigraphy

Murine teratocarcinomas were located in mice by external gamma-ray scintigraphy with an iodine-125-labeled monoclonal antibody specific to the tumors. The specificity of the method was increased by subtracting the radiation produced by an iodine-125-labeled indifferent monoclonal antibody of the same immunoglobulin class as the tumor-specific antibody.

Acute pancreatitis and hyperparathyroidism in pregnancy

A case of acute pancreatitis associated with hyperparathyroidism in the third trimester of pregnancy is summarized, and the clinical findings are discussed. Emphasis is placed on recognition of pancreatitis and its etiology in the third trimester of pregnancy. The surgical approach to the parathyroid pathology is analyzed and its advantages espoused.

Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication

Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: a) control--immobilization; b) control--immobilization plus periosteal stripping; c) simple fracture--osteotomy; d) delayed union--osteotomy plus periosteal stripping; and e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The nonunion group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning with quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment.